Podcast
From Crisis to Progress: Population Health in the New Normal
Dave Brooks
Chief Strategy Officer, People.Health
Few healthcare executives have as much experience in the industry as Dave Brooks. Currently the Chief Strategy Officer with People.Health, Dave became the CEO and vice president of physician services for Christus Medical Group in 1996 before becoming the executive vice president and COO for Central DuPage Health in 2002. He has also served as CEO of Providence Health and Services, president of Ascension St. John Hospital and senior vice president of their east region, president of St Joseph Mercy Health in Ann Arbor and Livingston, and the director of Wayne County Health in Detroit, Michigan. On this episode of Healthcare Market Matrix, Dave joins host John Farkas to discuss his career in healthcare, where the industry is headed, why it’s important to de-risk technology solutions, and much more.
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Transcript
Introducing Dave Brooks and His Healthcare Journey
John Farkas:
All right. Greetings everybody and welcome to Healthcare Market Matrix. Today we are privileged to be joined by none other than Dave Brooks. And Dave is currently the Chief Strategy Officer for People.Health. But let me just give you a little quick tour of his CV because he’s made some pretty impressive stops along the road here. Back in 1996, he took the helm as CEO of Christus Medical Group and vice president of physician services. There he was executive vice president and chief operating officer at Central DuPage Health.
He is CEO of Providence Regional Medical Center. He was the president of Ascension, St. John Hospital and senior vice president of the East region there. President of St. Joseph Mercy Health in Ann Arbor in Livingston, and then was the director of Wayne County here, Detroit Health and Veteran Services. And very conspicuously to me, Dave, that you concluded your term at Wayne County Health in 2020. Well, that may have been extremely fortuitous or… I mean, what I know is that you had a front row seat and certainly through your work at People.Health have had a front row seat at the effects of the pandemic in our healthcare system. And I’d love to start there. But before we jump into some of that, tell me us a little bit about that background, some of your journey as you’ve been in the leadership of a number of provider organizations in your tenure. Would love to hear a little bit about that journey and what that was like and some of the insights that you’ve gained along the way.
Dave Brooks:
Happy to do it. Thanks John for the app for the opportunity here to chat with you about all this. So I grew up here in Motown, Detroit area and I have a wonderful family. My wife Laura, two great kids who are now in their twenties. And that part of my life is great and stable and wonderful and I obviously made it back to the Motown area. That’s where I’m living now after a little bit of some travels there. From a professional viewpoint, I’ve spent pretty much my whole career, my whole adult life, literally in healthcare leadership of some sort or another. I’ve actually spent, it’s amazing to me as I think back on it, 35 years in some form or another of a C-suite position in large health systems. So large provider organizations that were very focused on organizing the care and organizing the services to serve everyone in their communities.
And I’m really proud of that and I’m proud of the teams that I got to be part of in helping to do that. And a lot of what we accomplished in serving those communities. I retired from the C-suite, if you will, of healthcare, organized healthcare a little bit early, a little bit young a few years ago. And that was after, again, just looking back 35 years. So a long run and an amazing run, but started so early that I still was reasonably young and therefore energetic and still wanted to contribute. And I had the chance to be a public appointee to Wayne County government. Wayne County, it’s about 2 million people, very urban, very challenged, socioeconomically probably one of the largest and one of the poorest counties, frankly in the country. So a lot of challenges. And I was offered the chance to be the director, the head of health and human services for the county.
And it was a chance to be in public service, give back all the cliches, but also learn a lot more about health in a community, wellness in a community and the social service aspects as well because my team was responsible for that. So I did that for a few years and like you said, good news, bad news, guilt, joy, literally like a month before the pandemic hit is when I left. So I feel a little bit of guilt for not being still with the county and with public health as the pandemic occurred. But the flip side is for my own mental health and security, I probably, in a way, not being there meant I was a lot more stable and less at risk from a lot of different pressures. No doubt.
I was on the advisory board of a friend of mine’s healthcare tech company and he was re-energizing it. And he talked me into joining as a full-time partner and a full-time chief strategy officer of what was then called from a public viewpoint patient education genius. And we went about rebuilding it. Obviously with the pandemic hitting, we had to pivot a little bit to create these tech tools to service the pandemic since at that point our core customer base were primarily physician and provider practice offices.
And if you’ll remember back to the beginning of 2020, most of those got shut down for a period of time around the country during the beginning of the pandemic. So we had to pivot. Patient education genius now is known as People.Health, thanks to some fine work from John, you and your team in Golden Spiral, helping us rethink some strategy in the future and the direction and with it creating a new brand and a new persona around that.
How Dave and People.Health Improved Healthcare Systems during the Pandemic
John Farkas:
Yeah. So Dave, in the context of what you saw happen, just leading up to the pandemic, but then certainly in the context of the pandemic, because you were certainly involved with still in the context of People.Health, because much of what you’re doing with People.Health has a very direct tie with providers and helping them address the public’s needs more effectively in the context of what was transpiring in public health and around public health around the pandemic. Talk about some of the core changes that you were witness to as providers confronted the needs, confronted the volume of challenge that was presented in the context of the pandemic. Talk about some of the core changes that you saw firsthand from your seat there.
Dave Brooks:
Well, remember we moved into a row, or I moved into a row as opposed to being a leader, an operator of either comprehensive healthcare services or the government, the county role obviously there we were there to support those that were providing that care and organizing that. So for me it was a very different perspective than I ever had personally or professionally. So I did everything I could to help. Again, back to that guilt reward dimension, not being in it, the thick of it. And if you think about it, I’m sure it’s an overused term, but those services were pressure tested and government public health particularly, whether it be county, city, even state or federal, my personal viewpoint, had been under invested for decades.
So they had not had the chance to have contemporary processes, had challenges in the sense of recruitment, retention and succession planning, and even professional development of a lot of the leaders and resources within public health. And probably most of all obvious, had not had any type of real ability to reinvest in automation and technology. Had some basic rudimentary things. Every now and then, there’s an exception to that, but had not, and I’m sure the journey would’ve eventually gotten there for public health, but COVID hits and the pressure test happens and it just was so clear how challenged those systems were to keep up and support, be efficient, be effective, provide care and information and services in at the scale and the speed that was needed because that was not ever other than isolated incidents here or there had not been needed at that type of mass scale before, at least in America recently.
So our role and what I observed was anything we could do to help them help public health and other providers involved in COVID, especially that first year, automate improve their processes, expand and extend the support staff and the professional staff in any way. Sometimes it’s referred as lean management thinking, take the waste out of the process so that they could work to the top of their profession. The top of their license was very much appreciated. So we ended up very early on, literally Detroit, Seattle, and New York, if you’ll recall, were the hotbeds for COVID in the beginning. So here we were in Detroit, obviously just our luck. And we therefore quickly supported the development of some testing sites that were happening.
If you remember back to the national news broadcasts, those first few weeks or month, you see cars lined up for a mile trying to get into a testing site and so on. We actually supported one of those right off the bat that had just opened. They were manually working through the process. They had four lanes going in Detroit. This was with Wayne State University’s provider group. And they had four testing lanes going and they were basically doing somewhere around 10 to 15 cars, people per hour. And because it was manual and we quickly scrambled and within about a day, it was a Saturday actually to helped automate some of their processes rudimentary at that point because it was the first time it had happened.
And literally when they turned us on the next hour, they were doing 50 cars an hour because while people were waiting in their cars in line through a text to sign that said text COVID to this number popped up a registration form, they could register while in the car anyway and safely by the way, since they were by themselves. By the time they got up actually to the testing site, the swab or so to speak, they were already in the IT system. They were already in the database and they didn’t have to reenter all that information so they could be swabbed and departed.
So it just improved throughput and I think the light bulb went off both to the provider group, Wayne State, but also to us that wow, this was not really a complicated model, but boy does it add value when it is such a ancient set of processes that were being put in place and ancient, not in a judgmental way, but just the best that they had at the time. Totally manual. I mean literally clipboards were being used. Now in hindsight, the infectiousness of handing a clipboard back and forth, we learned a lot at the beginning of COVID, if you’ll recall, and just avoiding that infectiousness, let alone the work process efficiencies.
So we just built around that from COVID support to then helping health departments, not just in testing but in result reporting and then education information and then even a lot of the other work that health departments were doing with COVID. And we became a great support, primarily in our area, although we ended up helping the New York Health Department in some ways, but mostly in the Michigan, Mid Midwest Metro Detroit area because that’s where we’re based. That’s where we had some relationships because everybody was scrambling.
Pitching Technology Solutions to Government Entities
John Farkas:
So Dave, jumping back into your time when you were the director of the health and veteran services for Wayne County, I’m curious. As you are in that role and are endeavoring to lead that framework, when you’re presented with opportunities to innovate, when you have things come across your desk that are opportunities to leverage technology to improve something, talk about your decision grid. Talk a little bit about what it is because our audience here is, are people who are trying to talk to people like you in positions like the ones you’ve had to help them embrace a new solution, a new way of doing things. So take us into your decision stream a little bit and what are some of the factors and things that you’re looking at weighing? What are some of the competing pressures? What would you want somebody who is trying to get your attention to know that would help you make a better informed decision or that would get your interest?
Dave Brooks:
And I’d separated out slightly. I think there are a lot of common issues or needs and dimensions, filters that would apply no matter where I was previously in my career, but then I would separate out when I was in the government sector, that health and human service job for the county.
John Farkas:
Let’s start there and then we can go back and maybe talk about when you were in at Trinity Health or one of the other positions.
Dave Brooks:
Because government is different and the culture’s different and the decision processes are different and so on. And the other thing to factor in COVID by being a national emergency, a lot of the traditional government procurement purchasing processes changed, but those aren’t there anymore. It’s no longer the pandemic emergency. So you go back to those. So I would make sure that anybody trying to work and support government related entities understand government procurement culture. It varies of course a little bit by municipal meaning city or county or state or federal. And each one of the municipals or county could be slightly dare or and states could be slightly different, but you’d want to understand that. And because that’s the philosophy and the model that the providers, the potential clients are operating under.
But obviously, and it applies to everybody, you got to have a level of ability to demonstrate that whatever you are potentially pitching suggesting adds true value. So what would it do? How would it be better than what they’re doing now? That’s the way our teams would always analyze it. And then how does it fit again into the financials, the budget. And again, government particularly acutely focuses on budget. If they’re not budgeted, if it is… It’s a whole different set of processes than when they do have some level of resources. A lot of the way government works is trickle down grant making.
So you may be dealing with a local public health department, county and or city health department, but it’s probably got its funding from the state and the state obviously gets its funding from the Feds. So a lot of the time those rules and those priorities and even the focus of what they’re trying to accomplish, cascade gown from those grants. So you’ve got to understand that not only would this county be interested in this, but they may have parameters that come about by where they’re getting their funding for it from.
John Farkas:
Parameters, or in some cases opportunities because what they had funding from could open doors that another organization, another state might not have just because they were given money that was designated for certain types of initiatives.
Dave Brooks:
And I don’t mean this necessarily in a negative or critical way, but from a government leader viewpoint, if you don’t want to leave money on the table, if you are given resources from the state, from the feds, or wherever that grant may be coming from, you don’t want to not bring that to your community. If you have an opportunity, you don’t want to waste money. So you wouldn’t want to spend it if it’s totally irrelevant, but it’s not likely going to be irrelevant. So if you’re being given an opportunity to bring down resources, again, from either state or federal levels, you’re going to want to try to find out how to do that. But again, you have to also then meet the parameters of that. So that’s a part of it.
The other part for government, and again, maybe this one I do meet a little more critically, but again, from the very brief time I was there, wonderful people, great hardworking people, God help, they’re there doing public service. Most of my career I didn’t do that. So I really respect people who are in government roles and trying to do that. But there is a aspect, a little bit higher aspect compared to private sector that I noticed of risk aversion. Because you’re in a government role, you have a lot different public persona, a formal public or non-formal public persona that goes along with it and you’re quickly criticized anytime you make a mistake or make a bad decision or what’s perceived as that. So you are a little bit more risk averse because of that.
So it means, I think in some ways it’s a challenge sometimes to be creative. It’s a challenge sometimes to be more innovative. So I think organizations that are trying to work with government entities and therefore government leaders have to recognize that is a part of the filter they’re going to have. Where I think a lot of times we present things to potential clients and customers as it’ll be great, you’ll be the first to do this. It’ll be wonderful, it’ll be innovative, it’ll be creative. That’s great.
John Farkas:
Not necessarily.
Dave Brooks:
But there’s still going to be that thing in the back of the head and especially in government, which is, yeah, but if it blows up on me, how much of the blame will I or my team take? Whereas if we go the safe route, even though it may not accomplish as much, I have less career, personal, professional and team risk. That’s just the reality of a government culture. And I don’t mean that necessarily hypercritical again, but it is what they deal with because they’re public servants. So they are held to a higher standard, but with it has that consequence. Does that make sense?
De-Risking Technology Solutions
John Farkas:
Absolutely. I would say anytime you’re selling into provider or provider related organizations, the risk associated with the deployment of any new solution is there. What I’m hearing is in the context of public service, it’s a step greater because first of all, what it takes to implement change in those organizations is pretty substantial. So there’s going to be a big move around it, but then there’s a lot more eyes on it. So how that is worked and perceived is really important, which tells me that one of the opportunities from a marketing perspective, and this is certainly easier said than done, but to do a lot of work around the de-risking story.
How are you going to demonstrate the pretty ironclad or sure to be successful nature of your solution so that it might help to build and instill confidence at a level that would allow a leader in one of those positions to take that risk. To jump in and say, “Okay. These guys have obviously done their homework. There’s several lookalike or communities here, or instances where they’ve deployed successfully. I can call my friend over there and ask them how it went,” and different elements like that that are going to be important, is that on target?
Dave Brooks:
Yeah, very much. I mean, think about it. It’s almost like back to undergrad or wherever we learned, I’m going to hold up a triangle there. Remember Maslow’s hierarchy? I forgot which class we learned about it in, and that-
John Farkas:
Psych something.
Dave Brooks:
I mean I think tech companies particularly, but I think a lot of companies that are trying to help serve customers and clients, we’re so quick to focus on innovation, creativity, and man, this will set you light years ahead. I’d almost refer to that as the self-actualization, remember the top part of the Maslow’s hierarchy that we’re all looking for. The bottom part of Maslow’s hierarchy was safety, security, needs, housing, food, whatever. And then you move up a little bit and all the way up to that self-actualization as the pinnacle. But think about it from a purchasing government viewpoint, and I’d almost say you almost are better off focusing on that safety security dimension first. Not say, “Hey, you’re going to be the first on your block to have the following and it’s going to be great, and it’s going to add so much value and they’re going to throw a parade for you down main street and all this type of thing.” Great. Wonderful if I get there, but I don’t want to roll the dice all the time.
John Farkas:
That’s not where you were starting. That’s not where the conversation starts.
Dave Brooks:
Taxpayer money, community confidence, my leaders, my bosses have to be reelected, literally reelected. So I think risk aversion is really the first filter. So I’d be focusing on here’s why others are already using this. And as many of those others that have brands that are a admired the better. Earlier on as an examples, I said the New York City Health Department in one of our customers that we have, I mean that’s a brand that, hey, well if New York City went through a process and used this, it’s probably safe for me here in rural county Wisconsin, or pick your favorite spot. Or at least I won’t get blamed or my team or my boss won’t get blamed if it doesn’t work because it wasn’t a farfetched decision I made. So I’d almost focus a lot more than you might usually do on that safety security trustworthiness then emphasize the innovation and the creativity and the advancement it can bring. Almost reversing the traditional order where I think people normally think about it. Does that,-
The Importance of Value Equations and Avoiding Over-Complexity
John Farkas:
Yeah. You are knocking on the door to one of, what I consider to be one of my hot buttons, because what I’m very aware of after working with a lot of technology organizations is what I call the tech bias and the anatomy of the tech bias is, if you’re in a technology company, you inherently love change. I mean, change is a part of your DNA. You embrace it, you look for it, you are instilling it, you are advocating for it. And what you are doing is bringing something forward that it is transformational and you love that about what you’re doing. You love the promise of it. You love the value that it has the opportunity to bring.
And what you inherently develop in that seat is a bias and comfort with that type of transformation. And it really does deaden your senses toward, and what I’ve seen is it creates a disrespect or certainly a lack of empathy for the people in the places that are really stuck in a whole, very complicated system that is inherently resistant to change in any shape or form. Layer onto that, the factors that you’re talking about the level of accountability, the level of transparency that exists in the public health spectrum, I mean that adds another layer on top of it.
So what I’m hearing, and I think this is a great point, I think you’re inverting the triangle is a really great way to look at it. So let’s really encourage, and honestly, I think this is largely true. I think it’s acutely true in the public health arena. I think it’s also pretty true in because I’m getting ready to ask you about your days as the CEO for Providence and some of those other organizations because I think it’s also true there. I mean you can’t take many wild, crazy flyers when you’ve got a community that you are caring for that is relying on you to provide a consistent high quality service. I mean, you have to make sure that you’ve got stuff buttoned up.
So risk and cost and everything, all those elements are critically important. I would also, I’m just going to take a minute here to underscore something you said earlier, because we hear it from everybody we’ve talked to on this podcast to this point. The value equation is essential and making sure you have a clear line to value that takes in as many… Well, I would say that line to value is different for nearly every provider organization you’re selling into. I mean the, it’s nuanced, it has different factors. You have to be aware of those and give instances and examples that are tailored to a number of different scenarios where you might be deployed. Because if you’ve talked to one health system, you’ve talked to one health system.
So I think that that’s another critical thing to keep in mind because it’s very common for technology companies to want to lead with the cool, new, innovative technology and what it makes possible and all the gizzy widgets and nuances of a platform that is whatever technology it’s bringing. And the value equation ends up on page three. From a decision perspective it needs to be on page one before you’ll even begin to consider it. And how it gets it done is not as important of the value it ends up delivering. Is that a fair casting fact?
Dave Brooks:
Very much. And again, I think a lot of how I described government public health and human services and some of the challenges there, I’d only put it down a slight notch below and only a slight notch provider, non private sector, in my experience, mostly nonprofit, but provider side, private sector healthcare for all the same reasons. Exactly what you’re saying and don’t. The other thing, I think that the challenge right now is you cannot underestimate the fatigue within the healthcare communities right now of automation and new software and new programs. So you’re almost going up against not a neutral review, but a critical review upfront.
Because the challenges of electronic health records, which are obviously comprehensive changes as along with a million other systems, whether they be human resource systems or finance systems or check-in processes or new way to order supplies or anything, healthcare overall had been so non-automated that and then over the last 20 years has tried to go from zero generation to third generation at once, all systems at the same time. You can imagine the burnout and fatigue that has created particularly on the caregiver side, but also then the support processes and the support people as well.
So you may have what you think is the world’s greatest innovation that will save so many dollars and so much process steps, but it doesn’t mean the burden of taking it on is going to be worth it to people. The lines aren’t going to cross quick enough for value versus effort. And we’ve got to convince them of that. How do you convince them of that?
John Farkas:
We’re hearing that a lot. I mean, the point solution fatigue, the fact that for many of the people that you’re introducing something to their experience of technology is that it is complicated their world, not that it simplified it. And the awareness of that, even though you have the perspective that what you’re bringing is an exception to that. You have to overcome the reality.
Dave Brooks:
Our baby is never ugly. Our baby’s beautiful, whatever we’ve created, it’s beautiful.
John Farkas:
Yeah. And it very well may be, but when you put beautiful on top of six other beautiful things that you have, that all of which speak a different language in some sense, it becomes confusing. It becomes hard. Especially when you’re dealing with clinicians who are not necessarily first technologists who whose days and times are extremely pressurized and need simplicity. It has to be genuinely labor saving and extraordinarily intuitive for it to be embraced. And I’ve heard that a number of times. We have several clients in the context of what we do, who have really eloquent solutions. And some of what we heard in some of the interviews that we’ve done with users is that they were coming to the table in evaluation of the solution, highly skeptical.
And then when they realized that this actually was going to help them, it was a surprise. They were surprised because every other deployment they’ve experienced has been in some layer adding a layer of complexity that was not welcome. So that’s a critical thing. It’s a essential component to value. Overcoming the technology bias and understanding that yes, you are seen as a potential complicator, not as a solution is important. And being willing to do the work of overcoming that and demonstrating it. You can’t assume you can’t because you have this wonderful AI enabled gizzy widget that represents a lot of really smart labor saving activities that it’s going to be seen that way. It’s going to be seen as a complicator. It’s going to be seen as a threat. It’s going to be seen as another thing that needs to be in some way trained and overcome. And you can’t underestimate the list there.
Dave Brooks:
And there’s two parts to that. There’s the eventual, once it’s implemented part of will this add value? Is it simple to use? Does it create less clicks not more clicks for the user, for the worker? But then there’s the burden of implementation and both of those are going to be looked at. And then right now, at least in this point in time, the challenge of healthcare workforce of vacant positions and caregiver fatigue and burnout and the mass resignation of nurses and doctors and all those types of things, it’s going to be a challenge for an organization, even if they drink the Kool-Aid and they believe this will be well worth doing, they still have to cross whatever that threshold is of, but is now the time to do it considering all of those factors.
So there is a timing issue to some of this. I don’t know how long that will last, but the sensitivity right now to listening to caregivers and caregiver management, the chief nurse, the chief doctor, the chief pharmacist, whomever it might be within the organization, and their influence on the decision making of what new processes and technology we take on and when do we do it, is probably they have more influence now than they’ve ever had. I’m not saying that’s a bad thing. I’m not saying it’ll go away, but you can understand why it’s escalated lately.
A CEO’s Perspective on Selling to a CEO
John Farkas:
Yeah, absolutely. Let’s shift gears a little bit here and talk about, and it’s only a little bit because these conversations have certainly been overlapping as we’ve gone through it. What I can tell you is that for nearly every one of the clients that we work with, and I know many of the people that are in our audience, the CEO or the president of a provider organization is at the top of their target list or one of their primary targets or one of the folks that they know they need to get to, to have a conversation with or to involve in the decision making process. They’re often there. And I also know that those roles are extremely complex, multi-variant, lots of oversight over lots of things, lots of elements coming across the desk that need attention or decisions or some time.
Give us a little sense of the day in the life looking at your role at Providence or in the context of Ascension or Trinity, some of the day in the life considerations and how is stuff brought to you? And we talked about the importance of the value equation in there, but give us a sense of the, your role in those seats and what it takes to capture your attention. What types of things are you looking at and as a leader of those organizations, what are things that you’re championing or getting behind or looking for from an innovation perspective?
Dave Brooks:
And it’s a little mixed because really part of why I love those roles, especially at the CEO level, there were very few typical days and typical periods. The organizations were trying to do such diverse things to serve the community that it meant the leadership of the organization also had to have a lot of diversity in what it did and not just a typical week, but a typical day. So I love that, but that it’s also therefore, little bit of a challenge. To answer your question of what’s typical. I would say that I’m sure, and again, it fits to what you’d probably predicted. You’d probably predict me saying, you’d be surprised at how little singular authority the CEO actually has. Yeah. They’re in charge of everything. I guess when you think of the top of the organizational chart, but I think most people who are get to that leadership level and those leadership roles do so by being very team oriented, by delegating and by really not rarely trying to push their individual direction or decision.
So when it comes to choices and purchases and directions to go to that level, I think having the CEO supportive is great, but they’re rarely going to be the one who initiates the idea or brings forward. Now them knowing what the mega trends are happening in healthcare or even if they’re part of a large health system that had corporate leadership at national or regional levels and I ran or I was leading business units or markets within. So knowing the CEO generally is the one who’s the connector to the corporate office to hear what mega trends and big projects that the system is thinking about, the corporation is thinking about. And that sensitivity is helpful there if the CEO’s aware, but it’s not likely the CEO’s going to bring forward. I think it’s time that we change our human resources platform, or I think it’s time that we add an attachment onto our electronic health record that helps us better code the billing codes or whatever it might be.
You’d want the CEO to know, hey, there’s new developments happening, there’s great value in innovation and improvements here. So when it gets to them, they know, I know we need to do something with regards to this, but the initiation is probably going to come out of other areas. Sometimes it’s going to come out of the IT area or the technology side, but even then, a lot of the time it’s more out of the user side. So if it’s a pharmacy program innovation, it’s likely that the pharmacy leadership is bringing it forward with some conversation, hopefully with IT technology, and they’re bringing forward together a project or a proposal or a initiative.
The CEO or even other members of the C-suite, again, you’re going to need to convince them because they have limited resources and overabundance of requests. So there’s processes in most organizations as to how do you prioritize that. So they’ll be certainly involved and influential there, but they’re probably not the ones bringing forward the need, the ask and the justification. That’s probably happening from the operator and, or IT and maybe even finance if it’s a big capital project, they’re partly involved sometimes in the development of the proposal as well.
John Farkas:
So if I’m hearing you, and I think this is pretty consistent with my experience. If you’re wanting to involve the CEO or if you’re wanting to have the CEO initiate or bring some ideas forward, it better be you’re wanting to bring things forward that are mega trends or macro movements that have the opportunity to affect change in a big way that is going to require… Well, that is asking for a pretty substantial change in how we’re approaching something that has big implications for the health system. Is that fair?
Dave Brooks:
Yeah. Again, and I think that will potentially not be individual offerings or companies or products. It may be, and I was always careful about it as a CEO, I certainly was approached by people or I go to a meeting or a conference or wherever and I’d learn about something and I always at least in my own mind thought through. So if I come back and I say, “Hey, I saw something really cool, we should look into it.” I wanted to be really careful. I only did that for the few things that I didn’t want anybody in the organization to think I’m inappropriately trying to sponsor this. And I don’t mean inappropriate ethically, I mean inappropriate, like, “Hey, Brooks wants us to do this,” because I wanted them to still to process it and have independent and objective thinking around the opportunity or the need and so on. So I had to be careful about that.
But every now and then I would bring it forward, but I usually would try to bring forward, I think the future’s heading toward much more automation at the bedside in the sense of patient monitoring and caregiver monitoring and support. So I wouldn’t say, “Hey, there’s this company out there doing this really neat things with regards to cameras and speakers in a room that help the caregiver do their work and even document their work. And the company’s name is Acme Telehealth, and they’re wonderful and they’ve already done it at two other places and they’d love us to be a beta site, et cetera.” I would probably almost never do that.
I might stoke the fire and say, “Hey, what have we done about understanding this or evaluating this trend or this new type of deployment into our work processes, and should we be looking at that? And then if so, who are the players out there? Who are the best and brightest and so on? What have others done? We can’t be the first ones struggling with it.” That’s usually the type of vernacular you’ll hear out of the CEO or the CMO or the chief medical officer or the chief nurse officer or somebody like that. It’s not I found this flyer, I stopped by the booth at this conference, I this, I that. And you should look into this. It could happen. I think it’s going to be pretty rare in today’s leadership philosophy. Does that make sense?
John Farkas:
Yeah, absolutely. Yeah,. I think that makes great sense. So really it has a lot to do with the approach, how you’re bringing those ideas forward, how you’re making that accessible from a thought leading perspective has a lot to do with it.
Dave Brooks:
You’re the guru of marketing, and I always remember my marketing 101 class, I think that’s the only one I took in college. One of the first things you do is after the Ps, remember the four or five Ps or whatever that was, price promotion, you segment your market. You got healthcare organization, I mean, think about it. I mean, I was leading healthcare divisions of healthcare organizations, markets that had 12, 13,000 employees. I mean, it’s an ecosystem in itself and has a tremendous amount of complexity that goes along with it. You got to segment that. So the message, if you are trying to bring forward a solution, a product, a tool, some assistance to the health system, you got to segment what the message and you’d communicate to the C-suite, which might be different than what you’d be communicating to the finance leadership, which is different than what you’d communicate potentially to the technology, the IT department. And then obviously very different than what you’d be communicating to the operator, the pharmacy department or the nursing department or whatever, the registration department, wherever most of the deployment would occur, the user side.
And you’d want to have different messages, different even ways of communicating to them and so on. And I think if you try to do a one shot to everybody, let’s start at the top, because if we get the CEO interested, life is good from then on, et cetera, is just too simplistic and generally unrealistic I think.
Addressing Workforce Issues
John Farkas:
So I would completely agree. One of the things we do, we have a biometrix process that we work through that helps distill some of that and understand how to have those different conversations and how to position things differently. And it’s really critical that you do that work because it’s not just about your technology. You can’t just tell a monolithic story and hope to connect the dots across the board. It’s really important to understand that segmentation and whose problems are where and what’s going to get their attention. It’s really critical.
I know we’re coming up on our time here, and I wanted to just get your opinion on, and one other thing, as you are looking at the horizon right now in technology, on the meta scale, on the big stage, what are some of the core thing, the problems you are seeing very pronounced in the market that technology really has a good play at solving, and what’s your point of view on that? What needs to happen right now to really be helpful in the provider space? What are some of the things that need to come across and happen that technology has a unique opportunity to fulfill?
Dave Brooks:
Well, I think it relates back to a little bit of what we were talking about earlier that I think you really need to understand your potential customer. And when you think of it as provider healthcare, as the customer, what are they going through right now? And not just short term, but medium to long term as well. And one of the huge challenges has been there, but is acute right now and is not expected to go away, has to do with workforce. So I think if you can bring forward things that simplify that, you used the term earlier, and I like it, simplify the work, simplify the systems, meaning at very least, integrate them, if not consolidate to the systems that people have to work in.
If you can help do anything that let’s, particularly caregivers, but all staff have more what’s referred to as pride and joy in their craft. Meaning they don’t burn out and they don’t spend more time looking at a screen than looking at a patient because that’s not why they got into healthcare. They got into healthcare to help people individually or collectively and to have professional challenge and hopefully professional opportunities back to Maslow. Pay and whatever else goes along with that. So anything you can do to enable that rekindle that is going to be real value added right now more than ever. It’s always probably been there, but more than ever, as you look at the nursing shortage that’s happening or the pharmacist shortage that’s happening, or the rehab professional, and obviously anything having to do with physicians as well.
From a clinical caregiver perspective, the professional side of healthcare right now, it’s in crisis and it’s going to get worse before it gets better for the next three to five years based on the aging of people, based on early retirements and burnout and all that. So I think that’s a huge opportunity for technology in the right way, as we’ve talked about this last hour, in the right way.
John Farkas:
Yeah. How are you enabling a clinician to take their hands off of a keyboard and focus their efforts and energies face to face in person with patients practicing at the top of their license? I think that is.
Dave Brooks:
Well summarized. They shouldn’t be touching a keyboard. They should be appropriately touching the patient.
John Farkas:
Very important qualifier.
Dave Brooks:
But that’s right. If that’s the true north right now for a lot of these companies that you’re helping to support so well, John, with your company, is how are we helping them do their craft better and back to the core of what that craft is about?
Closing Thoughts
John Farkas:
Yeah. David Brooks, thank you for your time here today. Great conversation. And I reserve the right to ping you again here because there’s a lot more I think we could mine and bring some meaningful reflection toward, because you have a lot of great experience that I think a lot of our listeners are going to take value in. So thanks for your time here today and I wish you the best. As you guys continue to make differences in that public health sphere with People.Health, there’s a lot of need there and glad that you’re given the energies in that realm.
Dave Brooks:
Thank you, and thanks for the chance to do this. I appreciate it. And for the value all of your clients bring to healthcare and public health and so on, I mean, there is a lot of value there. We just got to figure out how we connect it all as best as possible.
John Farkas:
Absolutely. Thanks again, Dave.
Dave Brooks:
Okay. Thanks, John.
Transcript (custom)
Introducing Dave Brooks and His Healthcare Journey
John Farkas:
All right. Greetings everybody and welcome to Healthcare Market Matrix. Today we are privileged to be joined by none other than Dave Brooks. And Dave is currently the Chief Strategy Officer for People.Health. But let me just give you a little quick tour of his CV because he’s made some pretty impressive stops along the road here. Back in 1996, he took the helm as CEO of Christus Medical Group and vice president of physician services. There he was executive vice president and chief operating officer at Central DuPage Health.
He is CEO of Providence Regional Medical Center. He was the president of Ascension, St. John Hospital and senior vice president of the East region there. President of St. Joseph Mercy Health in Ann Arbor in Livingston, and then was the director of Wayne County here, Detroit Health and Veteran Services. And very conspicuously to me, Dave, that you concluded your term at Wayne County Health in 2020. Well, that may have been extremely fortuitous or… I mean, what I know is that you had a front row seat and certainly through your work at People.Health have had a front row seat at the effects of the pandemic in our healthcare system. And I’d love to start there. But before we jump into some of that, tell me us a little bit about that background, some of your journey as you’ve been in the leadership of a number of provider organizations in your tenure. Would love to hear a little bit about that journey and what that was like and some of the insights that you’ve gained along the way.
Dave Brooks:
Happy to do it. Thanks John for the app for the opportunity here to chat with you about all this. So I grew up here in Motown, Detroit area and I have a wonderful family. My wife Laura, two great kids who are now in their twenties. And that part of my life is great and stable and wonderful and I obviously made it back to the Motown area. That’s where I’m living now after a little bit of some travels there. From a professional viewpoint, I’ve spent pretty much my whole career, my whole adult life, literally in healthcare leadership of some sort or another. I’ve actually spent, it’s amazing to me as I think back on it, 35 years in some form or another of a C-suite position in large health systems. So large provider organizations that were very focused on organizing the care and organizing the services to serve everyone in their communities.
And I’m really proud of that and I’m proud of the teams that I got to be part of in helping to do that. And a lot of what we accomplished in serving those communities. I retired from the C-suite, if you will, of healthcare, organized healthcare a little bit early, a little bit young a few years ago. And that was after, again, just looking back 35 years. So a long run and an amazing run, but started so early that I still was reasonably young and therefore energetic and still wanted to contribute. And I had the chance to be a public appointee to Wayne County government. Wayne County, it’s about 2 million people, very urban, very challenged, socioeconomically probably one of the largest and one of the poorest counties, frankly in the country. So a lot of challenges. And I was offered the chance to be the director, the head of health and human services for the county.
And it was a chance to be in public service, give back all the cliches, but also learn a lot more about health in a community, wellness in a community and the social service aspects as well because my team was responsible for that. So I did that for a few years and like you said, good news, bad news, guilt, joy, literally like a month before the pandemic hit is when I left. So I feel a little bit of guilt for not being still with the county and with public health as the pandemic occurred. But the flip side is for my own mental health and security, I probably, in a way, not being there meant I was a lot more stable and less at risk from a lot of different pressures. No doubt.
I was on the advisory board of a friend of mine’s healthcare tech company and he was re-energizing it. And he talked me into joining as a full-time partner and a full-time chief strategy officer of what was then called from a public viewpoint patient education genius. And we went about rebuilding it. Obviously with the pandemic hitting, we had to pivot a little bit to create these tech tools to service the pandemic since at that point our core customer base were primarily physician and provider practice offices.
And if you’ll remember back to the beginning of 2020, most of those got shut down for a period of time around the country during the beginning of the pandemic. So we had to pivot. Patient education genius now is known as People.Health, thanks to some fine work from John, you and your team in Golden Spiral, helping us rethink some strategy in the future and the direction and with it creating a new brand and a new persona around that.
How Dave and People.Health Improved Healthcare Systems during the Pandemic
John Farkas:
Yeah. So Dave, in the context of what you saw happen, just leading up to the pandemic, but then certainly in the context of the pandemic, because you were certainly involved with still in the context of People.Health, because much of what you’re doing with People.Health has a very direct tie with providers and helping them address the public’s needs more effectively in the context of what was transpiring in public health and around public health around the pandemic. Talk about some of the core changes that you were witness to as providers confronted the needs, confronted the volume of challenge that was presented in the context of the pandemic. Talk about some of the core changes that you saw firsthand from your seat there.
Dave Brooks:
Well, remember we moved into a row, or I moved into a row as opposed to being a leader, an operator of either comprehensive healthcare services or the government, the county role obviously there we were there to support those that were providing that care and organizing that. So for me it was a very different perspective than I ever had personally or professionally. So I did everything I could to help. Again, back to that guilt reward dimension, not being in it, the thick of it. And if you think about it, I’m sure it’s an overused term, but those services were pressure tested and government public health particularly, whether it be county, city, even state or federal, my personal viewpoint, had been under invested for decades.
So they had not had the chance to have contemporary processes, had challenges in the sense of recruitment, retention and succession planning, and even professional development of a lot of the leaders and resources within public health. And probably most of all obvious, had not had any type of real ability to reinvest in automation and technology. Had some basic rudimentary things. Every now and then, there’s an exception to that, but had not, and I’m sure the journey would’ve eventually gotten there for public health, but COVID hits and the pressure test happens and it just was so clear how challenged those systems were to keep up and support, be efficient, be effective, provide care and information and services in at the scale and the speed that was needed because that was not ever other than isolated incidents here or there had not been needed at that type of mass scale before, at least in America recently.
So our role and what I observed was anything we could do to help them help public health and other providers involved in COVID, especially that first year, automate improve their processes, expand and extend the support staff and the professional staff in any way. Sometimes it’s referred as lean management thinking, take the waste out of the process so that they could work to the top of their profession. The top of their license was very much appreciated. So we ended up very early on, literally Detroit, Seattle, and New York, if you’ll recall, were the hotbeds for COVID in the beginning. So here we were in Detroit, obviously just our luck. And we therefore quickly supported the development of some testing sites that were happening.
If you remember back to the national news broadcasts, those first few weeks or month, you see cars lined up for a mile trying to get into a testing site and so on. We actually supported one of those right off the bat that had just opened. They were manually working through the process. They had four lanes going in Detroit. This was with Wayne State University’s provider group. And they had four testing lanes going and they were basically doing somewhere around 10 to 15 cars, people per hour. And because it was manual and we quickly scrambled and within about a day, it was a Saturday actually to helped automate some of their processes rudimentary at that point because it was the first time it had happened.
And literally when they turned us on the next hour, they were doing 50 cars an hour because while people were waiting in their cars in line through a text to sign that said text COVID to this number popped up a registration form, they could register while in the car anyway and safely by the way, since they were by themselves. By the time they got up actually to the testing site, the swab or so to speak, they were already in the IT system. They were already in the database and they didn’t have to reenter all that information so they could be swabbed and departed.
So it just improved throughput and I think the light bulb went off both to the provider group, Wayne State, but also to us that wow, this was not really a complicated model, but boy does it add value when it is such a ancient set of processes that were being put in place and ancient, not in a judgmental way, but just the best that they had at the time. Totally manual. I mean literally clipboards were being used. Now in hindsight, the infectiousness of handing a clipboard back and forth, we learned a lot at the beginning of COVID, if you’ll recall, and just avoiding that infectiousness, let alone the work process efficiencies.
So we just built around that from COVID support to then helping health departments, not just in testing but in result reporting and then education information and then even a lot of the other work that health departments were doing with COVID. And we became a great support, primarily in our area, although we ended up helping the New York Health Department in some ways, but mostly in the Michigan, Mid Midwest Metro Detroit area because that’s where we’re based. That’s where we had some relationships because everybody was scrambling.
Pitching Technology Solutions to Government Entities
John Farkas:
So Dave, jumping back into your time when you were the director of the health and veteran services for Wayne County, I’m curious. As you are in that role and are endeavoring to lead that framework, when you’re presented with opportunities to innovate, when you have things come across your desk that are opportunities to leverage technology to improve something, talk about your decision grid. Talk a little bit about what it is because our audience here is, are people who are trying to talk to people like you in positions like the ones you’ve had to help them embrace a new solution, a new way of doing things. So take us into your decision stream a little bit and what are some of the factors and things that you’re looking at weighing? What are some of the competing pressures? What would you want somebody who is trying to get your attention to know that would help you make a better informed decision or that would get your interest?
Dave Brooks:
And I’d separated out slightly. I think there are a lot of common issues or needs and dimensions, filters that would apply no matter where I was previously in my career, but then I would separate out when I was in the government sector, that health and human service job for the county.
John Farkas:
Let’s start there and then we can go back and maybe talk about when you were in at Trinity Health or one of the other positions.
Dave Brooks:
Because government is different and the culture’s different and the decision processes are different and so on. And the other thing to factor in COVID by being a national emergency, a lot of the traditional government procurement purchasing processes changed, but those aren’t there anymore. It’s no longer the pandemic emergency. So you go back to those. So I would make sure that anybody trying to work and support government related entities understand government procurement culture. It varies of course a little bit by municipal meaning city or county or state or federal. And each one of the municipals or county could be slightly dare or and states could be slightly different, but you’d want to understand that. And because that’s the philosophy and the model that the providers, the potential clients are operating under.
But obviously, and it applies to everybody, you got to have a level of ability to demonstrate that whatever you are potentially pitching suggesting adds true value. So what would it do? How would it be better than what they’re doing now? That’s the way our teams would always analyze it. And then how does it fit again into the financials, the budget. And again, government particularly acutely focuses on budget. If they’re not budgeted, if it is… It’s a whole different set of processes than when they do have some level of resources. A lot of the way government works is trickle down grant making.
So you may be dealing with a local public health department, county and or city health department, but it’s probably got its funding from the state and the state obviously gets its funding from the Feds. So a lot of the time those rules and those priorities and even the focus of what they’re trying to accomplish, cascade gown from those grants. So you’ve got to understand that not only would this county be interested in this, but they may have parameters that come about by where they’re getting their funding for it from.
John Farkas:
Parameters, or in some cases opportunities because what they had funding from could open doors that another organization, another state might not have just because they were given money that was designated for certain types of initiatives.
Dave Brooks:
And I don’t mean this necessarily in a negative or critical way, but from a government leader viewpoint, if you don’t want to leave money on the table, if you are given resources from the state, from the feds, or wherever that grant may be coming from, you don’t want to not bring that to your community. If you have an opportunity, you don’t want to waste money. So you wouldn’t want to spend it if it’s totally irrelevant, but it’s not likely going to be irrelevant. So if you’re being given an opportunity to bring down resources, again, from either state or federal levels, you’re going to want to try to find out how to do that. But again, you have to also then meet the parameters of that. So that’s a part of it.
The other part for government, and again, maybe this one I do meet a little more critically, but again, from the very brief time I was there, wonderful people, great hardworking people, God help, they’re there doing public service. Most of my career I didn’t do that. So I really respect people who are in government roles and trying to do that. But there is a aspect, a little bit higher aspect compared to private sector that I noticed of risk aversion. Because you’re in a government role, you have a lot different public persona, a formal public or non-formal public persona that goes along with it and you’re quickly criticized anytime you make a mistake or make a bad decision or what’s perceived as that. So you are a little bit more risk averse because of that.
So it means, I think in some ways it’s a challenge sometimes to be creative. It’s a challenge sometimes to be more innovative. So I think organizations that are trying to work with government entities and therefore government leaders have to recognize that is a part of the filter they’re going to have. Where I think a lot of times we present things to potential clients and customers as it’ll be great, you’ll be the first to do this. It’ll be wonderful, it’ll be innovative, it’ll be creative. That’s great.
John Farkas:
Not necessarily.
Dave Brooks:
But there’s still going to be that thing in the back of the head and especially in government, which is, yeah, but if it blows up on me, how much of the blame will I or my team take? Whereas if we go the safe route, even though it may not accomplish as much, I have less career, personal, professional and team risk. That’s just the reality of a government culture. And I don’t mean that necessarily hypercritical again, but it is what they deal with because they’re public servants. So they are held to a higher standard, but with it has that consequence. Does that make sense?
De-Risking Technology Solutions
John Farkas:
Absolutely. I would say anytime you’re selling into provider or provider related organizations, the risk associated with the deployment of any new solution is there. What I’m hearing is in the context of public service, it’s a step greater because first of all, what it takes to implement change in those organizations is pretty substantial. So there’s going to be a big move around it, but then there’s a lot more eyes on it. So how that is worked and perceived is really important, which tells me that one of the opportunities from a marketing perspective, and this is certainly easier said than done, but to do a lot of work around the de-risking story.
How are you going to demonstrate the pretty ironclad or sure to be successful nature of your solution so that it might help to build and instill confidence at a level that would allow a leader in one of those positions to take that risk. To jump in and say, “Okay. These guys have obviously done their homework. There’s several lookalike or communities here, or instances where they’ve deployed successfully. I can call my friend over there and ask them how it went,” and different elements like that that are going to be important, is that on target?
Dave Brooks:
Yeah, very much. I mean, think about it. It’s almost like back to undergrad or wherever we learned, I’m going to hold up a triangle there. Remember Maslow’s hierarchy? I forgot which class we learned about it in, and that-
John Farkas:
Psych something.
Dave Brooks:
I mean I think tech companies particularly, but I think a lot of companies that are trying to help serve customers and clients, we’re so quick to focus on innovation, creativity, and man, this will set you light years ahead. I’d almost refer to that as the self-actualization, remember the top part of the Maslow’s hierarchy that we’re all looking for. The bottom part of Maslow’s hierarchy was safety, security, needs, housing, food, whatever. And then you move up a little bit and all the way up to that self-actualization as the pinnacle. But think about it from a purchasing government viewpoint, and I’d almost say you almost are better off focusing on that safety security dimension first. Not say, “Hey, you’re going to be the first on your block to have the following and it’s going to be great, and it’s going to add so much value and they’re going to throw a parade for you down main street and all this type of thing.” Great. Wonderful if I get there, but I don’t want to roll the dice all the time.
John Farkas:
That’s not where you were starting. That’s not where the conversation starts.
Dave Brooks:
Taxpayer money, community confidence, my leaders, my bosses have to be reelected, literally reelected. So I think risk aversion is really the first filter. So I’d be focusing on here’s why others are already using this. And as many of those others that have brands that are a admired the better. Earlier on as an examples, I said the New York City Health Department in one of our customers that we have, I mean that’s a brand that, hey, well if New York City went through a process and used this, it’s probably safe for me here in rural county Wisconsin, or pick your favorite spot. Or at least I won’t get blamed or my team or my boss won’t get blamed if it doesn’t work because it wasn’t a farfetched decision I made. So I’d almost focus a lot more than you might usually do on that safety security trustworthiness then emphasize the innovation and the creativity and the advancement it can bring. Almost reversing the traditional order where I think people normally think about it. Does that,-
The Importance of Value Equations and Avoiding Over-Complexity
John Farkas:
Yeah. You are knocking on the door to one of, what I consider to be one of my hot buttons, because what I’m very aware of after working with a lot of technology organizations is what I call the tech bias and the anatomy of the tech bias is, if you’re in a technology company, you inherently love change. I mean, change is a part of your DNA. You embrace it, you look for it, you are instilling it, you are advocating for it. And what you are doing is bringing something forward that it is transformational and you love that about what you’re doing. You love the promise of it. You love the value that it has the opportunity to bring.
And what you inherently develop in that seat is a bias and comfort with that type of transformation. And it really does deaden your senses toward, and what I’ve seen is it creates a disrespect or certainly a lack of empathy for the people in the places that are really stuck in a whole, very complicated system that is inherently resistant to change in any shape or form. Layer onto that, the factors that you’re talking about the level of accountability, the level of transparency that exists in the public health spectrum, I mean that adds another layer on top of it.
So what I’m hearing, and I think this is a great point, I think you’re inverting the triangle is a really great way to look at it. So let’s really encourage, and honestly, I think this is largely true. I think it’s acutely true in the public health arena. I think it’s also pretty true in because I’m getting ready to ask you about your days as the CEO for Providence and some of those other organizations because I think it’s also true there. I mean you can’t take many wild, crazy flyers when you’ve got a community that you are caring for that is relying on you to provide a consistent high quality service. I mean, you have to make sure that you’ve got stuff buttoned up.
So risk and cost and everything, all those elements are critically important. I would also, I’m just going to take a minute here to underscore something you said earlier, because we hear it from everybody we’ve talked to on this podcast to this point. The value equation is essential and making sure you have a clear line to value that takes in as many… Well, I would say that line to value is different for nearly every provider organization you’re selling into. I mean the, it’s nuanced, it has different factors. You have to be aware of those and give instances and examples that are tailored to a number of different scenarios where you might be deployed. Because if you’ve talked to one health system, you’ve talked to one health system.
So I think that that’s another critical thing to keep in mind because it’s very common for technology companies to want to lead with the cool, new, innovative technology and what it makes possible and all the gizzy widgets and nuances of a platform that is whatever technology it’s bringing. And the value equation ends up on page three. From a decision perspective it needs to be on page one before you’ll even begin to consider it. And how it gets it done is not as important of the value it ends up delivering. Is that a fair casting fact?
Dave Brooks:
Very much. And again, I think a lot of how I described government public health and human services and some of the challenges there, I’d only put it down a slight notch below and only a slight notch provider, non private sector, in my experience, mostly nonprofit, but provider side, private sector healthcare for all the same reasons. Exactly what you’re saying and don’t. The other thing, I think that the challenge right now is you cannot underestimate the fatigue within the healthcare communities right now of automation and new software and new programs. So you’re almost going up against not a neutral review, but a critical review upfront.
Because the challenges of electronic health records, which are obviously comprehensive changes as along with a million other systems, whether they be human resource systems or finance systems or check-in processes or new way to order supplies or anything, healthcare overall had been so non-automated that and then over the last 20 years has tried to go from zero generation to third generation at once, all systems at the same time. You can imagine the burnout and fatigue that has created particularly on the caregiver side, but also then the support processes and the support people as well.
So you may have what you think is the world’s greatest innovation that will save so many dollars and so much process steps, but it doesn’t mean the burden of taking it on is going to be worth it to people. The lines aren’t going to cross quick enough for value versus effort. And we’ve got to convince them of that. How do you convince them of that?
John Farkas:
We’re hearing that a lot. I mean, the point solution fatigue, the fact that for many of the people that you’re introducing something to their experience of technology is that it is complicated their world, not that it simplified it. And the awareness of that, even though you have the perspective that what you’re bringing is an exception to that. You have to overcome the reality.
Dave Brooks:
Our baby is never ugly. Our baby’s beautiful, whatever we’ve created, it’s beautiful.
John Farkas:
Yeah. And it very well may be, but when you put beautiful on top of six other beautiful things that you have, that all of which speak a different language in some sense, it becomes confusing. It becomes hard. Especially when you’re dealing with clinicians who are not necessarily first technologists who whose days and times are extremely pressurized and need simplicity. It has to be genuinely labor saving and extraordinarily intuitive for it to be embraced. And I’ve heard that a number of times. We have several clients in the context of what we do, who have really eloquent solutions. And some of what we heard in some of the interviews that we’ve done with users is that they were coming to the table in evaluation of the solution, highly skeptical.
And then when they realized that this actually was going to help them, it was a surprise. They were surprised because every other deployment they’ve experienced has been in some layer adding a layer of complexity that was not welcome. So that’s a critical thing. It’s a essential component to value. Overcoming the technology bias and understanding that yes, you are seen as a potential complicator, not as a solution is important. And being willing to do the work of overcoming that and demonstrating it. You can’t assume you can’t because you have this wonderful AI enabled gizzy widget that represents a lot of really smart labor saving activities that it’s going to be seen that way. It’s going to be seen as a complicator. It’s going to be seen as a threat. It’s going to be seen as another thing that needs to be in some way trained and overcome. And you can’t underestimate the list there.
Dave Brooks:
And there’s two parts to that. There’s the eventual, once it’s implemented part of will this add value? Is it simple to use? Does it create less clicks not more clicks for the user, for the worker? But then there’s the burden of implementation and both of those are going to be looked at. And then right now, at least in this point in time, the challenge of healthcare workforce of vacant positions and caregiver fatigue and burnout and the mass resignation of nurses and doctors and all those types of things, it’s going to be a challenge for an organization, even if they drink the Kool-Aid and they believe this will be well worth doing, they still have to cross whatever that threshold is of, but is now the time to do it considering all of those factors.
So there is a timing issue to some of this. I don’t know how long that will last, but the sensitivity right now to listening to caregivers and caregiver management, the chief nurse, the chief doctor, the chief pharmacist, whomever it might be within the organization, and their influence on the decision making of what new processes and technology we take on and when do we do it, is probably they have more influence now than they’ve ever had. I’m not saying that’s a bad thing. I’m not saying it’ll go away, but you can understand why it’s escalated lately.
A CEO’s Perspective on Selling to a CEO
John Farkas:
Yeah, absolutely. Let’s shift gears a little bit here and talk about, and it’s only a little bit because these conversations have certainly been overlapping as we’ve gone through it. What I can tell you is that for nearly every one of the clients that we work with, and I know many of the people that are in our audience, the CEO or the president of a provider organization is at the top of their target list or one of their primary targets or one of the folks that they know they need to get to, to have a conversation with or to involve in the decision making process. They’re often there. And I also know that those roles are extremely complex, multi-variant, lots of oversight over lots of things, lots of elements coming across the desk that need attention or decisions or some time.
Give us a little sense of the day in the life looking at your role at Providence or in the context of Ascension or Trinity, some of the day in the life considerations and how is stuff brought to you? And we talked about the importance of the value equation in there, but give us a sense of the, your role in those seats and what it takes to capture your attention. What types of things are you looking at and as a leader of those organizations, what are things that you’re championing or getting behind or looking for from an innovation perspective?
Dave Brooks:
And it’s a little mixed because really part of why I love those roles, especially at the CEO level, there were very few typical days and typical periods. The organizations were trying to do such diverse things to serve the community that it meant the leadership of the organization also had to have a lot of diversity in what it did and not just a typical week, but a typical day. So I love that, but that it’s also therefore, little bit of a challenge. To answer your question of what’s typical. I would say that I’m sure, and again, it fits to what you’d probably predicted. You’d probably predict me saying, you’d be surprised at how little singular authority the CEO actually has. Yeah. They’re in charge of everything. I guess when you think of the top of the organizational chart, but I think most people who are get to that leadership level and those leadership roles do so by being very team oriented, by delegating and by really not rarely trying to push their individual direction or decision.
So when it comes to choices and purchases and directions to go to that level, I think having the CEO supportive is great, but they’re rarely going to be the one who initiates the idea or brings forward. Now them knowing what the mega trends are happening in healthcare or even if they’re part of a large health system that had corporate leadership at national or regional levels and I ran or I was leading business units or markets within. So knowing the CEO generally is the one who’s the connector to the corporate office to hear what mega trends and big projects that the system is thinking about, the corporation is thinking about. And that sensitivity is helpful there if the CEO’s aware, but it’s not likely the CEO’s going to bring forward. I think it’s time that we change our human resources platform, or I think it’s time that we add an attachment onto our electronic health record that helps us better code the billing codes or whatever it might be.
You’d want the CEO to know, hey, there’s new developments happening, there’s great value in innovation and improvements here. So when it gets to them, they know, I know we need to do something with regards to this, but the initiation is probably going to come out of other areas. Sometimes it’s going to come out of the IT area or the technology side, but even then, a lot of the time it’s more out of the user side. So if it’s a pharmacy program innovation, it’s likely that the pharmacy leadership is bringing it forward with some conversation, hopefully with IT technology, and they’re bringing forward together a project or a proposal or a initiative.
The CEO or even other members of the C-suite, again, you’re going to need to convince them because they have limited resources and overabundance of requests. So there’s processes in most organizations as to how do you prioritize that. So they’ll be certainly involved and influential there, but they’re probably not the ones bringing forward the need, the ask and the justification. That’s probably happening from the operator and, or IT and maybe even finance if it’s a big capital project, they’re partly involved sometimes in the development of the proposal as well.
John Farkas:
So if I’m hearing you, and I think this is pretty consistent with my experience. If you’re wanting to involve the CEO or if you’re wanting to have the CEO initiate or bring some ideas forward, it better be you’re wanting to bring things forward that are mega trends or macro movements that have the opportunity to affect change in a big way that is going to require… Well, that is asking for a pretty substantial change in how we’re approaching something that has big implications for the health system. Is that fair?
Dave Brooks:
Yeah. Again, and I think that will potentially not be individual offerings or companies or products. It may be, and I was always careful about it as a CEO, I certainly was approached by people or I go to a meeting or a conference or wherever and I’d learn about something and I always at least in my own mind thought through. So if I come back and I say, “Hey, I saw something really cool, we should look into it.” I wanted to be really careful. I only did that for the few things that I didn’t want anybody in the organization to think I’m inappropriately trying to sponsor this. And I don’t mean inappropriate ethically, I mean inappropriate, like, “Hey, Brooks wants us to do this,” because I wanted them to still to process it and have independent and objective thinking around the opportunity or the need and so on. So I had to be careful about that.
But every now and then I would bring it forward, but I usually would try to bring forward, I think the future’s heading toward much more automation at the bedside in the sense of patient monitoring and caregiver monitoring and support. So I wouldn’t say, “Hey, there’s this company out there doing this really neat things with regards to cameras and speakers in a room that help the caregiver do their work and even document their work. And the company’s name is Acme Telehealth, and they’re wonderful and they’ve already done it at two other places and they’d love us to be a beta site, et cetera.” I would probably almost never do that.
I might stoke the fire and say, “Hey, what have we done about understanding this or evaluating this trend or this new type of deployment into our work processes, and should we be looking at that? And then if so, who are the players out there? Who are the best and brightest and so on? What have others done? We can’t be the first ones struggling with it.” That’s usually the type of vernacular you’ll hear out of the CEO or the CMO or the chief medical officer or the chief nurse officer or somebody like that. It’s not I found this flyer, I stopped by the booth at this conference, I this, I that. And you should look into this. It could happen. I think it’s going to be pretty rare in today’s leadership philosophy. Does that make sense?
John Farkas:
Yeah, absolutely. Yeah,. I think that makes great sense. So really it has a lot to do with the approach, how you’re bringing those ideas forward, how you’re making that accessible from a thought leading perspective has a lot to do with it.
Dave Brooks:
You’re the guru of marketing, and I always remember my marketing 101 class, I think that’s the only one I took in college. One of the first things you do is after the Ps, remember the four or five Ps or whatever that was, price promotion, you segment your market. You got healthcare organization, I mean, think about it. I mean, I was leading healthcare divisions of healthcare organizations, markets that had 12, 13,000 employees. I mean, it’s an ecosystem in itself and has a tremendous amount of complexity that goes along with it. You got to segment that. So the message, if you are trying to bring forward a solution, a product, a tool, some assistance to the health system, you got to segment what the message and you’d communicate to the C-suite, which might be different than what you’d be communicating to the finance leadership, which is different than what you’d communicate potentially to the technology, the IT department. And then obviously very different than what you’d be communicating to the operator, the pharmacy department or the nursing department or whatever, the registration department, wherever most of the deployment would occur, the user side.
And you’d want to have different messages, different even ways of communicating to them and so on. And I think if you try to do a one shot to everybody, let’s start at the top, because if we get the CEO interested, life is good from then on, et cetera, is just too simplistic and generally unrealistic I think.
Addressing Workforce Issues
John Farkas:
So I would completely agree. One of the things we do, we have a biometrix process that we work through that helps distill some of that and understand how to have those different conversations and how to position things differently. And it’s really critical that you do that work because it’s not just about your technology. You can’t just tell a monolithic story and hope to connect the dots across the board. It’s really important to understand that segmentation and whose problems are where and what’s going to get their attention. It’s really critical.
I know we’re coming up on our time here, and I wanted to just get your opinion on, and one other thing, as you are looking at the horizon right now in technology, on the meta scale, on the big stage, what are some of the core thing, the problems you are seeing very pronounced in the market that technology really has a good play at solving, and what’s your point of view on that? What needs to happen right now to really be helpful in the provider space? What are some of the things that need to come across and happen that technology has a unique opportunity to fulfill?
Dave Brooks:
Well, I think it relates back to a little bit of what we were talking about earlier that I think you really need to understand your potential customer. And when you think of it as provider healthcare, as the customer, what are they going through right now? And not just short term, but medium to long term as well. And one of the huge challenges has been there, but is acute right now and is not expected to go away, has to do with workforce. So I think if you can bring forward things that simplify that, you used the term earlier, and I like it, simplify the work, simplify the systems, meaning at very least, integrate them, if not consolidate to the systems that people have to work in.
If you can help do anything that let’s, particularly caregivers, but all staff have more what’s referred to as pride and joy in their craft. Meaning they don’t burn out and they don’t spend more time looking at a screen than looking at a patient because that’s not why they got into healthcare. They got into healthcare to help people individually or collectively and to have professional challenge and hopefully professional opportunities back to Maslow. Pay and whatever else goes along with that. So anything you can do to enable that rekindle that is going to be real value added right now more than ever. It’s always probably been there, but more than ever, as you look at the nursing shortage that’s happening or the pharmacist shortage that’s happening, or the rehab professional, and obviously anything having to do with physicians as well.
From a clinical caregiver perspective, the professional side of healthcare right now, it’s in crisis and it’s going to get worse before it gets better for the next three to five years based on the aging of people, based on early retirements and burnout and all that. So I think that’s a huge opportunity for technology in the right way, as we’ve talked about this last hour, in the right way.
John Farkas:
Yeah. How are you enabling a clinician to take their hands off of a keyboard and focus their efforts and energies face to face in person with patients practicing at the top of their license? I think that is.
Dave Brooks:
Well summarized. They shouldn’t be touching a keyboard. They should be appropriately touching the patient.
John Farkas:
Very important qualifier.
Dave Brooks:
But that’s right. If that’s the true north right now for a lot of these companies that you’re helping to support so well, John, with your company, is how are we helping them do their craft better and back to the core of what that craft is about?
Closing Thoughts
John Farkas:
Yeah. David Brooks, thank you for your time here today. Great conversation. And I reserve the right to ping you again here because there’s a lot more I think we could mine and bring some meaningful reflection toward, because you have a lot of great experience that I think a lot of our listeners are going to take value in. So thanks for your time here today and I wish you the best. As you guys continue to make differences in that public health sphere with People.Health, there’s a lot of need there and glad that you’re given the energies in that realm.
Dave Brooks:
Thank you, and thanks for the chance to do this. I appreciate it. And for the value all of your clients bring to healthcare and public health and so on, I mean, there is a lot of value there. We just got to figure out how we connect it all as best as possible.
John Farkas:
Absolutely. Thanks again, Dave.
Dave Brooks:
Okay. Thanks, John.
About Dave Brooks
David Brooks, is a seasoned leader driving impactful change in the healthcare landscape. As the Chief Strategy Officer at People.Health since January 2020, he has orchestrated innovative solutions that elevate healthcare services and revolutionize patient outcomes. With a distinguished history, David’s transformative influence spans prestigious roles, including Director at Wayne County Health, Human & Veteran Services, President of St. Joseph Mercy Health, President of Ascension St. John Hospital, and CEO of Providence Regional Medical Center Everett at Providence Health. His legacy is defined by exceptional leadership, paving the way for a brighter future in the healthcare industry. Having held the reins of influential institutions, he has consistently championed excellence in patient care and community well-being. His remarkable trajectory continues to leave an indelible mark on the healthcare sector, inspiring innovation, collaboration, and a renewed sense of purpose in the pursuit of healthier societies.