Podcast

Shortening the Sales Cycle with Value-Driven Solutions

Laura O'Toole

CEO, SureTest

On this episode of Healthcare Market Matrix, host John Farkas sits down with Laura O’Toole, Ratio Advisory Board Member and CEO of SureTest, for an enlightening conversation about her thirty-plus years of experience in healthcare enterprise IT implementation. After spending much of her career strategically designing, developing, and implementing transformational projects as a global consulting professional, Laura transitioned to the provider space with SureTest, where she and her team create intelligent healthcare IT automation solutions that save clients thousands of hours of work. Throughout the episode, John and Laura discuss value-driven solutions, selling to CIOs and becoming enterprise-ready.

Show Notes

(1:49) Introducing Laura O’Toole and Her Healthcare Journey

(5:57) SureTest

(8:58) Laura on Providing Value-Driven Solutions

(14:38) Inspiring Confidence in Your Solution

(24:24) Advice on Selling to CIOs

(30:01) Trends, Solutions, and Technologies That Impress Laura

(35:11) Becoming Enterprise-Ready

(47:33) Ethical Considerations with Generative AI

(53:31) Closing Thoughts

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Transcript

Introducing Laura O’Toole and Her Healthcare Journey

John Farkas:

Welcome everybody, and we are glad that you’re joining us here today for Healthcare Market Matrix and today we have joining us in our studios is none other than the incomparable Laura O’Toole. And Laura and I have known each other for a number of years and I’m just excited to have this conversation because there’s a lot that Laura’s bringing to the table. She currently serves as the CEO of Sure Test.

And I know we’re going to talk more about what Sure Test is and does but to give you some broader context for Laura, I just don’t know another person who’s had more broad-based exposure to the world of healthcare enterprise IT implementation than she has. She comes to us with more than 30 years of experience and so has definitely seen fire and rain and even knows who wrote the song that that phrase references. She’s spent a lot of her career as a global consulting professional, strategically designing, developing and implementing transformational projects in the healthcare provider space. And so she knows operational transformation and she’s got deep expertise in human capital leadership, in client engagement and success. And I could go on and on, but I’m going to let her fill in some of those gaps here in a few minutes. So Laura, welcome to Healthcare Market Matrix.

Laura O’Toole:

Thanks, John. As always, it’s great to be with you and to talk to you and of course, thanks for aging me, but the truth is the truth I guess.

John Farkas:

Well, and we got to wear that as a badge of honor, right? Because-

Laura O’Toole:

We do indeed.

John Farkas:

… experience is a valuable tool in the crazy waters that we’re navigating these days in healthcare, so we got to own it.

Laura O’Toole:

Yep, indeed.

John Farkas:

So take us back a little bit and into your journey into the healthcare and where you are now. So how’d you get into this? How’d you find yourself into this world?

Laura O’Toole:

I found myself working in healthcare right out of college. I had the opportunity to run the front end of an emergency room and then a business office and really more on the back office operations, financial side of the house. So came up, growing up working in hospitals, and then I’m sure you remember back in the day when Y2K hit and everybody was worried about all the systems and what was going to happen when we flipped the switch. And I had the opportunity at that point to really become a traveling consultant. I don’t know if you remember the old McKesson Suite, the STAR product. So back in the day I was a patient accounting STAR guru expert. I think McKesson used to say that I knew more than a lot of their employees. So that’s kind of how I grew up on the implementation side after I was doing operational work in hospitals and then became a road warrior traveling consultant, running projects, managing big projects.

And my career kind of went from there in terms of client management, overarching client responsibility, delivery responsibility for some really, really large projects primarily around the implementation space. And I spent a little bit of time certainly working for many companies. I worked back in the day for First Consulting Group, which was in its time, a lead niche healthcare IT consulting firm. And from my perspective, one of the best out there, of course acquisitions happened and moved on, worked on my own, and then was the chief people officer and COO of another healthcare consultancy and from that we spun off Sure test and I’m now the CEO of Sure Test, but like you mentioned, kind of did a little bit of everything primarily on the implementation and client delivery side of the house though.

SureTest

John Farkas:

Yeah. So very deep experience in that interface between solution providers and the hospitals’ health systems, the organizations that are implementing those solutions. Take us into Sure Test now because that’s the new hot thing and just a tremendous solution that’s meeting a real need. So introduce us to how Sure Test is situated.

Laura O’Toole:

Yeah, well Sure Test was born really out of a service offering in a business unit in a larger consultancy that we owned and ran, and we saw the value that our clients were getting, so we spun it out as its own company, but Sure Test essentially is an automation capability to test all the workflow end user experience of the EHR, really any system application. Certainly on the enterprise level, it’s an enterprise level tool and library and proprietary library of automation that gives our clients an immediate jumpstart to take the many times up to 30,000 hours of manual labor that our clients in the health delivery space spend on testing and regression testing their electronic health record in any application really, in their enterprise applications. And Sure Test takes those manual processes and moves them to automation in a managed services capacity.

So not only do we automate and develop all the automation, we maintain it ongoing for our clients, so it’s evergreen and stays fresh, so ready for every new upgrade, SU optimization, et cetera. So it was really important to us to launch this solution because we wanted to deliver something to our clients that had a meaningful ROI and provided real value, and particularly at this time in the staffing crisis and what our clients are dealing with, be able to give them back time, energy, and allow our clients the opportunity to work on more strategic projects than testing. So we take that headache completely away.

John Farkas:

And it’s just such a tremendous savings. And at a moment where resources for health systems are at a premium, there’s no substituting, there’s no way to underscore the importance enough of being able to redeem clinicians’ time and get them back on the floor, help make IT resources go farther, be more efficient, all of that right now is absolutely critical. And Sure Test is really at the nexus of that.

Laura on Providing Value-Driven Solutions

John Farkas:

I’m very curious, Laura, knowing that you’ve lived as a professional intermediary for a long time between solution providers and health systems, and now you’ve moved onto the solution provider realm, what’s been some of the biggest realizations that you’ve had in that move? What’s the difference between the consultant role and really working to connect the dots for organizations and now moving into the solution provider?

Laura O’Toole:

Yeah, if you think about it, if you’re a consultant or you’re doing consulting work or staff augmentation work or you’re coming in and just working on a project, my biggest struggle with that whole landscape and although I did it for many years, is that you go in and you help a client for a period of time, but a lot of times you take the information with you and nothing ever gets left for the client, in my opinion, when you’re thinking about either straight staff augmentation and certainly there’s huge value add in helping in that implementation and getting them to where they need to go. But I think when you bring a solution and a real managed solution that can literally give them back 300% in an ROI and make a difference for their staff day in and day out, and when they look in the rearview mirror, it’s doing it over time.

And when you can deliver something that you know works and you’re so confident in the delivery that you can deliver it at a fixed fee price, that to me is real value to a client. And I think those of us that are in the market that are really trying to listen to our client’s needs and bring full solutions that solve a specific problem is what it’s about. And I think it’s really important to meet your clients where they’re at and listen to them and understand what the biggest pain points are. And I think that those solutions that are solving a pain point are the ones that have the chance of winning.

John Farkas:

Yeah, we hear that very frequently in the context of the conversations that we’re having. First of all, super important to have a very clear, well-defined, well articulated value framework. You’ve got to know what value you are really providing for the organizations that you’re talking to, and you have to know the organizations you’re talking to, which is a problem for marketing, right? Because we want to come up with one big message that sort of blankets the whole thing.

And every health system, every hospital, every organization around healthcare is slightly different or a lot different. And the ability to kind of frame and tailor those messages, to really meet the specific needs or the challenges that an organization might be facing is an important piece. And figuring out how to discern that and how to target those messages effectively ends up being really an important component. As you look at how you have learned to listen, as you’ve learned to get around those problems and solutions, any insight or any suggestions for organizations trying to figure out how to zero in on that value proposition and what they’re going to be able to bring?

Laura O’Toole:

Yeah. Well, I think what you said is really important. You absolutely have to have a very clear message, a clear value proposition, and this day and age, especially when you look at the struggles that our healthcare partners are having and all the budget constraints that they have, you have to have a demonstrable ROI and you have to be able to help them see the path to get there. I think that’s probably-

John Farkas:

And not a vague ROI, a very specific, well-

Laura O’Toole:

Measurable-

John Farkas:

… documented, measurable-

Laura O’Toole:

Measurable ROI.

John Farkas:

… ROI.

Laura O’Toole:

I would say that’s the first thing. I think that the second thing is that you need to be very sensitive to the pressures that our clients are feeling because it’s like nothing I’ve ever seen in my 30 years of doing this work. And you have to walk into it saying, how can I make this lift lighter for them? What can we do? How crisp can our methodology be? You have to have a very clear methodology and implementation strategy around your solution.

And for us, it’s been really important to have a client success manager along the way from… even through the sales cycle out to the other side of success that really is a conduit and a liaison to help them help themselves get coordinated enough to get you as the solution partner the information that you need because typically it’s not that much that you need from the client, but their time is important and you have to recognize how important their time is. So I think listening, having a good methodology and a framework in order to get the solution quickly implemented so that they can start seeing the immediate value is really important. We have to help not kick the can down the road, if you know what I mean.

Inspiring Confidence in Your Solution

John Farkas:

Let’s dive deeper into methodology because I think that that’s an important thing and something that I often see missing. It’s one thing to have a solution, but it’s not enough. You have to have a very clear idea of how you’re going to apply that solution in a multivariate context, in context that could look a number of different ways. And so you have to have a methodology that is going to accommodate that to help ensure success. Talk about that some and how have you done that with Sure Test and what are some suggestions you would have for organizations that are wanting to bring that forward in a way… maybe farther up in their messaging and how they’re approaching things in ways that would help inspire confidence?

Laura O’Toole:

Yeah, I think you need to be able to demonstrate through technology how easy it is to connect and get people engaged. So I think… John, you and I have talked about this before. We’ve talked a lot about COVID and what that has done to the industry, but in my opinion for healthcare, the one thing that COVID did is made us as an industry move and move faster. It used to take us as an industry, in my opinion, so much longer to get things done. And we had to learn very quickly that you don’t have to see, touch, feel every person in every widget in order to be successful. And so on the heels of that, we had the opportunity to really do some creative things because so many of our colleagues are either working from home, the days of the big brick and mortar, even clients that have hybrid approaches, they’re not there all the time.

So I think you have to have a very clear documented framework on how you’re going to engage. And I know that seems so simple, but just the ins and outs of the technology, our entire solution can be delivered completely remotely. Clients don’t want to go out and engage as much as they used to. We’re seeing more of that. So you have to find ways to connect with your client in order to move the needle to get what you need done in order to get the solution deployed to them. So the tools that are out there and what you can do, even with things like Teams and Zoom and sharing folders and sharing information and checking in and out documents really makes a huge difference. And having that clearly outlined in your methodology, step-by-step, and making sure that you’ve proven it, you’ve tested it before, you engage with the client so they see the confidence and your ability to execute and deliver is very important.

John Farkas:

Such a good point. Laura, I can… [inaudible 00:17:36] so many ways I’ve learned this personally and I know that it’s echoed in what I am hearing you say, don’t assume things, don’t assume knowledge and familiarity. You’re dealing with a group of people who are absolutely inundated with systems, processes, frameworks that they have to somehow assimilate, internalize, understand, and carry forward. They don’t have capacity for all of it and they don’t know what you know. And you have a tremendous, as a solution provider, you have a tremendous bias. We talk about it here a lot. You have a familiarity bias that basically it’s ubiquitous to you, but that ubiquity doesn’t translate to the people that you’re talking to.

And so your ability to take a step back to imagine what it’s like to come in from ground zero and build an understanding of how we’re going to approach this implementation in a way that it’s going to ensure success and the processes and the check boxes that you’re willing to go through and work through to help demonstrate that is just going to… you might deal with somebody who can disregard 25% of it and pick up at 25% of the way down the road and then, okay, here’s what they’ve got. But then there’s people who need it from zero. And if you aren’t giving it to them, they’re not going to have the full picture. They’re not going to have the comfort or be inspired to say, okay, these guys really have it together and I’m not going to have to spend a whole lot of calories to get where I need to get. They’re going to move in, they’re going to take me where I need to go and we’re going to see success fast. That’s important.

Laura O’Toole:

And the other thing I would say is because of the virtual nature of what we’re doing, I think that you need to anticipate longer sales cycles. It’s going to be number one. The other thing that I would say is that trust is really important and you have to do the work, in my opinion, at every level of engagement to build trust with your customers. And that doesn’t happen just because I say, trust me, I have an obligation as a leader. My team has an obligation to deliver over and over and to mean what we say and say what we mean. Just like you tell your kid. And you have to have that repetition and it takes time and you have to build trust. Certainly we all have relationships where we’ve done work with customers in previous lives, so you have trust there but in order for I think a solution to get ingrained and get traction, you have to anticipate who are all the stakeholders.

It’s not just your buyer. It’s not just a person that has the ultimate yes decision. You need to engage at every level. So for a solution like Sure Test, we have a lot of work to do at the manager and the analyst level to help people feel comfortable that because this solution can give you automation, it doesn’t mean that your job is going to go away or your job’s going to be eliminated. Certainly, the solution has the opportunity to reduce FTE, but we encourage our clients to think about it in terms of replacement positions or to think about it in terms of maybe they won’t need to hire as many next year, but most importantly, so that they have a huge talent satisfier for these managers and analysts that now can go do more strategic work, engage with their customers, and work on projects that are going to be far more meaningful to them and their constituents.

And let us take over in this example, the automation of all the testing, that’s so critically important, but if we don’t engage above just our buyer or the senior leadership that we’re talking to about our solution, we have an obligation, in my opinion, to make those managers comfortable, to make those analysts comfortable because they’re the ones, once you’re signed your MSA and your statement of work, those are the people that are really going to be able to feel the benefit and where the bottom line savings is going to come in for our clients. So engage with them, make them a part of the process and that takes time and trust.

John Farkas:

Yeah, the sales cycle is not a small thing. What we’re seeing and I know you’re seeing, we’ve talked about it a few times, it’s moved from six, eight months to 18 months. It’s just the reality of it. And let’s talk about what can happen in 18 months. You start a conversation with an organization, they like you, they’re in some form a protracted procurement process and inundated with a number of other priorities that they’re trying to figure out with a constricted budget. And so you’re in a conversation and that conversation, we always say time kills deals. It is a challenge so that the clock is ticking. What you need to do and from a marketing perspective, an important thing to keep in mind, from the point that that sale starts, you are in a conversation and so are other competitors because a new competitor can launch and jump in midstream, that can happen and interrupt what you have going at any moment.

So you can’t assume, you have to nurture and actively bring along that whole… and not just your primary contact, but the opportunity you have in that 18 month window is to build affinity throughout the organization so that you can cover as many bases as you can during that time to build the kind of relationship, the kind of assurance, the kind of stakeholder buy-in so that the deal will fall your way. It’s going to take a long time. You need to use that time and not assume that just because you’ve got a good conversation going that it’s going to find its way to close in that time period. So that’s an important thing to keep in mind. It is all about nurturing and really feeding that fire.

Advice on Selling to CIOs

Laura O’Toole:

No, I completely agree. And you also have to be patient and I would encourage everybody, don’t take it personally. I think so many times people take it personally, well, I had this great rapport, they haven’t got back to me. What I’ve learned over the last couple of years is the amount of stress and challenge and competing priorities that our clients are facing are just extraordinary, beyond any measure like I said that I’ve seen, and I work primarily with CIOs and with no slight to any of the other C-suite colleagues in the health system, but I think CIOs these days have one of the absolute hardest jobs at the C-suite when you think about where our industry is going and all the competing priorities that they’re dealing with.

And I would encourage my colleagues out there on the solution side to be patient, not take things personally and always take a minute to walk a mile in their moccasins and what they’re dealing with. And I think it will give you a little pause to build that trust. And I think anytime you come from it at the place of are we putting our patients first? Are we focusing on quality and regulation and really caring about what our clients are facing? You’ll move your own window of that 18 months shorter when you’re focused on the right things in my opinion.

John Farkas:

The more you can get to know, the more you can understand, the more you can move in their stream, the better. Because you’re right, we’ve heard it from a number of the CIOs, first of all, totally agree with you. I think that they are… talk about the importance of discernment between competing priorities. It is just an exceedingly difficult challenge right now. And your ability to understand what specifically their competing priorities are and frame what you’re bringing toward how you can help solve for X is really important and understanding that they only have so many dollars and it’s not enough. They only have so much time and it’s not enough, and you are one of the things in their world that is keeping them from something else in their world that they need to do. And that’s hard, it’s a hard position.

Laura O’Toole:

And I think as a solution provider, it’s your job to not only connect the dots, but think about… if you think about their puzzle and all the pieces that they’re dealing with, where can you fit in that puzzle that might solve more than one problem, more than just your solution might be answering. So for us, as I think about it, if you think about all the application rationalization and portfolio rationalization that’s going on, with automation there’s an opportunity to help them solve that problem as well. Not just with RPA or automating processes or automating all the testing that they need to do in regression testing, but how can you use the tool set and the library in our example that we have that now has many clients in it to help look at best practices and what other puzzle pieces can your piece help impact for the problems that they’re trying to solve.

So it’s important to understand what’s on their docket globally to ask yourself, is there anything my solution can do or can I partner up with another solution? How do we all work together to put our client at the center to help them solve some of the collective problems that they’re facing? And that’s where I think you really begin to start becoming a partner, and a strategic partner to a client and not just a staff odd vendor or a widget or a solution that they use for a period of time. That’s how you build partnership and trust over time is thinking out of the box and being creative and getting to know them and know what’s keeping them up at night and who might we all know in the industry that might be able to help them, a solution that they maybe aren’t aware of that’s out there, it’s about taking the approach that everybody can win. I believe everybody can win.

John Farkas:

Yeah, and I think that that partnership element is a really great note, and it’s something to consider even in marketing initiatives, how can you bring a couple different entities together that have clearly complimentary solutions to communicate a story that is compelling to an organization? What can that look like? I know that you guys have worked with that in the context of Keysight, right? It’s clearly a platform that you do well to work alongside, and you guys have done some combined initiatives that help simplify and in a context where a number of health systems already own that platform and you’re able to come in and make it more valuable.

Laura O’Toole:

Exactly.

John Farkas:

That’s a great opportunity to look for win win win scenarios for sure.

Laura O’Toole:

Yep, exactly.

Trends, Solutions, and Technologies That Impress Laura

John Farkas:

So knowing your broad perspective on the market and your experience and how you’ve seen things come forward, what are some of the trends, the solutions, the technologies that you’re seeing that you’ve been most impressed with?

Laura O’Toole:

I think right now it’s all about doing anything you can to help our clients be more innovative around virtual care and making sure that those solutions are well vetted, well tested, so that when the patient engages, that you know that they’re engaging in the way that we need them to engage and provide access to our patients, for sure. I think at the end of the day, that’s what it’s all about is helping our clients. And for me, and maybe it’s just because I work primarily with CIOs, but helping them get a win, helping them be able to pump their own chest a little bit, because I think they need it to say we did this innovative work and how can… what we’ve done help our colleagues. There’s so many niche vendors. I really believe in Vibe and I love the platform of Vibe and a lot of the new technologies that are coming to play.

There’s so many, John that I just think it depends on what the client is trying to solve. I really do. And I think they need to be thoughtful in terms of making sure that what they’re buying is going to solve for the problem that’s at hand. But from my perspective, it’s really around innovation. It’s around automation. Obviously we’re hearing a ton about AI, but I think right now what clients are most faced with are their provider networks and access to care and making sure that they’re figuring out the virtual care landscape so they can take their own market, take more market share. It’s a fight out there for our clients to make sure that they-

John Farkas:

No doubt.

Laura O’Toole:

… keep and they retain their patients. So I think patient engagement and alignment around provider networks and the whole interoperability play and making sure that where we can share information, we start to share it. I think Epic’s doing some cool things. I wasn’t at UGM, but I heard a lot of folks were there and quite a bit of innovation certainly coming out of UGM.

John Farkas:

So let’s talk a little bit about interoperability for a minute because I know it is certainly an area that is one of the bigger challenges that we’re facing and one of the bigger opportunities. How should tech companies prioritize the data exchange and integration, how they need to communicate that? What are some of the essentials and the things to hold pretty far forward?

Laura O’Toole:

I think they need to think about regulatory first and patient experience second. And I think anything unrelated to that is probably secondary and making sure that the alignment of where the integration is coming from is culturally aligned with where they are and making sure that those standards are in place for what’s opting in and what’s opting out. But to me, first and foremost, we should be leading with regulatory and patient experience.

We talked about this, I just went through this last week with my aunt. I know I told you she passed away and it was absolutely deplorable to me. I knew for a fact that she had had a CT scan the end of May, and I’m her healthcare proxy, I had access to her portal. I knew she had had that test, and I’m in the hospital down the street from where she had the test and they are insisting to me, nope, she hasn’t had a CT of the abdomen since 2019. Nope, that’s not accurate. When I tell you I literally had to drive to the imaging center, get a copy of the films, get the report and bring it back and have it scanned into her portal, that’s a problem. That’s a-

John Farkas:

That’s a big problem.

Laura O’Toole:

… big problem.

John Farkas:

And it happens every single day.

Laura O’Toole:

Exactly right. So I think regulatory and patient experience, and those should be the drivers.

Becoming Enterprise-Ready

John Farkas:

Yep, that’s a good underscore there. When we think about… we work with a lot of early stage companies and we see a number of very aspirational claims that they’re wanting to make about their enterprise readiness. So let’s talk a little bit about enterprise readiness because I’m sure that you’ve seen some different things about how organizations, how companies have approached that and with some wins and losses. But when somebody is interested, when an organization’s interested in truly being enterprise ready, what does that mean and what do they need to be considering in how they’re communicating their abilities and what actually is manifest?

Laura O’Toole:

I think that they need to do the work to make sure that they have all the compliance and security cornerstones of the building in place so that a health system is completely comfortable, that if there’s an intersection between that infrastructure that their patients are not going to be put at any risk. So from my perspective, that’s first and foremost. You have to be able to very clearly demonstrate that you’re aware of the compliance issues, you’re aware of the regulatory requirements, that you can demonstrate that you have a strong and secure infrastructure and that you can be an extension of protecting their patients. So you have to be able to very easily, there’s questionnaires that all of our clients send to every solution provider. Make sure you can honestly and ethically answer all those questions. And if you can’t, spend the money to put in place what you need to put in place in order to serve our clients at the enterprise level.

John Farkas:

Yeah, we hear this often, you can’t afford a failed implementation.

Laura O’Toole:

Correct.

John Farkas:

There’s too much competition. There’s too many people talk to too many people in this field. If you end up falling down when you’re trying to stand it up, it’s going to get found out and it’s going to really hurt you.

Laura O’Toole:

John, you know this about Sure Test, we were very purposeful in our growth. We started with three pilot clients. We wanted to make sure that we knew we could deliver. We were careful in how we scaled our growth. We had the opportunity to bring on more clients faster, and we wanted to make absolute sure that our frameworks and our libraries and the way that we approach the automation to really deliver speed to value was rock solid. And we took the time that we had to take to have absolute confidence to then take it to the market in a big way. And obviously you helped us along that journey, but you don’t double your growth year over year without spending money to make sure that you have put the controls and the quality in place, and quite frankly, even hiring a head of demand to make sure that you will not slip up in terms of the delivery.

John Farkas:

The only thing more expensive than doing what you need to do to get where you need to get in that realm is not doing it.

Laura O’Toole:

Exactly right.

John Farkas:

Because not doing it will be the failure of your organization.

Laura O’Toole:

Exactly.

John Farkas:

Or close to it.

Laura O’Toole:

And it’s hard, you have to choose where you spend your money, especially when you’re a new company. Sure Test celebrates its third year as a totally separate standalone company. We’ve been doing this for years before, obviously as a part of another company in a business unit, but as a standalone company, we’re about to hit our third year. And there’s things that you do in the first six months, in the first year and the second year, and by the time you get to year three, you, if you’ve spent the right amount of money in terms of building out your infrastructure, getting the right talent on board, leveraging the tools that you need in order to get your message to market, documenting your message and testing your methodology, then you can really begin to soar. And we would not have been able to have a hundred percent growth year over year without that investment and you have to be willing to make it. You can’t do it on a shoestring and do it well.

John Farkas:

Yeah. And so something to camp out on here for just a second is what that means in the context of marketing, because how are you going to explain and inspire and demonstrate the kind of confidence that you have in how you’re going to make this happen? How do you bring that across? A part of it is… with very well articulated case studies that with customers who are willing to stand up on your behalf and say, yeah, they’re the real deal, and this was a waltz. This really went well and exceeded my expectations for how we would implement it, and the results have been fantastic. Now the trick is you really need that backdrop. You need those clients. And so it is really worth investing, especially for those companies who are on the early stage of this. Laura, I know with Sure Test you guys bent over backwards in those first clients that you had to make sure that they were well served because you knew the value of that.

Laura O’Toole:

And honestly, for me, John personally, you know how I feel about my clients, we bend over for every client because my goal is to have a hundred percent referenceable clients. So certainly in those early first clients, as we were working things out, I agree with you, it was increasingly important, but as I think back to the day when we did our discovery session, you have a term for it. I forget what you call it. What’s it called when we do that?

John Farkas:

Productized onboarding.

Laura O’Toole:

The whole session where we literally lock ourselves in a room and get challenged to make sure that we have heard our clients and that-

John Farkas:

Oh, you’re talking about the buyer matrix?

Laura O’Toole:

Yeah, the buyer matrix.

John Farkas:

The buyer matrix piece.

Laura O’Toole:

We have packaged our messaging well, and that from that buyer matrix, everything builds on it. So you make sure that you have your client testimonials, you have your white papers, you have your quotes from your clients. That’s a hard thing to get from clients these days. Again, it’s not personal. They’re busy. So to my earlier point, it’s about trust. It’s about making sure your clients feel like they’re winning and are really getting something out of your solution so they feel compelled to give you that white paper or to give you that reference. And it takes time, it takes energy, it takes marketing dollars to keep them engaged and it’s an important journey.

It’s almost like… just like we talk about our library like Lincoln Logs and Legos and why that framework is so efficient. It’s the same thing with this when you think about the methodology of launching a company and getting it from where we were to where we are now, you have to think about where are all those little Lego pieces that you need to stack up simultaneously to make sure that you get to the end game and you have to have a plan. You can’t just wing that.

John Farkas:

Yeah, no doubt. It is really important. And what I know is for you personally, I know every client is a first client, and I think the thing that is important to keep in mind, to get that flywheel rolling, it does take some initial really intentional, hard work on the front end to build those stories and ensure that you have them. It gets easier the more you do because those methodologies become more sure, they become more well-founded. You get the process rolling, but you can’t afford to assume knowledge and understanding on the part of those clients. They need to be shown. They need to be told, they need friends that they know that have implemented it, or at least people they recognize and respect that they can look at and say, okay, if they did it, I can call them up and ask. And that’s just so important in the space.

Laura O’Toole:

And I know you’ve heard Mark Scruggs, our president say, my colleague, for a long, long time, it’s the law of 3, 6, 10. You need your first three, then you have six, then you have 10 clients. We’re well past that for us, but once you get those 10 clients and you’ve done all that work to set up a machine to get those references, then your solution will start to get so much energy, I think, in the market and people will begin to talk about it. And I think you also have to be comfortable.

I’m a firm believer the most disarming thing you can say to another person is, I need your help. And if you’ve taken the time to do right by your clients, to deliver quality, to measure the ROI, to show them, I mean what I say, and I say what I mean, I think you earn the right to go to that client and say, hey, I need your help, and will you be a reference for me? And will you talk to so-and-so? And if you’ve done your part and you’ve built that trust, at least my clients say, sure, Laura, happy to help. And that’s where you want to get to but that takes energy and time and it’s a process.

John Farkas:

It comes down to something we talk about all the time in the context of ratio. It’s really important as you approach the market that you are not jumping into the hero seat. You are really working hard to hand the hero seat, to assign your client the role of the hero. Who you’re selling into, they need to know that you’re going to make them a hero.

Laura O’Toole:

Exactly right.

John Farkas:

Because the minute you make them a hero, you make them an advocate of yours.

Laura O’Toole:

And they deserve it. So they’re the one that’s made the decision, hey, I’m going to take a chance on this innovation. I believe in this, then they deserve it. We do QBRs, quarterly business reviews with all of our clients, and Mark and Steve [inaudible 00:46:22] right now flying to go see one. And I looked at the deck and I was just so happy to see that the main portion of the deck was, yeah, here’s the dashboards, here’s all the metrics, here’s all the things we’ve done. But at the end of the day, bravo to our client sponsor, in this case her name is Nikki, but bravo.

John Farkas:

Way to go, Nikki.

Laura O’Toole:

Way to go Nikki, [inaudible 00:46:49], bravo to her because she has led this innovation with us and she has engaged, she has told us what she thought. She has listened, she has helped us solve problems. If we needed a quick answer and somebody wasn’t responding, whatever, but she’s the hero, she should be the one that gets to stand up and say, what used to take us 20,000 hours a year is no more. And we use that for this, this, and this. And the client deserves the credit. We’re a little piece of the puzzle to help get them there, but they deserve the credit.

Ethical Considerations with Generative AI

John Farkas:

One of the things that I appreciate about Laura O’Toole is that… you just heard her passion around this. She’s a big chunk of why she does what she does is because there are lives to be saved, there are people to help along the care path, and there are providers, clinicians, working every day to make that possible and struggling to make that happen. And when we can relieve part of that burden, there’s no better story than the opportunity to help in that process. It’s why Ratio does what we do and why we’re excited to be and to partner with organizations like Sure Test to help see that happen. But I know that that’s a big part of your heartbeat, Laura, I appreciate you for that.

Laura O’Toole:

It is indeed.

John Farkas:

Kind of tied to that, I know that we are in this crazy era right now of the birth of generative AI. I know it’s an area you spent some time and looked at. I know that a big part of what you’re doing has to do with automation and turning a lot of trust and control over to quote-unquote, “the machine”. And so talk some about the ethical considerations that we’re looking at now. Knowing that healthcare is an industry where ethical considerations are paramount, what do tech companies need to be aware of and align with regarding guidelines? How do we need to be looking at that stuff?

Laura O’Toole:

Well, again, I think it goes down to regulatory and patient experience and always keeping the patient safe and making sure that the measures around quality that remain stay intact with solutions that are AI based. And I got to say, I use ChatGPT now every day administratively, I would say I do something with it every day. It helps me think of a phrase, there’s a host of things that we use it for. For a company like Sure Test, there’s a real opportunity. One of the things I love about our library is that if we have a client that comes on board and they are doing a particular workflow in 50 steps, and we know we have another client de-identified in our library that’s doing it in 20 steps, we want to be able to share that best practice with our client.

There’s an opportunity for an AI component to help us get there faster for our clients, and we’re using that and we will use that. But at the same time, there’s boundaries and guardrails around everything. And when it comes to patient care, I think there’s a tremendous opportunity in terms of helping providers with information that AI can be a catalyst for. I think there needs to be measure and guardrails around making sure that we’re not letting AI take the place of those critical components that someone feels, or even a physician’s hunch by some of the things that they’ve seen in their career. Once they look at all the data, they’ve got experiences. You can’t take away people’s experiences and how valuable experience is I think in relation to AI.

So my hope and encouragement for this technology is that it gives us a boost. It gives us a layup. It’s like a piggyback, but it’s not everything. And we need to have caution. And I think we have a fiscal responsibility, an ethical responsibility. Every one of us that uses AI needs to be completely comfortable in the mode that we’re using it and in the environment that we’re using it, and that it’s only going to be for the betterment and not do harm. And I think the ethics come into place if you’re continually asking yourself that question, making sure you’re balancing the regulatory and quality requirements that exist in our industry.

John Farkas:

Yeah, probably worth underscoring. I think it’s an important endeavor right now for any health tech company and any healthcare organization that is using or touching AI to frame a policy around it.

Laura O’Toole:

Exactly.

John Farkas:

That is clearly articulated, that lets people know how you are viewing and how you’re using the technology. What are the guardrails you’ve established for your organization, for your company that you’re going to abide by and put that out there so that people can see, know, understand, and learn from it, because that’s an important thing. We have to help people know how to think about this. We have to let them know how we are addressing it. And I think that that’s a critical component and something I know is in process in a lot of organizations, a few that I know of that have established it and something that I think we all need to be thinking about in some form or fashion. Any of us who are touching patient care need to be aware of. 

Closing Thoughts

John Farkas:

Laura, just real quick as we conclude here, I have a couple curiosities. I know that the channels that you’re tuned into are many of the same channels a number of our providers are tuned into. Where are you learning from? What are some of the conferences, the media channels, the publications that you are taking in regularly?

Laura O’Toole:

Yeah, so for me, obviously, I think LinkedIn has actually got a ton better in terms of even the articles that are out there. Obviously, I’m an avid reader of the Wall Street Journal and Harvard Business Review, but certainly I think Vibe has done a great job, Becker’s, these are publications and articles that I engage with on a daily basis. I think as you know, we’ve got really ingrained with Bill Russell and this Week Health, I love his story and I love his mission. His goal is to leave his career making healthcare technology leaders better and to bring up the next set of leaders and to make sure that they’re educated with what’s happening in our industry day in and day out. I think he does a great job of that. I listen to his podcast all the time. I’m involved a lot in his podcast. So that’s another area. I get Modern Healthcare electronically. I certainly read that all the time, but that’s probably where I spend the majority of my reading and engagement right now, John.

John Farkas:

Got you. Awesome. So if you have not already, as you’ve been listening to this, you want to go visit suretest.health and learn what Laura and her team are up to help automate healthcare in a lot of different ways, but certainly around the EHR and testing realm, that is where their primary focus on, and they have a lot of opportunities to help automate a lot of the administrative functions around healthcare. It’s super exciting work that they’re doing. Laura, where else can listeners follow you? You just said you’re very active in the LinkedIn realm.

Laura O’Toole:

Yeah, I’m pretty active on LinkedIn. Obviously my contact, we’re pretty transparent organization. All my contact information is out on our website and lotoole@sharetest.health, love to engage. And I mean this very sincerely for any companies that are where we were three, four years ago, I’m all about trying to help my colleagues win, and I believe we can all win, especially when you’re focused on the right things and you care about healthcare and you’re really putting your clients, and most importantly, our patients at the center.

John Farkas:

Yeah, part of the reason Laura’s here, part of the reason she’s a part of our advisory board, part of the reason I call her a friend is because she is a sincere human being who cares, and Laura, thank you for the investment you’re making in our healthcare ecosystem. Thank you for your sincerity and the willingness to come here today and share some of your backdrop and experience. I know there’s going to be a lot of value that comes from it.

Laura O’Toole:

Well, thanks John. It’s always, always great to be with you.

Transcript (custom)

Introducing Laura O’Toole and Her Healthcare Journey

John Farkas:

Welcome everybody, and we are glad that you’re joining us here today for Healthcare Market Matrix and today we have joining us in our studios is none other than the incomparable Laura O’Toole. And Laura and I have known each other for a number of years and I’m just excited to have this conversation because there’s a lot that Laura’s bringing to the table. She currently serves as the CEO of Sure Test.

And I know we’re going to talk more about what Sure Test is and does but to give you some broader context for Laura, I just don’t know another person who’s had more broad-based exposure to the world of healthcare enterprise IT implementation than she has. She comes to us with more than 30 years of experience and so has definitely seen fire and rain and even knows who wrote the song that that phrase references. She’s spent a lot of her career as a global consulting professional, strategically designing, developing and implementing transformational projects in the healthcare provider space. And so she knows operational transformation and she’s got deep expertise in human capital leadership, in client engagement and success. And I could go on and on, but I’m going to let her fill in some of those gaps here in a few minutes. So Laura, welcome to Healthcare Market Matrix.

Laura O’Toole:

Thanks, John. As always, it’s great to be with you and to talk to you and of course, thanks for aging me, but the truth is the truth I guess.

John Farkas:

Well, and we got to wear that as a badge of honor, right? Because-

Laura O’Toole:

We do indeed.

John Farkas:

… experience is a valuable tool in the crazy waters that we’re navigating these days in healthcare, so we got to own it.

Laura O’Toole:

Yep, indeed.

John Farkas:

So take us back a little bit and into your journey into the healthcare and where you are now. So how’d you get into this? How’d you find yourself into this world?

Laura O’Toole:

I found myself working in healthcare right out of college. I had the opportunity to run the front end of an emergency room and then a business office and really more on the back office operations, financial side of the house. So came up, growing up working in hospitals, and then I’m sure you remember back in the day when Y2K hit and everybody was worried about all the systems and what was going to happen when we flipped the switch. And I had the opportunity at that point to really become a traveling consultant. I don’t know if you remember the old McKesson Suite, the STAR product. So back in the day I was a patient accounting STAR guru expert. I think McKesson used to say that I knew more than a lot of their employees. So that’s kind of how I grew up on the implementation side after I was doing operational work in hospitals and then became a road warrior traveling consultant, running projects, managing big projects.

And my career kind of went from there in terms of client management, overarching client responsibility, delivery responsibility for some really, really large projects primarily around the implementation space. And I spent a little bit of time certainly working for many companies. I worked back in the day for First Consulting Group, which was in its time, a lead niche healthcare IT consulting firm. And from my perspective, one of the best out there, of course acquisitions happened and moved on, worked on my own, and then was the chief people officer and COO of another healthcare consultancy and from that we spun off Sure test and I’m now the CEO of Sure Test, but like you mentioned, kind of did a little bit of everything primarily on the implementation and client delivery side of the house though.

SureTest

John Farkas:

Yeah. So very deep experience in that interface between solution providers and the hospitals’ health systems, the organizations that are implementing those solutions. Take us into Sure Test now because that’s the new hot thing and just a tremendous solution that’s meeting a real need. So introduce us to how Sure Test is situated.

Laura O’Toole:

Yeah, well Sure Test was born really out of a service offering in a business unit in a larger consultancy that we owned and ran, and we saw the value that our clients were getting, so we spun it out as its own company, but Sure Test essentially is an automation capability to test all the workflow end user experience of the EHR, really any system application. Certainly on the enterprise level, it’s an enterprise level tool and library and proprietary library of automation that gives our clients an immediate jumpstart to take the many times up to 30,000 hours of manual labor that our clients in the health delivery space spend on testing and regression testing their electronic health record in any application really, in their enterprise applications. And Sure Test takes those manual processes and moves them to automation in a managed services capacity.

So not only do we automate and develop all the automation, we maintain it ongoing for our clients, so it’s evergreen and stays fresh, so ready for every new upgrade, SU optimization, et cetera. So it was really important to us to launch this solution because we wanted to deliver something to our clients that had a meaningful ROI and provided real value, and particularly at this time in the staffing crisis and what our clients are dealing with, be able to give them back time, energy, and allow our clients the opportunity to work on more strategic projects than testing. So we take that headache completely away.

John Farkas:

And it’s just such a tremendous savings. And at a moment where resources for health systems are at a premium, there’s no substituting, there’s no way to underscore the importance enough of being able to redeem clinicians’ time and get them back on the floor, help make IT resources go farther, be more efficient, all of that right now is absolutely critical. And Sure Test is really at the nexus of that.

Laura on Providing Value-Driven Solutions

John Farkas:

I’m very curious, Laura, knowing that you’ve lived as a professional intermediary for a long time between solution providers and health systems, and now you’ve moved onto the solution provider realm, what’s been some of the biggest realizations that you’ve had in that move? What’s the difference between the consultant role and really working to connect the dots for organizations and now moving into the solution provider?

Laura O’Toole:

Yeah, if you think about it, if you’re a consultant or you’re doing consulting work or staff augmentation work or you’re coming in and just working on a project, my biggest struggle with that whole landscape and although I did it for many years, is that you go in and you help a client for a period of time, but a lot of times you take the information with you and nothing ever gets left for the client, in my opinion, when you’re thinking about either straight staff augmentation and certainly there’s huge value add in helping in that implementation and getting them to where they need to go. But I think when you bring a solution and a real managed solution that can literally give them back 300% in an ROI and make a difference for their staff day in and day out, and when they look in the rearview mirror, it’s doing it over time.

And when you can deliver something that you know works and you’re so confident in the delivery that you can deliver it at a fixed fee price, that to me is real value to a client. And I think those of us that are in the market that are really trying to listen to our client’s needs and bring full solutions that solve a specific problem is what it’s about. And I think it’s really important to meet your clients where they’re at and listen to them and understand what the biggest pain points are. And I think that those solutions that are solving a pain point are the ones that have the chance of winning.

John Farkas:

Yeah, we hear that very frequently in the context of the conversations that we’re having. First of all, super important to have a very clear, well-defined, well articulated value framework. You’ve got to know what value you are really providing for the organizations that you’re talking to, and you have to know the organizations you’re talking to, which is a problem for marketing, right? Because we want to come up with one big message that sort of blankets the whole thing.

And every health system, every hospital, every organization around healthcare is slightly different or a lot different. And the ability to kind of frame and tailor those messages, to really meet the specific needs or the challenges that an organization might be facing is an important piece. And figuring out how to discern that and how to target those messages effectively ends up being really an important component. As you look at how you have learned to listen, as you’ve learned to get around those problems and solutions, any insight or any suggestions for organizations trying to figure out how to zero in on that value proposition and what they’re going to be able to bring?

Laura O’Toole:

Yeah. Well, I think what you said is really important. You absolutely have to have a very clear message, a clear value proposition, and this day and age, especially when you look at the struggles that our healthcare partners are having and all the budget constraints that they have, you have to have a demonstrable ROI and you have to be able to help them see the path to get there. I think that’s probably-

John Farkas:

And not a vague ROI, a very specific, well-

Laura O’Toole:

Measurable-

John Farkas:

… documented, measurable-

Laura O’Toole:

Measurable ROI.

John Farkas:

… ROI.

Laura O’Toole:

I would say that’s the first thing. I think that the second thing is that you need to be very sensitive to the pressures that our clients are feeling because it’s like nothing I’ve ever seen in my 30 years of doing this work. And you have to walk into it saying, how can I make this lift lighter for them? What can we do? How crisp can our methodology be? You have to have a very clear methodology and implementation strategy around your solution.

And for us, it’s been really important to have a client success manager along the way from… even through the sales cycle out to the other side of success that really is a conduit and a liaison to help them help themselves get coordinated enough to get you as the solution partner the information that you need because typically it’s not that much that you need from the client, but their time is important and you have to recognize how important their time is. So I think listening, having a good methodology and a framework in order to get the solution quickly implemented so that they can start seeing the immediate value is really important. We have to help not kick the can down the road, if you know what I mean.

Inspiring Confidence in Your Solution

John Farkas:

Let’s dive deeper into methodology because I think that that’s an important thing and something that I often see missing. It’s one thing to have a solution, but it’s not enough. You have to have a very clear idea of how you’re going to apply that solution in a multivariate context, in context that could look a number of different ways. And so you have to have a methodology that is going to accommodate that to help ensure success. Talk about that some and how have you done that with Sure Test and what are some suggestions you would have for organizations that are wanting to bring that forward in a way… maybe farther up in their messaging and how they’re approaching things in ways that would help inspire confidence?

Laura O’Toole:

Yeah, I think you need to be able to demonstrate through technology how easy it is to connect and get people engaged. So I think… John, you and I have talked about this before. We’ve talked a lot about COVID and what that has done to the industry, but in my opinion for healthcare, the one thing that COVID did is made us as an industry move and move faster. It used to take us as an industry, in my opinion, so much longer to get things done. And we had to learn very quickly that you don’t have to see, touch, feel every person in every widget in order to be successful. And so on the heels of that, we had the opportunity to really do some creative things because so many of our colleagues are either working from home, the days of the big brick and mortar, even clients that have hybrid approaches, they’re not there all the time.

So I think you have to have a very clear documented framework on how you’re going to engage. And I know that seems so simple, but just the ins and outs of the technology, our entire solution can be delivered completely remotely. Clients don’t want to go out and engage as much as they used to. We’re seeing more of that. So you have to find ways to connect with your client in order to move the needle to get what you need done in order to get the solution deployed to them. So the tools that are out there and what you can do, even with things like Teams and Zoom and sharing folders and sharing information and checking in and out documents really makes a huge difference. And having that clearly outlined in your methodology, step-by-step, and making sure that you’ve proven it, you’ve tested it before, you engage with the client so they see the confidence and your ability to execute and deliver is very important.

John Farkas:

Such a good point. Laura, I can… [inaudible 00:17:36] so many ways I’ve learned this personally and I know that it’s echoed in what I am hearing you say, don’t assume things, don’t assume knowledge and familiarity. You’re dealing with a group of people who are absolutely inundated with systems, processes, frameworks that they have to somehow assimilate, internalize, understand, and carry forward. They don’t have capacity for all of it and they don’t know what you know. And you have a tremendous, as a solution provider, you have a tremendous bias. We talk about it here a lot. You have a familiarity bias that basically it’s ubiquitous to you, but that ubiquity doesn’t translate to the people that you’re talking to.

And so your ability to take a step back to imagine what it’s like to come in from ground zero and build an understanding of how we’re going to approach this implementation in a way that it’s going to ensure success and the processes and the check boxes that you’re willing to go through and work through to help demonstrate that is just going to… you might deal with somebody who can disregard 25% of it and pick up at 25% of the way down the road and then, okay, here’s what they’ve got. But then there’s people who need it from zero. And if you aren’t giving it to them, they’re not going to have the full picture. They’re not going to have the comfort or be inspired to say, okay, these guys really have it together and I’m not going to have to spend a whole lot of calories to get where I need to get. They’re going to move in, they’re going to take me where I need to go and we’re going to see success fast. That’s important.

Laura O’Toole:

And the other thing I would say is because of the virtual nature of what we’re doing, I think that you need to anticipate longer sales cycles. It’s going to be number one. The other thing that I would say is that trust is really important and you have to do the work, in my opinion, at every level of engagement to build trust with your customers. And that doesn’t happen just because I say, trust me, I have an obligation as a leader. My team has an obligation to deliver over and over and to mean what we say and say what we mean. Just like you tell your kid. And you have to have that repetition and it takes time and you have to build trust. Certainly we all have relationships where we’ve done work with customers in previous lives, so you have trust there but in order for I think a solution to get ingrained and get traction, you have to anticipate who are all the stakeholders.

It’s not just your buyer. It’s not just a person that has the ultimate yes decision. You need to engage at every level. So for a solution like Sure Test, we have a lot of work to do at the manager and the analyst level to help people feel comfortable that because this solution can give you automation, it doesn’t mean that your job is going to go away or your job’s going to be eliminated. Certainly, the solution has the opportunity to reduce FTE, but we encourage our clients to think about it in terms of replacement positions or to think about it in terms of maybe they won’t need to hire as many next year, but most importantly, so that they have a huge talent satisfier for these managers and analysts that now can go do more strategic work, engage with their customers, and work on projects that are going to be far more meaningful to them and their constituents.

And let us take over in this example, the automation of all the testing, that’s so critically important, but if we don’t engage above just our buyer or the senior leadership that we’re talking to about our solution, we have an obligation, in my opinion, to make those managers comfortable, to make those analysts comfortable because they’re the ones, once you’re signed your MSA and your statement of work, those are the people that are really going to be able to feel the benefit and where the bottom line savings is going to come in for our clients. So engage with them, make them a part of the process and that takes time and trust.

John Farkas:

Yeah, the sales cycle is not a small thing. What we’re seeing and I know you’re seeing, we’ve talked about it a few times, it’s moved from six, eight months to 18 months. It’s just the reality of it. And let’s talk about what can happen in 18 months. You start a conversation with an organization, they like you, they’re in some form a protracted procurement process and inundated with a number of other priorities that they’re trying to figure out with a constricted budget. And so you’re in a conversation and that conversation, we always say time kills deals. It is a challenge so that the clock is ticking. What you need to do and from a marketing perspective, an important thing to keep in mind, from the point that that sale starts, you are in a conversation and so are other competitors because a new competitor can launch and jump in midstream, that can happen and interrupt what you have going at any moment.

So you can’t assume, you have to nurture and actively bring along that whole… and not just your primary contact, but the opportunity you have in that 18 month window is to build affinity throughout the organization so that you can cover as many bases as you can during that time to build the kind of relationship, the kind of assurance, the kind of stakeholder buy-in so that the deal will fall your way. It’s going to take a long time. You need to use that time and not assume that just because you’ve got a good conversation going that it’s going to find its way to close in that time period. So that’s an important thing to keep in mind. It is all about nurturing and really feeding that fire.

Advice on Selling to CIOs

Laura O’Toole:

No, I completely agree. And you also have to be patient and I would encourage everybody, don’t take it personally. I think so many times people take it personally, well, I had this great rapport, they haven’t got back to me. What I’ve learned over the last couple of years is the amount of stress and challenge and competing priorities that our clients are facing are just extraordinary, beyond any measure like I said that I’ve seen, and I work primarily with CIOs and with no slight to any of the other C-suite colleagues in the health system, but I think CIOs these days have one of the absolute hardest jobs at the C-suite when you think about where our industry is going and all the competing priorities that they’re dealing with.

And I would encourage my colleagues out there on the solution side to be patient, not take things personally and always take a minute to walk a mile in their moccasins and what they’re dealing with. And I think it will give you a little pause to build that trust. And I think anytime you come from it at the place of are we putting our patients first? Are we focusing on quality and regulation and really caring about what our clients are facing? You’ll move your own window of that 18 months shorter when you’re focused on the right things in my opinion.

John Farkas:

The more you can get to know, the more you can understand, the more you can move in their stream, the better. Because you’re right, we’ve heard it from a number of the CIOs, first of all, totally agree with you. I think that they are… talk about the importance of discernment between competing priorities. It is just an exceedingly difficult challenge right now. And your ability to understand what specifically their competing priorities are and frame what you’re bringing toward how you can help solve for X is really important and understanding that they only have so many dollars and it’s not enough. They only have so much time and it’s not enough, and you are one of the things in their world that is keeping them from something else in their world that they need to do. And that’s hard, it’s a hard position.

Laura O’Toole:

And I think as a solution provider, it’s your job to not only connect the dots, but think about… if you think about their puzzle and all the pieces that they’re dealing with, where can you fit in that puzzle that might solve more than one problem, more than just your solution might be answering. So for us, as I think about it, if you think about all the application rationalization and portfolio rationalization that’s going on, with automation there’s an opportunity to help them solve that problem as well. Not just with RPA or automating processes or automating all the testing that they need to do in regression testing, but how can you use the tool set and the library in our example that we have that now has many clients in it to help look at best practices and what other puzzle pieces can your piece help impact for the problems that they’re trying to solve.

So it’s important to understand what’s on their docket globally to ask yourself, is there anything my solution can do or can I partner up with another solution? How do we all work together to put our client at the center to help them solve some of the collective problems that they’re facing? And that’s where I think you really begin to start becoming a partner, and a strategic partner to a client and not just a staff odd vendor or a widget or a solution that they use for a period of time. That’s how you build partnership and trust over time is thinking out of the box and being creative and getting to know them and know what’s keeping them up at night and who might we all know in the industry that might be able to help them, a solution that they maybe aren’t aware of that’s out there, it’s about taking the approach that everybody can win. I believe everybody can win.

John Farkas:

Yeah, and I think that that partnership element is a really great note, and it’s something to consider even in marketing initiatives, how can you bring a couple different entities together that have clearly complimentary solutions to communicate a story that is compelling to an organization? What can that look like? I know that you guys have worked with that in the context of Keysight, right? It’s clearly a platform that you do well to work alongside, and you guys have done some combined initiatives that help simplify and in a context where a number of health systems already own that platform and you’re able to come in and make it more valuable.

Laura O’Toole:

Exactly.

John Farkas:

That’s a great opportunity to look for win win win scenarios for sure.

Laura O’Toole:

Yep, exactly.

Trends, Solutions, and Technologies That Impress Laura

John Farkas:

So knowing your broad perspective on the market and your experience and how you’ve seen things come forward, what are some of the trends, the solutions, the technologies that you’re seeing that you’ve been most impressed with?

Laura O’Toole:

I think right now it’s all about doing anything you can to help our clients be more innovative around virtual care and making sure that those solutions are well vetted, well tested, so that when the patient engages, that you know that they’re engaging in the way that we need them to engage and provide access to our patients, for sure. I think at the end of the day, that’s what it’s all about is helping our clients. And for me, and maybe it’s just because I work primarily with CIOs, but helping them get a win, helping them be able to pump their own chest a little bit, because I think they need it to say we did this innovative work and how can… what we’ve done help our colleagues. There’s so many niche vendors. I really believe in Vibe and I love the platform of Vibe and a lot of the new technologies that are coming to play.

There’s so many, John that I just think it depends on what the client is trying to solve. I really do. And I think they need to be thoughtful in terms of making sure that what they’re buying is going to solve for the problem that’s at hand. But from my perspective, it’s really around innovation. It’s around automation. Obviously we’re hearing a ton about AI, but I think right now what clients are most faced with are their provider networks and access to care and making sure that they’re figuring out the virtual care landscape so they can take their own market, take more market share. It’s a fight out there for our clients to make sure that they-

John Farkas:

No doubt.

Laura O’Toole:

… keep and they retain their patients. So I think patient engagement and alignment around provider networks and the whole interoperability play and making sure that where we can share information, we start to share it. I think Epic’s doing some cool things. I wasn’t at UGM, but I heard a lot of folks were there and quite a bit of innovation certainly coming out of UGM.

John Farkas:

So let’s talk a little bit about interoperability for a minute because I know it is certainly an area that is one of the bigger challenges that we’re facing and one of the bigger opportunities. How should tech companies prioritize the data exchange and integration, how they need to communicate that? What are some of the essentials and the things to hold pretty far forward?

Laura O’Toole:

I think they need to think about regulatory first and patient experience second. And I think anything unrelated to that is probably secondary and making sure that the alignment of where the integration is coming from is culturally aligned with where they are and making sure that those standards are in place for what’s opting in and what’s opting out. But to me, first and foremost, we should be leading with regulatory and patient experience.

We talked about this, I just went through this last week with my aunt. I know I told you she passed away and it was absolutely deplorable to me. I knew for a fact that she had had a CT scan the end of May, and I’m her healthcare proxy, I had access to her portal. I knew she had had that test, and I’m in the hospital down the street from where she had the test and they are insisting to me, nope, she hasn’t had a CT of the abdomen since 2019. Nope, that’s not accurate. When I tell you I literally had to drive to the imaging center, get a copy of the films, get the report and bring it back and have it scanned into her portal, that’s a problem. That’s a-

John Farkas:

That’s a big problem.

Laura O’Toole:

… big problem.

John Farkas:

And it happens every single day.

Laura O’Toole:

Exactly right. So I think regulatory and patient experience, and those should be the drivers.

Becoming Enterprise-Ready

John Farkas:

Yep, that’s a good underscore there. When we think about… we work with a lot of early stage companies and we see a number of very aspirational claims that they’re wanting to make about their enterprise readiness. So let’s talk a little bit about enterprise readiness because I’m sure that you’ve seen some different things about how organizations, how companies have approached that and with some wins and losses. But when somebody is interested, when an organization’s interested in truly being enterprise ready, what does that mean and what do they need to be considering in how they’re communicating their abilities and what actually is manifest?

Laura O’Toole:

I think that they need to do the work to make sure that they have all the compliance and security cornerstones of the building in place so that a health system is completely comfortable, that if there’s an intersection between that infrastructure that their patients are not going to be put at any risk. So from my perspective, that’s first and foremost. You have to be able to very clearly demonstrate that you’re aware of the compliance issues, you’re aware of the regulatory requirements, that you can demonstrate that you have a strong and secure infrastructure and that you can be an extension of protecting their patients. So you have to be able to very easily, there’s questionnaires that all of our clients send to every solution provider. Make sure you can honestly and ethically answer all those questions. And if you can’t, spend the money to put in place what you need to put in place in order to serve our clients at the enterprise level.

John Farkas:

Yeah, we hear this often, you can’t afford a failed implementation.

Laura O’Toole:

Correct.

John Farkas:

There’s too much competition. There’s too many people talk to too many people in this field. If you end up falling down when you’re trying to stand it up, it’s going to get found out and it’s going to really hurt you.

Laura O’Toole:

John, you know this about Sure Test, we were very purposeful in our growth. We started with three pilot clients. We wanted to make sure that we knew we could deliver. We were careful in how we scaled our growth. We had the opportunity to bring on more clients faster, and we wanted to make absolute sure that our frameworks and our libraries and the way that we approach the automation to really deliver speed to value was rock solid. And we took the time that we had to take to have absolute confidence to then take it to the market in a big way. And obviously you helped us along that journey, but you don’t double your growth year over year without spending money to make sure that you have put the controls and the quality in place, and quite frankly, even hiring a head of demand to make sure that you will not slip up in terms of the delivery.

John Farkas:

The only thing more expensive than doing what you need to do to get where you need to get in that realm is not doing it.

Laura O’Toole:

Exactly right.

John Farkas:

Because not doing it will be the failure of your organization.

Laura O’Toole:

Exactly.

John Farkas:

Or close to it.

Laura O’Toole:

And it’s hard, you have to choose where you spend your money, especially when you’re a new company. Sure Test celebrates its third year as a totally separate standalone company. We’ve been doing this for years before, obviously as a part of another company in a business unit, but as a standalone company, we’re about to hit our third year. And there’s things that you do in the first six months, in the first year and the second year, and by the time you get to year three, you, if you’ve spent the right amount of money in terms of building out your infrastructure, getting the right talent on board, leveraging the tools that you need in order to get your message to market, documenting your message and testing your methodology, then you can really begin to soar. And we would not have been able to have a hundred percent growth year over year without that investment and you have to be willing to make it. You can’t do it on a shoestring and do it well.

John Farkas:

Yeah. And so something to camp out on here for just a second is what that means in the context of marketing, because how are you going to explain and inspire and demonstrate the kind of confidence that you have in how you’re going to make this happen? How do you bring that across? A part of it is… with very well articulated case studies that with customers who are willing to stand up on your behalf and say, yeah, they’re the real deal, and this was a waltz. This really went well and exceeded my expectations for how we would implement it, and the results have been fantastic. Now the trick is you really need that backdrop. You need those clients. And so it is really worth investing, especially for those companies who are on the early stage of this. Laura, I know with Sure Test you guys bent over backwards in those first clients that you had to make sure that they were well served because you knew the value of that.

Laura O’Toole:

And honestly, for me, John personally, you know how I feel about my clients, we bend over for every client because my goal is to have a hundred percent referenceable clients. So certainly in those early first clients, as we were working things out, I agree with you, it was increasingly important, but as I think back to the day when we did our discovery session, you have a term for it. I forget what you call it. What’s it called when we do that?

John Farkas:

Productized onboarding.

Laura O’Toole:

The whole session where we literally lock ourselves in a room and get challenged to make sure that we have heard our clients and that-

John Farkas:

Oh, you’re talking about the buyer matrix?

Laura O’Toole:

Yeah, the buyer matrix.

John Farkas:

The buyer matrix piece.

Laura O’Toole:

We have packaged our messaging well, and that from that buyer matrix, everything builds on it. So you make sure that you have your client testimonials, you have your white papers, you have your quotes from your clients. That’s a hard thing to get from clients these days. Again, it’s not personal. They’re busy. So to my earlier point, it’s about trust. It’s about making sure your clients feel like they’re winning and are really getting something out of your solution so they feel compelled to give you that white paper or to give you that reference. And it takes time, it takes energy, it takes marketing dollars to keep them engaged and it’s an important journey.

It’s almost like… just like we talk about our library like Lincoln Logs and Legos and why that framework is so efficient. It’s the same thing with this when you think about the methodology of launching a company and getting it from where we were to where we are now, you have to think about where are all those little Lego pieces that you need to stack up simultaneously to make sure that you get to the end game and you have to have a plan. You can’t just wing that.

John Farkas:

Yeah, no doubt. It is really important. And what I know is for you personally, I know every client is a first client, and I think the thing that is important to keep in mind, to get that flywheel rolling, it does take some initial really intentional, hard work on the front end to build those stories and ensure that you have them. It gets easier the more you do because those methodologies become more sure, they become more well-founded. You get the process rolling, but you can’t afford to assume knowledge and understanding on the part of those clients. They need to be shown. They need to be told, they need friends that they know that have implemented it, or at least people they recognize and respect that they can look at and say, okay, if they did it, I can call them up and ask. And that’s just so important in the space.

Laura O’Toole:

And I know you’ve heard Mark Scruggs, our president say, my colleague, for a long, long time, it’s the law of 3, 6, 10. You need your first three, then you have six, then you have 10 clients. We’re well past that for us, but once you get those 10 clients and you’ve done all that work to set up a machine to get those references, then your solution will start to get so much energy, I think, in the market and people will begin to talk about it. And I think you also have to be comfortable.

I’m a firm believer the most disarming thing you can say to another person is, I need your help. And if you’ve taken the time to do right by your clients, to deliver quality, to measure the ROI, to show them, I mean what I say, and I say what I mean, I think you earn the right to go to that client and say, hey, I need your help, and will you be a reference for me? And will you talk to so-and-so? And if you’ve done your part and you’ve built that trust, at least my clients say, sure, Laura, happy to help. And that’s where you want to get to but that takes energy and time and it’s a process.

John Farkas:

It comes down to something we talk about all the time in the context of ratio. It’s really important as you approach the market that you are not jumping into the hero seat. You are really working hard to hand the hero seat, to assign your client the role of the hero. Who you’re selling into, they need to know that you’re going to make them a hero.

Laura O’Toole:

Exactly right.

John Farkas:

Because the minute you make them a hero, you make them an advocate of yours.

Laura O’Toole:

And they deserve it. So they’re the one that’s made the decision, hey, I’m going to take a chance on this innovation. I believe in this, then they deserve it. We do QBRs, quarterly business reviews with all of our clients, and Mark and Steve [inaudible 00:46:22] right now flying to go see one. And I looked at the deck and I was just so happy to see that the main portion of the deck was, yeah, here’s the dashboards, here’s all the metrics, here’s all the things we’ve done. But at the end of the day, bravo to our client sponsor, in this case her name is Nikki, but bravo.

John Farkas:

Way to go, Nikki.

Laura O’Toole:

Way to go Nikki, [inaudible 00:46:49], bravo to her because she has led this innovation with us and she has engaged, she has told us what she thought. She has listened, she has helped us solve problems. If we needed a quick answer and somebody wasn’t responding, whatever, but she’s the hero, she should be the one that gets to stand up and say, what used to take us 20,000 hours a year is no more. And we use that for this, this, and this. And the client deserves the credit. We’re a little piece of the puzzle to help get them there, but they deserve the credit.

Ethical Considerations with Generative AI

John Farkas:

One of the things that I appreciate about Laura O’Toole is that… you just heard her passion around this. She’s a big chunk of why she does what she does is because there are lives to be saved, there are people to help along the care path, and there are providers, clinicians, working every day to make that possible and struggling to make that happen. And when we can relieve part of that burden, there’s no better story than the opportunity to help in that process. It’s why Ratio does what we do and why we’re excited to be and to partner with organizations like Sure Test to help see that happen. But I know that that’s a big part of your heartbeat, Laura, I appreciate you for that.

Laura O’Toole:

It is indeed.

John Farkas:

Kind of tied to that, I know that we are in this crazy era right now of the birth of generative AI. I know it’s an area you spent some time and looked at. I know that a big part of what you’re doing has to do with automation and turning a lot of trust and control over to quote-unquote, “the machine”. And so talk some about the ethical considerations that we’re looking at now. Knowing that healthcare is an industry where ethical considerations are paramount, what do tech companies need to be aware of and align with regarding guidelines? How do we need to be looking at that stuff?

Laura O’Toole:

Well, again, I think it goes down to regulatory and patient experience and always keeping the patient safe and making sure that the measures around quality that remain stay intact with solutions that are AI based. And I got to say, I use ChatGPT now every day administratively, I would say I do something with it every day. It helps me think of a phrase, there’s a host of things that we use it for. For a company like Sure Test, there’s a real opportunity. One of the things I love about our library is that if we have a client that comes on board and they are doing a particular workflow in 50 steps, and we know we have another client de-identified in our library that’s doing it in 20 steps, we want to be able to share that best practice with our client.

There’s an opportunity for an AI component to help us get there faster for our clients, and we’re using that and we will use that. But at the same time, there’s boundaries and guardrails around everything. And when it comes to patient care, I think there’s a tremendous opportunity in terms of helping providers with information that AI can be a catalyst for. I think there needs to be measure and guardrails around making sure that we’re not letting AI take the place of those critical components that someone feels, or even a physician’s hunch by some of the things that they’ve seen in their career. Once they look at all the data, they’ve got experiences. You can’t take away people’s experiences and how valuable experience is I think in relation to AI.

So my hope and encouragement for this technology is that it gives us a boost. It gives us a layup. It’s like a piggyback, but it’s not everything. And we need to have caution. And I think we have a fiscal responsibility, an ethical responsibility. Every one of us that uses AI needs to be completely comfortable in the mode that we’re using it and in the environment that we’re using it, and that it’s only going to be for the betterment and not do harm. And I think the ethics come into place if you’re continually asking yourself that question, making sure you’re balancing the regulatory and quality requirements that exist in our industry.

John Farkas:

Yeah, probably worth underscoring. I think it’s an important endeavor right now for any health tech company and any healthcare organization that is using or touching AI to frame a policy around it.

Laura O’Toole:

Exactly.

John Farkas:

That is clearly articulated, that lets people know how you are viewing and how you’re using the technology. What are the guardrails you’ve established for your organization, for your company that you’re going to abide by and put that out there so that people can see, know, understand, and learn from it, because that’s an important thing. We have to help people know how to think about this. We have to let them know how we are addressing it. And I think that that’s a critical component and something I know is in process in a lot of organizations, a few that I know of that have established it and something that I think we all need to be thinking about in some form or fashion. Any of us who are touching patient care need to be aware of. 

Closing Thoughts

John Farkas:

Laura, just real quick as we conclude here, I have a couple curiosities. I know that the channels that you’re tuned into are many of the same channels a number of our providers are tuned into. Where are you learning from? What are some of the conferences, the media channels, the publications that you are taking in regularly?

Laura O’Toole:

Yeah, so for me, obviously, I think LinkedIn has actually got a ton better in terms of even the articles that are out there. Obviously, I’m an avid reader of the Wall Street Journal and Harvard Business Review, but certainly I think Vibe has done a great job, Becker’s, these are publications and articles that I engage with on a daily basis. I think as you know, we’ve got really ingrained with Bill Russell and this Week Health, I love his story and I love his mission. His goal is to leave his career making healthcare technology leaders better and to bring up the next set of leaders and to make sure that they’re educated with what’s happening in our industry day in and day out. I think he does a great job of that. I listen to his podcast all the time. I’m involved a lot in his podcast. So that’s another area. I get Modern Healthcare electronically. I certainly read that all the time, but that’s probably where I spend the majority of my reading and engagement right now, John.

John Farkas:

Got you. Awesome. So if you have not already, as you’ve been listening to this, you want to go visit suretest.health and learn what Laura and her team are up to help automate healthcare in a lot of different ways, but certainly around the EHR and testing realm, that is where their primary focus on, and they have a lot of opportunities to help automate a lot of the administrative functions around healthcare. It’s super exciting work that they’re doing. Laura, where else can listeners follow you? You just said you’re very active in the LinkedIn realm.

Laura O’Toole:

Yeah, I’m pretty active on LinkedIn. Obviously my contact, we’re pretty transparent organization. All my contact information is out on our website and lotoole@sharetest.health, love to engage. And I mean this very sincerely for any companies that are where we were three, four years ago, I’m all about trying to help my colleagues win, and I believe we can all win, especially when you’re focused on the right things and you care about healthcare and you’re really putting your clients, and most importantly, our patients at the center.

John Farkas:

Yeah, part of the reason Laura’s here, part of the reason she’s a part of our advisory board, part of the reason I call her a friend is because she is a sincere human being who cares, and Laura, thank you for the investment you’re making in our healthcare ecosystem. Thank you for your sincerity and the willingness to come here today and share some of your backdrop and experience. I know there’s going to be a lot of value that comes from it.

Laura O’Toole:

Well, thanks John. It’s always, always great to be with you.

About Laura O'Toole

Laura currently serves as CEO of SureTest Inc. She has more than 30 years’ of experience specific to the healthcare industry. In addition to working in executive and operational leadership, she has spent time as a global consulting professional, strategically designing, developing, and implementing transformational projects in the healthcare provider space. A strategic leader specializing in Operational Transformation, Human Capital leadership, Client Engagement & Success.

Prior to serving as the CEO of SureTest and CEO of Santa Rosa and as an independent consulting leader, Laura served as a Partner of Operations for Computer Sciences Corporation (CSC), a $16 billion Fortune 500 company. Prior to CSC, she served in a global role as a Vice President of Operations for First Consulting Group (FCG), a $300 million NASDAQ-listed company serving the healthcare industry. During her tenure at FCG, she was a member of the leadership council responsible for all aspects of the sales demand and resource and delivery management life cycle. Laura lead several multi-disciplined teams while being instrumental in implementing FCG’s shared services model, the offshore sourcing integration for the service delivery and product development components of the organization.

Member of the Healthcare Financial Management Association (HFMA) and the Health Information Management Systems Society (HIMSS). Laura holds a BS degree from the University of Florida and is a Lean Sigma Expert.

A strong team builder, people developer, and coach. Often described as a motivator, a leader who creates bridges between business and IT, open-minded, positive, willing to take risks, and collaborative.

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