HIStalk Interviews Tyler Smith, CEO, Health Data Movers

Tyler Smith, MBA is CEO of Health Data Movers.

Tell me about yourself and the company.

I began my career on Capitol Hill during the recession, but most importantly, it was during the passage of the Affordable Care Act. The HITECH act from the stimulus propelled the digital health transformation forward. Being on the Hill during this time, it was an exciting time to get into healthcare. I left after one year and went to work in the consulting space. I got certified in Epic, spent a little bit of time at Cumberland before they were acquired by Tegria, and then started building what became Health Data Movers.

I focused on application work, while one of my two co-founders focused on data migration and the third brought in our first software development. From the beginning, Health Data Movers has had a technologist focus. Today we offer six core services that we break into two categories. Signature services is software development, integration, and data migration, while foundation services is applications, PMO, and advisory. We are a technologist-first firm. While a lot of great firms that came before us have moved into a desire to be a Big Four advisory-type firm, we enjoy getting our hands dirty and doing the work.

How have health system financials changed the demand for consulting services and affected their technology acquisition process?

I realized as a leader during the pandemic that that change is the only constant. When we saw how the scaling back of fee-for-service could affect budgets, it taught me that have to be flexible and shape-shift with the needs of customers. During that time, we saw pauses in projects, but then when the government acted and figured out ways keep health systems solvent, we saw all these paused projects back in high demand. We were scrambling to put together teams to get these projects kicked off.

At the same time, we also saw a lot of interest in digital health that was created by the pandemic. You saw a lot more digital health firms. We saw more interest from biotech firms that needed to integrate data in and out of the system of record, which is the EHR.  

In terms of our investment, it is staying focused on what we do best, but understanding that ultimately our customers — health systems, biotech firms, digital health firms –have their strategic imperatives and we need to be able to support them from a technology perspective. The directions that they choose to go determines a lot of the direction that HDM ultimately goes.

Are health systems and their technologies prepared to integrate real-world data, life sciences research, and FDA marketing surveillance?

Companies are formed based on ideas and also pre-existing alignment. Especially consulting firms, because folks who have worked together in the past and liked it will work together in the future. One of our co-founders came from a company called OTTR, which was a transplant EHR that was acquired by CareDx, which is a massive life sciences biotech company in the transplant space. We always say that if you can move transplant data, you can move any type of data. We have roots with life sciences because of our transplant background. We’ve been working with CareDx for over three years to ensure that the data from their tests makes its way to the EHR and vice versa. 

As this massive influx of information comes about as these biotech firms are maturing, it has been awesome to see the data from tests that are done by the specialty labs that we work make its way into the EHR. Is the real-world, evidence-rich data entering into the EHR? One hundred percent yes. A lot of the work that we have been doing recently with Epic Aura is getting specialty lab data in and out of the system of record. 

I think we are going to see some really cool improvements in patient care because of the integration of this data. It’s exciting to see how the EMR is moving from being a system for charting and ensuring that there’s billable outcomes to a place where we can have true insights from the interface with the patient and physician that will improve care.

What will the healthcare impact be of new tools such as cloud services, ChatGPT, and low-code systems that make it easier to develop applications?

That’s really exciting. We have an internal team of developers and the energy and excitement they have behind ChatGPT is evident in the Slack channels that I’m lucky enough to lurk in. There’s a specialty that is required in healthcare development, which we see as a competitive advantage because we have a line team of developers. But we also have developers who are well versed in the intricacies of healthcare – HL7 v2, FHIR, and HIPAA-compliant cloud. If there’s now a way for developer to speed up execution, then we can get a lot more done with smaller teams and we can scale the projects that we’re able to take on at a greater pace than just simply scaling headcount.

I get asked a lot about this metric – how big is your headcount? That is important in time and materials type work, but if we are able to empower our engineers to be more efficient with their work, then we can talk more about how many projects were we able to execute. The projects are the work that is pushing healthcare forward. If we can leverage the geniuses that we have in house to take on projects with biotech and digital health firms and essentially scale their skillset, we will be about to move our integration and software development portfolio of work faster, which then ultimately we believe will make healthcare more interoperable, user friendly, and efficient.

How are health systems and their new digital-type C-level officers approaching consumer-facing projects as they begin to compete with big technology and consumer companies?

We have been working on some digital front door related projects with strategy firms and more payvider-type organizations. Then you look at the One Medical-Amazon combination and see the rise of concierge medicine and advanced primary care. We talk about the retail health side a lot internally. Patient experience is going to be a critical next piece where technology is applied. Our core is with the healthcare organizations. We are seeing a lot more interest in the patient experience. I’m excited about this next wave of technology that supports that and I’m confident that Health Data Movers will be involved in that next transition.

How does your experience as a Stanford MBA student influence how you run the company?

It’s crazy how much Stanford influence there is at Health Data Movers. We have a board member who was my professor at Stanford, another board member who was the associate CIO at Stanford Health Care, and then both of my co-founders were either full-time or consultants at Stanford Health Care. But to the broader question around the Stanford influence, it’s just insane how much innovation has come out of a really tiny piece of US geography. When you are around it, you understand the energy behind creating something new and using technology to change the world. It’s not just something people say, it’s something they believe.

I could give you a laundry list of all the positives that I got from my Stanford experience or from being around Stanford, but I’ll focus on the idea that we are all capable of making the world change no matter what discipline we decide to do that in. Going to business school at the time when we were developing the company made me realize that yes, we are a services firm, but services firms can create massive change. Having lofty goals to actually improve healthcare through the implementation of EHRs, optimization of EHRs, and software around EHRs is something that can be achieved if we work extremely hard and have total dedication to the mission and vision.

Are you encouraged that healthcare has the ability and the incentives to implement technology that will truly make a difference?

I’m encouraged because there’s been massive adoption. Everyone had to get on the grid. I think Paul Kenyon from OTTR sums it up really well. It’s like the land grant colleges, or the land grants in general, in the Midwest. The government had to create a reason for folks to move to a certain part of the country, and then they were able to step away. We had to HITECH to get everybody onto the grid, and then we had the pandemic. The pandemic was awful,  but in a lot of ways, it also brought in more interest into healthcare. 

As much as people like to write off the EHR vendors as being resistant to change, it’s impossible to separate that there’s so much interest now in healthcare and digital health. Even though some tourists have left, a lot of folks have stuck around. We will see innovation that comes from a lot of brains and energy being in this space.

Just look at your MyChart interface over the years. It is always improving. While the rate of change is slower in healthcare, it will continue to evolve. I am fully confident that it is continuing to become better. I am excited about everything that will be possible now that we are on the grid and folks are interested in making healthcare better through technology,

My dad was seen at two health systems with what turned out to be Parkinson’s. It’s crazy that they operated on his rotator cuff even though they could have looked in his record to see that it wasn’t necessary. Here I was five years ago, working at a healthcare technology firm, and I’m literally sitting there helplessly with him knowing that the physician isn’t getting the full record. That’s when it really clicked to me. We all have these personal stories and that’s just one of millions. A lot of what we are working towards is to become non-existent as a company, because at that point, we will have created truly interoperable patient care that will fix so many avoidable errors. This is also the platform where innovation from life sciences and biotech companies will be made available to the providers who are delivering the care.