Latest / Becker’s Healthcare Digital Health + Health IT / Steven Michaels, Vice President and Chief Technology Officer at Baylor Scott & White Health

Transcript

Steven Michaels, Vice President and Chief Technology Officer at Baylor Scott & White Health · Becker’s Healthcare Digital Health + Health IT

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the beckershospitalreview.com events page.
1:27
This is Laura Dierda
1:29
with the Becker's
1:31
Healthcare podcast. I'm thrilled today to be joined
1:33
by Stephen Michaels,
1:37
vice president and chief technology officer at Baylor
1:40
Scott and White Health. Steven, it's a pleasure
1:42
to have you on the podcast today.
1:45
Yeah. It's a pleasure to be here.
1:48
Well, thank you so much for joining us,
1:49
and, you know, I'm really looking forward to
1:51
learning more about how you're thinking about technology
1:53
at Baylor Scott and White and certainly some
1:55
of the cool things that you have on
1:57
tap. But before we dive into that discussion,
1:59
can you tell me a little bit more
2:00
about yourself and your background?
2:03
Yeah. Absolutely. I think the the best way
2:05
to kinda describe who I am is,
2:08
I I try to live a life of
2:10
purpose.
2:11
And so for me, that's that's kinda 3
2:13
chief categories of of my faith and my
2:16
family and my and my profession.
2:18
And, you know, you know, balancing those,
2:22
the best that I possibly can. You know,
2:24
I I've started my career,
2:26
off in the United States Air Force. So
2:28
one of the best decisions I ever made
2:31
because it really helped build a foundation that
2:34
I've used
2:35
throughout my career,
2:37
you know, from just
2:38
a a whole mindset of continuous
2:41
improvement
2:42
and, you know, being creative
2:44
and and and, you know,
2:46
structured and disciplined about,
2:48
you know, what I do.
2:50
And, you know, whenever
2:52
I came into health care
2:53
a little more than 15 years ago, I
2:55
just fell in love with kind of this
2:58
this serving,
3:00
the health
3:01
community, our patients, and patient families,
3:04
and just love what I do. As much
3:06
as I loved when I was serving in
3:08
the air force, it was almost like I
3:09
found a new way to serve
3:11
when I when I joined health care, specifically
3:13
whenever I got into hospital systems. It's just
3:15
such a,
3:16
an amazing environment to be in. And,
3:19
you know, if you don't love what you
3:21
do and you're in health care hospital systems,
3:24
you're in the wrong place
3:26
because, you know,
3:27
every day when I go into work, you
3:29
know, it's it's not unusual to hear a
3:31
helicopter coming overhead and and people aren't riding
3:34
those helicopters for joy rides. And it but
3:36
it really helps,
3:38
set your mindset as as having a real
3:40
purpose about what you're doing.
3:42
And I tell people that right now, as
3:45
we're talking
3:46
at Baylor Scott and White somewhere, and really
3:48
any hospital system, someone is having
3:51
either their best day or their worst day.
3:54
They're either, you know, welcoming a new baby,
3:56
which is amazing,
3:57
or they are saying goodbye to a loved
4:00
one. And so we have to keep that
4:02
in mind every day, and and it really
4:04
helps keep us grounded.
4:06
But it's just something that I love. I
4:07
love giving back.
4:09
Oh, that's amazing to hear. And, certainly, you
4:11
know, what a great perspective to have in
4:13
knowing, you know, just the wide variety of
4:16
experiences people are having in the hospital setting,
4:19
you know, in being able to meet them
4:21
where they are and understand how each particular
4:24
journey can be just a great opportunity to
4:26
support the community and support patients and and
4:28
really serve and give back as you said.
4:31
Now from your vantage point as chief technology
4:34
officer, what are some of the opportunities you
4:36
have your eye on right now as well
4:37
as the headwinds that you have to keep
4:39
front of mind?
4:41
Yeah. Absolutely. I think everybody in my position
4:44
and and probably generally across health care,
4:48
I think of this as there there's really
4:50
3 for me. 1, 1st and foremost, that
4:53
that is really in across
4:55
health care is the cybersecurity
4:58
threats.
4:59
And, you know, they're they're they're increasingly more
5:01
and more sophisticated,
5:02
you know, the ransomware
5:04
data breaches,
5:05
our supply chains, you know, being attacked and
5:08
and that sort of stuff. A a lot
5:10
of our 3rd party,
5:12
partners are are being hit, and so it's
5:14
it's it takes a lot of our,
5:18
effort and,
5:19
focus to to, you know, try to protect
5:23
those patients like we were just talking about.
5:26
Additionally, you know, across health care, there are
5:28
talent shortages, and,
5:30
you know, it's one of those things that,
5:33
you know, is is really probably going to
5:36
hit a lot of industries, especially for roles
5:39
that, you know, require people to, you know,
5:41
physically come into an environment, every day, like
5:44
our nurses and physicians and things like that.
5:47
And so, you know, a lot of,
5:49
jobs now, even my own, has a tremendous
5:52
amount of flexibility. You know, I could work
5:54
from home. I can come into the office.
5:55
I could do, different things. I I prefer
5:58
to come into the office, but, but that's
6:00
just because I like I like being around
6:02
people.
6:03
But, but, you know, challenges shortages are a
6:05
real deal,
6:06
specifically in nursing, and and it's even more
6:09
so in rural areas. That that's a real
6:11
health care challenge for us as a country,
6:14
something that we'll have to focus on and
6:17
and and deal with. And then, you know,
6:19
there's the technical debt. And from from a
6:21
hospital consolidation that has happened over, you know,
6:24
the last 20 years or so, what's happened
6:27
is, you know, some various technologies have been
6:29
incorporated into a larger enterprise. And those, I
6:29
think,
6:31
constant
6:32
focus on
6:45
really rationalizing the technology,
6:47
modernizing it, and, you know, trying to absorb
6:50
and overcome some of that technology,
6:53
debt.
6:54
I think that makes a lot of sense.
6:56
You know, it is really a fascinating array
6:58
of challenges and things you're keeping your eye
7:01
on from, as you mentioned, cybersecurity, not only
7:03
for,
7:04
Baylor Scott and White, but for your vendors
7:07
and third party partners as well. It's just
7:09
so crucial to,
7:10
make sure everything that's
7:12
happening, you know, and that you can control,
7:16
is controlled, but then to just being prepared
7:18
for the moment when it happens as well.
7:21
And then, you know, looking across the workforce
7:23
and talent shortages,
7:25
I can imagine on the clinical side and
7:27
to some degree, you know, the technology,
7:31
skills and and advancements in the technology just
7:34
makes it hard to keep up sometimes. And
7:36
so, you know, really a lot to think
7:38
about.
7:39
But in particular, when you're looking at the
7:41
technical debt that you just mentioned,
7:43
how do you try to stay on top
7:44
of that at Baylor Scott and White? Is
7:46
there processes that you put in place or
7:49
or or a certain philosophy that you think
7:50
about things so that you're putting yourself in
7:52
the,
7:53
best position to optimize that in the future?
7:57
Yeah. Really, it it it has a lot
7:58
to do with, you know, 1st and foremost
8:00
aligning to the organization and what the organization's
8:03
goals are.
8:04
For someone in my position,
8:06
you have to think of any dollar I
8:09
spend as
8:11
taking a dollar away from patient care potentially.
8:13
Right? So
8:15
so we have to be careful
8:17
about, you know,
8:19
misinvestments,
8:20
you know, putting money towards a technology that
8:23
maybe doesn't prove out to be what it
8:25
what it, needs to be, but also, you
8:28
know, being, conscious of, you know, that debt
8:32
that is aging technology that is going to
8:34
become increasingly, increasingly problematic either from a
8:40
reliability perspective,
8:41
and certainly from a cyber perspective because you'll
8:44
end up with technology that is no longer
8:46
supported, and that becomes
8:48
a a real problem.
8:50
And so then you're you're,
8:52
you know, investing time and and tech and
8:54
efforts around trying to protect it. So so
8:57
that's that's a real challenge. You know, for
8:59
for us, you know, we we kinda have,
9:01
you know, a structure
9:03
around,
9:04
strategic partners. So, for example, we are an
9:07
Epic shop.
9:08
And when we rationalize technology, what we're trying
9:11
to do is take advantage of some of
9:13
those strategic partnerships because there's a lot of
9:15
things that Epic can do that maybe we
9:17
are,
9:19
providing today with some other third party.
9:22
And so it's it's it's really simplifying the
9:25
environment and kinda bringing the technology into some
9:28
of those larger investments. And so that kinda
9:30
becomes a win win because it makes the
9:31
environment a lot more streamlined and simple for
9:35
the organization, but it also,
9:38
allows us to deliver the technology in a
9:41
more,
9:42
economical,
9:43
way for the organization.
9:45
That makes a lot of sense, you know,
9:46
and I truly appreciate you digging one bit
9:48
deeper there. Now how are you thinking about
9:51
growth and adding value to Baylor Scott and
9:53
White over the next few years or so?
9:55
How do you do that from the technology
9:56
side, especially as you mentioned, you know, thinking
9:58
critically about health care dollars, the investments that
10:01
you're making, and and truly understanding the support
10:04
for clinical care and caregivers?
10:07
Sure. You know, it it's it's really critical,
10:09
like I mentioned earlier, that I align to
10:12
the organizational,
10:14
objectives,
10:15
which,
10:16
for for any technologist,
10:19
means that you need to understand them. Unfortunately,
10:23
sometimes in, IT,
10:25
we
10:27
kinda become really good at technology,
10:29
and we become increasingly
10:31
disconnected
10:32
from the actual businesses that we support.
10:35
And that's that's a problem because, you know,
10:37
you kinda think about, like, you know, if
10:39
if I want to expand, you know, kind
10:41
of my horizons,
10:43
you know, beyond of just maybe being good
10:45
at technology and understanding that, in my world,
10:48
I need to become a health care professional
10:49
first.
10:51
So, you know, if you think about, like,
10:52
if if, you know, you and I worked
10:54
for a car dealership, for example, and I
10:56
could be amazing at technology. But if I
10:58
don't know the first thing about how to
11:00
buy and sell cars,
11:02
then my technical abilities are gonna bring limited
11:05
value.
11:06
And so if you think about the, you
11:08
know, the challenges that the health care systems
11:10
are facing today,
11:12
you know, the ability to provide quality care
11:14
and operate efficiently. You know, we've kinda talked
11:17
about staffing shortages,
11:19
but there's also financial pressures, you know, of,
11:22
you know, you know, kinda declining reimbursement rates,
11:26
from, you know, the payers,
11:28
you know, our increased operational costs, like what's
11:30
happening to everybody with, you know, the cost
11:33
of goods, going up the way that it
11:35
is. And that financial strain is is really,
11:39
you know, putting a lot of pressure,
11:41
in in health care. But and and, ultimately,
11:43
I guess, the last one I would say
11:44
is, you know, patient care and safety. Right?
11:47
So so that's the paramount at at everything
11:50
we do. That's that's the, the zero fail
11:53
mission. Like, we we can't have patient safety,
11:56
put at risk or whatever. And so, you
11:59
know, so so for me to kinda get
12:01
to your question about adding value, I have
12:03
to truly understand,
12:05
those impacts to the organization. And so whenever
12:08
I'm making a decision about, like, okay. I
12:10
wanna do a new contact center, for example,
12:13
because maybe my existing contact center is end
12:16
of life or whatever, I have to think
12:18
about, like, well, we have challenges with staffing,
12:21
and I need to make sure that, you
12:23
know, from a cost perspective, I'm bringing the
12:25
right model, the right model that makes sense,
12:28
like, whether I'm gonna capitalize expense or I'm
12:30
going to go with some sort of subscription
12:32
model or whatever. And then, ultimately, at the
12:35
end of the day, like, what is the
12:36
impact to patients? And am I improving that
12:38
impact,
12:40
to to patients? And,
12:41
you know, otherwise, I could just go and
12:44
pick a solution and kinda be oblivious to
12:46
what's happening to my, organization or the the
12:49
health care
12:50
population as a whole
12:52
and and just really not be that effective,
12:54
frankly. And and I think that's something that
12:56
as, you know, technologists are kinda going through
12:59
their career, you really need to think about
13:01
that. You need to there there is a
13:02
point at which, you know, you'll reach a
13:05
level that it is more and more critical
13:08
that you understand your business and, you know,
13:11
not always just look through the lens of,
13:13
you know, technology.
13:16
That's such a fascinating point. And especially, I
13:18
can imagine for, as you said, people who
13:21
are are raised with that technology background to
13:23
really just think first and foremost on,
13:26
the logic of of technical,
13:29
capabilities. And from that perspective, thinking more globally
13:32
and understanding the business impact is not always
13:35
an easy transition to make, but certainly a
13:37
crucial one, especially in health care as the
13:39
business
13:40
margins are are getting tighter and others are,
13:43
you know, really needing to
13:45
find support, with technology for the broader health
13:48
system. So it's fascinating to hear.
13:51
From your perspective, in in along those lines,
13:54
what are is one risk or investment that's
13:56
still worth making this year, especially
13:58
given, you know, those challenges
14:00
in the idea that, you know,
14:03
budgets and spending isn't unlimited?
14:06
Yeah. So,
14:08
you know, there is one risk,
14:11
or investment
14:12
that in from my perspective
14:15
is always worth it, and and that is
14:19
the investment that we make in our people.
14:21
You know, the,
14:23
the solutions that we deliver and all of
14:26
the opportunities and problems
14:28
that we face,
14:30
all the stuff we talked about today, right,
14:32
every single one of those
14:35
are solved by people.
14:37
So, so in my world, when I say
14:39
people, I I'm not just specifically talking about,
14:42
you know, Baylor Scott and White employees. You
14:43
know, people that get a paycheck from the
14:46
hospital system. That expands into all of our
14:49
various partners, you know, whether it is, you
14:52
know, you know, managed services that we have
14:55
or technology professional services
14:59
and and and beyond, frankly. And so,
15:02
you know, if I'm going to take a
15:04
risk and, you know, give something a chance,
15:07
it's I'm gonna lean towards, you know, people.
15:09
And, you know, technologies are are changing so
15:12
fast. I I heard a statistic that
15:15
now, like, if you were a specialist
15:17
in technology so for example, I'll update myself.
15:20
One of the very first platforms that I
15:22
supported in an enterprise was Lotus Notes.
15:25
And so I got really good at Lotus
15:28
Notes. I, like, understood how the databases work.
15:31
I understood how the whole platform work.
15:33
And who knows? Like, maybe I could still
15:35
be doing a job out there as a
15:37
Lotus Notes administrator somewhere.
15:39
But, but it changed. And so I had
15:42
to evolve into Microsoft Exchange, and then I
15:44
had you know, and I basically kinda went
15:45
on to do the other things in my
15:47
career.
15:47
But, what I've heard is that that window
15:50
is now, like, 18 months. You know? Whereas,
15:53
you know, maybe when I started my career,
15:54
I probably could have been a Lotus Notes
15:56
administrator for maybe a decade. Right? You know,
15:59
I would have probably been totally fine and
16:00
not had any pressures. And so you think
16:03
about that window shrinking more and more,
16:06
and these technologies are ever evolving. They're bleeding
16:09
into each other. You know? So if you're
16:12
gonna have, like, a Genesys,
16:14
contact center and you have ServiceNow and you
16:17
have a platform like Epic or whatever, there's
16:20
a lot of things that those three platforms
16:22
do that bleed over into each other.
16:25
And so
16:27
how do I how do I solve that
16:28
as as a, as a CTO
16:31
is it doesn't make sense that I would
16:33
constantly just go out there and try to
16:35
find, oh, let me go get a a
16:36
Genesis talent. Right? Well, let me go get,
16:38
like, whatever top or whatever is going on.
16:40
It's really better for me to invest in
16:42
my people
16:43
and trust that they're gonna have the ability
16:46
to kinda learn and evolve as we evolve
16:49
as an organization.
16:50
And, you know, it it doesn't always pay
16:52
out like any other investment. You know, some
16:54
some folks, you know, just really enjoy what
16:56
they're doing, and they may decide to go
16:57
elsewhere. They may not want to learn a
16:59
new technology.
17:00
But what I found is is that more
17:02
times than not, people are excited about that,
17:04
and it's a well,
17:06
a well, worth investment.
17:09
That's really cool to hear. And definitely, you
17:11
know, I I appreciate you
17:13
digging a little bit deeper and and thinking
17:15
about, the the people side because I think
17:17
so much, you know, we hear that as
17:19
a mission or a strategy is being able
17:21
to,
17:22
invest in, you know, the workforce and the
17:25
talent and upskilling and all those kinds of
17:27
things. But what that really looks like or
17:29
the impact that it could make,
17:31
you know, sometimes is a little bit more
17:33
nebulous. So it's cool to think about it
17:36
and hear you talk from the technology perspective,
17:38
the different ways you can,
17:40
really make a difference along those lines and
17:43
and,
17:44
moving forward. So, that's cool to hear. Now
17:46
before we wrap up our conversation, I was
17:48
wondering if you could talk about,
17:50
some of the best opportunities for growth and
17:52
development in the future. Where do you see
17:54
some of the ways that, growth is gonna
17:56
be happening for you as well as Baylor
17:57
Scott and White?
18:00
Absolutely. So I I would say, you know,
18:02
health care as a whole,
18:04
any
18:05
any any well, any business, frankly, but but
18:07
I'll just speak specifically to health care. It,
18:10
any business that evolves will grow,
18:13
and we are,
18:15
going through a significant
18:17
evolution,
18:18
in health care,
18:20
much like a lot of industries that are
18:21
being disrupted and and so forth. But, you
18:24
know, we kind of went through a period
18:26
of consolidation, and some of that is still
18:28
happening where hospital systems are going through acquisitions
18:30
and things like that, and they're kinda kinda
18:32
growing that way. But
18:34
but, really, it's it's now shifting, and we're
18:37
shifting more towards things like the experience and
18:40
kind of empowering people,
18:43
to,
18:45
you know, control their own health care outcomes.
18:48
And that's a big thing for us at
18:49
Baylor Scott and White is to focus on
18:51
the patient, the patient experience, but but, more
18:54
importantly, kind of empowering the patient,
18:57
to be a part of,
18:59
their their own outcomes and stuff like that,
19:01
in partnership with us. Yeah.
19:03
You know? The the point of care is
19:05
changing at a rapid pace. You know? It's
19:08
it's, no longer kind of exclusively to brick
19:11
and mortar facilities. You know? My my grandparents,
19:13
when they went to the doctor, they went
19:15
to the doctor's office, which was a building,
19:17
and that's what they did. They would have
19:19
never even imagined,
19:20
a virtual care. Like, they might have talked
19:22
to a doctor over the phone or something
19:24
like that, but but virtual visits, as they
19:26
are, are kind of no longer an experiment.
19:29
You know? You just, you know, pre COVID,
19:31
they were kind of this experiment that people
19:33
were trying to, you know, figure out whether
19:34
they work or not. They're they're here to
19:36
stay. And so that is an opportunity
19:39
of of of growth for sure.
19:42
I think we're gonna see more and more
19:43
care to be given at the home.
19:45
And from a technology perspective, we really need
19:48
to think about how we're going to support
19:50
that model, you know, you know, patients in
19:52
the home, hospital at home initiatives, and things
19:55
like that, and making sure that,
19:58
we're able to meet the standards of care,
19:59
which puts a lot more pressure on the
20:02
technology, frankly. Right? Because,
20:04
if a patient is in the hospital,
20:07
the, caregivers
20:08
have downtime procedures and stuff like that, and
20:11
so, you know, technologies
20:13
have issues, they're able to kinda make up
20:15
the difference. If we have a technology issue
20:18
with a patient at home,
20:20
then we've now completely isolated that patient, and
20:24
and that is that is, kind of an
20:26
unacceptable,
20:27
outcome for us, and so we really have
20:29
to to think about that. I also think
20:31
that you're gonna see a lot of growth
20:33
in medical devices
20:34
merging with consumer devices.
20:37
You know, it's kinda funny. I think the
20:39
Apple Watch is only the tip of the
20:41
iceberg, but it's kind of amazing what is
20:44
happening with, you know, wearables
20:46
and, how that is really benefiting,
20:49
the benefiting society, frankly, but but, benefiting, you
20:53
know, outcomes with a a lot of solid
20:55
data. You know, if you think about your
20:58
interaction with family members that have wearables,
21:01
you like, common phrases today are, like, oh,
21:04
I, you know, I I I got my
21:06
steps in, or, you know, gosh. You know,
21:08
my you know, I I guess my heart
21:10
rate's up up or whatever. So you kinda
21:11
hear these things that are that are happening
21:13
and are normal in society, so I think
21:15
that that's gonna continue to be,
21:18
to to be a growth opportunity. But I
21:20
think what it ultimately comes down to is
21:23
in health care, we need to think about
21:25
how other industries have been disrupted.
21:28
So think about
21:30
the music industry and how they were disrupted
21:33
by digital downloads.
21:34
They used to make a lot of money,
21:36
you know, making in, CDs and albums and
21:39
things like that, and their whole world got
21:42
shifted to digital. Think about
21:44
the the taxi driver
21:47
pre Uber
21:48
versus now. And and and then, of course,
21:51
the biggest one, is Amazon and what it
21:54
has done,
21:55
to retail. It really has changed how we
21:58
as a world consume
22:01
products.
22:01
And,
22:02
you know, so
22:04
think about those examples and what do they
22:06
all have in common. Well, what they did
22:08
was is they met their consumer where they
22:10
were,
22:11
every one of them. And so they kinda
22:13
removed,
22:15
the either, hey. I have to go to
22:17
the music store at the mall, or I
22:19
have to go to the mall to
22:22
buy something,
22:23
you know,
22:24
tennis shoes that I can now order on
22:26
on Amazon,
22:28
or, like, I gotta, you know, wait or
22:30
go find a taxi versus that taxi coming
22:34
directly to me where I am.
22:36
So each one of these disruptors are meeting
22:38
consumers where they were, and we have to
22:40
think about the fact that patients don't live
22:42
in our brick and mortar clinics. They don't.
22:45
And so I think the disruption is gonna
22:47
happen with us having to move care to
22:49
where the patients are.
22:51
Fascinating. And and, you know, really just interesting
22:54
to think about all those different industries that
22:56
have been disrupted over the years, and then
22:58
to see it happening right now in health
22:59
care,
23:00
is just really a lesson in, adapting and
23:03
adjusting. And then, like you said, figuring out
23:06
what patients want and need and and being
23:07
able to deliver it. This is a really
23:10
exciting time, to be in health care.
23:12
Absolutely. Well, thank you so much for joining
23:14
us today. It's been, a pleasure speaking with
23:16
you. I've really appreciated
23:18
hearing your perspective, and I look forward to
23:20
connecting with you again soon.
23:22
Absolutely. We'll see you in Chicago soon.