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April 8, 2024: In this episode Bill Russell sits down with Andy Chu, Chief Product Officer at Providence Digital Innovation Group, to delve into the intricacies of healthcare product development. Andy explains the mission of his role, emphasizing problem-solving and innovation within Providence's digital landscape. Through thoughtful discussion, Andy articulates the complex process of identifying healthcare challenges, generating solutions, and ultimately building sustainable platforms. As the conversation unfolds, listeners gain insight into Providence's strategic approach to product development, including the significance of external validation, platform integration, and the long-term sustainability of ventures. Engaging questions arise: How does Providence navigate the vast landscape of healthcare problems? What factors influence the decision to pursue a particular solution? What challenges do health systems encounter in product development, and how can they be mitigated? Through Andy’s expertise and experiences, this episode offers a thought-provoking exploration of the dynamic intersection between technology and healthcare.

Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Welcome to This Week Health. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare, one connection at a time. Today , we have an interview in action from the 2024 conferences, the spring conferences, VIVE in LA, HIMSS in Orlando.

Special thanks to our sponsors, Quantum Health, Gordian, Dr. First, CDW, Gozeo Health, Artisite, and Zscaler. You can check them out on our website, thisweekhealth. com. Now, onto our interview

(Interview 1)  Alright here we're from HIMSS 2024 in Beautiful Orlando. We're joined by Andy Chu with Providence, chief Product Officer. And welcome by the way. Thank you. I'm looking forward to the conversation. Chief Product Officers an interesting title.

And not common in health care. No, not at all. So give me an idea what it is and what you're trying to

do. Yeah, so within Providence, I work for the Chief Digital and Strategy Officer, Sarah Viasey, at Providence. And specifically, my mission is to figure it out, make problems, try to incubate from within Providence.

So build a product to solve a problem. A

problem. And if we can scale across Providence. Then we look at commercial opportunities and then we define there's a commercial opportunity that we bring on management team. We spit out

raised capital. Interesting. So start back at the problem here.

So I'd imagine there's a few problems. So

how do you go through the problems and say all right, this one looks, because there's probably when you even after you've called them all you'd like, all right, these 15 probably, Look, real, like we could do something here. How do you determine which one you're going

to attack?

Yeah it's more of an art than a science, as you can imagine. There's so many problems within healthcare, right? Where do you even start? So I think the way we go through the process of really living in the problem. We go talk to the operations team, we talk to clinicians, we talk to our IT department, we talk to venture capitalists, we talk to the ecosystem at large.

and see what actually is going on. And we also know operational metrics. What needles are we trying to move now and in the near future. And I would say it's more of a triangulation exercise. And then from talking with all these folks, we'll generate a set of thesis. And then based on those thesis, we'll do additional research.

That range from looking at what companies are out there. What are they doing? What are the big EMR vendors?

Right. Is Epic going to get into this in the next three years? Because if they are, let's go in a different path.

Even if they say they do, and most often times they do, I'll say that, hey, we're going to get into this space, doesn't mean they're going to do it well, right?

Doesn't mean that in a very complex environment like ours, we have many different applications. How do they actually work with each other? I think those are all the questions that we have to go ask. And then the other question we also try to answer is, why should we go build it? Vis a some company can be funded by, one of the big VCs, what makes us unique?

So those are all the questions we have to go through, and then figure it out. Hey, if this is a specific unique area that, because we have specific insights, relate to the workflow, or access to data or just planning operations, right? And then from there we're going to Essentially funneling down to a set of theses.

Even then, for example, we've been going through an exercise over the last I would say nine months or so. We have about ten theses, what we want to focus on. My team is fairly small, so we're probably going to go explore one or two of these opportunities. And then we're going to go deep dive in it. And typically what we do is we start building a prototype.

We work with our operations team to go build a prototype. We know exactly what metrics we're trying to move. And then from there, hopefully, before we write one line of code, we want to make sure that the problem that we're building is a big problem. We try to stay away from building point solution. We try to go after a bigger swing and really try to build a platform.

And then we also get external validation before we write one line of

code. So you don't try to be part of the problem and have another point solution. You want to have something that can grow and expand and That's right. So what does it mean to build a platform?

Yeah, so if you look at what we are in the process of spinning out, prior health we announced it back in October.

That problem we're trying to find is dealing with patient identity and patient engagement. As most health systems we included, our digital front door essentially is MyChart. But one of the things we realized a few years ago is that we as a health system, we have a lot of assets. From classes to programs different type of digital services.

And they're different from

market to market.

Exactly. And payers have a number of services offering. Employer may have other offering for their employees. Problem is, how do you bring all these things together? Very easily. Show to a patient, here are all the services you can consider, and then having a patient don't have to log in 50 times to different applications.

So that's the problem that we try to solve for. But as we know, you have MyChart ID, and it's difficult to integrate all these things with MyChart. So that was the first problem that we're trying to solve for, is how do We've built a system that can interoperate with MyChart, right? So we're treating MyChart as one of the many applications that we can single sign on into.

And then we can also access the electronic medical record so we know issues may have for those patients. And then based on those conditions, we can start recommending next best action for those patients. And those data can come from multiple places. So that's it. one of the main components in the platform.

And the second component is, when we start looking at this problem, it's very expensive to go build a very custom application on top of MyChart. MyChart has very many good features. we kind of marry both worlds. So as an example, within the Providence app, we pulled out specific shortcuts for MyChart.

But we can also now add on additional components, and as a patient, you have full access to MyChart. So that's the second component. The third component is the broader ecosystem I talked about. So as an example the state of Alaska is offering essentially free services, OMADA, which is a diabetes management program for their residents.

So we're fairly large in, Alaska, so we work with OMADA to promote their service within the Providence application. specifically for the hypertension and diabetes patients. And then we're also working with them right now to do single sign on. Cause one of the big issue for a lot of digital services companies is awareness and sign up, And then also sharing data. So that's the whole idea. We can start building an ecosystem of all of these different type of services. Could be transportation, could be other things that It's really good for the patient to be aware of. And then the fourth piece is analytics, because we can track what people are using, how they're using the services.

And then we can share the data with the operations team. So that is an example of a platform. We're not solving one problem. And then we actually bring in and tie them all together.

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There have been some organizations that have gone all the way through the process.

A handful of them. Talk a little bit about what those are.

So the other one was three years ago, DexCare. And specifically that problem that we're trying to solve for is access optimization. Balancing sort of supply and demand between, the provider's schedule online and what patients are looking for is still a very, it's a hard challenge.

That was a problem that we're trying to solve for is, hey, pulling in Number of different slots can come from different applications and then optimizing the access capability and what patient wants. So that was the whole premise behind, DexCare. And it's really spanning beyond just PCP.

Of course, we also know the challenge. Specialty docs may not want to put their stuff online, right? So a whole different conversation on its own. So that's the problem that we're trying to solve for. And DexCare, we spun it out, like I mentioned, about 10 years ago. They've raised a lot of money.

And then before that with Zelf it's really managing these third party applications, digital prescription. So that has done really well over the last few years. And the last company is Wildflower, so women's health. So they have content and programs and services.

gotchas with development? It's interesting because one of the gotchas I've found with development is People don't recognize the long term, like if you develop a product, the long tail of that, like releases, security, keeping it updated. But what you guys end up doing is spinning it out, getting its own team to sort of take it.

So it's not a Providence team that's taking it into the future. It's a Zelt team or a DexCare team that takes it in the future. are there other challenges or gotchas health systems try to get into the product development?

you have unique insight being as a CIO at St.

Joseph. So that's exactly right. So one of the main reasons why we spin out is building is one thing. Maintaining, continuous sustaining is a very expensive process. And growing a business. Yes. So when we build a product, we look through the lens. If this is something that is really a venture capitalist, the capital market is willing to fund this.

Even from a capital structure standpoint, we purposely, over time, to essentially reduce our ownership in those companies. Those are all the things that, other, some of the health systems are not aware of. So I think a big part of it is just running a company, continue to be competitive in the market, and then continue to build it, maintain it, right?

And sell it. The way we also think about this is, it's not so much a gotcha, but then, we also, the way we think about it is, if we can scale at Providence, we think it's also a bigger problem for other health systems. We want to have other health systems also leverage that benefit that we have discovered.

And, it's very expensive to build software, and that's why we use the capital market to fund those products that we've developed.

One of the things I admire about Providence is you guys have, figured out how to tap into resources overseas. There's Providence, India, and whatnot. You do the development, is it your small team or do you tap into that

broader pool?

It depends. In the case of Pryor, we have teams in India as well to help some of our development. also have teams doing analytics, some of the data science effort as well. So we utilize some of those resources. We don't utilize all the resources in India so it's a combination of stateside as well as India.

Is there a design benefit to keeping your team small?

We have to be nimble, and a big part of it is, there are benefits, but because we can move fast, right? Decision making is there are multiple layers of decision making, we partner

closely. You also can't take on three or four at a time.

You essentially say, okay, this is the problem we're going to solve, and you stay in that lane until you either prove it out, or you We

Photoshop. or close it up. Yeah. They're all products, for example, when we were developing Cryo, initially, when we started thinking about personalization, we thought, hey, we can just start with content.

But, as most health system content is is not as robust as we would like. Other than maybe a couple health systems in the country, right? Hey, we can't really start personalizing with content and what we can learn with it. So we pivoted and do something else, but explore a whole new dimension.

So I think that's another reason, especially when we start a project, it's literally like three people, right? We have a developer, we have a habit designer and sort of pseudo product person. I play some role like everyone on my team. Doesn't matter what title is. go pretty

deep. Fantastic. Andy, thank you for your time.

Thank you so

much.

Thanks

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