(light upbeat music) >> Hey, everyone. Welcome back to theCUBE's day long coverage of Women in Data Science 2023. Live from Stanford University, I'm Lisa Martin. We've had some amazing conversations today with my wonderful co-host, as you've seen. Tracy Zhang joins me next for a very interesting and inspiring conversation. I know we've been bringing them to you, we're bringing you another one here. Dr. Irene Dankwa-Mullan joins us, the Chief Medical Officer at Marti Health, and a speaker at WIDS. Welcome, Irene, it's great to have you. >> Thank you. I'm delighted to be here. Thank you so much for this opportunity. >> So you have an MD and a Master of Public Health. Covid must have been an interesting time for you, with an MPH? >> Very much so. >> Yeah, talk a little bit about you, your background, and Marti Health? This is interesting. This is a brand new startup. This is a digital health equity startup. >> Yes, yes. So, I'll start with my story a little bit about myself. So I was actually born in Ghana. I finished high school there and came here for college. What would I say? After I finished my undergraduate, I went to medical school at Dartmouth and I always knew I wanted to go into public health as well as medicine. So my medical education was actually five years. I did the MPH and my medical degree, at the same time, I got my MPH from Yale School of Public Health. And after I finished, I trained in internal medicine, Johns Hopkins, and after that I went into public health. I am currently living in Maryland, so I'm in Bethesda, Maryland, and that's where I've been. And really enjoyed public health, community health, combining that aspect of sort of prevention and wellness and also working in making sure that we have community health clinics and safety net clinics. So a great experience there. I also had the privilege, after eight years in public health, I went to the National Institute of Health. >> Oh, wow. >> Where I basically worked in clinical research, basically on minority health and health disparities. So, I was in various leadership roles and helped to advance the science of health equity, working in collaboration with a lot of scientists and researchers at the NIH, really to advance the science. >> Where did your interest in health equity come from? Was there a defining moment when you were younger and you thought "There's a lot of inequities here, we have to do something about this." Where did that interest start? >> That's a great question. I think this influence was basically maybe from my upbringing as well as my family and also what I saw around me in Ghana, a lot of preventable diseases. I always say that my grandfather on my father's side was a great influence, inspired me and influenced my career because he was the only sibling, really, that went to school. And as a result, he was able to earn enough money and built, you know, a hospital. >> Oh wow. >> In their hometown. >> Oh my gosh! >> It started as a 20 bed hospital and now it's a 350 bed hospital. >> Oh, wow, that's amazing! >> In our hometown. And he knew that education was important and vital as well for wellbeing. And so he really inspired, you know, his work inspired me. And I remember in residency I went with a group of residents to this hospital in Ghana just to help over a summer break. So during a summer where we went and helped take care of the sick patients and actually learned, right? What it is like to care for so many patients and- >> Yeah. >> It was really a humbling experience. But that really inspired me. I think also being in this country. And when I came to the U.S. and really saw firsthand how patients are treated differently, based on their background or socioeconomic status. I did see firsthand, you know, that kind of unconscious bias. And, you know, drew me to the field of health disparities research and wanted to learn more and do more and contribute. >> Yeah. >> Yeah. So, I was curious. Just when did the data science aspect tap in? Like when did you decide that, okay, data science is going to be a problem solving tool to like all the problems you just said? >> Yeah, that's a good question. So while I was at the NIH, I spent eight years there, and precision medicine was launched at that time and there was a lot of heightened interest in big data and how big data could help really revolutionize medicine and healthcare. And I got the opportunity to go, you know, there was an opportunity where they were looking for physicians or deputy chief health officer at IBM. And so I went to IBM, Watson Health was being formed as a new business unit, and I was one of the first deputy chief health officers really to lead the data and the science evidence. And that's where I realized, you know, we could really, you know, the technology in healthcare, there's been a lot of data that I think we are not really using or optimizing to make sure that we're taking care of our patients. >> Yeah. >> And so that's how I got into data science and making sure that we are building technologies using the right data to advance health equity. >> Right, so talk a little bit about health equity? We mentioned you're with Marti Health. You've been there for a short time, but Marti Health is also quite new, just a few months old. Digital health equity, talk about what Marti's vision is, what its mission is to really help start dialing down a lot of the disparities that you talked about that you see every day? >> Yeah, so, I've been so privileged. I recently joined Marti Health as their Chief Medical Officer, Chief Health Officer. It's a startup that is actually trying to promote a value-based care, also promote patient-centered care for patients that are experiencing a social disadvantage as a result of their race, ethnicity. And were starting to look at and focused on patients that have sickle cell disease. >> Okay. >> Because we realize that that's a population, you know, we know sickle cell disease is a genetic disorder. It impacts a lot of patients that are from areas that are endemic malaria. >> Yeah. >> Yeah. >> And most of our patients here are African American, and when, you know, they suffer so much stigma and discrimination in the healthcare system and complications from their sickle cell disease. And so what we want to do that we feel like sickle cell is a litmus test for disparities. And we want to make sure that they get in patient-centered care. We want to make sure that we are leveraging data and the research that we've done in sickle cell disease, especially on the continent of Africa. >> Okay. >> And provide, promote better quality care for the patients. >> That's so inspiring. You know, we've heard so many great stories today. Were you able to watch the keynote this morning? >> Yes. >> I loved how it always inspires me. This conference is always, we were talking about this all day, how you walk in the Arrillaga Alumni Center here where this event is held every year, the vibe is powerful, it's positive, it's encouraging. >> Inspiring, yeah. >> Absolutely. >> Inspiring. >> Yeah, yeah. >> It's a movement, WIDS is a movement. They've created this community where you feel, I don't know, kind of superhuman. "Why can't I do this? Why not me?" We heard some great stories this morning about data science in terms of applications. You have a great application in terms of health equity. We heard about it in police violence. >> Yes. >> Which is an epidemic in this country for sure, as we know. This happens too often. How can we use data and data science as a facilitator of learning more about that, so that that can stop? I think that's so important for more people to understand all of the broad applications of data science, whether it's police violence or climate change or drug discovery or health inequities. >> Irene: Yeah. >> The potential, I think we're scratching the surface. But the potential is massive. >> Tracy: It is. >> And this is an event that really helps women and underrepresented minorities think, "Why not me? Why can't I get involved in that?" >> Yeah, and I always say we use data to make an make a lot of decisions. And especially in healthcare, we want to be careful about how we are using data because this is impacting the health and outcomes of our patients. And so science evidence is really critical, you know? We want to make sure that data is inclusive and we have quality data. >> Yes. >> And it's transparent. Our clinical trials, I always say are not always diverse and inclusive. And if that's going to form the evidence base or data points then we're doing more harm than good for our patients. And so data science, it's huge. I mean, we need a robust, responsible, trustworthy data science agenda. >> "Trust" you just brought up "trust." >> Yeah. >> I did. >> When we talk about data, we can't not talk about security and privacy and ethics but trust is table stakes. We have to be able to evaluate the data and trust in it. >> Exactly. >> And what it says and the story that can be told from it. So that trust factor is, I think, foundational to data science. >> We all see what happened with Covid, right? I mean, when the pandemic came out- >> Absolutely. >> Everyone wanted information. We wanted data, we wanted data we could trust. There was a lot of hesitancy even with the vaccine. >> Yeah. >> Right? And so public health, I mean, like you said, we had to do a lot of work making sure that the right information from the right data was being translated or conveyed to the communities. And so you are totally right. I mean, data and good information, relevant data is always key. >> Well- >> Is there any- Oh, sorry. >> Go ahead. >> Is there anything Marti Health is doing in like ensuring that you guys get the right data that you can put trust in it? >> Yes, absolutely. And so this is where we are, you know, part of it would be getting data, real world evidence data for patients who are being seen in the healthcare system with sickle cell disease, so that we can personalize the data to those patients and provide them with the right treatment, the right intervention that they need. And so part of it would be doing predictive modeling on some of the data, risk, stratifying risk, who in the sickle cell patient population is at risk of progressing. Or getting, you know, they all often get crisis, vaso-occlusive crisis because the cells, you know, the blood cell sickles and you want to avoid those chest crisis. And so part of what we'll be doing is, you know, using predictive modeling to target those at risk of the disease progressing, so that we can put in preventive measures. It's all about prevention. It's all about making sure that they're not being, you know, going to the hospital or the emergency room where sometimes they end up, you know, in pain and wanting pain medicine. And so. >> Do you see AI as being a critical piece in the transformation of healthcare, especially where inequities are concerned? >> Absolutely, and and when you say AI, I think it's responsible AI. >> Yes. >> And making sure that it's- >> Tracy: That's such a good point. >> Yeah. >> Very. >> With the right data, with relevant data, it's definitely key. I think there is so much data points that healthcare has, you know, in the healthcare space there's fiscal data, biological data, there's environmental data and we are not using it to the full capacity and full potential. >> Tracy: Yeah. >> And I think AI can do that if we do it carefully, and like I said, responsibly. >> That's a key word. You talked about trust, responsibility. Where data science, AI is concerned- >> Yeah. >> It has to be not an afterthought, it has to be intentional. >> Tracy: Exactly. >> And there needs to be a lot of education around it. Most people think, "Oh, AI is just for the technology," you know? >> Yeah, right. >> Goop. >> Yes. >> But I think we're all part, I mean everyone needs to make sure that we are collecting the right amount of data. I mean, I think we all play a part, right? >> We do. >> We do. >> In making sure that we have responsible AI, we have, you know, good data, quality data. And the data sciences is a multi-disciplinary field, I think. >> It is, which is one of the things that's exciting about it is it is multi-disciplinary. >> Tracy: Exactly. >> And so many of the people that we've talked to in data science have these very non-linear paths to get there, and so I think they bring such diversity of thought and backgrounds and experiences and thoughts and voices. That helps train the AI models with data that's more inclusive. >> Irene: Yes. >> Dropping down the volume on the bias that we know is there. To be successful, it has to. >> Definitely, I totally agree. >> What are some of the things, as we wrap up here, that you're looking forward to accomplishing as part of Marti Health? Like, maybe what's on the roadmap that you can share with us for Marti as it approaches the the second half of its first year? >> Yes, it's all about promoting health equity. It's all about, I mean, there's so much, well, I would start with, you know, part of the healthcare transformation is making sure that we are promoting care that's based on value and not volume, care that's based on good health outcomes, quality health outcomes, and not just on, you know, the quantity. And so Marti Health is trying to promote that value-based care. We are envisioning a world in which everyone can live their full life potential. Have the best health outcomes, and provide that patient-centered precision care. >> And we all want that. We all want that. We expect that precision and that personalized experience in our consumer lives, why not in healthcare? Well, thank you, Irene, for joining us on the program today. >> Thank you. >> Talking about what you're doing to really help drive the volume up on health equity, and raise awareness for the fact that there's a lot of inequities in there we have to fix. We have a long way to go. >> We have, yes. >> Lisa: But people like you are making an impact and we appreciate you joining theCUBE today and sharing what you're doing, thank you. >> Thank you. >> Thank you- >> Thank you for having me here. >> Oh, our pleasure. For our guest and Tracy Zhang, this is Lisa Martin from WIDS 2023, the eighth Annual Women in Data Science Conference brought to you by theCUBE. Stick around, our show wrap will be in just a minute. Thanks for watching. (light upbeat music)

(upbeat music) >> TheCUBE presents UiPath Forward 5. Brought to you by UiPath. >> Hello and welcome back to TheCUBE's coverage of UiPath Forward 5. We're here in Las Vegas at the Venetian Convention Center. This is day two. We're wrapping up Dave Nicholson and Dave Vellante. This is the fourth time theCUBE has been at UiPath Forward. And we've seen the transformation of the company from, essentially, what was a really interesting and easy to adopt point product to now one through acquisitions, IPO, has made a number of enhancements to its platform. David Cardenas is here. Deputy Director of Operations for County of Los Angeles, the Department of Public Health. David, good to see you. Thanks for coming on theCUBE. >> Thanks for having me on guys. Appreciate it. >> So what is your role? What does it have to do with automation? >> So I had been, actually started off in the IT space within the public health. Had served as a CIO previously, but now been moving into broader operations. And I basically manage all of the back office operations for the department, HR, IT, finance, all that. >> So you've had a wild ride in the last couple of years. >> Yeah, I think, like I've been talking earlier, it's just been, the last two years have just been horrendous. It's been a really difficult experience for us. >> Yeah, and I mean, the scars are there, and maybe permanently. But it also had major effects on organizations, on operations that, again, seem to be permanent. How would you describe the situation in your organization? >> So I think it, the urgency that came along with the pandemic response, kind of required us to look at things, you know, differently. We had to be, realize we had to be a lot more nimble than when we were and try to figure out how to enhance our operations. But really look at the core of what we're doing and figure out how it is to be more efficient. So I think we've kind of seen it as an opportunity to really examine ourselves a little bit more deeply and see what things we need to do to kind of, to fix our operations and get things on a better path. >> You know, I think a lot of organizations we talked to say that. But I want to understand how you handle this is, you didn't have time to sit back in the middle of the pandemic. >> Yeah. >> And then as you exit, what I call the isolation economy, people are so burned out, you know? So how do you deal with that organizational trauma? Say, okay now, let's sit back and think about this. Do people, are they eager to do so? Do they have the appetite for it? What's that dynamic like? >> So I think certainly there's a level of exhaustion inside the organization. I can't say that there isn't because it's just been, you know, two years of 24/7/365 kind of work. And that's tough on any organization. But I think what we realize is that there's, you know, we need to move into action quickly 'cause we don't know what's going to come next, right? And we're expecting that this is just a sign of what's to come and that we're just at the start of that stage of, we're just going to see a lot more outbreaks, we're going to see a lot more conditions kind of hitting us. And if we're not prepared for that, we're not going to be able to respond for the, and preserve the health and safety of our citizens, right? So I think we're taking a very active, like, look at these opportunities and see what we've done and say how do we now make the changes that we made in response to the pandemic permanent so that the next time this comes at us, we won't have to be struggling the way that we were to try to figure things out because we'll have such a better foundation in place to be able to move things forward. >> I mean, I've never served in the military, but I imagine that when you're in the military, you're always prepared for some kind of, you know, in your world, code red, right? >> Yeah. >> So it's like this code red culture. And that seems to have carried through, right? People are, you know, constantly aware that, wow. We got caught off guard and we don't want that to happen again. Because that was a big part of the trauma was just the unknown- >> Right. >> and the lack of preparedness. So thinking about technology and its role in helping you to prepare for that type of uncertainty. Can you describe how you're applying technology to prepare for the next unknown? >> So I think, so that first part of what you said, I think the difficulty we've always had in the public health side is that there's the, generally the approach to healthcare is very reactionary, right? Your first interface with the healthcare system is, "I'm going to go see my doctor; I'm going to go to the hospital." The work that we do in public health is to try to do everything we can to keep you out of that, right? So it's broad-based messaging, social media now is going to put us out there. But also, to be able to surveil disease in a different way. And so the holy grail for us in healthcare has always been, at least on the public health side, has been to try to see how can we tap in more actively that when you go see the doctor or when you go to the hospital, how can I get access to that information very, very quickly so that I know, and can see, and surveil my entire county in my jurisdiction and know, oh, there's an outbreak of disease happening in this section of the county. We're 10 million people with, you know, hundreds of square miles inside of LA. There are places where we can see very, you know, specific targets that we know we have to hit. But the data's a little stale and we find out several months after. We need to figure out a way to do that more actively. Technology's going to be our path to be able to capture that information more actively and come up on something a little bit, so we can track things faster and be able to respond more quickly. So that's our focus for all our technology implementations, automation like UiPath has offered us and other things, is around how to gather that information more quickly and put that into action so we can do quick interventions. >> People have notoriously short memories. Please tell me (chuckles) any of the friction that you may have experienced in years past before the pandemic. That those friction points where people are thinking, "Eh, what are the odds?" >> Yeah. "Eh, I've got finite budget, I think I'm going to spend it on this thing over here." Do you, are you able to still ride sort of the wave of mind share at this point when putting programs together for the future? >> So whatever friction was there during the pandemic wiped away. I mean, we had amazing collaboration with the medical provider community, our hospital partners. The healthcare system in LA was working very closely with us to make sure that we were responding. And there is that wave that we are trying to make sure that we use this as an opportunity to kind of ride it so that we can implement all the things that we want. 'Cause we don't know how long that's going to last us. The last time that I saw anything this large was after the anthrax attacks and the bioterrorism attacks that we had after 9/11. >> How interesting. >> Public health was really in lens at that point. And we had a huge infusion of funding, a lot of support from stakeholders, both politically and within the healthcare system. And we were able to make some large steps in movement at that point. This feels the same but in a larger scale because now it touched every part of the infrastructure. And we saw how society really had to react to what was going on in a different way than anyone has ever prepared for. And so now is we think is a time where we know that people are making more investments. And our success is going to be their success in the longterm. >> And you have to know that expectations are now set- >> Extremely high. >> at a completely different level, right? >> Yes, absolutely. >> There is no, "Oh, we don't have enough PPE." >> Correct. >> Right? >> David: Correct. >> The the expectation level is, hey, you should have learned from all of- >> We should have it; we can deliver it, We'll have it at the ready when we need to provide it. Yes, absolutely. >> Okay, so I sort of mentioned, we're, David cubed on theCUBE (all laughing). So three Daves. You spoke today at the conference? >> Actually I'm speaking later actually in the session in an hour or so. >> Oh Okay. My understanding is that you've got this concept of putting humans at the center of the automation. What does that mean? Why is that important? Help us understand that. >> So I think what we found in the crisis is that the high demand for information was something we hadn't seen before, right? We're one of the largest media markets in the United States. And what we really had trouble with is trying to figure out how to serve the residents, to provide them the information that we needed to provide to them. And so what we had traditionally done is press releases, you know, just general marketing campaigns, billboards, trying to send our message out. And when you're talking about a pandemic where on a daily basis, hour-by-hour people wanted to know what was going on in their local communities. Like, we had to change the way that we focused on. So we started thinking about, what is the information that the residents of our county need? And how can we set up an infrastructure to sustain the feeding of that? Because if we can provide more information, people will make their own personal decisions around their personal risk, their personal safety measures they need to take, and do so more actively. More so than, you know, one of us going on camera to say, "This is what you should do." They can look for themselves and look at the data that's in front of them and be able to make those choices for themselves, right? And so we needed to make sure that everything that we were doing wasn't built around feeding it to our political stakeholders, which are important stakeholders. We needed to make sure that they're aware and are messaging out, and our leadership are aware. But it's what could we give the public to be able to make them have access to information that we were collecting on an every single day basis to be able to make the decisions for their lives. And so the automation was key to that. We were at the beginning of the pandemic just had tons and tons of resources that we were throwing at the problem that was, our systems were slow, we didn't have good ability to move data back and forth between our systems, and we needed a stop-gap solution to really fill that need and be able to make the data cycles to meet the data cycles. We had basically every day had to deliver reports and analytics and dashboards by like 10 o'clock in the morning because we knew that the 12 an hour and the five-hour news cycles were going to hit and the press were going to then take those and message out. And the public started to kind of come in at that same time and look at 10 and 11 o'clock and 12 o'clock. >> Yeah. >> We could see it from how many hits were hitting our website, looking for that information. So when we failed and had a cycle where that data cycle didn't work and we couldn't deliver, the public would let us know, the press would let us know, the stakeholders would let us know. We had never experienced anything like that before, right. Where people had like this voracious appetite for the information. So we needed to have a very bulletproof process to make sure that every single 24 hours we were delivering that data, making it available at the ready. >> Software robots enabled that. >> Exactly. >> Okay. And so how were you able to implement that so quickly within such a traumatic environment? >> So I think, I guess necessity is always the mother of invention. It kind of drove us to go real quickly to look at what we had. We had data entry operations set up where we had dozens and dozens of people whose sole job in life on a 24-hour cycle was to receive medical reports that we we're getting, interview data that's coming from our case interviews, hospitalization data that was coming in through all these different channels. And it was all coming in in various forms. And they were entering that into our systems of record. And that's what we were using, extracts from that system of record, what was using to generate the data analyses in our systems and our dashboards. And so we couldn't rely on those after a while because the data was coming in at such high volume. There wasn't enough data entry staff to be able to fit the need, right? And so we needed to replace those humans and take them out of that data entry cycle, pop in the bots. And so what we started to look at is, let's pick off the, where it is that that data entry cycle starts and see what we could do to kind of replace that cycle. And we started off with a very discreet workload that was focused on some of our case interview data that was being turned into PDFs that somebody was using to enter into our systems. And we said, "Well before you do that," since we can't import into the systems 'cause it wasn't working, the import utilities weren't working. We got 'em into simple Excel spreadsheets, mapped those to the fields in our systems and let the bots do that over and over again. And we just started off with that one-use case and just tuned it and went cycle after cycle. The bots just got better and better to the point where we had almost like 95% success rates on each submission of data transactions that we did every day. >> Okay, and you applied that automation, I don't know, how many bots was it roughly? >> We're now at like 30; we started with about five. >> Okay, oh, interesting. So you started with five and you applied 'em to this specific use case to handle the velocity and volume of data- >> Correct. >> that was coming in. But that's obviously dynamic and it's changed. >> Absolutely. >> I presume it's shifted to other areas now. So how did you take what you learned there and then apply it to other use cases in other parts of the organization? >> So, fortunately for us, the process that was being used to capture the information to generate the dashboards and the analyses for the case interview data, which is what we started with- >> Yeah. >> Was essentially being used the same for the hospitalization data that we were getting and for tracking deaths as they were coming in as well. And so the bots essentially were just, we just took one process, take the same bots, copy them over essentially, and had them follow the very same process. We didn't try to introduce any different workflow than what was being done for the first one so we could replicate quickly. So I think it was lucky for us a lot- >> Dave V.: I was going to say, was that luck or by design? >> It was the same people doing the same analyses, right? So in the end they were thinking about how to be efficient themselves. So they kind of had coalesced around a similar process. And so it was kind of like fortunate, but it was by design in terms of how they- >> Dave V.: It was logical to them. >> Logical to them to make it. >> Interesting. >> So for us to be able to insert the bots became pretty easy on the front end. It's just now as we're trying to now expand to other areas that were now encountering like unique processes that we just can't replicate that quickly. We're having to like now dig into. >> So how are you handling that? First of all, how are you determining which processes? Is it sort of process driven? Is it data driven? How do you determine that? >> So obviously right now the focus still is COVID. So the the priorities scale that we've set internally for analyzing those opportunities really is centered around, you know, which things are really going to help our pandemic response, right? We're expecting another surge that's going to happen probably in the next couple of weeks. That'll probably take us through December. Hopefully, at that point, things start to calm down. But that means high-data volume again; these same process. So we're looking at optimizing the processes that we have, what can we do to make those cycles better, faster, you know, what else can we add? The data teams haven't stopped to try to figure out how else can they turn out new data reports, new data analysis, to give us a different perspective on the new variants and the new different outbreaks and hotspots that are popping up. And so we also have to kind of keep up with where they're going on these data dashboards. So they're adding more data into these reports so we know we have to optimize that. And then there's these kind of tangential work. So for example, COVID brought about, unfortunately, a lot of domestic violence reports. And so we have a lot of domestic violence agencies that we work with and that we have interactions with and to monitor their work, we have certain processes. So that's kind of like COVID-adjacent. But it's because it's such a very critical task, we're looking at how we can kind of help in those processes and areas. Same thing in like in our substance abuse area. We have substance use disorder treatment services that we provide. And we're delivering those at a higher rate because COVID kind of created more of a crisis than we would've liked. And so that's how we're prioritizing. It's really about what is the social need, what does the community need, and how can we put the technology work in those areas? >> So how do you envision the future of automation in your organization and the future of your organization? What does that look like? Paint a picture for us. >> So I'm hoping that it really does, you know, so we're going to take everything that's COVID related in the disease control areas, both in terms of our laboratory operations, in terms of our clinic operations, the way we respond, vaccination campaigns, things of that nature. And we're going to look at it to see what can efficiencies can we do there because it's a natural outgrowth of everything we've done on COVID up to this point. So, you know, it's almost like it's as simple as you're just replicating it with another disease. The disease might have different characteristics, but the work process that we follow is very similar. It's not like we're going to change everything and do something completely different for a respiratory condition as we would for some other type of foodborne condition or something else that might happen. So we certainly see very easy opportunities to just to grow out what we've already done in terms of the processes is to do that. So that's wave one, is really focus on that grow out. The second piece I think is to look at these kind of other general kind of community-based type of operations and see what operations we can do there to kind of implement some improvements there. And then I'm certainly in my new role of, in Deputy Director of Operation, I'm a CIO before. Now that I'm in this operations role, I have access to the full administrative apparatus for the department. And believe me, there's enough to keep me busy there. (Dave V. Laughing) And so that's going to be kind of my third prong is to kind of look at the implement there. >> Awesome. Go ahead, Dave. >> Yeah, so, this is going to be taking a step back, kind of a higher level view. If we could direct the same level of rigor and attention towards some other thing that we've directed towards COVID, if you could snap your fingers and make that happen, what would that thing be in the arena of public health in LA County in particular, or if you want California, United States. What is something that you feel maybe needs more attention that it's getting right now? >> So I think I touched on it a little bit earlier, but I think it's the thing we've been always been trying to get to is how to really become just very intentional about how we share data more actively, right? I don't have to know everything about you, but there are certain things I care about when you go to the doctor for that doctor and that physician to tell me. Our physicians, our healthcare system as you know, is always under a lot of pressure. Doctors don't have the time to sit down and write a form out for me and tell me everything that's going on. During COVID they did because they were, they cared about their patients so much and knew, I need to know what's going on at every single moment. And if I don't tell you what's going on in my office, you'll never know and can't tell us what's going on in the community. So they had a vested interest in telling us. But on a normal day-to-day, they don't have the time for that. I got to replace that. We got to make sure that when we get to, not me only, but everyone in this public health community has to be focused and working with our healthcare partners to automate the dissemination and the distribution of information so that I have the information at my fingers, that I can then tell you, "Here's what's going on in your local community," down to your neighborhood, down to your zip code, your census tracked, down to your neighbors' homes. We'll be able to tell you, "This is your risk. Here are the things that are going on. This is what you have to watch out for." And the more that we can be more that focused and laser-focused on meeting that goal, we will be able to do our job more effectively. >> And you can do that while preserving people's privacy. >> Privacy, absolutely. >> Yeah, absolutely. But if people are informed then they can make their own decisions. >> Correct. >> And they're not frustrated at the systems. David, we got to wrap. >> Sure. >> But maybe you can help us. What's your impression of the, first of all, is this your first Forward? You've been to others? >> This is my first time. >> Okay. >> My first time. >> What's your sort of takeaway when you go back to the office or home and people say, "Hey, how was the show? What, what'd you learn?" What are you going to say? >> Well, from just seeing all the partners here and kind of seeing all the different events I've been able to go to and the sessions there's, you don't know many times I've gone to and say, "We've got to be doing that." And so there's certainly these opportunities for, you know, more AI, more automation opportunities that we have not, we just haven't even touched on really. I think that we really need to do that. I have to be able to, as a public institution at some point our budgets get capped. We only have so much that we're going to receive. Even riding this wave, there's only so much we're going to be able to get. So we have to be very efficient and use our resources more. There's a lot more that we can do with AI, a lot more with the tools that we saw, some of the work product that are coming out at this conference that we think we can directly apply to kind of take the humans out of that, their traditional roles, get them doing higher level work so I can get the most out of them and have this other more mundane type of work, just have the systems just do it. I don't need anybody doing that necessarily, that work. I need to be able to leverage them for other higher level capabilities. >> Well thank you for that. Thanks for coming on theCUBE and really appreciate. Dave- >> It's been great talking to you guys, thank you. >> Dave, you know, I love software shows because the business impact is so enormous and I especially love cool software shows. You know, this first of all, the venue. 3,500 people here. Very cool venue. I like the fact that it's not like booth in your face, booth competition. I mean I love VMware, VMworld, VMware Explore. But it's like, "My booth is bigger than your booth." This is really nice and clean, and it's all about the experience. >> A lot of steak, not as much sizzle. >> Yeah, definitely. >> A lot of steak. >> And the customer content at the UiPath events is always outstanding. But we are entering a new era for UiPath, and we're talking. We heard a lot about the Enterprise platform. You know, the big thing is this company's been in this quarterly shock-lock since last April when it went public. And it hasn't all been pretty. And so new co-CEO comes in, they've got, you know, resetting priorities around financials, go to market, they've got to have profitable growth. So watching that that closely. But also product innovation so the co-CEOs will be able to split that up, split their duties up. Daniel Dines the product visionary, product guru. Rob Enslin, you know- making the operations work. >> Operations execution business, yeah. >> We heard that Carl Eschenbach did the introduction. Carl's a major operator, wanted that DNA into the company. 'Cause they got to keep product innovation. And I want to, I want to see R&D spending, stay relatively high. >> Product innovation, but under the heading of platform. And that's the key thing is just not being that tool set. The positioning has been, I think, accurate that, you know, over history, we started with these RPA tools and now we've moved into business process automation and now we're moving into new frontiers where, where truly, AI and ML are being leveraged. I love the re-infer story about going in and using natural national (chuckles) national, natural language processing. I can't even say it, to go through messaging. That's sort of a next-level of intelligence to be able to automate things that couldn't be automated before. So that whole platform story is key. And they seem to have made a pretty good case for their journey into platform as far as I'm concerned. >> Well, yeah, to me again. So it's always about the customers, want to come to an event like this, you listen to what they say in the keynotes and then you listen to what the customers say. And there's a very strong alignment in the UiPath community between, you know, the marketing and the actual implementation. You know, marketing's always going to be ahead. But, we saw this a couple of years ago with platform. And now we're seeing it, you know, throughout the customer base, 10,000+ customers. I think this company could have, you know, easily double, tripled, maybe even 10x that. All right, we got to wrap. Dave Nicholson, thank you. Two weeks in a row. Good job. And let's see. Check out siliconangle.com for all the news. Check out thecube.net; wikibon.com has the research. We'll be on the road as usual. theCUBE, you can follow us. UiPath Forward 5, Dave Vellante for Dave Nicholson. We're out and we'll see you next time. Thanks for watching. (gentle music)

[upbeat electronic music] >> Hi everyone, welcome back to theCUBE's coverage of AnsibleFest 2021. I'm John Furrier, your host of theCUBE. We're here with Eric Pennington, Director of Solutions Engineering, and Mike Todaro, Senior Epic Cache Consultant at Sapphire Health. Gentlemen, thank you for coming on theCUBE and chatting about the wave of Cloud, cloud-native, Sapphire Health and Ansible. Thanks for coming on. >> Thanks for having us. >> Thank you. >> So, let's get started. Can you guys just briefly describe Sapphire Health and what you guys are doing there. The consulting services, the trends that you're seeing. Just take a step, a minute to describe the environment at Sapphire Health and what you guys are doing. >> For sure, yeah. So, Sapphire Health was a consultancy that was founded by the CEO back in 2016, Austin Park, who also serves as a CTO for some healthcare organizations, because he was having difficulty finding an organization that really specialized in Epic infrastructure. So you might be familiar with some of the large players in Epic consultancies, but they are typically focused more on the application side, so configuring like the ambulatory clinical system or something like that. And there really wasn't a solution that he could find in the market for an organization that was focused on Epic infrastructure and some of the more technical components of managing an Epic technical ecosystem. So, Austin founded a team. Mike was one of the early folks to join. I joined a little bit later. But he put a team together to, again, really focus on the technical components of an Epic implementation. And since then, we've been providing managed services for Epic infrastructure for a number of organizations. We've been focusing on platform migrations from, for example, AIX to REL for Epic organizations, and we've been focusing on some growth areas as well in the Cloud. Epic systems is now able to be hosted on the public Cloud, that's a relatively recent occurrence. So, we're working with some organizations in that space as well. Mike, anything you'd add there? >> No, I think that pretty much covers it. We've spent a large fraction of our effort making sure that we're engineering solutions for these clients that move them in the directions towards Cloud readiness, towards containerization, automation, and those sorts of things. I think Eric's description's spot on. >> So, you guys must be busy. I mean, I can only imagine the action happening right now as people realized, with the pandemic specifically, two areas that we've reported aggressive growth on was public sector and healthcare. Both were under massive strains of pressure to get faster. (chuckles) Can you guys just weigh in real quickly on what you guys are seeing and how that's impacted your consulting services, but also the customer. What's going on in their minds? >> Absolutely, we had some customers very early on in the beginning of the pandemic where we were given the cadence of updates coming from Epic, the needs for growth for those customers where both in ICU surge capability as well as just general admittance. There was a flurry of hardware purchasing, provisioning, set up. An increased cadence around patching for various pieces of the Epic environment including Epic code directly. All of those things. The tempo of all of that increased once the pandemic began, and we spent a significant fraction of time trying to find better ways, faster ways to engineer what we were already doing for clients, simply so that we could continue to keep up with the surge in demand without requiring an additional surge in investment in people, where it wasn't necessary. Obviously, some growth was necessary, but we wanted to help our clients get the most out of what they already had so that they could spend that money where it was needed to help patients. >> Yeah, awesome, great stuff. So, we're here at AnsibleFest getting into the action. It's all about automation. So I have to ask you guys, what led you to start exploring automation solutions at Sapphire Health? >> Yeah, so there's quite a few reasons. I would say the most critical is that we've been providing managed services to organizations around infrastructure management for some time. And as you can imagine, infrastructure management has some repetitive tasks, and I'm quoting my colleague, Mike, here, but a good administrator is a lazy administrator. And what we mean when we say that is, if there's a repetitive task that's being performed over and over again, if there's an opportunity to automate it, that's going to save us time. But more importantly, that's going to... Paul, these lights here. Let me move around a little bit, should come back, there we go. But it's going to provide an opportunity for us to focus on more value-add services for the client. It's going to reduce costs for the client in terms of the services that we're providing. And I think most importantly, it's removing the possibility for human error or the possibility for error overall. So it's a natural evolution of us observing the time that we're spending with our client partners, and again, it really provides a lot of value to Sapphire as an organization and our customer partners as well. >> Mike, you want to weigh in on this automation trend. How do you see it evolving? I mean, obviously sounds good when you want to automate things that you do repetitive tasks, but is there more going on that you see in automation that goes beyond just, okay, if you do it three times-automated kind of vibe. >> Sure. Automating repetitive tasks is the kiddie end of the pool. That's how we get... That's how we sell the idea to people who just don't get the concept yet. But there are workflows that really aren't feasible outside of automation. We tend to think of automation, in some cases in this sort of limited way, but automation is really... What we really are targeting with automation is more about workflow. It's less about individual tasks, and it's more about an idea of workflow or a business requirement from its origin all the way through its implementation. So, I've got just the simplest case that jumps immediately to mind, is I have a new hire, I've got to provision them an account. I need to provision it across multiple systems. I've got to do it in our single sign on. They need home directories. They might need access. They need building accesses we need to generate. You got to generate badges for these people. And these are all workflows that are normally disparate. You know, you have to take your sheet to this guy, take your sheet to this guy, here's my new hire form. Really, what you really want is, we got a new hire, everything's checked out, put it in this basket here and let the automation move it through all of these systems all the way across. And that's the sort of thing, like I said, that's a very limited, very simple idea, but that's the kind of thing we really want. We want to get in the door with automation with simple things and then we want to teach... We want clients and ourselves to be challenged, to be creative, to find new ways to apply it that aren't immediately obvious. >> Yeah, I was smiling because I love the example of the kiddie end of the pool because automation is going mainstream, and it used to be kind of, you know, for the geeks who were doing the hardcore stuff who got the whole big picture. Now you're seeing with AI automation moving in and with Cloud, a lot more automation happening. So, I can almost see in my mind mental image of people wearing bubbles in the pool, kind of like going in the deep end, get back over here. Stay in your lane. Yeah, but this is the trend, and I want to get into this because you guys are involved in this Epic migration that's been talked about. So for the folks that aren't in, say the health care space, put a little context around Epic and then I want to get into this whole migration discussion. I think that kind of points to some real value propositions. So, what is Epic for the folks outside healthcare? >> Sure, so Epic is one of the leading EHRs or electronic health records software in the world. It is by far the most deployed in the United States. What's involved in building an Epic, or performing an Epic migration. Epic is hundreds of systems. When you think about Epic as an umbrella concept, it is servers and end-user workstations and all of these things. When we talk about platform migration, what we're usually talking about is the transactional database. They call it the ODB or whichever term I think you feel applies best. When we perform all those migrations, we're usually talking about... When we perform one of those migrations, we're usually talking about an AIX to Red Hat migration, although you can just do hardware to hardware. Involved in that is a number of things. You're building new VMs. You're setting up patch cycles, setting up the patching server. Installing the various administration scripts that Epic provides. Installing the software that runs the DB, which at the moment is either InterSystems Cache or Iris. There's the provisioning of the local security users. There's the configuration of the OS. If you're moving from AIX to Red Hat, you're talking generally about a bit endians conversions, so, big endian to little endian, there's a tool for that. There's a lot of these little stats. And the thing is, is that, they're all very, very well defined and very similar, and so, they look identical in many of these cases from one implementation of Epic to the next. And that's not true for the entire Epic stack necessarily, but at the ODB level, this stuff is all very similar, and this is a very right place to automate. This screams automate, and we do this because, I mean, who wants to make mistakes. If you write and build your script and debug it, the script runs, it doesn't make mistakes. I make mistakes, the script doesn't. So, we do that, and we end up spending less time on these repetitive, unnecessary tasks. We guarantee the correctness of them, or we do a better job of guaranteeing the correctness of them, and all of that ends up saving money in the long run. >> That's awesome, and thanks for the context. I was going to get there on the automation piece. It really sets the table for the automation. Real quick clarification. How much or what kind of software work is involved in a migration? >> Oh, so there's the installation of... You have from the installation of the OS and the configuration of the OS, the building in the patch server, the implementation, testing, and patch cycling. There's those data conversions I talked about. There's environment refreshes where we copy an existing environment on a regular basis to another environment for things like testing, for troubleshooting purposes or for other reasons. There's more than one database for Epic. There's one big production database. You have training databases, and you have playground databases for people to work in so they can learn to use the system better, and then there are, I mean, there's a galaxy. >> Oh man, so it's a huge system. Okay, so I got to ask the security question. >> Sure. >> Is security element as important when selecting automation or how has that factored in? I mean, right now that's super important, obviously, records are key, but honestly, where does that fit into the automation piece of security? >> Yeah, I think that's a very important question, and as you alluded to, security is incredibly important. It's very important in healthcare in particular. And in fact, with healthcare, there's a lot of regulatory requirements. There's a lot of requirements that individual healthcare institutions have that we as a partner to that institution need to follow. So, as we were evaluating automation vendors and automation solutions, a highly secure system was not a nice to have or like a value add, it was something that was absolutely critical and paramount to being able to successfully automate any of the things that we're doing. So I'll turn it over to Mike to talk about some of the specifics, but as we evaluated Ansible, we saw that it really supported robust security. So, Mike, can you comment a little bit more on that? >> Sure. There's a number of ways that we use Ansible to help improve the security posture for clients. One of the ways is Ansible playbooks are written to be runnable against the server and nothing will change unless something is set incorrectly. And this lets us assure that the configuration is where we expect it to be so we don't get drift on these servers. Now, remember I said an Epic environment is a lot of servers. If one or two of these... >> John: Mike, if you don't mind, I need to interrupt. What is, when you say drift, what are you referring to? >> So when I say drift, what I mean is, if there's a bunch of different servers and I as an administrator have to work on one or two of these servers just for little things during the day, I might make a change on one of these servers advertently or inadvertently, and then that server's configuration is now slightly out of phase with the other servers, which could be benign, but it could also be a security hole. Having Ansible able to run nightly and continue to adjust these servers back to the expected baseline, and in the case of things like tower, be able to report that these things were out of position. Let us know, hey, it lets us reduce the attack surface, first of all. It lets us multiply it, like a force multiply our attention across this farm of servers, and it gives us that sort of clarity that we know we're doing what we have to do to make sure these servers continue to be safe. >> That's an awesome service. That right there is, I mean, just going in manually trying to figure all this stuff out, it's just a nightmare. I mean, what a great relief that is. I mean, just the alternative is what, you know, more pain and suffering human wise, that's the labor, and then risk on attack because people go to bed. >> I'm a patient. The thing is, on a personal note, I'm a patient too, all of us are. We all have doctors. We have to go to the hospital for things occasionally. And if we fail when we perform these security audits, if we fail when we perform these security checks, patient data can get lost. It can get sent to people who shouldn't have it. And I'm a patient, I have no desire for my medical information to be available anywhere but in the hands of my doctor or myself. And that's the thought I try to stay with when I'm working on these systems. I'm a patient. It's not that I'm doing this because... I mean, the knock-on effects of reducing liability for the customers cannot be ignored or overstated, and they're critical, but, ultimately, my eyesight is on the patient. >> Yeah and having that stability is huge. Okay, this brings up the whole automation thing as it becomes more mainstream for you guys, specifically, is critical. The system's there, you have to watch farms, all the action happening, it's a huge system. Complex automation is key. How are you guys continuing to push the automation envelope into the Sapphire Health's consulting practice? >> Well, as you mentioned, John, yeah, we're really taking a look at the entire technical infrastructure when we're working with our clients. And we are offering fully outsourced managed services for organizations, not just around the Epic infrastructure but things like networking devices, security and other third party systems. So with that, we're seeing a lot of these things that are going on, and we're always evaluating opportunities for automation. There's actually two areas in particular that we're seeing gain a lot of momentum with our customers, and we're seeing a lot of opportunity for automation. The first is business continuity and disaster recovery, specifically within Epic. So, Epic has very stringent requirements for resiliency, as you can imagine. When the system goes down, a hospital can't really do what it needs to do from a billing standpoint, a clinical standpoint, so very robust disaster recovery and resiliency standards and solutions are very important. However, there's not a lot of automation that's available either from Epic or, as far as I know, other consultancies, so what we did is we built a script that provides failover automation. So some of the tasks that would be very manual in terms of failing over to your DR solution, we've automated that, and that again, removes a lot of the opportunity for human error, really speeds up the failover process. And so with the customers that we work with, that's something that we provide. Another big area that we're seeing is environment refreshes. So within Epic, there are different environments that are, basically, all their data is copied over on a recurring basis from the production environment, and the refreshes can have a lot of manual steps involved, so we found an opportunity and have implemented some automation around environment refreshes for some of our managed services clients. And as we continue to go throughout, you know, building our Cloud practice in some other areas, I'm very confident that we're going to see, you know, infrastructure is code more opportunities for automation around areas like that. >> I mean, you guys got to love the DevOps vibe going on now. Mike, I mean, you guys have seen the movie before in the old legacy going back to the mainframes, so you probably still run into a lot of older systems that still do a purpose. I mean, I have a lot of friends and clients that are working in the big banks, and they still have all the old school that does their job well, but containerization and Cloud kind of give life to these systems because now we're living in this system architecture called distributed computing again with the Cloud. It's the same game, different, different stuff though. >> Absolutely. Years ago, almost every Epic client was running on AIX, and maybe not mainframe but more mini computer. The migration path for almost all of the clients has been to move from those AIX mini computers down to VMs running Red Hat, or running Linux, and the natural evolution of that path is to move at least disaster recovery data centers into the Cloud, and then for some clients, the economics say the whole data center to the Cloud. So, absolutely that path is, it's well forged, it's there. I suspect that we'll see a lot more of clients, even larger hospitals, beginning to move down that road in the near future. >> And for the folks watching who may not have the scar tissue that we have, AIX was IBM's old Unix, a kind of mid-range mini computer. It was kind of client server, it was client server going now again being modernized. So obviously Red Hat is now part of IBM, but it speaks not just to IBM, this is about Ansible, right. So this is like, there is action happening here, so this is a case study of pretty much all migrations. It's not just the fact that it's AIX to Red Hat, it's system to the new thing that has benefits. >> Absolutely. >> What's your take, Mike, on that that kind of paradigm, because a lot of people going through similar situations just change AIX to something else. You have a lot of this migration re-platforming going on with the opportunity to kind of tweak it and add stuff to it. What's your advice and what's your reaction to this big trend? >> My advice for this trend, honestly, my advice is when you're planning these migrations, you know they're coming. Even if you're not in the cycle yet, you know it's coming. My advice is start brainstorming your implementation of the automation now. Get your automation into the system as you platform into your new platform, because it is far easier to build that entire platform with automation as a critical component than it is to bolt it on later, and you will get much more out of your investment and time and effort if you've integrated it from the very beginning. I would say anyone that was looking to perform a platform migration now and hadn't already begun serious consideration of running automation or had no plans for an automation, was setting themselves up for a very long and very difficult road to hell, and I would advise against it at this point. >> Great, great insight, Mike and Eric. Thanks for coming on, appreciate your insight here. You guys want to give a quick plug for the company? What you guys are looking to do, hiring, any update you want to share because great, great content you guys just shared here. Thanks for doing that. Take a minute to put a plug for the company. >> Yeah, I think a quick plug here. Yeah, if you're a talented cache admin, there's not too many Mikes out there, so we're definitely looking for more Mikes. But more broadly, we're really looking to expand into the Cloud space. We're rapidly expanding our managed services opportunities, and what we're seeing is a lot of organizations have like one ODB admin or one client systems ECSA admin. And what they run into is that person will leave, that person will retire, that person needs to get married and go on their honeymoon. It's kind of a problem, so we're working with a lot of organizations to not just fully outsource their environment but to provide a hybrid-managed service to provide overflow, to provide capabilities, to scale up with upgrades and projects like that. So, talk to us, we're pretty darn good at it, as you heard from Mike. We've got a couple of Mikes, again, we could use more, so if you are a Mike, please reach out. >> I think we virtualized him, we just virtualized Mike, you know, virtualization is a huge trend. >> If data writes Mike, we need to do that, yeah. >> Are you a body, are you the real Mike? >> (laughing) As far as I know, my wife would appreciate it if you guys would clone me a few times. >> You know, I've heard horror stories, Eric, around root passwords, like, who has the root password, oh, she left two years ago, kind of situations, this happens. I mean, this is not... it sounds like crazy but people leave. >> Yeah, I mean, nobody works anywhere forever, right? >> Don't be that company where you lose the root password, and never mind the ransomware action. Oh my God, must be brutal. Anyway, we can go another segment on that. Eric, thank you for coming on. Mike, thank you for your insight, really appreciate it, thanks for coming on. Appreciate it. >> Absolutely. >> Absolutely, it was our pleasure. >> Stay right here for continued coverage of AnsibleFest 2021. This is theCUBE, I'm John Furrier. Thanks for watching. (slow tempo electronic music)

>> Narrator: From around the globe, it's theCUBE, with digital coverage of IBM Think 2021 brought to you by IBM. >> Welcome to theCUBEs coverage of IBM Think 2021. I'm Lisa Martin. Exciting conversation coming up about in vaccine cloud management. I've got two guests with me, Tim Elcott is here, the sales and delivery director of IBM services for Salesforce and Fran Thompson joins us as well, the CEO of the Health Service Executive in Ireland. Gentlemen, welcome to the program. >> Hi, there. >> Hi. >> Good to be here. >> So we're very socially distance, Northern California, UK. Glad to have you guys here. We're going to talk about what the Health Service Executive or HSE in Ireland has done with IBM and Salesforce to facilitate vaccine management. But Fran, let's go ahead and start with you, talk to us a little bit about HSE. >> Well, the HSE provides public health and social services to everyone living in Ireland, okay. We got Acute hospitals, community services nationally. We directly employ about 80,000 people and we formed a farther about 40,000 people. And our annual budget is slightly North of 21.6 billion a year. We are the largest employer in the state and the largest organizations in the state. And, you know, we provide a huge range of services right across the whole spectrum. And we also formed other organizations who provide those services as well. So we would fund some voluntary and charity organizations and we would also buy services from the likes of say GP and other organizations as well. >> So talk to me about a year or so ago when the pandemic hit what were some of the challenges that HSE faced? And then when it came time to, we have a vaccine, we have multiple vaccines that rollout capability what were some of the challenges that you faced initially? >> So from an organizational perspective, there were huge challenges in that we were like every other health service worldwide facing an enormous pandemic that was impacting on people. And this is all about people, it's all about people's lives at the end of the day. People can talk about numbers and they can talk about costs and they can talk about other elements but at the end of the day this is about individual, people's lives, their families and their communities. And for the HSE, our challenge was really about how do we manage to protect the totality of the population in Ireland, as much as we can from the ravages of the virus. And the initial challenge we had was around contact tracing and managing that before a vaccine became available. And once the vaccine became available it was then how do we stand up a national vaccine solution that we would be able to deliver and record vaccines to the totality of the population who were getting a vaccine. >> Yeah, so there was no preexisting vaccination program of course, probably in most places you needed to get healthcare workers vaccinated ASAP and it's also needed to be a national program. So what did you do next after determining all right, we need to work with some partners to be able to build technology to facilitate equitable efficient rollout of the vaccine? >> So we did have regional vaccine systems and we do have a number of vaccine programs out there that were managing flu vaccine, Hep C vaccine, but we didn't have a national program and we needed to vaccinate people immediately. And we also wanted to make sure that vaccine program was not dependent on the HSE infrastructure, because we want to be able to vaccinate people in non HSE sites, and we wanted non HSE staff to be able to vaccinate. And we didn't want a huge pre-dependence on our existing infrastructure. So the first thing we did, we looked at a number of vendors and we chose IBM as our partner with Salesforce. And that partnership is really a strategic partnership and it's a partnership that we worked to all the bumps and all the lumps through the program together and there have been challenges but like it's still working with Tim and his team and to our team that we've overcome some of those challenges. And like, when we started off I remember the very first conversation I had with Tim he said, "Look, we need to vaccinate healthcare workers now, okay? And you've got two weeks to start and we need to configure a system, get it up and running and to be able to roll it out to the hospitals and very quickly then to all of our nursing care homes now" and that was the challenge. >> And let's bring Tim in, and this is a radically quick project from MPV to roll out in two weeks. Tim talk to us first about the IBM partnership with Salesforce and what you're building together. >> Absolutely, it's great and Fran it's interesting to hear you speaking about the running into this, 'cause from my perspective a week before we all started this we had a simple conversation called into the Health Service Executive they're talking about some vaccination program how can we help? And then within a week, we've gone from zero to having how many calls with Fran and team just to understand and with the Salesforce team to really understand how the three parties can bring the best of IBM, the best of Salesforce and the best of HSE in terms of the adaptability and what we need to get done to get those vaccinations up and running for the healthcare workers now. When Fran said to me, "We need something in two weeks." There was absolutely clarity, if you can't do it in two weeks there's the door, right? So we knew exactly the challenge and that's the kind of thing right before Christmas that we were so fortunate to really bring in the team, like everyone you think about this, everyone has probably the 14th of December was thinking of winding down, thinking of having their Christmas holidays and vacation time. And everybody from the Irish team and from the English team said, "No, we will cancel Christmas, we will cancel everything." So is it really Christmas came early and Christmas was canceled all at once. So, and the key bit here, the strategic partnership is IBM and Salesforce have been working together for years and years and years growing out a partnership. We know their products really well, we've got huge capability in that space. But actually with the new health cloud part of it the vaccine management parts are quite new to Salesforce as well only launched back in sort of the August, September time. So it's quite new. So we had to go in together as a sort of a partnership there to say, "Did you get this done?" So we had the best people from Salesforce who know the product, the best people from IBM all turning up on the 14th of December and saying, "Right, we've got to get this done by the 29th, with Christmas holidays in the way, the vacation time in the way." I think we had 36 hours of time off to eat turkey and fill ourselves before getting back to the wheel and really getting this done. And to get I think it was four acute hospitals we went into as of the 29th to start the vaccination program. So trying to do that, understanding everything is a compromise at that point. Yeah, but it has to be secure, you know this is personal data going into these systems. So you can't forget about all the aspects it's got as minimum, but minimum with those kinds of constraints as a health system. So it needs to be secure, it needs to also be that national platform going forwards as well. So basing on a great platform like Salesforce, you know you can scale out, you know you've got those options to grow in the future, but yeah, not without a lot of challenge and then working out what's now getting to know each other, but if we only talked about twice before we ever know each other pretty well now. But just trying to work out how we then structure what's going to happen every two weeks afterwards, how's that going to move forward? We're going live every two weeks and we have done that now for the last three months, so, good fun. >> So, yeah, good fun. But so much work to get done and accord a huge coordinated effort in a very short time period during a very challenging time. Talk to me a little bit about Fran but you launched this Vaccine Cloud Management in January, 2021. And to date, I think you told me 1 million people have been vaccinated so far. Talk to me about what the IBM, Salesforce solution enables you to deliver to the HSE and to the Irish citizens. >> So we have delivered a million vaccines, okay in two stages. The dose one, the dose two for most people in Ireland. And there's about 720,000 people got their dose one and the balance have got the dose two. That's about sort of just about one in five of the population that has to be vaccinated. And one of things we were very conscious of is that as an organization like that we need to take a risk based approach to this. So we need to look at the most vulnerable groups there were lots of people who were dying from this. And a lot of people were elderly groups, and people who were vulnerable with pre medical conditions. So our challenge was how do we vaccinate those people quickly and effectively and also vaccinate healthcare workers who are going to care for these people. And that's where we prioritize the work. So we have to go into 50 acute sites about 600 or so care homes, we set up a lot of what we call pop-up clinics literally a tent in a location, or we took over a sports hall or whatever we did. We rolled it out to the GP so about two and a half thousand GP sites. And all of that was being done while we were building the system. So we were building the system and designing a system on two week sprints. We have to be agile, we have to be quick, we had to make huge compromises and we know that. Though I hate to admit it everyone wants a perfect system, which will make the compromise and look into what do you need to do now to keep the program running? And how you manage that with about 3,000 users all to be set up fairly quickly or a little over half thousand users. So you have to manage all that as you're going through everything. >> I think agile is the name of the game here. Tim, talk to us about how you're delivering the agility in such a tenuous time. >> Well, we're all virtual, which is added to the mix. But the funny thing with that agility we've got a span of people across all the countries and everywhere that we can bring in to that party. And yeah, we're running what I would call a normal agile project, except normally it would take two, three months to really get that team working effectively, getting to know each other and we just not had time to do that. So there's been a core team here and we're bringing in the experts around it but really just everything is working with Fran, worked very hand in glove trying just to work out, what we need to do here, to look at the next sprint to look at the next go live, to look at the compromise. How do we compromise for two weeks? What can we live with for two weeks? What's in the backlog for now and Fran and I have many conversations. What do we need to do this week and then what's next week? And that's level of fluidity and that's in part because of the way the pandemics and the response of pandemic is mapping out. As we saw the vaccines are changing, availability is changing, the rollout plan is changing. None of us have worked through a pandemic before. So agility is the name of the game at the highest level. I think we're all now very used to being, sorry there's a problem something's changed, can we adapt the system too, you know, and normally in a sprint I'll be thinking, I've got some fixed requirements for two weeks, I'll build that and then do the next two weeks. Everything is up for grabs and we're just having to maintain quality at the pace, the responsiveness and balancing it all as an IBM team and you think. And whilst we're also doing that on a platform that it takes time to configure and build these things as well. So it's some of it is you're going to have to wait a few days. So we're sorry, you know, a few days is really the probably sometimes the maximum amount of time that can be you can defer, but as Fran and everyone in the HSE and the National Immunization Office, everyone's pragmatic about realizing we're all in this together and it's really just being one single team, one unit working out and very open and transparent about the odds that are possible. >> And when doing something... Go ahead, Fran. >> We had a phrase there like there was a pieces we just had, "Just do it now." And we did a lot of that, okay? You know, where there were things that were prioritized were in the middle of a sprint, there were changes in the program or there were changes in how the vaccination was going to be delivered. And we couldn't waste the week just wasn't available. So we have the thing just got to do it now. And Tim and the team they'll drop what they were doing you know, made the changes, we tested them fast and we pulled them in and then gave us an extra time to actually then deliver the rest of the sprint. We have to do that several occasions, several very, very late night delivers. >> And I imagine that's still going on, but to wrap here guys, an amazing work that you've done together so far with the Salesforce Vaccine Club Management rolling out across the HSE you said 1 million vaccinations delivered many hundreds of thousands in the queue. I'm sure more iterative work and sleepless nights but what you're doing for the country of Ireland is literally as Fran said in the beginning, lifesaving. Gentlemen, thank you so much for joining me today on the program. >> You're welcome, thank you. >> You're very welcome. Thank you. >> From Tim and Fran I'm Lisa Martin. You're watching theCUBEs coverage of IBM Think 2021. (upbeat music)

>> Welcome to this IBM Watson Health Client Conversation. Here, we are probing the dynamics of the relationship between IBM and its key clients. We're looking back and we're also exploring the present situation. And we're going to talk about the future state of healthcare as well. My name is Dave Vellante from theCUBE and with me are Ryad Rondo who's the Associate director of Data Management at Veristat and Tim Watson, IBM Watson Health. Welcome gents. Tim, any relation? >> (chuckles) If I had a nickel for every time I was asked that question I'd be a wealthy man. >> Well, relationships and trust. I mean, they're pretty fundamental to any partnership and the pandemic certainly has tested us, and we've had to rely on those personal and professional relationships to get us through COVID. So let me start Ryad by asking you, how did the partnership with IBM support you last year? >> Last year as you know was particular year for our industry. So the relationship with our provider was key of the success of any studies we had last year with the new world we had. So we were working very close with IBM Clinical, and I think collaboration was key for successful (indistinct). >> So Tim, I wonder if you could talk about some of the things that you've done with Ryad and his team, maybe some of the things that you accomplished in 2020 anything that stands out. And then maybe take it from there and query Ryad on some of the more important topics that are top of mind for you. >> Yeah, absolutely. I think in 2020, we all know it was a challenging year but IBM actually put together a really good program to support our clients as as it relates to COVID-19 trials. And Veristat did a great job of taking advantage of that with a number of their clients that offered a free promotion for 18 months of a subscription to support individual sponsors in their efforts and trying to find a vaccine that supports the whole world out there. So I think we put together a program that Veristat and their clients were able to take advantage of as it relates to COVID. But in addition to that the platform supported their efforts to maintain the clinical trials that were ongoing. And that was actually probably even bigger challenge for the Veristat team. >> Yeah, so maybe do a little mock session here. Tim you're used to role-playing so let's do a little role-playing. So we're in 2021 you guys are sitting down, unfortunately you're not face-to-face, but imagine you were and Ryad, talk about the objectives that you have in 2021, as you think about your relationship with Watson Health and Tim I'd love for you to respond in real time as to how you're going to help Ryad. Ryad kick it off, what are you trying to get done in 2021? What's the priority? >> Let me take a step back from 2020 and I go to 2021. I think one of the biggest challenge we have in 2021 with studies we had, is the extreme rapid startup of several projects we had. So we needed to start, design and push studies live in the record time. We were able to design a study in a week, another study in two weeks from the protocol to the goal of the study. And all that was with the collaboration of IBM, of course. And 2020 actually brought a change of the approach the client have to the study. So now they are more willing to use more electronic solutions than before. 2020 forced our client and the industry in general to look at the solutions offered electronically by the ADC provider by IBM Clinical. So right now in 2021, we will be leveraging those solutions, I'm thinking about monitoring module, I'm thinking about ePRO, I'm thinking about eConsent which is coming soon and I'm thinking about visualization as well. So these solutions provided by the system are now more acceptable than before and we will be used in 2021. Visualization is in the top list of these solutions eConsent comes with it as well. >> Alright so Tim, how are you going to help? How's Watson Health going to be a great partner in 2021 and beyond? >> Well, I think IBM is continuing to focus on what do these solutions mean going forward and how can we extend the functionality of our platform out there? So with the release of eConsent that's something that I believe Veristat can take advantage of. And the near term is just a matter of getting the Veristat team educated on our eConsent functionality to be able to offer that out to their clients. And visualization is another area that we've had a number of discussions with Veristat on over the past 12 months and leveraging the tool set that we are able to bring to the table with smart reports and how that can provide additional value and then finding that balance where we can get them off the ground quickly maybe with some pre-packaged reports but also educating their team so that they're able to take that tool set and be able to extend that functionality to their clients. >> So Ryad what's the situation like? I wonder if you could think pre pandemic, post pandemic. A lot of clients that I talked to, they would talk the digital game, but in reality it's not that simple. You know things are done a certain way and then I've often called it the forced march to become digital. And that's kind of what happened to us. And so I'm curious as to your sense as to what the climate was like pre and post? How much if at all, I have to believe that everybody's digital strategies were compressed, but was it months? Was it years? And it was sort of overnight we had to make the changes. So it was like a Petri dish. You really didn't have time to plan, you just did. So by how much was that digital transformation compressed and what were the learnings and how do you see taking that forward? >> We historically would go to clients with solutions and you know human nature resists to change. So when we go offering electronic solutions before the pandemic, we always had to define, to use a lot of argument actually to explain to the client that this is the way to go. This is the time to do use more electronic solutions. With the pandemic, the fear forced the client to use these solutions. And they realized that it's working. They realize that we can do it. We can do it very well. Even for complex study, solutions are available and can be used. We also was forced somehow to shorten our timeline to find best way to push studies live in as short as possible timelines without jeopardizing the quality, finding solutions. Splitter is one of the solutions IBM can offer so this is one of the solution we used. The release of the ECRS done later in the edit. IBM offered the capability to do that without jeopardizing the quality. >> So Tim, maybe you could chime in here. I mean, that's really important point. We had sort of no choice but to rush into digital and electronic last year how do you help clients maintain that quality? Maybe you guys could talk amongst yourselves as to the kinds of things you did to maintain that both, when things were going crazy and they somewhat still are. And then how do you preserve that going forward maybe turn the dial maybe a little bit based on your learnings. >> I think one of the advantages that our platform brings to the table is the flexibility. And that flexibility is what Veristat was able to take advantage of in different situations, in different parts of the platform. So whether that was the ability to design trials very quickly and be very flexible with the rollout of that trial to address specific timelines or just the different areas of the platform like ePRO to be able to extend things out to their clients as well so that patients are entering data into the clinical trial so that they're not having to go visit sites necessarily out there. So there's a lot of things that we have within the platform that our clients are able to take advantage of that really came into full focus in the year of 2020. >> Does that resonate with you Ryad? Do you trust what Tim just said? Does it give you a good feeling based on your experience? How confident are you that IBM can deliver on that objective? >> Yeah, actually the pressure we received from the industry in general, in the last year and still this year is to always shorten with high quality deliverables. So we were able to use the flexibility IBM system offers to achieve that goal. Splitting release performing a complex MSU successfully. So all these features and the flexibility we have with the status and flexibility we have with the user roles all these features and flexibilities was key performing that high quality MSU complex updates and in the record time. >> I wonder if you could each talk about sort of personally and bring it professional if you like, but how have you changed as a result of the pandemic and how has it helped you position for what's coming ahead? Ryad maybe you you could start. >> One of the things I'd like to say about what happened last year is that, it has never been easier for me to explain what I do. Historically, when I asked what do they exactly? I had to spend hours explaining what I do. Now I tell them, do you know what's the phase three phase two we are all waiting for the vaccine? That's what we do. So that's I think the number one success of the year for me. Honestly, it's just proud to work in an industry like that. Proud to work in a company like Veristat who cares about the quality who cares about providing the safety of the patient using the best system in the market working with IBM Clinical in this case. We're working to achieve that goal. I think 2020 gave me that just another level of proud maybe, if I may say. Partnership with client, partnership with IBM offered free for COVID studies for an 18-month program. So all of these just confirm that we are, I am personally in the right place, right company, having the right partnership to help humanity actually get better. >> Thank you for that, that's great. And Tim, you too you're obviously part of that, but I wonder if you could comment. >> Well, I'd like to kind of echo just what Ryad had said that professionally I feel we play a very small part. The Veristat team, the Sponsors team they do all the hard work, trying to find new medications, new vaccines to bring to life. But it means a lot to play a small part in that process to offer a technology that helps them do that quicker. And if we can get those drugs and vaccines to market quicker then that's going to have a very positive impact on the world as a whole. So it's a very exciting time to be in this industry. >> Undoubtedly. Ryad what can IBM do to help you near-term, mid-term and long-term? What are some of the most important things that Tim and his company can help with? >> Yeah, as Tim mentioned, we will have eConsent coming soon. I'm sure IBM will have other electronic solution coming soon so partnership, support and training. So education between our two entities between Veristat and IBM to use this new feature now became key for the success of any study. So I expect partnership support on an education from them. We've been successfully doing that and hoping that we'll continue in this case. >> Tim, any comments on that? >> Well, we have a great relationship with Veristat and we try to have that same kind of relationship with all of our clients. We meet regularly with governance meetings. That's a great time to share new information, to revisit old questions that may still be out there. And so, we're going to continue to offer the additional training options to our clients to allow them to leverage that platform so that they can then cater to their clients, the sponsors that are contracting with them for their clinical trials. >> So Ryad, Tim did say lower the price. That's a good sign. What about that though? What about value for investment? How Ryad would you grade IBM's track record in that regard? If you had to put a grade on it, you know, A, B, C, D, E, F. >> I would put a good grade, actually. I think it's the right balance. You know, a client expect always to pay less, but we are the experts, we are doing the job. And we have to guide them, make the right decision. We tell them why they should pick that or that system. And what are they getting for the price they're paying for. Right now we didn't have much trouble selling IBM and there is something common I think so, is to revise the price to be more specific for study, I think will help the client actually. Will help selling the products. >> So if you had to put a letter grade on it what would you give them? >> A grade? (chuckles) >> A grade, come on A, B? >> An A. >> An A, you'd give them an A? >> Yes. Solid A, 4.0 that's great, Tim you got a-- >> A minus to just leave some space for improvement. (Tim chuckles) >> Okay A minus just because, hold the carrot out there right? That's good, it's okay. Tim, how do you feel about that? You don't mind having a little extra incentive, right? >> No, absolutely not. It's always great to work with the Veristat team and we have I think a great relationship and there are certainly opportunities that we can hopefully work together. And If the price needs to be addressed then we can address it and win the business. >> Tim, anything I missed? Anything that you feel like there's a gap there that you want to cover that I didn't touch on? >> No, I think we're good. >> Great, awesome. Well, great conversation guys. I really appreciate it and thanks for the good work that you guys are doing on behalf of everybody who's living through this. It's a critical time and it's amazing how your industry has responded so thank you for that. And thank you for spending some time with us. You're watching Client Conversations with IBM Watson Health.

>>Welcome to this IBM Watson health client conversation here. We're probing the dynamics of the relationship between IBM and its clients. And we're looking back, we're exploring the present situation and discussing the future state of healthcare. My name is Dave Volante from the cube and with me are Alex Dillard. Who's a senior director data analysis at blue choice, blue choice health plan, and Darryl decode, who is IBM with IBM Watson health. Of course. Welcome gentlemen. Good to see you. Thanks for coming on. >>Hey, >>So, you know, you think about lasting relationships. They're the foundation to any partnership and this past year, and it's tested all of us. We've had to rely on both personal and professional relationships to get us through the pandemic. So Alex, let me start with you. How has the partnership with IBM supported you in 2020? >>Well, uh, I've just a piece of a larger puzzle. Uh, the relationship that Darrell and I have had is confined to IBM Watson health, but blue cross blue shield, South Carolina, which food choice is a wholly owned subsidiary of has had a standing relationship with IBM on the it side. Uh, we are a mainframe shop, uh, about 70% of our it infrastructure is on a mainframe. And, uh, that puts us as a segment one client for IBM, we're in the top 300 of all of their clients in the Americans. And more specifically we're the fourth largest, um, uh, Linux on Z shop in the world. So, uh, we've got a lot of diversification at blue cross blue shield of South Carolina and the mainframe and the vastness of that. It infrastructure reflects that, uh, diversification. We are more than just a crossing the shield. Uh, that's typically what people think of is insurance when they think of crossing shield, but we also have a division that does a lot of subcontract work for government programs, uh, track air, which is the military healthcare, uh, claims processing and Medicare claims processing. >>We were a subcontractor of other folks that use our back office, it infrastructure to, to run their claims through. So that's, that's the larger, um, aspect of our relationship that, that blue cross blue shield of South Carolina house with IBM, uh, as it relates to Watson health, we have been a client since 1994 and obviously that predates the IBM proper. Uh, we were a client of med stat and then Truven, who then, uh, was bought by IBM. So we have used the products from Watson health throughout our system to support provider profiling, uh, count group reporting, um, and ad hoc analysis and to some extent to, uh, support our value-based products with, uh, ACO and PCMH, >>Uh, products. >>Awesome. Thank you for that. So Daryl is very long-term relationship. Obviously, if people forget sometimes that, uh, how IBM has modernized the Z Alex talked about, uh, Linux on the mainframe. That's pretty cool. I wonder if you could talk about specifically the things that, that you've done with Alex in his, in his, in his team, you know, thinking back last year, what were your accomplishments that you really stand out? >>Yeah, so, so one thing that jumps to mind is, uh, given the long standing relationship, I relied heavily on Alex to help us work through a multi-year renewal. And it was, it was a, um, a good adventure for us. We, we were able to laugh along the way. We certainly had some, some phone calls that, that were a little bit challenging, but the great thing about it was that the relationship that Alex and I had, he really views it as a partnership. And that was just so encouraging and uplifting. So to me, from my perspective, that was absolutely, uh, one of the highlights of my year and working through even through the pandemic and all that, we figured it out. >>So you guys, when you get together, go ahead, please. >>That's what I had as well. Um, you know, the, the unique thing about the Watson health contract is because it involves data. Uh, we take the stance that it's an it contract, so I'm on the business side. So I've got to just, as Daryl has to navigate it with me, we've got to navigate a large of your it bureaucracy. Um, and, uh, it, it was challenging. Um, you know, the business people kind of smooth the tracks and then you get the lawyers involved in, it just goes haywire. So, um, we were able to navigate that. Um, uh, so yeah, so it was a big accomplishment. So Alex, it's not real sexy to talk about, but we got it done >>Well. So Alex you're, you're in sales, so you're, you're used to role playing. So imagine you're, you're, you're sitting down, uh, sorry, Darryl. You're used to, role-playing out. Imagine you're sitting down with Alex and you're thinking about 20, 21 planning, so, you know, take it away. W what do you, what would you ask, what would you talk about or share with us? >>Yeah, yeah, absolutely. So, so I, I know that, you know, one of the key objectives is, uh, continued to ingest, engage with your members and you have key business strategies. I know you recently migrated over to a new PBM, and so there, there's some complexities that come with that. Um, but just, you know, Alex, if you don't mind, why don't you share a little bit about kind of your, your perspective on what 2020 would hold for you in your organization? Well, I think that due to the pandemic, we are, I personally kick the, can down the road on a couple of things, particularly >>Having a strategic roadmap discussion, um, you know, uh, I was going to get into this later, but I enjoy doing things face-to-face rather than, uh, over the phone or, or virtually. And so, uh, I guess I was a little too optimistic about maybe being able to get together late 2020 to have that strategic roadmap discussion. Um, I think, uh, given what has developed with, um, the pandemic and vaccines and stuff, I may, I may be able to get everybody on the same page later this year, hopefully. Uh, but certainly we want to have a strategic roadmap discussion. Um, we license, uh, Watson Hills, uh, cat group insights, uh, tool, which we use for employer group reporting. And we are currently in the beginning stages of rolling that out to our external clients, whether it's agents, brokers, um, those types of folks. And then it vanished we as our core product that we use for analysis, and that product is transitioning to what is called health insights. And so from an analytical standpoint, my staff and the staff of our cluster areas will need to sort of move to health insights since that's where it's going, uh, from an analytic standpoint. So we're going to work on that as well. Um, and then some more detailed things around database rebuilds and stuff like that. Those are all sort of on the roadmap for 2021. >>Yeah. So, you know, you talk about strategic planning and you think about the way planning used to be. I mean, sometimes you take a longer term horizon, maybe that's five years, you know, technology cycles, you know, even though they go very fast, but you see major technology shifts, they're like go through these seven year cycles, you see that in financial world. And then with the, with the pandemic, we're talking about seven day cycles, you know, how do I support people work from home? Do I open the store or not? You know, it's a day-to-day type of thing. So I wonder if you could each talk about personally and professionally w how, how is 2020, you know, changed you and maybe position you for, for what's ahead, maybe Alex, you could start, >>Well, you know, I'm an analyst, so I always fall back to the numbers. What are the numbers show us, um, you know, people can have four perceptions, but, uh, the numbers give us a reality. So the reality is that a year ago, pre pandemic, uh, just 13% of blue cross blue shield employees were working from home a hundred percent, uh fast-forward to today. And that number is now 87%. So think about, uh, just the lift from a it infrastructure to support that we almost, all of those people are using Citrix to get in to our network. Uh, we're using a remote desktop. So you've got this pipeline that probably had to go from, you know, this small, to huge, to get all this bandwidth, all this data and everything. So you've got that huge lift. Um, and then it affects different areas, um, differently. Uh, I don't have any first-line staff, any staff that are member facing, so I didn't really have to navigate, you know, how do these people talk to our member? >>How does staff talk to our members on the phone when they're at home, as opposed to in the office, and, you know, is there background noise, things like that. So I've got analysts, uh, they're just crunching numbers. Um, but my, my, my personal, uh, feeling was I like doing managing by walking around, you know, stopping and talking to other, working on. So that went away and I like face-to-face meetings, as I've mentioned, and that went away. So it was really a culture change for me personally, it was a culture change for our organization. Uh, and, and now we're having conversations with executive management that, you know, if you've got staff who have been doing a good job and they remain productive, you know, give me a reason they got to come back in, which is just, as you told me that I'm going to be the case a year ago, I would have been, you know, flabbergasted, but that's where we are right now. >>And so on a personal standpoint, you know, I went home for a little while and then came back. And so my wife also works for blue cross blue shield of South Carolina. Um, so, you know, she set up in the dining room working, uh, I have my own book in our living room working, and then we've got a great side, you know, the school is not in session, you know, in person. So he's doing virtual learning. So combine all those things, and you've got all kinds of crazy things that could happen. Uh, and then you've got staff who are in the same situation. Um, so it was a lot to handle. And the longer it goes on the novelty of working from home wears off, and you kind of realize, you know, I can't go do this. I can't go out to eat. I can't do all types of things that I used to do. And so that affects your mental health. So as, as a leader, um, of my small area, and then our executives really had to become more, uh, uh, in, in people's faces. So we've got, we've done a lot more video, uh, messages, a lot more emails. Um, I have been tasked with being very deliberate about checking on how everything is going at their house. Are they getting what they need? Um, you know, how are they feeling? Are they getting up and exercising, all those things that you took for granted, uh, beforehand. >>Yeah. So Daryl, anything you'd add to that in terms of specifically in terms of how you might, how you might change the way in which you interact with your clients generally, uh, an Alex specifically, Alex likes, face to face, you know, we can't wait. All right. >>Yeah, yeah. It's funny. We never quite got to do it Alex, but we were talking about doing a virtual happy hour at one point too, to just celebrate the success. Um, but for me, you know, typically I would travel and visit Alex face-to-face on maybe a monthly basis. And so it it's been really hard for me. I didn't realize how, how much I enjoyed that in-person interaction. And so that, that was something that I I've been, you know, working through and finding ways to, to still interact with people. And I'm certainly making, making the best of, of the video phone calls and, you know, that sort of thing. So, uh, just work working to maintain those relationships. >>I wonder if I could ask you when, when, when this thing, when we're through the pandemic, what do you expect the work from home percentage? I think I heard 13% prior to the pandemic, 87% today. What do you think is going to be post pandemic? >>That is a good question. Um, it, it may go back to maybe 60% at home. I think, I think there will be a simple majority, uh, working from home. Um, that's, that's from our planning, uh, space planning standpoint. That's, that's what we are, uh, what we're expecting, um, if, if production stays, um, at acceptable levels, um, >>Do you feel like productivity was negatively impacted positive? It will be impacted or it's kind of weird. >>Yeah. All the metrics that we track show that it was, it was sustained and in some areas even better. Uh, and if you really think about, um, sort of your typical day when you work from home, I found, uh, that I was logged on an hour earlier. That's probably what's happening with other staff as well is they're, they're motivated to get up and, and get online, uh, earlier. >>Yeah. Mostly tech leaders that I talk to share that sentiment, that the productivity is actually improved. So Darryl, I presume you see the same thing in your observation space. Yeah. >>Yeah. I, I do. And, and I have other clients too, and, and, and they are definitely looking at ways to continue to work remotely. I know that for a lot of people who are in the office all the time, uh, having a little bit more flexibility when you work from home can be a good thing. And, and like you said, you, you have to make sure that the productivity is still there and the productivity is up. Um, but I, I could see that the trend continuing absolutely >>I'd love for you to, to look at Darryl and say, and tell him what the kinds of things that IBM can do to help you both today, immediately 20, 21, and in the future and a Darryl, how, how your, how you'll respond. >>Well, I'll tell you that. Um, so in 2020, what, what changed most dramatically for us as a health plan? Uh, and, and I, it echoes what we see across the country is the gigantic shift in telehealth. Um, you know, if, if, again, if you look at the numbers, uh, our telehealth visits per thousand, so that's the number of visits per thousand members in a given month, went up 1472%. And so, you know, the common response to that is, well, you know, your visits overall probably, you know, were flat because, uh, you know, they just weren't happening in that. And that's not necessarily true for us. So if you look at visits overall, they written down four and a half percent. Um, so there was a shift, but it, it was not a big enough shift to account for, uh, visits overall sustaining the level that they were pre pandemic. >>Um, so as we look into 2021, uh, we will be investigating how we can maintain, uh, the, uh, the accessibility of our healthcare providers via telehealth. Um, you know, one of the projects that we started in 2020, uh, was based upon the choosing wisely campaign. So if you're not familiar with choosing wisely, it's a very well thought out process. It involves many, many provider specialties and its sole target is to reduce low value care. Uh, so we took it upon ourselves to Institute sort of a mirror of that plan or that program at, at blue cross here in South Carolina. And so as we moved to 2021, obviously those low value services just because of the pandemic were reduced, uh, and some of the high-value care was reduced as well. And so what we are going to try to do is bring back habit, bring back that high value care, but not bring back that low value care and so low value care or things like vitamin D testing. Uh, it can be other things like, um, uh, CT for head headaches, um, imaging for low abdominal pain, things like that. So, uh, we want to focus on low, uh, eliminating what value care, bringing back high value care, >>Okay, Dale, you're up? How are you going to help Alex achieve that? So, so good news is, is that we've got the analytic warehouse and the database where all of the data is captured. And so we we've got the treasure trove of information and data. And so what we'll do is we'll come alongside Alex and his team will do the analytics, we'll provide the analytic methods measures, and we'll also help him uncover where perhaps those individuals may be, who had postponed care, um, because of the pandemic. And so we can put together strategies to help make sure that they get the care that they need. Uh, I also a hundred percent agree that tele-health hopefully is something that will continue because I do think that that is a good way and efficient way to get care for people. Um, and, you know, as a, as, as a way to, to address some of their needs and, and in, in a safe way too. >>So, um, I, I look forward to working with Alec and his team over this coming year. I think there is, uh, knowing Alex and, and the partnership and his readiness to be a client reference for us. You know, those are all great, um, recognition of how he partners with us. And we really value and appreciate, uh, the relationship that we have with blue cross blue shield, South Carolina and, and blue choice. Excellent. Daryl's right. The, the, the database we use already has some of that low value care measures baked into it. And so throughout 2020, I've worked with our analytic consulting team. Uh, it's under Daryl too, to talk about what's on the product product roadmap for adding to the cadre of live low value care measures inside advantage suite. Uh, so that's something that we'll actively be, um, uh, discussing because certainly, you know, we're, we're obviously not the only client only health plan clients. So there may be other plans that have priorities that very different made very differently than ours. Uh, so we want to give them what we're studying, what we're interested in, so they can just add it in to all their other client feedback, uh, for advantage suites, roadmap. Excellent. >>Look, my last question, Alex is how would you grade IBM, if you had to take a bundle of sort of attributes, you know, uh, delivery, uh, value for service relationship, uh, et cetera, how would you grade the job that IBM is doing? >>I, the thing that I enjoy most about working with IBM and Darryl specifically, is that they're always challenging us to look at different things. Um, things that sometimes we hadn't considered, because obviously it may be an issue for another health plan client or an employer client that they've got. Uh, they tell us, this is what we're seeing. You know, you should look at it. Uh, a lot of times they do some of the foundational work in producing a report to show us what they're seeing in our data that is similar to what is in some of their other clients data. So that's refreshing to be, uh, challenged by IBM to look at things that we may not be, uh, looking at, uh, or maybe missing, because we've got our eye on the ball on something else you >>Care to put a letter grade on that. >>Oh, definitely. Definitely. Thank you. >>Well, Darryl, congratulations, that says a lot and, uh, we have to leave it there and one at a time, but, but Daryl, anything that I didn't ask Alex, that you, you wanted me to, >>So, um, Alex re able to keep your tennis game up during the pandemic? Uh, I, yes, I tried as, as often as my wife would let me good. I would play every time I was asked, but, uh, yeah, so I, I did have to temper it a little bit, although when you spend all day with her and, and my son, you know, she may be a little more, uh, lenient on letting me leave the house. Well, maybe she's >>Yeah. The tribute to the late great comedian Mitch Hedberg, who says, uh, you know, when I, I played tennis, I played against the wall walls. Really good, hard to beat if it's pandemic appropriate. >>Oh, that's good. That's a true statement. And there was a lot of that going on, a lot of that play and playing against the wall. >>Hey, thanks so much, stay safe and really appreciate the time. Thank you. >>Thank you. Thank you. You're >>Really welcome. It was a great conversation and thank you for watching and spending some time with client conversations with IBM Watson health.

>> Welcome to this IBM Watson Health client conversation. And we're probing the dynamics of the relationship between IBM and it's clients. We're going to look back at some of the challenges of 2020 and look forward to, you know, present year's priorities. We'll also touch on the future state of healthcare. My name is Dave Vellante. I'll be your host and I'm from theCUBE. And with me are Doctor Alex Towbin, who's Associate Chief Clinical Operations and Informatics at Cincinnati ChilDoctoren's Hospital and John Chrisman of course from IBM Watson health. Welcome gentlemen, Good to see you. Thanks for coming on. >> Thanks for having us. >> Yeah, thanks for having me. >> Yeah I know from talking to many clients around the world, of course virtually this past year, 11 months or so that relationships with technology partners they've been critical over during the pandemic to really help folks get through that. Not that we're through it yet but, we're still through the year now, there's I'm talking professionally and personally and Doctor Towbin, I wonder if you could please talk about 2020 and what role the IBM partnership played in helping Cincinnati children's, you know press on in the face of incredible challenges? >> Yeah, I think our story of 2020 really starts before the pandemic and we were fortunate to be able to plan a disaster and do disaster drill scenarios. And so, as we were going through those disaster drill scenarios, we were trying to build a solution that would enable us to be able to work if all of our systems were down and we worked with IBM Watson Health to design that solution to implement it, it involves using other solutions from our primary one. And we performed that disaster drill in the late January, early February timeframe of 2020. And while that drill had nothing to do with COVID it got us thinking about how to deal with a disaster, how to prepare for a disaster. And so we've just completed that and COVID was coming on the horizon. I'm starting to hear about it coming into the U.S for the first time. And we took that very seriously on our department. And so, because we had prepared for this this disaster drill had gone through the entire exercise and we built out different scenarios for what could happen with COVID what would be our worst case scenarios and how we would deal with them. And so we were able to then bring that to quickly down to two options on how our department and our hospital would handle COVID and deal with that within the radiology department and like many other sites that becomes options of working from home or working in a isolated way and an and an office scenario like where I'm sitting now and we planned out both scenarios and eventually made the decision. Our decision at that point was to work in our offices. We're fortunate to have private offices where we can retreat to and something like that. And so then our relationship with IBM was helpful and that we needed to secure more pieces of hardware. And so even though IBM is our PACS vendor and our enterprise imaging vendor, they also help us to secure the high resolution monitors that are needed. And we needed a large influx of those during the pandemic and IBM was able to help us to get those. >> Wow! So yeah you were able to sort of test your organization resilience before the pandemic. I mean, John, that's quite an accomplishment for last year. I'm sure there are many others. I wonder if one of you could pick it up from here and bring your perspectives into it and, you know maybe ask any questions that you would like to ask them. >> Yeah, sure, Doctor Towbin, that's great that we were able to help you with the hardware and procure things. So I'm just curious before the pandemic how many of the radiologists ever got to read from home, was that a luxury back then? And then post pandemic, are you guys going to shift to how many are on-site versus remote? >> Yeah, so we have a couple of scenarios. We've had talk about it both from our PACS perspective as well as from our VNA enterprise imaging perspective from PACS perspective we always designed our solution to be able to work from a home machine. Our machines, people would access that through a hospital-based VPN. So they would log in directly to VPN and then access the PACS that way. And that worked well. And many of our radiologists do that particularly when they're on call works best for our neuroradiologist who are on call a little bit more frequently. And so they do read from home in that scenario. With enterprise imaging and are used to the enterprise viewer and iConnect access. We always wanted that solution to work over the internet. And so it's set up securely through the internet but not through the VPN. And we have radiologists use that as a way to view studies from home, even not from home, so it can be over one of their mobile devices, such as an iPad and could be at least reviewing studies then. We, for the most part for our radiologist in the hospital that's why we made the decision to stay in the hospital. At COVID time, we have such a strong teaching mission in our department in such a commitment to the education of our trainees. We think that hospital being in the hospital is our best way to do that, it's so hard. We find to do it over something like zoom or other sharing screen-sharing technology. So we've stayed in and I think we'll continue to stay in. There will be some of those needs from a call perspective for example, reading from home, and that will continue. >> And then what's your success been with this with the technology and the efficiency of reading from home? Do you feel like you're just as efficient when you're at home versus onsite? >> The technology is okay. The, our challenges when we're reading from the PACS which is the preferred way to do it rather than the enterprise archive, the challenge is we have to use the PACS So we have to be connected through VPN which limits our bandwidth and that makes it a little bit slower to read. And also the dictation software is a little bit slower when we're doing it. So moving study to study that rapid turnover doesn't happen but we have other ways to make, to accelerate the workflow. We cashed studies through the worklist. So they're on the machine, they load a little bit more rapidly and that works pretty well. So not quite as fast, but not terrible. >> We appreciate your partnership. I know it's been going on 10 years. I think you guys have a policy that you have to look at the market again every 10 years. So what do you think of how the market's changed and how we've evolved with the VNA and with the zero footprint viewers? A lot of that wasn't available when you initially signed up with Amicas years ago, so. >> Yeah, we signed up so we've been on this platform and then, you know now the IBM family starting in 2010, so it's now now 11 years that we're, we've been on as this version of the PACS and about eight, seven or eight years from the iConnect platform. And through that, we've seen quite an evolution. We were one of the first Amicas clients to be on version six and one of the largest enterprises. And that went from, we had trouble at the launch of that product. We've worked very closely with Amicas then to merge. And now IBM from the development side, as well as the support side to have really what we think is a great product that works very well for us and drives our entire workflow all the operations of our department. And so we've really relished that relationship with now IBM. And it's been a very good one, and it's allowed us to do the things like having disaster drill planning that we talked about earlier as far as where I see the market I think PACS in particular is on the verge of the 3.0 version as a marketplace. So PACSS 1 one was about building the packs, I think, and and having electronic imaging digital imaging, PACS 2.0 is more of web-based technology, getting it out of those private networks within a radiology department. And so giving a little bit more to the masses and 3.0 is going to be more about incorporating machine learning. I really see that as the way the market's going to go and to where I think we're at the infancy of that part of the market now about how do you bring books in for machine learning algorithms to help to drive workflow or to drive some image interpretation or analysis, as far as enterprise imaging, we're on the cusp of a lot there as well. So we've been really driving deep with enterprise imaging leading nationally enterprise imaging and I have a role in the MSAM Enterprise Imaging Community. And through all of that work we've been trying to tackle works well from enterprise imaging point of view the challenges are outside of radiology, outside of cardiology and the places where we're trying to deal with medical photos, the photographs taken with a smart device or a digital camera of another type, and trying to have workflow that makes sense for providers not in those specialty to that don't have tools like a DICOM modality workloads store these giant million-dollar MRI scanners that do all the work for you, but dealing with off the shelf, consumer electronics. So making sure the workflow works for them, trying to tie reports in trying to standardize the language around it, so how do we tag photos correctly so that we can identify relevancy all of those things we're working through and are not yet standard within our, within the industry. And so we're doing a lot there and trying and seeing the products in the marketplace continuing to evolve around that on the viewer side, there's really been a big emergence as you mentioned about the zero footprint viewers or the enterprise viewer, allowing easy access easy viewing of images throughout the enterprise of all types of imaging through obtained in the enterprise and will eventually incorporate video pathology. The market is also trying to figure out if there can be one type of viewer that does them all that and so that type of universal viewer, a viewer that cardiologists can use the same as a radiologist the same as a dermatologist, same as a pathologist we're all I think a long way away from that. But that's the Marcus trying to figure those two things out. >> Yeah, I agree with you. I agree with your assessment. You talked about the non DICOM areas, and I know you've you've partnered with us, with ImageMover and you've got some mobile device capture taking place. And you're looking to expand that more to the enterprise. Are you also starting to use the XDS registry? That's part of the iConnect enterprise archive, or as well as wrapping things in DICOM, or are you going to stick with just wrapping things in DICOM? >> Yeah, so far we've been very bunched pro DICOM and using that throughout the enterprise. And we've always thought, or maybe we've evolved to think that there is going to be a role for XDS are I think our early concerns with XDS are the lack of other institutions using it. And so, even though it's designed for portability if no one else reads it, it's not portable. If no one else is using that. But as we move more and more into other specialties things like dermatology, ophthalmology, some of the labeling that's needed in those images and the uses, the secondary uses of those images for education, for publication, for dermatology workflow or ophthalmology workflow, needs to get back to that native file and the DICOM wrap may not make sense for them. And so we've been actively talking about switching towards XDS for some of the non DICOM, such as dermatology. We've not yet done that though. >> Given the era children's hospital has the impact on your patient load, then similar to what regular adult hospitals are, or have you guys had a pretty steady number of studies over the last year? >> In relay through the pandemic, we've had, it has been decreased, but children fortunately have not been as severely affected as adults. There is definitely disease in children and we see a fair amount of that. There are some unique things that happen in kids but that fortunately rare. So there's this severe inflammatory response that kids can get and can cause them to get very sick but it is quite rare. Our volumes are, I think I'm not I think our volumes are stable and our advanced imaging things like CT, MRI, nuclear medicine, they're really most decreased in radiography. And we see some weird patterns, inpatient volumes are relatively stable. So our single view chest x-rays, for example, have been stable. ER, visits are way down because people are either wearing masks, isolating or not wanting to come to the ER. So they're not getting sick with things like the flu or or even common colds or pneumonias. And so they're not coming into the ER as much. So our two view x-rays have dropped by like 30%. And so we were looking at this just yesterday. If you follow the graphs for the two we saw a dip of both around March, but essentially the one view chest were a straight line and the two view chest were a straight line and in March dropped 30 to 50% and then stayed at that lower level. Other x-rays are on the, stay at that low level side. >> Thanks, I know in 2021 we've got a big upgrade coming with you guys soon and you're going to stay in our standalone mode. I understand what the PACSS and not integrate deeply to the VNA. And so you'll have a couple more layers of storage there but can you talk about your excitement about going to 8.1 and what you're looking forward to based on your testimony. >> Yeah we're actually in, we're upgrading as we're talking which is interesting, but it's a good time for talking. I'm not doing that part of the work. And so our testing has worked well. I think we're, we are excited. We, you know, we've been on the product as I mentioned for over 10 years now. And for many of those years we were among the first, at each version. Now we're way behind. And we want to get back up to the latest and greatest and we want to stay cutting edge. There've been a lot of reasons why we haven't moved up to that level, but we do. We're very careful in our testing and we needed a version that would work for us. And there were things about previous versions that just didn't and as you mentioned, we're staying in that standalone mode. We very much want to be on the integrated mode in our future because enterprise imaging is so important and understanding how the comparisons fit in with the comparison in dermatology or chest wall deformity clinic, or other areas how those fit into the radiology story is important and it helped me as a radiologist be a better radiologist to see all those other pictures. So I want them there but we have to have the workflow, right. And so that's the part that we're still working towards and making sure that that fits so we will get there. It'll probably be in the next year or two to get to that immigrating mode. >> As you, look at the number of vendors you have I think you guys prefer to have less vendor partners than than more I know in the cardiology area you guys do some cardiology work. What has been the history or any, any look to the future of that related to enterprise imaging? Do you look to incorporate more of that into a singular solution? >> Cardiology is entirely part of our enterprise imaging solution. We all the cardiology amendments go to our vendor neutral archive on the iConnect platform. All of them are viewed across the enterprise using our enterprise viewer. They have their unique specialty viewer which is, you know, fine. I'm a believer that specialty, different specialties, deserve to have their specialty viewers to do theirs specialty reads. And at this point I don't think the universal viewer works or makes sense until we have that. And so all the cardiology images are there. They're all of our historical cardiology images are migrated and part of our enterprise solution. So they're part of the entire reference the challenge is they're just not all in PACSS. And so that's where, you know, an example, great example, why we need to get to this to the integrated mode to be able to see those. And the reason we didn't do that is the cardiology archive is so large to add a storage to the PACS archive. Didn't make sense if we knew we were going to be in an integrated mode eventually, and we didn't want to double our PACS storage and then get rid of it a couple of years later. >> So once you're on a new version of merge PACS and you're beyond this, what are your other goals in 2021? Are you looking to bring AI in? Are you using anybody else's AI currently? >> Yeah, we do have AI clinical it's phone age, so it's not not a ton of things but we've been using it clinically, fully integrated, it launches. When I open a study, when I opened a bone age study impacts it launches we have a bone age calculator as well that we've been using for almost two decades now. And so that we have to use that still but launching that automatically includes the patient's sex and birth date, which are keys for determining bone age, and all that information is there automatically. But at the same time, the images are sent to the machine learning algorithm. And in the background the machine determines a bone age that in the background it sends it straight to our dictation system and it's there when we opened the study. And so if I agree with that I signed the report and we're done. If I disagree, I copy it from my calculator and put it in until it takes just a couple of clicks. We are working on expanding. We've done a lot of research in artificial intelligence and the department. And so we've been things are sort of in the middle of translation of moving it from the research pure research realm to the clinical realm, something we're actively working on trying to get them in. Others are a little bit more difficult. >> That's the question on that John, Doctor, when you talk about injecting, you know machine intelligence into the equation. >> Yeah. >> What, how do you sort of value that? Does that give you automation? Does it improve your quality? Does it speed the outcome and maybe it's all of those but how do you sort of evaluate the impact to your organisation? >> I there's a lot of ways you can do it. And you touched on one of my favorite one of my favorite talking points, in a lot of what we've been doing and early machine learning is around image interpretation helping me as a radiologist to see a finding. Unfortunately, most of the things are fairly simple tasks that it's asking us to do. Like, is there a broken bone? Yes or no, I'm not trying to sound self-congratulatory or anything, but I'm really good at finding broken bones. I get, I've been doing it for a long time and, and radio, you know so machines doing that, they're going to perform as well as I can perform, you know, and that's the goal. Maybe they'll perform a little bit better maybe a little bit worse but we're talking tiny increments there they're really to me, not much value of that it's not something I would want. I don't value that at a time where I think machine learning can have real value around more on some of the things that you mentioned. So can it make me more efficient? Can it do the things that are so annoying that and they'd take, they're so tedious that they make me unhappy. A lot of little measurements for example are like that an example. So in a patient with cancer, we measure a little tumors everywhere and that's really important for their care, but it's tedious and so if a machine could do that in an automated way and I checked it that, you know, patient when because he or she can get that good quality care and I have a, you know, a workflow efficiency game. So that one's important. Another one that would be important is if the machine can see things I can't see. So I'm really good at finding fractures. I'm not really good at understanding what all the pixels mean and, you know in that same patient with cancer, oh what do all the pixels mean in that tumor? I know it's a tumor. I can see the tumor, I can say it's a tumor but sometimes those pixels have a lot of information in them and may give us prognosis, you know, say that this patient may, maybe this patient will do well with this specific type of chemotherapy or a specific or has a better prognosis with one with one drug compared to another. Those are things that we can't usually pick out. You know, it's beyond the level of that are I can perceive that one is really the cutting edge of machine learning. We're not there yet and then the other thing are things that, you know just the behind the scenes stuff that I don't necessarily need to be doing, or, you know so it's the non interpretive artificial intelligence. >> Dave: Right. >> And that's what I've been also trying to push. So an example of when the algorithms that we've been developing here we check airways. And this is a little bit historical in our department, but we want to make sure we're not missing a severe airway infection. That can be deadly, it's incredibly rare. Vaccines have made it go away completely but we still check airways. And so what happens is the technologist takes the x-ray. They come in to ask us if it's okay, we are interrupted from what we're doing. We open up the study, say yes or no. Okay, not okay, if it's not okay they go back, take another study. Then come back to us again and say, is it okay or not? And we repeat this a couple of times it takes them time that they don't need to spend and takes us time. And so we have, we've built an algorithm where the machine can check that and their machine is as good or a little bit worse than us, but give can give that feedback. >> Dave: Got it. >> The challenge is getting that feedback to the technologist quickly. And so that's, that's I think part for us to work on stuff. >> Thank you for that. So, John, we've probably got three or four minutes left. I'll let you bring it home and appreciate that Doctor Towbin >> I think one of the biggest impacts probably I knew this last year with the pandemic, Doctor Towbin is this, I know you're a big foodie. So having been to some good restaurants and dinners with the hot nurse in a house how's the pandemic affected you personally. And some of the things you like to do outside of work. >> Everything is shut down. And everything has changed. I have not left the house since March besides come to work and my family hasn't either. And so we're hardcore quarantining and staying you know, staying out and keeping it home. So we've not gone out to dinner or done much else. >> So its DoorDash and Uber Eats or just learned to cook at home. >> It's all cooking at home. We're fortunate, my wife loves to cook. My kids love to cook. I enjoy cooking, but I don't have the time as often. So we've done a lot of different are on our own experimenting. Maybe when the silver lining one of the things I've really relished about all this is all this time I get to spend with my family. And that closeness that we've been able to achieve because of being confined in our house the whole time. And so I've played get to play video games with my kids every night. We'd been on a big Fortnite Keck lately since it's been down making. So we've been playing that every night since we've watched movies a lot. And so as a family, we've, I it's something I'll look back fondly even though it's been a very difficult time but it's been an enjoyable time. >> I agree, I've enjoyed more family time this year as well, but final question is in 2021, beyond the PACS upgrade what are the top other two projects that you want to accomplish with us this year? And how can we help you? >> I think our big one is are the big projects are unexpanded enterprise imaging. And so we want to continue rolling out to other areas that will include eventually incorporating scopes, all the images from the operating room. We need to be able to get into pathology. I think the pathology is really going to be a long game. Unfortunately, I've been saying that already for 10 years and it's still probably another 10 years ago but we need to go. We can start with the gross pathology images all the pictures that we take for tumor boards and get those in before we start talking about whole slide scanning and getting in more of the more of the photographs in the institution. So we have a route ambulatory but we need inpatient and ER. >> All right one last question. What can IBM do to be a better partner for you guys? >> I think it's keep listening keep listening and keep innovating. And don't be afraid to be that innovative partner sort of thinking as the small company that startup, rather than the giant bohemoth that can sometimes happen with large companies, it's harder. It is fear to turn quickly, but being a nimble company and making quick decisions, quick innovations. >> Great, quick question. How would you grade IBM, your a tough grader? >> It depends on what I am a tough grader but it depends on what, you know as the overall corporate partnership? >> Yeah the relationship. >> I'd say it's A minus. >> Its pretty good. >> I think, I mean, I, we get a lot of love from IBM. I'm talking specifically in the imaging space. I not, maybe not, I don't know as much on the hardware side but we, yeah, we have a really good relationship. We feel like we're listened to and we're valued. >> All right, well guys, thanks so much. >> So even if it's not an A plus- >> Go ahead. >> I think there's some more to, you know, from the to keep innovating side there's little things that we just let you know we've been asking for that we don't always get but understand the company has to make business decisions not decisions on what's best for me. >> Of course got to hold that carrot out too. Well thanks guys, really appreciate your time. Great conversation. >> Yeah, thank you. >> All right and thank you for spending some time with us. You're watching client conversations with IBM Watson Health.

>> Welcome to this IBM Watson Health "Client Conversation." We're probing the dynamics of the relationships between IBM and its clients. And we're going to look back, we're going to explore the present situation and we're going to discuss the future state of healthcare. My name is Dave Vellante from theCUBE and with me are Dr. David Huelsman, who is a radiologist at TriHealth, which is a provider of healthcare in hospitals and John Kritzman who is with of course IBM Watson Health. Gentlemen welcome. Thanks so much for coming on. >> Thank you. >> Yeah, thanks for having us. >> Doctor let me say you're welcome. Let me start with you. As an analyst and a TV host in the tech industry, we often focus so much on the shiny new toy, the new widget, the new software. But when I talk to practitioners, almost to a person, they tell me that the relationship and trust are probably the most important elements of their success, in terms of a vendor relationship. And over the last year, we've relied on both personal and professional relationships to get us through some of the most challenging times any of us have ever seen. So, Dr. Huelsman, let me ask you, and thinking about the challenges you faced in 2020, what does partnership mean to you and how would you describe the relationship with IBM? >> Well, it is exactly the reason why when we started our journey on this enterprise imaging project at TriHealth, that we very early on made the decision We only wanted one vendor. We didn't want to do it piecemeal, like say get a vendor neutral archive from one organization, and the radiology viewer from another. We wanted to partner with the chosen vendor and develop that long-term relationship, where we learn from each other and we mutually benefit each other, in sort of not just have a transactional relationship, but that we share the same values. We share the same vision. And that's what stood out to us is Watson Health imagings vision, mirrored TriHealth's in what we were trying to achieve with our enterprise imaging project. >> You know, let me follow up with that if I could. A lot of times you hear the phrase, "Single throat to choke" and it's kind of a pejorative, right? It's a really negative term. And the way you just described that Dr. Huelsman is you were looking for a partnership. Yeah, sure. Maybe it was more manageable and maybe it was a sort of Singletree, but it was really about the partnership, going forward in a shared vision and really shared ownership of the outcome. Is that a fair characterization? >> Yeah, how about more positive is "One hand to shake." >> Wow, yeah, I love it. (chuckles) One hand to shake. I'm going to steal that line. That's good. I like it. Keep it positive. Okay, John, when you think about the past 12 months and I know you have history with TriHealth, and more recently have rejoined the account, but how would you kind of characterize that relationship and particularly anything you can add about the challenges of the 2020? What stands out to you? >> Yeah, I think going back to your one hand to shake or one vendor to hug all that's not allowed during COVID, but we're excited to be back working with you, I am in particular. And at the beginning of this sales process and RFP when you guys were looking for that vendor partner, we did talk to you about the journey, the journey with AI that we already had mature products on the vendor neutral archive side and all the product pieces that you were looking for. And I know you've recently went live over the last year and you've been working through, crawling through and learning to walk and starting to run, hopefully. And at some point we'll get to the end of the marathon, where you'll have all the AI pieces that you're looking for. But this journey has been eyeopening for all of us, from using consultants in the beginning, to developing different team members to help make you successful. So I think I've been tracking this from the outside looking in, and I'm happy to be back, more working direct with you this year to help ensure your longterm success. >> Yeah, that's great John. You have some history there. I'm going to probe that a little bit. So doctor, you talked about this enterprise imaging project. I presume that's part of, that's one of the vectors of this journey that you're on. What are you trying to accomplish in the sort of near term and midterm in 2021? John mentioned AI, is there a data element to this? Are there other, maybe more important pressing things? What are your main goals for 2021? >> Sure. Well, where we are, where we've started, the first step was getting all of our imaging stored consistently in the same place and in the same way. We had like many health system, as you grow, you acquire facilities, you acquire physician practices and they all have their own small packs system, different ways of storing the data. And so it becomes very unwieldy to be a large organization and try to provide a consistent manner of your physicians interacting with the data, with the imaging in the same way. And so it was a very large dissatisfier in our EMR to, oh if you wanted to see cardiovascular imaging, it's this tab. If you wanted to see radiology, it was this tab. If you wanted to see that, oh you got to go to the media tab. And so our big goal is, okay, let's get the enterprise archive. And so the Watson enterprise archive is to get all of our imaging stored in the same place, in the same way. And so that then our referring physicians and now with our patients as well, that you can view all the imaging, access it the same way and have the same tools. And so that's the initial step. And we're not even complete with that first step, that's where COVID and sort of diverting resources, but it's there, it's that foundation, it's there. And so currently we have the radiology, cardiology, orthopedics and just recently OB-GYN, all of those departments have their images stored on our Watson Enterprise Archive. So the ultimate goal was then any imaging, including not just what you typically think of radiology, but endoscopy and arthroscopy and those sort of images, or wound care images, in that any image, any picture in our organization will be stored on the archive. So that then when we have everything on that archive, it's easier to access consistently with the same tools. But it's also one of the large pieces of partnering with with Watson Health Imaging, is the whole cognitive solutions and AI piece. Is that, well now we're storing all the data in a consistent manner, you can access it in a consistent manner, well then we hope to analyze it in a consistent manner and to use machine learning, and the various protocols and algorithms that Watson Health Imaging develops, to employ those and to provide better care. >> Excellent, thank you for that. John, I wonder if you could add to that? I mean, you've probably heard this story before from other clients, as well as TriHealth, I call it EMR chaos. What can you add to this conversation? I'm particularly interested in what IBM Watson Health brings to the table. >> Sure, we've continued to work with TriHealth. And like we said earlier, you do have to walk before you can run. So a lot of this solution being put in place, was getting that archive stood up and getting all the images transferred out of the legacy systems. And I think that we're nearly done with that process. Doing some find audits, able to turn off some of the legacy systems. So the data is there for the easier to do modalities first, the radiology, the cardiology, the OB, as Dr. Huelsman mentioned and the ortho. And now it's really getting to the exciting point of really optimizing everything and then starting to bring in other ologies from the health system, trying to get everything in that single EMR view. So there was a lot of activity going on last year with optimizing the system, trying to fine tune hanging protocols, make the workflow for everybody, so that the systems are efficient. And I think we will continue on that road this year. We'll continue down further with other pieces of the solution that were not implemented yet. So there's some deeper image sharing pieces that are available. There are some pieces with mobile device image capture and video capture that can be deployed. So we look forward to working in 2021 on some of those areas, as well as the increased AI solutions. >> So Dr. Huelsman I wonder if you could double click on that. I mean if you're talking to IBM, what are the priorities that you have? What do you, what do you really need from Watson Health to get there? >> So I spoke with Daniel early last week, and sort of described it as now we have the foundation, we sort of have the skeleton and now it's time to put meat on the bones. And so what we're excited about is the upcoming patient synopsis would be the first piece of AI cognitive solutions that Watson Health Imaging provides. And it's sort of that partnership of we're not expecting it to be perfect, but is it better than we have today? There is no perfect solution, but does it improve our current workflow? And so we'll be very interested of when we go live with patients synopsis of does this help? Is this better than what we have today? And the focus then becomes partnering with Watson Health Imaging is how do we make it better for ourselves? How do we make it better for you? I think we're a large health organization and typically we're not an academic or heavy research institution, but we take care of a lot of patients. And if we can work together, I think we'll find solutions. It's really that triple aim of how to provide better care, at cheaper costs, with a better experience. And that's what we're all after. And what's your version of patient, the current version of patients synopsis, and okay does it work for us? Well, even if it does, how do we make it better? Or if it doesn't, how do we make it work? And I think if we work together, make it work for TriHealth, you can make it work at all your community-based health organizations. >> Yeah. So, John that brings me to, Dr. Huelsman mentioned a couple of things in terms of the outcomes. Lower costs, better patient experience, et cetera. I mean, generally for clients, how do you measure success? And then specifically with regard to TriHealth, what's that like? What's that part of the partnership? >> Yes, specifically with TriHealth, the measure of success will be when Dr. Huelsman is able to call and be a super reference for us, and have these tools working to his satisfaction. And when he's been able to give us great input from the customer side, to help improve the science side of it. So today he's able to launch his epic EMR in context and he has to dig through the data, looking for those valuable nuggets and with using natural language processing, when he has patients synopsis, that will all be done for him. He'll be able to pull up the study, a CT of the head for instance and he'll be able to get those nuggets of information using natural language processing that Watson services and get the valuable insights without spending five or 10 minutes interrogating the EMR. So we look forward to those benefits for him, from the data analytics side, but then we also look forward to in the future, delivering other AI for the imaging side, to help him find the slices of interest and the defects that are in that particular study. So whether that's with our partner AI solutions or as we bring care advisers to market. So we look forward to his input on those also. >> Can you comment on that Dr. Huelsman? I would imagine that you would be really looking forward to that vision that John just laid out, as well as other practitioners in your organization. Maybe you could talk about that, is that sort of within your reach? What can you tell us? >> Well, absolutely. That was sort of the shared vision and relationship that we hope for and sort of have that shared outlook is we have all this data, how do we analyze it to improve, provide better care cheaper? And there's no way to do that without you harnessing technology. And IBM has been on the cutting edge of technology for my lifetime. And so it's very exciting to have a partnership with WHI and IBM. There's a history, there's a depth. And so how do we work together to advance, because we want the same things. What impressed me was sure, radiology and AI has been in the news and been hyped and some think over-hyped, and what have you. Everyone's after that Holy grail. But it's that sense of you have the engineers that you talk to, but there is an understanding that don't design the system for the engineers, design it for the end user. Design it for the radiologist. Talk to the end user, because it can be the greatest tool in the world, but I can tell you as a radiologist, if it interrupts my workflow, if it interrupts my search pattern for looking at images, it doesn't help me and radiologists won't use it. And so just having a great algorithm won't help. It is how do you present it to the end user? How do I access it? How can I easily toggle on and off, or do I have to minimize and maximize, and log into a different system. We talked earlier is one throat to choke, or one vendor to hug, we only want one interface. Radiologists and users just want to look at their... They have the radiology viewer, they have their PACS, we look at it all day and you don't want to minimize that and bring up something else, you want to keep interacting with what you're used to. And the mouse buttons do the same thing, it's a mouse click away. And that's what the people at Watson Health Imaging that we've interacted with, they get it. They understand that's what a radiologist would want. They want to continue interacting with their PACS, not with a third vendor or another program or something else. >> I love that. That ton of outside in thinking, starting with the radiologist, back to the engineer, not the reverse. I think that's something that IBM, and I've been watching IBM for a long time, it's something that IBM has brought to the table with its deep industry expertise. I maybe have some other questions, but John I wanted to give you an opportunity. Is there anything that you would like to ask Dr. Huelsman that maybe I haven't touched on yet? >> Yeah. Being back on your account this year, what do you see as a success? What would you count as a success at the end of 2021, if we can deliver this year for you? >> The success would be say, at the end of the year, we've got the heavy hitters, all stored on the archive. Do we pick up all the little, we've got the low hanging fruit, now can we go after the line placement imaging and the arthroscopy and dioscomy, and all those smaller volume in pickups, that we truly get all of our imaging stored on that archive. And then the even larger piece is then do we start using the data on the archive with some cognitive solution? I would love to successfully implement, whether it's patient synopsis or one of the care advisors, that we start using sort of the analytics, the machine learning, some AI component that we successfully implement and maybe share good ideas with you. And sure we intend to go live with patient synopsis next month. I would love it by the end of the year, if the version that we're using patients synopsis and we find it helpful. And the version we use is better than what we went live with next month, because of feedback that we're able to give you. >> Great we looked forward to working with you on that. I guess, personally, with the pandemic in 2020, what have you become, I guess in 2020 that maybe you weren't a year ago before the pandemic, just out of curiosity? >> I'm not sure if we're anything different. A mantra that we've used in the department of radiology at TriHealth for a decade, "Improved service become more adaptable." And we're a service industry, so of course we want to improve service, but be adaptable, become more adaptable. And COVID certainly emphasize that need to be adaptable, to be flexible and the better tools we have. It was great early in the COVID when we had the shutdowns, we found ourselves, we have way more radiologists than we had studies that needed interpreted. So we were flexible all often and be home more. Well, the referring physicians don't know like, well is Dr. Huelsman working today? We don't expect them to look up our schedules. If I get a page that, Hey, can you take a look at this? It was great that at that time I didn't have a home workstation, but I had iConnect access. Before there was no way for me to access the images without getting on a VPN and logging on, it takes 10, 15 minutes before I'm able. Instead I could answer the phone, and I'm not going to say, "Oh, I'm sorry, I'm not at the hospital day, call this number someone else will help you." I have my iPad, go to ica.trihealth.com logged on, I'm looking at the images two minutes later. And so the ease of use, the flexibility, it helped us become adaptable. And I anticipate with we're upgrading the radiology viewer and the iConnect access next month as well, to try to educate our referring physicians, of sort of the image sharing capabilities within that next version of our viewer. Because telehealth has become like everywhere else. It's become much more important at TriHealth during this pandemic. And I think it will be a very big satisfier for both referring physicians and patients, that those image sharing capabilities, to be able to look at the same image, see the annotation that either the radiologist or the referring physician, oncologist, whoever is wanting to share images with the patient and the patient's family, to have multiple parties on at the same time. It will be very good. >> With the new tools that you have for working from home with your full workstation, are you as efficient reading at home? >> Yes. >> And having full access to the PACS as in-house? >> Absolutely. >> That's great to hear. Have you been able to take advantage of using any of the collaboration tools within iConnect, to collaborate with a referring physician, where he can see your pointer and you can see his, or is that something we need to get working? >> Hopefully if you ask me that a year from now, the answer will be yes. >> So does that exit a radiologist? Does that help a radiologist communicate with a referring physician? Or do you feel that that's going to be a- >> Absolutely. We still have our old school physicians that we love who come to the reading room, who come to the department of radiology and go over studies together. But it's dwindling, it's becoming fewer and fewer as certain individuals retire. And it's just different. But the more direct interaction we can have with referring physicians, the better information they can give us. And the more we're interacting directly, the better we are. And so I get it, they're busy, they don't want to, they may not be at the hospital. They're seeing patients at an outpatient clinic and a radiologist isn't even there, that's where that technology piece. This is how we live. We're an instantaneous society. We live through our phone and so great it's like a FaceTime capability. If you want to maintain those personal relationships, we're learning we can't rely on the orthopedist or whomever, whatever referring physician to stop by our reading room, our department. We need to make ourselves available to them and make it convenient. >> That market that you working in Cincinnati, we have a luxury of having quite a few customers with our iConnect solutions. There's been some talk between the multiple parties, of potentially being able to look across the other sites and using that common tool, but being able to query the other archives. Is that something that you'd in favor of supporting and think would add value so that the clinicians can see the longitudinal record? >> Yes And we already have that ability of we can view care everywhere in our EMR. So we don't have the images right away, but we can see other reports. Again, it's not convenient. It's not a click away, but it's two, three, four clicks away. But if I see, if it's one of my search patterns of I just worked the overnight shift last week and then you get something through the ER and there's no comparisons, and it's an abnormal chest CT. Well, I look in Care Everywhere. Oh, they had a chest CT at a different place in the city a year ago, and I can see the report. And so then at that time I can request, and it can take an hour or so, but look back and the images will be accessible to me. But so how do we improve on that? Is to make the images, that I don't have to wait an hour for the images. If we have image sharing among your organizations that can be much quicker, would be a big win. >> As you read in your new environment, do you swivel your chair and still read out of any other specialty systems, for any types of studies today? >> No, and that was a huge win. We used to have a separate viewing system for mammography and we were caught like there were dedicated viewing stations. And so even though we're a system, the radiologist working at this hospital, had to read the mammograms taken at that hospital. And one at the other hospital could only read the ones taken at that hospital. And you couldn't share the workload if it was heavy at one site and light at the other. Well, now it's all viewed through the radiology viewer if you merge PACS, in not just general radiology, but impressed. It has been so much better world that the workflow is so much better, that we can share the work list and be much more efficient. >> Do you feel that in your, your new world, that you're able to have less cherry picking between the group, I guess? Do you feel like there's less infighting or that the exams are being split up evenly through the work list? Or are you guys using some sort of assignment? >> No. And I'm curious with our next version of PACS, the next version of merge packs of 008. I forget which particular >> John: 008. >> It's 008, yeah. I know there's the feature of a smart work list to distribute the exams. Currently, we just have one. It's better than what we have before. It's one large list. We've subdivided, teased out some things that not all of the radiologist read of like MSK and cardiac and it makes it more convenient. But currently it is the radiologist choose what study they're going to open next. To me how I personally attack the list is I don't look at the list. Some radiologists can spend more time choosing what they're going to read next than they do reading. (chuckles) And so if you don't even look, and so the feature I love is just I don't want to take my eyes off my main viewer. And I don't want to swivel my chair. I don't want to turn my head to look at the list, I want everything right in front of me. And so currently the way you can use it is I never look at the list. I just use the keyboard shortcuts of, okay, well I'm done with that study. I mark it, there's one button I click on my mouse that marks it dictated, closes it and brings up the next study on the list. >> Hey guys, I got to jump in. We're running up against the clock, but John if you've got any final thoughts or Dr. Huelsman, please. >> Sure. Dr. Huelsman, I guess any homework for me? What are the top two or three things I can help you with in 2021 to be successful? >> Keep us informed of what you're working on, of what's available now. What's coming next, and how soon is it available? And you let us see those things? And we'll give you a feedback of hey, this is great. And we'll try to identify things, if you haven't thought of them, hey, this would be very helpful. >> Gents, great conversation. Gosh we could go on for another 45 minutes. And John you really have a great knowledge of the industry. And Dr. Huelsman, thanks so much for coming on. Appreciate it. >> Thank you. >> You're welcome >> And thanks for spending some time with us. You're watching "Client Conversations" with IBM Watson Health.

>>Welcome to this IBM Watson health client conversation here. We're probing the dynamics of the relationship between IBM and its clients. And we're looking back, we're going to explore the present. We're going to discuss the future state of healthcare. My name is Dave Volante from the Cuban with me are Robert Stell horn. Who's associate director, H E O R at sukha, otherwise known as pharmaceuticals, America and Rena Felton. Who's with of course, IBM Watson health. Welcome folks. Great to have you. Hi, so like strong relationships, as we know, they're the foundation of any partnership. And of course over the past year, we've had to rely on both personal and professional relationships to get us through some of the most challenging times, if not the most challenging times of our lives. So let me start with you, Robert, how has the partnership with IBM helped you in 2020? >>I think it was just a continuation of the excellent relationship we have with Rena and IBM. Um, starting in March, we had really a shift to an all remote, uh, workplace environment. And I think that constant communication with Rina and IBM helped that situation because she kept us up to date with, uh, additional products and offerings. And basically we came up with some additional solutions towards the end of the year. So we're gonna watch >>Pick it up from here. Let's go, let's go a little bit deeper and maybe you can talk about some of the things that you've done with Robert and his team and, and maybe some of the accomplishments that you're most proud of in 2020. >>No, absolutely. And I have to kind of echo what you first said about the foundation and our partnerships being the foundation, um, of our past present and future. So I do want to take the opportunity to thank Rob again for joining us today. It is, um, I know, you know, with his kids home and remote learning, um, it's a lot, uh, to, to ask in addition to, you know, your day to day work. So, so thank you, Rob. Um, I guess the question that I have for you is what would be the greatest accomplishment, um, that Watseka and IBM Watson had in 2020? >>I would say it was the addition of the linked claims EMR data, the LDCD product that we were able to license in-house, uh, thanks to your attention and to show the advantages and the strengths of that data. We are able to license that in to our, uh, set up assets we have internally. And what that's gonna allow us to do is really find out more information about the patients. Uh, we're existing users of the Mark IBM, uh, market scan data. Um, this is going to allow us to tie into those same patients and find out more about them. Um, in particular, uh, a lot of our products are in the mental health space and a lot about standing questions we have are why are the patients getting different products? And with the notes are available in that link data. We're going to now be able to tap into more information about what is happening with the patient. >>Okay. Can I ask a question on that? Um, if you guys don't mind, I mean, you know, when you, when you hear about, you know, uh, EMR, uh, in the early days, it was a lot about meaningful use and getting paid. It sounds like you guys are taking it much deeper and as a, as a, you know, as an individual, right, you're, you're really happy to hear that this information is now going to be used to really improve, uh, healthcare is, do I have that right? Is that, you know, kind of the nature of where you guys are headed? >>Well, I think ultimately it's the, the, the, the main goal is to help the patients and provide the products that can really, um, help them in their daily lives. So, um, really with this data, now, we're going to be able to tap into more of the why, um, exist in claims data. We cannot really get that information, why VC information, about what diagnoses they incurred during their treatment history. And we also can see, uh, different prescriptions that are given to them, but now we're going to be able to tie that together and get more understanding to really see more focused treatment pattern for them. >>So, Reno, w w you sit down with Rob, do you have like a, sort of a planning session for 2021? Why don't you sort of bring us up to, uh, to what your thinking is there and how you guys are working together this year? >>Yeah, no, absolutely. Um, actually, before we get to that, I wanted to kind of add onto what Rob was saying as well. It's interesting given, you know, the pandemic in 2020 and what the LCD data is going to do, um, to really be able to look back. And as Rob mentioned, looking specifically at mental health, the ability to look back and start looking at the patients and what it's really done to our community and what it's really done to our country, um, and looking at patients, you know, looking back at, at sort of their, their patient journey and where we are today. Um, but Rob and I talk all the time, we talk all the time, we probably talk three or four times a day sometimes. So I would say, um, we, we text, uh, we do talk and have a lot of our strategic, um, sessions, uh, our outlook for 2021 and what the data strategy is for Otsuka. Um, in addition, additional data assets to acquire from IBM, as well as how can we sort of leverage brander IBM, um, assets like our red hat, our OpenShift, our cloud-based solutions. So, you know, Rob and I are constantly talking and we are, um, looking for new ways to bring in new solutions into Otsuka. Um, and you know, yeah, we, we, we talk a lot. What do you think, Rob? >>I think we have an excellent partnership. Uh, basically, um, I think their relationship there is excellent. Um, we have excellent communication and, you know, I find when there's situations where I may be a bind Reno's is able to help out instantly. Um, so it's, it's really a two way street and it's an excellent partnership. >>I wonder if I could double click on that. I mean, relative to maybe some of your, I mean, I'm sure you have lots of relationships with lots of different companies, but, but what makes it excellent specifically with regard to IBM? Is there, is there anything unique Rob, that stands out to you? >>It would be the follow-up, um, really, it's not just about, uh, delivering the data and say, okay, here you have your, your product work with it in basically the, the, the vendor disappears, it's the constant followup to make sure that it's being used in any way they can help and provide more information to really extract the full value out of it. >>So I'm gonna forget to ask you guys, maybe each of you, you know, both personally and professionally, I feel like, you know, 20, 20 never ended it just sort of blended in, uh, and, and, but some things have changed. We all talk about, geez, what's going to be permanent. How have you each been affected? Um, how has it helped you position for, for what's coming in in the years ahead, maybe Reena, you could start and then pick it up with, with Rob. >>Oh man. Um, you know, 2020 was definitely challenging and I think it was really challenging given the circumstances and in my position where I'm very much used to meeting with our customers and having lunch and really just kind of walking down the hallways and bumping into familiar faces and really seeing, you know, how we can provide value with our solutions. And so, you know, that was all stripped in 2020. Uh, so it's been, it's been quite challenging. I will say, working with Rob, working with some of my other customers, um, I've had, uh, I've had to learn the resilience and to be a little bit more relentless with phone calls and follow ups and, and being more agile in my communications with the customers and what their needs are, and be flexible with calendars because there's again, remote learning and, and, um, and the like, so I think, you know, positioned for 2021 really well. Um, I am excited to hopefully get back out there and start visiting our customers. But if not, I certainly learned a lot and just, um, the follow-up and again, the relentless phone calls and calling and checking up on our customers, even if it's just to say, hi, see how everyone's doing a mental check sometimes. So I think that's, that's become, um, you know, what 2020 was, and, and hopefully, you know, what, 2021 will be better and, uh, kind of continue on that, that relentless path. >>What do you think, Rob? Hi, how are you doing? >>I would echo a lot of Rina's thoughts and the fact of, yeah, definitely miss the in-person interaction. In fact, I will say that I remember the last time I was physically in the office that Scott, it was to meet with Rina. So I distinctively remember that they remember the date was March, I believe, March 9th. So it just shows how this year as has been sort of a blur, but at the same time, you remember certain milestones. And I think it's because of that relationship, um, we've developed with IBM that I can remember those distinctive milestones and events that took place. >>So Rob, I probably should have asked you upfront, maybe tell us a little bit about Alaska, uh, maybe, maybe give us the sort of quick soundbite on where you guys are mostly focused. Sure. >>Oh, it's guys, uh, a Japanese pharmaceutical company. The focus is in mental health and nephrology, really the two main business areas. Um, my role at guys to do the internal research and data analytics within the health economics and outcomes research group. Um, currently we are transitioned to a, uh, name, which is global value and real world evidence. Um, fact that transition is already happened. Um, so we're going to have more of a global presence going forward. Um, but my role is really to, uh, do the internal research across all the brands within the company. >>So, so Rena, I wonder this, thank you for that, Robert. I wonder if you could think, thinking about what you know about Scott and your relationship with Robin, your knowledge of, of the industry. Uh, there's so much that IBM can bring to the table. Rob was talking about data earlier, talking about EMR, you were talking about, you know, red hat and cloud and this big portfolio you have. So I wonder if you could sort of start a conversation for our audience just around how you guys see all those assets that you have and all the knowledge, all that data. How do you see the partnership evolving in the future to affect, uh, the industry and the, in the future of healthcare? >>Well, I would love to see, um, the entire, uh, uh, platform, um, shift to, to the IBM cloud, um, and certainly, you know, leverage the cloud pack and analytics that, that we have to offer, um, baby steps most definitely. Um, but I do think that there is, uh, the opportunity to really move, um, and transform the business into something a lot more than, than what it is. >>Rob has the pandemic effected sort of how you think about, um, you know, remote services and cloud services and the, like, were you already on the path headed there? Did accelerate things, have you, you know, have you not had time because things have been so busy or maybe you could comment? >>Yeah, I think it's really a combination. And so I think you hit on a, a fair point there, just the time, uh, aspect. Um, it's definitely been a challenge and your, um, I have two children and remote learning has definitely been a challenge from that perspective. So time has definitely been, uh, on the short side. Um, I do see that there are going to in the future be more and more users of the data. So I think that shift to a potential cloud environment is where things are headed. >>So we, I have a bunch more questions, but I want to step back for a second and see if there's anything that you'd like to ask Rob before I go onto my next section. Okay. So I wonder if you could think about, um, maybe both of you, the, the, when you think back on, on 2020 and all the, you know, what's transpired, what, what transitions did you guys have to make? Uh, maybe as a team together IBM and Alaska. Um, and, and, and what do you see as sort of permanent or semi-permanent is work from home? We're gonna going to continue at a higher rate, uh, are there new practice? I mean, I know just today I made an online appointment it's for a remote visit with my doctor, which never could have happened before the pandemic. Right. But are there things specific to your business and your relationship that you see as a transition that could be permanent or semi-permanent? >>Well, I, I think it's there, there's definitely a shift that's happened that will is here to stay, but I don't know if it's full, it's going to be a combination in the future. I think that in-person interactions, especially what Rena mentioned about having that face-to-face interaction is still going to be one things are in the right place and safe they're going to happen again. But I think the ability to show that work can happen in a virtual or a full remote workplace, that's going to just allow that to continue and really give the flex of people. The flexibility I know for myself, flexibility is key. Like I mentioned, with two small children, um, that, that, that becomes such a valuable addition to your work, your life and your work life in general, that I think that's here to stay. >>Okay. Um, so let me ask you this, uh, w one of the themes of this event is relentless re-invention. So what I'm hearing from you Rob, is that it kind of a hybrid model going forward, if you will, uh, maybe the option to work from home, but that face to face interaction, especially when you're creating things like you are in the pharmaceutical business and the deep R and D that collaborative aspect, you know, you, it's harder when you're, when, when, when you're remote. Um, but maybe you could talk about, you know, some of those key areas that you're, you're going to be focused on in 2021 and, and really where you would look for IBM to help. >>I think in 2021, the team I'm part of it, part of is, is growing. So I think there's going to be additional demand for internal research, uh, uh, capabilities for analysis done within the company. So I think I'm going to be looking to Rena to, uh, see what new data offerings are available and all what new products are going to be available. But beyond that, um, I think it's the potential that, you know, there's so much, uh, projects, um, that are going to be coming to the table. We may need to outsource some of that projects and IBM could be potentially be a partner there to do some of the analysis on to help out there. >>Anything you'd add. >>Uh, no, I think that, that sounds good. >>How would you grade IBM and your relationship with IBM Rob? >>Well, I have to be nice to Rina cause she's been very nice to me. I would say an a, an a plus >>My kids, I got kids in college. Several, they get A's, I'm happy. Oh, that's good. You know, you should be proud. So, congratulations. Um, anything else Reno, you give you, I'll give you a last word here before we wrap, >>You know, 2020 was, was a challenging. And, you know, we talked a little bit about, you know, what time in 2020, you know, Rob and I have always had a really good relationship. I think 2020, we got closer, um, with just both professionally and really diving in to key business challenges that they have, and really working with him to understand what the customer needs are and how we can help, not only from, you know, an HR perspective, but also how can we help Otsuka, um, as a company in, in totality. So, you know, we've been able to do that, but personally, I would say that I really appreciated the relationship. I mean, we can go from talking about work to talking about children, to talking about family, um, all in the same five minute conversation or 10 minute conversation, sometimes our conversation. So, you know, thank you, Rob 2020 was definitely super challenging. >>I know for you on so many levels. Um, but I have to say you've been really great at just showing up every time picked up the phone, asked questions. If I needed something I can call you, I knew you were going to pick up, I had an offering and be like, do you have 10 minutes? Can I share this with you? And you would pick up the phone, no problem, and entertain a call or set up a call with all your internal colleagues. And I, I appreciate that so much. And, you know, I appreciate our relationship. I appreciate the business and I, I do hope that we can continue on in 2021, we will continue on in 2021. Uh, but, um, but yeah, I thank you so much. >>Rain has been extremely helpful. I don't want to thank you for all the help. Um, just to add to that one point there, you know, we have, uh, also another product, which I forgot to mention that we licensed in from IBM, it's the treatment pathways, um, tool, which is an online tool. Um, and we have users throughout the globe. So there's been times where I've needed a new user added very quickly for someone in the home office in Japan. And Rena has been extremely helpful in getting things done quickly and very proactively. >>Well, guys, it's really clear that the depth of your relationship I'm interested that you actually got closer in 2020. Uh, the fact that you communicate, you know, several times a day is I think Testament to that relationship. Uh, I'm really pleased to hear what you're doing and the potential with the EMR data for patient outcomes. Uh, as I say in the early days, I used to hear all about how well you have to do that to get paid. And it's really great to see a partnership that's, that's really focused on, on, on patient health and, and changing our lives. So, and mental health is such an important area that for so many years was so misunderstood and the, and the data that we now have, and of course, IBM's heritage and data is key. Uh, the relationship and the follow-up and also the flexibility is, is something I think we all learned in 2020, we have to, we've kind of redefined, you know, resilience in our organizations and, uh, glad to see you guys are growing. Congratulations on the relationship. And thanks so much for spending some time with me. >>Thank you. Thank you, Dave. Thank you, Raina >>For watching this client conversation with IBM Watson health.

>>with me are and Crystal Graham, a k a a C. She's the C R O of talent, and Chris Degnan is the C R. O of Snowflake. We have to go to market heavies on this section, folks. Welcome to the Cube. >>Thank you. >>Thanks for having us. >>That's our pleasure. And so let's let's talk about digital transformation, right? Everybody loves to talk about it. It zone overused term. I know, but what does it mean? Let's talk about the vision of the data cloud for snowflake and digital transformation. A. C. We've been hearing a lot about digital transformation over the past few years. It means a lot of things to a lot of people. What are you hearing from customers? How are they thinking about when I come, sometimes called DX and what's important to them? Maybe address some of the challenges even that they're facing >>Dave. That's a great question to our customers. Digital transformation literally means staying in business or not. Um, it's that simple. Um, the reality is most agree on the opportunity to modernize data management infrastructure that they need to do that to create the speed and efficiency and cost savings that digital transformation promises. But but now it's beyond that. What's become front and center for our customers is the need for trusted data, supported by an agile infrastructure that and allow a company to pivot operations as they need. Um, let me give you an example of that. One of our customers, a medical device company, was on their digital journey when Cove it hit. They started last year in 2019, and as the pandemic hit at the earlier part of this year, they really needed to take a closer look at their supply chain. On went through an entire supply chain optimization, having been completely disrupted in the you think about the logistics, the transportation, the location of where they needed to get parts, all those things when they were actually facing a need to increase production by about 20 times. In order to meet the demand on DSO, you can imagine what that required them to do and how reliant they were on clean, compliant, accurate data that they could use to make extremely critical decisions for their business. And in that situation, not just for their business but decisions. That would be the about saving lives, so the stakes have gotten a lot higher, and that's that's just one industry. It's it's really across all industries. So when you think about that, really, when you talk to any of our customers, digital transformation is really mean. It really means now having the confidence in data to support the business at critical times with accurate, trusted information. >>Chris, I've always said a key part of digital transformation is really putting data at the core of everything you know, Not not the manufacturing plant, that the core in the data around it, but putting data at the center. It seems like that's what Snowflake is bringing to the table. Can you comment? >>Yeah. I mean, I think if if I look across what's happening and especially a Z A. C said, you know, through co vid is customers are bringing more and more data sets. They wanna make smarter business decisions based on data making, data driven decisions. And we're seeing acceleration of of data moving to the cloud because they're just in abundance of data. And it's challenging to actually manage that data on premise and and as we see those those customers move those large data sets. Think what A C said is spot on is that customers don't just want to have their data in the cloud. But they actually want to understand what the data is, understand, who has access to that data, making sure that they're actually making smart business decisions based on that data. And I think that's where the partnership between both talent and stuff like are really tremendous, where you know we're helping our customers bring their data assets to to the cloud, really landing it and allowing them to do multiple, different types of workloads on top of this data cloud platform and snowflake. And then I think again what talent is bringing to the table is really helping the customer make sure that they trust the data that they're actually seeing. And I think that's a really important aspect of digital transformation today. >>Awesome and I want to get into the partnership. But I don't wanna leave the pandemic just yet. A c. I want to ask you how it's affected customer priorities and timelines with regard to modernizing their data operations and what I mean to that they think about the end and life cycle of going from raw data insights and how they're approaching those life cycles. Data quality is a key part of, you know, a good data quality. You're gonna I mean, obviously you want to reiterate, and you wanna move fast. But if if it's garbage out, then you got to start all over again. So what are you seeing in terms of the effect of the pandemic and the urgency of modernizing those data operations? >>Yeah, but like Chris just said it accelerated things for those companies that hadn't quite started their digital journey. Maybe it was something that they had budgeted for but hadn't quite resourced completely many of them. This is what it took to to really get them off the dying from that perspective, because there was no longer the the opportunity to wait. They needed to go and take care of this really critical component within their business. So, um, you know what? What Covic, I think, has taught companies have taught all of us is how vulnerable even the largest. Um, you know, companies on most robust enterprises could be those companies that had already begun Their digital transformation, maybe even years ago, had already started that process and we're in a better. We're in a great position in their journey. They fared a lot better and we're able to be agile. Were able Thio in a shift. Priorities were able to go after what they needed to do toe to run their businesses better and be able to do so with riel clarity and confidence. And I think that's really the second piece of it is, um or the last six months people's lives have really depended on the data people's lives that have really dependent on uncertainty. The pandemic has highlighted the importance of reliable and trustworthy information, not just the proliferation of data. And as Chris mentioned this data being available, it's really about making sure that you can use that data as an asset Ondas and that the greatest weapon we all have, really there is the information and good information to make a great business decisions. >>Of course, Chris, the other thing we've seen is the acceleration toe to the cloud, which is obviously you're born in the cloud. It's been a real tailwind. What are you seeing in that regard from your I was gonna say in the field, but from your zoom >>advantage. Yeah, well, I think you know, a C talked about supply chain, um, analytics in in her previous example. And I think one of the things that that we did is we hosted a data set. The covert data set over 19 data set within snowflakes, data marketplace. And we saw customers that were, you know, initially hesitant to move to the cloud really accelerate there. They're used to just snowflake in the cloud with this cove Cove. A data set on Ben. We had other customers that are, you know, in the retail space, for example, and use the cova data set to do supply chain analytics and and and accelerated. You know, it helped them make smarter business decisions on that. So So I'd say that you know, Cove, it has, you know, made customers that maybe we're may be hesitant to to start their journey in the cloud, move faster. And I've seen that, you know, really go at a blistering pace right now. >>You know, you just talked about, you know, value because it's all about value. But the old days of data quality in the early days of Chief Data, Officer all the focus was on risk avoidance. How do I get rid of data? How long do I have to keep it? And that has flipped dramatically. You know, sometime during the last decade, >>you can't get away too much from the need for quality data and and govern data. I think that's the first step. You can't really get to, um, you know, to trust the data without those components. And but to your point, the chief Data officers role, I would say, has changed pretty significantly. And in the round tables that I've participated in over the last, you know, several months. It's certainly a topic that they bring to the table that they'd like Thio chat with their peers about in terms of how they're navigating through the balance, that they still need toe to manage to the quality they still need to manage to the governance they still need. Thio ensure that that they're delivering that trusted information to the business. But now, on the flip side as well, they're being relied upon to bring new insights. And that's on bit's, um, really requiring them to work more cross functionally than they may have needed to in the past where that's been become a big part of their job is being that evangelist for data the evangelist. For that, those insights and being able to bring in new ideas for how the business can operate and identified, you know, not just not just operational efficiencies, but revenue opportunities, ways that they can shift. All you need to do is take a look at, for example, retail. You know, retail was heavily impacted by the pandemic this year on git shows how easily an industry could be could be just kind of thrown off its course simply by by a just a significant change like that. Andi need to be able to to adjust. And this is where, um when I've talked to some of the CEOs of the retail customers that we work with, they've had to really take a deep look at how they can leverage their the data at their fingertips to identify new in different ways in which they can respond to customer demands. So it's a it's a whole different dynamic. For sure, I it doesn't mean that that you walk away from the other and the original part of the role of the or the areas in which they were maybe more defined a few years ago when the role of the chief data officer became very popular. I do believe it's more of a balance at this point and really being able to deliver great value to the organization with the insights that they could bring >>well, is he stayed on that for a second. So you have this concept of data health, and I guess what kind of getting tad is that In the early days of Big Data Hadoop, it was just a lot of rogue efforts going on. People realize, Wow, there's no governance And what what seems like what snowflake and talent are trying to do is to make that the business doesn't have to worry about it. Build, build that in, don't bolt it on. But what's what's this notion of data health that you talk about? >>Companies can measure and do measure just about everything, every aspect of their business health. Um, except what's interesting is they don't have a great way to measure the health of their data, and this is an asset that they truly rely on. Their future depends on is that health of their data. And so if we take a little bit of a step back, maybe let's take a look at an example of a customer experiences to kind of make a little bit of a delineation between the differences of data, data, quality, data trust in what data health truly is. We work with a lot of health, a lot of hotel chains. And like all companies today, hotels collect a ton of information. There's mountains of information, private information about their customers through the loyalty clubs and all the information that they collect from there, the front desk, the systems that store their data. You can start to imagine the amount of information that a hotel chain has about an individual, and frequently that information has, you know, errors in it, such as duplicate entries, you know. Is it a Seagram, or is it in Chris Telegram? Same person, Slightly different, depending on how I might have looked or how I might have checked in at the time. And sometimes the data is also mismanaged, where because it's in so many different locations, it could be accessed by the wrong person of someone that wasn't necessarily intended to have that kind of visibility. And so these are examples of when you look at something like that. Now you're starting to get into, you know, privacy regulations and other kinds of things that could be really impactful to a business if data is in the wrong hands or the wrong data is in the wrong hands. So, you know, in a world of misinformation and mistrust, which is around us every single day, um, talent has really invented a way for businesses to verify the veracity, the accuracy of their data. And that's where data health really comes in Is being able to use a trust score to measure the data health on. That's what we have recently introduced is this concept of the trust score, something that can actually provide and measure, um, at the accuracy and the health of the data all the way down to an individual report. We believe that that that truly, you know, provides the explainable trust issue resolution, the kinds of things that companies are looking for in that next stage of overall data management. >>Thank you, Chris. Bring us home. So, one of the key aspects of what snowflake is doing is building out the ecosystem is very, very important. Really talk about how how you guys we're partnering and adding value in particular things that you're seeing customers do today within the ecosystem or with the help of the ecosystem and stuff like that they weren't able to do previously. >>Yeah. I mean, I think you know a C mentioned it. You mentioned it. You know, we spent I spent a lot of my zoom days talking Thio, chief data officers and as I'm talking to the chief data officers that they are so concerned their responsibility on making sure that the business users air getting accurate data so that they view that as data governance is one aspect of it. But the other aspect is the circumference of the data of where it sits and who has access to that data and making sure it's super secure. And I think you know, snowflake is a tremendous landing spot being a data warehouse or data cloud data platform as a service, you know, we take care of all the, you know, securing that data. And I think where talent really helps our customer base is helps them exactly What what is he talked about is making sure that you know myself as a business users someone like myself who's looking at data all the time, trying to make decisions on how many sales people I wanna hire house my forecast coming. You know, how's the how's the product working all that stuff? I need to make sure that I'm actually looking at at good data. And I think the combination of all sitting in a single repository like snowflake and then layering it on top or laying a tool like talent on top of it, where I can actually say, Yeah, that is good data. It helps me make smarter decisions faster. And ultimately, I think that's really where the ecosystem plays. An incredibly important, important role for snowflake in our customers, >>guys to great cast. I wish we had more time, but we gotta go on dso Thank you so much for sharing your perspectives. A great conversation

>> Announcer: From around the globe, it's theCUBE with digital coverage of AWS Public Sector Online, brought to you by Amazon Web Services. >> Everyone welcome back to theCUBE's coverage virtually of the AWS, Amazon Web Services, Public Sector Summit Online. Normally we're face to face in Bahrain or Asia Pacific, or even down in New Zealand and Australia, but we have to do it remotely. I'm John Furrier host of theCUBE, we've got a great segment here with a great guest, Ian McCrae, Founder and CEO of Orion Health, talking about the Global Healthcare Industry with Cloud Technology because now more than ever, we all know what it looks like, before COVID and after COVID, has upending the health care business, we're seeing it play out in real time, a lot of great benefits to technology. Ian, thank you for coming remotely from New Zealand and we're here in Palo Alto, California, thank you for joining me. >> Thank you for the invitation. >> You're the Founder and CEO of Orion Health global, award-winning provider of health information technology, supports the delivery of optimized healthcare throughout New Zealand, but now more than ever around the world, congratulations. But now COVID has hit, what is the impact of COVID because this is changing healthcare for the better and speed agility, is the services up to snuff, is it up to par? What is the situation of the post-COVID or the current COVID and then what we'll post-COVID look like for healthcare, what's your opinion? >> So, sir, I've never seen such a dramatic change in such a short time, as has happened over the last nine to 10 months. And you know what we're seeing is before COVID, a lot of focus on automating hospitals, probably primary care, et cetera, now all the focus is on putting medical records together, digital front doors giving patients access to their medical records, and much of the same way you have access to your bank records, when you travel you go into well, we don't travel now actually, but when you go into the lounges, the airline apps are very, very user friendly and the healthcare sector has been a laggard on this area, that's all about to change. And patients will be wanting, they don't want to go when they're feeling ill, they don't want to go down to their local physician practice because, well, there are other sick people there, they want to get the right care, at the right time, and the right place. And usually when they're not feeling well, they want to go online, probably symptom checking, if they need to have a consult they would like to do it there and then and not two or three days later, and they'd like to it virtually, and you know, there are definitely some things that can be done remotely and that's what people want. >> One of the things that comes up in all my interviews around innovation and certainly around AWS and cloud is the speed of innovation, and we were talking before we came on camera about I'm in Palo Alto, California, you're in Auckland, New Zealand, I don't have to fly there, although it's been quarantined for 14 days in New Zealand and summer is coming. but we can get remote services, we're talking and sharing knowledge right now. And when you were also talking before we went on about how healthcare is taking a trajectory similar to the financial industry, you saw our ATM machines, what an innovation, self service, then you got apps and then, you know, the rest is history just connect the dots. The same kind of thing is happening in healthcare, can you share your vision of how you see this playing out, why is it so successful, what are some of the things that need to be worked on and how does cloud bring it all together? >> Just on the banking front, I haven't been to the bank for many years because I understood all online, I had to go to the bank the other day, it was a novel experience. But you know I have a lot of, when I discussed with our developers and they say, well what are the requirements, I said, well, hold on, you're a patient you know what you want, you want your medical record pulled together, right, you want everything there, you can have easy access to it, perhaps you might like the computer to make some suggestions to you, it may want to give you warnings and alerts. And you know what we're also getting is a lot more data, and historically a medical record will be your lab, your radiology, your pharmacy, few procedures, maybe, but what we're getting now is genomic data getting added to its social determinants, where do you live, where do you work, behavioral and lots of other things are getting entered onto the medical record and it is going to get big. Oh, actually I forgot device data as well, all sorts of data. Now, within that vast amount of data, there will be signals that can be picked up, not by humans, but by machine learning and we need to pick the right suggestions that I give them back to the patients themselves, or the circle of care, be it their doctors, physicians, or maybe their family. So the picture I'm trying to paint here is health is going to, historically it's been all seated around physicians and hospitals, and it's all about to change. And it's going to happen quickly, you know normally health is very slow, it's a leg out it takes forever and forever to change, what we're seeing right across the world, I'm talking from Europe, Middle East, Asia, the North America, right across the world, the big health systems looking to provide firm or far richer services to their populations. >> Big joke in Silicon Valley used to be about a decade ago when big data was hitting the scene, we have the smartest data engineers, working on how to make an ad, be placed next to for you and on a page, which in concept is actually technically a challenge, you know, getting the right contextual, relevant piece of information in front of you, I guess it's smart. But if you take that construct to say medicine, you have precision needs, you also have contextual needs so if I need to get a physician, why not do virtually? If that gives me faster care, I got knowledge based system behind it, but if I want precision, I then can come in and it's much efficient, much more efficient. Can you share how the data, 'cause machine learning is a big part of it and machine learning is a consumer of data too, not just users, you're consuming data, but the results are still the same, how are you seeing that translate into value? >> I think the first thing is that if you can treat patients earlier more accurately, you can ultimately keep them healthier and using less health resources. And, you know, you notice around the world, different health systems take a different approach. The most interesting approach we see is when a payer also happens to own the hospitals, their approach changes dramatically and they start pouring a lot of money into primary care so they have to have less hospital beds, but, with data information, you can be more precise in the way you treat the patient. So I've had my genome done, probably quite a few times actually, I just one of the care pair, the different providers so I have avian called CYP2C19, I'm pretty sure I've got it right, and that means I hyper metabolize suite on drugs, so you give them to me they won't work. And so there's information in our medical records, with machine-learning, if you can keep a Tesla on the road, we must be able to use the same, in fact we're, we have a very big machine learning project here on this company, and to not only get the information out of the medical records but save it back up, this is the hard part, save it back up to the providers, and to the patients in a meaningful useful way, an actionable way, not too much, not too little and that's usually the challenge, actually. >> You're a customer in your business, and you guys are in New Zealand, but it's global, you've a global footprint, how are you leveraging cloud technology to address your customers? >> It's usually useful because we end up with one target platform so when we come to deploy in any part of the world, it's the same platform. And you know from a security point of view, if we're trying to secure all these on-prem installations, it's very, very hard so we have a lot of security features that are provided for us, there are lots of infrastructure tooling, deployment and monitoring all the stuff is just inherent within the cloud and I guess what's most important we have a standard platform that we can target right across the world. >> And you're using Amazon Web Services, I mean, I'd imagine that as you go outside and look at the edge, as you have to have these secure edge points where you're serving clients, that's important, how're you securing that edge? >> Well, fortunately for us as Amazon is increasingly getting right across the world so there are still some regions which, this tool are working on, but over time, we would be expecting officially every country in the world to have all sorts of services available. >> You see the future of health care going from your standpoint, I mean, if you had to throw a projectile in the future to say, you know, five years from now, where are we on the progress and innovation wave, how do you see that Ian, playing out? >> So, certainly last 30 years, we've had various ways of innovation on healthcare, I think this pandemic is going to transform healthcare in such a major way in such a short time, and we'll see it totally transform within two to four years. And the transformation will be just like your bank, your airline, or lots of other buying stuff actually via Amazon actually, we'll see that sort of transformation of healthcare. We have talked a lot about healthcare, historically being patient centric, it is really not true, our healthcare today and most parts of the world has been geared around the various healthcare facilities, so this change we're going to see now, it'll be geared around the patients themselves, which is really intriguing but exciting. >> Position, I want to get my genome done, you've reminded me, I got to get that done. >> Finding that out, you know, you know--- >> I want to know, (laughs) I want to kind of know in advance, so I can either go down the planes, have a good time or low the loam games. >> I find out I had the positivity gene, you know, I kind of knew that and you know, I'm the fairly positive individual, so (laughs). >> Yeah, well, so as you I'm going to get my, I've to go through that process. But you know, again, fundamentally, you know that I agree this industry is going to be right for change, I remember the old debates on HIPAA and having silos, and so the data protection was a big part of that business and privacy as a huge, but one area, I'll get to that in a second, but the one area I want to touch on first is that really an important one, for everyone around the world is how does technology help people, everywhere get access to healthcare? How do you see that unless there's one approach that the government do it all, some people like that, some people don't, but generally speaking technology should help you, what's your view on how technology helps us, get accessible healthcare? >> What it means no matter where you live or what you do, most people have access to the internet either via our phone or a computer. And so what you want to be able to do, what we need to do, as a society, is give everybody access, just like they have access to their banking records, have a similar access to their medical records. And again, you know, the standard features, you know, symptom checking for patients who have chronic conditions, advice, help, medication charts are really important, the ability to go online and do internet consult or the conditions that don't require a physical examination, be able to message your circle of care, it's basically the automation of healthcare, which, you know, sadly has legged other industries. >> It is a critical point, you mentioned that early, I want to get back on the date and we'll get to privacy right after. You mentioned AI and machine learning, obviously it's a huge part of it, having data models that are intelligent, I know I've covered Amazon SageMaker and a bunch of other stuff they're working on, so they're getting smarter and they're doing it by industry, which I think is smart. But I want to ask you about data, I was just having a conversation this morning with a colleague, and we hear about AI and AI and machine learning, they're consumers too, (chuckles) so if machines are going to automate humans, which they are, the machines are consuming data so the machine learning is now a consumer, not just a technology. So when you're consuming data, you got to have a good approach. You guys are doing a lot with data, how should people think about machine learning and data, because if you believe that machine learning will assist humans, then machines are going to talk to other machines and consume data, and create insights, et cetera, and spoil another systematic effects. How should people think about data who are in healthcare, what's your insight there? >> Well, the tricky thing with machine learning and healthcare is not so much the algorithms, the algorithms are readily available on Amazon and elsewhere, and the big problem that we have found, and we've been working on this for some time and have a lot of people working on it, the big problem we have is first of all marshaling, getting all the data together, wrangling the data, so and then there's a fun part where run the algorithms and then the next big problem is getting the results back into the clinical workflow. So we spent all our time upstream and downstream and a bit in the middle, which is the fun bit, takes a very small amount of time. And so it's probably the hardest part is getting it back into the clinical workflow, that's the hardest part, really, it's really difficult. >> You know, I really appreciate what you do, I think this is going to be the beginning of a big wave of innovation, I was talking with Max Peterson about some areas where they saw, you know, thousands and thousands of people being cared, that they never would have been cared for virtually with the systems and then cloud. Again, just the beginning, and I think this is a reconfiguration of the healthcare value chain and--- >> Configuration, I mean, at pre-COVID we as a company spend so much time on planes, traveling all over the world, I've hardly traveled this year and zoom and all the other technologies, I've quite enjoyed it to be fair. So, and I think that there's a reconfiguration of how business is done, it's started to happen in healthcare and--- >> If tell my wife, I'm coming to New Zealand, I get quarantined for 14 days. >> That's right. >> Yeah, I'm stuck down under summertime. >> You get one of those hotels with the view of the Harbor, very nice. >> And final question and just close it out here in the segments, I think this is super important, you mentioned at the top, COVID has upended the healthcare industry, remote health is what people want, whether it's for, you know, not to being around other sick people, or for convenience, or for just access. This is a game changer, you got iWatches now, I was just watching Apple discuss some of the new technologies and processes that they have in these things for heartbeat, so, you know how this signals. This is absolutely going to be a game changer, software needs to be written, it has to be so far defined, cloud is going to be at the center of it. What's your final assessment, share your partying thoughts? >> We are definitely, in a major reconfiguration of healthcare that's going to happen very quickly, I would've thought that 24 months, maybe no more than 36 and what we're going to end up with is a health system, just like your bank and the big challenge for our sector is first of all, the large amounts of data, how do you store it, where do you store, and the cloud is ideal place to do it, then how do you make sense of it, you know, how do you give just the right advice to an elderly patient versus a millennial who is very technology aware? So these, there's lots of innovation and problems to be solved and lots of opportunities I believe for startups and new innovative companies, and so it's interesting times. >> I think time's short, you know, it's just so much to do, great recruitment opportunity in Orion Health. Thank you for spending time, Ian McCrae, Founder and CEO of Orion health, an award winning provider of health information global based out of New Zealand, thank you for taking the time to come on, appreciate it. >> Thank you. >> Okay, I'm John Furrier with theCUBE coverage of AWS Public Sector Summit Online. We're not face to face, normally we'd be in person, but we're doing it remotely due to the pandemic, thank you for watching theCUBE. (soft upbeat music)

>> From theCUBE studios in Palo Alto in Boston, connecting with thought leaders all around the world, this a CUBE conversation. >> Hello, and welcome to this CUBE conversation, I'm John Furrier, host of theCUBE here, in our Palo Alto, California studios, here with our quarantine crew. We're getting all the remote interviews during this time of COVID-19. We've got two great remote guests here, Rachini Moosavi who's the Executive Director of Analytical Services and Data Governance at UNC Healthcare, and Sonya Jordan, Enterprise Analytics Manager of Data Governance at UNC Health. Welcome to theCUBE, thanks for coming on. >> Thank you. >> Thanks for having us. >> So, I'm super excited. University of North Carolina, my daughter will be a freshman this year, and she is coming, so hopefully she won't have to visit UNC Health, but looking forward to having more visits down there, it's a great place. So, thanks for coming on, really appreciate it. Okay, so the conversation today is going to be about how data and how analytics are helping solve problems, and ultimately, in your case, serve the community, and this is a super important conversation. So, before we get started, talk about UNC Health, what's going on there, how you guys organize, how big is it, what are some of the challenges that you have? >> SO UNC Health is comprised of about 12 different entities within our hospital system. We have physician groups as well as hospitals, and we serve, we're spread throughout all of North Carolina, and so we serve the patients of North Carolina, and that is our primary focus and responsibility for our mission. As part of the offices Sonya and I are in, we are in the Enterprise Analytics and Data Sciences Office that serves all of those entities and so we are centrally located in the triangle area of North Carolina, which is pretty central to the state, and we serve all of our entities equally from our Analytics and Data Governance needs. >> John: You guys got a different customer base, obviously you've got the clinical support, and you got the business applications, you got to be agile, that's what it's all about today, you don't need to rely on IT support. How do you guys do that? What's the framework? How do you guys tackle that problem of being agile, having the data be available, and you got two different customers, you got all the compliance issues with clinical, I can only imagine all the regulations involved, and you've got the business applications. How do you handle those? >> Yeah, so for us in the roles that we are in, we are fully responsible for more of the data and analytics needs of the organization, and so we provide services that truly are balanced across our clinician group, so we have physicians, and nurses, and all of the other ancillary clinical staff that we support, as well as the operational needs as well, so revenue cycle, finance, pharmacy, any of those groups that are required in order to run a healthcare system. So, we balance our time amongst all of those and for the work that we take on and how we continuously support them is really based on governance at the end of the day. How we make decisions around what the priorities are and what needs to happen next, and requires the best insights, is really how we focus on what work we do next. As for the applications that we build, in our office, we truly only build analytical applications or products like visualizations within Tableau as well as we support data governance platforms and services and so we provide some of the tools that enable our end users to be able to interact with the information that we're providing around analytics and insights, at the end of the day. >> Sonya, what's your job? Your title is Analytics Manager of Data Governance, obviously that sounds broad but governance is obviously required in all things. What is your job, what is your day-to-day roles like? What's your focus? >> Well, my day-to-day operations is first around building a data governance program. I try to work with identifying customers who we can start partnering with so that we can start getting documentation and utilizing a lot of the programs that we currently have, such as certification, so when we talk about initiatives, this is one of the initiatives that we use to partner with our stakeholders in order to start bringing visibilities to the various assets, such as metrics, or universes that we want to certify, or dashboards, algorithm, just various lists of different types of assets that we certify that we like to partner with the customers in order for them to start documenting within the tools, so that we can bring visibility to what's available, really focusing on data literacy, helping people to understand what assets are available, not only what assets are available, but who owns them, and who own the asset, and what can they do with it, making sure that we have great documentation in order to be able to leverage literacy as well. >> So, I can only imagine with how much volume you guys are dealing from a data standpoint, and the diversity, that the data warehouse must be massive, or it must be architected in a way that it can be agile because the needs, of the diverse needs. Can you guys share your thoughts on how you guys look on the data warehouse challenge and opportunity, and what you guys are currently doing? >> Well, so- >> Yeah you go ahead, Rachini. >> Go ahead, Sonya. >> Well, last year we implemented a tool, an enterprise warehouse, basically behind a tool that we implemented, and that was an opportunity for Data Governance to really lay some foundation and really bring visibility to the work that we could provide for the enterprise. We were able to embed into probably about six or seven of the 13 initiatives, I was actually within that project, and with that we were able to develop our stewardship committee, our data governance council, and because Rachini managed Data Solutions, our data solution manager was able to really help with the architect and integration of the tools. >> Rachini, your thoughts on running the data warehouse, because you've got to have flexibility for new types of data sources. How do you look at that? >> So, as Sonya just mentioned, we upgraded our data warehouse platform just recently because of these evolving needs, and like a lot of healthcare providers out there, a lot of them are either one or the other EMRs that are top in the market. With our EMR, they provide their own data warehouse, so you have to factor almost the impact of what they bring to the table in with an addition to all of those other sources of data that you're trying to co-mingle and bring together into the same data warehouse, and so for us, it was time for us to evolve our data warehouse. We ended up deciding on trying to create a virtual data warehouse, and in doing so, with virtualization, we had to upgrade our platform, which is what created that opportunity that Sonya was mentioning. And by moving to this new platform we are now able to bring all of that into one space and it's enabled us to think about how does the community of analysts interact with the data? How do we make that available to them in a secure way? In a way that they can take advantage of reusable master data files that could be our source of truth within our data warehouse, while also being able to have the flexibility to build what they need in their own functional spaces so that they can get the wealth of information that they need out of the same source and it's available to everyone. >> Okay, so I got to ask the question, and I was trying to get the good stuff out first, but let's get at the reality of COVID-19. You got pre-COVID-19 pandemic, we're kind of in the middle of it, and people are looking at strategies to come out of it, obviously the world will be changed, higher with a lot of virtualization, virtual meetings, and virtual workforce, but the data still needs to be, the business still needs to run, but data will be changing different sources, how are you guys responding to that crisis because you're going to be leaned on heavily for more and more support? >> Yeah it's been non-stop since March (laughs). So, I'm going to tell you about the reporting aspects of it, and then I'd love to turn it over to Sonya to tell you about some of the great things that we've actually been able to do to it and enhance our data governance program by not wasting this terrible event and this opportunity that's come up. So, with COVID, when it kicked off back in March, we actually formed a war room to address the needs around reporting analytics and just insights that our executives needed, and so in doing so, we created within the first week, our first weekend actually, our first dashboard, and within the next two weeks we had about eight or nine other dashboards that were available. And we continuously add to that. Information is so critical to our executives, to our clinicians, to be able to know how to address the evolving needs of COVID-19 and how we need to respond. We literally, and I'm not even exaggerating, at this very moment we have probably, let's see, I think it's seven different forecasts that we're trying to build all at the same time to try and help us prepare for this new recovery, this sort of ramp up efforts, so to your point, it started off as we're shutting down so that we can flatten the curve, but now as we try to also reopen at the same time while we're still meeting the needs of our COVID patients, there's this balancing act that we're trying to keep up with and so analytics is playing a critical factor in doing that. >> Sonya, your thoughts. First of all, congratulations, and action is what defines the players from the pretenders in my mind, you're seeing that play out, so congratulations for taking great action, I know you're working hard. Sonya, your thoughts, COVID, it's putting a lot of pressure? It highlights the weaknesses and strengths of what's kind of out there, what's your thoughts? >> Well, it just requires a great deal of collaboration and making sure that you're documenting metrics in a way where you're factoring true definition because at the end of the day, this information can go into a dashboard that's going to be visualized across the organization, I think what COVID has done was really enhanced the need and the understanding of why data governance is important and also it has allowed us to create a lot of standardization, where we we're standardizing a lot of processes that we currently had in correct place but just enhancing them. >> You know, not to go on a tangent, but I will, it's funny how the reality has kind of pulled back, exposed a lot of things, whether it's the remote work situation, people are VPNing, not under provision with the IT side. On the data side, everyone now understands the quality of the data. I mean, I got my kids talking progression analysis, "Oh, the curves are all wrong," I mean people are now seeing the science behind the data and they're looking at graphs all the time, you guys are in the visualization piece, this really highlights the need of data as a story, because there's an impact, and two, quality data. And if you don't have the data, the story isn't being told and then misinformation comes out of it, and this is actually playing out in real time, so it's not like it's just a use case for the most analytics but this again highlights the value of proposition of what you guys do. What's your personal thoughts on all this because this really is playing out globally. >> Yeah, it's been amazing how much information is out there. So, we have been extremely blessed at times but also burdened at times by that amount of information. So, there's the data that's going through our healthcare system that we're trying to manage and wrangle and do that data storytelling so that people can drive those insights to very effective decisions. But there's also all of this external data that we're trying to be able to leverage as well. And this is where the whole sharing of information can sometimes become really hard to try and get ahead of, we leverage the Johns Hopkins data for some time, but even that, too, can have some hiccups in terms of what's available. We try to use our State Department of Health and Human Services data and they just about updated their website and how information was being shared every other week and it was making it impossible for us to ingest that into our dashboards that we were providing, and so there's really great opportunities but also risks in some of the information that we're pulling. >> Sonya, what's your thoughts? I was just having a conversation this morning with the Chief of Analytics and Insight from NOA which is the National Oceanic Administration, about weather data and forecasting weather, and they've got this community model where they're trying to get the edges to kind of come in, this teases out a template. You guys have multiple locations. As you get more democratized in the connection points, whether it's third-party data, having a system managing that is hard, and again, this is a new trend that's emerging, this community connection points, where I think you guys might also might be a template, and your multiple locations, what's your general thoughts on that because the data's coming in, it's now connected in, whether it's first-party to the healthcare system or third-party. >> Yeah, well we have been leveraging our data governance tool to try to get that centralized location, making sure that we obtain the documentations. Due to COVID, everything is moving very fast, so it requires us to really sit down and capture the information and when you don't have enough resources in order to do that, it's easy to miss some very important information, so really trying to encourage people to understand the reason why we have data governance tools in order for them to leverage, in order to capture the documentation in a way that it can tell the story about the data, but most of all, to be able to capture it in a way so that if that person happened to leave the organization, we're not spending a lot of time trying to figure out how was this information created, how was this dashboard designed, where are the requirements, where are the specifications, where are the key elements, where does that information live, and making sure we capture that up front. >> So, guys, you guys are using Informatica, how are they helping you? Obviously, they have a system they're getting some great feedback on, how are you using Informatica, how is it going, and how has that enabled you guys to be successful? >> Yeah, so we decided on Informatica after doing a really thorough vetting of all of the other vendors in the industry that could provide us these services. We've really loved the capabilities that we've been able to provide to our customers at this point. It's evolving, I think, for us, the ability to partner with a group like Prominence, to be able to really leverage the capabilities of Informatica and then be really super, super hyper focused on providing data literacy back to our end users and making that the full intent of what we're doing within data governance has really enabled us to take the tools and make it something that's specific to UNC Health and the needs that our end users are verbalizing and provide that to them in a very positive way. >> Sonya, they talk about this master catalog, and I've talked to the CEO of Informatica and all their leaders, governance is a big part of it, and I've always said, I've always kind of had a hard time, I'm an entrepreneur, I like to innovate, move fast, break things, which is kind of not the way you work in the data world, you don't want to be breaking anything, so how do you balance governance and compliance with innovation? This has been a key topic and I know that you guys are using their enterprise data catolog. Is that helping? How does that fit in, is that part of it? >> Well, yeah, so during our COVID initiatives and building these telos dashboards, these visualizations and forecast models for executive leaders, we were able to document and EMPower you, which we rebranded Axon to EMPower, we were able to document a lot of our dashboards, which is a data set, and pretty much document attributes and show lineage from EMPower to EDC, so that users would know exactly when they start looking at the visualization not only what does this information mean, but they're also able to see what other sources that that information impacts as well as the data lineage, where did the information come from in EDC. >> So I got to ask the question to kind of wrap things up, has Informatica helped you guys out now that you're in this crisis? Obviously you've implemented before, now that you're in the middle of it, have you seen any things that jumped out at you that's been helpful, and are there areas that need to be worked on so that you guys continue to fight the good fight, come out of this thing stronger than before you came in? >> Yeah, there is a lot of new information, what we consider as "aha" moments that we've been learning about, and how EMPower, yes there's definitely a learning curve because we implemented EDC and EMPower last year doing our warehouse implementation, and so there's a lot of work that still needs to be done, but based on where we were the first of the year, I can say we have evolved tremendously due to a lot of the pandemic issues that arised, and we're looking to really evolve even greater, and pilot across the entire organization so that they can start leveraging these tools for their needs. >> Rachini you got any thoughts on your end on what's worked, what you see improvements coming, anything to share? >> Yeah, so we're excited about some of the new capabilities like the marketplace for example that's available in Axon, we're looking forward to being able to take advantage of some of these great new aspects of the tool so that we can really focus more on providing those insights back to our end users. I think for us, during COVID, it's really been about how do we take advantage of the immediate needs that are surfacing. How do we build all of these dashboards in record-breaking time but also make sure that folks understand exactly what's being represented within those dashboards, and so being able to provide that through our Informatica tools and service it back to our end users, almost in a seamless way like it's built into our dashboards, has been a really critical factor for us, and feeling like we can provide that level of transparency, and so I think that's where as we evolve that we would look for more opportunities, too. How do we make it simple for people to get that immediate answers to their questions, of what does the information need without it feeling like they're going elsewhere for the information. >> Rachini, thank you so much for your insight, Sonya as well, thanks for the insight, and stay safe. Sonya, behind you, I was pointing out, that's your artwork, you painted that picture. >> Yes. >> Looks beautiful. >> Yes, I did. >> You got two jobs, you're an artist, and you're doing data governance. >> Yes, I am, and I enjoy painting, that's how I relax (laughs). >> Looks great, get that on the market soon, get that on the marketplace, let's get that going. Appreciate the time, thank you so much for the insights, and stay safe and again, congratulations on the hard work you're doing, I know there's still a lot more to do, thanks for your time, appreciate it. >> Thank you. >> Thank you. >> It's theCUBE conversation, I'm John Furrier at the Palo Alto studios, for the remote interviews with Informatica, I'm John Furrier, thanks for watching. (upbeat music)

>>from around the globe. It's the Cube with digital coverage of Red Hat. Summit 2020 Brought to you by Red Hat. >>Hi. And welcome back to the Cube's coverage of Red Hat Summit 2020. I'm stew Minuteman. And while this year's event is being held virtually, which means we're talking to all of the guests where they're coming from, one of the things that we always love about the user conference is talking to the practitioners themselves And Red Hat Summit. Of course, we love talking to customers and really happy to welcome to the program. Uh, Alejandro Lopez Asano, who's the director of e health with the Argentine Ministry of Health, Coming to us from Buenos Iris, Argentina. Alessandro, thank you so much for joining us. Thank you for having me. All right, So Ah, you know, look, healthcare obviously is, You know, normally, you know, challenging in the midst of what is happening globally. There are strange and pressures on. What? What is happening? So really appreciate. You think with us? Um, tell us a little bit about you know, the organization, and you know your role in Nike's role in supporting the company's mission. >>I'm part of the minister of girls in Argentina, Argentina Federal country. That's a national military girls, according it's Felker Healthcare System. All around the country with different provinces work, we work with the with the Ministry of Culture, which problems with the governor of problems trying to maintain and coordination the healthcare system. And we create the national policies that tried everybody. Show them to apply on the assistance that we create national incentive. This is much more. It's similar to the US, with the national government. Create incentives the province since the states adopt new new new practices and the best quality >>Excellent. So, yeah, the anytime we talk about healthcare, you know, uh, you know, medical records, of course, critically important. It's usually a key piece of, I d you know, governance, compliance in general. So what are some of the challenges that the ministry basis when it comes to you know, this piece >>of overall health care? My role in the midst of cops is exactly that. Coordinate health information systems around the country and having and access to the single sorts of medical records around the country. It's a great thing that we're trying to achieve We don't want to have a central repository, but they're going to have some kind of have that allows you to access information for all around the country. So the fragmentation of the seat between different provinces and also having public providers and private providers. It's a challenge because the information for one patient is this. Turn a lot of different places. I need to have some kind off have or enterprise services. But you're allows you to gather this information at the point of care and to provide the best quality of care for the patient having the full road regardless of work. It was taking her before. >>Yeah, pretty Universal Challenger talking about their distributed architecture, obviously security of Paramount performance, but still has to have the scale and performance that customers need to bring us in a little bit. This this project, you know, how long has this national health information system? How long has it been to put that together, Bring us through a little bit as to you know, how you choose how to architect these pieces, >>except that we've been working on for the last three years and then be able to create an architecture that was not invasive, that anyone can collaborate and contribute to this information network, but still having the on the rights and other responsibility for Monday in their own data. And we didn't want to have a central that the rates that it's acceptable security issues or privacy issues. We wanted information to remain distributed. But to be able to collect that a 10 point so they're able to create a set off AP Eyes Bay seven Healthcare interoperability standards that allow developers off critical systems all around the country to adopt this new way of changing information to your and privately provided to the practitioners so they can access information. Another side, >>Excellent. And so three years. You know, that's a rather big project. You've got quite a lot of constituents, and obviously, you know, healthcare is, you know, completely essential and critical service. There, underneath the pieces obviously were part of Red Hat Summit covering this so help us understand a little bit, you know, Red Hat and any other partners. You know what technologies they're using to deliver this? >>That's the big challenge was to have this kind of distributed organization with a central how that needs to provide services around the country at any time today. And we really think people need to be confident that they can use this network, that we're treating patients. We don't want them to try to do it and fail from the lost confidence in that you're not going to have the greater adoption from system developers. We need to have a very strong and company in the world, and this can grow really exponentially cause data. I mean, any chess is constructing, like one billion right work on math or something like that. But we know we can grow exponentially, but we need to have some kind of infrastructure that was reliable, but it was easy to deploy the first time. But the house and growth road map that will allow us to incorporate all the extra capacity around Argentina, Mr Safeway Way, need to be confident that we can grow a dog's level. So basically we were working already. We're Kalina and all the basic things. We wanted to go to open shift. It was really important to be able to have the container station system that allows us to found according to the needs and the adoption, right? That was really unpredictable because we need to create incentives for election. But you never know how fast the adoption would be. We need to have some flexibility of attracted by open ship, but also, we need to use a P. I like the scale in order to provide this way to communicate ap eyes to give people secure form to access the FBI's to learn about them and to try. So we're using different parts off the off the stack we have in order to do that. >>Okay, great. Tell us the adoption of this solution. How was the how is the learning curve? But, you know, moving to containerized architectures. You talking about all the AP eyes in there? How much was there a retraining of your group? Were there any new people that came in? You know what was what was Red Hat's role in really the organizational pieces of getting everybody on this on this new skill set? >>Well, the role of record was central because we didn't have the capability to go on research all these open source tools and find the proper combination between the container administrated orchestrator, the continuous integration part it was really difficult for us to start from scratch. I mean, this is something that this violent wanting to have a huge team, a lot of time, special skills and when you, because there are teams were used to work in monolithic applications with a very long development cycles that every time you need to change, we need, like, three months another. See, the change lives in the application for the end user, but we need to make a radical change there. So we saw in Red Hat Opportunity. We have a robot on the container adoption program sandcastle the steps that we need to work true. So what's really good to have our 16 team to retrain and to go through the container adoption program to use the combination of tools that breath already provides, like a stock that's the really compatible with each other. Then you need to know that that is easy to update when there are changes in their security things that they need to take to get the notification. So this and you have the daily support also because we have to create a new brand developers and the Dev Ops team was negative and you have developers and very technical person that didn't know anything about the application. We helped to create the tools that this, these new roles that combined these activities on the day to day work record expert was really key to that because they give us the roadmap. But what we need to do with timeframe with thing, that sort of statement we need to do in order on give us the daily support, the retraining, and they were really excited to work. Yeah, attempting that also was really good news for them because they were using old versions of job on old versions, off deployment systems, that they were everything by heart and the common life. And now, when they learn to do that with sensible and with the continuous integration system, a lot of menial tasks that they were doing everything you know there are automated. But that's a really great impact on the quality of life for them. >>Well, it's interesting that you talk about that, you know. Automation, of course, has been something we've been talking about for decades, but critically important today, you know, 100. I'm curious with kind of the situation happening with the pandemic. You know, people are having to work from home. There needs to be social, distancing the automation. And you know some of this new tooling. You know, what impact has that had on being able to deal with today's work >>environment? That kind of very good impact also, because not only for the automation, because that was that. It's really people have a secure way to work from home to the place ever. You don't need to access directly. Each one of the servers with logging or things like that is much more secure, much safer, much easier to work from home and maintaining the city. But also the dynamic has put a strain on the system because we are maintaining in open shift the whole family objects and violence system for Argentina, and that has much more information going through all the decision making. Politicians are getting information from the violence system and make predictions the style policies and they did. That information is to be available all the time, and previously, when a new strain came like the officially system went down, what was old workings globally So but now, with open shift, we were able to dial up more resources. The system, I maintain the quality, the world, the perimeter Signet work until the decision making person that needs information just in there. >>All right, so So all 100. We've talked about kind of a transformation that you've had. There's the government impact. There's the practice, the other providers of services. If you talk about you know, the ultimate end patient, you know what is the impact on them or you know what? What you have implemented here, >>what they did, that the patients now would be able to move between different parts of this complex system we have before. It was very common that the patient arrived hospital with about full of studies in paper, like somebody from a previous hospital finishes reported lab reports. And they have to bring about Dr and don't have to go to all the way from the foundation or a basic both from a province to the capital to get terrible, especially when they go back. And the Dr in the province don't have any information about what happened on one side that said no. They will care if you but no information. I get it through the patient. But now I think the system will integrate the older caregiver around Argentina in a much more simpler where you will be able to collaborate with doctors, another throwing, sitting, other CPIs on the patient will be able to vote from private to public. We have different kind of procedures, and every information will follow him on. Everyone will be able to take care of him with the best information. >>I'll under that. That's really powerful pieces there. So I guess the last piece is a little bit about kind of where you are with the overall project. What future goals do you have for this initiative? >>You've been really happy with the way we're starting to have adoption. We have more than 37 knows not already working in this network. And so this is really good. We have a good adoption right on. The implementation of open shift is going really well. The developers are really happy. We see the impact. That there are no downtime is really good. We need to continue transforming old legacy applications, monolithic applications to transform that into micro services. This work to do in deconstructing these big applications into more scalable micro services, and we need to take more advantage off. Sorry. Scale, Because really excellent feature for Developer portal. So, like that, everything will be about the adoption of the FBI. That information much simpler when we give all those tools developed. >>That's that. Once again, Andre, thank you so much. This has been, ah, really important work that your team is doing. Congratulations on the progress that you've made and, you know, definitely hope in the future. We will get to see you at one of the Red hat summits in person. So thank you so much for joining us. Thank you very much. All right, Lots more coverage from the cube at Red Hat Summit 2020. I'm stew minimum. And thank you. As always for watching the Cube. >>Yeah, yeah, yeah, yeah.

(upbeat techno music) >> Announcer: From New York City, it's theCUBE, covering New Relic FutureStack 2019, brought to you by the New Relic. >> Hi, I'm Stu Miniman and this is theCUBE's exclusive coverage of New Relic's Futurestack 2019 here in New York City, seventh year of the show. Our first year here, about 600 or so in attendance, and real excited, because we've had some of the users here to help kick off our coverage. And joining us, first time guest on the program, Josh Biggely is a senior engineer of Enterprise Monitoring, with Cardinal Health coming to us from a little bit further north and east than I do, Prince Edward Island, thank you so much for coming here to New York City and joining me on the program. >> Yeah, thanks for having me Stu, I'm excited to be here. I haven't been in New York, it's probably been more two decades. So it's nice to be back in a big city, I live in a very small place. >> Yeah, so if you go to Times Square, it's now Disneyland, is what we call it. It's not the 42nd street that it might've been a couple of decades ago. I grew up about 45 minutes from here, so it's gone through a lot, love the city, especially gorgeous weather we're having here in the fall. >> I'm excited for it. >> All right, so Josh, Cardinal Health, health is in the name so we think we understand a little bit about it, but tell us a little bit about the organization itself and how it's going through changes these days. >> Sure, so Cardinal Health is a global healthcare solutions provider. We are essential to care, which means we deliver the products and solutions that your healthcare providers need to literally cure disease, keep people healthy. So we're in 85% of the hospitals in the United States, 26,000 pharmacies, about 3,000,000 different home healthcare users receive products from us. Again we're global, so we're based in Dublin, Ohio, just outside of Columbus. But obviously, I live in Canada so I work for the Cardinal Health Canada Division. We've got acquisitions around the world. So yeah, it's an exciting company. We've recently gone through a transformation not only as a company, but from a technology side where we've shifted one of our data centers entirely into the cloud. >> All right, and Josh, your role inside the company, tell us a little bit about, you said it's global, what's under your purview? >> So my team is responsible for Enterprise Monitoring, and that means that we develop, deploy, support and integrate solutions for monitoring both infrastructure applications and digital experience for our customers. We have a number of tools, including New Relic, that we use. But it's a broad scope for a small team. >> Stu: Okay, and you've talked about that transformation. Walk us through a little bit about that, what led to, as you said, some big moves into public cloud? >> Yeah, our team is part of an overall effort to allow Cardinal Health to be more adaptive, to be more agile. The move to cloud allows teams that are developing applications and platforms to make a decision how to respond to the needs of their customers more rapidly. Gone are the days of, "I need a new server, "I need to predict six months from now "that I'm going to need a new server, "put the order in, get it delivered, "get it racked, get it wired." We watch a lot of people, the provision on demand. I mean, our senior vice president, or my senior vice president, likes to say, "I want you to fail fast, fail cheap." He does not say fail often. Although sometimes I do that, but that's okay. As long as you recognize that you're failing and can roll that back, redeploy, It's been really transformative for my team in particular, who was very infrastructure focused when I started with the company five years ago. >> Stu: All right, and can you bring us inside from your application portfolio, was it a set of applications, was it an entire data center? What moved over, how long did it take, and can you share what cloud you're using? >> Sure, so it's been about a two year journey. We're actually a multicloud company. We've got a small footprint in Azure, small footprint in AWS, but we're primarily in Google Cloud. We are shutting down one data center, we are minimizing another data center, and we've moved everything. We've moved everything from small bespoke applications that are targeted on team to entire ecommerce platforms and we've done everything from lift and shift, which I know you don't like to hear. But we've done lift and shift, we've done rehosting, we've done refactoring and we have re-architected entire platforms. >> Yeah, so if you could expand a little bit when we say lift and shift, I'm fine with lift and shift as long as there's another word or plan after that which I'm expecting you do have. >> Josh: Yeah, absolutely. So the lift and shift was, "Hey, let's move from our data centers into GCP. "Let's give teams the visibility, the observability "that they need so that they can make the decisions on "what they need to do best." In a lot of cases, or in fact, in 15% of the 6,500 severs that we touch, we actually full out decommed the instance. Teams had them, they were running at our data centers but they weren't actually providing any value to the company. >> So you said your team before was mostly concerned about infrastructure and a lot of what you did is now on GCP so you fired the entire team and you hired a bunch of PhDs to be able to manage Google environments? >> Absolutely not. (laughter) The principals of enterprise monitoring as a practice still apply in a cloud. We are, at heart, data geeks. And I would fair say that we're actually data story tellers. Our job is to give tools and methodologies to application teams who know what the data means in context, but we give the tools to provide that data to them. >> Stu: All right, love that. I believe I've actually seen data geek shirts at the the New Relic shows itself. But data story tellers, that was kind of thing that you heard, "I have a data scientist "that's going to help us to do this." Is that data scientist in New York or are you actually enabling who is able to tell those data stories today? >> So that is the unique part. Data story telling is not a data science. I wish that I could be a data scientist, I like math, but I'm not nearly that good at it. A data story teller takes the data and the narrative of the business, and weaves them together. When you tell someone, "Here's some data." They will look at it and they will develop their own narrative around it. But as a story teller you help craft that narrative for them. They're going to look at that data and they're going to feel it, They're going to understand it and it's going to motivate them to act in a way that is aligned with what the business objectives are. So data story tellers come in all forms. They come as monitoring engineers, they're app engineers, but they're also people who are facing the customer, they're business leaders, they're people in our distribution centers who are trying to understand the impacts of orders in their order flow, in their personnel that they have. It is a discipline that anyone can engage in if we're willing to give them the right tools. >> All right, so Josh, you got rid of a data center, you're minimizing a data center, you're shifting to cloud, you're making a lot of changes and now being able to tell data stories. Can you tell us organizationally everything goes smoothly or are their anythings that you learned along the way that maybe you could share with your peers to help them along that journey? And any rough spots, with hindsight being what it is, that you might be able to learn from? >> Yeah, so hindsight definitely 20/20. The one thing that I would say to folks is get your data right. Metadata, trusting your data is key, it's absolutely vital. We talk a lot about automation and automation is one of those things that the cloud enables very nicely. If you automate on garbage data, you are going to automate garbage generation. That was one of our struggles but I think that every organization struggles with data fidelity. But teams need to spend more time in making sure that their data, specifically their metadata, around, "Hey is this prod, is it non-prod, "what stack is this running, who built it?" Those things definitely need to be sorted out. >> Okay, talk about the observability and the monitoring that you do, how long have you been using New Relic and what products? And tell us a little about that journey. >> Sure, so we've been using New Relic for about two years. It was a bit of a slow run up to its adoption. We are a multi-tool company so we have a number of tools. Some of them are focused primarily on our network infrastructure, our on-prem storage. Although Cardinal had moved predominantly to the cloud, we have distribution centers, nuclear pharmacies all around the world. And those facilities have not gone into the cloud. So you've got network connectivity. New Relic for us has filled our cloud niche and observability, as Lou announced, is going to give us context to things that we're after. You hear the term dark data, we call them obs logs. It's data that we want to have, we only need it for a very short period of time to help us do post-op or RCAs as well as to look at, overall in our organization, the performance of the applications. For us, New Relic is going to give us an option to put data for observability. Observability is really about high fidelity data. In its world of cloud, everyone wants everything right now. And they also want it down to the millisecond. A platform that can pull that off, that's a remarkable thing. >> Yeah, Veruca Salt had it right, "I want it now." So are you using New Relic One yet? >> We have been using New Relic One for at least a couple of months going back into March this year. It's exciting, we're one of those companies that Lou talked about in his key note, we have hundreds of sub accounts. And we did so very intentfully, but it was a bit of a nightmare before we got to New Relic One. That ability for a platform team to see across multiple sub accounts, really powerful. >> Okay, so you saw a lot of announcements this morning. Anything particular that jumped out, you were excited? Because Lou kept saying over and over, and if you're using New Relic One, "This is free, this is free, this is free." That platform where it's all available for you now. >> I think the programmability is one of the things that really got me excited. One of the engineers on my team had a chance to go and sit with Lou and team, two weeks ago, and was part of that initial Hackathon. Made some really interesting things. That's exciting so shout out to Zack and the work he did. Logging, for me, is something that is huge. I know we've got data that we should have in context. So that Lou announced five terabytes of ingestion for free, all I could do was tap my fingers together and think, "Oh, okay. You're asking for it, Lou. Challenge accepted." (laughter) >> Stu: That's exciting, right. So you feel that you're going to be building apps, it sounds like already, at the FutureHack. That you're starting to move down that path. >> Definitely, and I'm really excited. Not to necessarily give it to my team. We build the patterns for teams that needs patterns, but there are so many talented individuals at Cardinal Health who, if we give them the patterns to follow, they're just going to go execute. Open sourcing that is a brilliant idea and really crowd sourcing development is the way to go. >> Yeah, I think you bring up a really interesting point. So even though your team might be the one that provides the platform, you're giving that programmability, sensibility to a broader audience inside the team and democratizing the data that you have in there. >> Yes, you keyed in on one of the things I love to talk about which is democratized access to data. Over and over again you'll hear me preach that, "I know what I know but I also know what I don't know "and more particular I don't know what I don't know. "I need other people to help me recognize that." >> We've really talked about that buzzword out there about digital transformation. When it is actually being happened, it goes from, "Oh, somebody had an opinion," to, "Wait, I actually now can actually get to the data, "and show you the data and leverage the data "to be able to take good actions on that." >> That's right, data driven decision making is not just just an idiom. It's not something that is a buzzword, it is a practice that we all need to follow. >> Stu: All right, so Josh, you're speaking here at the show. Give our audience just a quick taste, if you will, about what you're going to be sharing with your peers here at the show. >> We've actually talked about a lot of it already so I hope that people are not going to watch this session before my session later. But it really is around the power of additional transformation, the power of observability, what happens when you do things right, and the way the cloud makes teams more nimble. I won't give you it all because then people won't watch my session on Replay but, yeah, it'll be good. >> Well, definitely they should check that out. I'm hoping New Relic has that available on Replay. Give the final word here, what you're really hoping to come out of this week. Sounds like your team's deeply engaged, you've done the Hackathon, you're working with the executive teams. So FutureStack 2019, what are you hoping to walk away with? >> For me, it's about developing patterns. My team, in addition to our enterprise architecture team, is responsible for mapping out what we're going to do and how we're going to do it. Teams want to go fast and if we're not going to lay down the foundation for them to move quickly, especially in the realm of enterprise monitoring, they're going to try do it themselves. Which may or may not work. We don't want to turn teams away from using specific tools if it fits, but if there's a platform that will allow them to execute and to keep all that data centralized, that is really the key to observability. Having that high fidelity data, but then being able to ask questions, not just of the data you put in, but the data that put in maybe by a platform team or by a team that supported Kubernetes or PCF. >> All right, well, Josh Biggely, thank you so much for sharing all that you've been going through in Cardinal Health's transformation. Great to talk to you. >> Thanks so much, Stu. >> All right, lots more here at New Relic's FutureStack 2019. I'm Stu Miniman and as always, thank you for watching theCUBE. (light techno music)

>> Narrator: From the Cosmopolitan Hotel in Las Vegas, Nevada, it's theCUBE, covering Coupa Inspire 2019, brought to you by Coupa. >> Welcome to theCUBE, Lisa Martin on the ground at Coupa Inspire'19 from the Cosmopolitan in Vegas. And I'm pleased to be joined by one of Coupa's spend setters from Highmark Health, Gary Foster, VP of Procurement. Gary, welcome to theCUBE. >> Thank you, it's pleasure to be here. >> So we're here with about 2,300 folks or so I think this is the eighth Coupa Inspire. Lots of energy and excitement this morning in the general session as Rob kicked that off. There is some of the interesting things that I've learned about Coupa in the last short while including this morning was that there's now $1.2 trillion of spend going through being managed by the Coupa platform. Tremendous community of data. And so imperative as the role of Chief Procurement Officer is changing, the CFO is changing. You are a veteran in the procurement industry. Before we talk about Highmark Health, give me a little bit of an overview of some of the things that you've seen change in procurement and where you think we are today in terms of that role being not only very strategic, but very influential to the top line of a business. >> Okay, it's a great question. I have spent a little over three decades in procurement. We've come a long way from back then. There was a lot of carryover from the industrialization era, and post-World War II and Korean War era, et cetera. Where really wasn't even called procurement it was purchasing. And there was a bit of the darling in the manufacturing industry, because that had such a high impact on the cost of goods sold. And as you got into other organizations, it was kind of relegated to a back office function, very transactional, very administrative, very clerical. So it really took someone with a lot of guts and a lot of vision to say we can be more than that. We can provide insights, we can deliver efficient transaction work and free up people to do more advisory type of roles. So I'm pleased to say I experimented with that early on in my procurement career. And that has been the shift that I think is continuing on. The whole buzz around digitization is another enabler to free up the talent that we have, that we can put into providing insights and predictions and becoming true strategy advisors to the business. So when the most recent, I've had for teams that I've taken over to either completely transform or build from the ground up. And this most recent one, I've sort of mashed up a lot of things that I've learned over the past three decades, to try to prepare them for where I believe that the profession is going, where I believe the function is going. Back to your original question. It's really evolved a lot from that back office transactional, just focus on price, a little bit on supply reliability, if it was in manufacturing, to slowly but surely started evolving to, what can you do to help us with some business objectives? And do we trust you with some important strategic initiatives that we need to accomplish as a company or in my business? >> Right, so it sounds like early on that you had this awareness of, there's pockets, there's silos of spend and purchasing happening there that we don't have the visibility into, 'cause we're talking a lot about that today with, that's what today's CPO and CFO really need is that visibility and control. >> Gary: Right. >> Especially as all of these forcing functions or disruptors happen, the more regulatory requirements or companies growing organically or inorganically. And suddenly, there's many, many areas within a business that are buying and spending. >> Right. >> And if they don't have that awareness and visibility into it, not only is it obviously, it's a cost issue, but one of your points to the resource utilization perspective. There's a lot of opportunities miss. So it sounds like you kind of saw that early on in your career, that there are things going on, we need to get visibility into all of this. >> Yes, yes. And it's, that's probably the, that's one of the foundational building blocks is to get a good handle on where's the money going. So the financial side of the house understands it from their journal entries and from their cost centers. But procurement, really great world class procurement, brings a different lens that the business doesn't think of. And that the financial industry, financial segment of the business doesn't think of. So that's, but you're really kind of a chicken and egg thing, you can't really provide the insights, if you don't have your hands on the information. And the information is got to be usable, right? Data versus information-- >> Absolutely. >> Quandary. That's very much the case with procurement. But you can't get bogged down and going for perfection, because then you'll just, analysis paralysis. You won't get out of that cycle and you'll never be able to provide. So you have to know, you have to have a gut feel that this is enough, this is directionally correct. Let's take this to the next level. Let's start moving with, here are the patterns that we see, here's what we think is happening, here's where we think there are issues, right? So those are, I think, are some of the foundational pieces to the spend analysis question. >> So talk to us a little bit about Highmark Health. What you're doing there and how you guys are really focused on changing America's approach to healthcare? Which I think would be welcomed by a lot of people, by the way. >> (chuckles) Yes, we have a very, very ambitious goal. We believe we can be a catalyst to change healthcare in America. >> Lisa: How so? >> Well, first of all, we think that the model was wrong. If you think about the way that the healthcare industry has grown up in the US, you went to a hospital because you were either sick or injured. You had to go to those locations. You had to follow those procedures. You had to fill out those forms. You had to, you went to where the care was, and you had to bend to your schedule to whatever was available, right? We've all experienced trying to get an appointment with a doctor, and it's four months out, right? So we're doing, this was a year and a half ago, we introduced same-day appointments. So we have both a hospital system and an insurance company. So we can see the whole value chain-- >> Lisa: Okay. >> Through the healthcare experience. And one of the fundamentals that we're doing is, we're trying to bring a retail mindset to healthcare. >> Where the wellness comes to- >> You, as opposed to you having to go somewhere to access your health or to get connected with experts that can advise you or for checkups, et cetera. You're wearing an Apple Watch, that's only one of those Fitbits, et cetera. There's a multitude of wearables that are coming. The combination of IoT, and healthcare and big data is intersecting at a rapid rate where we will be, we are already able to look at millions of records, of chart information about patterns of diagnoses. And we know that the data tells us that if we can get people to engage in their health and make small changes, and just learn more, be educated and learn more about how, we know that the long-term costs of their healthcare will go down. So we are looking to partner, obviously, can't do this all on our own. >> Right. >> So this is not a David and Goliath kind of a thing. So we're looking actively to partner with breaking company, lead companies and breaking technology companies to be partners with us on this journey of how do we bring health to people and help improve their health, lower their disease rates, provide a better quality of life, lower their cost of health care, lower all the complications, you can see the graphs, right? It all runs, as you get as you get older, if you don't take care of yourself. >> Lisa: Right. >> The complications of healthcare issues just go exponentially up. And we know we can bend that curve down if we can transform the way that health is thought of and delivered to people in the country. >> Well, I'm already signed, you got me. So talk to me, though, about from a technology perspective. If we think about all the emerging technologies, you mentioned IoT, millions and millions of devices, we are sometimes overly connected. >> Gary: Yes. >> What is the opportunity that Highmark is working on with Coupa to be able to start changing that mindset and bringing that retail model to healthcare? How are they hoping to ignite that? >> Well, it's not on a direct connection with Coupa. Coupa is our procuring platform. So it enables us to provide efficient transactions and we get data insights. Coupa is very much an enabler for us in this process. What I would say is, and this goes back to the evolution of procurement as a profession, by having Coupa and other technologies at the fingertips of my team, it frees them to immerse themselves into their clients' business as well as their categories. So if they're, if I have someone who's a category manager of digital marketing, they can immerse themselves into that, and they can work that, my folks go, they attend senior level staff meetings, they have one on ones with executive VPs, they co-locate with the client on a regular basis. We really immerse ourselves into it. What Coupa is doing is it's allowing us to spend less time on transactions and process, and more time learning the business, more time understanding the industries that they operate in, looking for innovation, and bringing those innovative partners to the business that wouldn't necessarily have happened on its own. We have this incredible network, particularly if we have people that really, really have a passion for procurement, and really have a passion for being intimate with the customer. I know it's an overused phrase, but the trusted advisor status is definitely where we should be. That's an, the Coupa org, the Coupa platform, and tools enable my team to have, to bring those insights and those opportunities to the business. And we've gotten tremendous accolades from the CEO through the entire C-suite, about the level of business partnership that the procurement organization has, with all of the various areas of the Highmark organization. >> So you have this visibility now that you didn't have before with Coupa? >> Yeah. >> This control. Sounds like your resources and different parts of the organization are much better able to use their time to be strategic on other projects and to really start bringing that retail experience out there. Coupa kind of as, you mentioned, as an enabler is really foundational to that. I know you've actually won some awards. I think, Rob Bernstein actually mentioned this on stage this morning that you took top honors at the Procurement Leaders, Inaugural America's Procurement Awards. >> Gary: Yes. >> You've also been recognized as a Procurement Leader of the Year for transforming Highmark Health. What I love about the story is that showing how procurement, not only has it transitioned tremendously to be very strategic, but you're helping to transform an industry by getting this visibility on everywhere, where there's spend there, that operationally, Highmark Health seems to have a big leg up. >> Yes, yeah. No one could be everywhere at once. And if we can earn that trust, then the people in the business who are hired to play certain roles, strategy, development, or whatever, if they're, if they will, let us help them with our expertise, they can spend, they're more effective in their role. >> Right. >> Because they're not doing procurement work. They're not talking to suppliers. They're not negotiating deals. They're not looking, then let us provide that service, that professional service to them, really, as a consultant, as an advisor, and bring companies that, the more we get in depth into understanding the industries that we're buying in, the more we're learning about emerging companies. Who are the innovators? Who are the disruptors? Bringing those organizations because we're studying that in our markets, to our business partner, and making that introduction, which sparks an idea, which sparks an opportunity for the two to work together collaboratively on something new, or to resolve an issue that has not been addressed and no one found an answer to in the past. >> Well, you've put this really strong foundation in place that not only gives you the visibility and control, but it's going to allow Highmark Health on this ambitious goal, as you mentioned, about bringing wellness to us. And of course, there's the whole, there's the human in the way. So maybe tomorrow, Deepak Chopra, who's keynoting, will be able to give you guys some insight into how to help these people. And it's all of us people, right? Really embrace mindfulness, to be able to focus more on our passions. But what you guys are doing to transform healthcare is really inspirational so Gary, thank you-- >> Thank you very much. >> For joining me on theCUBE today. >> It was a pleasure. >> Likewise. For Gary Foster, I'm Lisa Martin. You're watching theCUBE from Coupa Inspire'19. Thanks for watching. (upbeat music)

(upbeat techno music) >> Live from Las Vegas. Its theCUBE, covering Informatica World 2019. Brought to you by Informatica. >> Welcome back everyone to theCUBE's live coverage of Informatica World 2019 here in Sin City Nevada. I'm your host Rebecca Knight, along with my co-host John Furrier. We have two guests for this segment: we have Pinkrose Hamilton, she is the VP Business Intelligence at Hackensack Meridian Health. Thanks for coming on the show. >> Thank you for having me. >> And we have Andy Crago, he is the Managing Consultant at Infoverity, thanks so much Andy. >> Thanks for having me. >> So tell us a little bit about this partnership between Hackensack and Infoverity. >> Well we were looking for an implementation partner, we were looking for the skills to come in and help us really implement MDM specifically, we're also implementing a few other technologies that we can probably speak about, but that's how we got connected. >> So tell us a little bit about what life was like before MDM. What were sort of the obstacles, the challenges that you were wrestling with? >> So Hackensack Meridian Health is the largest health system in New Jersey, and we are a very fast-growing, we like to consider ourselves disruptive, health industry in New Jersey, and so because of that we were growing and acquiring mergers acquisitions, and many different EMRs, many different physician credentialing systems were involved in this so we had to make a decision of do we wait 'til we're all on one system, which we all know will never happen, or never happen in time sometimes, so we decided to do the MDM approach which makes the most sense to us. >> One of the things that's interesting we talked, we go to hundreds of events, we talk to a lot of experts and practitioners, and everyone buys into cloud at some level, cloud natives, certainly born in the cloud, great benefits. Data's critical because in SAS, data's great if you have it because you can feed machine learning, you can take more risks, be agile, and more risk more reward. And the apps, it's all good, right? On the enterprise side, on premises, legacy kind of kicks in. If data can't feed machine learning or can't feed the app, AI really can't be enabled. This becomes a key challenge in the industry. How do you guys look at that? Because as you lay out, it's not a simple answer go to the cloud, just do on prem, you got to think about architecture. What do you guys doing with regards to where the data's stored, how do you think about it, what's some advice, best practice can you share? >> Well, I consider data storage being more like a house you're living in, right? So we buy our starter homes and we start our families. And then we outgrow this house, and then we have to say okay, I need a bigger house and we start growing. And so data's run pretty much the same way. We start outgrowing our on prem houses, and so now we're moving out, and we're moving to bigger and better things, which is cloud. And so I think hybrid is where we start, right? We can't start with okay, everybody move out and move into this new house, it's let's go build this new house somewhere else, let's test it out and see if we like it. So that's my thought process around it. >> So you've got the addition, that's got to work with all the plumbing, right? >> Right! >> So it's the same thing And then you got more track homes, and you got electronic cars that go in between. >> Exactly. >> Automation. So this is more of a systems view? >> Yes. Take care of the operational piece. >> Absolutely. >> Then think about developer angle, what's that, how does that architecture look? >> So in terms of what we're trying to do right now, I mean, it has to be kind of short-term vision with kind of a larger scale architecture, so you know as Pink was saying in terms of the hybrid architecture, if we are able to develop reusable cleanse functions such as the address doctor funtionality, we're were reaching out to a third party service, bringing in more enriched information, we have that in an on prem model right now. But in the future, that configuration and work will easily transition into that cloud architecture, so we're trying to keep our eye on the future and make sure that things are reusable as we move forward. >> And how do you two work together? I mean, this is such an interest, in this age of co-opetition, you're not necessarily competitors of course, but how do you work together to come up with the right solutions? What does that look like, the partnership? >> Well, we totally hate each other. >> That's right. (laughs) >> It's the first we've talked in a while. >> No, the partnership, I think, we hit it off right from the beginning. It was just a matter of you know, when we acquire new technologies and that decision of how much time and effort is it going to take for me to train my team and to identify the right folks on my team and what work am I going to take away from them in order to give them this additional work and this learning curve that needs to go into place. So I think we have to augment our teams with experts like Infoverity to come in and say, this is how this tool functions, and sometimes we bring in the technologies and we kind of just crack it open, but we don't really get the full use of it to understand exactly every bell and whistle we can take advantage of, and these guys are the experts that help us do that. >> And it's always a challenge, I mean, I think data's been center of the version for many many years, it's kind of mainstream now, and you can't look at the headlines these days without hearing one year anniversary of GDPR, privacy, so there's always been that risk management compliance stuff that's been around, certainly you guys know that. But everyday there's a new thing. Oh, you've got cloud, you got georegions, you're in this country, you're in that country. So as more regulatory things creep up, who knows, maybe blockchain's out there. So again, all these things are circling around complexity, which constrains data, not necessarily frees it so much. Well maybe build software. Do how does Informatica and customer deal with this, because I'd imagine you have to build an extraction layer, has to be some tooling around it, monitoring. >> Yeah. >> What's your take on this complexity? >> So in terms of an architecture perspective, we consolidate all of the different silos of patient data into a centralized repository. Historically, you would build a lot of point to point feeds based on a certain application. We built some custom work and we ship them off some data. But really what we want to do is be able to master once and publish to a canonical model that's more self-service and hub and spoke so as consumers and customers of the data need to come and get it, they can come to a centralized place, we can augment what data's available there, and kind of scale that with the architecture across real time capabilities, cloud, and other use cases that we come across. >> Do you feel good, data's frictionless, it's out there, it's addressable. >> In terms of the vision that we're on? So I mean, it's a couple steps at a time. But in terms of; >> It's that addition to the house. The journey and set of tools that we have, that's definitely where we're going, so. >> I want to ask you about the skills gap. One of the things that has emerged is that in the healthcare industry, it is much more evolved in the sense of there's an understanding of how to work with data. And perhaps because you've just always worked with more data than say a retail company or a consumer products company. So first of all, how big a problem is this for Hackensack Meridian Health? Is it as bad as the headlines suggest? And also what are you doing to combat it? >> So our main goal is to take care of the patient, right? So when a patient is introduced to our system, we want to be able to take care of that patient and their family members in the best possible way that we can. So if we're working with a very disparate organization, where we're on multiple EMRs specifically, it's hard for us to identify that episode of care for that patient. So the MDM piece particularly, with the patient domain allows us to do that. It allows us to view the entire episode of care for that patient, to see you went to these doctor's offices, you had these things done, you went to this lab, you had these tests done, you went to the hospital, you had this procedure, and this is what your follow-up looked like. So from a; and we're also conscious of the patient's expense in all of this as well as you know what's the provider's expense, what's the payer's expense, so you want to make it cost-effective. You want to make it accessible so that are there services that a certain zip code or patient population needs that we're not providing? That we can provide? And so this is the whole entire continuity of care. To take care of our patients the best way we can. >> My daughter just graduated college this week in Cal, the first ever data analysis college class, inaugural class so it shows how early it is. Cal's a great school, been doing data for a while. Data's a huge opportunity. Whether it's women in tech, new service area comes up. You don't need to be a hardcore programmer to get into the data business. But there's certain patterns we're seeing emerge, that you don't have to have a certain degree, because the jobs that are open, there's no degree for. There's only the first class has graduated from Berkeley. So I got to ask you for the folks in high school, or parents out there or anyone looking to reskill, what specific foundational and/or advanced skill sets should people be looking at if they really want to get into data? It could be anything. So I'd love to get your take on what you think those skills are for people out there that they want to learn something new and ride the wave. >> I'll start a little bit. I think a lot of people get really technical with data, but I think you really have to understand data within business contexts. I mean, if you're looking at a physician record, understanding the type of physician, maybe where the care was administered. You have to really think about okay, what am I trying to solve, what pain point am I looking at. So it's not about relational databases and writing sequel, you really have to understand the functional purpose of data within the business problem that you're considering. >> So machine learning's hot, the nerds go there, the geeks go there, but there's a bigger picture than just coding. >> Exactly. There's a whole data strategy that you need to consider and kind of plug and play as you go along and really understanding the data within the business context is key. >> I'm so glad you asked that question, because I'm going to give a different viewpoint from this. I have a daughter who's a junior in high school, and she's preparing her career path, and so she wants to follow mom's career path and wants to do data science, so it's very exciting for me, you know? I'm actually a role model, which you never expect your children to think of you as one. >> Congratulations. >> But yeah, she picked up a few sequel classes early on in high school. And I think that the underlining foundation of coding is probably a little bit important to get that piece of it, because when you're leading the function, and definitely knowing the business knowledge. When we start any project, we go in and we start with discovery, right? What is it that you do, how do you do it, what are your workflows, what do they look like? So that's definitely key. But adding in that technical piece makes you that perfect data science human that I would look for as an employer. >> It's certainly evolving. There's no one yet playbook, 'cause there's so many diverse opportunities to take in from visualization to ethics to coding to business value, unbelievable. >> Yeah. >> Great. Well Pink and Andy thank you both so much for coming on the show. >> Thank you so much for having me. >> Lots of great advice for newly minted graduates! >> That's right >> Yes. >> Thank you. >> I'm Rebecca Knight, for John Furrier, you are watching theCUBE. (upbeat techno music).

>> Live from Anaheim, California It's the queue covering nutanix dot next twenty nineteen. Brought to you by Nutanix >> Welcome back, everyone to the Cubes Live coverage of nutanix dot Next here in Anaheim, I'm your host, Rebecca Night, along with my co host, John Furrier. We are joined by Victoria Hurtado. She is the director I t operations at current Health Care System's Welcome, Victoria. I think >> you've having me >> So for our viewers that are not familiar with current to tell us a little bit about what you do and what you're all about. >> Sure. So we're a health payer provider. So we are managed care medical plan. We have a contract with the state of California to provide medical services. Teo, about two hundred fifty five thousand members, and Kern County, located in Bakersfield, California s. So if you really think no one to know more about this like a Kaiser without the provider network and so we pay, uh, the services, the bills that come in a swell is authorized the services that need to be rendered for members. >> So talk about your decision to move from traditional storage to H. C. I. >> So really, where decisions stemmed from was our road map. And over the last several years we have had a three tier traditional storage, Um, and the daily task of our system administrators have increased over time with integration and as technology increases, there's more integration. And so we really wanted to focus on how do we decrease that as well as increased efficiencies so that we can for her by the services that we need Teo, for our internal customers as well as our external customers are members and providers >> and and the efficiency. Suppose the project plan. How did you go? Proud. You approach it? >> Sure, So her strategy was really a three phase approach. So we wanted to implement VD I for our internal employees. So we started off with VD. I Once we have transition to that, we will be migrating or in the process of right now, our core claim system, which is that are our bread and butter really on DH? So we'll do a six plant a month plan on that, see how that goes and then once that is successful, which I feel will be successful, we will migrate our entire infrastructure over >> and you're happy with the new tactics so far? >> Yes. So the first deployment was nutanix with Citrix and VM Where that entire combination I've had a few consultants come in and they're like, Oh, you've got the Ferrari of Edie I. And I'm like, Yes, we absolutely dio s Oh, yes, >> when you're thinking about efficiencies. I mean, one of the things Before the cameras were rolling, you were talking a little bit about what it means for employees. Can you talk a little bit about how they then structure of their day? They structure how which projects they work on and how they are more productive given these different changes? >> Sure. So unorganised ation like us, we are always challenged with guidelines changing from the state. They have a tendency to want to change things very frequently. So we often have a lot of critical projects that were doing on an everyday basis, and that work really gets them consumed. And so what we're able to do with nutanix is alleviate those responsibility so that we can focus on the more critical, you know, impacting scenarios versus, you know, managing alone and moving a volume and making sure the system is up and running. We're really focused on providing care to our members because our members or what count, Um and, you know, it also allows for, you know, a member to get the services that they need while they're sitting in the doctor's office waiting for a response from our organization. >> How's the cops world these days? Because there's so much tech out there. When you look at the landscape because you got you got unique situation, you got care and you got payments were relying on this so you don't have a lot of room for mistakes. Crap. What do you guys see in that Operations suppliers out there, Other people you looked at, what was some of the solutions and why need nutanix? >> So it actually took us a while to make that decision. We made a collaborative decision with our engineers, uh, my CEO and some of our business units. We compared different technologies that were out in the landscape of both storage and hyper converged. What was the right path for us? We did a very thorough cost analysis of five year ten year what that road map looks like for us. And, um, like you said. Mistakes. We can't make mistakes. And with growing security risk and healthcare industry and more people wanting that data, it's really important for us to protect it and have it secure. Eso nutanix really offered us a lot of the key components that we were looking for in our grading system. When we you know, we're looking for a storage solution, >> how's the event here? What's what you would have you learned? Tell us your experience. Nutanix next. >> Sure. So coming to this event, I really thought that we would be looking into new technologies. What other integration? Like typical conferences, I think. Sitting in the initial Kino, I heard a lot of great positive things that are aligned with the industry. The buzz words right now in technology as well as our own road mount for technology going to the cloud convergence, using multiple technologies for integration so really kind of paved what this conference was going to be. In addition, I think the sessions having thie cheered approach of you can follow a pathway throughout the conference was a brilliant idea and planning. Um, so I think there's much to learn about how this conference was put on. So >> I want to ask you about your role as the as the director of operation. I mean, somewhere. So you're hearing so much that these roles air really being dramatically transformed that it's not just about keeping the lights on, it really is. You're taking a much more strategic role in the business. How would you say you approach your job differently? How would you say it is changed? Your leadership style And And how much? How much time do you spend thinking about being more visionary? More forward? Thinking versus this is what we're doing each day. >> Yeah, s o I think Historically traditional technology departments and and management within technology of really focused on technology on Lee. Um, over the last several years, I've made it a point to learn our business units so that we can apply good technology, Teo, a good process. I'm a true believer in an advocate for our technology department and our staff to really know the business so that we're not putting technology on a bad process and because that doesn't really help anyone to be successful. So I would say the shift in transition is being merged and converges ight hee in business entity a ce faras approach Getting the business to come uphill with us has been really important. I'm not on ly for technology for the the underlying infrastructure, but systems today systems there so much ability to customize it to your heart's content, which also leads to different issue. So using technology with business process to gain efficiencies is really the road that is ahead of us. >> One of the things that the senior execs that nutanix talk about it their value propositions about, you know, helping consolidate little bit. Here is one of the side benefits. But there's a new role in the kind of looking for spent the new kind of persona person with nutanix solution is a new kind of operator. Yes. What? What? What do you think he means by that? >> So I really think it means And I had this challenge internally, actually, a cz You know, we we have a lot of technical engineers that have grown up with the mentality that I have to know everything about this one silo topic. Right? I need to be the expert in this Andre. Really? Where we're going is you don't have to worry about that. I need you to know about the business. I need you to know about how you can make change, inefficiencies, to help us be successful. And that is a transition for a lot of technologist. And we will get there. I truly believe that because we have Tio. >> It's a cultural thing. >> It is definitely a culture >> of an old dog. New tricks? Kind of >> Yes, Absolutely. How do you hire? I mean, look, what's weirder that what air to you? An applicant comes into your office. What? What do you want to see? >> So technology has historically been the focus of what do you know? How well can you do it? To what experience? You have enterprise grade level experience and now that's really shifting. Teo, are you able to participate on our project? Can you build requirements? Do you understand what your customers asking for? A swell is asking the questions of Is this the right thing to Dio? I'm not just doing what our customer asked us to dio. Does it make sense? If we're going archive data Do we need to secure it when we're transferring that in and out of the organization. Uh, does that make sense? And so they were looking for people that are going to be out spoken a little bit and ask those hard questions. >> Now, we have always talk about Ransomware because healthcare's been targeted. You got your mission's security earlier. Thinking broadly. You got data? Yes. Got the crown jewels, bread in butter. As you said, the data are you Have you experience ransom? Where you guys ready for it? What's the strategy? >> So we've actually take a layered approach to security. Obviously, in health care, there is no single pane of glass for security. We've really stepped into the world of having our data encrypted at rest in transit. Uh, multi layers. We do audits every >> year >> to make sure that we're compliance. We pay people to try to hack us, you know, legally because we want to know where are our possibilities are s o wait. Do that purposefully with intent to make sure that we have the technologies and place that are going to provide us what we need for our data. >> Fascinating. Victoria, Thank you so much for coming on the Cube. It was a pleasure having you. Thank you. I'm Rebecca Knight for John Farrier. You are watching the Cube