Podcast
Empowering Care: HCA’s Journey to Quality Care through Tech Partnerships
Nicole Tremblett
Vice President ITG Nursing + HR, HCA Healthcare
While many in the healthcare industry knew a nursing shortage was on the horizon, the pandemic expedited the crisis in a way few saw coming. Now more than ever, it’s imperative that healthcare creates an environment that allows nurses to focus less on administrative tasks and more on what they love to do: caring for patients. Nicole Tremblett is the vice president of the Information Technology Group, responsible for nursing, HR technologies, and identity and access at HCA, and she joins host John Farkas on this episode of Healthcare Market Matrix to discuss how she’s addressing this crisis in her role at HCA. Throughout the episode, John and Nicole examine the nursing crisis, HR’s important role in bringing stability, HCA’s approach to implementing technology solutions, and much more!
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Transcript
Introducing Nicole Tremblett
John Farkas:
We are privileged to be joined in the healthcare market Matrix Studios today by none other than Nicole Tremblett. And Nicole is the vice president of the Information Technology Group, responsible for nursing and HR technologies and identity access for none other than HCA. Now, here’s what I want you to know. Nicole has what I would consider to be a remarkable 27 year tenure at HCA. And Nicole, I was looking back at my LinkedIn, at the people I know over there that you work with and around just because I was curious. And I’m guessing that you and Marty Paslick, who’s currently the CIO, were hired just about the same time, if I’m not mistaken.
Nicole Tremblett:
He might have 10 years on me?
John Farkas:
10 years at HCA?
Nicole Tremblett:
10 extra years. 37, I believe.
John Farkas:
So LinkedIn’s only a little bit verifiable, but he is been there for a while. Chad Wasserman, who oversees operations for a chunk of the IT group, was there a little bit before you. And I think Jay Levy, who I know led a lot of the software development over there, must have helped pour the foundation at the headquarters building because he was there for 30 years or so. But you are certainly one of the more tenured information tech execs over there, which makes sense why you have purview over nursing and HR technologies and identity access, because my goodness, talk about some of the hot seats right now. Those are certainly that. And I should just mention that Nicole is also part of our advisory board. And I want to take just a second to tell you why I’m excited about that, because Nicole is passionate about helping bring innovation to healthcare.
And when I told her about being a part of our advisory board and that would mean that she’d have the chance to speak into some health tech companies to help them improve how they bring their solutions to forward in the market, she was all in. She wants to be a part of the solution, contribute to the solution in meaningful ways. So Nicole, I’m really looking forward to our conversation today. Thanks for joining us here.
Nicole Tremblett:
Thanks for having me.
Healthcare’s Nursing Crisis
John Farkas:
So let’s talk about… Certainly looking at the information universe around nursing and HR, I don’t think I… If somebody were to ask me the two hot issues right now in healthcare, I would say that’s the epicenter. Is that your perspective of things?
Nicole Tremblett:
That is absolutely my perspective. Nursing is the heart of healthcare, and we have to help our nurses in this challenging time. And then when we think about HR experiences and onboarding and giving the colleague the best experience they can while they’re at work and understanding what’s going on, the whole person comes to work and treating everybody with respect, I think both of those are absolutely paramount to healthcare in general.
John Farkas:
Yeah. It’s super critical. And talk us through. And I know for a lot of folks listening, there’s some pretty clear familiarity with some of these issues. But if you were to kind of rewind the last three years and talk about what’s happened to bring us to what many would consider the crisis point we’re at right now in the nursing realm and in around HR, tell that story. What were some of the factors and the way you saw things play out and the implications that it’s had?
Nicole Tremblett:
I think we always saw a nursing shortage coming on the horizon, and people were getting plans in place for how to deal with that. The pandemic expedited that. Nurses were at the front line working their hearts out in times that were uncertain and scary. And I think after they lived through that, many nurses decided to exit the profession and pursue other things. So now we’re left with a nursing shortage, I believe years in advance of where we thought they would be, and nurses that have carried a lot of burden with them. And we need to create an environment that has less administrative tasks for them, that lets them be at the bedside and do what they absolutely love to do, which is care for patients.
John Farkas:
Yeah. And so there’s certainly some opportunities for technology to help that happen. What I also know and what I’ve heard is that, especially from the nurses’ perspectives, and this is true of pretty much anybody I’ve talked to in the clinical profession, their natural association with technology is not necessarily assistive. It usually is a layer of additional stuff to do. Talk about that a little bit, how have you seen that? And how are you looking to help alleviate some of that impression?
Nicole Tremblett:
I think in that case, perception’s reality. There has been a lot of technology solutions given at healthcare and maybe not really thought about the optimal workflow. And so nurses have a lot of tools in their toolkit, but they’re not designed to work together efficiently and effectively. There’s so much data in healthcare that they’re overwhelmed by which reports to look at. There are so many audits and regulatory requirements coming at them that a nurse leader has to work way over the number of hours we’d want them to just to do their job. And so I think there’s a mountain for us to climb. I think step one is, hey, there’s a lot of awareness around it. We have done a lot in the healthcare space to advance technology. And now, we’ve really got to make it all work together to release that burden on everyday nurses, and especially nurse leaders.
Recommendations for Selling to Large Healthcare Organizations
John Farkas:
So look, tell us a little bit about your reporting structure. How are you set in the organization? And how is that end up affecting your purview on bringing some of those types of solutions forward?
Nicole Tremblett:
Yeah. So our organization, ITG, is about actually 7,000 people strong. We have obviously IT people elbow to elbow with nurses and physicians in our hospitals, but then we have almost 60% of the folks here at the corporate headquarters that are responsible for everything from support services and operations, right through product development and supporting our products. My organization specifically now reports to the operations roles to Chad Wasserman. And we are directly aligned with the senior vice president of each of the specific areas. So you think about nursing for HCA Healthcare, Sammy Mosier is the chief nursing executive. I work closely with Sammy and her team on solutions to make the lives of nurses better.
John Farkas:
Gotcha. I’ve definitely heard, from a number of our clients and some others, that having the opportunity, I guess selling into HCA is the best of times and the worst of times, kind of a tale of two cities motif there. It’s not… And you just iterated something that helps me understand some of why. It’s a 7,000 person org that you’re navigating. And nobody that knows HCA thinks it’s a simple equation. It is a vast, complex organism, for sure. But talk a little bit about what are some of the factors that organizations who may have a good solution that they’re wanting to bring forward, what do they need to be considering as they are looking at opening up conversations with you and some of your team and associates?
Nicole Tremblett:
I think when you think about working with any large organization, how do you peak of those that are working directly in your space? I think one of the things that we find with small organizations, they have solutions but they don’t necessarily always be able to articulate our environment very well. And so I think the key is really understanding the problem statement. And is it a problem for the organization you’re targeting right now? And if it is, who do you need to talk to? And great ways to, I think, connect with organizations, large organizations, is obviously just internal referrals, right? If you know somebody who knows somebody that can open a door, that’s always a great opportunity. We love to listen and learn. I think our Nashville Technology Council and things that go on there, that is a gateway for a lot of technologies here in town, brings them a lot of visibility. I think we have lots of conferences and networking events that people can get together at round table events. And that’s always a nice way too to get connected to new ideas and what people are thinking and doing.
John Farkas:
Gotcha. So I know there are a lot of things competing for your attention right now, a lot of potential opportunities. Talk about how you’re weighing those opportunities as you are looking at decisions, and how you evaluate what are some of the things that you might spend some time to work to implement?
Nicole Tremblett:
I think when we think about it, let’s think about three factors, right? Will it improve the quality of care? Will it improve our outcomes for our patients? And will it bring efficiency to our bedside nurses? And so when you think about the three of those, often, if you can get one, it’s an equation in itself. However, if you can hit a couple of those factors at the same time, I think your solution really gets some legs. And so I think about our earlier conversation about relieving burden from our bedside nurses. How do you bring them efficiencies in their day-to-day where they have data when they need it, when they walk in a room, people know they’re there and they automatically get the information they need to care for a patient? So just thinking through what the future could look like.
Healthtech Solutions that Nicole Is Considering
John Farkas:
Gotcha. And so if you’re looking now at what are some of the things… Let’s take nursing to start with. As you’re evaluating opportunities and looking at, solving some of the problems, what’s in your critical path currently? What are some of the things that you’re evaluating and the technologies that you’re looking at now? And what are some of the things on the horizon that you know that you need to be considering that you’re exploring?
Nicole Tremblett:
I think thinking about a modern patient room and how the TV can be a convergent point for care. Thinking about some of these facilities, you go in, they’re a million square feet. So if a family member is visiting and a physician is a mile away in the facility, how can you use a virtual care opportunity? They could do a consult through the TV to talk to the patient and the family at the same time. There are certain things when you think about a virtual nursing platform. A nurse does a lot of documentation. And we want great documentation and in our health records, right? That helps us understand, helps the whole care team understand what’s going on with the patient. But does a nurse at the bedside really need to do all that documentation? Can a nurse that is a virtual nurse working from a command center or at home help with the burden of that documentation by doing admission history, MedDirect discharge instructions and really engage with the patient through a modern platform and spend quality time with that patient? Right?
A lot of times a bedside nurse is very distracted. There’s an alarm going off in the room next door, their phone is buzzing. So they’re trying to gather information and type it into the EHR as time permits. But a virtual nurse can spend quality time with that patient, having that dialogue and really getting great information. So I think that modern patient room includes help for the bedside nurse. It includes treating the family as a part of the care team, allowing collaboration with physicians and family and nurses, all the caregivers at the same time. I think going into the future, the things that the art of the possible, you think about ambient voice, walk into a room, the room can recognize you through RTLS tags or something. They know you’re a physician, a nurse. They can automatically help you with that documentation, start that dialogue, start collecting that. And hopefully in the future, again, be able to put it into the medical record where it can be viewed and used for care in the future.
HR’s Impact on the Nursing Crisis
John Farkas:
Gotcha. Yeah, I think that that’s certainly a lot of what I’m hearing is, what are the tasks that are very clearly replaceable that are or were a virtual presence or something similar can be automated or taken off of the nurse so they’re not spending 30% of their time in front of a keyboard in that interface, and able to spend that same time in front of patients that they would normally be keying stuff in? That sounds like a really critical link. Talk about the HR side of things, what’s happening there?
Nicole Tremblett:
Gosh, in my world, HR was always important, and it was always a function that kind of almost behind the curtain I would say it operated. Everybody did their role. But I think during the pandemic, HR became a top priority of many organizations. And now, it is how do you have the best onboarding experience? How do you find the best colleagues? How do you retain those colleagues? And what does a modern workplace look like? So thinking about from your core base foundation systems to the way you can engage people and understand the temperature of your organization, how you can help them with career pathing, just really creating a vision for the future around your workplace.
John Farkas:
And so knowing that that’s gone from a more, probably a parallel function to what a lot of organizations would look at to one of the most critical components, from my understanding, one of the most critical equations for hospital’s survival right now, what are some of the ways that, as you were thinking about solving for those opportunities? What are some of the things on the horizon that are exciting there? What’s some of the technology that’s coming forward that’s letting you address those issues better?
Nicole Tremblett:
I think there’s a few things in the works. I think in the past we really focused on HR as an operations. And so now, user experience and how people engage with the platforms and really make it easy is top of mind. So there’s a lot of focus groups around the casual users of these platforms, how do you make their day-to-day job easier? And I think that’s a little bit of table stakes. Then there’s our engagement platforms, your recognition platforms. What can you do that really fuels an organization and gets them excited about your mission and what they’re doing, and their contributions to the mission every day? And then you think about the industry, I’m really excited about a digital credentialing project that we’re involved in. That’s not just my company’s focus, but an industry focus. And it’s almost like you think about you’re carrying your, you as a patient are responsible for your electronic health record.
Well, you as an employee also can own your credentials, and they’re verified credentials. And so if you’re applying for a job at company A and B, you just can share those verified credentials. And waiting for background checks and things like that to take place is taken out of the equation. It’s already done. It will help you get to onboarding faster and more accurate.
John Farkas:
Yeah, that makes great sense, and certainly something, as we look at the technology surrounding various forms of identity verification and things like that, that’s certainly a fast evolving world right now that I could definitely see having some good implications in HR, for sure.
Identity, Access, and Data
John Farkas:
Talk about, so then the other part of your triad here, when we’re looking at the whole access world. And I know that security and identity is right in the cross hairs of a lot of conversations currently. What’s HCA looking at there? How is AI factoring into that, especially as it pertains… I’m guessing privacy is part of this equation in some ways, so curious to get your perspective on that.
Nicole Tremblett:
I always like to start out with identity and access is the elephant in the room. It is years and years of good decisions that have put organizations in places where they’re facing a mountain in a lot of times. You need a transformation in this space. And I think we’re no different than anybody else that we’re trying to figure out what does the world of identity look like in five or 10 years, and how do you make it frictionless but absolutely secure, so that every time my hands hit the keyboard, that who Nicole is and that this is the right kind of data for her to be accessing?
And so you look at the future for identity and access, I think it is making it from the day one that you arrive in an organization that you have access to everything that you need to provide care, to do your job most effectively as possible, but not providing too much access and making sure that you have great controls, that you understand how your data’s being used and where it’s going and what’s being done with it. And so we’re really excited about a journey of really looking at our legacy platforms and envisioning what they can be in the future, incorporating your cloud journey into it, making sure that we understand what it is in this new, hey, people are working remotely. We might have global capabilities in the future. How does this all play into an identity and access strategy that protects your critical asset, your data, but also allows people to do their job at the top of their license?
John Farkas:
Yeah, just reducing that friction and the accuracy seems like a really big opportunity for that right now. Because I know it’s tough. I definitely have seen the friction. As a patient, I’ve seen it, and I’ve watched the clinicians deal with it too, just my first person experiences and having to ask the same questions over and over, having to just watch them scan badges and do things that seem like,,, it doesn’t seem like a lot. But when you have to do it 30 times a day, it’s a lot.
Nicole Tremblett:
Yes.
John Farkas:
And that can be a real drain on… When you’re looking at people that you need every moment of their time on the floor to be optimally productive, that’s a critical part of the equation, for sure.
Nicole Tremblett:
Many of our caregivers have up to 30 systems they need to access in a day.
John Farkas:
Yeah. And so how many logins does that represent because it’s not just a one and done when they’re…
Nicole Tremblett:
It is not.
How Nicole and HCA Stay Up to Date with Healthcare Solutions
John Farkas:
That is clearly a big issue. So Nicole, as I think about, and knowing that our audience is really interested in ultimately getting a part of your attention at some point, what are some of the channels? You already talked about first person introductions, which is clearly, if you know somebody, that’s a great path. And we’re assuming that there’s not a warm introduction here, that there’s not a first easy way in. What are some of the channels where you are taking notice of things and getting informed? What are some of the things you’re tuned into that help you stay abreast of things?
Nicole Tremblett:
Yeah, I think we’re always scanning the horizon to see what’s out there. We work closely with a number of consultant partners. We use industry papers, the headlines, things that are being talked about. I also think we also look at our industry colleagues and see what what’s everybody doing. That’s one of the things I love about the healthcare industry in general, is that we tend to share. I don’t know. I don’t feel that it’s that competitive when it comes to, “Hey, there are these solutions that exist out there, and this is all mine.” It is, “Oh, this is a great solution and it brings healthcare forward. You should know about it.” And so I think having some successes and referrals from other folks that you’ve been engaged with always opens doors and tends to open our ears as well. So I think there’s just a multitude of channels, a lot of…
One of the things I love about here in Nashville, Tennessee is that the fact that we do have a pretty tight-knit tech community, and I feel like we have a tight nonprofit community. And I think when people ask you to pay attention to something or you’re at a networking event, you tend to open up the doors and give people time.
John Farkas:
That’s definitely good to know. Are there conferences or events that you spend time at? Or what are some of your priorities there?
Nicole Tremblett:
Yeah. Gartner does a really nice job for us when we think about conferences and healthcare related. Many of my colleagues, myself included, many times have attended HIMSS and kind of walked the floors with everybody else to see, hey, what’s interesting out there, and what sparks your interest? There was [inaudible 00:24:54] here in town. I know that a lot of people enjoyed having the opportunity to have that in our backyard so that we could attend there and get exposure to folks. I think all of those are important. Health is out there. I think it just kind of ebbs and flows on where we participate and what we do. But we definitely try to go to at least one or two a year.
John Farkas:
And when you say we, who’s on the team that is out there doing that type of stuff?
Nicole Tremblett:
So me and my colleagues. So you think about Paul Curry, who’s the heads up our enterprise architecture strategy. He tends to spend a lot of time kind of, really in the three to five year range, looking out in advance to us. I think there’s probably, gosh, how many people at Marty’s table? I think probably 12 or 14. And so kind of all my colleagues were responsible for different service lines, everything from our group purchasing organization and our revenue cycle to implementing our EHR and data science, right? So everybody’s kind of industry or service line driven.
HCA’s Approach to Implementing New Technologies
John Farkas:
So you just mentioned a table of 14 or 15 people that, in a lot of health systems, would maybe be two or three. So what is the current number of ACA facilities?
Nicole Tremblett:
We have 183 facilities each, give or take a day. But we really look at ourselves as an ecosystem. We have over 2200 access points. So everything from imaging centers, urgent caress, freestanding eds, physician clinics, cancer clinics, so everything that a patient could need on their healthcare journey, we want to make sure we’re there for. And then most of those access points are connected to one of our hospitals in case that they never need those services.
John Farkas:
So 2200 access points. Talk about… There’s certainly, as I think about managing information technology in that broad of a spectrum, talk about some of the challenges you guys encounter with doing that, because it’s a colossal task. It requires a whole lot of smart… And certainly HCA has the reputation of really looking at innovative ways of doing things, efficient ways of doing things. And it can’t happen overnight. It’s not a super nimble organization just by the fact that it’s so large. So what are some of the factors, as you guys are looking at deploying things across the system? How are you looking at vetting? How are you looking at testing? How do you approach the implementation of new technology when we’re looking at a pretty gigantic organization
Nicole Tremblett:
In the future, the way we’d want to see ourselves is how does things embed in the workflow? And if there is a solution out there for a nurse, for example, how does that solution embed in the current workflow and become almost seamless to that nurse that it’s there when they need it? So you have to think about, one, usability. What is it like to interface with? Two, access. Does it integrate with our current identity and access management solutions? Three, data. How do you get data from it so that we can use it in data science and other capabilities. And just pure integration. I think having open APIs and things that are easy to get data in and out of is absolutely key to anything we do in the future.
John Farkas:
So when you look at some of the standards and some of the practices that HCA holds, what are things that you frequently see people surprised by or caught off guard by or not prepared for as far as some of the standards that you’re looking for?
Nicole Tremblett:
Yeah, I think one, again, it’s just a complex environment, and there are a lot of controls in place. So I think when we look at working with a new vendor, there’s a pretty rigorous security assessment upfront. And we have a good process, but I’m not sure that smaller organizations are always ready for it. However, I think looking at us as a large organization, we’ve gotten better about helping small organizations be ready for it as well, right? So our findings hopefully help that organization grow, and help them be better for the next company they want to work with.
Our contracting process is not simple. There’s a lot of years of findings and things built into our contracts. And I would just say, hey, don’t be intimidated by it. Let’s sit down and have a conversation and work through the big rocks all at the same time. And then I guess just volume and scale. When you think about anything that we do, lots of solutions work in a one-off environment. So it’s easy to put it into one doctor’s office or one hospital. But when you think about the fact that you want it to work across an enterprise, it gets pretty complex even for us who’ve done it for years, but especially new entrants into the market. So just understanding that that is a lot more difficult than people often realize. But hopefully we’ve learned enough over the years as well where we can help people succeed in that.
John Farkas:
You talked about some clinicians having 30 logins, which is a testimony to the challenges that surround various point solutions for the clinical environment. Talk about what your organization’s doing now in and around point solutions and trying to simplify what’s possible, trying to increase interoperability. How are you guys looking at that? And what would health tech companies do well to understand as you guys are working to simplify the clinician and the patient experience?
Nicole Tremblett:
We’ve done a pretty good job over the last while about single sign on. And so hopefully once you get into one machine, you’re there and can have access to lots of other applications without having to log into each. It complicated it when we introduced smartphones. And so we have over 100,000 iPhones out there in the hands of our clinicians. But every good idea tends to be an app now. And we have yet to crack that nut about single sign on for our smartphones because we have shared devices. And so people can dock a device and pick up a new one, and all their data’s transferred. And so getting to a point where we can have seamless integration of our mobile solutions would absolutely be key. And then I believe on the back end, we’ll get to a point where we’ll be able to use our data and hopefully create solutions with partners that already fit into our ecosystem, that we have standards going out of the gate where, hey, this is a toolkit that helps you integrate and do single sign-on.
John Farkas:
So I haven’t done this research, so I don’t know what’s out there, so disclosure there. But where are you guys in the process of the development of an AI policy, and how are you approaching AI? As we’re looking at the ethics, as we’re looking at the privacy elements, how is that taking shape currently at HCA?
Nicole Tremblett:
I’d say it’s not squarely in my wheelhouse, but I’ll say eyes wide open. We have a lot to learn, like everybody else in this space. I think there’s a lot of hope and promise for the future of what AI can bring us. But we also know… I think as individuals, we’ve all played with different AI solutions, and we know often, it’s a starting point, right? You’ve got to use your own thoughts and your experience and apply to what AI gives you. So I think figuring out the balance between how you use AI to help guide and get you to an answer fast, but realizing there’s always going to be a clinician in the loop when you start making decisions, definitely in healthcare because complex and every individual’s different. There might be more opportunities in the backend where things are more standard and repeatable in processes.
John Farkas:
Good. Yeah. It is certainly going to… I think eyes wide open is right. I’ve never seen as bright a firestorm as we’ve had in the last 18 months in and around that space. It’s a super critical area, and from my vantage point, one of the biggest opportunities for truly helping clinicians.
Nicole Tremblett:
Agreed.
Nicole’s Magic Wand Solutions
John Farkas:
And so it’s really exciting in that regard. So I’m curious, as I’m looking at your realm, if you had a… I’m handing you the virtual magic wand here, Nicole, and so we’re going to take each of your three areas here. If you could solve today, if you had the magic wand and could solve one problem in and around nursing information technology, what would that one problem be?
Nicole Tremblett:
I would have a modern patient room where any new solution, any new idea can plug in and you can scale it quickly. So think about a room that is already has a camera and audio, it has a television, it has wireless points where somebody comes up with a solution that can help a bedside nurse today, we can deploy it quickly without having to go in and go, oh, I’ve got to put a different type of camera in a room. I’ve got to install this. And when you’re thinking about 45,000 beds, it takes a long time. And so if I had a magic wand right now, I’d have a modern patient room where any solution you could plug and play quickly and get value and help our patients and all of our caregivers.
John Farkas:
Yeah. That stuff is coming. It certainly is.
Nicole Tremblett:
It is.
John Farkas:
So, okay, HR. You have the HR magic wand now. What would be the thing that you would want to be able to solve?
Nicole Tremblett:
I would like to figure out how you can really predict and help and gain feedback on employee retention. What makes a difference to every colleague? Every person is unique, and everybody has something that drives them differently. And I think in healthcare, we all have a common goal. We all want to transform healthcare. We’re all patients, our loved ones are all patients. And so I think we have that as a grounding mission. So then what helps? What’s the next layer that will make you feel like you are able to work at the top of your talents and do the most and add the most value to the organization that you can?
John Farkas:
Great. And then the last one, the last stool or the last leg on the stool here, identity and access, if you could get the magic wand.
Nicole Tremblett:
It is a hundred percent frictionless. We know who you are before you walk in the door, and we know the who you are when you walk out the door. And so how do you make that experience so easy that a nurse never has to worry whether or not she’ll have access to what she needs to care for a patient?
John Farkas:
And you know what, from my perspective, as I listen to you, what I feel like is exciting is that you’re not too far, I don’t think. And easy for me to say because not overseeing 2200 points of access, but you’re closer to those things being reality than we were even three years ago, much closer. And so I think there’s some real hope of some of that coming to fruition in the not too distant future, I hope.
Nicole Tremblett:
I agree.
John Farkas:
I hope for all of us…
Nicole Tremblett:
I agree.
John Farkas:
… especially for you.
Nicole Tremblett:
I think technology has never been more important to healthcare and transforming healthcare and the way we deliver care than it is right now. And I think there’s a big opportunity for all of us to work together to solve this and to make it better for the future.
Closing Questions
John Farkas:
So if you had a set of a couple concise advice points for people who are working in health tech companies trying to make connections with organizations like yours, what would be some of your top headline points you’d want? And we’ve talked about a number of them here, but if just again, simplifying it to the primary takeaways, what would be some of the things you would want them to make sure they’re coming with an awareness of?
Nicole Tremblett:
Know the real problem you’re trying to solve. Understand kind of where that is in the healthcare landscape and the company landscape. Know that scalability is paramount. It’s not easy, but people are willing to work with you on it. So I would say admit that upfront, right? It’s not easy to scale and to go enterprise wide anywhere, so understand that it’s going to need help. And then be a great partner. How do you get feedback? How do you iterate together? How do you dream about the future and set that vision collectively so that you can get something that people are really excited about? Trying, doing, growing.
John Farkas:
Awesome. I guess what’s been one of your surprise delight discoveries in the last six months or so? What’s something that you’ve seen come forward that you were like, there it is, or that’s really exciting?
Nicole Tremblett:
Think we’re on the doorstep of something really special with this virtual nursing platform, virtual care platform. And actually, it’s bigger than nurses, right? It’s case management, being able to collaborate with the family on where the patient is going. It is physicians being able to get advice from specialists when they need it. It is a whole kind of virtual care concept I believe that is really going to help us transform healthcare.
John Farkas:
That’s great. And I would agree. The things that I’ve have come across my viewfinder recently that I can, from my seat on the bus, which is certainly several steps removed from yours, but just as a person who knows something about the realm and who’s been in the seat of a patient, I can quickly see how that could be helpful. I watch the struggle of a lot of the clinicians as they are trying to make it happen. And it’s not enviable, that’s for sure. So Nicole, is there anything else, anything you would want a company to know? Any secrets that you would want to bring forward here that would be good pearls of wisdom to depart as we conclude?
Nicole Tremblett:
I think, again, technology is the opportunity to transform healthcare and to think about alternate care models. Be willing to iterate and dream with somebody about how you can make an environment more friendly, impact better outcomes, sustainable, thinking about just the future in general. I think people, nurses, physicians, they’re busy. They’re always running around. Their hands are always in use. So how do you think about ways to engage with them that doesn’t require their hands, it doesn’t require them logging into a device. What does that future look like where we can really help them as they are just caring for patients?
John Farkas:
That’s great. And I really want to thank you for taking the time today and for what you had the opportunity to share. It’s definitely a gold mine and very consistent with a lot of what I’ve been hearing and see happen and emerge in this space. So I’m not at all surprised to see and to hear the HCA is kind of on the forefront of looking at some of those issues. And really eager to see some of the start to take root, and expect that it will here soon. So Nicole Tremblett, thank you so much for joining us today on Healthcare Market Matrix.
Nicole Tremblett:
Thanks, John. Look forward to updating you in the future.
Transcript (custom)
Introducing Nicole Tremblett
John Farkas:
We are privileged to be joined in the healthcare market Matrix Studios today by none other than Nicole Tremblett. And Nicole is the vice president of the Information Technology Group, responsible for nursing and HR technologies and identity access for none other than HCA. Now, here’s what I want you to know. Nicole has what I would consider to be a remarkable 27 year tenure at HCA. And Nicole, I was looking back at my LinkedIn, at the people I know over there that you work with and around just because I was curious. And I’m guessing that you and Marty Paslick, who’s currently the CIO, were hired just about the same time, if I’m not mistaken.
Nicole Tremblett:
He might have 10 years on me?
John Farkas:
10 years at HCA?
Nicole Tremblett:
10 extra years. 37, I believe.
John Farkas:
So LinkedIn’s only a little bit verifiable, but he is been there for a while. Chad Wasserman, who oversees operations for a chunk of the IT group, was there a little bit before you. And I think Jay Levy, who I know led a lot of the software development over there, must have helped pour the foundation at the headquarters building because he was there for 30 years or so. But you are certainly one of the more tenured information tech execs over there, which makes sense why you have purview over nursing and HR technologies and identity access, because my goodness, talk about some of the hot seats right now. Those are certainly that. And I should just mention that Nicole is also part of our advisory board. And I want to take just a second to tell you why I’m excited about that, because Nicole is passionate about helping bring innovation to healthcare.
And when I told her about being a part of our advisory board and that would mean that she’d have the chance to speak into some health tech companies to help them improve how they bring their solutions to forward in the market, she was all in. She wants to be a part of the solution, contribute to the solution in meaningful ways. So Nicole, I’m really looking forward to our conversation today. Thanks for joining us here.
Nicole Tremblett:
Thanks for having me.
Healthcare’s Nursing Crisis
John Farkas:
So let’s talk about… Certainly looking at the information universe around nursing and HR, I don’t think I… If somebody were to ask me the two hot issues right now in healthcare, I would say that’s the epicenter. Is that your perspective of things?
Nicole Tremblett:
That is absolutely my perspective. Nursing is the heart of healthcare, and we have to help our nurses in this challenging time. And then when we think about HR experiences and onboarding and giving the colleague the best experience they can while they’re at work and understanding what’s going on, the whole person comes to work and treating everybody with respect, I think both of those are absolutely paramount to healthcare in general.
John Farkas:
Yeah. It’s super critical. And talk us through. And I know for a lot of folks listening, there’s some pretty clear familiarity with some of these issues. But if you were to kind of rewind the last three years and talk about what’s happened to bring us to what many would consider the crisis point we’re at right now in the nursing realm and in around HR, tell that story. What were some of the factors and the way you saw things play out and the implications that it’s had?
Nicole Tremblett:
I think we always saw a nursing shortage coming on the horizon, and people were getting plans in place for how to deal with that. The pandemic expedited that. Nurses were at the front line working their hearts out in times that were uncertain and scary. And I think after they lived through that, many nurses decided to exit the profession and pursue other things. So now we’re left with a nursing shortage, I believe years in advance of where we thought they would be, and nurses that have carried a lot of burden with them. And we need to create an environment that has less administrative tasks for them, that lets them be at the bedside and do what they absolutely love to do, which is care for patients.
John Farkas:
Yeah. And so there’s certainly some opportunities for technology to help that happen. What I also know and what I’ve heard is that, especially from the nurses’ perspectives, and this is true of pretty much anybody I’ve talked to in the clinical profession, their natural association with technology is not necessarily assistive. It usually is a layer of additional stuff to do. Talk about that a little bit, how have you seen that? And how are you looking to help alleviate some of that impression?
Nicole Tremblett:
I think in that case, perception’s reality. There has been a lot of technology solutions given at healthcare and maybe not really thought about the optimal workflow. And so nurses have a lot of tools in their toolkit, but they’re not designed to work together efficiently and effectively. There’s so much data in healthcare that they’re overwhelmed by which reports to look at. There are so many audits and regulatory requirements coming at them that a nurse leader has to work way over the number of hours we’d want them to just to do their job. And so I think there’s a mountain for us to climb. I think step one is, hey, there’s a lot of awareness around it. We have done a lot in the healthcare space to advance technology. And now, we’ve really got to make it all work together to release that burden on everyday nurses, and especially nurse leaders.
Recommendations for Selling to Large Healthcare Organizations
John Farkas:
So look, tell us a little bit about your reporting structure. How are you set in the organization? And how is that end up affecting your purview on bringing some of those types of solutions forward?
Nicole Tremblett:
Yeah. So our organization, ITG, is about actually 7,000 people strong. We have obviously IT people elbow to elbow with nurses and physicians in our hospitals, but then we have almost 60% of the folks here at the corporate headquarters that are responsible for everything from support services and operations, right through product development and supporting our products. My organization specifically now reports to the operations roles to Chad Wasserman. And we are directly aligned with the senior vice president of each of the specific areas. So you think about nursing for HCA Healthcare, Sammy Mosier is the chief nursing executive. I work closely with Sammy and her team on solutions to make the lives of nurses better.
John Farkas:
Gotcha. I’ve definitely heard, from a number of our clients and some others, that having the opportunity, I guess selling into HCA is the best of times and the worst of times, kind of a tale of two cities motif there. It’s not… And you just iterated something that helps me understand some of why. It’s a 7,000 person org that you’re navigating. And nobody that knows HCA thinks it’s a simple equation. It is a vast, complex organism, for sure. But talk a little bit about what are some of the factors that organizations who may have a good solution that they’re wanting to bring forward, what do they need to be considering as they are looking at opening up conversations with you and some of your team and associates?
Nicole Tremblett:
I think when you think about working with any large organization, how do you peak of those that are working directly in your space? I think one of the things that we find with small organizations, they have solutions but they don’t necessarily always be able to articulate our environment very well. And so I think the key is really understanding the problem statement. And is it a problem for the organization you’re targeting right now? And if it is, who do you need to talk to? And great ways to, I think, connect with organizations, large organizations, is obviously just internal referrals, right? If you know somebody who knows somebody that can open a door, that’s always a great opportunity. We love to listen and learn. I think our Nashville Technology Council and things that go on there, that is a gateway for a lot of technologies here in town, brings them a lot of visibility. I think we have lots of conferences and networking events that people can get together at round table events. And that’s always a nice way too to get connected to new ideas and what people are thinking and doing.
John Farkas:
Gotcha. So I know there are a lot of things competing for your attention right now, a lot of potential opportunities. Talk about how you’re weighing those opportunities as you are looking at decisions, and how you evaluate what are some of the things that you might spend some time to work to implement?
Nicole Tremblett:
I think when we think about it, let’s think about three factors, right? Will it improve the quality of care? Will it improve our outcomes for our patients? And will it bring efficiency to our bedside nurses? And so when you think about the three of those, often, if you can get one, it’s an equation in itself. However, if you can hit a couple of those factors at the same time, I think your solution really gets some legs. And so I think about our earlier conversation about relieving burden from our bedside nurses. How do you bring them efficiencies in their day-to-day where they have data when they need it, when they walk in a room, people know they’re there and they automatically get the information they need to care for a patient? So just thinking through what the future could look like.
Healthtech Solutions that Nicole Is Considering
John Farkas:
Gotcha. And so if you’re looking now at what are some of the things… Let’s take nursing to start with. As you’re evaluating opportunities and looking at, solving some of the problems, what’s in your critical path currently? What are some of the things that you’re evaluating and the technologies that you’re looking at now? And what are some of the things on the horizon that you know that you need to be considering that you’re exploring?
Nicole Tremblett:
I think thinking about a modern patient room and how the TV can be a convergent point for care. Thinking about some of these facilities, you go in, they’re a million square feet. So if a family member is visiting and a physician is a mile away in the facility, how can you use a virtual care opportunity? They could do a consult through the TV to talk to the patient and the family at the same time. There are certain things when you think about a virtual nursing platform. A nurse does a lot of documentation. And we want great documentation and in our health records, right? That helps us understand, helps the whole care team understand what’s going on with the patient. But does a nurse at the bedside really need to do all that documentation? Can a nurse that is a virtual nurse working from a command center or at home help with the burden of that documentation by doing admission history, MedDirect discharge instructions and really engage with the patient through a modern platform and spend quality time with that patient? Right?
A lot of times a bedside nurse is very distracted. There’s an alarm going off in the room next door, their phone is buzzing. So they’re trying to gather information and type it into the EHR as time permits. But a virtual nurse can spend quality time with that patient, having that dialogue and really getting great information. So I think that modern patient room includes help for the bedside nurse. It includes treating the family as a part of the care team, allowing collaboration with physicians and family and nurses, all the caregivers at the same time. I think going into the future, the things that the art of the possible, you think about ambient voice, walk into a room, the room can recognize you through RTLS tags or something. They know you’re a physician, a nurse. They can automatically help you with that documentation, start that dialogue, start collecting that. And hopefully in the future, again, be able to put it into the medical record where it can be viewed and used for care in the future.
HR’s Impact on the Nursing Crisis
John Farkas:
Gotcha. Yeah, I think that that’s certainly a lot of what I’m hearing is, what are the tasks that are very clearly replaceable that are or were a virtual presence or something similar can be automated or taken off of the nurse so they’re not spending 30% of their time in front of a keyboard in that interface, and able to spend that same time in front of patients that they would normally be keying stuff in? That sounds like a really critical link. Talk about the HR side of things, what’s happening there?
Nicole Tremblett:
Gosh, in my world, HR was always important, and it was always a function that kind of almost behind the curtain I would say it operated. Everybody did their role. But I think during the pandemic, HR became a top priority of many organizations. And now, it is how do you have the best onboarding experience? How do you find the best colleagues? How do you retain those colleagues? And what does a modern workplace look like? So thinking about from your core base foundation systems to the way you can engage people and understand the temperature of your organization, how you can help them with career pathing, just really creating a vision for the future around your workplace.
John Farkas:
And so knowing that that’s gone from a more, probably a parallel function to what a lot of organizations would look at to one of the most critical components, from my understanding, one of the most critical equations for hospital’s survival right now, what are some of the ways that, as you were thinking about solving for those opportunities? What are some of the things on the horizon that are exciting there? What’s some of the technology that’s coming forward that’s letting you address those issues better?
Nicole Tremblett:
I think there’s a few things in the works. I think in the past we really focused on HR as an operations. And so now, user experience and how people engage with the platforms and really make it easy is top of mind. So there’s a lot of focus groups around the casual users of these platforms, how do you make their day-to-day job easier? And I think that’s a little bit of table stakes. Then there’s our engagement platforms, your recognition platforms. What can you do that really fuels an organization and gets them excited about your mission and what they’re doing, and their contributions to the mission every day? And then you think about the industry, I’m really excited about a digital credentialing project that we’re involved in. That’s not just my company’s focus, but an industry focus. And it’s almost like you think about you’re carrying your, you as a patient are responsible for your electronic health record.
Well, you as an employee also can own your credentials, and they’re verified credentials. And so if you’re applying for a job at company A and B, you just can share those verified credentials. And waiting for background checks and things like that to take place is taken out of the equation. It’s already done. It will help you get to onboarding faster and more accurate.
John Farkas:
Yeah, that makes great sense, and certainly something, as we look at the technology surrounding various forms of identity verification and things like that, that’s certainly a fast evolving world right now that I could definitely see having some good implications in HR, for sure.
Identity, Access, and Data
John Farkas:
Talk about, so then the other part of your triad here, when we’re looking at the whole access world. And I know that security and identity is right in the cross hairs of a lot of conversations currently. What’s HCA looking at there? How is AI factoring into that, especially as it pertains… I’m guessing privacy is part of this equation in some ways, so curious to get your perspective on that.
Nicole Tremblett:
I always like to start out with identity and access is the elephant in the room. It is years and years of good decisions that have put organizations in places where they’re facing a mountain in a lot of times. You need a transformation in this space. And I think we’re no different than anybody else that we’re trying to figure out what does the world of identity look like in five or 10 years, and how do you make it frictionless but absolutely secure, so that every time my hands hit the keyboard, that who Nicole is and that this is the right kind of data for her to be accessing?
And so you look at the future for identity and access, I think it is making it from the day one that you arrive in an organization that you have access to everything that you need to provide care, to do your job most effectively as possible, but not providing too much access and making sure that you have great controls, that you understand how your data’s being used and where it’s going and what’s being done with it. And so we’re really excited about a journey of really looking at our legacy platforms and envisioning what they can be in the future, incorporating your cloud journey into it, making sure that we understand what it is in this new, hey, people are working remotely. We might have global capabilities in the future. How does this all play into an identity and access strategy that protects your critical asset, your data, but also allows people to do their job at the top of their license?
John Farkas:
Yeah, just reducing that friction and the accuracy seems like a really big opportunity for that right now. Because I know it’s tough. I definitely have seen the friction. As a patient, I’ve seen it, and I’ve watched the clinicians deal with it too, just my first person experiences and having to ask the same questions over and over, having to just watch them scan badges and do things that seem like,,, it doesn’t seem like a lot. But when you have to do it 30 times a day, it’s a lot.
Nicole Tremblett:
Yes.
John Farkas:
And that can be a real drain on… When you’re looking at people that you need every moment of their time on the floor to be optimally productive, that’s a critical part of the equation, for sure.
Nicole Tremblett:
Many of our caregivers have up to 30 systems they need to access in a day.
John Farkas:
Yeah. And so how many logins does that represent because it’s not just a one and done when they’re…
Nicole Tremblett:
It is not.
How Nicole and HCA Stay Up to Date with Healthcare Solutions
John Farkas:
That is clearly a big issue. So Nicole, as I think about, and knowing that our audience is really interested in ultimately getting a part of your attention at some point, what are some of the channels? You already talked about first person introductions, which is clearly, if you know somebody, that’s a great path. And we’re assuming that there’s not a warm introduction here, that there’s not a first easy way in. What are some of the channels where you are taking notice of things and getting informed? What are some of the things you’re tuned into that help you stay abreast of things?
Nicole Tremblett:
Yeah, I think we’re always scanning the horizon to see what’s out there. We work closely with a number of consultant partners. We use industry papers, the headlines, things that are being talked about. I also think we also look at our industry colleagues and see what what’s everybody doing. That’s one of the things I love about the healthcare industry in general, is that we tend to share. I don’t know. I don’t feel that it’s that competitive when it comes to, “Hey, there are these solutions that exist out there, and this is all mine.” It is, “Oh, this is a great solution and it brings healthcare forward. You should know about it.” And so I think having some successes and referrals from other folks that you’ve been engaged with always opens doors and tends to open our ears as well. So I think there’s just a multitude of channels, a lot of…
One of the things I love about here in Nashville, Tennessee is that the fact that we do have a pretty tight-knit tech community, and I feel like we have a tight nonprofit community. And I think when people ask you to pay attention to something or you’re at a networking event, you tend to open up the doors and give people time.
John Farkas:
That’s definitely good to know. Are there conferences or events that you spend time at? Or what are some of your priorities there?
Nicole Tremblett:
Yeah. Gartner does a really nice job for us when we think about conferences and healthcare related. Many of my colleagues, myself included, many times have attended HIMSS and kind of walked the floors with everybody else to see, hey, what’s interesting out there, and what sparks your interest? There was [inaudible 00:24:54] here in town. I know that a lot of people enjoyed having the opportunity to have that in our backyard so that we could attend there and get exposure to folks. I think all of those are important. Health is out there. I think it just kind of ebbs and flows on where we participate and what we do. But we definitely try to go to at least one or two a year.
John Farkas:
And when you say we, who’s on the team that is out there doing that type of stuff?
Nicole Tremblett:
So me and my colleagues. So you think about Paul Curry, who’s the heads up our enterprise architecture strategy. He tends to spend a lot of time kind of, really in the three to five year range, looking out in advance to us. I think there’s probably, gosh, how many people at Marty’s table? I think probably 12 or 14. And so kind of all my colleagues were responsible for different service lines, everything from our group purchasing organization and our revenue cycle to implementing our EHR and data science, right? So everybody’s kind of industry or service line driven.
HCA’s Approach to Implementing New Technologies
John Farkas:
So you just mentioned a table of 14 or 15 people that, in a lot of health systems, would maybe be two or three. So what is the current number of ACA facilities?
Nicole Tremblett:
We have 183 facilities each, give or take a day. But we really look at ourselves as an ecosystem. We have over 2200 access points. So everything from imaging centers, urgent caress, freestanding eds, physician clinics, cancer clinics, so everything that a patient could need on their healthcare journey, we want to make sure we’re there for. And then most of those access points are connected to one of our hospitals in case that they never need those services.
John Farkas:
So 2200 access points. Talk about… There’s certainly, as I think about managing information technology in that broad of a spectrum, talk about some of the challenges you guys encounter with doing that, because it’s a colossal task. It requires a whole lot of smart… And certainly HCA has the reputation of really looking at innovative ways of doing things, efficient ways of doing things. And it can’t happen overnight. It’s not a super nimble organization just by the fact that it’s so large. So what are some of the factors, as you guys are looking at deploying things across the system? How are you looking at vetting? How are you looking at testing? How do you approach the implementation of new technology when we’re looking at a pretty gigantic organization
Nicole Tremblett:
In the future, the way we’d want to see ourselves is how does things embed in the workflow? And if there is a solution out there for a nurse, for example, how does that solution embed in the current workflow and become almost seamless to that nurse that it’s there when they need it? So you have to think about, one, usability. What is it like to interface with? Two, access. Does it integrate with our current identity and access management solutions? Three, data. How do you get data from it so that we can use it in data science and other capabilities. And just pure integration. I think having open APIs and things that are easy to get data in and out of is absolutely key to anything we do in the future.
John Farkas:
So when you look at some of the standards and some of the practices that HCA holds, what are things that you frequently see people surprised by or caught off guard by or not prepared for as far as some of the standards that you’re looking for?
Nicole Tremblett:
Yeah, I think one, again, it’s just a complex environment, and there are a lot of controls in place. So I think when we look at working with a new vendor, there’s a pretty rigorous security assessment upfront. And we have a good process, but I’m not sure that smaller organizations are always ready for it. However, I think looking at us as a large organization, we’ve gotten better about helping small organizations be ready for it as well, right? So our findings hopefully help that organization grow, and help them be better for the next company they want to work with.
Our contracting process is not simple. There’s a lot of years of findings and things built into our contracts. And I would just say, hey, don’t be intimidated by it. Let’s sit down and have a conversation and work through the big rocks all at the same time. And then I guess just volume and scale. When you think about anything that we do, lots of solutions work in a one-off environment. So it’s easy to put it into one doctor’s office or one hospital. But when you think about the fact that you want it to work across an enterprise, it gets pretty complex even for us who’ve done it for years, but especially new entrants into the market. So just understanding that that is a lot more difficult than people often realize. But hopefully we’ve learned enough over the years as well where we can help people succeed in that.
John Farkas:
You talked about some clinicians having 30 logins, which is a testimony to the challenges that surround various point solutions for the clinical environment. Talk about what your organization’s doing now in and around point solutions and trying to simplify what’s possible, trying to increase interoperability. How are you guys looking at that? And what would health tech companies do well to understand as you guys are working to simplify the clinician and the patient experience?
Nicole Tremblett:
We’ve done a pretty good job over the last while about single sign on. And so hopefully once you get into one machine, you’re there and can have access to lots of other applications without having to log into each. It complicated it when we introduced smartphones. And so we have over 100,000 iPhones out there in the hands of our clinicians. But every good idea tends to be an app now. And we have yet to crack that nut about single sign on for our smartphones because we have shared devices. And so people can dock a device and pick up a new one, and all their data’s transferred. And so getting to a point where we can have seamless integration of our mobile solutions would absolutely be key. And then I believe on the back end, we’ll get to a point where we’ll be able to use our data and hopefully create solutions with partners that already fit into our ecosystem, that we have standards going out of the gate where, hey, this is a toolkit that helps you integrate and do single sign-on.
John Farkas:
So I haven’t done this research, so I don’t know what’s out there, so disclosure there. But where are you guys in the process of the development of an AI policy, and how are you approaching AI? As we’re looking at the ethics, as we’re looking at the privacy elements, how is that taking shape currently at HCA?
Nicole Tremblett:
I’d say it’s not squarely in my wheelhouse, but I’ll say eyes wide open. We have a lot to learn, like everybody else in this space. I think there’s a lot of hope and promise for the future of what AI can bring us. But we also know… I think as individuals, we’ve all played with different AI solutions, and we know often, it’s a starting point, right? You’ve got to use your own thoughts and your experience and apply to what AI gives you. So I think figuring out the balance between how you use AI to help guide and get you to an answer fast, but realizing there’s always going to be a clinician in the loop when you start making decisions, definitely in healthcare because complex and every individual’s different. There might be more opportunities in the backend where things are more standard and repeatable in processes.
John Farkas:
Good. Yeah. It is certainly going to… I think eyes wide open is right. I’ve never seen as bright a firestorm as we’ve had in the last 18 months in and around that space. It’s a super critical area, and from my vantage point, one of the biggest opportunities for truly helping clinicians.
Nicole Tremblett:
Agreed.
Nicole’s Magic Wand Solutions
John Farkas:
And so it’s really exciting in that regard. So I’m curious, as I’m looking at your realm, if you had a… I’m handing you the virtual magic wand here, Nicole, and so we’re going to take each of your three areas here. If you could solve today, if you had the magic wand and could solve one problem in and around nursing information technology, what would that one problem be?
Nicole Tremblett:
I would have a modern patient room where any new solution, any new idea can plug in and you can scale it quickly. So think about a room that is already has a camera and audio, it has a television, it has wireless points where somebody comes up with a solution that can help a bedside nurse today, we can deploy it quickly without having to go in and go, oh, I’ve got to put a different type of camera in a room. I’ve got to install this. And when you’re thinking about 45,000 beds, it takes a long time. And so if I had a magic wand right now, I’d have a modern patient room where any solution you could plug and play quickly and get value and help our patients and all of our caregivers.
John Farkas:
Yeah. That stuff is coming. It certainly is.
Nicole Tremblett:
It is.
John Farkas:
So, okay, HR. You have the HR magic wand now. What would be the thing that you would want to be able to solve?
Nicole Tremblett:
I would like to figure out how you can really predict and help and gain feedback on employee retention. What makes a difference to every colleague? Every person is unique, and everybody has something that drives them differently. And I think in healthcare, we all have a common goal. We all want to transform healthcare. We’re all patients, our loved ones are all patients. And so I think we have that as a grounding mission. So then what helps? What’s the next layer that will make you feel like you are able to work at the top of your talents and do the most and add the most value to the organization that you can?
John Farkas:
Great. And then the last one, the last stool or the last leg on the stool here, identity and access, if you could get the magic wand.
Nicole Tremblett:
It is a hundred percent frictionless. We know who you are before you walk in the door, and we know the who you are when you walk out the door. And so how do you make that experience so easy that a nurse never has to worry whether or not she’ll have access to what she needs to care for a patient?
John Farkas:
And you know what, from my perspective, as I listen to you, what I feel like is exciting is that you’re not too far, I don’t think. And easy for me to say because not overseeing 2200 points of access, but you’re closer to those things being reality than we were even three years ago, much closer. And so I think there’s some real hope of some of that coming to fruition in the not too distant future, I hope.
Nicole Tremblett:
I agree.
John Farkas:
I hope for all of us…
Nicole Tremblett:
I agree.
John Farkas:
… especially for you.
Nicole Tremblett:
I think technology has never been more important to healthcare and transforming healthcare and the way we deliver care than it is right now. And I think there’s a big opportunity for all of us to work together to solve this and to make it better for the future.
Closing Questions
John Farkas:
So if you had a set of a couple concise advice points for people who are working in health tech companies trying to make connections with organizations like yours, what would be some of your top headline points you’d want? And we’ve talked about a number of them here, but if just again, simplifying it to the primary takeaways, what would be some of the things you would want them to make sure they’re coming with an awareness of?
Nicole Tremblett:
Know the real problem you’re trying to solve. Understand kind of where that is in the healthcare landscape and the company landscape. Know that scalability is paramount. It’s not easy, but people are willing to work with you on it. So I would say admit that upfront, right? It’s not easy to scale and to go enterprise wide anywhere, so understand that it’s going to need help. And then be a great partner. How do you get feedback? How do you iterate together? How do you dream about the future and set that vision collectively so that you can get something that people are really excited about? Trying, doing, growing.
John Farkas:
Awesome. I guess what’s been one of your surprise delight discoveries in the last six months or so? What’s something that you’ve seen come forward that you were like, there it is, or that’s really exciting?
Nicole Tremblett:
Think we’re on the doorstep of something really special with this virtual nursing platform, virtual care platform. And actually, it’s bigger than nurses, right? It’s case management, being able to collaborate with the family on where the patient is going. It is physicians being able to get advice from specialists when they need it. It is a whole kind of virtual care concept I believe that is really going to help us transform healthcare.
John Farkas:
That’s great. And I would agree. The things that I’ve have come across my viewfinder recently that I can, from my seat on the bus, which is certainly several steps removed from yours, but just as a person who knows something about the realm and who’s been in the seat of a patient, I can quickly see how that could be helpful. I watch the struggle of a lot of the clinicians as they are trying to make it happen. And it’s not enviable, that’s for sure. So Nicole, is there anything else, anything you would want a company to know? Any secrets that you would want to bring forward here that would be good pearls of wisdom to depart as we conclude?
Nicole Tremblett:
I think, again, technology is the opportunity to transform healthcare and to think about alternate care models. Be willing to iterate and dream with somebody about how you can make an environment more friendly, impact better outcomes, sustainable, thinking about just the future in general. I think people, nurses, physicians, they’re busy. They’re always running around. Their hands are always in use. So how do you think about ways to engage with them that doesn’t require their hands, it doesn’t require them logging into a device. What does that future look like where we can really help them as they are just caring for patients?
John Farkas:
That’s great. And I really want to thank you for taking the time today and for what you had the opportunity to share. It’s definitely a gold mine and very consistent with a lot of what I’ve been hearing and see happen and emerge in this space. So I’m not at all surprised to see and to hear the HCA is kind of on the forefront of looking at some of those issues. And really eager to see some of the start to take root, and expect that it will here soon. So Nicole Tremblett, thank you so much for joining us today on Healthcare Market Matrix.
Nicole Tremblett:
Thanks, John. Look forward to updating you in the future.
About Nicole Tremblett
Nicole Tremblett is Vice President of Information Technology Group (ITG), responsible for Nursing & HR Technologies, and Identity & Access for HCA Healthcare ITG, one of the nation’s leading providers of healthcare services. The ITG organization employs 6000+ professionals across the country and is responsible for delivering IT services to HCA Healthcare.
Nicole led clinical product development and business performance efforts before taking on her VP role. She credits much of her clinical and business understanding to years early in her career where she developed a solid foundation and respect for caregivers as an implementation coordinator at facilities nationwide.
Her organization focuses on delivering solutions that transform the colleague and caregiver experience. In addition, her team oversees Identity and Access for the vast array of technology assets. These teams work together to help HCA innovate, create and deliver on healthcare technology solutions.
Most recently, Nicole served as board chair for TechBridge TN which is a nonprofit that works with other nonprofits to break the cycle of generational poverty. TechBridge provides the technology tools and resources nonprofits need to advance and sustain their missions more effectively.
Nicole also served as Board Chair for the Nashville Technology Council from July 2015 to July 2017, an organization that exists to be a catalyst for the growth and influence of Middle Tennessee’s technology industry by connecting, uniting, developing, and promoting technology-based innovation and development in the Nashville area.