Hello, everyone. This is Jacob Emerson with the Becker's Health Care podcast. Thanks so much for tuning in today where we're excited to talk about navigating market dynamics, innovation, and the future of member care. Joining me today for our discussion is Rob Duffy, who is the chief technology officer at HealthEdge. Rob, thanks so much for taking the time to be with me on the podcast today. Hey. Thank you for the invite. I really appreciate it. Thank you for listening to the conversation.
Absolutely. Likewise. And before we dive into everything we wanna talk with you about, can you tell us a little bit more about yourself and your career background? Yeah. My name's as you've introduced already, my name's Rob Duffy.
I come from a background, at, large tech companies like Amazon and, Uber and Expedia and Salesforce, you know, really developing large scale platforms and and creating these incredible pieces of technology that can be leveraged to unlock huge amounts of innovation and and velocity with the with their consumers. And, I joined HealthEdge nine months ago, ten months ago. And when I joined HealthEdge, it was, undergoing a little bit of a platform transformation.
And, I brought with me, the the sort of non health care, technical expertise that you would find at these large companies, and the the job has been really transforming and bringing the the products that we have together and creating, creating this platform of converge technology. Absolutely. So it sounds like a unique career journey that brought you to HealthEdge, Rob.
Let let's get started today by talking about, as you know, interoperability and integration becoming increasingly crucial in health care operations today. Yeah. In this environment, what do you think is the role of platform based technology, and what are some of the key advantages for health plans in particular?
So if you think about a a, you know, a health plan, they have thousands, if not tens of thousands of different integrations and and pieces of data flying around and different data models and ways that they get, data from one place to another. And what we're looking at now is some, regulation that, is saying, well, we should we should try and talk in a standard format. We should try and talk in a in a
single way. And when you have lots of in integrations and you have lots of pieces of technology, what you essentially have is is a large piece of technical debt that you have to deal with when you have to try and get all of those things to speak the same standard.
And I think many people in the industry have seen in the last, you know, five years, maybe even ten years, that an approach of sort of stringing lots of different point solutions together means that anytime you wanna change something, you have to change it in many different places. And now that we're seeing this broad, generalized drive towards a standard data format and a standard data model, it means that this string of pearls approach is becoming increasingly difficult and
complex complex to manage. So I I think when I think about platforms, I think about taking it away from a large number of point solutions and point tools that you have to constantly change to keep up with changing regulations and and changing standards and changing formats and really moving that across to, you know, a platform level approach.
That means that companies like HealthEdge can do that work once we can do it in in the right places, and then you don't have to worry about trying to keep up with all of these changes in standards and formats and regulations. As a health plan, you can really lean more on these platform based technologies or or technology platforms to do that work once. Let me follow-up with you there, Rob. How would you say that regulations are driving the push for a more connected health care ecosystem?
I mean, we obviously have, you know, this buyer standard is coming on, coming on. We have the, you know, the the auth requirements, and and those are really driving this consolidation around a a data model and a way of communicating across different health health care applications. And it it's become not optional. You know? It's become a thing that the the regulation is driving. People have to keep up with that regulation
and have to be compliant with it. And what that means is that, you you know, the CIOs and CTOs that I speak to are really looking at a a large project ahead of them to get all of their different systems and tools compliant. And and that means that the the work to do that is can sometimes feel overwhelming.
And what we're seeing is people are looking for more converged solutions that talk to each other, that work together, and can handle the the changing regulatory environment, because I don't think anyone thinks, you know, this is gonna be a short journey, towards interoperability, but, they're looking for these converged technology platforms that can handle that for them and and allow them to keep up with the pace of change without having to make constant investments in in the technology.
And then they can focus their energy more on helping their business users and helping their their their internal customers and their external customers with with more innovative products. Absolutely. And I think the the natural question to that, Rob, is what are some of the biggest challenges you're seeing payer organizations face when transitioning from that siloed technology to a fully integrated platform? And and, ultimately, how can they navigate that effectively?
Yeah. I think when you look at any large, ecosystem of tools that has been built up over time, anytime you you pick a tool and you implement something and you model a business process, you make some trade offs, you make some assumptions, and you have to, you know, change the way you work because of something that that tool does or doesn't do, in a way that you'd like it to
do. And when you deal with that and you have a we have a large ecosystem of maybe twenty, twenty five, 30, 40 tools, that's, you know, a huge number of places where you have made assumptions and made changes to your business model, and you've made changes to your, internal process and maybe even the staff mix. So the the organization becomes a reflection of the technology that that you have in place.
And that is a, hard thing to change because if you want to swap out tools, you can't just swap the tool out, replace it with a new one because that new tool will have, you know, assumptions and things that it does well and things does doesn't do. So you really have to think about this as a a transformation of the business and a transformation of the business models and business processes as well as just, a a technology transformation.
And and that is, I would say, one of the biggest challenges, which is making like, figuring out what to keep and and what to throw out and what what is, you know, broken and and needs fixing and should be fixed and can be fixed. And, you know, doing that and doing the technology change is is a big challenge. Understood. So this has to be an enterprise
wide approach. And as you see health plans continue to adopt a platform based approach, are there change management principles that they should be keeping in mind to ensure a smooth transition and to maximize their their impact? Any any resources you'd recommend, Rob? You know, change management for me and the the dealing with the people aspects of of technology transformation, I think is 70, if not 80% of the job.
I think I've I've been doing platform transformations for two and a half decades, and I think I've come to the conclusion that focusing on the people and focusing on the people's transformation and and helping people have agency and decisions and ensuring that you're not forcing technology on them that they're bought in. They understand the why, and you really dial on dial into the change management, the human elements of change management. I I think that is one of the key things to adopt.
And I don't think any platform really is ever successful when it focuses just on the technology, and and sort of underestimates the amount of, people change management and and human change management that's gonna need to to go on. And, you know, in terms of frameworks or resources, I think as you go through this sort of change management process, there's there's a large number of, like a cloud migration is a good example.
And there's a large number of resources that are are really applicable to any kind of any kind of large scale change management initiative that is put out by companies like AWS and Azure. And those those kind of cloud hyperscalers that it's their bread and butter
to do large scale technology transformation. So they often have playbooks and frameworks that will enable you to do the cloud migration, but I've often found that they're actually just as applicable, if you're changing, what what ticketing system people are using or, you know, if you're changing Office or whatever. It's it's the same principles to, get people aligned, make sure people are bought in, make sure people understand why things are happening, make sure they have agency
in the decision making. And and those those frameworks, they're published on these websites. They're they're very easy to consume. And, often, the large scale of cloud migrations means that they have to be very good and very robust. So you can sort of copy that as a template and move it move it across. And I'll say, like, never underestimate the amount of times you have
to communicate with people. I think when you are a a leader leading change and leading transformation, it is your day to day job to to constantly be thinking about the transformation and constantly be thinking about the the change management and constantly be thinking about, like, how the communications go out and the why, and you probably are, you know, giving the same presentation
to 10 different people every week. But I always think about it in terms of what is that the person that I am talking to or I'm communicating with or presenting to, what is their worldview? And oftentimes, their worldview is thirty or twenty nine days out of the month, they are doing their day job and they have fire drills and customers to deal with and they need to, work on that. And then one day a month for, you know, thirty minutes, they hear a status update on your big change management
approach. So while you feel like you're over communicating and you should communicate until you feel like you're over communicating, the people that you're communicating to are oftentimes hearing what you're saying, you know, in in a in a sea of other information that's that's very noisy. So the biggest thing I would say is treat everything, when you're thinking about change management, and you're thinking about adopting a platform approach.
Treat everything as a large scale transformation because it is, and communicate, communicate, communicate, communicate almost until you're sick of communicating your message. You know? It's a lot of great advice for for our listeners. So so thank you, Rob. If you were to look ahead into the future, how do you see innovation then continuing to unfold at health plans? What's exciting you right now, and how can our audience listen listening in? How can leaders prepare for this future state?
I am incredibly excited about the concept of having data in a consistent data model and stored in in, you know, systems that you can understand the entire enterprise data portfolio. I think once you have that, there are tremendous amounts of things you can do from a business intelligence and and data intelligence perspective. And machine learning and AI are are, you know, two obviously,
top of everyone's mind examples of that. But you can also just start thinking about efficiency and and monitoring customer journeys through the system. And for us in this industry where we have this, you know, mess of integrations with thousands of different tools that we and then systems and APIs and batch jobs and messaging.
For us to be able to consolidate that data into a single platform where we can start making really, really intelligent decisions about about the businesses that we're running is
really exciting. And I think it's not just us making intelligent decisions about the business that we're running, but it's pointing these ML and these AI tools at that data and then training those models and and, you know, asking these agents to to make, decisions about about that data too and and asking them for input and seeing patterns across massive amounts of data. It's just it's incredibly exciting concept given the amount of data that
that payers and health plans have. And then I think if I I sort of play that out in my mind, you know, you can take that data and you can take that intelligence and, you know, combine that with cloud, this the infinite scalability of cloud, and you can start doing digital twins of that data and digital twins of the plans and and using that to to do what if modeling and and planning out different scenarios and saying if I change this this contract here or, you know, I change this plan line item
here or this this, in our case, the health rules, you know, what impact would that have had over the last twelve months? Where do we think that's gonna go in the future? And you you can have tens of hundreds of or tens and hundreds of these digital twins of your business in the cloud that you're you're able to, to model different scenarios and different tweaks and different pieces of business efficiency and and different, things that are gonna have a real impact
to your customer and their customer experience. And that's something that is just a vision that's almost unheard of right now where your data is everywhere. You have to, you know, cut a ticket to a a a business, analyst team or a business intelligence team. You know, they'll put the dashboard together or they'll put the report together. You know, you're looking at two, three week cycle times, sometimes at best. And then you finally get the data, and
then you analyze it. You wrote something wrong. You have to go back. You know, there's this really long lead time on business intelligence right now. And I think as we start to consolidate data models and we start to consolidate our data infrastructure, we're gonna be able to, you know, get answers in in almost real time to very, very complex business scenario modeling, and that's gonna be incredibly powerful for for customers. Well, clearly, a lot of really exciting things
on the horizon. So, Rob, I wanna thank you for taking the time to sit down with us and for sharing your insights with our listeners. We really appreciate it. Thank you. It's been a pleasure. I'd also like to thank our podcast sponsor, HealthEdge. You can tune in to more podcasts from Becker's HealthCare by visiting our podcast page at beckershospitalreview.com.