Podcast
The Horizon of Data and Analytics
Tod Fetherling
Managing Director, Huron
On this episode of Healthcare Market Matrix, host John Farkas is joined by Tod Fetherling for an astute conversation about the growing role of data and analytics in healthcare. Tod is Huron’s managing director of data and analytics and global products, and he has spent over three decades building a comprehensive understanding of the importance of the smart use of data in healthcare. Throughout the episode, John and Tod discuss healthcare’s changing approach to data, the importance of data literacy in healthcare today, and several of the emerging trends in healthcare data analytics.
Show Notes
(1:14) Tod’s Healthcare Journey
(8:16) Healthcare’s Changing Approach to Data
(13:25) Taking Data-Informed Action
(18:33) Educating the Target Market on the Practical Benefits of Data
(23:06) The Importance of Data Literacy and Security
(30:54) Emerging Trends in Data Analytics
(37:27) An Overview of Huron
(39:31) Upcoming Healthcare Trends
(49:02) Closing Thoughts
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Transcript
Tod’s Healthcare Journey
John Farkas:
Greetings everyone, and along with the team at Ratio, I would like to welcome you to Healthcare Market Matrix. I’m your host, John Farkas, and we are getting ready to dive headlong into the world of healthcare, data, and analytics with our guest today, who, from my vantage point, is at least one of the kings, if not the king, of the topic, J. Tod Fetherling. I first got to know Tod when he was leading the Nashville Technology Council, but I learned quickly that he carries a deep understanding of, and passion for, the importance of the smart use of data in healthcare. And had that well before it became, what I would consider, a mainstream conversation.
So personally, I don’t know anyone who has more comprehensive understanding of that arena than Tod has, and he’s been soaking in it for a lot of years. I think for over 30 years he’s been in this realm, and now is applying it as the Managing Director over data and analytics and global products at Huron. But before that, he was the founder, CEO and Chief Data Science at Perception Health, which ended up being where I got to know him. They were acquired by Huron in 2021. But prior to that, our worlds intersected most vividly, and I learned the most about his expertise, when we helped them brand and position Perception Health. But then before that, he founded another healthcare data science company called Stratasan. And I’m only going part way back. There’s more to the story, but you get the picture. It is a passion and a calling to help improve data literacy in healthcare. So Tod, welcome to Healthcare Market Matrix.
Tod Fetherling:
Thank you. It’s great to be here with you today, and I love this topic, as you know, and so excited to understand what is on people’s minds, as it relates to healthcare data. And probably more important, the innovation that we’re seeing in analytics today.
John Farkas:
Yeah, there’s a lot going on in this subject. I was just at the Becker’s conference and the panel discussion that was going on, as I was on my way to catch my plane, was about data literacy. And some of the folks up on the panel there were bemoaning the travails of helping the healthcare system into better use of data. And I know that that’s no small part of the mission you’ve been on for a long time. So, eager to dive into that a little bit, and to get your perspectives. But before we do, take us back a little bit. How did you get on this path, Tod? Talk about the journey that led you here.
Tod Fetherling:
Well, for those native Nashvillians, they’ll probably really enjoy this next story, because it’s almost like how people get in the music business. I was a bartender at O’Charley’s on Murfreesboro Road.
John Farkas:
That’s assuming there are such a thing as Nashville natives.
Tod Fetherling:
Well, that’s true. I was a bartender at O’Charley’s on Murfreesboro Road, and I had this opportunity to be a runner in a healthcare data strategic planning firm that was run by Paul Keckley. Many people listening to your podcast will be familiar with Paul. And so this was a company called the Keckley Group, 3100 West End. And so that’s how I got my first start into healthcare. They needed somebody with a market research background to run statistics on surveys, and that was my major at the University of Tennessee. And so it was a match made in heaven.
After about two weeks of being a runner, I got my first project, which was one of the craziest projects I’ve ever worked on in my entire career. And we put together some really amazing analytics over a period of five days, and presented that back to the client. We then got hired to do their strategic plan, because they liked the way we thought. That was Brim Healthcare out in Oregon. And that led to the jumping off point for healthcare data for me.
John Farkas:
Gotcha. Yeah. So from there, talk about some of those next moves. What led to the start of the companies?
Tod Fetherling:
Yeah. So from there I went up to Louisville to work for First Research, and then I was hired by my first true hospital job at Jewish Hospital, doing data and strategic planning, and then got hired by HCA. It was at HCA that I really got the bug for entrepreneurialism. I used to tell people all the time I was an entrepreneur, Rick Scott gave me a pot of money and said, “Hey, go figure out this internet thing”. The internet came on board in ’95 for whatever crazy reason the research geek got… I had a CompuServ account, so I guess that made me qualified to run the internet strategy for HCA in ’95, because there weren’t too many of us back then.
And we really looked at the internet as a database to be researched, and to interface with. And so we had a lot of luck out of the gate. Built out, I don’t know, 325 hospital websites in less than a year, using Excel macros. It was really a fun time. And that just sort of made us hungry to do this over and over again. So whenever I left HCA, started creating companies, and all of them with a central theme around trying to help people improve their health outcomes, while we reduce costs. And I’ve literally spent every day for the last 22 years trying to get that done, and I still have a long way to go.
Healthcare’s Changing Approach to Data
John Farkas:
Well, there’s plenty of room for improvement, and plenty of necessity for that right now, in our realm. I mean a big emphasis of the conference I just came from was revenue cycle, and everybody’s looking for that little bit of extra right now, in this economy, and in the situation that healthcare finds itself. So it is an important part of the equation, for sure. So if we look at healthcare, traditionally, one of the great clouds cast over healthcare is the slow pace of change. But we are in a rapidly changing landscape right now, and I’m guessing you’ve seen a dramatic difference in how the leadership of healthcare organizations understand and approach data over the last several years. How would you characterize that change?
Tod Fetherling:
Yeah, so I’d probably disagree a little bit with the pace of change. If you’re working in healthcare today, I mean it is rapid fire. The requirements that are being delivered, what is opening up around interoperability, what the federal government is driving, to get people to understand what data is already available, and what could be done with that. I think what I see in healthcare today is really a chasm. There are some significant players, like an HCA, here in Nashville. They have a partnership with Google, and they are literally pushing the edge of the envelope, in what they’re doing in that regard.
There are other providers, and unfortunately they’re more of the small independents, and that’s where I think healthcare gets its reputation is, there are limited dollars in those communities and those facilities to adopt technology, to innovate, and that’s what causes the slowness. So I think there are people, like a Vanderbilt and others, who are advanced in technology adoption and analytics. And then there are others that don’t have the resources in order to capitalize on all the great technology changes that are occurring right now.
John Farkas:
So if you look at what’s changed, and what are some of the core understandings that have been adopted over the last couple of years, where you’ve seen some of the places where you were struggling to get things across, and now is ubiquitous. What have been some of those stones that have turned over?
Tod Fetherling:
I think one area is machine learning. We have come a long way in this one category, of being able to build advanced models and operationalize those. Like at Perception Health that you mentioned, and now Huron, I’ve built 55 different disease models that do a fairly accurate job of predicting when someone is at risk of having a diagnosis for like a lung cancer. To that point, one of our partners up in West Virginia, Modern Health, they’ve taken an active role in using this model with us. And to date, we have about 811 patients’ lives that have been impacted by this model. So those are some examples that I see where people are actually using advanced technologies, in order to improve the health of their community, and lower costs at the same time.
The other area I’d probably mention is kind of around analytics. I think the majority, 85 plus percent, of what I see in analytics today, are base level, descriptive statistics. Many people have started to move up this adoption curve, from descriptive statistics to diagnostic, sort of understanding the why. And then of course the predictive, which allows us to see into the future a little bit about what’s about to happen. And then the next level will be prescriptive, which is kind of where Amazon has been already for a long time. Let’s take books for example. I order four books that you can see on my bookshelves here, and everyone else in the country who’s ordered those four books, also buy the fifth book. And so Amazon’s going to prompt me to say, “Hey, do you want this book?” And of course I’m going to say yes, because it is right in line with the learning path that I’m on.
And so wouldn’t it be great if we could do the same thing in healthcare? So you’re on this path to become diabetic. If I can get you to do this, this, and this, I can change that curve on your personal healthcare journey. We did this up in Chicago with Cigna and Matter, where you were just at across the river, and it had profound impacts. We showed evidence of about $4,000 per patient per year of cost savings, by just re-engineering the network of how they are delivering care to diabetics in that city.
Taking Data-Informed Action
John Farkas:
That’s amazing. And so if you were to say… Well, looking at how that understanding is beginning to get traction, are you seeing more people asking for the insights? Are they coming after it, or are they having to be convinced to go get it? How are you seeing that curve?
Tod Fetherling:
That is a really good question. So once again, I think, and you’re acutely aware of this, more than probably anybody else, John, but the personas are what I find differentiating on analytics, what I would call pull versus push. I have many executives who are convinced that the data’s right, and they just want the answer. Tell me the three physicians in my community I need to go talk to this afternoon, that are going to significantly impact my revenue, and the ability for me to continue to live out my mission. There are others, and I won’t name them, that want to argue with the data, instead of taking action when it’s appropriate. And so that is a real struggle for analysts, especially in my firm. I’m managing a little over 40 billion records. And so when I tell somebody, “Hey, I feel about 99% accurate on this”, and then people want to go, “Well, you’re still missing that 1%”. And I’m like, “Yep, I’m not ever going to get over that one percent”.
John Farkas:
Deal with it.
Tod Fetherling:
Yeah. And I don’t know if it may be a human nature thing, that I just haven’t sort of done enough study and design around, but I’m reminded of a quote from Colin Powell where he said, “Look, if you get me to 80% knowledge on this subject, I’m going to make a decision to move forward. I don’t have time or the luxury on the other 20%”. I do think we have a lot of hospitals and healthcare systems that are getting to that point, where if they’re going to wait for the last 20%, they’re probably going to go out of business.
John Farkas:
Yeah, well that is true. They’ve got to push. And then they’ve got to push toward it now. What are you seeing, as far as if you were to wave a magic wand and say, “Gosh, if I could instill one piece of understanding surrounding data literacy to leaders of health systems”, is there a common thread, or one thing that you… And you kind of alluded to it, part of it is, we have data, let’s trust it, right? I mean, let’s look at it. But is there any other element, or a shade there, of misunderstanding, or lack of knowledge, that you see consistently, that if you could change it it could make a big difference?
Tod Fetherling:
I always come back to taking action on the insights. If individuals can look at the data, figure out a strategy, take an action, they are way better off, all the time, from doing that. And so that becomes-
John Farkas:
Yeah, there’s an objective reality there that is just… That some people don’t want to embrace.
Tod Fetherling:
Well, and part of it is, going back to the personas, and where you are on an adoption curve. Right? So we always have the individuals who jump to the front of the line, they’re willing to test anything, and they want to be leading on innovation. There are the laggards, who are very invested in the status quo. And many times, this technology, and we can talk a little bit about Gen AI if you want, these technologies are scary to the status quo, because they’re going to change their fundamental job. And so I get that. But at the end of the day, for me, patient outcomes, reduce costs, outweighs our fear of losing our jobs. Right?
And so I can sort of go through example after example of where I think these technologies are going to be disruptive, but what we have to do as healthcare executives is constantly challenge ourselves, and use this data to make better decisions. And it’s those decisions that then are going to lead us to success in our communities. And it’s always about providing quality care to your community. If you ever lose sight of that… That’s what gets me up and excited every day to come to work, is trying to save a life.
Educating the Target Market on the Practical Benefits of Data
John Farkas:
So I’m going to jump what I had listed in the order of questions I was going to ask, because it’s what we’re talking about right now. I know a common challenge in health tech is bridging the gap between what is technically possible and what healthcare professionals believe is possible or useful. And so looking at marketing leaders, because that’s who we’re talking about here, when you have a solution that is presenting data insight, what can you do to effectively educate the target market on the potential and practical benefits of their data analytics solutions, without overwhelming them with tech jargon or whatever? What are some of the keys to helping them in? Because helping them know how to think, is one of our biggest challenges with healthcare technology. Helping people know how to turn the corner, how to see what’s true, in light of what’s now possible.
Tod Fetherling:
Well, this is truly, over the last 20 months I’ve been living this, is once again being a entrepreneur here at Huron, of taking the base concept MVP pilot approach, and showing someone, here’s what the data says. If you do change this 1%, let’s take nurse recruitment. If I’m able to reduce your nurse quit rate by 1%, I’m working-
John Farkas:
What’s that worth?
Tod Fetherling:
It’s worth $40,000 per nurse.
John Farkas:
Yep.
Tod Fetherling:
And so if I’m able to save 2000 nurses across a large organization, that’s amazing. Right?
John Farkas:
Yeah.
Tod Fetherling:
We improve the employee’s quality of life, we’re able to reuse that money in patient care and other employee health benefits. Every dollar that you can save allows you to enrich the benefits of care to your community. And if you have that investment loop, which is what a lot of VCs and other people in healthcare services in Nashville have done for decades now, is reuse that money to constantly improve the community. Then it’s just a home run all the time. So I always try to take one example and go all the way to the bottom, show what that looks like, and then that allows people to see the bigger picture, and truly the art of what’s possible.
John Farkas:
Yeah. One of the things that I keep hearing over and over, and you just underscored it, but the things I keep hearing over and over from hospital leaders, health system leaders, talking to health tech companies, is, don’t tell us what you can do. Tell us the value what you can do is going to end up bringing to me. I don’t care about the technology. I don’t care about what whizzbang things you can frame together to do X, Y, Z. Start with what this is going to result in happening in my situation that you have done the research on, and know, and can come to me with some understanding about what you’re doing. And start there. Show me how that’s going to work. I think that’s an important underscore to keep in mind, in anything we’re doing. Start with the value equation.
Tod Fetherling:
And I ask the same thing from my vendors every day. Right? So it’s the same thing we should all be asking, whether we’re the CEO, or we’re a managing director in a consulting firm, buying technology, is the ROI. Help me quantify it. How many hours am I going to save? Because time is money in our business, for sure, and probably likely everyone else listening to this podcast. And then the other thing is, show me how it’s going to advance my business. I want to see our people increase their productivity. I want to see them be more happy. I want to create some space. We’re trying an initiative in my group right now, of carving out 5% of our time to focus on innovation. So take Friday afternoon, or Tuesday morning, write some new code that has nothing to do with your job. Go do something else. Go pull down a data set, analyze it. That muscle memory is worth its weight and gold.
The Importance of Data Literacy and Security
John Farkas:
That’s a great. Great underscore. I know that health tech companies often face challenges integrating new data-driven solutions into their existing healthcare infrastructure. It’s always a challenge. From your experience, what are some of the key factors that health tech companies, the vendors, need to know, and make sure they’re considering, when they’re promoting their integration capabilities? What do they need to hold forward there?
Tod Fetherling:
Well, there’s a very large one that’s very closed. It’s extremely difficult to drive value alongside of them. There are other vendors who are also large, who have open marketplaces, and they, I believe-
John Farkas:
You’re not going to name names for us, Tod?
Tod Fetherling:
Not publicly. Catch me at any Nashville healthcare happy hour, and I’m sure I’ll be glad to tell you.
John Farkas:
After a drink or two, we’re going to be slamming somebody.
Tod Fetherling:
No, it’s just, and we see this in other areas of software as well, where there’s a ecosystem at play between the hospitals, the EMRs, and all of the other wraparounds that have to be there in order for us to deliver patient care to our community. Right? And so we should all be working together to find the best of what solutions are out there to do that. And interoperability is driving that interface engines. Here in town, a company like Trinisys is doing a lot to open up those channels. And so I do think that’s the key to our future success, is that the data is in transport. And so I used to use a term at HCA all the time called bit streaming, whereby I had a Silicon Graphics, I’m going to take you guys back a few years into history.
I had this machine that basically just took a feed every day of all the transactions going on across 325 hospitals. Well, I knew where infectious diseases were breaking out way before the CDC, and so each day I could go look and see everything going on across the country. It’s that sort of analytic that is transformational. Where you can go and take an action based on what happened yesterday. And now I would tell you, like fast-forward 25 years, it’s more real time. And so how do we operate in this ecosystem of open and closed systems, in order to help people fully utilize the analytic? And to get there, everyone has to be data fluent. We also have to be very security-conscious. We have to know what we’re doing with the data, because the first rule in healthcare analytics is do no harm. And so those are paramount to having a successful program, I think, in the future.
John Farkas:
That leads right into a question I was going to ask, in relation to data privacy and security. Huge concerns. When you’re a health tech company that’s touching somebody’s data, that is working with the extraction of data, however it’s moving, what do marketing leaders need to make sure they’re saying? What needs to be in the messaging, that will help ensure trust and credibility in the eyes of perspectives?
Tod Fetherling:
Great question. It’s number one for me, almost every single day. First of all, you’ve got to follow best practices. You need to understand the concept of expert determination, and what is HIPAA and what is not HIPAA. You need to have as close to bulletproof systems as you can have. Even with all of the technology that exists, the number one problem is always the humans. And so somebody saves a file, puts it on a flash drive, drops the flash drive on the commuter train going to work, or leaves it at Dunkin’ Donuts, all of a sudden you’ve got a breach, and bad things are happening.
And so I think training and education is number one. And then having the technology as bulletproof as you can get. So many organizations, I think, have gotten very astute at this point, John, of being able to have a security questionnaire that identifies where there are risks in what’s happening with their data, and then also carrying with that-
John Farkas:
So you’re talking about on the buyer side, they’re interviewing their vendors saying, what are your things?
Tod Fetherling:
Yes. Now what I would like to see us evolve to, and we tried an initiative about a decade ago, and unfortunately it didn’t really get off the ground, but what I’d like to see, is a body that would help credential health tech companies. So that I can answer an annual survey, actually have people come in and do an audit of my processes, and be certified. And then use that certification to go and say, “I’ve got this, I’ve got this.” Today we have SOC 2, we have HITRUST, and things like that. But I think the industry needs to go beyond some of that, and that would be one opportunity for some other great entrepreneur to go build.
John Farkas:
What are some of the things on those checklists that you mentioned, there’s some things that some of the organizations are drilling into. What are some of those questions that you’re seeing being asked that are on some of those profiles?
Tod Fetherling:
Yeah. It’s, where’s the data going to be housed? With many people leaving secure data centers and going to the cloud, it’s important to make sure that the cloud infrastructure they’re on is certified, and it does meet the standards. And if you’re dealing with any type of federal government or state government, you may need to be FedRAMP certified in order to provide an application that’ll be doing analytics on the data itself. And then I would say, the other main thing that is involved in these surveys, is chain of command. So who has command of that data at which point, and then what that responsibility for that chain of command is. Who’s touching the data? What analytics are you running on it? Because at the end of the day, all of us want to get to a point where we can do the analytics, and we want to do it in a de-identified way.
It’s not important for me to know that Tod Fetherling is the person behind this record, but what is important for me to know is that Tod Fetherling has had a history of X, Y, and Z. When we see somebody, going back to the Amazon’s discussion, this person has X, Y, and Z, they are likely to have A next. And let’s help that person get there faster, instead of having them fumble through the darkness of the healthcare system today.
Emerging Trends in Data Analytics
John Farkas:
Yeah. The horizon right now, there’s a lot leaning heavily on predictive analytics, as you mentioned just a little bit ago. It’s moving predictive, moving to prescriptive. From your vantage point, what are the emerging trends in data analytics that health tech companies need to be considering, as they continue to innovate? What are some of the things that they just need to have in their windshield as they’re moving forward?
Tod Fetherling:
So I’m going to walk it through what I think is the continuum of next generation. So feel free to disagree or agree, and maybe the audience can give us some great feedback on this. So where I think we are today is, first and foremost, what I call supervised machine learning. I am building a model to determine X outcome. I have enough data that points me in a regression analysis to have a high degree of accuracy on predicting that outcome. Whether that’s financial performance, quality care performance, community, like overall community consumption of resources, which is something I’m working on right now. Fascinating, fascinating work. And so the supervised machine learning is something that any health tech company needs to have some skill level in.
The second would be unsupervised machine learning. This is where I’m just going to drop large data sets, let the machines come back and tell me what they find. I don’t even know what I’m looking for. Right? And that leads us into generative AI. Because where I think we’re going to be very quickly, if we’re not technically already there, which we probably are, is the ability to interface with the data. And so I’m a CEO of a hospital, I have what is a “dashboard” about my community and what’s going on. I can now start to interact with that data. I can ask questions in a natural language. And I have processes on the backside that convert all of my knowledge base, from medical coding, revenue cycle, financial operations, my debt, my buildings. I’ve got all of that in an ability to ask questions now.
And I think that that will open up untold opportunities. At the same time, it’s going to get rid of a lot of jobs. And so as a result, we need to be thinking today of how to transform those employees to be innovators and thinkers. And I may have to retrain some of those people in new skillsets across my community, that I didn’t need two years ago, but I need them now. And you’re going to hear terms like prompt engineers. These are the people who are going to learn how to use this generative AI technology, and be able to make these data sets return the information that they’re looking for.
John Farkas:
I know companies that are already hiring prompt engineers. It’s happened incredibly quickly, and that pace of change is only going to increase. Yeah. And I’m very aware that I’ve sat in a number of rooms where leaders of health tech companies are really concerned about using any language around replacing people. And what I’m becoming increasingly convinced of, and hearing the challenges that a lot of organizations are facing right now, it really is about the retraining of people. Because they can’t get enough people to solve the problems that they’re sitting in front of across the board. It’s not just nursing and clinical staff that they’re lacking. It’s people in the information technology, information management universe. They don’t have enough of them. They can’t solve all the problems they have as it sits, and the technology’s going to start making some of the functions not pertinent. So let’s figure out how to quickly transition them into meaning-making in other positions. I think that that’s an important piece.
Tod Fetherling:
Yeah. And healthcare and IT are number one, number two, according to Bureau of Labor Statistics, over the next eight years. So I mean, you’ve heard me preach on this, probably the last decade, as much as anybody in the country. I need health analysts like nobody’s business. And we’ve worked with Belmont and Vanderbilt, and others here in this community, to really grow the workforce to be intelligent, to be flexible, to grow into these new jobs that are occurring. Because, to your point, every time you push on the balloon, technology’s always pushing, something else is going to happen as a result of that. And we have to have the ability and the vision to see what that future is going to be, and get those employees there faster.
John Farkas:
Yeah. And I think that that’s an opportunity, too, for health tech companies who are doing something that is displacing somebody in some realm, to help understand what is the need that this is going to open up. Or what is the need that this is going to create. Or what is the opportunity this is going to mean for somebody who can help make meaning out of what’s coming out of this solution, not just what it’s going to replace, but what it opens up. I think that that’s an opportunity in how you position things, how you talk about things, how you help an organization adopt, and use, your solution. I think that’s a major opportunity in there. One of the things-
Tod Fetherling:
Yeah, I would say, to add onto that, let’s create a new title called Friction Reducer. Right? And let’s have that person go into the community and reduce all the friction between the patient and the providers. The patient and the payer. There is untold opportunities to help people get to better care at the right point in time. And so, once again, there’s a whole new generation of problems to be solved. And so we’re not lacking problems in healthcare, by any stretch of the imagination, but we are lacking creative talent who can use technology, processes, and people, to go solve those problems.
An Overview of Huron
John Farkas:
Yep. Absolutely. One of the things I failed to ask at the front of this is, tell us a little bit about Huron. And what Huron’s doing, what you’re doing there, and what people should know about your organization.
Tod Fetherling:
Yeah. Huron is a global consultancy. What most people don’t know, especially all of us who came from healthcare, is they’re also deeply seated into the education market. Top 100 research institutions use our software every day. I’m on the global product side. We have a digital overlay that is helping organizations implement Oracle, and Workday, and tools like that, to help the operational efficiency of their organizations. And so Huron’s a global company, publicly traded, HURN is the stock symbol. And I say this tongue in cheek, so don’t take me out of context, but the stock price has nearly doubled since they acquired Perception Health. So that’s a really good thing. And so-
John Farkas:
That’s a good bragger.
Tod Fetherling:
We’ve had significant growth over the last two years, and more growth forecasted. Very exciting. I think today we’re a little over 4,500, maybe 5,000 employees now. And building new technologies every day to reduce all that friction. It’s amazing how many more opportunities there are in revenue cycle, in care transformation. Been on multiple calls today where we’ve been talking about people transformation. So like we just said, there are a lot of problems to be solved, and we help thousands of organizations across the globe do that.
Upcoming Healthcare Trends
John Farkas:
You’re touching on it here. What are some of the strategies and business models in healthcare that we’re going to see some major pivots happen in the next couple of years?
Tod Fetherling:
I just taught a healthcare economics class two weeks ago, and I put some numbers in, and people were shocked at what the numbers are saying. So I think one fundamental transformation, and a big opportunity, is around private pay, personal pay. That number has grown to 10.5% of the healthcare spend of $4 trillion.
John Farkas:
Yep.
Tod Fetherling:
And so that’s a big number. Right?
John Farkas:
That’s what big deductibles will do.
Tod Fetherling:
Yeah. And so there’s a whole opportunity for what I would call the new generation. So if I was getting out of college today, I would want my parents to put a thousand dollars into a health savings account, and I’ll put a hundred dollars a month in for the rest of my life. Well, if I lead a healthy life, I’m going to be a millionaire, off of that one investment strategy, by the time I retire. Not to mention my 401k and other things. And so we, as a country, don’t know how to think like that. And we would always have the funding for the out-of-pocket expenses, which are going to continue to grow.
I think number two that I see is, self-insured businesses and brokers are going to take a more proactive role at trying to rationalize healthcare. So there are direct contracting vehicles today, there are value-based care components today, where I can go at risk. And I can give a provider all my hearts and all my babies, I’m going to pay a flat rate per employee, and both sides win. The hospital actually makes a better margin, the employer reduces their cost. I did some of this at Perception Health with a captive plan. We reduced our costs 80% in the first year. One Digital, which was recently sold as well, became our partner in helping me manage my employee health costs. And so I paid a hundred percent of the premiums for the employees.
It was a radical concept, but we all won in that opportunity by working together as employee, as employer, and as a payer network, and a provider network. And so I think that is going to be a fundamental shift that is going to occur, that I see. There’s other things that are a little more obvious, pharmaceutical therapeutics continuing to grow in expenditure, and also our expectations of what those drugs are going to deliver. Look no further than obesity and what’s rolled out on the market in the last 18 months. It’s having a profound impact on people’s lives, and that’s what it’s there for.
And so when people talk about sometimes innovation in healthcare, I’m like, “Hey, there’s radical innovation going on depending on where you look”. There’s innovation going on in imaging today. What we can do in imaging blows my mind. And what we can see down to the cellular level, the genetics level, is mind-blowing. Pharmaceuticals and therapies are being innovated on every single day. So you really have to put innovation and technology into context, as to what problem you’re actually looking to solve.
John Farkas:
Working to solve. Yep. If you had gas in the tank and wanted to go start another company right now in the healthcare world, what would you go do? What’s the problem you would want to try and solve?
Tod Fetherling:
Huron leadership is very excited that my wife has said no more startups, after five startups over the last 22-
John Farkas:
That’s why I said if you had gas in the tank. Because you’ve been there, done that a few times.
Tod Fetherling:
Yeah. But like I said, one of the fun things about my job today is I do get to be a bit of an entrepreneur. If I see an opportunity, I can request investment and go build out that solution. Good news is, I have 2,500 hospital clients. I can go to them and say, “Anybody interested in a pilot program?”
John Farkas:
What if we did this. Yeah.
Tod Fetherling:
Yeah. And always somebody’s like, “Oh, I’ll go do that with you guys. I have a specific problem and you can help me solve that.” So what are the things that I would go do if I was out there? I’d probably create some kind of self-pay finance model, and I think I could make a whole lot of money for that. I called Jeff Bezos one day and told him I’d like to turn prime into a captive health plan. He didn’t think that was possible at the time. So maybe I have to call him back and see if now’s a better time. Because I think… I really, I don’t say that tongue in cheek. I think they could create a purchasing ecosystem around healthcare, where I could sort of get a physician office visit, get my dentistry. I could get all my basic concepts done for a couple hundred bucks a month for my whole family. And the power of having a hundred million consumers give you $200 a month-
John Farkas:
That’s not bad.
Tod Fetherling:
I can buy a lot of healthcare for that. So those are the things that I always kind of think about and try to figure out how to go do that. I think the other thing is more related to jumping on the transparency bandwagon. We have dabbled in this at Perception and Huron, on creating an algorithm to allow people to understand the difference of services by hospitals, and by physicians, looking at quality care, and components like that. I usually use volumes and outcomes and access, that triple lane sort of thing. And we’ve created an algorithm, and an acronym VOCAL, volumes, outcomes, charges, access, and loyalty, as a way to really understand high performance providers in a certain disease state. And so the other thing that hasn’t changed in my 25 years since I was at HCA is, three things drive satisfaction with healthcare. Nurse communication, physician communication, and high-tech capabilities in the services I need today. And so I think we have to get better at understanding what that consumer is looking for from us, and actually deliver on it.
John Farkas:
Yeah. That’s a great telltale, and I don’t know that I would’ve put it in that order, but that makes sense. And I think I would follow that. I think that if you were to ask me, that might be something similar to how I would answer it. That’s interesting.
Tod Fetherling:
Yeah. The other thing I would do is I’d probably go to DC and be a pain in the butt, and be a advocate. Because out of all the stuff we do in healthcare, we never asked the most important question. Did the patient get better? Right? Go look through all the HCAP surveys, the [inaudible 00:47:21]
John Farkas:
I wish that we had better statistics.
Tod Fetherling:
… surveys, the Medicare stars. No one asked the most important question. Did you get better? Can you walk without pain? Can you run now, after you got your knee joint replaced? After spine surgery, I can sleep at night. Right? It blows my mind how unsophisticated we are about the patient, the human condition.
John Farkas:
Yeah. It comes down to a lot of financial equations, and not as much care as there needs to be. But you’ve been stewing in this for three decades, Tod, and you’ve been wrestling a lot of the challenges, and working to educate people. If you were to look at what’s giving you hope right now for where we are, what’s the star on the horizon, from your perspective, as you are looking out there? What’s bringing you some hope, and that might bring us to the place we need to be?
Tod Fetherling:
I think today the work that we’re doing in care transformation, care progression, and really truly understanding the continuum of care, gives me the greatest hope. Because I think we are getting closer to a position of being able to provide the right type of care at the right time, at the right place of service. Those three components, when they work well together in a community, it’s amazing. And so we’re getting closer and closer to figuring that thing out. I would actually say that’s one of the positive outputs of covid, is it forced brand new partnerships to occur that weren’t there before.
Closing Thoughts
John Farkas:
Yeah. We have to get more efficient in how we’re bringing in the cross. And that means, at the end of the day, more effective care. Right? I mean, it has to translate out into that, otherwise it’s all going to go backwards. So that’s good. Tod, thank you for joining us today. If our listeners are wanting to learn more about your work right now at Huron, where’s the best place for them to go, or to get exposed to that?
Tod Fetherling:
Go to the probably LinkedIn and follow Huron. I’m Fetherling on LinkedIn. It’s good to have a really weird last name when [inaudible 00:49:38] now the only one.
John Farkas:
Better spell that for us, because it’s not how you might expect to spell it.
Tod Fetherling:
Yeah, so no A. F-E-T-H-E-R-L-I-N-G. And then pretty active on the socials as well, under JTodWork on Twitter, Yahoo, probably back to AOL. So lots of different ways to find me, but JTodWork is pretty prominent out there.
John Farkas:
Awesome. Thanks. And for those of you who are listening, if you enjoyed this episode, please take a moment to rate and subscribe to our podcast. Your feedback really is important to us, and we’re always eager to hear your suggestions for future topics. And for additional information about this episode, and to explore more about our podcast, visit us at our website at goratio.com. Tod, parting shot here. What’s on your bookshelf right now? What are you reading?
Tod Fetherling:
Let’s see here. Got to look for one here. I usually have a whole stack. Oh. And this is going to be boring. So it’s the Elements of Style.
John Farkas:
Oh, there you go. A classic.
Tod Fetherling:
Yeah. Yeah. I’m constantly trying to figure out how to communicate analytics, and that storytelling, and doing it in the right manner. And you of all people know that words matter.
John Farkas:
They do matter, and it is important. And when we’re bringing… The thing to keep in mind in all of this is, when we are trying to communicate technology, at the end of the day, we are people talking to people. And we have to help people into an understanding of what is going to happen, how do they need to think about things differently, that will allow them to change? Because change is not an easy thing for any of us. And how we tell that story, how we bring it across, it can’t be with the new latest, greatest whizzbang thing. It has to start where they are, and lead them to where they want to go, but they don’t understand they want to go yet. And that takes a story. It really does. You got to be careful in how you tell it.
Tod Fetherling:
Yeah. And I would add onto that, what I have found in analytics, believe it or not, you have to tell the story three times. There’s an initial reaction to the data, well, this can’t be right, I’ve never seen this before. Come back and tell it second time. They’ve tested you on a couple of things already and they’re like, You were right about that. And that’s interesting. So what else can you tell me?” The third time you show up, it’s like, okay, we’re good, let’s move on to the action. And that may be frustrating to people in analytics, but I will tell you, if you’re not at least telling the story three times, you’re going to lose your audience along the way.
John Farkas:
Yeah. And few have the patience to do it, and really it’s a critical thing. It really is. J. Tod Fetherling, thank you for joining us at Healthcare Market Matrix. And folks, until next time, stay healthy, and we’ll see you soon.
Healthcare Market Matrix is a Ratio original podcast. If you enjoyed today’s episode, then jump over to healthcaremarketmatrix.com and subscribe. And we’d really appreciate your support in the form of a five star rating on your favorite podcast platform. It does make a difference. Also, while you’re there, you can become a part of the Healthcare Market Matrix community, and get access to courses and content that’s created just for you, by signing up for Insights Squared, a monthly newsletter dedicated to bringing you the latest health tech marketing insights right to your inbox. Ratio is an award-winning marketing agency headquartered in Nashville, Tennessee. We operate at the intersection of brand and growth marketing, to equip companies with strategies to create meaningful connections with the healthcare market, and ultimately drive growth. Want to know more? Go to goratio.com. That’s G-O-R-A-T-I-O.com. And we’ll see you at noon Central next week for an all new episode From our team at Ratio Studios. Stay healthy.
Transcript (custom)
Tod’s Healthcare Journey
John Farkas:
Greetings everyone, and along with the team at Ratio, I would like to welcome you to Healthcare Market Matrix. I’m your host, John Farkas, and we are getting ready to dive headlong into the world of healthcare, data, and analytics with our guest today, who, from my vantage point, is at least one of the kings, if not the king, of the topic, J. Tod Fetherling. I first got to know Tod when he was leading the Nashville Technology Council, but I learned quickly that he carries a deep understanding of, and passion for, the importance of the smart use of data in healthcare. And had that well before it became, what I would consider, a mainstream conversation.
So personally, I don’t know anyone who has more comprehensive understanding of that arena than Tod has, and he’s been soaking in it for a lot of years. I think for over 30 years he’s been in this realm, and now is applying it as the Managing Director over data and analytics and global products at Huron. But before that, he was the founder, CEO and Chief Data Science at Perception Health, which ended up being where I got to know him. They were acquired by Huron in 2021. But prior to that, our worlds intersected most vividly, and I learned the most about his expertise, when we helped them brand and position Perception Health. But then before that, he founded another healthcare data science company called Stratasan. And I’m only going part way back. There’s more to the story, but you get the picture. It is a passion and a calling to help improve data literacy in healthcare. So Tod, welcome to Healthcare Market Matrix.
Tod Fetherling:
Thank you. It’s great to be here with you today, and I love this topic, as you know, and so excited to understand what is on people’s minds, as it relates to healthcare data. And probably more important, the innovation that we’re seeing in analytics today.
John Farkas:
Yeah, there’s a lot going on in this subject. I was just at the Becker’s conference and the panel discussion that was going on, as I was on my way to catch my plane, was about data literacy. And some of the folks up on the panel there were bemoaning the travails of helping the healthcare system into better use of data. And I know that that’s no small part of the mission you’ve been on for a long time. So, eager to dive into that a little bit, and to get your perspectives. But before we do, take us back a little bit. How did you get on this path, Tod? Talk about the journey that led you here.
Tod Fetherling:
Well, for those native Nashvillians, they’ll probably really enjoy this next story, because it’s almost like how people get in the music business. I was a bartender at O’Charley’s on Murfreesboro Road.
John Farkas:
That’s assuming there are such a thing as Nashville natives.
Tod Fetherling:
Well, that’s true. I was a bartender at O’Charley’s on Murfreesboro Road, and I had this opportunity to be a runner in a healthcare data strategic planning firm that was run by Paul Keckley. Many people listening to your podcast will be familiar with Paul. And so this was a company called the Keckley Group, 3100 West End. And so that’s how I got my first start into healthcare. They needed somebody with a market research background to run statistics on surveys, and that was my major at the University of Tennessee. And so it was a match made in heaven.
After about two weeks of being a runner, I got my first project, which was one of the craziest projects I’ve ever worked on in my entire career. And we put together some really amazing analytics over a period of five days, and presented that back to the client. We then got hired to do their strategic plan, because they liked the way we thought. That was Brim Healthcare out in Oregon. And that led to the jumping off point for healthcare data for me.
John Farkas:
Gotcha. Yeah. So from there, talk about some of those next moves. What led to the start of the companies?
Tod Fetherling:
Yeah. So from there I went up to Louisville to work for First Research, and then I was hired by my first true hospital job at Jewish Hospital, doing data and strategic planning, and then got hired by HCA. It was at HCA that I really got the bug for entrepreneurialism. I used to tell people all the time I was an entrepreneur, Rick Scott gave me a pot of money and said, “Hey, go figure out this internet thing”. The internet came on board in ’95 for whatever crazy reason the research geek got… I had a CompuServ account, so I guess that made me qualified to run the internet strategy for HCA in ’95, because there weren’t too many of us back then.
And we really looked at the internet as a database to be researched, and to interface with. And so we had a lot of luck out of the gate. Built out, I don’t know, 325 hospital websites in less than a year, using Excel macros. It was really a fun time. And that just sort of made us hungry to do this over and over again. So whenever I left HCA, started creating companies, and all of them with a central theme around trying to help people improve their health outcomes, while we reduce costs. And I’ve literally spent every day for the last 22 years trying to get that done, and I still have a long way to go.
Healthcare’s Changing Approach to Data
John Farkas:
Well, there’s plenty of room for improvement, and plenty of necessity for that right now, in our realm. I mean a big emphasis of the conference I just came from was revenue cycle, and everybody’s looking for that little bit of extra right now, in this economy, and in the situation that healthcare finds itself. So it is an important part of the equation, for sure. So if we look at healthcare, traditionally, one of the great clouds cast over healthcare is the slow pace of change. But we are in a rapidly changing landscape right now, and I’m guessing you’ve seen a dramatic difference in how the leadership of healthcare organizations understand and approach data over the last several years. How would you characterize that change?
Tod Fetherling:
Yeah, so I’d probably disagree a little bit with the pace of change. If you’re working in healthcare today, I mean it is rapid fire. The requirements that are being delivered, what is opening up around interoperability, what the federal government is driving, to get people to understand what data is already available, and what could be done with that. I think what I see in healthcare today is really a chasm. There are some significant players, like an HCA, here in Nashville. They have a partnership with Google, and they are literally pushing the edge of the envelope, in what they’re doing in that regard.
There are other providers, and unfortunately they’re more of the small independents, and that’s where I think healthcare gets its reputation is, there are limited dollars in those communities and those facilities to adopt technology, to innovate, and that’s what causes the slowness. So I think there are people, like a Vanderbilt and others, who are advanced in technology adoption and analytics. And then there are others that don’t have the resources in order to capitalize on all the great technology changes that are occurring right now.
John Farkas:
So if you look at what’s changed, and what are some of the core understandings that have been adopted over the last couple of years, where you’ve seen some of the places where you were struggling to get things across, and now is ubiquitous. What have been some of those stones that have turned over?
Tod Fetherling:
I think one area is machine learning. We have come a long way in this one category, of being able to build advanced models and operationalize those. Like at Perception Health that you mentioned, and now Huron, I’ve built 55 different disease models that do a fairly accurate job of predicting when someone is at risk of having a diagnosis for like a lung cancer. To that point, one of our partners up in West Virginia, Modern Health, they’ve taken an active role in using this model with us. And to date, we have about 811 patients’ lives that have been impacted by this model. So those are some examples that I see where people are actually using advanced technologies, in order to improve the health of their community, and lower costs at the same time.
The other area I’d probably mention is kind of around analytics. I think the majority, 85 plus percent, of what I see in analytics today, are base level, descriptive statistics. Many people have started to move up this adoption curve, from descriptive statistics to diagnostic, sort of understanding the why. And then of course the predictive, which allows us to see into the future a little bit about what’s about to happen. And then the next level will be prescriptive, which is kind of where Amazon has been already for a long time. Let’s take books for example. I order four books that you can see on my bookshelves here, and everyone else in the country who’s ordered those four books, also buy the fifth book. And so Amazon’s going to prompt me to say, “Hey, do you want this book?” And of course I’m going to say yes, because it is right in line with the learning path that I’m on.
And so wouldn’t it be great if we could do the same thing in healthcare? So you’re on this path to become diabetic. If I can get you to do this, this, and this, I can change that curve on your personal healthcare journey. We did this up in Chicago with Cigna and Matter, where you were just at across the river, and it had profound impacts. We showed evidence of about $4,000 per patient per year of cost savings, by just re-engineering the network of how they are delivering care to diabetics in that city.
Taking Data-Informed Action
John Farkas:
That’s amazing. And so if you were to say… Well, looking at how that understanding is beginning to get traction, are you seeing more people asking for the insights? Are they coming after it, or are they having to be convinced to go get it? How are you seeing that curve?
Tod Fetherling:
That is a really good question. So once again, I think, and you’re acutely aware of this, more than probably anybody else, John, but the personas are what I find differentiating on analytics, what I would call pull versus push. I have many executives who are convinced that the data’s right, and they just want the answer. Tell me the three physicians in my community I need to go talk to this afternoon, that are going to significantly impact my revenue, and the ability for me to continue to live out my mission. There are others, and I won’t name them, that want to argue with the data, instead of taking action when it’s appropriate. And so that is a real struggle for analysts, especially in my firm. I’m managing a little over 40 billion records. And so when I tell somebody, “Hey, I feel about 99% accurate on this”, and then people want to go, “Well, you’re still missing that 1%”. And I’m like, “Yep, I’m not ever going to get over that one percent”.
John Farkas:
Deal with it.
Tod Fetherling:
Yeah. And I don’t know if it may be a human nature thing, that I just haven’t sort of done enough study and design around, but I’m reminded of a quote from Colin Powell where he said, “Look, if you get me to 80% knowledge on this subject, I’m going to make a decision to move forward. I don’t have time or the luxury on the other 20%”. I do think we have a lot of hospitals and healthcare systems that are getting to that point, where if they’re going to wait for the last 20%, they’re probably going to go out of business.
John Farkas:
Yeah, well that is true. They’ve got to push. And then they’ve got to push toward it now. What are you seeing, as far as if you were to wave a magic wand and say, “Gosh, if I could instill one piece of understanding surrounding data literacy to leaders of health systems”, is there a common thread, or one thing that you… And you kind of alluded to it, part of it is, we have data, let’s trust it, right? I mean, let’s look at it. But is there any other element, or a shade there, of misunderstanding, or lack of knowledge, that you see consistently, that if you could change it it could make a big difference?
Tod Fetherling:
I always come back to taking action on the insights. If individuals can look at the data, figure out a strategy, take an action, they are way better off, all the time, from doing that. And so that becomes-
John Farkas:
Yeah, there’s an objective reality there that is just… That some people don’t want to embrace.
Tod Fetherling:
Well, and part of it is, going back to the personas, and where you are on an adoption curve. Right? So we always have the individuals who jump to the front of the line, they’re willing to test anything, and they want to be leading on innovation. There are the laggards, who are very invested in the status quo. And many times, this technology, and we can talk a little bit about Gen AI if you want, these technologies are scary to the status quo, because they’re going to change their fundamental job. And so I get that. But at the end of the day, for me, patient outcomes, reduce costs, outweighs our fear of losing our jobs. Right?
And so I can sort of go through example after example of where I think these technologies are going to be disruptive, but what we have to do as healthcare executives is constantly challenge ourselves, and use this data to make better decisions. And it’s those decisions that then are going to lead us to success in our communities. And it’s always about providing quality care to your community. If you ever lose sight of that… That’s what gets me up and excited every day to come to work, is trying to save a life.
Educating the Target Market on the Practical Benefits of Data
John Farkas:
So I’m going to jump what I had listed in the order of questions I was going to ask, because it’s what we’re talking about right now. I know a common challenge in health tech is bridging the gap between what is technically possible and what healthcare professionals believe is possible or useful. And so looking at marketing leaders, because that’s who we’re talking about here, when you have a solution that is presenting data insight, what can you do to effectively educate the target market on the potential and practical benefits of their data analytics solutions, without overwhelming them with tech jargon or whatever? What are some of the keys to helping them in? Because helping them know how to think, is one of our biggest challenges with healthcare technology. Helping people know how to turn the corner, how to see what’s true, in light of what’s now possible.
Tod Fetherling:
Well, this is truly, over the last 20 months I’ve been living this, is once again being a entrepreneur here at Huron, of taking the base concept MVP pilot approach, and showing someone, here’s what the data says. If you do change this 1%, let’s take nurse recruitment. If I’m able to reduce your nurse quit rate by 1%, I’m working-
John Farkas:
What’s that worth?
Tod Fetherling:
It’s worth $40,000 per nurse.
John Farkas:
Yep.
Tod Fetherling:
And so if I’m able to save 2000 nurses across a large organization, that’s amazing. Right?
John Farkas:
Yeah.
Tod Fetherling:
We improve the employee’s quality of life, we’re able to reuse that money in patient care and other employee health benefits. Every dollar that you can save allows you to enrich the benefits of care to your community. And if you have that investment loop, which is what a lot of VCs and other people in healthcare services in Nashville have done for decades now, is reuse that money to constantly improve the community. Then it’s just a home run all the time. So I always try to take one example and go all the way to the bottom, show what that looks like, and then that allows people to see the bigger picture, and truly the art of what’s possible.
John Farkas:
Yeah. One of the things that I keep hearing over and over, and you just underscored it, but the things I keep hearing over and over from hospital leaders, health system leaders, talking to health tech companies, is, don’t tell us what you can do. Tell us the value what you can do is going to end up bringing to me. I don’t care about the technology. I don’t care about what whizzbang things you can frame together to do X, Y, Z. Start with what this is going to result in happening in my situation that you have done the research on, and know, and can come to me with some understanding about what you’re doing. And start there. Show me how that’s going to work. I think that’s an important underscore to keep in mind, in anything we’re doing. Start with the value equation.
Tod Fetherling:
And I ask the same thing from my vendors every day. Right? So it’s the same thing we should all be asking, whether we’re the CEO, or we’re a managing director in a consulting firm, buying technology, is the ROI. Help me quantify it. How many hours am I going to save? Because time is money in our business, for sure, and probably likely everyone else listening to this podcast. And then the other thing is, show me how it’s going to advance my business. I want to see our people increase their productivity. I want to see them be more happy. I want to create some space. We’re trying an initiative in my group right now, of carving out 5% of our time to focus on innovation. So take Friday afternoon, or Tuesday morning, write some new code that has nothing to do with your job. Go do something else. Go pull down a data set, analyze it. That muscle memory is worth its weight and gold.
The Importance of Data Literacy and Security
John Farkas:
That’s a great. Great underscore. I know that health tech companies often face challenges integrating new data-driven solutions into their existing healthcare infrastructure. It’s always a challenge. From your experience, what are some of the key factors that health tech companies, the vendors, need to know, and make sure they’re considering, when they’re promoting their integration capabilities? What do they need to hold forward there?
Tod Fetherling:
Well, there’s a very large one that’s very closed. It’s extremely difficult to drive value alongside of them. There are other vendors who are also large, who have open marketplaces, and they, I believe-
John Farkas:
You’re not going to name names for us, Tod?
Tod Fetherling:
Not publicly. Catch me at any Nashville healthcare happy hour, and I’m sure I’ll be glad to tell you.
John Farkas:
After a drink or two, we’re going to be slamming somebody.
Tod Fetherling:
No, it’s just, and we see this in other areas of software as well, where there’s a ecosystem at play between the hospitals, the EMRs, and all of the other wraparounds that have to be there in order for us to deliver patient care to our community. Right? And so we should all be working together to find the best of what solutions are out there to do that. And interoperability is driving that interface engines. Here in town, a company like Trinisys is doing a lot to open up those channels. And so I do think that’s the key to our future success, is that the data is in transport. And so I used to use a term at HCA all the time called bit streaming, whereby I had a Silicon Graphics, I’m going to take you guys back a few years into history.
I had this machine that basically just took a feed every day of all the transactions going on across 325 hospitals. Well, I knew where infectious diseases were breaking out way before the CDC, and so each day I could go look and see everything going on across the country. It’s that sort of analytic that is transformational. Where you can go and take an action based on what happened yesterday. And now I would tell you, like fast-forward 25 years, it’s more real time. And so how do we operate in this ecosystem of open and closed systems, in order to help people fully utilize the analytic? And to get there, everyone has to be data fluent. We also have to be very security-conscious. We have to know what we’re doing with the data, because the first rule in healthcare analytics is do no harm. And so those are paramount to having a successful program, I think, in the future.
John Farkas:
That leads right into a question I was going to ask, in relation to data privacy and security. Huge concerns. When you’re a health tech company that’s touching somebody’s data, that is working with the extraction of data, however it’s moving, what do marketing leaders need to make sure they’re saying? What needs to be in the messaging, that will help ensure trust and credibility in the eyes of perspectives?
Tod Fetherling:
Great question. It’s number one for me, almost every single day. First of all, you’ve got to follow best practices. You need to understand the concept of expert determination, and what is HIPAA and what is not HIPAA. You need to have as close to bulletproof systems as you can have. Even with all of the technology that exists, the number one problem is always the humans. And so somebody saves a file, puts it on a flash drive, drops the flash drive on the commuter train going to work, or leaves it at Dunkin’ Donuts, all of a sudden you’ve got a breach, and bad things are happening.
And so I think training and education is number one. And then having the technology as bulletproof as you can get. So many organizations, I think, have gotten very astute at this point, John, of being able to have a security questionnaire that identifies where there are risks in what’s happening with their data, and then also carrying with that-
John Farkas:
So you’re talking about on the buyer side, they’re interviewing their vendors saying, what are your things?
Tod Fetherling:
Yes. Now what I would like to see us evolve to, and we tried an initiative about a decade ago, and unfortunately it didn’t really get off the ground, but what I’d like to see, is a body that would help credential health tech companies. So that I can answer an annual survey, actually have people come in and do an audit of my processes, and be certified. And then use that certification to go and say, “I’ve got this, I’ve got this.” Today we have SOC 2, we have HITRUST, and things like that. But I think the industry needs to go beyond some of that, and that would be one opportunity for some other great entrepreneur to go build.
John Farkas:
What are some of the things on those checklists that you mentioned, there’s some things that some of the organizations are drilling into. What are some of those questions that you’re seeing being asked that are on some of those profiles?
Tod Fetherling:
Yeah. It’s, where’s the data going to be housed? With many people leaving secure data centers and going to the cloud, it’s important to make sure that the cloud infrastructure they’re on is certified, and it does meet the standards. And if you’re dealing with any type of federal government or state government, you may need to be FedRAMP certified in order to provide an application that’ll be doing analytics on the data itself. And then I would say, the other main thing that is involved in these surveys, is chain of command. So who has command of that data at which point, and then what that responsibility for that chain of command is. Who’s touching the data? What analytics are you running on it? Because at the end of the day, all of us want to get to a point where we can do the analytics, and we want to do it in a de-identified way.
It’s not important for me to know that Tod Fetherling is the person behind this record, but what is important for me to know is that Tod Fetherling has had a history of X, Y, and Z. When we see somebody, going back to the Amazon’s discussion, this person has X, Y, and Z, they are likely to have A next. And let’s help that person get there faster, instead of having them fumble through the darkness of the healthcare system today.
Emerging Trends in Data Analytics
John Farkas:
Yeah. The horizon right now, there’s a lot leaning heavily on predictive analytics, as you mentioned just a little bit ago. It’s moving predictive, moving to prescriptive. From your vantage point, what are the emerging trends in data analytics that health tech companies need to be considering, as they continue to innovate? What are some of the things that they just need to have in their windshield as they’re moving forward?
Tod Fetherling:
So I’m going to walk it through what I think is the continuum of next generation. So feel free to disagree or agree, and maybe the audience can give us some great feedback on this. So where I think we are today is, first and foremost, what I call supervised machine learning. I am building a model to determine X outcome. I have enough data that points me in a regression analysis to have a high degree of accuracy on predicting that outcome. Whether that’s financial performance, quality care performance, community, like overall community consumption of resources, which is something I’m working on right now. Fascinating, fascinating work. And so the supervised machine learning is something that any health tech company needs to have some skill level in.
The second would be unsupervised machine learning. This is where I’m just going to drop large data sets, let the machines come back and tell me what they find. I don’t even know what I’m looking for. Right? And that leads us into generative AI. Because where I think we’re going to be very quickly, if we’re not technically already there, which we probably are, is the ability to interface with the data. And so I’m a CEO of a hospital, I have what is a “dashboard” about my community and what’s going on. I can now start to interact with that data. I can ask questions in a natural language. And I have processes on the backside that convert all of my knowledge base, from medical coding, revenue cycle, financial operations, my debt, my buildings. I’ve got all of that in an ability to ask questions now.
And I think that that will open up untold opportunities. At the same time, it’s going to get rid of a lot of jobs. And so as a result, we need to be thinking today of how to transform those employees to be innovators and thinkers. And I may have to retrain some of those people in new skillsets across my community, that I didn’t need two years ago, but I need them now. And you’re going to hear terms like prompt engineers. These are the people who are going to learn how to use this generative AI technology, and be able to make these data sets return the information that they’re looking for.
John Farkas:
I know companies that are already hiring prompt engineers. It’s happened incredibly quickly, and that pace of change is only going to increase. Yeah. And I’m very aware that I’ve sat in a number of rooms where leaders of health tech companies are really concerned about using any language around replacing people. And what I’m becoming increasingly convinced of, and hearing the challenges that a lot of organizations are facing right now, it really is about the retraining of people. Because they can’t get enough people to solve the problems that they’re sitting in front of across the board. It’s not just nursing and clinical staff that they’re lacking. It’s people in the information technology, information management universe. They don’t have enough of them. They can’t solve all the problems they have as it sits, and the technology’s going to start making some of the functions not pertinent. So let’s figure out how to quickly transition them into meaning-making in other positions. I think that that’s an important piece.
Tod Fetherling:
Yeah. And healthcare and IT are number one, number two, according to Bureau of Labor Statistics, over the next eight years. So I mean, you’ve heard me preach on this, probably the last decade, as much as anybody in the country. I need health analysts like nobody’s business. And we’ve worked with Belmont and Vanderbilt, and others here in this community, to really grow the workforce to be intelligent, to be flexible, to grow into these new jobs that are occurring. Because, to your point, every time you push on the balloon, technology’s always pushing, something else is going to happen as a result of that. And we have to have the ability and the vision to see what that future is going to be, and get those employees there faster.
John Farkas:
Yeah. And I think that that’s an opportunity, too, for health tech companies who are doing something that is displacing somebody in some realm, to help understand what is the need that this is going to open up. Or what is the need that this is going to create. Or what is the opportunity this is going to mean for somebody who can help make meaning out of what’s coming out of this solution, not just what it’s going to replace, but what it opens up. I think that that’s an opportunity in how you position things, how you talk about things, how you help an organization adopt, and use, your solution. I think that’s a major opportunity in there. One of the things-
Tod Fetherling:
Yeah, I would say, to add onto that, let’s create a new title called Friction Reducer. Right? And let’s have that person go into the community and reduce all the friction between the patient and the providers. The patient and the payer. There is untold opportunities to help people get to better care at the right point in time. And so, once again, there’s a whole new generation of problems to be solved. And so we’re not lacking problems in healthcare, by any stretch of the imagination, but we are lacking creative talent who can use technology, processes, and people, to go solve those problems.
An Overview of Huron
John Farkas:
Yep. Absolutely. One of the things I failed to ask at the front of this is, tell us a little bit about Huron. And what Huron’s doing, what you’re doing there, and what people should know about your organization.
Tod Fetherling:
Yeah. Huron is a global consultancy. What most people don’t know, especially all of us who came from healthcare, is they’re also deeply seated into the education market. Top 100 research institutions use our software every day. I’m on the global product side. We have a digital overlay that is helping organizations implement Oracle, and Workday, and tools like that, to help the operational efficiency of their organizations. And so Huron’s a global company, publicly traded, HURN is the stock symbol. And I say this tongue in cheek, so don’t take me out of context, but the stock price has nearly doubled since they acquired Perception Health. So that’s a really good thing. And so-
John Farkas:
That’s a good bragger.
Tod Fetherling:
We’ve had significant growth over the last two years, and more growth forecasted. Very exciting. I think today we’re a little over 4,500, maybe 5,000 employees now. And building new technologies every day to reduce all that friction. It’s amazing how many more opportunities there are in revenue cycle, in care transformation. Been on multiple calls today where we’ve been talking about people transformation. So like we just said, there are a lot of problems to be solved, and we help thousands of organizations across the globe do that.
Upcoming Healthcare Trends
John Farkas:
You’re touching on it here. What are some of the strategies and business models in healthcare that we’re going to see some major pivots happen in the next couple of years?
Tod Fetherling:
I just taught a healthcare economics class two weeks ago, and I put some numbers in, and people were shocked at what the numbers are saying. So I think one fundamental transformation, and a big opportunity, is around private pay, personal pay. That number has grown to 10.5% of the healthcare spend of $4 trillion.
John Farkas:
Yep.
Tod Fetherling:
And so that’s a big number. Right?
John Farkas:
That’s what big deductibles will do.
Tod Fetherling:
Yeah. And so there’s a whole opportunity for what I would call the new generation. So if I was getting out of college today, I would want my parents to put a thousand dollars into a health savings account, and I’ll put a hundred dollars a month in for the rest of my life. Well, if I lead a healthy life, I’m going to be a millionaire, off of that one investment strategy, by the time I retire. Not to mention my 401k and other things. And so we, as a country, don’t know how to think like that. And we would always have the funding for the out-of-pocket expenses, which are going to continue to grow.
I think number two that I see is, self-insured businesses and brokers are going to take a more proactive role at trying to rationalize healthcare. So there are direct contracting vehicles today, there are value-based care components today, where I can go at risk. And I can give a provider all my hearts and all my babies, I’m going to pay a flat rate per employee, and both sides win. The hospital actually makes a better margin, the employer reduces their cost. I did some of this at Perception Health with a captive plan. We reduced our costs 80% in the first year. One Digital, which was recently sold as well, became our partner in helping me manage my employee health costs. And so I paid a hundred percent of the premiums for the employees.
It was a radical concept, but we all won in that opportunity by working together as employee, as employer, and as a payer network, and a provider network. And so I think that is going to be a fundamental shift that is going to occur, that I see. There’s other things that are a little more obvious, pharmaceutical therapeutics continuing to grow in expenditure, and also our expectations of what those drugs are going to deliver. Look no further than obesity and what’s rolled out on the market in the last 18 months. It’s having a profound impact on people’s lives, and that’s what it’s there for.
And so when people talk about sometimes innovation in healthcare, I’m like, “Hey, there’s radical innovation going on depending on where you look”. There’s innovation going on in imaging today. What we can do in imaging blows my mind. And what we can see down to the cellular level, the genetics level, is mind-blowing. Pharmaceuticals and therapies are being innovated on every single day. So you really have to put innovation and technology into context, as to what problem you’re actually looking to solve.
John Farkas:
Working to solve. Yep. If you had gas in the tank and wanted to go start another company right now in the healthcare world, what would you go do? What’s the problem you would want to try and solve?
Tod Fetherling:
Huron leadership is very excited that my wife has said no more startups, after five startups over the last 22-
John Farkas:
That’s why I said if you had gas in the tank. Because you’ve been there, done that a few times.
Tod Fetherling:
Yeah. But like I said, one of the fun things about my job today is I do get to be a bit of an entrepreneur. If I see an opportunity, I can request investment and go build out that solution. Good news is, I have 2,500 hospital clients. I can go to them and say, “Anybody interested in a pilot program?”
John Farkas:
What if we did this. Yeah.
Tod Fetherling:
Yeah. And always somebody’s like, “Oh, I’ll go do that with you guys. I have a specific problem and you can help me solve that.” So what are the things that I would go do if I was out there? I’d probably create some kind of self-pay finance model, and I think I could make a whole lot of money for that. I called Jeff Bezos one day and told him I’d like to turn prime into a captive health plan. He didn’t think that was possible at the time. So maybe I have to call him back and see if now’s a better time. Because I think… I really, I don’t say that tongue in cheek. I think they could create a purchasing ecosystem around healthcare, where I could sort of get a physician office visit, get my dentistry. I could get all my basic concepts done for a couple hundred bucks a month for my whole family. And the power of having a hundred million consumers give you $200 a month-
John Farkas:
That’s not bad.
Tod Fetherling:
I can buy a lot of healthcare for that. So those are the things that I always kind of think about and try to figure out how to go do that. I think the other thing is more related to jumping on the transparency bandwagon. We have dabbled in this at Perception and Huron, on creating an algorithm to allow people to understand the difference of services by hospitals, and by physicians, looking at quality care, and components like that. I usually use volumes and outcomes and access, that triple lane sort of thing. And we’ve created an algorithm, and an acronym VOCAL, volumes, outcomes, charges, access, and loyalty, as a way to really understand high performance providers in a certain disease state. And so the other thing that hasn’t changed in my 25 years since I was at HCA is, three things drive satisfaction with healthcare. Nurse communication, physician communication, and high-tech capabilities in the services I need today. And so I think we have to get better at understanding what that consumer is looking for from us, and actually deliver on it.
John Farkas:
Yeah. That’s a great telltale, and I don’t know that I would’ve put it in that order, but that makes sense. And I think I would follow that. I think that if you were to ask me, that might be something similar to how I would answer it. That’s interesting.
Tod Fetherling:
Yeah. The other thing I would do is I’d probably go to DC and be a pain in the butt, and be a advocate. Because out of all the stuff we do in healthcare, we never asked the most important question. Did the patient get better? Right? Go look through all the HCAP surveys, the [inaudible 00:47:21]
John Farkas:
I wish that we had better statistics.
Tod Fetherling:
… surveys, the Medicare stars. No one asked the most important question. Did you get better? Can you walk without pain? Can you run now, after you got your knee joint replaced? After spine surgery, I can sleep at night. Right? It blows my mind how unsophisticated we are about the patient, the human condition.
John Farkas:
Yeah. It comes down to a lot of financial equations, and not as much care as there needs to be. But you’ve been stewing in this for three decades, Tod, and you’ve been wrestling a lot of the challenges, and working to educate people. If you were to look at what’s giving you hope right now for where we are, what’s the star on the horizon, from your perspective, as you are looking out there? What’s bringing you some hope, and that might bring us to the place we need to be?
Tod Fetherling:
I think today the work that we’re doing in care transformation, care progression, and really truly understanding the continuum of care, gives me the greatest hope. Because I think we are getting closer to a position of being able to provide the right type of care at the right time, at the right place of service. Those three components, when they work well together in a community, it’s amazing. And so we’re getting closer and closer to figuring that thing out. I would actually say that’s one of the positive outputs of covid, is it forced brand new partnerships to occur that weren’t there before.
Closing Thoughts
John Farkas:
Yeah. We have to get more efficient in how we’re bringing in the cross. And that means, at the end of the day, more effective care. Right? I mean, it has to translate out into that, otherwise it’s all going to go backwards. So that’s good. Tod, thank you for joining us today. If our listeners are wanting to learn more about your work right now at Huron, where’s the best place for them to go, or to get exposed to that?
Tod Fetherling:
Go to the probably LinkedIn and follow Huron. I’m Fetherling on LinkedIn. It’s good to have a really weird last name when [inaudible 00:49:38] now the only one.
John Farkas:
Better spell that for us, because it’s not how you might expect to spell it.
Tod Fetherling:
Yeah, so no A. F-E-T-H-E-R-L-I-N-G. And then pretty active on the socials as well, under JTodWork on Twitter, Yahoo, probably back to AOL. So lots of different ways to find me, but JTodWork is pretty prominent out there.
John Farkas:
Awesome. Thanks. And for those of you who are listening, if you enjoyed this episode, please take a moment to rate and subscribe to our podcast. Your feedback really is important to us, and we’re always eager to hear your suggestions for future topics. And for additional information about this episode, and to explore more about our podcast, visit us at our website at goratio.com. Tod, parting shot here. What’s on your bookshelf right now? What are you reading?
Tod Fetherling:
Let’s see here. Got to look for one here. I usually have a whole stack. Oh. And this is going to be boring. So it’s the Elements of Style.
John Farkas:
Oh, there you go. A classic.
Tod Fetherling:
Yeah. Yeah. I’m constantly trying to figure out how to communicate analytics, and that storytelling, and doing it in the right manner. And you of all people know that words matter.
John Farkas:
They do matter, and it is important. And when we’re bringing… The thing to keep in mind in all of this is, when we are trying to communicate technology, at the end of the day, we are people talking to people. And we have to help people into an understanding of what is going to happen, how do they need to think about things differently, that will allow them to change? Because change is not an easy thing for any of us. And how we tell that story, how we bring it across, it can’t be with the new latest, greatest whizzbang thing. It has to start where they are, and lead them to where they want to go, but they don’t understand they want to go yet. And that takes a story. It really does. You got to be careful in how you tell it.
Tod Fetherling:
Yeah. And I would add onto that, what I have found in analytics, believe it or not, you have to tell the story three times. There’s an initial reaction to the data, well, this can’t be right, I’ve never seen this before. Come back and tell it second time. They’ve tested you on a couple of things already and they’re like, You were right about that. And that’s interesting. So what else can you tell me?” The third time you show up, it’s like, okay, we’re good, let’s move on to the action. And that may be frustrating to people in analytics, but I will tell you, if you’re not at least telling the story three times, you’re going to lose your audience along the way.
John Farkas:
Yeah. And few have the patience to do it, and really it’s a critical thing. It really is. J. Tod Fetherling, thank you for joining us at Healthcare Market Matrix. And folks, until next time, stay healthy, and we’ll see you soon.
Healthcare Market Matrix is a Ratio original podcast. If you enjoyed today’s episode, then jump over to healthcaremarketmatrix.com and subscribe. And we’d really appreciate your support in the form of a five star rating on your favorite podcast platform. It does make a difference. Also, while you’re there, you can become a part of the Healthcare Market Matrix community, and get access to courses and content that’s created just for you, by signing up for Insights Squared, a monthly newsletter dedicated to bringing you the latest health tech marketing insights right to your inbox. Ratio is an award-winning marketing agency headquartered in Nashville, Tennessee. We operate at the intersection of brand and growth marketing, to equip companies with strategies to create meaningful connections with the healthcare market, and ultimately drive growth. Want to know more? Go to goratio.com. That’s G-O-R-A-T-I-O.com. And we’ll see you at noon Central next week for an all new episode From our team at Ratio Studios. Stay healthy.
About Tod Fetherling
Over the past 30 years, Tod has lead teams as CEO, CPO, VP of Business Development, Interactive Marketing, and Research Director. He’s started companies and worked at a Fortune 50 Company. His professional career began in marketing research and after several pivots through the Internet, Healthcare Information Technology, and Media, he find myself back in health data/analytics, the discipline I love so much.
In each experience, Tod has learned about people, technology, and processes. It is the learning process that is the constant in his career.