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INTERVIEW: Digital Healthcare Transformation in COVID-19

Author
Publish Date
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Ryan Carlson
October 26, 2021

In our video health data series, "Leaders in Leveraging Health Data", we chat with David Steele, Vice President, Performance Analytics & Outcomes of Stryker.

Use solutions others have developed - don't reinvent the wheel.

As a result of the pandemic, everyone's journey toward digital transformation has been affected. While it may be tempting to jump in and build technology on your own, the industry currently offers tons of great resources that you should consider leveraging. Learn about Stryker's plan for its own innovation initiatives. 

Transcript

Stryker with David Steele: Digital Healthcare Transformation During COVID-19

Ryan: This is Ryan Carlson with Healthjump. And I'm here today with David Steel at Stryker. And this is digital health analytics, but first, David, thank you for being here. Tell me about Stryker before we get into the whole data thing. 

David: Yeah. Thanks Ryan. So, Striker is a leading med tech company. It's been traditionally organized around orthopedics. Med surge neurotechnology and spine. And we have run as a company, those different divisions semi-independently, it's a very decentralized organization. But recently we have decided to form a new entity within Stryker digital robotics and enabling technology. And yeah. And so this was an acknowledgment that divisions were all going down in their strategic planning process and their development of their new products components of digital applications and data analytics needs for those to support those applications, as well as some major investments in robotics, navigation, and other enabling technologies.

And rather than have these divisions all invested. You know, Desperately in there's these, the solutions recognize that the world's changing and we need to start thinking about how we can look at enterprise-wide needs. 

Ryan: So are you looking at like a center of excellence for connectivity and robotics and automation?

David: Exactly. Ryan. So we're thinking about that as a yeah. Call it a shared service center of excellence, where we're going to be working on enterprise-wide solutions, conductivity device to device, device to cloud. Data analytics and advanced analytics and the data science side application development and cloud infrastructure management that could support the whole organization.

Ryan: Right? 

Imagine the, the advantages here is to keep every little division from running down a , disparate rabbit, whole that could build a lot of technical debt. I mean, Is this like building around like standards around like your data interoperability, the, maybe like the provisioning of devices common things that every product would, need to go through.

David: You're right on about that. That's right. So some of it's about standards and creating those standards. And some of it's about building that infrastructure that can support all these organizations, some of the tech blocks that we're going to need, and we can leverage for example, connectivity of devices, we don't need to have different devices.

Yeah, the governance around that and that, and the technology itself can be deployed in multiple different Stryker devices. Now all that's generating data, so having us common cloud or managing that, and then all the privacy and security components that go into all that. I absolutely not. It doesn't need to be decentralized.

We can organize that in a center of excellence. 

Ryan: Yeah. I I've had almost gosh, over a decade or more. Deep in the bowels of internet of things and industrial internet of things. So what, you're, what you're saying, it's exciting because we've seen industry 4.0 and smart factory and all of these other places and med device to around traceability and quality control have leveraged a lot of the stuff that came from internet of things.

And, and I think it's paved the way to take a lot of that risk that people in health. Like med device, you're putting a device in someone's chest. If there's quality control problems, you really want to make sure that is it's gone through a lot of steps. What, has me most excited about healthcare is that paved path where the risk isn't so scary for cloud, for wireless, for putting data some place that's not on a chip.

With a hardliner some of these things that were more or less people objections and not technology challenges that's right. In order to push things forward. 

David: So that's a, that's a great observation and we're in that journey now. That's great. We've started that journey. We've got a long ways, it's a journey, so it needs a ways to go.

But the idea of. Understanding the risks we're taking on and getting comfortable with those and putting in the legal agreements that are going to help us manage that risk, all the infrastructure that's also going to mitigate and allow us to make some big bets and accelerate the work and go full bore into this rather than kind tiptoeing into it.

 Those are all parts of this this new entity that I was talking about. It's thinking about those things so that we can accelerate our pathway forward, especially in the digital side where, you can't be slow. no, You need to be able to move as quickly as some of the startups, even though we've got different levels of responsibility, as you said, when, you know, the FDA approval process, when you're putting in med devices in people's bodies is a little different than a software and a cloud application, but we're kind of operating in both. So we have to be agile. In our approach. 

Ryan: So it sounds like what you're doing is maybe part of a larger digital transformation initiative.

So how much of what you're doing is internal. And is there any external components that you're engaging in the market? 

David: So internally is a big part of it. When you have a decentralized organization, part of the digital transformation is culture change. That's more important than even the technology investment.

Ryan: People problems, not engineering problems. 

David: Exactly. Ryan. So, so we're, we've been working on that you know, understanding internally in the us planning process where other divisions what they had planned to do and where we are seeing overlaps and therefore redundancies and therefore opportunities to standardize and build enterprise wide solution.

So that's an internal exercise, but the other part you asked about the external component is also One of the reasons why we're at this conference at HIMSS today is getting to know externally what some of the best practices are out there. How they're leveraging technology we're we're, we're much slower moving in some ways than, what's going on in the larger industry.

And we can learn so much from that and we're going to need partners. of the other recognition is we're not going to be, we don't need to reinvent the wheel here and build everything our own and we don't need to control it. 

Ryan: The not invented here mentality of a lot of big companies over the years.

What, I've, what I've really appreciated over 20 years of seeing that, there is value in finding the best in class. And there's even a lot of value in where I think where you're sitting in that second or third mover advantage. Yeah, Apple's never the first mover, right? Oh, no, it's a drinking game.

I invoked apple in a technology conversation. So forgive me please. But the fact is that you get to benefit from a little bit of hindsight where other people have gone. It's maybe a little bit easier if you're talking about people, problems in an internal adoption. How much of that do you find leveraging other world experiences other industries as way to onboard people to new ideas.

David: We have been doing some of that on the other industries, but we've even just been trying to learn from some of the similar type companies in healthcare that have gone as started down the digital transformation pathway. you know, GE healthcare for example, has had great success in that. So spending some time understanding what their pathway was and how they got there and where they leveraged partners and how they did the internal or also decentralized organization. So that would be a good example of trying to learn from others in this space and how they went down this path. Yeah, we're going to do a heavy amount of both as we're planning the future and executing on this this roadmap.

Ryan: So here's an observation I've had at HIMSS thus far. The pandemic has caused all growing pains along everyone's digital transformation journey, or just journey to digital in healthcare. It's created a focusing, a lens that amplified some growing pains into mission critical pains. Tele-health yeah, like clearly we found the weakest links in this ecosystem and it, we had to make. There's this discontinuous leap where leaders had this sobering epiphany that, oh my gosh, the strategic need to change is greater than our ability to adapt to it. So you're looking around for providers that go we've solved that.

Yeah. So that's where we've interviewed some really cool companies where they've they're, helping address those needs. My question for you is someone who is looking at HIMSS and looking at companies that are talking here.. What are the pains that went from growing pains to mission critical things that you feel is both innovative or what are the, what are the things that are catching your attention, where you're leaning in at a conference like this

David: Well, so one, 

, that we'll call it that the transformation from COVID to adopt technology and therefore some of our big customers, whether they're hospitals or affiliated clinicians are using technology that is capturing data. And that data is now recognized that can help to support their treatment planning process and their care management.

And, so those pain points are the pain. Not changing wanting to stay. This is how we do things, how we've been doing things that pain point is being addressed through a lot of the technologies out here in the in the exhibit. And now we're looking at how we can piggyback off of that moment, moment. Exactly. One of the a good example is in the surgical planning process, there are big opportunities to start utilizing clinical decision support applications, and AI driven insights that coming off the mapping of data across the longitudinal continue of care for a particular acute patient episode.

 And so some of the technologies, like you've mentioned telehealth, and then some of the applications that are now collecting data on, let's say that and the remote patient monitoring side are now great, inputs in building some of those models. And while we're now focusing on the pain point is how do you connect the dots on, the data across that continue we've typically played in in the med device space, for example.

So we have discrete data coming off of medical equipment, that Stryker equipment, and some of it's very clinically oriented. And mapping that to the hospital provided data and clinician provided data and the patient provided data is the holy grail of opportunities to create. In that ecosystem is to create new insights, new clinical decision support applications that are going to help guide clinicians and making more informed treatment to them.

Ryan: So we're getting more data created, but isn't it creating more silos though? I mean, I'm hearing where the trick is. The data is out there.. How do we get it to create that picture? 

David: Yes, exactly. So now that's that's the new, opportunity, for the pain point how do you, how do you make it more seamlessly able to connect the dots between those disparate datasets before it, what the data might not be even tracked?

So you had gaps that you couldn't address easily, but now we're starting to see much more adoption of technology that the gaps are, the data is being collected. You just got to pull it. Yeah, so interoperability, right? You see a lot of that, these, some of the themes, interoperability, a lot of companies trying to solve that opportunity for for, for the industry, but especially for companies like Stryker.

Ryan: So where do you see the future of, of addressing that problem? If, data acquisition is the challenge, knowing that it's there, like where do you. You know, From, from your seat, you get a, you get, you have the luxury of actually kind of looking back and see what other peoples have been doing. 

What are your takeaways?

David: If I had the, answer I'd tell you I, I'm looking at the solutions around here and trying to evaluate, who's got who's got it figured out, or who's got a pathway forward and has already been able to prove, and that they can do this and execute on this in a scale.

Yeah. Yeah. Those are the ones we want to partner with. So that's part of why we're here too, is evaluating different approaches to it. You've heard people talking about tokenizing data across different data sets and then being able to bring that together and doing that in a, in a scalable way.

That's something I want to learn more about. Yeah. How that can be applied to our different use cases. 

Ryan: I think it's an interesting conversation. IOT is no different in that it's disparate sets of data. Are not in any way attributed to me Ryan, unless they're at some place, they all live at the same database at the same time.

Is that really there? Otherwise it's just like a heating and cooling of a nest thermostat. It's when I register my nest thermostat that it brings those things together. But do you really need those things together? Create new insights to help people in the aggregate. They don't need to know about me unless they want to market.

Healthcare is not about that. That's right. 

David: You're absolutely right. Ryan, we don't need to know it's Ryan per se. Yeah. To build the models. So we need to know all the things about Ryan. This is that process of then being able to have a digital twin that we're you know, can leverage.

Ryan: Exactly. Yeah. Right. And, and, and I keep thinking that there's this conversation that needs to be had a bit more around idea of health, metadata, there's anything, that's the protected health information. When you're talking about Phi and that needs to be sacrosanct, right? It needs to be kept rest or in motion only in the right instances for the right authorized users.

But there's a significant amount of medical or clinical metadata that is created by doctors who are inputting information. Exactly. How is it that we can start leveraging. That metadata that is, it's never identifiable in the first place. You don't have to redact it with the marker. So I think this is the conversation we should all be having more of is what do we do with data that can't be re identified, cause it was never identifiable in the first place? And I think living in there is a lot of those different pieces, right? Cause privacy, security and regulation. The minute, our names addresses, phone numbers, touch it. We have to be extra, careful, right? No one questions that, yep. So that's how do we, remove that from the conversation for AI, for aggregated data?

And it sounds like this is exactly what the center of excellence is attempting to. Do you have health metadata all over the place? Yep. And it's how do we bring it together in a meaningful So, What is it? Data scientists, let me know who is it that you're having there? 

David: Sure. Yeah. Users of this. So they can build the models that are gonna drive clinically relevant decision support applications in the future, or built sometimes into our products, as they're using them, they're in the operating room and you're getting guidance on what's the right approach to do this particular type of procedure. That's where it gets really exciting. But you're absolutely right. So we're trying to think about this. We're not gonna solve that somebody in this industry or multiple companies are trying to solve that.

We want to make sure we're working with those companies to to piggyback off of that effort and take advantage of their ability to unlock in essence, the value of the data by taking off the identification issue off the table. 

Ryan: Thank you for sharing the Stryker story and how you're. Congratulations on bringing the center of excellence together. And what you're doing, I think is an excellent first step on taking a whole route of independent squirly paths that can lead into dark places or big wins that no one ever else gets the benefit from. So kudos to you. Yeah, that's right. I think that's fantastic for having me and good luck on your journey on getting all the right pieces of the puzzle together to inform what you're doing next.

David: Yep. It's going to be it. I appreciate it. 

Ryan: It is a journey. Thank you so much. 

All right. Thanks Ryan.

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