HIStalk Interviews Erik Littlejohn, CEO, CloudWave

Erik Littlejohn is president and CEO of CloudWave of Marlborough, MA.

Tell me about yourself and the company.

I joined CloudWave in 2013 out of a desire to be part of a team that served a terrific market, had great potential, and allowed me to continue my career in healthcare IT. One of the things that attracted me to CloudWave is that most of the people there had devoted their careers in and around various aspects of healthcare. 

I was fortunate to join it at a pivotal point in its transformation. I initially led our technology services organization that focused on the resale of on-premise technology solutions, storage servers, et cetera. I got to interact with a ton of customers and serve a ton of customers. Then over the next eight years, we continued our transformation from being a legacy reseller of those solutions to a multi-cloud services, edge, private public cloud that solved numerous challenges faced by hospitals. We are building and continuing to build something special, and we cherish the relationships that we have had with customers going back many, many years.

What does the mix of on-premises infrastructure and cloud computing look like for the typical hospital, and how is that changing?

When I joined the company in 2013, 70% of our proposals were on-prem integration types of deals and 30% were cloud-based, whether that was full hosting or disaster recovery. As we sit here today eight or so years later, it has flipped and completely inverted. I would say that 65 to 70% of our proposals and solutions are cloud-based and the remainder are on-prem, or what we now call edge solutions.

Cerner was becoming more active in hosting its own systems back then as I recall, while Epic and Meditech weren’t doing much of that. What is different now?

Cerner continues with its model and there are no on-prem Cerner solutions. All of that is hosted, and they have been successful at doing that. Epic and Meditech have been similar, in that organizations like CloudWave have provided private cloud hosting operations or solutions. Meditech has certified a number of providers like ourselves to be able to do those, and we go through certifications or testing on an annual or biannual basis. Like everyone else, Meditech has wanted to associate themselves with a public cloud offering, and about a year and a half ago, they launched a partnership with Google. Cerner has launched a partnership with AWS and Epic has certified its platform to run on Azure or AWS as well. Everyone made their claim to a partnership. We are doing the same things and trying to evolve our solutions to be not only private cloud, but to take advantage of public clouds and their evolution.

What are the practical results of hospitals moving some of their data center operations to cloud providers?

Some of it becomes a preference based on financial models, whether it helps them to have an operational expense versus a capital expense, for example. A lot of organizations prefer CapEx, so the cloud may not fit that model very well. However, clouds, public or private, offer a lot of other benefits. Think about hospitals trying to maintain talent and the number of skills that you need for various software vendors, and keeping abreast of those certifications. Complex security challenges are daunting for organizations today, and it has been tough to keep up, particularly if you are a community hospital, with all the ransomware threats coming out of any number of countries these days. Then maintaining all of that talent over time. Healthcare certainly has been slow to adopt cloud solutions over the years, but they are becoming comfortable that that cloud can help them solve some of those challenges.

How has cloud deployment helped hospitals prevent ransomware attacks and recover from them?

First and foremost, it’s ensuring that you have the basics done of clean backups, that you have recover points that you can go to when – not if – someone is impacted by a ransomware or security event. Ensuring that there are multiple copies and multiple restore points and options you can go to so that you know you have a safe recovery point, and trusting in an air gap type of solution. We have multiple sets of data or backups available for customers, and that gets pretty expensive and complex for any organization to manage by themselves. That’s another reason that working with cloud providers makes a lot of sense for hospitals.

Why do attempts to restore from backups fail so often?

We test ours on an annual basis for our customers. That in and of itself is a huge difference. You think your backups are fine and you see that all the saves were occurring, but until you actually restore that and try to run the system, you just don’t know what you have or you don’t have. We feel like doing that annual test is critically important, and it’s a big reason that a lot of customers want to do that and choose a recovery service or a backup service with us. Otherwise, they probably wouldn’t do it on their own.

It becomes a good tool for the organization to rally around. They have this recovery test over the span of a week, they get clinicians involved, and they get people to pressure test it and figure out where the kinks might reside or find issues that need to be fixed. Figuring out what didn’t go well is as important as anything else in a test so that we can make sure they have a clean, restorable backup that they can rely upon.

What do hospitals typically need to do to prepare for moving to the cloud?

The funny thing about being a cloud service provider is that your service is only as good as the end user’s perception. Looking at connectivity and service providers in the local area is important, ensuring that you have multiple paths and redundancy in case a provider has an outage, that you have the capability to fail over and have adequate bandwidth when there’s some sort of outage with Verizon or AT&T, et cetera. First and foremost, you need to make sure that’s solid and that you have redundancy. You also need to make you have adequate Active Directory permissions and user access.

It isn’t just flipping a switch and saying, “I’m going to go into the cloud tomorrow.” We spend one to two weeks assessing the readiness of our customers and remediating any issues that may exist. That holds true with any cloud service provider. You need to be thoughtful about assessing anything in the environment that may impact an end user’s ability to use the system successfully, and make sure it’s not going to be slow, that it doesn’t time out, or that you don’t encounter authentication type of issues, because that creates a downstream headache for everyone.

How do you see the company’s business and strategy changing with its recent acquisition by a private equity firm?

We are excited about the Abry Partners investment. They have a great reputation and a ton of experience in our industry. We felt like they would help position us for future growth and enhance our capabilities, grow our team, and provide meaningful strategic input or guidance. Just as importantly, we just liked their team. There is a sense of familiarity, a lack of ego, and a near-perfect alignment about the potential of our business. We couldn’t ask for a better partner, and we know that they are willing and able to invest in capabilities that we need going forward, whether that’s acquisitions or building our organic capabilities.

What were the most useful lessons you learned from being a West Point graduate and an Army officer?

One of the things that I always talk about with the team is explaining why. That may seem counterintuitive if you’re thinking about the military and you think of people just being told to take the hill, salute smartly, and go do it. But in the military, we always concerned ourselves with the commander’s intent. I had to understand what was going on to the left and the right of me, why I needed to take that hill, and how that fed it into a larger objective. It is important as leaders to always provide that context and the “why” to our teams and the people we work with. Because if you just ask a question without context, they may not give you the right answer, or they may not meet the ultimate objective that you are trying to get to.

What will the company’s emphasis be over the next few years?

We will expand our use and footprint of public cloud and make that more accessible and user friendly to our end customers. That’s an important part of our growth in the next three to five years. We will continue to diversify our capabilities and provide more services than we do today beyond hosting and recovery and backup, providing other things like service desk and security services and expanding those. We will also diversify our customer mix. We have been pretty focused on the Meditech space up to this point, or hospitals running Meditech, but we think that nearly all of our solutions translate nicely to hospitals running other EHRs. We are having some success in Cerner hospitals and Epic hospitals, and we are anxious to do that and to serve a wider mix of customers.

Do you have any final thoughts?

CloudWave will continue to be a customer-first business. Our relationships with our customers have always been at the center of what we do, and we are going to continue investing and expanding in those relationships in various ways. We can be a great partner with customers that are looking to transform their operations through the adoption of cloud. We see the whole industry being at an inflection point and more aggressively adopting cloud, and we are in a great position to do that based on our experience. We look forward to helping customers in that journey.