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September 13: Today on TownHall Lee Milligan, former SVP & CIO for Asante Health interviews Kyle Gibson, Director - Strategic Sales West for Agfa HealthCare about the evolving interactions between vendors and CIOs brought on by the COVID-19 pandemic. What was it like for vendors to interact over the internet rather than over lunch face-to-face? How has this changed Kyle's outlook on relationships and investing in his customers? What are new challenges that have arisen from navigating a new way of communication? What is the best policy for business and building a reputation?

Transcript

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Today on This Week Health.

I remember it was PACS related. The first question out of his mouth was Hey, we need to buy a new PACS system. And I don't really know how to do this.

My brain almost broke for a second, that's the CMIO? They work with the EMRs, they know all of this backwards and forwards and it was that level of honesty and it changed my approach.

Welcome to This Week Health Community. This is TownHall a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels designed to amplify great thinking to propel healthcare forward. We want to thank our show sponsors Olive, Rubrik, Trellix, Medigate and F5 in partnership with Sirius Healthcare for investing in our mission to develop the next generation of health leaders. Now onto our show

Hello, and welcome to town hall. My name is Lee Milligan. And I'm your host today? I'm the CIO for a health system in Southern Oregon.

Today. We're pleased to have Kyle Gibson with us. Kyle works for Agfa. He's a director at Agfa, but he's been in imaging for many years.

Yes. I've been with Agfa for 18 months. I do sales across the central us. And prior to that, worked for change. Healthcare used to work for Siemens. So I've done the it side, sold MRIs, CTS ultrasound.

ng side, over the last, since:

Awesome. So today we're gonna attempt to do something a little bit. So Kyle and I are actually not in business together. We don't have a contract. We don't currently do business, but here are kind of friends. We met on LinkedIn and we've connected through hymns and chime and LinkedIn and email and whatnot over the last few years.

And we thought it might be interesting to have a conversation about. How to navigate our new world. We find ourselves in, as it relates to the vendor and the CIO trying to work together, we both recognize that it's a different world and we're trying to kind of sort out that different world. And we're really trying to make a scenario where it's a win-win for both sides.

So today is really discussion around what's current state. And how do we optimize that? So, Kyle, let's start with some basic questions and I'll actually get all four questions out at once. So folks watching can get a sense, whether it makes sense to keep listening. The first is how has the vendor CIO interaction changed as a result of the pandemic?

The second is what are today's current challenges that didn't exist before? The third is what are companies doing to cross a divide within this new ecosystem? And lastly, what are some ideas around how to improve this to the benefit of both the vendor and the CIO? So let's start with that first one.

How have things changed since the pandemic, from your perspective?

nd I, I look back to March of:

And so overnight, I still remember the last meeting I did before COVID hit was in Casper, Wyoming. Cause I was in San Diego the week before I flew home. And I was like, well, I can go to Casper. There's no way this is gonna be in Casper. drove out to Casper, had a great meeting over there.

And during our time in Casper, I was with one more rep, you get the company wide email of everybody needs to go home. Right. Wow. Time to go home for the next two weeks, which I still love that how the additional deal was for, you know, for the next two weeks, we're gonna stop the curve and everything.

And so I made some poor decisions for those two weeks, but I had a very good time, but then all of a sudden you're like, oh, this is still going on. This is there. And it really changes. , I mean, one of the biggest things I look at is. Previously I used to do, I would just call it the bagel run. So if I'm going out to go see you in Medford, like I said, we hadn't met in person yet at that time.

Mm-hmm , I'd be like, Hey, I'm going to core Val, Eugene Medford, a couple other hospitals in Southern Oregon. And I'd let you know, three to four weeks in advance. Hey, I'm coming by. Can I do breakfast with the team lunch with the team don't know much about your facility. So we'd start out that way of just trying to find a way to get a meeting.

And in:

I think they have 285. It employees and only 40 are on site now. Mm-hmm so even if I stop by with a box of bagels over there, I'm gonna drop two off and be taking 11 home for myself. So you just like what you used to do that was successful. Just won't work cuz no one's there. So

What else would you do in the old days in terms of interacting with either existing customers or new customers?

s my original, like back from:

You ask. Yeah. Can y'all walk me around, go to different departments. Like, in the it side, if I start out with it, I always joke with everybody that that's typically where deals go to die. If you're looking to get a, no, it is a great place to start and then once you get to it, it's like, okay, well

where's the need, , do they need to see me there? I'm selling something. That's usually seven digits. Are there issues with radiology? Is there something an interventional that we can go do? Is there something there archiving issues? What is the problem? And you can find that out a lot better.

When you're in person, cuz you get to shoot the bull with people. It's awkward whenever you're trying to do it via zoom calls. Cause everyone's just staring at each other, like a Brady bunch style meeting. And at the end of the day, you don't know people's kids names. You don't know if they like sports or anything along the lines, like the usual topics that are important to sales.

Yeah. So it's.

Yeah. And I imagine as you get to know people, you get to understand the decision making framework that's in place within that system. So do they have a PMO? Who's in charge of imaging who leads the imaging strategy who are the key players in this space because frequently those decisions are made either in conjunction with it or sometimes external to it, depending on, on how it's framed up for the organization.

So, okay. So the pandemic hits. This world's turned upside down and can no longer walk the halls and kinda learn people's scenarios and you can't drop by bagels and have a conversation. So what did you do?

The first thing I did is I got onto LinkedIn, like I've never really been before. So I've used LinkedIn.

've probably been on it since:

And at first, I don't mind saying I did it wrong. I'd see something out there. A CIO would post something and I'd get real excited. So I'd go out, reach out, connect, then we'd connect and I'd immediately, Hey, we could do this and this and this for you, which as I've learned from using LinkedIn, it's kind of better to take it slow, like a first date You're not out there. Just going nuts for your very first meeting. And that's, I look at it now. I probably get 5 to 10 requests on LinkedIn where someone's pitching me something immediately. So I went deep on utilizing LinkedIn, joining webinars, and then finding out who really sounded like they knew what they were doing and I'd want to engage with so from sales.

I'm always trying to figure out, obviously I've got my products. I've gotta sell, but I can't come pitch you. On products. If I don't know the first thing about your systems, like if I was going into Asante, I should probably do my homework on how long Epic's been the EMR, how long you've had Fuji PACS Because if I walk in there excited to talk to you about PACS you're like, well, Kyle, we signed a contract for five years, three months ago, then it's okay, well, let's have lunch and I'm gonna go ahead and get out of here. So it made it tough You know when it was remote, you lost those abilities to have those easy conversations and you're doing it via email, doing it via LinkedIn. And I also recognized I was competing with 200 to 300 plus vendors just like me per account. So then I had to figure out how am I gonna get through when everybody else is trying to relate the same way.

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Right. That makes perfect sense. Let me pause here for a second. I'm gonna give you my perspective. On some of these elements as well. I was thinking before this meeting, what are some of the things that work well, and I'm skipping around a little bit, my apologies. That's alright.

What are, some of the things that actually work well? Cause you and I have joked about, the mistake that a CIO will make of accepting a LinkedIn request. And then the very next message is 18 pages. And you just say, okay, enough, want nothing to do with that?

That's a really common entity.

Yeah. You get disconnected like two minutes later and, just people go over and do it again and again. So I mean, what I've found that's been successful on it? it's like when I reached out to you, the first thing I saw, it was an article about you delivering a baby in a parking lot.

And, I've worked with a lot of CIOs. I didn't realize at the time you had an emergency medicine background. So I was just kind of chuckling. I was like, what went wrong to deliver a baby in a snowstorm in Oregon, which they don't get a lot of snow there anyway, in a parking lot. So, it's like, that's kind of interesting.

I'm gonna reach out. I just gotta ask about that one. Yeah. And then. I remember we connected you. Let me know you had your background on emergency medicine. And again, I sold a device that did a liter of blood a minute back on the body. So I know from ERs gunshot wounds, stabbings, car wrecks, they're great at those things, if someone's going into labor and the ER, I mean, they try to find a turbo rocket to get them to OB.

They want nothing to do with that. It's kind of hilarious. The first few times I saw that I was like, what are you doing? They're like delivering their baby, get him outta here. It's like, you're the emergency room? Like, no, not that you take him to the next floor or whatever it is.

I think you tapped into something there, for sure.

So lemme go back to a couple of things that I think do work, at least from my perspective, the first is if I get a reference from a trusted C. So let's go back to PeaceHealth. PeaceHealth has a CIO by the name of will. Wheater he's one of my personal heroes. He's a terrific CIO and I love his leadership style.

Very thoughtful in how he approaches things. If he says Lee, I've been doing business with X company for three years now, and I've had a terrific experience to great value. And here are the three reasons why I've had a great experience. I'm gonna look at that. Absolutely. So, so from a vendor perspective, I think it's really important to know, not just your clientele, but know who knows who within that clientele now.

Absolutely. I think that's kind of a key, thing. The second you alluded to this around developing the relationship, I liked your analogy of. It's like dating, right? You're not getting married on the first date. Right. It's really about getting know one another, a little bit.

And that's one, thing I really appreciated about our communications back and forth and kind of just getting to know one another and then eventually meeting up at was at chime fall form. I can't remember it was chime.

It was one of like the first meetings. I can't remember if we had to wear masks at chime or not.

k we did. Yeah. In October of:

Like mine, I look a little skinnier than I am in this photo here, so I need to update mine.

The reason that this struck me is that I remember a few years back. I ended up connecting with a gentleman by the name of Aaron Brown who worked for a company called Huron consulting.

And he did a really good job of trying to understand the Asante space, the situation, the problems we were trying to solve. He asked really good questions. It was a really good listener and reminded of you in that way. And I remember thinking afterwards, if I have a need that here on does I'm gonna go to Huron?

Yeah. Right. Cause I felt like there was a point person within that realm that. Took the time to understand our circumstance. And it's interesting how that works, right? You think it should all be about dollars and cents and expertise and all that stuff, but really if you get a human in place, Who takes the time to understand the individuals they're gonna interact with.

It makes such a difference.

It really does. And like, that's the single biggest thing. Obviously in sales, you've always got a number you have to hit. So, know, there's an expectation of you're gonna sell a certain amount per year, you mentioned will at PeaceHealth, by the way, he's a great follow on Twitter.

He's pretty hilarious on there. So. If you can get to that reference or referability point, that's huge. Cuz that makes it so much easier to go into a system. If so, and so says like, Hey, this guy's alright or this company's done well biased for years. Mm-hmm it's a heck of a lot easier. Just coming in, cuz I also accept like the market we're in, packs, enterprise imaging VNA.

It's a completely established market. Right. So we're either replacing a competitor or being replaced by a competitor. So it's one of those, like, there's very cool things that we do, but it's so tricky from your side because you hear the terms like. Enterprise imaging, artificial intelligence, interoperability.

Like it makes you hair go gray, cuz everybody throw these turn. They throw all the terms around, but then you ask the question, you're like, great. What does that mean to you? You'll get 20 wildly different answers from people where yeah,

so, so well said so well said the third part I wanted to make is around honesty.

So one of the things that a vendor can do when I'm interacting with them, that really makes me want to keep talking to them is to have them tell me. What they can't do. Mm-hmm so I'll, I'm dealing with an issue. I've got a problem at some level, and they say to me, you know what, that's not something that we're gonna be able to solve.

But, we know folks in that space happy to kind of point you in that direction, but we don't wanna waste your time because we're not really there or plan to go there when they come forward with that level of honesty and transparency. When they do tell me they can solve a problem. I tend to believe them right.

Because they've already told me something that, you know, where they, can't do something. So that piece helps. And then lastly, I wanna go back to the idea of kinda listening. I feel like. They always say like all politics is local, all health systems operations are local.

Despite the fact that we have, standard products out there, how it's implemented, how it's utilized and leveraged in a local scenario is key. And so when I interact with a vendor and a vendor really tries to understand the operational workflow that we're trying to optimize first, before layering on the technology, that helps me get a sense that that individual really has our best interest in.

mind

Yeah. And a lot of what you're saying, it's the key, like in and I could use this example. This is back when I used to work for Toshiba we had a RF room and it had a 370 pound, maybe 375 pound dynamic table limit. So if the table was moving, it could only work up to 375 pounds,which in Japan is spectacular.

But in the us, our folks are a little bit bigger and all the competition had 550 pound table limits so I remember the lady's name was Renee ward. She's now the CEO of Penrad imaging in Colorado Springs. She was a Rad Director at the time for one of the hospitals in Colorado Springs. I remember we're going into a deal, starting, it's going to be a nine month deal, you know, Hey, we're looking at this like, look real quick. I have a 375 pound dynamic table weight limit. You're gonna find that out at some point. I'd rather tell you right.

now Is that gonna work for your community? And I remember she was like, thank you. She's like, no, it won't, but now we don't have, I was like, I don't wanna waste nine months of bringing people down to Colorado Springs, doing meeting after meeting. And you're gonna have spreadsheets of every single capability everyone has knowing that that was probably gonna eliminate me anyway.

And it was funny because she, and I we don't do business currently, but she's referenced that a few times as we've talked through the years, because she was like, Hey, like you're one of the guys that you didn't waste our. time came in their first meeting. Like, look, you want to talk CT, which we came in second on that project over there.

Maybe I needed to be a better sales rep at that time. but it was. It's funny when you do the right thing for your customers, they'll even tell your friends. So like, when I come to how I've grown, my opportunities, a little over half, my funnel is now via LinkedIn So, from a company standpoint, they don't, obviously they pay my salary, but you're not paying outside marketing.

You're not paying in different areas. And I had a call that came in and this was December of 20. It was from a CMIO. And I remember it was PACS related. So I'm just super excited. They want to look at PACS And The first question out of his mouth was Hey, we need to buy a new PACS system. And I don't really know how to do this.

And I remember sitting there and my brain almost broke for a second, because I was like, that's the CMIO? They work with the EMRs, they know all of this backwards and forwards and it was that level of honesty and it changed my approach. because then I realized I'm going out, I'm talking bits, bytes widgets, all this stuff that really nobody cares about versus what seems to be the problem.

So like where can we come in and fix it and more and more nowadays, I see it on the vendor neutral archive plus universal viewer. Cardiology's a great example. Folks, keep buying systems. They're now recording all the surgeries mm-hmm in cardiology. So those files are not small. At that time, it's not an image from a CT or MRI.

So you've got DICOM rat versus is it nine DICOM? And that's been such a great entry point just to talk to folks about, Hey, if you're doing this, what are you doing with the files? How are they getting to the right place? Or even more that we deal with all the time on my side of the business is if the radiologist clicks the button, they expect the image up in front of them, immediate.

Not a half a second later. And if it's a half a second later, that's usually not great at some places. So mm-hmm, , it's funny when you, if you're proactive and you address it that way, you could have a hell of a lot more luck, cuz let's say I was doing business with Asante. When I get to your level, you're not gonna care about the bits and bites and where widget is and where you click on everything.

It's is it gonna work across my system? , what's the support, if something goes wrong, which in full disclosure, and this just means sales, like there's no such thing as a perfect install. Mm-hmm so I tell folks when stuff goes wrong and it will, judge us on the response. Yeah. So, when you're able to call me or call your team, how do we handle your challenges and problems?

Cause if you do it right.

I wanna go back to what you were saying about that CMIO who called you up? Cuz I do think, as we think about strategies to be effective in this space, moving forward from the vendor side, I do think education is a really important element of this because the complexity associated with healthcare it today is so vast mm-hmm and so layered and so complicated.

I feel like, that's a role that a good. Vendor who is also has kind of a teaching ability, have that teaching thread in their psyche can share things with folks and the more you teach and the more that individual learned, essentially, the more they, learn to trust you as well.

Moving forward. So I do think teaching is a key element.

It's very true. And here's where we really struggle with it remotely. You, and I know each other we've developed a good relationship, but a lot of other folks that are coming in again, like I mentioned, the buzzwords of enterprise imaging, AI, same thing, you'll hear oh, it's a consultative approach.

It's a partnership we're gonna do. It's like, my kid's. Like, where did I go to college? Yeah. And you're like, what state am I from? Yeah. And, it's like, well, I don't know any of those, but, and now we're talking about partnership really. And it's like, we're getting a little bit ahead of ourselves here.

You can earn it. It just simply takes time. And that's where it's tough for organizations because you can't just flip it on tomorrow. And then all of a sudden have that, like if you had a product you were selling that, it's only a one time use or something that would absolutely work, but it relationships we are gonna be married to each other for usually three to five year contract.

When we start together and if it's not going well, and I tell folks, Hey, week one has to go, well, we've gotta be on site. We're going to address, challenges, concerns, and what we can do to make it better. Cuz if week one goes poorly weeks, two to 52, aren't very fun. Yeah. If week one goes, well, You can have a very good existence, and this is where it's gonna change so much moving forward, because again, your team is not all there anymore.

told you that at the start of:

Let's just take the Asante team. You might fly them all out to med. Two or three times a year, get everybody together so we can do stuff. And I think vendors are now gonna try to come out on those, sponsor dinner sponsor, a happy hour, find a way to get in front of people, but it's gonna be tough because it's a free for all of vendors once again.

So you're not gonna invite, every single person's ever called you to come out there, but it's like, Hey, who are the. Or 10 folks that , we want to talk to, because you've got the challenge, I believe y'all are about 1.1 billion in annual revenue. Mm-hmm of, what are you gonna do?

And the capital budget it's changed so much through the years. You'd win or lose to other vendors sometimes, but now I'm seeing more and more hospitals with the capital budget that projects are getting pushed. Wages, they've gone significantly higher finding texts, finding nurses, burnout retention.

There's so many different areas that are going into budgets where it hasn't been before. and, everybody's trying to adapt to the new ones. I know when I'm calling on you or other customers, generally your biggest issue is often are we able to retain employees? Do we have folks where they need to be and those are the things like when the nursing aspect from the radiologist aspect, from the tech aspect, Those are huge.

So let me go back to what you were saying before about coming on site. Let me make a suggestion, something to think about. I think there's value in that, but I also think there's value in flying the customer or having the customer fly to your headquarters. Mm-hmm to meet with your staff.

Prior to the pandemic, I sat down with my, leadership team and I wanted to define what I called our core vendors ultimately became a list. Vendors that I really have a good relationship with that. We take significant product and services from and that we have dependencies , with them to some degree.

And once we defined those, then the goal was to identify whether we could move into a true partnership with them or if it would remain transactional. Yeah. And as I thought about that and kind of thought through that, I started talking to some of these vendors and the first vendor I spoke to was Microsoft and Microsoft.

At the time asked me to come up to Redmond and present the Asante its strategy three to five year strategy. Moving forward to their executive healthcare. So I flew up there, spent the day with them. I was supposed to be a 30 minute presentation, turned into an hour and 45 minutes with Q and a up there.

And then they had an opportunity to kinda showcase where they thought things were going. And at the time they were focused on teams and a few other, and other things that we focused on, it was a really great meeting. It was, to this day, it's a couple years later, it still freshened my memory of how that happened.

So I would say with. Individuals and customers bringing them on site, having them present to you where their head is, you can learn about that. And then you can present to them where you're headed as an organization can really be impactful.

first off, I really like that idea. I I'd be bad at sales, but I didn't invite you out to Greenville, South Carolina after that one real quick.

Or, or Bellson before allowed to go overseas for it. again, very different thinking. It's not something I've done before, but you can see the light bulb in my head's kind of going off on it because. If we have the right folks there and from us, I'm looking at product development.

Mm-hmm innovation service. You can have a lot of the folks there to hear from a customer. Cause it's, I'm sure you've seen it through the years. When some companies come out with certain things, you're like, well, why'd you pick that? Yeah. And like, well, you know, R and D said, we wanted to do it.

It's like who from R and D said we needed something that's gonna get used once a year versus something that, you know, is it applicable to our customers? Which. Yeah, that's a great idea. I like that.

Yeah. One, one more last, last thought on this. And I wanna give you the last word, cause I want to hear any additional thoughts you might have on how we can kind of optimize this vendor CIO relationship and this world we're in.

Yeah, but the last idea I was gonna put out there is this concept of an advisory council. You probably already have one, but I think it's really important for companies that do business with healthcare systems to put together an advisory council that consists of representation from a variety of different clients they have, who can meet on a, let's say quarterly basis, in person, but if not virtually.

Who can really provide feedback on a regular cadence about what's happening with their use of the product, and they can generate the Genesis of ideas about how to make it better. Moving forward. I've done this on a number of occasions with halo. Help before they're acquired by simpler. I currently am on the advisory council for Galen health, which is a legacy data archive.

It's a terrific relationship. It's a true partnership that we have with Galen. I've been really, really pleased with that. And then I get a chance to give back to them and hear from them about where they're headed at the same time. And so it really helps put in place tangible ways that, that so-called partnership can actually evolve and be there.

But I wanna give you the last.

again, great idea on that. And I know overall we're talking about how to make it different, do different things that other people aren't doing in order to be successful in sales. And that's a lot of what I've just tried to figure out on it.

Whether it's , we know we're going to trade shows and people are presenting. Most folks, don't go through the 250 different presentations that are going on and the topics there, they're usually as fun as watching grass grow for the most part for the general public. But occasionally, like you see a few topics that you really wanna see.

And I still remember one, this was again, that chime meeting in San Diego and October 21. It was Aaron, Mary he's out of Baptist. I think in Jacksonville. Now he's previously at Austin in will wheats. Again, you always get a good moment where you learn something and they were on stage for a presentation will had just gotten pulled up to join the panel cuz somebody else couldn't make it.

s. They're like, Hey, we have:

But then I was like, well, where do I have that messaging? And it's , okay, I need to do a better job getting that out there to people. But yeah, it's just, finding ways to reach out, I joke it's like, Hey, whether you wanted, LinkedIn text message, smoke, signal, email, regular mail.

I don't care. I can do all those ways over there. probably not smoke signal, but just finding a way to communicate and connect. And once you do it, it goes back to the old sales 1 0 1. If people buy from people. So if they like you, if they trust you, they believe you. And you've paid attention.

You've shown how you can add value. You can do stuff. But the other big thing on that is you hit on it early. Just no one to walk away. If you're ultimately the wrong fit, just say, Hey guys, somebody might be able to do this better than us. Yeah. And or if it's referred to another area, cause I still get questions all the time based on my modality background from folks of like, Hey, we're looking to buy an MRI or CT.

What do we do? What's the best way to do that. And it's kind of funny cause I can nerd out on the equipment, service, engineers, uptime, and stuff that usually bore most people to death. But to me it's thankfully I enjoy what I do, but no, I appreciate getting on here on the time and hope I did well for the first one of these I've ever done.

Yeah. You, you did great. And I really appreciate your approach to the whole vendor CIO relationship. And I'm sure this will be the first of many conversations that we'll have on this ongoing topic. Thanks for Kyle.

Hey, looking forward to it.

Thanks again, Dr. Milligan. All right. Take care. Bye.

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