Sherri Douville serves as Chief Executive Officer for Medigram, Inc.
On Saturday, September 23, Ms. Douville will moderate a panel at Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place September 21 through September 23 in Chicago.
To learn more about the conference and Ms. Douville's session, click here.
Question: Looking at your IT budget, what is one item or expense that has surprised you in terms of ROI? How so?
Sherri Douville: Medigram Enterprise is a mobile first intelligence solution for healthcare. Our mission is to save lives through mobile, contextual information. Our team has made the decision to build our own infrastructure, moving away from the original Medigram 1.0 version sitting on top of the public cloud. This decision has brought the most surprising ROI. Public cloud is the best option for a lot of use cases, such as administrative functions and CRM. However, performance, storage and hosting requirements for Medigram's use case is to support quick mobile delivery of insight to drive action. Fulfilling customer dictated needs would snowball into excruciating public cloud costs that would not fulfill application performance requirements. Therefore, we had to design for a fast, reliable and secure service with the storage capacity to store relevant data for more than seven years (what HIPAA requires). For Medigram, having our own infrastructure will allow us to trim down to one-fourth of the cost of public cloud for our performance requirements. To manage performance and capacity, you can end up quadrupling your costs in the public cloud in our use case specifically. This is not the case for many apps which can be very successful on the cloud, especially in well-wired consumer environments, which have good connectivity.
Q: Finding top tech talent is always a challenge. Say a CIO called you up today to ask for an interview question that would distinguish the best candidates from the mid- to low-performers. What question do you suggest he or she ask?
SD: "Walk me through how you solved a recent product or technical problem. Share with me what you were thinking and what the priorities were that drove both your short-term and long-term decisions. How were these priorities analyzed as you considered the available options or solutions. Who and what did you consult for expertise or team collaboration?"
As CEO of a technology company, just as I'm assuming a CIO would, I want to see that the candidates have thought about the best interests of our customers and patients that we serve. I need to have assurance that they have the capacity to understand what the real technical requirements are. I also want to know if the candidates have the aptitude to be mindful of our goals for scaling the technology. We have a strong distaste for buzzwords at Medigram. Therefore, we want to make sure technical leadership wouldn't just be apt to select a trendy, knee-jerk, off-the-shelf, or easy library, or tool without the appropriate consideration.
On a related note, as a follow up to a recent Becker's article comment by Victor Buzachero, a senior vice president at San Diego-based Scripps Health, where he stated, "While Scripps' culture is a drawing point for most employees, outdated and "clunky" technology sometimes repels younger individuals. He said healthcare as a whole has under-performed in attracting younger professionals, who are accustomed to using sophisticated mobile technology in their daily lives and expect to use the same tools in their work space." If I may, in response, I would advise that health systems would do much better to partner with instead of hiring digital talent. As Gartner points out here, digital talent strongly prefers working for digital native companies. Beyond the compensation differential and the clunkiness of tools, most health system leaders don't understand the culture needs of digital talent. Digital talent tends to inhabit highly networked worlds both offline and online. Digital talent wants to be around other advanced technical talent. This is so that they can continue achieving, growing, and can prevent becoming irrelevant in the technology world. Culture is a main reason why digitally native companies will continue to be preferred by digital talent. Top digital talent tends to join teams primarily by word of mouth and reputation as opposed to traditional Marketing and PR messaging. A good option is to benefit from the expertise of digital talent by standing up a digital board so that digital talent can advise healthcare executives and the CIO. This could create substantial two way wins without the digital talent having to consider any cultural and technical drawbacks for their everyday work environment.
Q: We spend a lot of timing talking about the exciting innovation modernizing healthcare. It's also helpful to acknowledge what we've let go of. What is one form of technology, one process or one idea that once seemed routine to you but is now endangered, if not extinct? What existed in your organization two to five years ago but not anymore?
SD: At Medigram, which has been around since 2012, we've started filtering inputs much more specifically as it relates to technology and tools. We now don't take anything at face value with respect to using a potential tool, regardless of its "popularity." Sometimes tools that are marketed as "plug and play" type solutions don't work well together in the healthcare environment. This is especially true for mobile in healthcare, which often involves a high interference environment with low connectivity. We especially have to filter inputs from generously kind friends with technical backgrounds in different contexts who want to help. They may have been traditionally consumer-oriented or hold experience in web technology leadership and have no real understanding for the use case and challenges of the environment we're tackling. For example, with our first version of the platform, we initially used one very common and recommended open source tool for memory data structure store, message brokering and to cache data. In the high interference environment that is a hospital, this particular tool would frequently lose connection to the old server, thereby making this data structure tool unreliable for us. We've learned the specific use case and actual environment in which the technology will run overrides all advice from self or media proclaimed experts, and in particular consumer tech experts.
Q: Tell us about the last time you were truly, wildly amazed by technology. What did you see?
SD: When you think about building platforms for mobile, it's best to think about how to optimize the experience for a mobile game, whether the platform is a game or not. Why wouldn't clinicians be just as demanding as gamers for their mobile experience? Trust me, they are. I'm fascinated by mobile computing, which represents the most complex computing systems we've ever seen. Chip designers have done a great job overcoming chip size constraints to improve processing power through implementing multiple cores or processing units running in parallel. For reference, the first computers had just one core. We have some friends that are using recent high-end graphical processing units in their systems, which are similar to central processing units, except a GPU's purpose is to optimize graphics. The results are incredible for rendering 3-D images, videos and other elements to users very quickly. The performance contribution is amazing as well. Highly performant GPUs are like having a second workhorse around on a farm, which in this case is your device, whether a smartphone or some other computer. The GPU can also offload the computer processing units, thereby increasing the capabilities of the computer or smartphone. We look forward to exploring their use at Medigram.