Episode 64: Digital Transformation & Lumary ABA with Joseph Mercorella

So it's, it's, um, yeah, look, it's precious being in Adelaide, it's, it's not a huge city. It's about a couple million people. But, um, but we're blessed with, you know, lots of, really good, environment and culture and food and everything. we're, we're very lucky here. Yeah.

and I think, from my experience in years of, you know, 20 years of being in software, development and implementation, the trickiest part obviously is the integration and the adoption into business for, for web technology. so for me it's, it's the goal that we all work towards, but sometimes we are disconnected or not fully appreciative of what it means to be a proprietor or business owner or director and leader of an enterprise.

And how that technology, which is trying to help is properly integrated and utilized, you know, within a healthcare provider practice specifically. And, um, and so my goal for healthcare and the digitalization of it, um, and, and the Lumary mission and vision is better wellbeing through technology. So technology is a great enabler, but if, if it's not incorporated effectively, then it actually becomes an inhibitor. and what it sorts out to do isn't achieved.

So the digital transformation process is about integrating something that truly works and understanding the magnitude of what you are tackling when you try to introduce technology into a business outfit. Um, yeah, so that's, that's what it means to me and what it means to us, what we refer to ourselves internally as luminaries. So, um, yeah.

Sure, it can be shiny, but what's most important is how it unlocks the opportunity to do something either more efficiently or in a better way for your team or in a better way for the patient. Right. Um, but I mean that enablement is, um, it feels core to digital transformation, but why is this idea of digital transformation so critical to ABA providers specifically?

And what we've seen for many years in healthcare, is that it's not well, uh, incorporated and integrated, and therefore the experience is very low when it comes to interacting with information and data in a digital way. So, for ABA providers, it's, there's another level on top of that. You know, the working in a, in an environment which is very much controlled around service, around price. So it becomes commoditized.

which means the margin to operate becomes leaner and thinner, but the technology element doesn't become less complicated, right? So that's a critical component. You have less money to do just as much as what you need to do, which means someone must supplement you, at, economies of scale, the solution that you need in order to truly run an effective and economical outfit.

When we speak of digital transformation, we, we don't just talk about the business operationalizing and just being able to, to, you know, do what you need to do day to day. That's only one element of the incorporation of technology into a business. The other two are optimizing and differentiating.

And if you're an ABA healthcare provider, the goal is to get the differentiation through technology as fast as you can, because you are operating in a highly commoditized market and your need to inform the market that you are serving of who you as an organization are or is, um, what's unique about you, why you're different to someone else, what's your ethos and your mission and your values and principles.

All of that has to be represented in every interaction that you have, whether that be your staff or whether the customers that you're serving. and the technology is the conduit that enables that. So if it's not flexible and not structured in such a way to enable that, you will never realize what you are truly trying to set out, you know, as, as a mission. And that's basically Lumary's mission is not to help healthcare provider markets that have got infinite amounts of money in cash.

Um, that's all lovely from a financial aspect of things, but Lumary's a social impact business, an enterprise. And so, uh, our goal is to provide more technology to underserved markets. And ABA, the reason why we targeted ABA in the US is it squarely sit into that, um, into that criteria.

It's been a market that's been served for a long time, um, in the same way, but every, every organization you interact with, it's very obvious that a digital business structure is not understood and is not incorporated, and so it's in real need to be served effectively.

And, and that's not a one year journey, that's a several year journey, and it has to be phased and, um, it has to be rolled out in such a way which is commercially viable, um, and, and enables the business to consume and adopt it effectively. So where I've seen it work, primarily, well, there's a few healthcare providers that we have in Australia, um, that we started.

So obviously with my accent so far, I started, we started in Australia helping healthcare providers in predominantly in the disability and, uh, aged care, elderly care, um, supported services, and we've seen organizations grow with very minimal or nominal amounts of operational expenditure in their technology department, from 70 staff to 900 staff in, in two and a half years.

Now that can only happen when your business is optimized and the technology beneath it is enabling that level of scale at that speed. and this is an organization that's not coming with, so to give some more context, it's not an organization that's got infinite amounts of funding to call in, uh, you know, build up from a private equity or venture capital type growth that didn't exist.

This is your, your standard, typical, you know, business, owner, got a mission and a charge had 70 staff was inhibited with the technology and the framework that they had adopted. Something like Lumary. Spend a lot of time with us, work, work closely with us as partnership as you can be, other than obviously normally not having an investment in, in that company.

And, um, strategically, we, we aligned and helped each other throughout that whole journey so that they could enable and realize that outcome. Yeah.

And I'll never forget cuz we had, my team had given you some feedback and then we showed up and you had this like beautiful lucid chart diagram. Sorry, the diagram was beautiful. It was a spaghetti on the wall of, i, I, I don't know, 40 different kinds of systems, which in fairness, right, we'd have been growing up over five years and every technology, every system, there's a job to be done. But it was just, I looked at it and just like cringed.

Don't, don't judge us on this, what I really appreciated, um, was that you all served, I don't know if this is the right term, but like as a fractional chief technology officer, like you took the time to understand what those jobs to be done were and how we brought this tech stack together, and then how we could simplify it over time.

So I got to experience it directly and I mean, candidly that two days that you spent with us was more than you know, I'd spent with our, our, our prior practice management system, um, whom we've been with for years. But how do you recommend Joseph to get specific here? How do you recommend that ABA practices think planfully and strategically about building out their tech stack?

And I'm a multi-business owner myself for many years, you know, for the last 15 years. So I know what you feel and I know how you think, and I know what you're looking to achieve. And also know that you don't know how to get there. Um, and you tell me that when you present me with a text stack and architecture with, you know, 40 or 30 or 40 different applications, and you are not alone, it's the same everywhere.

The only difference is how many and how much you're still doing manually, and also some, some organizations have had, taken on, um, the, um, the challenge in trying to solve it themselves. and what they've developed and what they've got to a lot of the time is they've built everything themselves and then they've realized the continual investments to maintain that is not sustainable.

But you know, these things when you've done my job for many years as to not just what the continued expenditure is today, but what it is in three years, five years from now. And that's what we're helping organizations try to achieve and do is, you know, take on that journey. But we do that to your question and we're acting like a, um, consultative or pseudo-CIO or you know, CTO, but I would say we also delve into the coo.

We tap into what are your strategic initiatives, so we're asking you and getting a sense and understanding of what you're trying to achieve. What would success look like for you in three or five years time? Um, because all of those aspects inform how the technology should be represented and what we're trying to unearth, because Lumary might not be the right fit for everybody. So we're trying to unearth is are we actually the right fit? Do you understand what's required? Does it align?

what are the ways that you wanna run the business? Do you, do you wanna establish a, a fairly prominent IT department? Or do you wanna run very lean and just have operational staff who leverage services from someone like Lumary to, to bring in and invoke at certain points of time? We wanna understand how you wanna run the business and how you wanna achieve your strategic initiatives. And if you don't know that, we'll elicit it out of you. Right?

And then we will help you translate it into a pathway and a model. So, you know, typically you would do this and you would pay, you know, tier one or tier two or so type consulting agencies to come and do this level of, well, we're doing it as part of the implementation of, of our technology because, one without the other means you won't succeed.

Uh, and let's be honest, the Salesforce consultants are extremely expensive, but that's a story for another day. But you're, uh, tell me more about like, why this is so important and that, you know, this is something that ABA providers aren't gonna see, right? That, like this underlying data infrastructure and security and everything else. But why is it so important to be built on a platform like Salesforce?

Um, what's not obvious to a healthcare provider is what's required to stand up, um, a technology solution like a Lumary on a platform like a Salesforce and how that differs between a Salesforce and Microsoft and Oracle and so forth. Of course, you appreciate how can you know this, right? But not things all equal, right? Naturally, they do things differently and it results and translates to different pros and cons for the technology vendor.

One aspect that Salesforce does very well, um, is the leading by, still by a mile is when it upgrades its platform, it doesn't break the applications that are built on it. And I know this firsthand is there's not some speculatory thing. I've been doing this for, on Salesforce for 13 years and at not, not one point has it ever done that. and see, the thing that Salesforce do is they give, uh, a very good test period before it happens.

And if anything is of issue or concern, it's all addressed prior to the major release coming out. Now, I know on other platforms that's not the case. Now you would say, well, what's that got to do with me? I'm the healthcare provider. You're the vendor. You're meant to sort that all out. Costs more, harder, more problematic, limitations. When you try and do and build functional stuff, when you are customizing your own little, your solution, your expectation is that nothing's going to break it.

And those down times that people have, they're not always explained as to why they happen. These come from these things. Architectural, constructs and frameworks that you know have not been established effectively, which lead to problems. You see them as this downtime issue and you think that it's solvable, but if I tell you it's maybe not solvable, that's when you would probably start to realize the magnitude of the problem. So that's one part.

The other part is probably what's not appreciated, and it's, I'm starting to get better and better recognition of it every day. But I think my job is to translate how important it is, is that security layer. Like it's very, very wrong to compare Lumary with a software vendor that isn't built on a platform like Salesforce from a security level, because more security control is embedded within that software vendor.

Now, I don't know exactly the figure that Salesforce spend on security, but I can assure you it's more than all the vendors in the ABA land will generate revenue each year. Now, that should scare you.

And you have to ask yourself the question is like I asked the question for myself, for my own sanity and confidence and comfort when I run this and operate this business, the liability that I am obviously subjected to, am I comfortable with that security layer with Salesforce over on top of me managing it? And the answer is absolutely yes. And that's hard to measure when you're trying to compare price points.

But for that reason alone, you should really strongly consider, and it's only two, you know, it's like insurance until something happens. You, you know, like the insurance policy doesn't come in, but you should factor in that the insurance aspect and price of our software with, with that security requirement. Now that's only two. I could give you a dozen or so more, but those two are probably compelling enough to, to know why you should factor in something like a Salesforce

My next point like this can't be taken for granted cuz this doesn't happen in many other softwares in our space, but just the fact that they're APIs. Right. Can you explain a little bit about the ability to simply move data between systems, um, and how Salesforce just does that easily and natively versus others don't and why that's important.

The difference, the major difference is, is that when you install these apps into your, um, operating system, the expectation is that they speak to each other and they're connected, and you get a seamless experience. So it's far more complicated than what happens on your phone as a means of platform significantly by a lot.

And, um, and the beautiful part about Salesforce is that because these applications have been built on the, on the Salesforce platform, To your point, Jonathan, the API calls so the interfaces that are created to, to support the flow of data are all retained in the one environment. So you're not making outside calls and when you are making outside calls.

The beauty about Salesforce is, is that, um, unlike other platforms and technologies, is everything is available to be messaged out under very strict security protocols, and we won't go into all of those. And, and, you know, I've probably lost touch on some of them now as, as I've moved away from all of the technology. But you can't do that without applying the right protocols. Um, and it's, you know, it's absolutely critical.

I mean, like for Lumary for example, we embed a middleware tool, like also like jitterbit into your solution.

So if you are, an organization that's wanting to expand more into, incorporating different technologies, then we can enable that straight away with the provision, the actual, API calls being made to that software very quick, very, it's easy to scale up now these are things you probably don't even know because it's not in your vision of three years pathway of your technical or digital transformation and your technology stack on what it's going to look like.

But Lumary knows you probably want to do it one day, so when you need to do it, it's okay. We got you back. It's covered. It's already there. It's incorporated in your, your price already. And when you want to extend it, just let us know. Um, we're, we're future proofing your business because we know once you start to operationalize and get the real goodness out of the, the baseline technology, you'll go, okay, what else can I do?

I've got a business process here that's, you know what we wanna do differently now we wanna optimize. We're ready to do it, let's do it. Or we wanna bring in a third party system. Let's bring in that, you know, that learning management software system that we really like, and, um, we want to, we, we think it's really powerful, important to our staff as a means of training and onboarding and service provisioning. Let's, let's bring that in. Yeah.

I mean, there are apps within the SalesForce and Lumary ecosystem once you are ready, 1, 2, 3 years down the road, you plug that in and you're not having to move and copy and paste data between systems. You just turn that on and it's natively built in. Is that right?

ABA is actually a lot simpler for just a full, transparency and as a means of your, you're dedicated mostly to one type of practice and service, right? Uh, we're talking about organizations that are funded from 40 different funding bodies for 40 different types of practices of service within healthcare.

So it's, it, it can get very complicated, but to your point, we already know what you're going to need for the next, you know, three to five years to get to that differentiation phase, which is, you'll need some middleware, you'll need this strong communication platform. You'll need good document generation and signing.

You'll need strong, continued support around the optimization of the practice and the regulatory compliance and the subject matter expertise being embedded within the solution from day one. Things that you are not expected to do because that's just commoditized and standard across the market. So why would you need to pay for something that you're not gonna get a return on investment for? So that is already embedded when you engage within the software.

And I think sometimes we probably don't do the best job in articulating that because it's so much to, you know, digest and take in all that one hit. And we've gotta just, just go little bits and bits of the way through to take you on that journey. So, yeah, completely digital, no Excel spreadsheets, no manual processes. There's no word type documents. There's no duplication of data, no lack of integrity on the quality of the data.

None of that, you know, exists when you, when you use a mechanism like that.

by the way, like, I think something really important for ABA practice owners is, you know, have your teams be the ones. Making the decisions, right, because they're gonna live with that day-to-day. And it's easy as a CEO or an owner to say, oh, that's cool. Yep. And I'm gonna go, let's start using that and then make your teams do it. But, um, really important to get your teams buy-in and that, that's, that's the way we work the process. But yeah.

Tell me a little bit more about Hi Rasmus and how you chose Hi Rasmus and, um, you know, the ability, I know you're starting to integrate, um, data even from there.

But the quality and the expertise that are, um, upheld within the Hi Rasmus application areas in which, um, Lumary is not. um, you know, knowledgeable in and have the experience in, and, and the commercial model that Hi Rasmus have deployed is something that we, we've assessed and we believe it's very viable and supportive, and enables continued development and, and improvement. all the things that you're looking for us. So we're expecting of us all the same things we expect from our partners.

They have to have those, aspects present within their, you know, the business and product strategy. Otherwise, um, someone will affect the experience to our customers. And so the same, um, standards need to be upheld. Yeah.

Um, and what Lumary did, and I think this is really important, this concept of build versus buy, right? And as a technology company, you have, um, you've got the ability, like you said, you could build anything on Salesforce, but, finding that solution in the marketplace and then integrating that. I think that's, that's, I think it's a powerful testament to it.

But Joseph, it's funny, when we first chatted, uh, I remember you very clearly describing how lifelong relationships are really important. And I was like, in the back of my head, I gotta be honest, I was like, yeah, yeah. every freaking technology company I've ever talked to in my 25 year career has told me that. Um, and, and this is lip service, right? Oh my God. I saw this commitment firsthand.

I mean, starting with that couple days, um, offsite we did in Denver, and yes, it was freezing freaking cold and we got a whole bunch of snow that night if I remember correctly. But what, like, it, it, this was, um, this is a genuine and legitimate like foundational commitment for you. Why is that so important and what, what are customers gonna experience differently with Lumary given your commitment?

It went from, um, a volume type based care where he, healthcare provider, just go do these 20 visits a month and we'll give you x money every quarter in front, in, in advance to here is an assessed and specific plan, quite like aba. Here's a assessed specific plan. We wanna see value, outcome measured. We want, here's the price, here's the control, and you get paid in arrears.

Now, in a, in Australia, most of the disability healthcare providers are non-for-profit, and they were running anywhere between 30 and 50% off x. Now, if you are a business person like I am and a technologist like I am, we know when you look into that market, you're like, this is dangerous. So from the get go, it was all, yes, we need to make money, we need to be commercially viable, and we want to, so that we can, you know, we can obviously benefit ourselves and benefit the community.

But like this was about some, so social impact, right? And making sure that we were gonna play a critical role in the revision, to, the healthcare system in Australia, which affects, you know, 25 million people and it has about 50 billion Australian dollars that, that supports it. So it's a, it's a major economic aspect to the Australian community. And it's the same thing when we look at aba. You know, it's a, it's a growing market there.

There's, there's better tools and assessments for identification early on for the kiddos. There's better ways in which it can be incorporated. There's a lot more, um, support now from an insurance perspective. And, um, and we are like, we wanna be part of that journey, support it, but we can see the same problems that is in the Australian marketers to do there.

So knowing that and knowing the journey that you are going on to digitalize and run an effective, um, enterprise and business, it can't be a two or three year relationship. And that's why our perspective and our mindset is, is set on 15 plus year relationships. So we look at the, yeah, we have to, because we know what journey you're on. It's gonna take you a few years to just get into the shape of what's needed.

Now, I might scare a few people when I say at the beginning, but we know what, cuz you know your limiters as to how much change you can make in the business. You spoke about it before, like it's great for an owner to say, Hey guys, we're doing all this tomorrow. But the people are the most critical piece. And if they're not along on the journey and don't believe in it and haven't had their voice to hear about the change, then it will never succeed. And that just takes time.

Change always takes time. And so, um, we see our relationships as 15 plus years. We therefore see our return on investment as 15 plus years, which means we can invest a lot more upfront knowing that we will get the return later on. Cause we also have to be commercially, savvy and sensible on what we're doing. Otherwise, all the customers and all the people that we support, you know, um, we've got over 60,000, 70,000 staff workers that we support through our system.

They're gonna get let down if we're not, if we're not here tomorrow. So we make 15 plus year commitments. and we would sign a contract for 15 years, if someone wanted to, of course, because to us it makes no difference. But, um, everything that we do, the way that we strategize, the way that we engage is all geared on that.

And so we spend a significant amount up front to ensure that we've got a pathway that you are going to get the value and realize, um, what you are trying to achieve within your business. And we gotta stick with each other till, till the job is done.

It's funny, Joseph, you know, we're going through implementation right now, the most common phrase I hear uttered at Ascend because we're still in our old practice management system, is this kind of like, si ah, this is all gonna be better once we're in Lumary They've got to see it firsthand. So this is the real deal, dude. Yeah, it's a real deal. But I wanna, let me pivot a little cuz you helped to turn me on to something that was super cool, super cool.

Um, called, uh, the Buurtzorg Model of Care, um, in community nursing and in that in the Netherlands. Can you just explain the Buurtzorg model a little more and what it could mean for the future of the healthcare field? Yeah.

absolute vulnerability amongst each other. Transparency and no bureaucracy. Right? And we do that because we believe that is how people are happiest and most satisfied, both in their personal, um, goals and what they're trying to achieve within the community. The Buurtzorg model is a, um, a well or mature. realization of that in an enterprise, specifically within healthcare.

That's why it resonates so much with us and they've reset and redefined, um, the values and principles within people to get better outcomes for everybody within the ecosystem. And I think that's really important. If we look at how much pain, dissatisfaction and churn there is from the employment workforce, which ABA is not alone by the way, but just, let's just say aba, right? It is very high, which means we are doing something wrong.

It can't be right if you keep getting the same results that are wrong, you need to do something different. Problem is, unfortunately, most healthcare providers are not fit enough from a technology sense to make these operational changes that will enable different outcomes for their people and happy people automatically from the Buurtzorg model translates into better care for people. Always does and always will. Doesn't matter. That's that's not a subjective thing.

That's proven time and time over again data wise. So our goal and our hope is that We enable our customers to get to a stage of right, great digital, business integration that enables them to whatever the, whatever it looks like for you. I'm not trying to dictate as or determine what it looks like, but that there's a pathway where the people that work for the organization and those that are the families and those that are receiving the care.

everyone's happier, everyone's getting better outcomes, and we've got, you know, maximum utilization and benefit from, the technology that we're deploying, you know, and that collaboration that we're seeking. And, I think the Buurtzorg model has 3% of their operational expenditure is allocated to, uh, management.

So it's not just clinical responsibilities, but you have responsibilities for recruiting and a whole variety of other things. And as you point out, like you're in the single digits of like overhead in this model, which is a hard model. I'm, I'm no expert, and, and we don't use it. I, I would absolutely aspire to it. So it, it takes a lot of intention and planning to get right, but it feels like that's part of the future of healthcare, doesn't it?

Or, Hey, so and so, I think we are not quite doing something right. We might need to change, like the agency and the level of empowerment that is bestowed on that individual is withdrawn. But this person's in charge of looking after that person's life in many cases. So they can have that responsibility, but they can't have the one to communicate and share. Which one of the two do you think is more absolutely critical?

So, and that is a hierarchical stupidity ultimately the, the and I, I know that firsthand. I can see that within our business, the level of agency. what you would say, the most junior staff member has is the same agency that I have within the roles that we play that we energize within the business. So it's absolutely possible, right? But it requires education. It requires, um, an actual application and framework of principles and values and process.

That, needs to be established in order for that to happen. And that's what Buurtzorg did so it's not like it's not achievable. Buurtzorg's been around for a long time. It's very achievable, but it is a massive shift. A massive shift, you know, in the mindset in psychology. Yeah.

So what exists in market today, um, prior to Lumary coming in, is there's lots of applications that are, you know, doing great jobs. I'm not gonna take anything away from them, but they're all about just baseline operationalizing. There's nothing in there which enables you to grow and optimize and differentiate your business and do things that you need to do one day.

And so what you do is naturally you solve the problem by adding different applications, or you do things manually, and of course you have no other choice. But I'd say stop trying to solve the problem yourself. So therefore start doing, probably start speaking to someone like a Lumary who wants to help you, who's invested millions to help you.

And at all these years of experience, of consultative and understanding on how technology needs to be integrated into the business, we're dedicating that to this community. And we're starting with an, you know, the North America ABA Market, um, and helping businesses, um, in, in that specifically. And if it's not us, speak to someone like us, right? Who has the same principles and values and is trying to achieve the same thing with you.

Um, but you already know what, uh, the outcomes are gonna be with what's already been in market for you for a long period of time. And don't get dazzled by AI and this and that. Guys, you gotta start with the basics. You know, there's a reason why they say crawl, walk, run. You gotta crawl first, and that's what we're helping you do. You, you gotta get the structure right before you can then build upon it. Everything else is just, it's just sales Rubbish.

Yeah, for sure.