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October 7, 2024: Laura O’Toole, CEO and Founder at SureTest joins Bill for the news. The lawsuit against Epic’s alleged monopolistic behavior is also discussed—does its strong client satisfaction reflect a true monopoly, or is it simply good business? They touch on Epic’s recruitment strategy—how does hiring for culture impact the long-term success of tech giants? The episode ends on leadership, with reflections on gender diversity in healthcare and the power of effective hiring processes. Can these strategies continue to drive transformation in healthcare IT, or will future challenges demand new approaches?

Key Points:

  • 02:22 Epic Systems Antitrust Lawsuit Discussion
  • 03:59 Epic's Market Position and Client Satisfaction
  • 07:22 Hiring Practices and Strategies
  • 16:18 Team Achievements and Future Plans

News articles:

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.

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performance.

Bill Russell: 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. Newstay discusses the breaking news in healthcare with industry experts

Now, let's jump right in.

All right. It's Newsday. And today we are joined by Laura O'Toole with Suretest. Laura, how's it going?

Laura O'Toole: Going great, bill.

How are you? I'm wearing my yellow hat.

Bill Russell: Yeah, yellow

Laura O'Toole: Hat Club.

Bill Russell: Keep waiting

Laura O'Toole: to see more pictures.

has been [:

And I love the fact that as we're out in the community, people will come up to me and tell me stories and we'll have discussions and it's really good. So I

Laura O'Toole: very cool.

Bill Russell: How are things in the. Suretest world, are people finally figuring out that they can save money and automate these processes?

And is, are we starting to see that the market realized the potential of this?

Laura O'Toole: Absolutely. The light bulb has gone off. It's been a fun, fun ride. It's exciting. I think we have enough ROI studies now that, like anything, when you have proof. And you're able to go back to a client and say, these are the hours that were saved and how your analysts could put them to better use.

o folks at Yale, their stork [:

I want to be next. So we're getting that effect started. That is what I've heard. It's

Bill Russell: we brought it in, we weren't really sure what to expect. And then we were like, Oh my gosh, we can use it here. We can use it here. We use it here. And it explodes like that. I've not been doing news days recently.

I've been traveling a lot and doing 229 meetings and various things. And I'm going to be traveling most of the month of October as well. So I haven't been doing news day. So going to go back to a story that is still top of mind for a lot of people. And that is. Particle Health filed a federal antitrust lawsuit against Epic Systems accusing the health IT giant of using its monopoly power over which cover 94 percent of Americans, to stifle competition in emerging payer platform markets.

d health care providers. And [:

The first thing that strikes me is, People don't read anymore. They don't read the actual article. And so I see people going, Oh, this and that. And I'm like, lawsuit has nothing to do with that. First of all, it's the payer platform market. which is a new space that Epic's going into that they're looking at.

The second thing that is the most common comeback is, the patient owns the record, and the patient doesn't own the record. Whoever creates the record owns the record. And that's true in 49 states. That's the law in 49 states. And people are like, why is that? doesn't make sense. It makes perfect sense when you step back and think about it.

does. It gives you the right [:

Gives you a view into it. And I'll give you the floor in just a minute. This is me on my soapbox here. And then the last one is people are all worked up about Epic's monopolistic position in the market. And yes, they have made huge inroads. They're growing and those kinds of things. But there's a couple of things that sort of strike me.

One is. It's not a monopoly. By definition, it's not a monopoly, it's spread across multiple EHR vendors in enough to be spread out. But the other is, when you talk to their clients, typically when there's a monopoly, and you talk if there's an airline, I feel like there's close to an airline monopoly.

yeah, I want more people to [:

Anyway, curious your thoughts on this one.

Laura O'Toole: You know how I feel. I think competition is good in the market. I think it's important. I think it keeps people on their toes. I think Epic keeps themselves on their toes. If you look, I think Judy just wrote one of her news notes or whatever the latest innovation that they're coming with around Simplify and how they're going to better integrate their AI tools.

When a health system, I just read, I think Northwell is going to spend 1. 2 billion rolling out Epic. When you're spending that kind of money, you demand service and I do think that you get service from EPIC. It's, I, it's the top, it's the top notch vendor. So it doesn't surprise me if you look at what's going on with interoperability.

You still, it's still a hard time with Cerner and Oracle. I think you've got really Athena and EPIC. And, Judy's out there saying, how do we solve the interoperability problem? So I believe she really cares and puts the patient at the center and it makes a difference. So I'm not surprised hear that our clients are happy.

ell: me ask you this. Again, [:

Laura O'Toole: I think they do three things.

I do think they put the patient at the center. They also put their physicians and their clinicians at the center. And the other thing that they do really well. Is they're very careful and very prescriptive about who they hire. was reading and I thought it was so cool that the way that, the EPIC has their test, you have to come in, you have to have a test, you have to have a certain aptitude, and it's not so much skill test, as it is in the analytics test, to make sure that, you have a certain amount of capability, certainly, but how you're going to assimilate in the culture, how you're going to program, what kind of developer you're going to be.

old son. I read an article. [:

This kid actually came up with the characteristics and the components of what this test was going to be. And they've evolved it, but they used it for many years. think they're very prescriptive about the types of people that they hire for what they know their clients and their company needs.

And they're continually evolving and they push the envelope. And that's what I think they do right.

Bill Russell: I'm going to come back and we're going to riff on hiring for a little bit. I think there's a handful of things that are beneficial to them. One is they're not a publicly traded company, so they do not have quarterly earnings.

st like to just push it just [:

They're like. That's a different deal. You're constantly pushing for earnings and she doesn't have that. And you could see over time that really benefited Epic to not have that kind of.

Laura O'Toole: It's a different kind of pressure. It's a different kind of pressure when you have to hit a number every single quarter as a public company.

I didn't think about that one, Bill, but I think you're absolutely right. And you and I were talking not too long ago about succession plan and what's going to happen. And I said, really interesting to see what the succession plan is. And I just read, as a part of this other article, she says she has no interest in retiring.

And the company will not go public. It'll remain employee owned and that she has a detailed plan for that. It'll be interesting to see what specifically that is, but I do think that's a differentiator. I completely agree with you.

Bill Russell: you want to have some fun sometime, and I've done this with her, I'm like, what does Epic look like a hundred years from now?

wer for that question, which [:

Laura O'Toole: It's amazing. And for me, the fact that she's a woman, got to tell you, I had such a cool experience last week. It was my birthday. I went to a client meeting in New Orleans, and not only was the CIO at the helm, a woman, her entire senior cabinet that was around the table.

There were other people on the phone that, were men, very diverse group. But to see that many senior women leaders in healthcare technology brought me so much joy, you have no idea.

CIOs around the country [:

If I'm always, every third interview is going to be a woman, then I'm going to just keep repeating the women. And I'm like, we've got to solve the problem there I can solve it.

Laura O'Toole: Yep. You can only do so much with that one, Bill.

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Laura O'Toole: let's

Bill Russell: talk about hiring.

ngs that Judy believes is in [:

organization and it was health adjacent. Let's call it healthcare adjacent. And, I've led a seven and a half billion dollar organization and whatnot. And I go through the interview and they're like, Oh my gosh, you just crushed it. It was fantastic. All we have left is take this little test and we'll get back to you.

So I take the test. And the guy calls me back and says I'm sorry, we can't hire you. I'm like, what? I don't understand what just happened. He goes, everything about this test says that you will get incredibly bored if you work here and you'll leave within two years and we're not willing to make that investment.

h stock in that test? And he [:

healthcare CIO role, or being an entrepreneur. It's interesting, size, in this case, size really doesn't matter because I'm an entrepreneur for managing 13 people or whatever. Plenty, plenty of challenge and creative outlet and that kind of stuff. They identify, it's this job, he is not the guy for this job in the test.

Do you guys employ some of those things?

Laura O'Toole: do have a test that some certain analytical and behavioral questions that we apply to everybody. And of course, that's the key. You've got to be very careful. You have to do it for everybody within that group. And so all our developers, etc.

he only indicator. Component [:

And yes, I do believe they can be very helpful. What's really important is that you have to apply a consistent approach. I've told you anybody that's ever interviewed with me directly, One way or another, I weave into the conversation, Hey, when you were a kid and you had a coloring book, did you like just the pretty pictures?

Tell me what you liked. Did you do the outline with the coloring? What did you think about the puzzles and the connect the dot pages? And invariably if they say, I hated the connect the dot pages. I skipped them. That's a red flag for me because it's about getting through the muck to the other side, solving a problem, getting to the end, figuring it out.

every connect the dot page. [:

Bill Russell: So when I come into the lobby of your company, if you had a lobby, and there's like little coloring books there, I should make sure I do some of the Connect the Dot pages.

Laura O'Toole: We actually do send them out during mental health week. We send coloring books because it relieves stress, and there are some Connect the Dot pages in it, and we talk about it. Everybody does them, at least does at least one. You don't have to do them all, but some.

Bill Russell: So one of my things is you really want to see somebody do the job.

If you're hiring somebody for the job, to the extent that you could see them doing the job, that would be the best. And in some cases, you can, the referrals, it boggles my mind how many of my managers would not call referrals. And I'm like, ask for eight. And they're like, eight?

People can't give you eight referrals. I'm like, six then, ask for six. And they're like, people can't give you six referrals. I'm like, if they can't give you six referrals. I don't know what we're doing here.

Laura O'Toole: Exactly. The other thing is entry

Bill Russell: level is different than, Of

ourse, than senior the other [:

Have that conversation early and often. Embrace the conflict. Don't surprise people. Be authentic. Be transparent.

Bill Russell: of the things that was interesting about calling references to me was at least twice. I can remember I called references. I ended up hiring somebody on the reference list.

Laura O'Toole: Absolutely. it's an absolute great recruiting tool. And I agree. If somebody can't come up with six references, not just up, not just, who you've worked for. Yeah. But across your, even your subordinates, give your subordinates as a reference. I think that's a really vulnerable thing to do.

And it's telling to me, I asked for it. I say, give me the name of someone that worked for you.

Bill Russell: Yeah. I'll tell you one of the other interesting things we did at St. Joe's, I was hiring for a CTO role and I wanted to see them do the job. So I put my entire. IT infrastructure team in the room and a couple of the senior leaders and we're down to two candidates.

[:

And the first guy sits down. I said, Hey here's what we'd like for you to do. We're trying to move to the cloud. Everybody who you need to ask questions of is in this room. We'd love for you to, map out the architecture and then, make some recommendations on what we're doing and that kind of stuff.

He completely froze. I don't understand. What are you asking me to do? I'm like I'm asking, essentially I'm asking you to do the job, like the job you're going to do in the first week anyway. And he just couldn't, he just completely froze. The next person comes in, I said, I gave him the same thing. , he picked up the marker, went up to the whiteboard, and he goes, okay, who's in charge of networking here? Oh, you are? Okay, describe for me the so there's a course, and he starts mapping it all out. Before he's done, the whole whiteboard's full. And he's asking plenty of questions.

ht of this? Have you thought [:

Laura O'Toole: And he engaged the room, and didn't try to do it all himself. So

Bill Russell: See them do the job is always good.

Laura O'Toole: I have to say, I am amazed at your little team and the output that comes out of this group.

And I, last weekend, just catching up, looking, on LinkedIn, looking at the Newsday, looking at the Expanded Now 229, trying to figure out which ones we're going to do, support, whatever. And I'm like, mind blown! Like, how are you doing this with this teeny team? Now you got some obviously, Sarah and Drex coming on board, their energy is infectious and that just trickles down.

Megan, I love what she's doing with all her leader stuff, but the output, forget about that. How are you doing it?

are applicable for health IT [:

And we're essentially going to talk about philosophy of leadership, culture, all those things, and we're going to get those things out there. But yeah, we're doing 20 summits. We're doing 36 city tours next year. We'll go to, as many major conferences as we possibly can. Plus producing, I don't know, eight shows a week.

And people are like, Hey, you produce too much. I can't listen to it all. I'm like,

Laura O'Toole: yeah, you just, you drive, you put it on your podcast, you listen in the backdrop, you get the snippets. It's just, bravo. And of course I get to, be one of the early. People in, and I keep adding more folks to come work with you, and I'm thrilled to be a part of your advisory group, etc.

But, bravo, bravo, really. I think we do a lot with what we've accomplished in our team, but I look at you, and It's like magic.

I didn't say congratulations [:

We're recording this on Tuesday. She's getting married on Thursday. By the time someone's hearing this, she's married. new last name and all the things that entails. Because I'm still in charge of IT here. So I've got to change that all the places she wants me to change that. I will I will get to that when I can.

I

Laura O'Toole: saw that. I congratulated her. Actually, we were supposed to chat on my birthday, and then I had technical difficulties because I was traveling in New Orleans and my hotel. From Marriott, I gotta say it was a real problem, but so that's why we're here today, but you would have wished you did wish me a happy birthday and.

And it was awesome. It was, I was traveling, but I got to see all those women leaders in one place. And that was like the best birthday gift. It was so cool.

Bill Russell: Yeah. Yeah. That is fantastic. In fact, the same time you were seeing all those women leaders in there, I was seeing all the women leaders,

Laura O'Toole: right.

rd to it next year for sure. [:

I saw, I think you've raised almost close to 200, 000

Bill Russell: since you started. Yeah, we are getting close to that. And you are the first guest that I know of that has worn the hat on the show.

Laura O'Toole: Everyone needs to be sporting their yellow hat. We even, my dad passed away recently and I was excited that we got some donations in lieu of flowers for Alex's lemonade stand.

Anybody that's a parent and I, I've been a cancer patient, but to be a little person and go through that, I just, I love what you're doing, Bill. I really do.

Bill Russell: I appreciate your support. I appreciate you as an advisor and I'm looking forward to the next time we're on the show.

These are fun.

Laura O'Toole: Yeah. Great to see ya.

Bill Russell: Great to see you.

ail, which delivers Expertly [:

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