[00:00:00] Liat: I'm your host Liat, and today we have a very special guest, Angela Yochem, Executive VP, and Chief Transformation and Digital Officer of Novant Health, a super regional healthcare system with one of the largest medical groups in the. Angela and her teams oversee growth initiatives and deliver world class consumer capabilities, differentiating technologies and advanced clinical solutions that allow the integrated system to provide remarkable patient care.
[00:00:22] Liat: Angela, it's so great to have you with us today.
[00:00:24] Angela: Thank you. I'm so glad to be here.
[00:00:26] Liat: So I think what's unique about you, Angela, and, others recognize this as well, is your strive for experimentation in a heavily regulated healthcare industry, that's traditionally been slow to embrace digital. And you once said “meaningful innovation always comes with risks attached,” and I believe this is something that you keep in your mind and it keeps you at the cutting edge of innovation.
[00:00:47] Liat: So let's backtrack and hear a bit about your journey. Fun fact, for those who don't know, Angela got her undergrad degree in music. You started writing code in sixth grade. Take us from that point and share a brief overview of your journey.
[00:00:59] Angela: I've been very fortunate in that I've had an opportunity to work in a variety of industries that were under some degree of transformation at the time.
[00:01:08] Angela: Um, and my, my area of expertise has historically been everything to do with transformation. So, um, yes, I was a deep technologist and I started out, you know, transforming systems, modernizing legacy systems are the like, or, or building new, uh, software solutions that maybe no one else. Uh, no one else had.
[00:01:28] Angela: But over time, um, I found myself being, um, asked to transform businesses and, uh, business lines and then, and then businesses, and then finally, um, companies. And when I joined Novant health, It was because my boss, uh, Carl Amato, who's a great visionary CEO. Um, had the, the aspiration to transform the industry.
[00:01:53] Angela: So, um, that's been my, my path. Um, I go, where transformation is, is needed. Um, now as it relates to healthcare specifically, um, my, my journey began four and a half years ago. Um, closer to five now, however, I actually. Attempt in college, in a medical records department. Not a lot of people know that . And so, uh, I have had, uh, some experience in legacy medical records, um, transformation from micro fi into, um, What was at the time, modern EMR technology, um, from way, way back.
[00:02:39] Angela: Uh, and I was just thinking of it the other day, I guess, technically I could tell people, oh, you know, I started in healthcare 20 years ago,
[00:02:48] Liat: whatever. Well, you can write a book. I know about, you know, everything you've seen and how things have really transformed you. Can't wait to pick your brain and soak in some of your insights.
[00:02:56] Liat: So let's get started. We all know too well that Novant. Set up an innovation lab this past April to showcase some of the emerging technologies and vendors that you've been working with, including Hiro. Can you tell us more about that lab?
[00:03:07] Angela: Sure. So. Our belief is that, um, we need to have space and, and by the way, need not be physical space.
[00:03:15] Angela: In our case, uh, we had the lab inner workings, um, logically in place long before the physical space came to fruition. Um, but we believe there needs to be space for learning. Um, we need to, to have the opportunity to work with emerging technologies, um, emerging solution sets that may not be commercially available yet.
[00:03:37] Angela: Uh, we work with individual inventors. We work with startups who are hoping to bring a product to market, and sometimes we work with other entity types that have a solution that again, they may not be selling commercially just yet, but would certainly apply to a problem we're trying to solve. And the, the innovation lab gives us a chance to experiment with this emerging tech.
[00:04:01] Angela: So we get a chance to learn a little bit about, um, you know, how it works. How might we, uh, work on a, a co-creation opportunity with, with the tech? Is there opportunity for us to, to shift it in any way or do any sort of customization if that's appropriate, um, and, and learn a little bit. About the, and
[00:04:27] Angela: before making a major investment. So it's really to,
[00:04:41] Angela: uh, with inventors and early stage.
[00:04:44] Liat: Amazing. So when you do take on a certain technology, how do you measure digital transformation? Novant health is considered extremely innovative in the space that we know. How do you set the bar? What are some milestones you track to make sure you're on the right.
[00:04:56] Angela: Well, first, I should tell you though, that we don't make a distinction between digital, uh, transformation and just transformation itself, because there is, as you know, it's impossible to think about a business transforming, um, or, you know, patient care, transforming or increasing the quality of care or expanding access to care without some sort of digital underpinning.
[00:05:17] Angela: And that's not just sort of back. Digital capability sets that's digital channels through which, um, our patients engage us or digital channels through which our, um, our providers and our advanced practitioners and our physicians and our nurses and our team members all engage with one another. And the ways in which we work are allowed to evolve as a result of that digital enhancement.
[00:05:39] Angela: So. Regardless of the nature of the, of the, of the outcome we're seeking, there's always a digital component. So as we think about, uh, doing that work and, uh, making sure that that work is successful again, when we optimize for learning, it gives us a chance to pressure tests, continually pressure tests, hypotheses about the outcome that will be generated from a given project activity.
[00:06:03] Angela: And as we pressure test that hypothesis, sometimes we learn that we were incorrect and, but we, if we can learn that relatively soon in the, in the course of an investment cycle that gets us, uh, that gets us out of, uh, our own way faster. What
[00:06:19] Liat: motivated you to automate certain points of the patient journey and use AI for patient's digital experiences?
[00:06:25] Angela: Similar to the way we think about transformation as just transformation. I don't think about the patient's journey as having a digital, you know, being. A digital journey versus a, a, a regular journey. It's just the journey. And one of the great things, um, that Hiro has allowed us to do is to allow that journey and the, the incorporation of digital capability sets into that journey and enhancing that patient's experience in a very seamless way.
[00:06:51] Angela: So, um, so think about, you know, even if a patient is going in. Let's say that a patient is, is, is, you know, wants to see their, their primary care physician and, and intends to go into, you know, a clinic to see that primary care physician. So very, you know, traditional sort of engagement, um, chances are the patient made.
[00:07:13] Angela: The appointment using a digital channel, chances are the patient, the patient, um, found their way to the clinic using digital capability sets. Some of which we would provide chances are that they were automatically checked in because of the geofencing capability we have in our clinics. They walked in, they were automatically checked in.
[00:07:31] Angela: Maybe they were asked a couple of extra questions, but they would do that through again, digital channel. Um, they might have. Leveraged way finding capability set that we have in certain locations. Um, maybe once they get back to the clinic, they notice that they're, and they're speaking to their provider.
[00:07:47] Angela: Maybe they notice that the pro the, the physician is looking at them and not typing on the keyboard because. You know, that it's being transcribed, using natural language processing and voice recognition, um, automatically into the EMR, you know, maybe they had an opportunity to have as part of that primary care visit.
[00:08:07] Angela: Maybe there's a, um, a remote, uh, uh, specialty consult that happens in the same office before they leave using a digital channel to, to, to make that happen. Maybe they're sent home with enhanced sensor capabilities in a wearable device that allows them to. Track, um, their own vitals in a, in a more consistent way, um, than they had planned.
[00:08:30] Angela: And, you know, in between all of that, they might very well be on our website asking questions of a hi enabled chat bot. absolutely just part of journey that we want our patients to help with us. And the digital capabilities sets are just intrinsically. Interwoven throughout.
[00:08:51] Liat: Do you wanna mention a mission that you spoke about, which was keeping every member of the community healthy and the role that healthcare providers play in that mission is, uh, expanded access to care and improved quality of care.
[00:09:04] Liat: Those are still at your top two focus pillars of your day to day. That's definitely evident, um, at Novant health and also just in general, in, in the transformations that we're seeing going on now. And you mentioned wearables, so that's gonna take. To a fun game that we're gonna play now time, uh, for you to place your digital bets.
[00:09:21] Liat: Okay. I'm gonna be naming a technology in healthcare, and you're gonna tell me if it's bullish or bearish. Number one, Angela telehealth
[00:09:31] Angela: bullish from perspective its span and the incorporation into more of the patient journey, um, into telehealth enabled channels. Bearish in the investment space because it is absolutely a crowded market.
[00:09:53] Angela: Number
[00:09:53] Liat: two, wearables
[00:09:55] Angela: bullish. I think that there's a tremendous appetite, um, in our society for continued collect data about one's own health. And I think that continued at curiosity will expand and as, uh, the sensor landscape continues to, uh, Rapidly because of the advances that are happening in these advanced sensors, we're gonna see form factors that are increasingly small providing increasingly larger array of data about one's health.
[00:10:31] Angela: And because of that, I think that that is a hot market for both, um, adoption and for investment
[00:10:38] Liat: number three, conversational.
[00:10:42] Angela: Bullish. And I would say of the three you've mentioned so far, that is by far, um, the most important as we try to think about the, um, the expansion of access to care we have to, and, and by the way, keeping in mind that.
[00:10:59] Angela: We are seeing the industry is seeing, um, people leaving the healthcare industry in droves. I mean, the, the, the nursing shortage is well known here in the us. The physician, um, population is reporting that they'll be planning to, um, leave the profession in the next, you know, I think it's something like. Now I'm gonna quote something that I don't remember the source.
[00:11:25] Angela: So I take it with a grain of salt, but I heard the other day that 30% of physicians are practicing physicians. Surveyed said they would be leaving the industry in the next three years, something crazy like that. Um, so if you think that if you think that. Is, if you believe that, then you have to believe that any way we can expand the practicing clinicians reach, uh, and the expand and expand access to those practicing clinicians through digital means.
[00:11:58] Angela: That's when we think about how natural language processing and voice activated assistance and all of the things that are incorporated in, in that one item, uh, will, will come into play. And it's that technology is only getting better and better and better. So, um, I I'm very, very bullish on it. Okay.
[00:12:21] Liat: Remote patient
[00:12:21] Angela: monitoring bearish.
[00:12:23] Angela: And not because I don't think that it's something that everybody needs and not that I don't think it's something that absolutely should be just a part of the patient journey, particularly when you think about getting patients out of high cost hospitals and into, you know, environments where they will be surrounded by their, um, you know, They're caretakers that are, that are part of their family or their friend group, their communities.
[00:12:46] Angela: Um, it, it, it, it certainly helps with the expansion of the reach of physicians, as I just mentioned. And, and for all of those things, all of those reasons, I love it. I am less certain that the, um, various state legislatures. Will, um, make the moves that will allow for clinicians to be appropriately compensated for their, their use of their full use of their range of remote patient monitoring capabilities.
[00:13:24] Angela: Um, and as a result, I think that we won't see it as much in use as we should see it. And for that reason I'm bearish not cause.
[00:13:34] Liat: Last one, augmented reality.
[00:13:40] Angela: What's the timeframe. Is it this year. Okay. Oh, so here's, I think that there's tremendous. Uh, I think it's tremendous capabilities that are enabled by augmented reality. So for example, imagine smart glasses where the person dispensing a pharmaceuticals in, you know, a hospital setting, um, has on the glasses, an indication of, um, you know, the patient.
[00:14:09] Angela: Pulled directly from the record. Here's the patient, here's what you're dispensing. Here's what the pill should look like. Here's how much you should be. Here's how much you should be giving them today. Right now at this moment, you know, and have that be that sort of augmented experience that, that helps, um, Automate day to day, or I should say enhances, um, the quality of day to day tasks.
[00:14:30] Angela: Um, I'm very bullish on that sort of thing. I, but I'm bearish on the timeframe. So I think that's going to, not that the technology doesn't exist totally exist. It would be really. Fairly straightforward to make that, uh, to put that into place, but from an adoption perspective and a change management perspective and the cost associated with leveraging augmented reality, um, in, you know, wide in a widespread manner in, in, in hospitals and clinics that are already, um, you know, challenged, uh, for all sorts of reasons with costs.
[00:15:04] Angela: I don't see that being big in the next. So Angela,
[00:15:07] Liat: um, let's just talk pre-health care for a sec. You've spent your career filling technology leadership roles at fortune 500 companies, including Dell bank of America. And most recently as the CIO of Renta center. What's one major facet of those industries, something in the digital space that they do exceptionally well, that you'd love to see adopted in healthcare.
[00:15:24] Liat: You
[00:15:25] Angela: a lot of time talking about omnichannel in healthcare. Let let's talk about omnichannel in banking and let's talk about Omni, uh, omnichannel in, in retail. And then I think it'll be obvious where we've not fully realized the potential in healthcare. So in banking, omnichannel, um, looks like. You know, a banking customer would use their app or they'd log in, you know, online and, you know, look at their account so they can initiate a transaction to move money from account a to account B.
[00:15:58] Angela: And that transaction maybe is happening. And then suddenly you lose connectivity. Right. And you, oh no, where's my money. Like I just lost connectivity. uh, did the transition go through, like, I didn't, I didn't receive a notification before I lost connectivity. So then you pick up the phone and you call a call center, right.
[00:16:18] Angela: And you say, Hey. This is Angela Yoko. I just tried to transfer money from account a to account B and then my internet went out or, you know, my phone died or whatever. So I need help. Um, you know, the call center, the expectation is that the call center, um, person would be able to view, or they're using a chat bot if, if internet come to still exists.
[00:16:37] Angela: But in my example of Denmark, so the call center person, uh, says, okay, I see your transaction. Yep. I can see the status of your transaction. It did. You're good to go. Like there's a transactional integrity between the two. Great. Um, if you wanted to walk into a branch, let's say that something, in fact did go wrong with a transaction.
[00:16:58] Angela: And they said, why don't you go into your nearest branch? Well, then you go around the corner to the nearest branch you walk in. And again, there's an expectation that you have, uh, you know, that that person can see the tr the status of your transaction, and you can complete it there, or you can complete it at the ATM outside.
[00:17:13] Angela: Anyway, multi-channel transactional integrity. Great. Now that's something that healthcare actually does pretty well, but I'm gonna come back to that in a minute. Let's talk about retail, retail. Omnichannel means I'm going to. Go to a store. I'm gonna sit on a bunch of couches. I'm gonna decide that I want this sofa.
[00:17:34] Angela: Um, I liked it. I got to try it, so I'm gonna order it, but I don't wanna pick it up in this store. I want it to be delivered to my house. And so you start the transaction in one channel, but you complete the transaction in another channel similarly. Um, You can go online, uh, order something. I'm gonna go to, you know, an online retailer, I'm gonna order a big screen TV and I'm gonna pick it up around the corner later today.
[00:17:58] Angela: I'm gonna schedule that pickup. I'm just gonna drive by pop the trunk and someone's gonna stick it in the back of my trunk and I'm gonna drive off and bring it home so I can watch that big screen TV tonight. Um, now in healthcare, imagine a scenario where I start my transaction. I start my visit. Online.
[00:18:19] Angela: So I'm coughing. Um, I. Want them to hear my cough. Um, I'm feeling kind of bad. The physician on the other end of the phone says, yeah, you know, they they're looking at me. They can see me, but if I don't have access, if they don't have access or if I'm not using one of the advanced sensor devices that no one health actually offers, which allows us to hear the lungs, uh, remotely, if that patient doesn't have that, then they might say, you know, someone really.
[00:18:49] Angela: To listen to your lungs. I don't like the sound of that cough. Um, I see, you know, are, are you at home now? Yes, you are. I see that there's a clinic around the corner and they have an appointment available in 15 minutes. Can you make it there? Oh, you don't have a car. I will send a Lyft for you and you will get, or an Uber or whatever, and then you will be delivered to this clinic in 15 minutes.
[00:19:14] Angela: So, uh, if you can, if you can, if you can make that. Yes. Okay, great. I've secured the appointment and comes a lift. Someone takes me to my appointment. I walk in. Oh, miss Yoko. I understand you have a nasty cough. Come on back. You're gonna be in room number. We're gonna take a, we take a listen to your lungs.
[00:19:30] Angela: These are the sorts of experiential consistencies that do not exist in healthcare today in healthcare. What would happen is I can, I can have that appointment. The physician might say, uh, yes, you need to hear, have someone listen to your lungs. Why don't you go online and make an appointment to see somebody
[00:19:50] Angela: So then the patient starts over. They go online, they make an appointment to see someone at the physician right around the corner. Then they have to go there and then they have to start from scratch. So they start from scratch. Hi, I'm Angela Yoko. I just had this appointment. They told me that I need to have some, those are my lungs.
[00:20:04] Angela: So here's where, that's why I'm here. And then they go back and those are the lungs and that's fine. And the transactional integrity is intact. I mean, because you all have the same EMR, so it's fine, but. Experiential integrity is completely disjointed and there's no connection between this encounter and this next encounter.
[00:20:23] Angela: They're not linked in any way, other than the data in the patient's the clinical data in the patient's record. So the opportunity for healthcare is to make that experience that when a patient flows between channels extraordinarily seamless and it's been done in other industries, we can certainly do a.
[00:20:41] Angela: That was so
[00:20:41] Liat: eloquent and you just described heaven on earth for a patient and what I would love to experience, but we're not there yet, but I think you're at, you're at the cutting edge of that. Angela, we have a few more questions. Um, what advice would you give to a room full of 100 new CIOs in healthcare?
[00:21:00] Angela: Hmm,
[00:21:04] Angela: that's a great question. Um, So I will give the same advice that I would give to any senior executive in any industry. Um, Understand that you wear two hats. The first hat that you wear is your domain leadership hat. So yes, if you are a CIO, then you will be optimizing for, you know, the, the outcomes you've been hired to produce.
[00:21:31] Angela: Um, and that's amazing and that's fabulous. And that's why you've been hired to do that work in that space, or if you're a CFO or if you're, you know, physician leader, et cetera. However, the second hat you wear is the leadership. You are a C level executive leading the company for which you work. And that leadership does not stop at the bounds of your domain space.
[00:21:56] Angela: You need to make sure that the, the decisions you're making the investment decisions, you make, the hiring decisions you make the way in which you engage with your colleagues and who, who run other domain. All of that has to be with a greater good in mind and don't ever let yourself, but especially don't ever let everybody else in the room forget that you have the greater good in mind, because then you will be always included in the conversations, the conversations where big decisions are being made, you have a chance to contribute your not only domain expertise, but also just your brain power.
[00:22:35] Angela: If you're a CIO, you've automated every process in a company. Regardless of what that company does, you know exactly how, you know, the process from a, if you're in a manufacturer, you know, order to cash, you know, that cold, right? If you're in a, a retail organization, you understand, you understand the full supply chain of how products come to market.
[00:22:59] Angela: If you're in high tech, uh, or the tech sector, you understand everything about the way. The, the, both the, the business, uh, clients, as well as the, the consumer clients engage with your company and you understand everything about the way that company has, um, changed the thinking and the engagement with that client, because that's the nature of your domain space.
[00:23:22] Angela: Bring that expertise to this next role and, you know, do great things. If you work in a domain. HR or domain, like to some degree, even, you know, uh, finance, certainly marketing to think of your internal constituents as your customers. That's not really true. Um, certainly you want to be extremely easy. Uh, uh, certainly you want to be, um, Someone with whom they find it very easy to work.
[00:23:56] Angela: Um, absolutely. And, you know, provide excellent service levels for whatever your domain space is. Of course, of course, but the customer is your, is your company's customer and you are partners in delivering the best possible outcome for that customer. In our case, it's for our patients, those are our customers and it is important to actively engage in things.
[00:24:21] Angela: That will benefit that customer, uh, regardless of whether or not it is your domain space's responsibility to deliver that thing, whatever it is, you know, have you, have you thought about this? Have you, I mean, engage actively just as you would, as if you were the CEO of the company, you strive to understand, make sure you're striving to understand what's happening in the other parts of the company and just do that overtly.
[00:24:46] Liat: Love it. Angela lastly, uh, if, and when we have you back here with us in five years from now on the podcast, what do you hope to be sharing with us? Um, personally at Novant health?
[00:24:59] Angela: Hmm. Well, I'd love to spend that time. Listening to, to, to, you know, clips from today's discussion and laughing at how quaint our our discussion was.
[00:25:16] Angela: I'd love to think about, you know, all of these problems being the solutions, being. Long standing, just table stakes. Um, by the time we, we get to five years, it's gonna be a different world in five years. So I would expect you look back and laugh.
[00:25:37] Liat: Amen. Yeah. And then there will be more issues to solve. Just, just how life works.
[00:25:42] Liat: Amazing. Angela, I wanna thank you for your time, sharing your unique insights with us on patient journey pioneers. Um, is there anyone you view as a trailblazer in the industry that you'd like to nominate as a future guest on our podcast?
[00:25:55] Angela: How about Annette Walker from city of hope. She's a trailblazer and she has a reputation of being someone who lifts others around her.
[00:26:05] Angela: She has not only, um, done great things for the systems she's served over the years, but also she has through, through the network of people. Whom she has reached out and lifted. Um, she has had a tremendous impact across, um, the healthcare industry as a whole in the us. Definitely. Uh, someone I think you should speak with.
[00:26:31] Angela: Okay, you
[00:26:32] Liat: will go after her then. Angela, thank you again. And this has been wonderful.
[00:26:36] Angela: It's my pleasure.
[00:26:39] Liat: Thank you for listening to patient journey. Pioneers brought to you by Hiro. Subscribe to our podcast on your favorite listening platform. See you on our next episode.