Podcast
Inside AMSURG: Navigating Healthcare Innovation, Challenges, and the Future of Surgery Tech
Justin Mooneyhan
Senior Director of Strategy, Solutions, and Innovation; AMSURG
On this episode of Healthcare Market Matrix, host, John Farkas is joined by Justin Mooneyhan, Senior Director of Strategy, Solutions, and Innovation at AMSURG, with over a decade of expertise in healthcare, technology, strategy, process improvement, and project and portfolio management. He has led all efforts related to IT strategy, technology solution design, architecture, and efforts to drive innovation and technology enablement/modernization across enterprise-level organizations.
Tune in as John and Justin delve into the exciting prospects of AMSURG, exploring the challenges associated with integrating cutting-edge technologies within Ambulatory Surgical Centers (ASCs).
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Transcript
Introducing Justin Mooneyhan and His Healthcare Background
John Farkas:
Hello and welcome everybody to Healthcare Market Matrix. I’m your host, John Farkas, and I am privileged today to be joined in the Healthcare Market Matrix studio with Justin Mooneyhan.
Justin is the Senior Director of Strategy Solutions and Innovation for AmSurg. Justin’s here in large part because I heard him in the context of a panel discussion that he was a part of talk about how AmSurg is really looking at deploying AI and a lot of advanced technologies right now to help up their standard of care and patient experience and what that can mean and look like in the next several years. AmSurg is in an interesting situation right now where they get to dream some and to explore what is going to be possible in that context. Today I’m excited about the opportunity to dive into some of that.
Justin holds an MBA in healthcare management from Belmont University. He also has various professional certifications, including his project management, professional certified professional in health information management systems. He’s got a decade of experience in this realm. He’s a Lean Six Sigma black belt among other things. And so he knows how to get things done in this world. It’s not an easy place to navigate, but he has a lot of experience in that world in making new things happen and making change happen in organizations like AmSurg. So Justin, welcome and we’re excited to have you here.
Justin Mooneyhan:
Yeah, excited to be here, John. Appreciate you having me on.
John Farkas:
You bet. Well, I am curious to just get some backdrop. So tell us a little bit about how you got to where you are and your journey as you’ve grown into the position you’re in, in the context of AmSurg. Tell us a little bit about that.
Justin Mooneyhan:
Yeah. Thanks John. Yeah, so it’s been a bit of an interesting journey. I started out coming out of college entrepreneurship major at Belmont University, and I knew I had that entrepreneurial bone and it has always been in me, and I’ve been interested in that, but I didn’t really know what I wanted to do per se, much like most undergrads coming out. I graduated in 2008, which was an interesting time from a macroeconomic perspective. There weren’t a lot of companies hiring. And so I actually had worked a job in college at Smoothie King and it was just kind of on the side. I fit it in with played college soccer.
John Farkas:
Very convenient. Conveniently located to Belmont.
Justin Mooneyhan:
That’s right, yeah. And so I played college soccer, so I was busy as a student athlete and had to fit that in a little bit. And so just coming out, I had networked, I was a national native, so I networked with some friends’ fathers and got connected with a local serial entrepreneur Mike Shmerling actually with his former company XMI. And they were standing up a healthy frozen yogurt concept. And so with my frozen dessert industry experience, I joined their area management team and we were looking to grow that footprint across the Middle Tennessee area.
Fast-forward about a year and a half, two years. Didn’t really pan out as they had planned. It was kind of a fad that faded and it wasn’t necessarily the industry or the job that I saw myself in for my career. And so I started networking again and actually got connected with a local business process outsourcing firm to do some business development work.
It was a great organization, W Squared. They really took me under their wing. I got to work very closely with their executive team who were just amazing to me. Shannon Farrington, Mark Farrington, Casey Correnti and Kimberly Goessele were just a few that just really were good to me and gave me the opportunity. They had a healthcare technology arm of that BPO organization because it was right around the time that the American Recovery and Reinvestment Act was going into effect with stage one meaningful use, basically digitizing medical records. And so that was a very hot happening at the time, and I had some friends that were kind of in that space, some soccer buddies of mine, and I kind of asked them about it, and it just seemed like a great opportunity.
I’d always been interested in healthcare in general, just playing sports my whole life and trying to keep healthy myself. It just seemed like that was an industry that I could be impactful and grow myself and just be interested in, quite frankly. And so the opportunity there, I remember approaching Kimberly Goessele actually the day, and she ended up talking to Shannon Farrington and I was like, “Hey, I don’t have any experience in this. I’m a hard worker. I will bust it to figure out and learn and do whatever I can to be successful. Will you guys give me an opportunity?”
And thankfully they did. And they slotted me over into a role where I was basically building electronic medical records into the configuration. Then they deployed me to go train physicians and nurses, front and back office staff and physician practices. We had a slew of clients across pretty much every different specialty in the physician practice setting. And they basically just turned me loose. It was kind a throw you in the deep end and see if you can swim, which it was challenging.
Learning healthcare, learning technology, learning business in a professional setting at a very early age was tough, but it obviously helped me to get to where I am today. So I did that for a few years. I naturally transitioned to a quasi solution specialist and then a project manager wearing multiple hats with some of the clients that we service. And from there actually moved over to LifePoint. It was right around the time W Squared was kind of merging into what is now Premise Health onsite and near-site employer clinics. And there was just a good opportunity at LifePoint, and it was really tough to leave because I just really enjoyed leadership team, which quite a few of them, they’re still at Premise Health.
But yeah, it was a good opportunity with a great company. And so I made the switch still doing the electronic medical record implementations with project management, some program management. Pretty quickly there, I moved into a leadership role. There was an opportunity with the director of that group that left, and I’ve been there maybe a year and a half or so, and threw my name in the hat. Luckily they moved me into the role and took on a pretty sizable team. We had three kind of core functions, a part of that team, and we were basically leading ambulatory implementations, technical operations, and the interface and device integrations between those systems. So did that for several years and really learned a ton, worked with some really great people. And from there, it really, I think LifePoint was the place that really piqued my interest in innovation as we know it.
There was a lot of opportunity to plug into the electronic medical record and the billing systems, the practice management systems. There was a lot of innovation happening with point solutions. And so I really got to look at a lot of companies and solution providers to see how it would work, how it would fit with our organization, our technology stack. And again, just started learning more and more and more.
Right about that time, I got more plugged into Tennessee HIMSS. They have a workforce accelerator program that kind of teaches folks fairly new to healthcare or making a career change. It gives you a good wide understanding of all the key domains of healthcare. So I did that and had a really great experience with that certification program and met some guys like Eric Thrailkill, I think you’ve had on the podcast, Todd Fetherling and some of those guys.
And from there, it just organically grew my passion for healthcare and technology innovation to the point where there was an opportunity at AmSurg about well over four years ago where I was recruited over from LifePoint, which again was hard to leave there. I had a great team there. It’s a great leadership, but it just seemed like a really good opportunity. The surgery center space seemed like it was going in the right direction, and there was a lot of growth opportunity there. The surgery center space felt like a fairly untapped technology sector too, that I felt like there was a lot of learning opportunities for myself. And so yeah, I made the switch, started out rebooting the project management office, the PMO.
Did that for a few years, and we went through COVID. And with that, there was some leadership turnover on the AmSurg side, and we brought in a new CIO Robert Cook who really is a pure technologist in every sense. He’s a software engineer background, and he really understands technology, he understands healthcare, and he just really saw a need for having more of a strategy and innovation function for our organization. And so he created this role, moved me into that role little over a year ago to really focus on our strategy, focus on what innovation capabilities we can be looking at as an organization to and improve various capabilities and functions within our business. And so that’s kind where I am today. So a little bit of a long-winded story there. But yeah, it’s an interesting space. There’s a lot going on in healthcare in the ASC sector and at AmSurg, as I’m sure we’ll get into a little bit more. But yeah, that’s kind of my journey up until now.
Prioritizing Physician Partners
John Farkas:
So for those of you who don’t know, AmSurg manages a network of more than 250 ASCs nationwide. And so they’re one of the largest players in this space. And certainly there is … I’m really eager to get into some of the challenges of managing innovation across a network of ASCs involving some 4,400 physicians, which I’m sure is really easy and always the same every day. But no, there is a lot to consider in that realm.
And what I know, Justin, about the ASC space is that it is … we’re definitely looking at, there’s two big vectors, and feel free to correct me if I’m wrong, but there’s two big vectors here. One is patient experience, and one is efficiency, if I’m looking at the two critical points for ASCs to manage as it pertains to as it pertains to innovation. And I would have to think that those are the two big underscores. Is that accurate?
Justin Mooneyhan:
Yeah. Yeah, those are huge. I think I might add on though the physician experience too. It’s funny, we’ve talked a lot about this the past year internally, who is really AmSurg’s customer at the end of the day? With any healthcare provider organization, there’s an obvious kind of answer of it’s, well, it’s the patient. You’ve got to provide really high quality patient care. That’s kind of the cornerstone. But for our business, that while that is extremely important, and I think we do a really good job of that and the data shows that, the physician partners are really our customer, if you think about it. We’re trying to provide a strong value proposition to our physician partners and the physicians that bring their procedures-
John Farkas:
That’s the operating partner.
Justin Mooneyhan:
Yeah. To bring the procedures to our organization and our surgery centers across the country. And so we’ve been thinking a lot from a strategy perspective and innovation perspective, how do we enhance that value proposition? As we try to figure out how to grow the organization and scale it beyond the 250 plus that we have, what are those key legs of the stool, if you will, that we can create that strong value proposition? So that’s been a big focus this year and will be over the next probably three to five years as we think about what is the surgery center of the future look like. Yeah, little addition there. But yeah.
John Farkas:
No, that makes great sense. I would think too, that as the operating partner, and as you’re looking at innovation, the opportunity to bring things forward that clearly make physicians’ lives better, that help them practice more effectively, help them free up more of their time to be human beings, I think anything in that equation would be really important. Talk about how you are set up in the organization, if I’m hearing right, you’re reporting into the CIO, is that correct?
Justin Mooneyhan:
We actually created a newer position, our chief technology officer. So I actually report directly into him, and I have a dotted line to our CIO. So an interesting structure, but it works really well. We work really well together, especially with our domain or functional leaders in IT. But yeah, that’s the structure.
Justin’s Role at AMSURG
John Farkas:
As an innovation leader, talk a little bit about what is in your purview, what’s your job? What are you charged with making happen?
Justin Mooneyhan:
Yeah, good question.
John Farkas:
I’m sure it’s changing. It’s probably a pretty dynamic role right now, I’m guessing.
Justin Mooneyhan:
It’s pretty dynamic. It’s pretty fluid. As you kind of alluded to earlier, there’s a lot going on at AmSurg with our chapter 11 situation, which we can get into a little bit more of that. But yeah, my role, it’s pretty wide at this point. I’ve got a small team, but it’s really focused on enterprise architecture, solution architecture, data architecture. Where are we right now? Really assessing the landscape of our architecture. How do we look towards the future, at new platforms and new point solutions and take the business strategy, the business goals and leverage technology to help us achieve those goals?
And so that’s at a very high level, the role. I mean, we do a lot of solution evaluations of technology, work very closely with our business leaders. They might have, “Hey, we want to implement this new solution to solve this problem,” we really try to dig in and understand what the problem they’re actually trying to solve is, how does it impact the business process? And then try to look and find the right technology solutions that help to achieve that aim.
There’s also a big component of that of governance. So IT governance, are we assessing things at the right time, including the right people, things like that. And so we’ve actually, this year put a really good process in place, still working on refining it, there’s a lot of processes you have to do, but really putting that structure and that framework in place to better allow us, again, to focus on the right things at the right time. And so that’s a big one that’s kind of been my purview as well.
There’s a financial management component if you think about the strategy, how are we deploying capital to the right solutions in the right ways? And really kind of everything in between. I mean, there’s a little operational side of things from if you think about just departmental operations and coordination of things with our business leaders. So again, it’s pretty wide. There’s never a dull moment. They keep me pretty busy, but it’s great and we’ve got a great team overall.
How Justin Stays Up-to-Date with New Innovations
John Farkas:
Talk to me a little bit about how you are learning. What are some of the channels you’re tuned into that help you be apprised of new technology, new things coming forward? How are you typically learning of those things?
Justin Mooneyhan:
Yeah, so I try to read a lot. I’m subscribed to a slew of industry articles from the macro down to the technical micro level. I really enjoy it. I really am passionate about learning more. There’s so much happening in technology space, so I am voracious about going out and finding what’s new, what’s on the horizon. There’s been a lot this year, as I know you’ve heard, John, around artificial intelligence. So over the past eight or nine months this year, I’ve been delving into a lot of that, the Gen AI, LLM stuff. But even outside of that, just AI in general, predictive AI, things like that.
Because I just see the opportunity with that technology. As you think about all the data that we have in healthcare growing exponentially month over month, year over year, I think AI has got a lot of potential to help leverage that data, provide better insights to business leaders, functional leaders to solve problems, and to create new solutions.
And so those are things that are, again, I try to look at and look into. And again, reading books, things like that. I try to stay involved in the community. I think there’s an obvious need to stay plugged into the community to understand what are the other organizations doing? How are they approaching solving these problems, or how are they thinking about these technology solutions, bringing those into their organizations to solve those problems? And so organizations like the National Healthcare Council, Leadership Healthcare, the Tennessee HIMSS chapter of course, those are organizations I think are doing a lot of great work to bring educational opportunities, networking opportunities to the surface for leaders to collaborate and learn from each other. I feel like learning from industry experts and leaders at these various companies in our ecosystem in Nashville is just a great way to learn. And so I try to stay plugged into that as much as I can.
AMSURG’s Innovation Blueprint
John Farkas:
Yeah, it is definitely a great community to be a part of. And I think it speaks to the importance of … well, I think it’s really critical for people to stay involved with other professionals in organizations and parallel organizations, because innovation comes from a lot of different directions, and staying enterprised is really important. As you’re looking at the opportunities for AmSurg, and I know we talked briefly in the context of the chapter 11 and the reorganization and what doors … talk about the doors you see that opening for your organization and how it’s affected your innovation blueprint in the next year or so. How are you guys looking at the horizon right now?
Justin Mooneyhan:
Yeah, actually it’s been an interesting time, but it’s been a very exciting time. We haven’t fully emerged from the chapter 11 proceedings, but I think there’s a lot of positive energy internally because in a lot of respects, it’s allowing us to kind of hit the reset button in certain ways, bringing in new systems and technologies to stand up new departments, things like that that we haven’t really had the ability to do prior and so how those systems connect and interact and creating efficiencies and new processes, leveraging technology to enable these new departments and some existing departments. It’s like getting a fresh set of eyes and hands on things that we probably wouldn’t have done, quite frankly, if this didn’t happen. So it’s definitely changed the blueprint.
We’re still refining that blueprint. I think the next 6, 12, probably into the 18 month range, it’ll be fairly fluid. But I do know that we’ve got a great investment group coming in that will own us coming out of emergence. And from all that I’ve heard and seen, they really want us to grow. They see the value in the platform that AmSurg just built over the past 30 plus years, and they want to grow it. They want to bring in more physician partners, bring more procedures, set up new service lines to really grow the business, which I think is really cool. There’s some really great opportunities out there in the surgery center space as hospitals are pushing more of those procedures to an inventory setting.
And so we’re poised and in a really good position to accept that and to grow and really scale the business. So it’s pretty exciting. Again, still figuring out the exact blueprint. We’ve got a pretty good roadmap in mind over the next three years that we’ll tweak around the edges as we learn more emerging from chapter 11. But overall, it’s exciting.
John Farkas:
Justin, talk about, as you look at the things that you are seeing as primary pursuits for problems you’re trying to solve for right now, that technology has the opportunity to play a part in, what’s on your critical list? What are some of the things you’re going after right now in particular?
Justin Mooneyhan:
It’s a very interesting question for where we’re at, because I’d say right now we’re in what we’re kind of dubbing as this modernization mode. We’ve got a lot of legacy systems at the corporate level, at the surgery center level that we really haven’t invested in, in some cases, decades. We’ve got a few of those projects going right now where we’re trying to modernize those platforms so that we can do more of the innovative, sexy things that we’re hearing in the industry.
We can’t do that until we get those platforms up to par with where things are technologically right now. And so that’s been a big focus. You think of your larger platforms like Microsoft, like Salesforce, things like that, that are really starting to unlock and grow new technology capabilities, leveraging AI, leveraging some of those types of newer technologies.
We actually just recently implemented ServiceNow, which is a fascinating platform. They’re doing some really exciting things, not just in the service management space, but more broadly. So I think we’re going to really start scaling those capabilities on that platform, creating new business processes where we can automate things and really take back the time and the day to repurpose to more higher level task and more innovative tasks for our employees. And so those are, it’s kind of like the short-term focus is really getting that foundational layer of platforms in place. And then I think we can start stacking on the more solution blocks to really grow our innovation footprint.
Obviously, we look at point solutions for specific domains or functions of our business. At the surgery center level, there’s always requests to evaluate this care coordination solution or this practice management solution, scheduling solution, things like that that we’re looking at. But what we’re really looking at is how … for those organizations, what’s their product roadmap? How do they integrate with these larger enterprise platforms? What efficiencies can they bring us? What cost savings can they bring us? Those are the types of things we’re looking at right now as we refine our roadmap.
So again, modernize is kind the motor in now. We’ll move into this optimization phase, if you will, and then the transformation phase kind of comes after that. So that’s kind of how we’re at least looking at our three year roadmap, modernize, optimize, transform. And so obviously there’s a lot in the details of that, but that’s kind of how we’re thinking about it.
Difficulties with Deploying New Technologies
John Farkas:
Sure. Justin, talk a little bit about how you all, as you look at 250 entities out there that you guys are somehow trying to give leadership to, which I can only imagine that some days feels like herding cats. No offense to cat lovers out there, but I got to think it presents a whole unique set of challenges. If I’m a health tech company and I have an opportunity to talk to AmSurg, what do I need to know about just the DNA of what it means to lead innovation, to deploy technology? I’ve got to think it’s not as simple as standing something up and pressing a go button. So talk about some of the things, the challenges in between those organizations and broad scale deployment at AmSurg.
Justin Mooneyhan:
Yeah, it’s a great question. And I think just to give context of AmSurg, but I think it’s more broad than AmSurg, the ASC sector in general. So technology has not really been deployed, not necessarily in the best way, but it really just hasn’t been deployed widespread across a lot of the surgery centers. So you think back to the HITECH Act, they really incentivized physician practices and hospitals to digitize records and to get these EHRs in place. They didn’t really do anything for the surgery centers. And then post-acute, another story too, and I think part of it anecdotally is providers are like, “You’re making us learn this EMR system at the practice and this at the hospital, please don’t make us learn another one at the surgery center level,” because the workflows and what you have to do to properly document your clinical notes is just different in the surgery center space.
So we have some centers that are still on paper. And so from a technology perspective, you can deploy point solutions in different parts of the workflow from if you think of a patient arriving, to getting their procedure, to leaving a center, but it’s very fragmented. And to do things at scale is very challenging right now. And again, that’s why we’re trying to think of what platforms can we start leveraging.
I think a lot of point solution health tech companies think they can come in and say, “Hey, this will solve all these problems. Here’s some use cases of ROI that we did at X hospital and we can apply it in OR setting here. It’s like, yeah, theoretically that makes sense, but practically it doesn’t because of the things I mentioned. There’s integration components that I think, at least from what I’ve seen in my experience looking at these solutions, there’s not a deep understanding of how the technology to integrate with other existing technologies.
Some of that’s either because we’re on old tech or just the new tech, there’s resource constraints and capacity to connect, or there’s cost constraints. Deploying new technology, you’ve got to pay for it and does it make sense? Is it going to bring the value to make that investment? So those are things that are challenging. I think from a scale perspective, deploying these types of solutions is challenging with our business model. We essentially have 250 plus legal entities. And so they all have their own operating boards, physician partners have seats, and AmSurg has seats. We have some joint ventures obviously pocketed throughout the company as well. And so it’s hard to say, “Hey, we’re going to deploy this new technology solution at scale.” You’ve got to get approvals across times 250 to make that happen.
So I think as we’re starting to think about leveraging technology and tech enabled service solutions, we have to pilot first. We’ve got to figure out, okay, again, what problems is this solving? Does it make sense in this geographic area? Let’s find a concentrated area of centers maybe where we have six or seven depending on the solution, and let’s deploy in a pilot way so that we can build an internal business case and to go take that to say, “Hey, we piloted this for 3, 6, 12 months. It brought back these returns and this value, these efficiencies. Let’s try it over here now and let’s try it in these pockets versus this widespread big bang scaled approach.” And so you kind of made a joke about that. It’s challenging. There’s solutions, and I’m like, “I wish we could just scale this across everyone. We would gain so many efficiencies,” it’s just not that simple with our business model, but yeah.
What Justin Looks for in Healthtech Solution Providers
John Farkas:
If you were to advise a health tech company coming in wanting to look at one of those initial pilots, wanting to say, okay, how can we show our value here? What would you tell them they need to have on lockdown? What would you want them to know? A better way to say it, what would inspire your confidence past the integrity of the solution or what they say they are able to do? What would inspire your confidence that they’re ready for primetime?
Justin Mooneyhan:
Yeah, another good question. I think one thing that I’ve seen that I really appreciate when I talk to these solution providers is just at a very basic level, did you do your homework on AmSurg? I think you have these organizations that think, “Oh, they’re a surgery center business.” They kind of understand at a very, very high level, but they don’t understand the intricacies of a surgery center. And in some cases you can’t expect them to because they’ve never worked in it, they never worked for an organization like AmSurg. But there’s very basic things that you can just do via Google search.
I can quickly pick out now after doing this for years, meeting with hundreds of these types of companies, the ones that have at least done a little bit of initial homework. So that’s a big one for me because if you haven’t done that and I’m meeting you for the first time, it doesn’t really set a good precedent that you’re going to continue doing your homework if we were to engage and partner.
I think another thing I look for is integration capabilities with other systems, as I kind of alluded to earlier. How can their technology connect to these types of systems? I’m sure that if it’s a more established health tech company, they’ve probably worked with some of these other types of systems and done integration work, whether it’s HL7 type integrations, FHIR, things like that. But having them have a good solid team to understand that, because that’s one thing is we evaluate solutions that’s lost or in some cases not understood from some of our operators. They’re like, Oh yeah, we just put the solution in. We don’t need a lot of IT support from the corporate level.” And as you get down the path of implementing the solution, you’re like, “Oh, we have to connect this to that. The data has to be interoperable,” and it really kills the deal, kills the momentum in a pretty big way. So that’s another big one.
Security’s huge. It’s paramount. Ensuring they have good security controls baked into the solution I think is huge. I mean, we have a process security risk assessment, which all healthcare providers do at this point, but a pretty rigorous one where they’ve got to be ready to execute that and generally turn that around pretty quickly, which I think a lot of them have solved for. I think that’s been a topic over the past few years that a lot of these solution providers have solved for.
But those are some big ones to me that really stand out, that are table stakes for even thinking about a pilot. And then again, obviously there has to be some kind of significant value proposition, and in large cases it has to be supported by someone in the business. I think a lot of people come to me and say, “Hey, we got this solution,” and in some cases I’ll bring in some of the business leaders to kind of validate, is this something that could really actually work? But at the end of the day, it’s got to be supported by the business. It can’t drive and support everything. And so those are just some key points, I think I would say.
John Farkas:
Good. That’s definitely some good backdrop there. What are some of the factors as you look at how companies present themselves and when you’re looking at it from a purely subjective standpoint, looking at a website, looking at their collateral materials, what are some of the things that you’re looking for? What are some of the things that flip your switch off when you see it or don’t see it? Are there some things there that you can highlight?
Justin Mooneyhan:
One, which it’s the world we’re-
John Farkas:
I’m hearing integration is a big one no matter what.
Justin Mooneyhan:
Big one. That’s huge. Another one is just in some cases, not in all cases, but in some cases the sales professionals that are trying to sell the solution don’t really understand the product at a deep level. And so you can get into these conversations and you asked some pretty basic questions and really they can’t answer. So that to me is a little bit of a turnoff.
And again, it’s all relative. Some might be brand new and they’re trying to find their footing with the company or the product, website, marketing collateral. Obviously it’s got to look professional out of the gate. Those are fairly simple. Social media presence, how I can do a quick LinkedIn search and see how they’re engaged and who they’re engaged with and what content they’re pushing out, I think to me is an indicator maybe not for everyone in the space I operate in, but for me, I think that’s something that having good content, being pushed out from a leadership perspective is something that I think again, personally is good and shows well and bodes well for them. So those are a couple things. Yeah, I’d say.
Healthtech Events and Conferences Highlights
John Farkas:
Yeah. As you were looking at some of the events, you mentioned some of the Nashville centric ones, but if you looked at a national scale, what are some of the places that you’re looking and that you would expect to learn some things?
Justin Mooneyhan:
Yeah, so ViVE, which actually was in Nashville this year. It was actually my first time. It’s only the second time that it’s been put on, but it was an amazing conference, I thought. Obviously it’s great to host it in Nashville being the health services capital, but they did really good. I haven’t been to Health yet. I’d like to go to that one. I know that they’ve got that one coming up.
HIMSS is a big one that’s been a staple for many, many years, but they have a lot of sessions with a lot of great content and speakers. I’ve gone to, I don’t know, six or seven over the past probably decade, and I’ve always learned a lot at those events. And then I think some of these larger platform conferences are great. I had the privilege to go to the ServiceNow knowledge conference this year, and I mean, I was just blown away with the capabilities and looking at their product roadmap and all the value that it can lock for not just our organization, but healthcare organizations in general. I think they’re a really strong company doing some really cool things. Those are places I kind of tend to look.
I mean, again, as I mentioned and you referenced the local community events are great. Just again, being a national, we’ve got a plethora of great organizations that put on a lot of good content and have access to a lot of great executive type leaders in some of these national level organizations. So that’s generally where I try to focus. I’d like to go to more conferences. I’d like to do more of that stuff. Unfortunately, time is the biggest constraint there, but yeah.
Efficiency Driven Solutions
John Farkas:
No doubt. If you were talking to an organization wanting to market into, sell into the ASC space, what are some things that are, I mean, there’s plenty of things unique to ASCs, but what are some of the high points other than the fact that we’re talking about a broad diversity of different instances that you need to consider, and we have that piece, but looking at what an ASC exists to do, and when you are looking at the deployment of technology in a place purposed to effectively perform surgeries over and over and over again, what are some of the considerations that you have that you would bring forward there?
Justin Mooneyhan:
Yeah, I think efficiency gains, like is this solution really going to drive efficiency, at the operational level, at the clinical level? Provider organizations right now, they’re hamstrung by having more than they can handle on their plate. So if there’s solutions that can really drive efficiency, I think those are huge. I think in the clinical innovation space, some of these newer diagnostic tools, robotics, things like that, especially in the surgery center space, I think those are areas where there’s a lot of potential.
I alluded to artificial intelligence and data and analytics, advanced analytics. I think those are areas where a lot of value opportunity there. And so for some of those solution providers, really having a good understanding of the data capabilities for their offering, what data we can leverage as an organization from leveraging their solution, how it drives insights, how it drives inefficiency, things like that I think are paramount and will continue to be important in the foreseeable future.
John Farkas:
It would be helpful to you if a platform provider said, “Hey, if you deploy what we’re providing, you’ll have access to the insights gleaned from everybody across our deployments everywhere.”
Justin Mooneyhan:
Yeah, and even maybe the agility to, depending on the solution of course, but are we able to connect and pull in the data into our own warehouse and leverage our own analytics capabilities? I think most, if not all have some kind of analytics capability, but if you think about the end users of the technology, whether it’s at the surgery center level or it’s a corporate function, they don’t want to have to go to five or six or seven different analytics tools that are embedded within your solution. They want to have the capability or ability to say, “Okay, we’re piping in the data to our warehouse. We’ve normalized it and configured it in a way that we can leverage and we can kind of stay within that tool that we leverage internally, and they don’t have to learn again, all these other solution or analytics tools. So yeah.
Creating a Consumer-Centric Digital Experience
John Farkas:
As you look at innovation in the context of your space, and as healthcare is increasingly getting into the hands of the consumer and being controlled by consumer, how big a part does the idea of innovation play as you consider the AmSurg brand and how that dovetails into consumer interest and people’s understanding of what is the shape of a good provider, what makes a good option for this surgery that I’m getting ready to have?
Justin Mooneyhan:
That’s a great question, John. And this is something quite frankly we’ve been talking about for years, even probably before my time at AmSurg. I know there was some passionate folks on this, but it’s like, you’re right, healthcare is becoming more consumer-centric and people want a better experience. They want a digital experience. And so as you think about digital transformation, and it’s a buzzy term these days, but as a surgery center operator, how can we be a cog in a really good digital experience?
So think patient navigation, again, it’s something we’ve talked about internally, externally for years and had some different partnership opportunities that hadn’t materialized for various reasons. But yeah, I mean the patients want … I know if it’s me, I want to be able to do my pre-op on my phone and input my information that sends it directly to the surgery center so I don’t have to fill it out on paper and all these different hops. And it’s just not a good experience, especially with, I think the millennial generation, the younger generations, they pretty much expect that experience because they’re getting that across all the other industries and organizations they interact with. So that’s something that-
John Farkas:
What do you mean I can’t sign in with Facebook?
Justin Mooneyhan:
Exactly, exactly. They want that. And I think in a larger respect, the surgery centers have kind of been left out, and again, I go back to the fact that they were never incentivized to digitize their technology. And so they’re having to fund that wholly on their own versus getting any kind of incentive. And so again, I think there’s ways to go there. I think there’s a lot of opportunity to create that experience from the hospital to the surgery center, back to the hospital or the practice, to the surgeon or back to the practice. The digital front door, if you will.
I think there’s a lot of opportunity, and that’s an area where I try to keep following the trends and seeing where things are going there and how things are evolving. Because at some point in time when we relay the foundation from a technology perspective, I think that’s something getting into the patient experience domain that we really need to put some investment focus towards.
The Importance of a Strong Operating Capability
John Farkas:
It might be related, but as we’re coming to a conclusion here, as you look at, if there was a problem that you could wave your innovation wand and solve right now in the context of AmSurg, if there’s one thing that you know technology could make a real dent in that, if you could just make it happen, what would it be? What would be that thing that would be at the top of the list?
Justin Mooneyhan:
That is a fascinating question. I think there is, I could go so many ways with this-
John Farkas:
Just pretend you’re the innovation wizard right now and you can make it happen.
Justin Mooneyhan:
Yeah, put that hat on. I think being a operation centric organization and really priding ourself in being really good operators, I think my innovation muscle would be focused towards that, I think. Ways we can create efficiency for our teams internally through leveraging technology to improve process, to improve insights into process and efficiencies gained, I think there’s so many demands on our operators on a daily basis. They do so much for our surgery centers.
I hear stories all the time, and I’m just wowed by how they can keep it all together and run efficient and profitable surgery centers. So if I’ve got a large bank of money and I’m going to invest in innovation and tools, I’m putting a lot of it and really creating a strong operating capability and enhancing it because I think it creates better patient experiences, because they’ve got a good well-oiled machine, it creates better physician experiences and it creates better employee experiences if you’ve got really good operations and efficiency capabilities. So that’s probably right now where I’d put it. If you asked me tomorrow, I might say something else, but yeah.
John Farkas:
Well, Justin, I really, as I consider what you’re doing and what you have the opportunity to watch happen, I know there’s plenty of variables in your world, but it’s got to be an exciting space to be in right now and to try and solve for, because the mandates are clear that we’ve got to get this on better rails. It’s got to operate more efficiently and effectively, and information and how we manage that and how we connect things together is all a part of the answer to that equation. And so innovation is a mandate.
Especially in an organization like AmSurg right now, because it needs to … how we work has to change. And so I am excited for the role you have the opportunity to fill and excited to see how you continue to thrive in there. So thanks for joining us today.
Justin Mooneyhan:
Thank you, John. I think it’s well said. I think a lot of opportunity and definitely an exciting place to be and really appreciate the candor and the conversation today.
John Farkas:
You bet. Justin Mooneyhan, thank you very much.
Justin Mooneyhan:
Thank you.
Transcript (custom)
Introducing Justin Mooneyhan and His Healthcare Background
John Farkas:
Hello and welcome everybody to Healthcare Market Matrix. I’m your host, John Farkas, and I am privileged today to be joined in the Healthcare Market Matrix studio with Justin Mooneyhan.
Justin is the Senior Director of Strategy Solutions and Innovation for AmSurg. Justin’s here in large part because I heard him in the context of a panel discussion that he was a part of talk about how AmSurg is really looking at deploying AI and a lot of advanced technologies right now to help up their standard of care and patient experience and what that can mean and look like in the next several years. AmSurg is in an interesting situation right now where they get to dream some and to explore what is going to be possible in that context. Today I’m excited about the opportunity to dive into some of that.
Justin holds an MBA in healthcare management from Belmont University. He also has various professional certifications, including his project management, professional certified professional in health information management systems. He’s got a decade of experience in this realm. He’s a Lean Six Sigma black belt among other things. And so he knows how to get things done in this world. It’s not an easy place to navigate, but he has a lot of experience in that world in making new things happen and making change happen in organizations like AmSurg. So Justin, welcome and we’re excited to have you here.
Justin Mooneyhan:
Yeah, excited to be here, John. Appreciate you having me on.
John Farkas:
You bet. Well, I am curious to just get some backdrop. So tell us a little bit about how you got to where you are and your journey as you’ve grown into the position you’re in, in the context of AmSurg. Tell us a little bit about that.
Justin Mooneyhan:
Yeah. Thanks John. Yeah, so it’s been a bit of an interesting journey. I started out coming out of college entrepreneurship major at Belmont University, and I knew I had that entrepreneurial bone and it has always been in me, and I’ve been interested in that, but I didn’t really know what I wanted to do per se, much like most undergrads coming out. I graduated in 2008, which was an interesting time from a macroeconomic perspective. There weren’t a lot of companies hiring. And so I actually had worked a job in college at Smoothie King and it was just kind of on the side. I fit it in with played college soccer.
John Farkas:
Very convenient. Conveniently located to Belmont.
Justin Mooneyhan:
That’s right, yeah. And so I played college soccer, so I was busy as a student athlete and had to fit that in a little bit. And so just coming out, I had networked, I was a national native, so I networked with some friends’ fathers and got connected with a local serial entrepreneur Mike Shmerling actually with his former company XMI. And they were standing up a healthy frozen yogurt concept. And so with my frozen dessert industry experience, I joined their area management team and we were looking to grow that footprint across the Middle Tennessee area.
Fast-forward about a year and a half, two years. Didn’t really pan out as they had planned. It was kind of a fad that faded and it wasn’t necessarily the industry or the job that I saw myself in for my career. And so I started networking again and actually got connected with a local business process outsourcing firm to do some business development work.
It was a great organization, W Squared. They really took me under their wing. I got to work very closely with their executive team who were just amazing to me. Shannon Farrington, Mark Farrington, Casey Correnti and Kimberly Goessele were just a few that just really were good to me and gave me the opportunity. They had a healthcare technology arm of that BPO organization because it was right around the time that the American Recovery and Reinvestment Act was going into effect with stage one meaningful use, basically digitizing medical records. And so that was a very hot happening at the time, and I had some friends that were kind of in that space, some soccer buddies of mine, and I kind of asked them about it, and it just seemed like a great opportunity.
I’d always been interested in healthcare in general, just playing sports my whole life and trying to keep healthy myself. It just seemed like that was an industry that I could be impactful and grow myself and just be interested in, quite frankly. And so the opportunity there, I remember approaching Kimberly Goessele actually the day, and she ended up talking to Shannon Farrington and I was like, “Hey, I don’t have any experience in this. I’m a hard worker. I will bust it to figure out and learn and do whatever I can to be successful. Will you guys give me an opportunity?”
And thankfully they did. And they slotted me over into a role where I was basically building electronic medical records into the configuration. Then they deployed me to go train physicians and nurses, front and back office staff and physician practices. We had a slew of clients across pretty much every different specialty in the physician practice setting. And they basically just turned me loose. It was kind a throw you in the deep end and see if you can swim, which it was challenging.
Learning healthcare, learning technology, learning business in a professional setting at a very early age was tough, but it obviously helped me to get to where I am today. So I did that for a few years. I naturally transitioned to a quasi solution specialist and then a project manager wearing multiple hats with some of the clients that we service. And from there actually moved over to LifePoint. It was right around the time W Squared was kind of merging into what is now Premise Health onsite and near-site employer clinics. And there was just a good opportunity at LifePoint, and it was really tough to leave because I just really enjoyed leadership team, which quite a few of them, they’re still at Premise Health.
But yeah, it was a good opportunity with a great company. And so I made the switch still doing the electronic medical record implementations with project management, some program management. Pretty quickly there, I moved into a leadership role. There was an opportunity with the director of that group that left, and I’ve been there maybe a year and a half or so, and threw my name in the hat. Luckily they moved me into the role and took on a pretty sizable team. We had three kind of core functions, a part of that team, and we were basically leading ambulatory implementations, technical operations, and the interface and device integrations between those systems. So did that for several years and really learned a ton, worked with some really great people. And from there, it really, I think LifePoint was the place that really piqued my interest in innovation as we know it.
There was a lot of opportunity to plug into the electronic medical record and the billing systems, the practice management systems. There was a lot of innovation happening with point solutions. And so I really got to look at a lot of companies and solution providers to see how it would work, how it would fit with our organization, our technology stack. And again, just started learning more and more and more.
Right about that time, I got more plugged into Tennessee HIMSS. They have a workforce accelerator program that kind of teaches folks fairly new to healthcare or making a career change. It gives you a good wide understanding of all the key domains of healthcare. So I did that and had a really great experience with that certification program and met some guys like Eric Thrailkill, I think you’ve had on the podcast, Todd Fetherling and some of those guys.
And from there, it just organically grew my passion for healthcare and technology innovation to the point where there was an opportunity at AmSurg about well over four years ago where I was recruited over from LifePoint, which again was hard to leave there. I had a great team there. It’s a great leadership, but it just seemed like a really good opportunity. The surgery center space seemed like it was going in the right direction, and there was a lot of growth opportunity there. The surgery center space felt like a fairly untapped technology sector too, that I felt like there was a lot of learning opportunities for myself. And so yeah, I made the switch, started out rebooting the project management office, the PMO.
Did that for a few years, and we went through COVID. And with that, there was some leadership turnover on the AmSurg side, and we brought in a new CIO Robert Cook who really is a pure technologist in every sense. He’s a software engineer background, and he really understands technology, he understands healthcare, and he just really saw a need for having more of a strategy and innovation function for our organization. And so he created this role, moved me into that role little over a year ago to really focus on our strategy, focus on what innovation capabilities we can be looking at as an organization to and improve various capabilities and functions within our business. And so that’s kind where I am today. So a little bit of a long-winded story there. But yeah, it’s an interesting space. There’s a lot going on in healthcare in the ASC sector and at AmSurg, as I’m sure we’ll get into a little bit more. But yeah, that’s kind of my journey up until now.
Prioritizing Physician Partners
John Farkas:
So for those of you who don’t know, AmSurg manages a network of more than 250 ASCs nationwide. And so they’re one of the largest players in this space. And certainly there is … I’m really eager to get into some of the challenges of managing innovation across a network of ASCs involving some 4,400 physicians, which I’m sure is really easy and always the same every day. But no, there is a lot to consider in that realm.
And what I know, Justin, about the ASC space is that it is … we’re definitely looking at, there’s two big vectors, and feel free to correct me if I’m wrong, but there’s two big vectors here. One is patient experience, and one is efficiency, if I’m looking at the two critical points for ASCs to manage as it pertains to as it pertains to innovation. And I would have to think that those are the two big underscores. Is that accurate?
Justin Mooneyhan:
Yeah. Yeah, those are huge. I think I might add on though the physician experience too. It’s funny, we’ve talked a lot about this the past year internally, who is really AmSurg’s customer at the end of the day? With any healthcare provider organization, there’s an obvious kind of answer of it’s, well, it’s the patient. You’ve got to provide really high quality patient care. That’s kind of the cornerstone. But for our business, that while that is extremely important, and I think we do a really good job of that and the data shows that, the physician partners are really our customer, if you think about it. We’re trying to provide a strong value proposition to our physician partners and the physicians that bring their procedures-
John Farkas:
That’s the operating partner.
Justin Mooneyhan:
Yeah. To bring the procedures to our organization and our surgery centers across the country. And so we’ve been thinking a lot from a strategy perspective and innovation perspective, how do we enhance that value proposition? As we try to figure out how to grow the organization and scale it beyond the 250 plus that we have, what are those key legs of the stool, if you will, that we can create that strong value proposition? So that’s been a big focus this year and will be over the next probably three to five years as we think about what is the surgery center of the future look like. Yeah, little addition there. But yeah.
John Farkas:
No, that makes great sense. I would think too, that as the operating partner, and as you’re looking at innovation, the opportunity to bring things forward that clearly make physicians’ lives better, that help them practice more effectively, help them free up more of their time to be human beings, I think anything in that equation would be really important. Talk about how you are set up in the organization, if I’m hearing right, you’re reporting into the CIO, is that correct?
Justin Mooneyhan:
We actually created a newer position, our chief technology officer. So I actually report directly into him, and I have a dotted line to our CIO. So an interesting structure, but it works really well. We work really well together, especially with our domain or functional leaders in IT. But yeah, that’s the structure.
Justin’s Role at AMSURG
John Farkas:
As an innovation leader, talk a little bit about what is in your purview, what’s your job? What are you charged with making happen?
Justin Mooneyhan:
Yeah, good question.
John Farkas:
I’m sure it’s changing. It’s probably a pretty dynamic role right now, I’m guessing.
Justin Mooneyhan:
It’s pretty dynamic. It’s pretty fluid. As you kind of alluded to earlier, there’s a lot going on at AmSurg with our chapter 11 situation, which we can get into a little bit more of that. But yeah, my role, it’s pretty wide at this point. I’ve got a small team, but it’s really focused on enterprise architecture, solution architecture, data architecture. Where are we right now? Really assessing the landscape of our architecture. How do we look towards the future, at new platforms and new point solutions and take the business strategy, the business goals and leverage technology to help us achieve those goals?
And so that’s at a very high level, the role. I mean, we do a lot of solution evaluations of technology, work very closely with our business leaders. They might have, “Hey, we want to implement this new solution to solve this problem,” we really try to dig in and understand what the problem they’re actually trying to solve is, how does it impact the business process? And then try to look and find the right technology solutions that help to achieve that aim.
There’s also a big component of that of governance. So IT governance, are we assessing things at the right time, including the right people, things like that. And so we’ve actually, this year put a really good process in place, still working on refining it, there’s a lot of processes you have to do, but really putting that structure and that framework in place to better allow us, again, to focus on the right things at the right time. And so that’s a big one that’s kind of been my purview as well.
There’s a financial management component if you think about the strategy, how are we deploying capital to the right solutions in the right ways? And really kind of everything in between. I mean, there’s a little operational side of things from if you think about just departmental operations and coordination of things with our business leaders. So again, it’s pretty wide. There’s never a dull moment. They keep me pretty busy, but it’s great and we’ve got a great team overall.
How Justin Stays Up-to-Date with New Innovations
John Farkas:
Talk to me a little bit about how you are learning. What are some of the channels you’re tuned into that help you be apprised of new technology, new things coming forward? How are you typically learning of those things?
Justin Mooneyhan:
Yeah, so I try to read a lot. I’m subscribed to a slew of industry articles from the macro down to the technical micro level. I really enjoy it. I really am passionate about learning more. There’s so much happening in technology space, so I am voracious about going out and finding what’s new, what’s on the horizon. There’s been a lot this year, as I know you’ve heard, John, around artificial intelligence. So over the past eight or nine months this year, I’ve been delving into a lot of that, the Gen AI, LLM stuff. But even outside of that, just AI in general, predictive AI, things like that.
Because I just see the opportunity with that technology. As you think about all the data that we have in healthcare growing exponentially month over month, year over year, I think AI has got a lot of potential to help leverage that data, provide better insights to business leaders, functional leaders to solve problems, and to create new solutions.
And so those are things that are, again, I try to look at and look into. And again, reading books, things like that. I try to stay involved in the community. I think there’s an obvious need to stay plugged into the community to understand what are the other organizations doing? How are they approaching solving these problems, or how are they thinking about these technology solutions, bringing those into their organizations to solve those problems? And so organizations like the National Healthcare Council, Leadership Healthcare, the Tennessee HIMSS chapter of course, those are organizations I think are doing a lot of great work to bring educational opportunities, networking opportunities to the surface for leaders to collaborate and learn from each other. I feel like learning from industry experts and leaders at these various companies in our ecosystem in Nashville is just a great way to learn. And so I try to stay plugged into that as much as I can.
AMSURG’s Innovation Blueprint
John Farkas:
Yeah, it is definitely a great community to be a part of. And I think it speaks to the importance of … well, I think it’s really critical for people to stay involved with other professionals in organizations and parallel organizations, because innovation comes from a lot of different directions, and staying enterprised is really important. As you’re looking at the opportunities for AmSurg, and I know we talked briefly in the context of the chapter 11 and the reorganization and what doors … talk about the doors you see that opening for your organization and how it’s affected your innovation blueprint in the next year or so. How are you guys looking at the horizon right now?
Justin Mooneyhan:
Yeah, actually it’s been an interesting time, but it’s been a very exciting time. We haven’t fully emerged from the chapter 11 proceedings, but I think there’s a lot of positive energy internally because in a lot of respects, it’s allowing us to kind of hit the reset button in certain ways, bringing in new systems and technologies to stand up new departments, things like that that we haven’t really had the ability to do prior and so how those systems connect and interact and creating efficiencies and new processes, leveraging technology to enable these new departments and some existing departments. It’s like getting a fresh set of eyes and hands on things that we probably wouldn’t have done, quite frankly, if this didn’t happen. So it’s definitely changed the blueprint.
We’re still refining that blueprint. I think the next 6, 12, probably into the 18 month range, it’ll be fairly fluid. But I do know that we’ve got a great investment group coming in that will own us coming out of emergence. And from all that I’ve heard and seen, they really want us to grow. They see the value in the platform that AmSurg just built over the past 30 plus years, and they want to grow it. They want to bring in more physician partners, bring more procedures, set up new service lines to really grow the business, which I think is really cool. There’s some really great opportunities out there in the surgery center space as hospitals are pushing more of those procedures to an inventory setting.
And so we’re poised and in a really good position to accept that and to grow and really scale the business. So it’s pretty exciting. Again, still figuring out the exact blueprint. We’ve got a pretty good roadmap in mind over the next three years that we’ll tweak around the edges as we learn more emerging from chapter 11. But overall, it’s exciting.
John Farkas:
Justin, talk about, as you look at the things that you are seeing as primary pursuits for problems you’re trying to solve for right now, that technology has the opportunity to play a part in, what’s on your critical list? What are some of the things you’re going after right now in particular?
Justin Mooneyhan:
It’s a very interesting question for where we’re at, because I’d say right now we’re in what we’re kind of dubbing as this modernization mode. We’ve got a lot of legacy systems at the corporate level, at the surgery center level that we really haven’t invested in, in some cases, decades. We’ve got a few of those projects going right now where we’re trying to modernize those platforms so that we can do more of the innovative, sexy things that we’re hearing in the industry.
We can’t do that until we get those platforms up to par with where things are technologically right now. And so that’s been a big focus. You think of your larger platforms like Microsoft, like Salesforce, things like that, that are really starting to unlock and grow new technology capabilities, leveraging AI, leveraging some of those types of newer technologies.
We actually just recently implemented ServiceNow, which is a fascinating platform. They’re doing some really exciting things, not just in the service management space, but more broadly. So I think we’re going to really start scaling those capabilities on that platform, creating new business processes where we can automate things and really take back the time and the day to repurpose to more higher level task and more innovative tasks for our employees. And so those are, it’s kind of like the short-term focus is really getting that foundational layer of platforms in place. And then I think we can start stacking on the more solution blocks to really grow our innovation footprint.
Obviously, we look at point solutions for specific domains or functions of our business. At the surgery center level, there’s always requests to evaluate this care coordination solution or this practice management solution, scheduling solution, things like that that we’re looking at. But what we’re really looking at is how … for those organizations, what’s their product roadmap? How do they integrate with these larger enterprise platforms? What efficiencies can they bring us? What cost savings can they bring us? Those are the types of things we’re looking at right now as we refine our roadmap.
So again, modernize is kind the motor in now. We’ll move into this optimization phase, if you will, and then the transformation phase kind of comes after that. So that’s kind of how we’re at least looking at our three year roadmap, modernize, optimize, transform. And so obviously there’s a lot in the details of that, but that’s kind of how we’re thinking about it.
Difficulties with Deploying New Technologies
John Farkas:
Sure. Justin, talk a little bit about how you all, as you look at 250 entities out there that you guys are somehow trying to give leadership to, which I can only imagine that some days feels like herding cats. No offense to cat lovers out there, but I got to think it presents a whole unique set of challenges. If I’m a health tech company and I have an opportunity to talk to AmSurg, what do I need to know about just the DNA of what it means to lead innovation, to deploy technology? I’ve got to think it’s not as simple as standing something up and pressing a go button. So talk about some of the things, the challenges in between those organizations and broad scale deployment at AmSurg.
Justin Mooneyhan:
Yeah, it’s a great question. And I think just to give context of AmSurg, but I think it’s more broad than AmSurg, the ASC sector in general. So technology has not really been deployed, not necessarily in the best way, but it really just hasn’t been deployed widespread across a lot of the surgery centers. So you think back to the HITECH Act, they really incentivized physician practices and hospitals to digitize records and to get these EHRs in place. They didn’t really do anything for the surgery centers. And then post-acute, another story too, and I think part of it anecdotally is providers are like, “You’re making us learn this EMR system at the practice and this at the hospital, please don’t make us learn another one at the surgery center level,” because the workflows and what you have to do to properly document your clinical notes is just different in the surgery center space.
So we have some centers that are still on paper. And so from a technology perspective, you can deploy point solutions in different parts of the workflow from if you think of a patient arriving, to getting their procedure, to leaving a center, but it’s very fragmented. And to do things at scale is very challenging right now. And again, that’s why we’re trying to think of what platforms can we start leveraging.
I think a lot of point solution health tech companies think they can come in and say, “Hey, this will solve all these problems. Here’s some use cases of ROI that we did at X hospital and we can apply it in OR setting here. It’s like, yeah, theoretically that makes sense, but practically it doesn’t because of the things I mentioned. There’s integration components that I think, at least from what I’ve seen in my experience looking at these solutions, there’s not a deep understanding of how the technology to integrate with other existing technologies.
Some of that’s either because we’re on old tech or just the new tech, there’s resource constraints and capacity to connect, or there’s cost constraints. Deploying new technology, you’ve got to pay for it and does it make sense? Is it going to bring the value to make that investment? So those are things that are challenging. I think from a scale perspective, deploying these types of solutions is challenging with our business model. We essentially have 250 plus legal entities. And so they all have their own operating boards, physician partners have seats, and AmSurg has seats. We have some joint ventures obviously pocketed throughout the company as well. And so it’s hard to say, “Hey, we’re going to deploy this new technology solution at scale.” You’ve got to get approvals across times 250 to make that happen.
So I think as we’re starting to think about leveraging technology and tech enabled service solutions, we have to pilot first. We’ve got to figure out, okay, again, what problems is this solving? Does it make sense in this geographic area? Let’s find a concentrated area of centers maybe where we have six or seven depending on the solution, and let’s deploy in a pilot way so that we can build an internal business case and to go take that to say, “Hey, we piloted this for 3, 6, 12 months. It brought back these returns and this value, these efficiencies. Let’s try it over here now and let’s try it in these pockets versus this widespread big bang scaled approach.” And so you kind of made a joke about that. It’s challenging. There’s solutions, and I’m like, “I wish we could just scale this across everyone. We would gain so many efficiencies,” it’s just not that simple with our business model, but yeah.
What Justin Looks for in Healthtech Solution Providers
John Farkas:
If you were to advise a health tech company coming in wanting to look at one of those initial pilots, wanting to say, okay, how can we show our value here? What would you tell them they need to have on lockdown? What would you want them to know? A better way to say it, what would inspire your confidence past the integrity of the solution or what they say they are able to do? What would inspire your confidence that they’re ready for primetime?
Justin Mooneyhan:
Yeah, another good question. I think one thing that I’ve seen that I really appreciate when I talk to these solution providers is just at a very basic level, did you do your homework on AmSurg? I think you have these organizations that think, “Oh, they’re a surgery center business.” They kind of understand at a very, very high level, but they don’t understand the intricacies of a surgery center. And in some cases you can’t expect them to because they’ve never worked in it, they never worked for an organization like AmSurg. But there’s very basic things that you can just do via Google search.
I can quickly pick out now after doing this for years, meeting with hundreds of these types of companies, the ones that have at least done a little bit of initial homework. So that’s a big one for me because if you haven’t done that and I’m meeting you for the first time, it doesn’t really set a good precedent that you’re going to continue doing your homework if we were to engage and partner.
I think another thing I look for is integration capabilities with other systems, as I kind of alluded to earlier. How can their technology connect to these types of systems? I’m sure that if it’s a more established health tech company, they’ve probably worked with some of these other types of systems and done integration work, whether it’s HL7 type integrations, FHIR, things like that. But having them have a good solid team to understand that, because that’s one thing is we evaluate solutions that’s lost or in some cases not understood from some of our operators. They’re like, Oh yeah, we just put the solution in. We don’t need a lot of IT support from the corporate level.” And as you get down the path of implementing the solution, you’re like, “Oh, we have to connect this to that. The data has to be interoperable,” and it really kills the deal, kills the momentum in a pretty big way. So that’s another big one.
Security’s huge. It’s paramount. Ensuring they have good security controls baked into the solution I think is huge. I mean, we have a process security risk assessment, which all healthcare providers do at this point, but a pretty rigorous one where they’ve got to be ready to execute that and generally turn that around pretty quickly, which I think a lot of them have solved for. I think that’s been a topic over the past few years that a lot of these solution providers have solved for.
But those are some big ones to me that really stand out, that are table stakes for even thinking about a pilot. And then again, obviously there has to be some kind of significant value proposition, and in large cases it has to be supported by someone in the business. I think a lot of people come to me and say, “Hey, we got this solution,” and in some cases I’ll bring in some of the business leaders to kind of validate, is this something that could really actually work? But at the end of the day, it’s got to be supported by the business. It can’t drive and support everything. And so those are just some key points, I think I would say.
John Farkas:
Good. That’s definitely some good backdrop there. What are some of the factors as you look at how companies present themselves and when you’re looking at it from a purely subjective standpoint, looking at a website, looking at their collateral materials, what are some of the things that you’re looking for? What are some of the things that flip your switch off when you see it or don’t see it? Are there some things there that you can highlight?
Justin Mooneyhan:
One, which it’s the world we’re-
John Farkas:
I’m hearing integration is a big one no matter what.
Justin Mooneyhan:
Big one. That’s huge. Another one is just in some cases, not in all cases, but in some cases the sales professionals that are trying to sell the solution don’t really understand the product at a deep level. And so you can get into these conversations and you asked some pretty basic questions and really they can’t answer. So that to me is a little bit of a turnoff.
And again, it’s all relative. Some might be brand new and they’re trying to find their footing with the company or the product, website, marketing collateral. Obviously it’s got to look professional out of the gate. Those are fairly simple. Social media presence, how I can do a quick LinkedIn search and see how they’re engaged and who they’re engaged with and what content they’re pushing out, I think to me is an indicator maybe not for everyone in the space I operate in, but for me, I think that’s something that having good content, being pushed out from a leadership perspective is something that I think again, personally is good and shows well and bodes well for them. So those are a couple things. Yeah, I’d say.
Healthtech Events and Conferences Highlights
John Farkas:
Yeah. As you were looking at some of the events, you mentioned some of the Nashville centric ones, but if you looked at a national scale, what are some of the places that you’re looking and that you would expect to learn some things?
Justin Mooneyhan:
Yeah, so ViVE, which actually was in Nashville this year. It was actually my first time. It’s only the second time that it’s been put on, but it was an amazing conference, I thought. Obviously it’s great to host it in Nashville being the health services capital, but they did really good. I haven’t been to Health yet. I’d like to go to that one. I know that they’ve got that one coming up.
HIMSS is a big one that’s been a staple for many, many years, but they have a lot of sessions with a lot of great content and speakers. I’ve gone to, I don’t know, six or seven over the past probably decade, and I’ve always learned a lot at those events. And then I think some of these larger platform conferences are great. I had the privilege to go to the ServiceNow knowledge conference this year, and I mean, I was just blown away with the capabilities and looking at their product roadmap and all the value that it can lock for not just our organization, but healthcare organizations in general. I think they’re a really strong company doing some really cool things. Those are places I kind of tend to look.
I mean, again, as I mentioned and you referenced the local community events are great. Just again, being a national, we’ve got a plethora of great organizations that put on a lot of good content and have access to a lot of great executive type leaders in some of these national level organizations. So that’s generally where I try to focus. I’d like to go to more conferences. I’d like to do more of that stuff. Unfortunately, time is the biggest constraint there, but yeah.
Efficiency Driven Solutions
John Farkas:
No doubt. If you were talking to an organization wanting to market into, sell into the ASC space, what are some things that are, I mean, there’s plenty of things unique to ASCs, but what are some of the high points other than the fact that we’re talking about a broad diversity of different instances that you need to consider, and we have that piece, but looking at what an ASC exists to do, and when you are looking at the deployment of technology in a place purposed to effectively perform surgeries over and over and over again, what are some of the considerations that you have that you would bring forward there?
Justin Mooneyhan:
Yeah, I think efficiency gains, like is this solution really going to drive efficiency, at the operational level, at the clinical level? Provider organizations right now, they’re hamstrung by having more than they can handle on their plate. So if there’s solutions that can really drive efficiency, I think those are huge. I think in the clinical innovation space, some of these newer diagnostic tools, robotics, things like that, especially in the surgery center space, I think those are areas where there’s a lot of potential.
I alluded to artificial intelligence and data and analytics, advanced analytics. I think those are areas where a lot of value opportunity there. And so for some of those solution providers, really having a good understanding of the data capabilities for their offering, what data we can leverage as an organization from leveraging their solution, how it drives insights, how it drives inefficiency, things like that I think are paramount and will continue to be important in the foreseeable future.
John Farkas:
It would be helpful to you if a platform provider said, “Hey, if you deploy what we’re providing, you’ll have access to the insights gleaned from everybody across our deployments everywhere.”
Justin Mooneyhan:
Yeah, and even maybe the agility to, depending on the solution of course, but are we able to connect and pull in the data into our own warehouse and leverage our own analytics capabilities? I think most, if not all have some kind of analytics capability, but if you think about the end users of the technology, whether it’s at the surgery center level or it’s a corporate function, they don’t want to have to go to five or six or seven different analytics tools that are embedded within your solution. They want to have the capability or ability to say, “Okay, we’re piping in the data to our warehouse. We’ve normalized it and configured it in a way that we can leverage and we can kind of stay within that tool that we leverage internally, and they don’t have to learn again, all these other solution or analytics tools. So yeah.
Creating a Consumer-Centric Digital Experience
John Farkas:
As you look at innovation in the context of your space, and as healthcare is increasingly getting into the hands of the consumer and being controlled by consumer, how big a part does the idea of innovation play as you consider the AmSurg brand and how that dovetails into consumer interest and people’s understanding of what is the shape of a good provider, what makes a good option for this surgery that I’m getting ready to have?
Justin Mooneyhan:
That’s a great question, John. And this is something quite frankly we’ve been talking about for years, even probably before my time at AmSurg. I know there was some passionate folks on this, but it’s like, you’re right, healthcare is becoming more consumer-centric and people want a better experience. They want a digital experience. And so as you think about digital transformation, and it’s a buzzy term these days, but as a surgery center operator, how can we be a cog in a really good digital experience?
So think patient navigation, again, it’s something we’ve talked about internally, externally for years and had some different partnership opportunities that hadn’t materialized for various reasons. But yeah, I mean the patients want … I know if it’s me, I want to be able to do my pre-op on my phone and input my information that sends it directly to the surgery center so I don’t have to fill it out on paper and all these different hops. And it’s just not a good experience, especially with, I think the millennial generation, the younger generations, they pretty much expect that experience because they’re getting that across all the other industries and organizations they interact with. So that’s something that-
John Farkas:
What do you mean I can’t sign in with Facebook?
Justin Mooneyhan:
Exactly, exactly. They want that. And I think in a larger respect, the surgery centers have kind of been left out, and again, I go back to the fact that they were never incentivized to digitize their technology. And so they’re having to fund that wholly on their own versus getting any kind of incentive. And so again, I think there’s ways to go there. I think there’s a lot of opportunity to create that experience from the hospital to the surgery center, back to the hospital or the practice, to the surgeon or back to the practice. The digital front door, if you will.
I think there’s a lot of opportunity, and that’s an area where I try to keep following the trends and seeing where things are going there and how things are evolving. Because at some point in time when we relay the foundation from a technology perspective, I think that’s something getting into the patient experience domain that we really need to put some investment focus towards.
The Importance of a Strong Operating Capability
John Farkas:
It might be related, but as we’re coming to a conclusion here, as you look at, if there was a problem that you could wave your innovation wand and solve right now in the context of AmSurg, if there’s one thing that you know technology could make a real dent in that, if you could just make it happen, what would it be? What would be that thing that would be at the top of the list?
Justin Mooneyhan:
That is a fascinating question. I think there is, I could go so many ways with this-
John Farkas:
Just pretend you’re the innovation wizard right now and you can make it happen.
Justin Mooneyhan:
Yeah, put that hat on. I think being a operation centric organization and really priding ourself in being really good operators, I think my innovation muscle would be focused towards that, I think. Ways we can create efficiency for our teams internally through leveraging technology to improve process, to improve insights into process and efficiencies gained, I think there’s so many demands on our operators on a daily basis. They do so much for our surgery centers.
I hear stories all the time, and I’m just wowed by how they can keep it all together and run efficient and profitable surgery centers. So if I’ve got a large bank of money and I’m going to invest in innovation and tools, I’m putting a lot of it and really creating a strong operating capability and enhancing it because I think it creates better patient experiences, because they’ve got a good well-oiled machine, it creates better physician experiences and it creates better employee experiences if you’ve got really good operations and efficiency capabilities. So that’s probably right now where I’d put it. If you asked me tomorrow, I might say something else, but yeah.
John Farkas:
Well, Justin, I really, as I consider what you’re doing and what you have the opportunity to watch happen, I know there’s plenty of variables in your world, but it’s got to be an exciting space to be in right now and to try and solve for, because the mandates are clear that we’ve got to get this on better rails. It’s got to operate more efficiently and effectively, and information and how we manage that and how we connect things together is all a part of the answer to that equation. And so innovation is a mandate.
Especially in an organization like AmSurg right now, because it needs to … how we work has to change. And so I am excited for the role you have the opportunity to fill and excited to see how you continue to thrive in there. So thanks for joining us today.
Justin Mooneyhan:
Thank you, John. I think it’s well said. I think a lot of opportunity and definitely an exciting place to be and really appreciate the candor and the conversation today.
John Farkas:
You bet. Justin Mooneyhan, thank you very much.
Justin Mooneyhan:
Thank you.
About Justin Mooneyhan
Justin Mooneyhan is a Nashville native and healthcare professional with over 13 years of experience in healthcare and technology. He has extensive experience in healthcare, technology, strategy, process improvement, and project and portfolio management. He has led all efforts related to IT strategy, technology solution design, architecture, and efforts to drive innovation and technology enablement/modernization across enterprise-level organizations.
Mr. Mooneyhan holds an MBA in Healthcare Management from Belmont University. He also holds various professional certifications including his Project Management Professional, Certified Professional in Health Information Management Systems, and a Lean Six Sigma Black Belt, among others. He enjoys exercising, soccer, reading, and spending time with his wife and three children.