Wes Wright has the experience of being a large system CTO and now one of the leading IAM providers in healthcare. We tap into both experiences in this wide ranging discussion to explore how Health IT is changing.
Bill Russell: 00:11 Welcome to this week of health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is Bill Russell. Recovering healthcare CIO and creator of this week in health it, a set of podcasts and videos dedicated to training the next generation of health it leaders. This podcast is brought to you by health lyrics, helping you build agile, efficient, and effective health it let's talk, visit health lyrics.com to schedule your free consultation. We were recording a series of discussions with industry influencers at the Chime Hims\s 2019 conference. Here's another of these great conversations. Hope you enjoy
Wes Wright: 00:47 Here we are Friday afternoon were still on the floor.
Wes Wright: 00:48 Thurday
Bill Russell: 00:49 yes, in fact, it's Thursday afternoon were still on the floor. It's been a long,
Wes Wright: 00:53 seems like Friday.
Bill Russell: 00:54 I made the mistake of bringing shoes and think I was going to break them in at the show. Oh, that's a bad. And that was a really stupid idea. Yeah. Sneakers. I go,
Wes Wright: 01:04 never do new shoes before. A marathon. Yeah. This is your marathon.
Bill Russell: 01:08 Yeah. That was actually called you. So today we're with Wes West, right? Uh, I, I call myself a recovering CIO. You're recovering CTO from a health system now your CTO with Imprivata.
Wes Wright: 01:21 Yeah. Yeah. I was, uh, came out of Sutter about 10 months ago.Imprivata is is, you know, I thought and I saw things developing that Sutter that told me that identity is going to be the new perimeter. And then healthcare, if you think identity, you think Imprivata and David Tang who was the founder, CTO left and I never considered that I'd be able to take that spot. But uh, cause he was is wicked smart and I'm not, so I didn't think I'd have a shot at that. But Lo and behold, here I am.
Bill Russell: 01:53 But the thing you have is experience.
Wes Wright: 01:55 Yeah. I've got about 25 years of provider experience and Imprivata, you know, when I was on the CTO, Cio side, I work with Imprivata a lot. And I think anybody that does work with Imprivata, they'll go, oh, these guys actually get it. They know workflow, they know healthcare. And that drove me here too. And really one of the, one of the major decision factors was, you know, they bought Caradigm two years ago. So one that gave them 140 customers. But to what it allowed is that with Caradigm came a provisioning system at GRC provisioning system. We took it and rolled it up, modernized it, and now we have a new GRC provisioning system, which then allows me to have a suite of services. So I can offer almost everything in the IAM sweet.
Bill Russell: 02:49 So here's what we're going to do. Okay. A recovering CIO, a 16 hospital system. So how we used Imprivata a pretty, essentially we also were one of the first clients for Caradigm. Okay. And, uh, that didn't go nearly as well as the provider
Wes Wright: 03:06 when I was at Scripts. I bought Centillian. So on there. Yeah, there you go.
Bill Russell: 03:09 We all have, we all have a history, but, um, so what I want to talk about, really leverage your CTO background and say, um, that the listeners are primarily, uh, health health care provider, it organization, the world's changing on that big time. So, especially on, so let's talk infrastructure and operations back office. So, um, you say identities is the new perimeter. Yeah. So how, how are we going to start seeing identities play out in terms of provisioning of new services and those kinds of things?
Wes Wright: 03:47 It will all be identity based with, uh, with the new FIDO standards coming out to identity is just identity without a password, everything, it's identity and data, the identity, the identity of the not of the data of the data producer is, is where that perimeters
Bill Russell: 04:08 and it's all being driven by security
Wes Wright: 04:10 100%.
Bill Russell: 04:10 So how do we get to a point where there's no password?
Wes Wright: 04:13 Uh, it's, uh, you know, in the cloud world you're almost there and we've been doing a lot of work with Microsoft and had a conversation with them a couple of weeks ago and they've got some fido stuff. He just, you know, the Fido Fob, you like the Yubikey or something, you plugged that sucker in. You never see a piece of a password prompt again. But that's really only aimed at the cloud application stuff. Like it doesn't work with applications that are LDM. Uh, stuff.
Bill Russell: 04:41 So you'd probably struggle with it. I mean, you were CTO, Sutter was 10 billion. Yeah, about 12 billion, seven 28 hospitals, 20 hospitals. And you're, your biggest security threat is peop people, right? So, and people know their passwords and then they use it over and over again around the Internet and then they create all sorts of challenges that way. Um, I mean are you guys, are you guys looking at the larger, larger, uh, identity across all the applications? Are you really focusing on the clinical applications?
Wes Wright: 05:13 We're laser like focused on the clinical applications. That's what's made us, made us our money. That's w that's our secret sauce. Not only from an identity perspective, but it's the, it's the workflow integration that really makes in epic. There's this, I think about 140 different places in epic where you can call for a second authentication and we know them all and can prompt for that second authentication. So it's really the laser like focus on the clinical applications. But what we've come to realize is, hey, we've set up this great SSO amsso situation for all our clinicians. And then we got like a second tier community that has to still use username and password. So we've, we've, uh, we'd really like to see people using Imprivata in enterprise. So for nonclinical users we've really done some huge price reductions for the nonclinical users so that people like me, the operating people only have to manage one pane of glass from an SSL perspective.
Bill Russell: 06:13 Yeah. Are you finding that, are you guys able to drive higher efficiencies? I mean, clearly that that's one of the reasons we use you was uh, you know, you took the login times way down for us. The clinician experience obviously goes obviously do you find cost being one of the major drivers right now within healthcare.
Wes Wright: 06:33 Oh yeah. Uh, about every other CTO, CIO I talk to really wants to expand their Vdi, but it costs a lot of money in hardware and licensing and they can't expand that even outside. They may even have just a little pod for an operating clinical section. And that's the only people can use it. Why? because of cost. I think there's gonna be some big breakthroughs in that area here pretty soon.
Bill Russell: 07:03 It's interesting. So it works. Technology that works. It works in a lot of different areas. It, it drives a satisfaction, drives efficiency. Um, and you know, clinician experiences issues. Yeah. Physician burnout and what not, yeah. You would think, hey, this, this is a working great solution. We, we roll it out. Um, are, do you guys help people to build the business case to go back in and say, look,
Wes Wright: 07:30 from a Vdi perspective, not really sure. We built the heck out of the business case on the am SSO or EPBCS or any of that, any of our product type stuff. Um, because I've done a bunch of Vdi, I'll offer, you know, hey, I do it this way if you, if I were you, this way, if I were you. But other than that, nothing really formal from an Roi Perspective on Vdi.
Bill Russell: 07:54 So what's the CTO? The landscape's changing it. Oh yeah. Healthcare it. Oh yeah. What are some of other areas where you're just seeing it change particular dramatically?
Wes Wright: 08:04 Uh, I'm seeing a real bifurcation in your it stacks right now. I mean, there are two camps, two really solid. You're either Dell AWS or you're on the Microsoft stack. And what I see is a lot of people making what they think our tactical decisions but are really lock in decisions in one of those camps. Uh, so that's Kinda, that's a little concerning. And I tried to talk to people enough to where they know, hey, if you make that MDM decision, you know, you've made an MDM decision for your whole enterprise. You can't, can't do anything around that.
Bill Russell: 08:43 It really is a data decision at this point because you're, you're trying to tap into, you're really trying to trap tap into Azure and AWS machine learning AI capabilities. Right? Yeah. Um, is Google play in that or are not as much
Wes Wright: 08:57 Google plays in it? You know, we haven't seen Google from a cloud perspective as as much as we seen a AWS and Azure of course, but Google's there, Google really wants to come in to healthcare. Matter of fact, we just did a press announcement this at this ends that you can tap and go into a Chromebook now. Oh really? Yeah. That's pretty cool. Yeah.
Bill Russell: 09:16 The, uh, so you have the three stack, you have those two stacks. Yeah. And uh, you know, the Microsoft stack just ended up being a default, right. Cause you could just, you take that MSA every year and you just go, I'm just going to add cloud or I'm just going to add whatever in a way you go. Um, but that's, that's a really bad way to make that decision isn't
Wes Wright: 09:37 it is. You know, what's really driven, I think Microsoft's enterprise business and they're oh three 65 and Azure business, it's exchange online. I mean that was, that was the easy decision that was ah, I could spend a whole bunch of money and put four or five resources on prem to manage exchange or I can just put it in the cloud.
Bill Russell: 09:57 Yeah. I want to be real clear cause I, I was a huge Microsoft Fan. It stack at the Azure stack is a really good stack.
Wes Wright: 10:06 100% agree. Everybody knows I'm a Microsoft Fan.
Bill Russell: 10:09 Oh yeah. But the Amazon stack is, is also a really, it's a really good stack. Had, the challenge we had was talent 100%. Right. So we, we had, we just had a wealth of Microsoft talent and it was a natural progression to get here. Yeah. But you were in San Francisco, you couldn't get Amazon talent.
Wes Wright: 10:27 I was in Sacramento. Sacrad okay. Yeah. Um, and I guess I could have, but I think to this day, Amazon doesn't have a BAA in California. Oh, okay. Yeah. So that's a little concerning. And, uh, I came from Seattle children's right across the river for seven years from Redmond. So I had developed a bunch of Microsoft relationships and uh, and knew I wanted to, to use the Microsoft stack because I knew, I knew that Microsoft much like you, I knew that stuff. I didn't know the AWS stuff.
Bill Russell: 11:05 And the BAA was when Microsoft finally deciding to do the Ba.
Wes Wright: 11:09 That was huge. I actually, at Seattle Children's, I, I, uh, helped with that a bit.
Bill Russell: 11:14 Well, I mean, back in 2000 and 2010, 2011, we were building out our cloud environment and we went to the major players with the conceptof NPA and they just, they looked at me like I was insane. And so we ended up building out our own, uh, you know, essentially our own internal cloud on vmware stack. Private cloud. Exactly. Uh, it's interesting. It was a private cloud. And then what's interesting is vmware kept building all these other things and so now you can actually get out to, into a public cloud. Um, and I, I'm not saying we knew that that was going to happen. We sort of got lucky. Sometimes it's better to be lucky to pick, pick right venders and uh, and they will figure out the future for you. Um, so it's, it's, so Amazon, those are the stacks.
Wes Wright: 12:07 I think the big disruptor that's coming out right now, windows virtual desktop. And why is that? Um, because you only pay for compute and store in Azure and no other licensing costs.
Bill Russell: 12:24 Anything that changes the licensing model will be interesting. But I can't imagine he's going to drive down the licensing costs.
Wes Wright: 12:31 Yeah. Uh, yeah, It will for us if I don't have to pay a Citrix license or a VM tax.
Bill Russell: 12:36 Oh yeah. Okay. I see what you're saying. Yeah. So we were a significant citric shops.
Wes Wright: 12:42 Yeah. It sounds like we're a lot the same. I ran, that's what I ran to.
Bill Russell: 12:47 Um, well it's interesting because Citrix is so Citrix is, is uh, starting to get into that identity space and essentially saying, look, uh, to, to a certain extent you can get rid of some of the licensing and around badging in that goes. Yep. Yep. So do they end up becoming a competitor or something?
Bill Russell: 13:08 Not really. We still have a pretty good relationships are really deep into Yup. Yup, Yup, Yup. Uh, we do a lot of work with them, of course. Sorry, on the receiver and that kind of stuff. Yeah. We had with both Citrix and Vm, we have a really good relationships because really it's our VDA product that allows those Vdi stacks to work. So it's a pretty symbiotic relationship. So one of the interesting conversations I just had was a lot of mergers going on lot of displacement within health care and whatnot. Let's talk career for a second. So you've been on the provider side, now you're on the vendor side. Um, you know, when these people get displaced and then you could go to the vendor direction, if you could go in the provider, our consulting back in, in those kind of things. Uh, you know, what, what would you tell people who are trying to make that transition?
Wes Wright: 14:00 The, the gist I got displaced transition or the transition to the Var side is because it's happening at a fair amount of it is, but you know, I also see there's a fair amount of the, you know, the old gray hairs that are retiring now too, that just don't want to mess with.
Bill Russell: 14:18 I'm not going to take it personnel
Wes Wright: 14:20 you shouldn't. Uh, you're just gray hair. Not all.
Bill Russell: 14:23 No, I, well, I said, yeah, I am a, I am not as old as some of the CIO's who I've been talking to.
Wes Wright: 14:30 Exactly. That's what I mean. Those people are starting to retire cause you know, with the new high tech and the interruptability, you know, they just go, no mass, I'm just, I'm just tired of, and that's creating a bunch of opportunity out there. I think that people need to just be aware of. Yeah. I asked John Halakah what he's looking for in the CTO. He, I'm looking for somebody with, uh, with very little gray hair who's going to really push the envelope. Somebody who's going to be,
Wes Wright: 14:57 I think every CIO was looking for that. Yeah, yeah. Well are they out their card the other day? There's a few, there's a few out there. Um, you know, I think somewhere, somewhere in our CIO career or healthcare CIO career, we decided that it was better that a CIO really know the business more than the technology. And, and I think, I think we did ourselves a disservice. Um, you know, that's why I think we see a bunch of the non-healthcare CIO is coming in because they, they know their technology stack really deep then can apply that to the business where we have been going, well, let's know the business really good and see how we can use the it staff. They've, the non-healthcare world goes the opposite way. So
Bill Russell: 15:54 yeah, so a Cio, traditional chief innovation officers, chief digital officers come up. And, uh, I think part of that is what you're describing is that the, uh, Cio said, hey, I want to be at the table and I to, I want to know the business. Well, that's all well and good, but we need the, we need to get stuff done faster than we've ever had before. And so if the CIO spending all this time on the business, somebody needs to be looking at architecture and saying, hey, you know what, in order to be agile, we need, we need architecture.
Wes Wright: 16:26 Yeah. Yeah. And you know, I've worked with drex in several different place, the drex to Ford in several different places. That's exactly how we separated things. I mean, it was like, okay. He goes up, I concentrate on down and that's the key. That's where you need a CTO for. If you're going to focus on the business, then you need somebody focusing on operations and the it stack and the innovation. Yeah. Wes, thank you for your time. Oh, grabbed you yesterday, man. You were really dressed up yet when I called my Imprivata uniform on red shoes. Red Shirt. Red Hoodie. Wow. Yeah, cause it looks pretty wild. Looked. Very California. Thank you. Thank you. That's what I was going for. Great. Great, great. Hanging out with you. You can go get it.
Bill Russell: 17:09 I hope you enjoyed this conversation. This shows a production of this week in health it for more great content. You can check out our website @www.thisweekinhealthit.com or the youtube channel at thisweekinhealthit.com/video. Thanks for listening. That's all for now.