Podcast
The Premise Health Playbook: What does it mean to be Enterprise-ready?
Haden McWhorter
Chief Information Officer, Premise Health
On this episode of Healthcare Market Matrix, host John Farkas sits down with Haden McWhorter for an insightful conversation about Premise Health and the future of direct healthcare. Haden is the chief information officer at Premise and has spent the better part of a decade driving meaningful change as a leader in the healthcare ecosystem. Throughout the episode, John and Haden discuss the importance of member engagement, Haden’s unique value equation, Epic’s BFF program, and much more.
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Transcript
Haden’s Accidental Journey to Healthcare
John Farkas:
Well, hello everybody and welcome back to the Healthcare Market Matrix where we offer genuine market insights straight from the decision makers who are driving change in the healthcare industry. And the longer I am in this ecosystem, the more impressed I am with the number of people who are passionately dedicating their careers to meaningful change in healthcare. And our guest today is, without a doubt, a great example of that kind of leader. Let me introduce you to Haden McWhorter. He is the chief information officer of Premise Health.
And for those of you who might not be familiar with Premise, Premise health is, I think we’re safe to say, the leading direct healthcare provider to employer populations. And that means that instead of employees going outside to outside providers for healthcare, employers can offer those services on onsite or nearby, which effectively improves utilization. It can result in reduced time away from work, which often translates into lower cost, and ultimately better healthcare outcomes. And I’m going to let Haden dive deeper into that.
But as I mentioned, Haden serves as the chief information officer at Premise. And it is safe to say that he has had a tiger by the tail over the last almost 10 years as he’s presided over what has been really incredible growth, both organic and through acquisitions. And we all know how easy acquisitions are to handle in the CIO role. Right, Haden? No problem.
Haden McWhorter:
Super easy. Super easy. That’s right.
John Farkas:
His career in healthcare information management dives way back into the AS/400 mainframe era, as I would refer to it, but also the dawn of the internet. So his perspective and experience, coupled with the fact that he remains really a determined innovator means he’s got some great insight to bring us in the context that we’re going to talk about today.
So that’s one of the reasons we invited him to join us on Ratio’s advisory board. And the other reason is that, no matter who you talk to that has any experience working with or around Haden, they say he is one of the most kind, generous, gracious, and smart people they’ve had the chance to work with. So Haden, first thanks for what you’re doing to improve healthcare, and thank you for joining us on the podcast today.
Haden McWhorter:
Well, thank you very much, and I hope I can live up to that awesome introduction. I appreciate it. I have been around the industry for a long time. And it’s interesting how things have changed over the many years, but glad to be here and looking forward to the conversation.
John Farkas:
Yeah. Well take us back. Let’s go in the Wayback Machine for a second. And if you know what the Wayback Machine is, you have lived in the Wayback Machine for a while, but just share your journey in how you landed into the healthcare realm, and what are some of the primary steps you took that have brought you to where you are today?
Haden McWhorter:
Well, I would say sometimes people say it’s better to be lucky than good, and I think I was very lucky to land in the healthcare sector. Some have heard this story before, John, I don’t think I’ve ever told you this story, but there is a gentleman who’s retired now who was a local CIO. His name was Mark Farrington, and Mark has been my mentor and friend for many years. So my healthcare days started back when I was at Auburn University. I went to Auburn. I’m from Birmingham, Alabama originally, although I’ve been in Nashville now for about 31 years. So I don’t know if I get to call myself a true Tennesseean, but I’m super close.
But back at Auburn, it was my sophomore year, and I had been a 4.0 student leaving high school and had not become a 4.0 student in college. I joined a fraternity. I learned all about stuff you get to do in college, and I was behind. And so my mom called me one day and she said, “Look, you have spent more money in two years than we thought you’d spend in four. You have to get a job, and you need to come home next quarter and you’re going to work.” So I hang up the phone, and this is, again, John-
John Farkas:
She laid it down.
Haden McWhorter:
My mom was a lay it down kind of person. What was interesting was this was back before cell phones or anything else. I was living at the fraternity house, and my suitemates were next door, so there was four of us to one phone. And as soon as I hung up the phone, phone rings again, and my suitemate picks it up and he said, “Hey, it’s for you.” And it was my neighbor. And my neighbor was like, I won’t say the exact words he used, but sometimes men and women probably are lucky that they have someone in their life that treats them as if they are family but may not be family. And this man treated me like I was his nephew. He felt like an uncle to me, but he was just a neighbor, a friend.
And in a nice way, he said, “I hear you’re on the outs with your mom.” That’s not exactly the way he said it, but he was pretty accurate in the way he described it. And I said, “Yes sir, I am.” And he said, “Well, why don’t you come up to Birmingham, and come up to my office and let’s see what we can do for you.” And so I had no idea what he did for a living. I thought that he worked in a morgue because I knew that he wore a white coat around, kind of that show Quincy, John, we’ll show our age, like Quincy, he walked around, and I thought he did something with dead bodies. But I was like, by golly, if he’s going to help me out, I’m going to go try to take his help.
So I drove to Birmingham, and went to this nondescript warehouse, walked in. And back in the day, at this place at least, you filled out an application and then you waited to be interviewed right then. And so this woman came to grab me, I’ll never forget her or her name because we ended up working together, but she came and grabbed me and sat me down. And she started asking me, “Well, tell me about your background,” and, “How’d you hear about this job?” And I was like, “I don’t even know what job I’m applying for.” I said, “My neighbor told me to come talk to you guys.” And she’s like, “Who’s your neighbor?” And I said, “His name’s Joe Young.” And she said, “Oh, you’re that guy.” Which quickly taught me that networking is important. What you know, who you know. But you know who kind of gets you in the door, what you know kind of keeps you in the door. That’s always my expression with my kids.
And making a long story a little bit longer, I ended up, Joe comes in, he’s wearing the same white lab coat. Again, I have no idea what he does. And we sat down in the VP of HR’s office and he started talking to me about the company. And he’s like, “You’re too young to do a lot of stuff. What can you do?” And this is where luck comes into it. He looks at me, and I have no idea what to say. At the time, I’m 18 years old. I’d started school early, so I was 18, maybe almost 19. And I was like, “I don’t know what to say here.” But my neighbor being the kind gentleman he was, he’s like, “Well, you’re good with computers, right?”
And so it just so happened that he knew in high school that I’d helped with the computer lab. I’d also worked for a computer store. And I was like, “Yeah, I’m pretty good with computers.” And he’s like, “That’s great.” He said, “My DP manager,” so they didn’t even call IT, they called it data processing, “My DP manager’s always looking for somebody. So if you go upstairs, you’re going to take a drug screen, and if you pass your drug screen, then we’ll hire you on Monday.” And retrospectively, I’m a pretty straight-
John Farkas:
Thus were the early days of the computer realm.
Haden McWhorter:
Very early. And what’s really funny there is I didn’t know what a chance my neighbor took on me. Because at the time, I’m a very kind of straight laced person. I never did anything I shouldn’t really. Drank a little bit in college. That was about it. But as we’re walking upstairs, they both look at me, because they were literally like, “Okay, we’re going to go do a drug screen.” I’m like, “Okay.” Start walking upstairs. And they started explaining to me what a drug screen is like. “Yeah, sounds good.” And he kind of pulls me aside, he’s like, “So it’s going to test for a whole bunch of stuff.” I’m like, “Yeah.” So I didn’t even put it together. Years later I thought, oh my gosh, he was probably thinking at that point, I hope he’s as straight laced as I think he is.
But it turned out that that company was a clinical and pathology laboratory. It turned out that my neighbor was actually a histotech, which meant that he worked with tissue that came from surgeries. He would dissect the tissue into slides that the pathologist would read. And so that’s where my healthcare journey started. But Mark Farrington at the time, we would call it the CIO, was the leader of technology for that organization in Birmingham. And so I worked there through school.
And when I graduated from Auburn, I had an offer to stay with the company. And Mark had gone on to a new company here in Nashville called Allied Clinical Labs. They had an opening in Texas, and he called me and said, “If you’re interested, I’d like you to apply and interview for it.” And I did, and I got the job. So I went to Texas for two years before coming here. But I would say in the beginning it was very, very lucky that I rolled into what I did. I don’t actually have a computer science background. I have a finance background. But computers and math have always come easy to me, and that’s kind of how I started. So that’s luck. Luck is what got me into healthcare and I’ve been here ever since.
An Overview of Premise Health
John Farkas:
Well, and having a finance background for a CIO role is not a bad combination when you’re having to balance a lot of the factors you’re balancing now. So that makes sense. So as you look at your role, well first of all, tell us a little bit about Premise. I gave a brief introduction. But this is an organization that is incredibly dynamic, fast moving, fast growing, lots of different equations under your purview. Give us a little idea of what you oversee in the company, the ecosystem, and the information flows that you’re overseeing. Because it’s very dynamic because you are kind of in that in-between space, between employers and providers.
Haden McWhorter:
That is the truth. I mean, I would say we are, first of all, you did a great job of giving the elevator speech as to what direct primary care is. We work with large self-insured employers who are trying to control their healthcare costs and provide great healthcare value to their employees. And many times that breaks down to access to healthcare. So if you look at it, direct primary care, in the old days when I first started in this industry, which Premise can track themselves way back. So Premise was a come together of two of the industry leaders in direct primary care. But a lot of us have worked together for many, many years.
And in the beginning, it was onsite healthcare, that’s kind of what they called it. So it was the ability for a employee to have access to primary care, pharmacy, occupational healthcare, probably 25 or other 30 products they could have access to, depending on the client. But it was really about the access to care on site. Well, as we started to mature, what we realized was that you could serve the employee, and if you hear me say member, in our world, because of the number of services we provide, we call our patients members.
But when you looked at it, it’s like, okay, well we can help the primary employee, but how are we helping the family because we’re there for the family as well. But no one really wanted to drive on campus to one of our locations, have to get through the security guards. Because many times it was manufacturing to start, and access was hard to get to. So really we were driving towards the main employee, the person that was employed by the organization.
Over time we started doing these facilities called near site, which is if you think about it’s where, okay, where is the majority of the population live that we’re serving, and how do we put locations in place that they can have access there? And I think we’ll talk about it a little bit later. Where we did our Epic migration, and we had a lot more access and a lot higher quality virtual care, it really became just meeting the member where they were. So we could do onsite, near site, or virtually. We could meet that member and help them in their health journey.
So that is kind of direct primary care. We do offer a lot more services. As you said, we offer Connected Care+, which is for us, where we take claims information from our employers, we stratify that data in a way that we can help them attack where high claims live, where we have high disease states, and also where we can then have a plan for how we would engage those employees and help those employees find out who’s engaged, who’s not engaged. But there’s lots of things that we do today.
I’m proud of the fact of what we do. We actually here in Brentwood have our own clinic for our office. We also share it. It’s a near site facility, so we share it with others in the community if they have signed up for it. So it’s not an open to everybody, but if your employer has signed up for it, you’re free to go to it. And I had a couple health scare healthcare issues last year. And access to care was really important to me, and I was able to get to my physician when I needed to and speak to him, and now her. And so it’s really important.
And I think as you look at what we see driving next year, healthcare costs and healthcare spend is just going to continue to go up. I think we have seen some conservative values of what we think those percentages are going to be, and we believe, as an organization, they’re going to be higher even than what’s being reported. And ultimately it is becoming a problem that has always been out there for companies on how they help their employees. But now it’s becoming it’s a share issue. It’s an earning per share issue because now it is impacting their stock price and other pieces. And they’re going to have to start making these investments, hopefully with us, but with one of our competitors to help try to control some of this cost. So we believe as an organization, we are set up at a great place to help employees and to help employers.
John Farkas:
So give us a feel for the number of lives. How many companies are you working with? How many people are you charged with helping in the context of their care? How big is the community?
Haden McWhorter:
So roughly 800 wellness centers. We’re in 45 states and Guam. Probably about 2,500 organizations that we work with. And I would say 11 million lives roughly. Now those big numbers, they look at a lot of stuff that looks at the full umbrella of the things that we are supporting from a healthcare perspective. We have two organizations that are under the Premise umbrella that have to do with engagement, and also have to do with health fairs and things like that, that helps broaden the number of lives that we can touch.
So I would say if you look at our health center specifically, we’re probably a little bit under that 11 million number as far as those that we have an opportunity to see in and out in that type of scenario. And also those numbers, for clarity, because someone listening to this will ask is how many of those are engaged and how many of those are unengaged? Meaning what of that are the folks that we’re actually providing healthcare for today, and what are those employees that are potential that we could provide healthcare for? And so all those numbers kind of roll into that greater number.
Haden’s Role with Premise Health
John Farkas:
Gotcha. I’m going to jump off the page here a little bit and just ask, if you look at how you as the CIO of Premise would compare as far as your purview and the kinds of issues and organizational elements that you have purview over compared to your peer in a health system, how would you contrast your role and some of the things that you’re looking at that might differ from a CIO of a mid-size health system?
Haden McWhorter:
Well, I think the health system is looking, that peer of mine, because there’s a lot of folks that I work with, especially when you look at Epic and what they’re focused on, the things that they’re focused on and the things I’m focused on in some ways are very much alike, quality of care, member engagement, patient engagement, health outcomes, those type of things. But then that may be where it splits. If you look at a CIO at a mid-size health system, they’re also looking at tons of other departments inside their one little umbrella. They’re looking at emergency rooms or emergency departments, they’re looking at radiology. They’re looking at all these other pieces that today, for me, because we’re really around ambulatory care, I’m not having to work on those things.
And I think more, for me, my job is to make sure that our centers are powered with the technology they need to meet the member where the member is. But also how my organization looks at how we can provide scalability to reducing costs, which any other CIO’s probably looking at. But also my team is fairly heavily aligned with how we build products and how we deliver those products. And so I would say, and maybe not fair because I would probably want to go ask somebody, but I deal a lot with the business every day and working on the business and what we’re trying to do to do in the business. So that might be some of the things. Thank goodness, there’s a lot of things when I go to Epic and we have the CIO conferences, usually 50% of what they’re stressed about and what they’re dealing with, I’m not having to deal with, which allows me to focus on how we best use Epic, how we best use the tools we have, and how we provide that care.
John Farkas:
My sense is, based on what I understand about Premise, is that in your role maybe you have a little bit more agility and ability to innovate because you have maybe a higher level of control over fewer factors. Is that a fair assessment?
Haden McWhorter:
Well, I think we have to innovate because we are dealing with so many types of employers. So if you look at it, I mean, back in the day, I don’t know this is still fair, but on the East Coast you had a standard employer for us might be really focused on how to keep someone butts in seat. So how do I keep one of my investment bankers here onsite so that I can maximize the work they need to do for the day? Because it meant dollars. In the Midwest, back in the day, it was about manufacturing, and how there was a health component, but it was really also about cost savings. Then you went to the West Coast and it was really about the number of, and this may not be 100% fair, but just in general pieces, how do we stack up, and things that we offer to our employees as far as their healthcare and other pieces.
And so we have such a wide range of employers, we are constantly challenged to see how we put the best products forward that meet them where they are, and how do we help them engage and get their population to a journey of health. So how do you start with them? What we try to do, if you look at it, if we have the ability to fully engage with a client, meaning that we get claims data and all the pieces that go with that, we have a really strong opportunity first to engage the members, get them involved with a health center, make sure they understand what their benefits provide them, and then get them into a loop of making sure they’re having their physicals, making sure they’re having, if they have a disease state, that they’re getting constant care, and then from there they have to leave.
So for me, for instance, last year, and I think maybe I talked to you about this, I might not have, I was diagnosed with not one but two types of cancer. And in that, I was able to not only have my health center here that was helping me, not only get to work with our Connected Care folks who were doing care navigation, but we were able to send my case to Mayo to make sure that the treatment that I was receiving here in Nashville was going to be the right treatment for what I had. And it worked out beautifully. I mean, if you look at, taking out the diagnosis, the whole piece behind the scenes of how we navigated and what we did, it was awesome. So I had my healthcare home next door. I knew the people next door would draw blood and do the things that I needed to do. So that was super important in the journey, and that’s one of the many ways that we can help provide for our customers.
Promoting Member Engagement
John Farkas:
One of the things I like about Premise’s model that I think bears some study in understanding how we can continue it or make it more common is because the US is so employer healthcare focused. I mean it’s a big channel for where people receive their healthcare benefits. The clear alignment between incentive for participation in preventative care. I mean the incentives are really nicely aligned, right?
Haden McWhorter:
Yes.
John Farkas:
In some ways that are not as common in some of the other frameworks that you look at. And so I’m really interested in what you are doing to drive that engagement, and some of the initiatives that you’re putting forward that are helping to mobilize people to take advantage of the services that you’re providing.
Haden McWhorter:
That unto itself could take an hour and a half to two hours to talk about.
John Farkas:
I’m sure.
Haden McWhorter:
If you look at it, I mean, that is one of the things that is going to, and I don’t know if you saw it, we just recently, Milliman just produced a report based on our ROI calculations in how we interact with our clients. It’s the first time in our industry this has been done. And it was really interesting about the things that they showed impacted mostly that ROI. And one of them is member engagement.
And so member engagement is extremely important, and that’s where we probably have the greatest opportunity right now. Because as we were talking about earlier, if you look at that 11 million people that we potentially have the ability to impact, how many of those are engaged, that we’re seeing all the time, and how many of those is there an opportunity to make sure they understand their healthcare benefits as it goes to however we’re providing care. Whether that’s virtually, if that’s near site, if that’s onsite, or all of the above, and how we get them involved.
I think the first thing that we always have to work with our customers on is making sure that we have the ability to market to their employees. Some of our customers, for different reasons, don’t always allow us to market. And so we had to find creative ways to make sure that those employees understand the benefits they have and how they can engage with us in a traditional way. So we do have the opportunity today, and again, the reason I say this could go on forever is that we are knee deep in this right now.
The first thing we try to do is break it up into, and you’ve heard me say this several times, who’s engaged, who’s unengaged? And so who’s engaged? Who are we providing care to? And who’s attributed to a physician that we have there? Because important for us that we have physician attribution, it’s important for us that we’re getting folks in. Then the next thing you have to look at is, okay, where do we have proximity to our health centers, whether they’re near site or there’s a virtual program or whatever, where is their proximity? And starting to look at that low hanging fruit of proximate members and how we engage those folks.
Most of the time, what you do, very similar to other health systems, you find a group for whatever makes them the cohort they are. And then you create a campaign, and through that campaign you’re either doing mailings, you’re doing email, you’re doing texting, you’re trying to reach out and get to folks. And I would say today we do a pretty good job of that. It’s just where we end up having clients who do not allow us to proactively reach out to people who are unengaged. So there’s a big piece about being engaged and being unengaged.
We have a full team though. It’s really great. Over the last year, we have brought in some really seasoned professionals around member engagement. We have a big project that’s going on right now, that it’s going on this year, it will go into next year, about how we’re engaging and tools that we’re using. We’re using Epic as a good bit of it. We’re using Salesforce Marketing Cloud as a good bit of it. We have a data project that has been running now for a year and a half. And that data project, one of the use cases was pulling member data to a point that the analytics teams for our member teams could start to query the data and find new insights that would allow them to see where they could interact with those members. So that is a huge piece of it. Huge piece is that engagement.
Haden’s Value Equation
John Farkas:
No doubt, no doubt. Let’s jump into some of the business of deploying technology that you get to oversee. So you emphasized that equation, clinical security plus business equals value of investment. It’s one of the things that we talked about in preparation for this podcast. And I’m curious, and you talked about how the success of alignment with the CFO is really critical in there. What do health tech companies need to know about that equation, how you look at that, and how they need to present what they’re bringing to address that framework? Because I think that that’s a pretty important idea.
Haden McWhorter:
And I think there’s two things there. I think there is, as we look at it from a Premise standpoint, the quality of the clinical services, clinical operations teams that we have and the work they do. I mean the people in the field are the ones that really make us successful because they’re seeing patients day in and day out. And they really have the relationships with our clients.
When you and I were having that conversation, I think at a higher level, when you’re looking at your entire organization, and you’re trying to figure out where you think you should be making investments that align with the strategic goals and objectives of the organization, it’s really important, one, to have a roadmap and a plan of how you think you can implement those pieces. But the other is to understand what the CFO’s roadmap is as they try to look at things. We are private equity owned, which for those in the podcast world that are private equity owned, you know that private equity is-
John Farkas:
We should put together a support group.
Haden McWhorter:
Yeah, We should. But I will tell you that I got the lucky draw. The private equity group that we work with is out of Canada, so they are not a US-based private equity group. So they don’t have the same normal structure, like the stuff that you’ve been used to and I’ve been used to. You get on the Ferris wheel for a three year or five year run. And at a certain point you’re investing, then you’re not investing in how you do things. That’s not how OMERS, who is our private equity group, does things. They see the value in what we do, and I think they are a great partner in continuing to invest in the things that we do day in and day out.
John Farkas:
That’s awesome.
Haden McWhorter:
That’s been great. But even with there, there is still, you have to find the line of making the right investments for the organization, and tying those to how the CFO sees what his or her playbook is as far as-
John Farkas:
[inaudible 00:29:59].
Haden McWhorter:
… what they’ve laid out for financials for whoever. It doesn’t have to be a private equity group. It can be whoever owns you. Ultimately, they care about your financial health because if you’re financially healthy, you can continue to provide the goods and services that you need to provide. I’m fortunate that in the weird connection of my life that Mark Farrington, who I told you was the gentleman that I first worked for in healthcare, I started working with his wife in 1992. And so she and I have worked together since ’92 at several different organizations. At one time, she was my boss. She and Mark and her sister were a founder of a company called W Squared here that was one of the companies that fell into Premise Health. Well, some of us fell into Premise Health there.
But Shannon and I have worked together for a really long time. And when I first started working with her again, we just sat down and she started telling me, “Here are the levers that are important to me. Here are the things that are important to me strictly from a financial standpoint.” She’s a little bit different and interesting to talk to because she is not your typical CFO. She is very much a strategic thinker, not that CFOs aren’t, but more she could hold multiple roles in our organization, and kind of holds multiple roles in our organization. But she’s balancing that, I would say, fiscal conservativeness with how you grow the organization, how you launch the organization, how you keep things fresh, and how you keep things moving. And so we sat down a long time ago-
John Farkas:
That’s a great combination in that role for sure.
Haden McWhorter:
It is great and not common. And so it’s great when I sit down with her because she has the ability to say, “Here are the levers, here’s what we’re looking for, here’s where I see things going. Where do you see things going?” And from that, we can develop a plan that’s cohesive. So I don’t ever feel like, either with Stu, our CEO, or her, any of my other peers do I feel like we’re an afterthought. Many times we are one of the first thoughts because what we’re doing could impact everything else that we have going on.
John Farkas:
And so as you are looking at making some of those decisions for investment, knowing that there is a lot of factors entering the equation right now, what are some of the primary challenges? What are some of the horizons you’re going after, and how are you evaluating the spend compared to what you’re hoping to see out of it? What are some of the factors entering your world right now, specifically as you are looking to advance your agenda?
Haden McWhorter:
Well, I mean I think it goes back to, from the Milliman study, if you look at that, what are the things that we drive that help-
John Farkas:
And by the way, we’ll look to reference that in the notes for listeners.
Haden McWhorter:
Yeah, that would be great. And I’m glad to send you some links. If you just go to Milliman, you can find it. Or just Google Premise and Milliman. I think again, how we engage our patients, attribution, and a couple other pieces are really the first big pieces that we start to look at. So if you look at what we’re focused on for this year and next year, it started with looking really strongly at how and who we go with to partner and look for from a revenue perspective. We’re looking for folks that aggregate belly buttons together. We’re looking for large employers. We’ve talked to health plans. We’ve just announced some of that stuff. So that was our first thing, okay, where do we see that we’re going to focus on revenue? And from a technology standpoint, I like to say, okay, what are the things that my team needs to do to empower that team?
And then you go to kind of the next thing, which is strategic projects. And we’ve talked about several of those. Member engagement is a strategic project for us this year. How we engage and how we continue to engage, and how do we become the best at that? Data is another big project that we’ve taken on. The joke, I can’t remember exactly how it goes, but if you don’t want to stay a CIO long, do a data project. Fortunately I’ll say that our data project is moving well and it’s understood by our executives.
And so there is a data component because we want to be able to be agile with our data so that we can use that data to make the best decisions at the right times. And today, we just cannot be very agile for lots of reasons. We feel like that Premise has only been around for 10 years or so, but Premise has been around for many, many years. Because we are, I’d say, a culmination of others in the industry that have come together. And so we carry a lot of data with us. We have a lot of, in some ways, you might say data baggage, but others just, there’s a lot of folks here that understand data. And so it’s how do we become more agile with the data?
We looked at Connected Care, that product and how we continue to find ways to identify spin, identifying where we can help our patients, our members, look at ways that we can continue to help our clients control cost. And so those were three big projects, as well as how do we continue to organize ourselves for growth. So that’s kind of stuff we looked at. We looked at products and the products that we were delivering to do those things. And so everything was a building point on the other. And I would say probably at the end of ’22, going into ’23, ’23 into ’24, I would say our full e-team is laser focused on those things. Those are the things that we all talk about. How does my project impact this project? How does this project impact this project? All to come together to have one outcome that betters the organization.
Using Data to Improve Engagement
John Farkas:
So you’re right, Haden, I think we could spend a lot of time here, which we’ll be cognizant of that. But hey, talk a little bit about some of the initiatives that you have moving or what you’re farming right now around member engagement. Engagement is huge. And healthcare in general for Premise, and how you guys are set up and structured, it is extra critical for your business and how you prove value. So talk a little bit about what are some of the horizons and engagement that you guys are looking at in particular?
Haden McWhorter:
I would say, first and foremost, just continuing to improve in our ability to engage members so that at its base level as its foundation, how do we continue to make that a core tenet of what we’re trying to do and how do we improve on it day in and day out, or maybe quarter in and quarter out. From a technology standpoint, there is a lot of data out there that we can provide to our member engagement teams to help them figure out what is the best course of engagement. We’ve done partnerships with others outside the org to look at data, to look at more conventional marketing buckets of where people might be in their engagement lifecycle and ways that we can do those things better. As I said earlier, we have two strong tools. We have Epic as one of the tools, which has a lot of this stuff built in, but we also use Salesforce Marketing Cloud as another way to get our campaigns out.
I think looking into ’24, it’s going to be very interesting because some of the things we’ve had to do outside of Epic in the past. Eventually Epic will catch up with where you are and will pass you very quickly. And so there’s a lot of things that we have been doing for our customers for engagement, microsites and direct reach outs and things like that, that Epic is starting to pull back into their system. So I think the question for ’24 is how those things we’re doing today and the things that we potentially can do with the tools we have, how do we pull those together? But how do we make them easier for our teams that are responsible for that?
Because today, it’s not super easy for our member engagement teams to do the engagement they want to do. They know the questions they want to ask, but it goes back to data agility, it goes back to access, it goes back to how data flows. We are an organization that takes data privacy very, very seriously. So we have to look at how things flow internally and externally, and what that means. One of the things that makes our lives exciting is that we have lots of customers. And so different from a health system, maybe that’s one of the things that really differentiates us is like, I’m worried about 2,500 customers. I’m not worried about one health system. I’m worried about a whole gamut of things that different clients have different concerns about, GDPR versus not GDPR, how we interact with data, how we don’t interact with data.
John Farkas:
That’s where I was going to kind of go next. And knowing that you have 2,500 customers, and a lot of people that you’re taking care of, and you’re interested in data agility.
Haden McWhorter:
Might be a oxymoron. Yeah.
John Farkas:
I’m looking at the vectors here and trying to resolve them, but talk a little bit about the unique challenges of that. Because you are finding ways to integrate in some form or fashion with 2,500 customers and several million humans. So that’s a whole lot of points. And so talk about some of those unique challenges.
Haden McWhorter:
I would say, if you start to look at it, the biggest is you have to balance several pieces. You first have to balance your contractual obligation to your client. So whatever that contract laid out and what they require you to do from a data standpoint or other pieces. But normally for our probably customers, and this goes from most of our customers that are data aware, there’s usually some type of data provision inside those contracts. So our teams have to understand what those individual contracts may have or may not have.
You also have to balance that from a contractual basis, we have customers who have been around for a very long time, and those standard contracts stay in place. And so we may have just done addendums when we’ve renewed with a customer, but our CISO would call me one day, and he is like, “Hey, we need to talk to this customer.” I was like, “Why?” And he said, “Oh, their contract is so old that it limits us from doing something that today no one would even blink at, but it was contractually there.” So our teams have to think about a lot of things. They have to think about what does our clients expect? And then after that they have to go, okay, what state do those clients live in? Are there state guidelines they have to be concerned about? What are the governmental guidelines that we have? It’s not just cut and dry on this is what you can do and this is what you can’t do.
And so sometimes it feels like you’re working a giant jigsaw puzzle. So as we looked at the data project, and as we continue to look at the data project, what are things that we could do today that will make us more agile? And it’s not only where is the puck today, but where is the puck getting shot in the future so that we can try to head off some of the things that limit us today around what we can or can’t do. And lots of times our customers are very understanding, but it takes our security, privacy, and legal teams just a lot of time to go back and say, “Hey, because of this product, now these are things that we want to do.” And many times you’re dealing with an HR team that has to defer to a security team that then has to defer to a legal team.
And so it doesn’t feel like things happen very fast. Even with our customers, we have great relationships, but even the customers that you have the best relationships, you still know that it’s not going to happen quickly. So we’re like, okay, on this side as we do the data project, what are the things that we think we know, from all of our experience, the things we get hit with, the things we get asked, and how do we just plan for that so that if we need to go through and turn certain things off, we can without having everything be a rework. And so that’s the challenge. A lot of times it’s like my teams are doing less, there’s always a technical component, but a lot of times they’re having to think about things more from a legal contractual component.
John Farkas:
That makes sense and not easy. There’s-
Haden McWhorter:
Not easy.
Epic’s BFF Program and Other Premise Health Partners
John Farkas:
… a lot of points there. And I want to be cognizant of our time here, and there’s a lot to talk about. I know that you guys are recently, and I will call it an Epic convert. You went through that migration, and I know that you feel really good about that relationship. And part of what helps you feel good about that is their BFF program. One of the things we talk to our clients a lot about is the critical importance for solution providers of customer success. And knowing that when you jump in and are coming in as a partner, making sure that all the I’s are dotted, T’s are crossed, and if something needs to get re-dotted or re-crossed, there’s an easy path to making that happen. Talk about why that wins for you all and how that’s a differentiator.
Haden McWhorter:
Well, I think with Epic in the beginning, there’s a couple of things. One, as we did the Epic implementation, we said, let’s not do what has happened to us in the past. Let’s not get this awesome tool and then us tell Epic how we’re going to implement. Let’s let the person who does this day in and day out, the team that does this day in and day out, tell us how we should implement. So we took all the feedback that Epic gave us very seriously, and worked with them in the very beginning. They were part of the team that helped us. A lot of teams go to a lot of outside contractors. We hired our own team internally, and then brought contractors in to fill day-to-day jobs.
While our teams got to work on this project, we worked with Epic very closely so they could understand what we did. Because this was new for them to go outside of health systems into something more of what we were like. And so that was super important. So that started the relationship off great. But the BFF program specifically, and why I think this is important for people that provide solutions is, I feel like I have someone who is trusted that I can go to day in and day out. I can email them, I can contact them, and they understand my business well.
I have two individuals, one’s our BFF, her husband, which we just got really lucky, who leads R&D for the development team, and then our technical services person, the technical services person and our BFF understand our business so well that it’s almost like having an extension of the team. As things happen at Epic, as new things get rolled out, they’ll reach out to us and say, “Hey, I think we should look at this. Look more for this, less for this.” But it’s just they have our best interests at heart. And I know that sounds really maybe naive because you can say that’s not really true.
But the things they’ve done, we have a story where we were there with Epic, and we were having a hard conversation about licenses that we had pre-purchased ahead of our implementation. And at the time it looked like we over purchased. And one of our representatives, you could call it an account person, but he’s our technical services guy, when he understood the problem, and I didn’t realize at the time, in front of the CFO of Epic, was basically like, “We should give these guys a refund or credit because,” and he went through this whole thing. I mean talk about flying too close to the sun. And we realized at the time, it was me and one of our SVPs, and I was just looking at her. And she texted me and she’s like, “I hope he still has a job after this.”
But to the credit of the teams that we work with, and I’m sure there’s outliers in every organization, but Epic, the teams we’ve worked with seem to be very driven towards our success, and how they can help us be successful and what’s best for us. There’s always been a time in your career where you’re like, if I could do this the right way, this is the way I would do it. And it just seems like our teams, the Epic teams, at least for us, that’s how it’s always been. It seems like they do it the right way, they don’t do it the shortcut way. They do it the right way.
John Farkas:
Yeah, I think that that’s such an important piece. And it’s to me so easily overlooked or undervalued. Once you have an agreement, that’s the start point. It really is. And understanding that. And I think even starting in the context of marketing and instilling the understanding of how you are going to deliver, and why that’s important, and how that is going to end up manifesting, I think ends up being a critical piece in how you carry that stuff forward. And I think that is not to be undersold for sure.
Haden McWhorter:
No, those relationships are important for sure.
John Farkas:
Other than Epic, have you seen some other good examples of how organizations have done that? Probably looking at maybe in advance of you signing on.
Haden McWhorter:
100%.
John Farkas:
How’s that happened?
Haden McWhorter:
Well, I would say now in a lot of the things that we’ve done, if it’s Trace3, who’s been a great partner for us from a technology standpoint. I feel like this is almost like the Academy Awards. I don’t think you can name all the folks that have been great to work with without accidentally leaving somebody out and someone feeling hurt. But I will tell you, things that we-
John Farkas:
I’m sure they’re all going to be listening to this podcast.
Haden McWhorter:
That’s right. And they’re all going to say, so we love them all. But I would say that after having such a strong experience with Epic, when I get asked, Databricks team reached out to me recently. Another team reached out to me recently. And they are asking us what are things that are important? And to their credit, they said, “Give us an example of a vendor that you work with that does an outstanding job.” And we always go back to Epic and explain-
John Farkas:
No pressure.
Haden McWhorter:
Yeah, no pressure, but here’s-
John Farkas:
The largest healthcare IT company on the planet.
Haden McWhorter:
And probably have pretty good revenues. They can afford to do all this stuff. But if you look at it it’s like it’s really more about having that person that you can go to that understands what you’re doing. It is a relationship. I know that not everybody believes it’s a relationship, but there are a lot of folks here in Nashville that this is about the relationship. Plow Networks does a great job with that. We really don’t buy very much from Plow, but if I needed something, I could call those guys and it’s as if I bought a million dollars from them the day before. The owners will reach out to me, what can we do for you? And it’s just, I think, Nashville, we might be lucky. I talk about this when we’re in Verona at Epic and I talk to other CIOs. And in some ways we might be lucky here in Nashville that we do have a strong healthcare community, and we actually have a very strong technology community of people wanting to come together and really support and help each other. And so those are the examples that we use.
John Farkas:
Yeah, that’s great. I think that some of what I’m hearing, and I think that this is true in my experience, you have to have a team that is ready to engage and understand the business that you are. Your business. So it’s not just understanding how their solution integrates, it’s being willing to jump in and get a macro understanding, or at least an attempt to get a macro understanding, of where you’re going and what your objectives are. So that they can be on the lookout. So they can look at how we are going to optimize and maximize and be your advocate in that. I think that that’s so important. And I see, one of the big errors often that I witness is people are just understaffing that function with people that are just solution supporters, not business-minded, consultant framed.
Haden McWhorter:
I was just going to say, and you hit on it. As I was thinking here, thinking about people that are providing solutions and what they may take away from it is one of the things to understand is that we have been on Epic now since, we signed our deal in 2017, I would say fully integrated at the end of 2018, so five years now. And my BFF is still my BFF. She has had promotions through Epic. So this is not a job where this is her only… She has a day job and then she does this, holds this function. And I hurt her feelings one time because I asked her, I said, “Well, how many people are you BFF for?” And she’s like, “You can only be one BFF.” And so they take the volume of employees that they have that have the skillset to do this, and they apply them to their clients.
And so I don’t have to worry that this is actually her full-time job, and then she gets promoted and I have to get somebody else and train them. So the team that we have has been the team that’s been assigned to us since we went live. And I think that goes to retaining good employees, that goes to investing in them, that goes for us, we’ve invested a lot of time in them so they understand what we do and how we do it. And we’ve always seen fruit from that investment. But I would say really over the last few years, they understand us so well that they provide a lot of value for us. But anybody can do that, to your point. But there is an investment that you have to make, you have to be willing to make.
Haden’s View on AI
John Farkas:
Yeah, that’s a great insight. All right, I’m going to ask the AI question. AI is the hot topic these days. As Premise is looking at the use of integration of AI, it fits into everything we’ve talked about in some form or fashion, but are there any particular initiatives or corners that you’re looking to AI to help solve problems in particular?
Haden McWhorter:
Well, I think first and foremost, how can we take any burden that our providers have today and help them with that burden? I mean, something that we haven’t called out, and something that I think is unique to the way that we provide healthcare is that our providers are not required to see a certain number of employees or patients a day. So they’re not sitting there having to churn through. So we encourage them to have time, have conversations, really get to know that person.
But how do we make Epic, which we think does a great job, how do we make Epic better and easier to work with? And so Epic as a whole has introduced, we were just there in August, they’ve introduced several AI enhancements that will be coming out in current product releases and upcoming product releases. We’ll definitely implement those so that we can help our providers and help those that are providing care. I think other things that we’ll look at are our partners first on, we do a lot of SaaS-based stuff. So there’s not a ton that we host here. There’s a lot of partnerships that we’ve formed. We are dialing into those partnerships to see how they’re going to be handling AI, and what we think is important.
Obviously the way that we do RFPs and ways we can help our legal team, we think there’s great value there. I’m not of the belief that people go away. There’s a whole bunch of people think we’re going to start replacing jobs. I think what we’re doing is we’re providing that person, because we make a lot of our people do a lot of work day in and day out, their desks are wide and they have a lot of… You hear about people doing stuff off the side of their desk. A lot of our people have massive desks because there’s stuff piled on.
So we’re looking at it it’s like, well, how do we help with AI to do those things? How do we help the legal team maybe review contracts better, maybe go through and pull things together? How can we help the marketing team? How can we help RFPs? Because we spend a lot of time on making sure that we’re doing the right responses on these requests for proposals. How do we pull that stuff together? So we’re looking at all that. And we’re looking at how does just a normal chat bot today help our folks work?
I mean, there is a concern, we are much more interested in things that say self-contained so that we know that they’re not breaching, either like Microsoft, they’re not breaching outside of the Microsoft environment or other things. We’re probably a little bit more apprehensive about things like that, but more ready to engage things where we know that our-
John Farkas:
It lives in your ecosystem.
Haden McWhorter:
.. intellectual property doesn’t go someplace else, and it helps enhance what we’re doing.
Closing Questions
John Farkas:
Yep, that makes sense. Great. So if you were to leave a health tech company with one piece of advice, thinking about in the marketing frame, knowing that you look at solutions all the time, you’re engaging, what would be something that you would want them to know that they could use practically as they frame their work in marketing? What would be a single piece of advice you’d have?
Haden McWhorter:
I would say do your homework. I mean, to those that have been in the industry for a long time and do a great job, they’re going to say, okay, that’s what you tell me? But you would be surprised-
John Farkas:
No, I wouldn’t.
Haden McWhorter:
… how many people come to us with solutions that really don’t have an idea of what we do. And I would rather, before you came and presented something, I’d much rather have a 30 minute, 45 minute conversation to at least give you a framework. Because I don’t have time to waste energy. My teams don’t have time to waste energy. And again, it kind of goes back to that partnership is respecting the time and the energy and the things we’re trying to do. We want to find the right solutions. But going into it, thinking about the ways that you’re going to try to help us solve a problem and what that problem is and what’s important.
Because to some, it may be less about money and more about the solution and how quickly you do it. So to some the solution is important, but hey, I’m really in a bind over how I’m going to spend dollars in ’23 and what can I do for ’24? And I think if you do a little homework, it goes a long way. And again, I think relationships matter. Forming a relationship, not having that person on the other end feel like it’s just about a sell, that you have a care in have that tool, application, whatever you might be selling, will impact and help that organization move forward.
John Farkas:
Yeah, makes sense. Okay, curious, final question. I know that peer-to-peer is a primary channel for how you’re hearing about things and taking in information as far as innovation and new horizons. Go outside of the peer network, what are some of the channels that you’re tuned into? How are you hearing about new things? What are you listening to? What conferences are you going to?
Haden McWhorter:
I would say I’m going to less conferences because I’m hoping that my team members, I mean we have a fixed budget on those things, I hope that our teams are going to the conferences they need to go to. I just do a lot of reading. I subscribe to a lot of different newsletters. I subscribe to McKinsey. I subscribe to CIO Magazine. To your point, I do a lot of peer-to-peer type stuff. I feel like after having 31 years in Nashville, I have a great group of people that I can go to to find out about things. Sit on a couple CIO councils. And so I would say it’s kind of a mixed bag.
But mainly I like to read. I like to get out. So as soon as I find a topic we need to hit up on, I’ll do some research. I’ll go out, I’ll subscribe to some newsletters. And then from there I’ll try to do more of a targeted outreach to some of my peers who I think might be trying to implement those pieces. The OMERS’s relationship, our private equity relationship, has been really nice because they bring together all the CIOs for all their portfolio companies quarterly, and we have a chance to talk about things that are impacting us.
So after the pandemic, we were actually an example, as well as a European-based company, on how we were able to switch from basically being in the office to being at home overnight. So there’s a lot of things that we do around stuff like that. I do attend the Epic conference every year, every year that I can, because I do find more and more they are starting to have a lot of great information around Epic and the CIOs. But also just stuff that’s even outside of what Epic is doing, but they’re thinking about their roadmap. And that’s always super helpful too.
John Farkas:
Haden, thanks for the input here and the opportunity to spend this time and get a little window into your world. It is a fascinating place. Is there anything else that we haven’t covered, anything that’s occurred to you here that would be good to bring out as we finish?
Haden McWhorter:
No. I mean, I think we hit a lot of stuff. I think I would be remiss, and you said so many nice things about me in the beginning, and at the end of the day, it’s really not about me, it’s about the teams. I have great teams. I have leaders who have been with us for over 10 years. One of my direct reports has been, I hired her 20 years ago. We have a really solid group of individuals who’ve been with the organization for a really long time, and that makes it a lot easier. I’m not having to do a lot of lifting. There’s lots of folks that can do lifting, and that makes it important. So my team is what really makes us hum.
John Farkas:
Haden McWhorter, CIO of Premise Health. Thank you for your time today, and thank you all for listening to Healthcare Market Matrix.
Haden McWhorter:
Thanks, John.
John Farkas:
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.
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Transcript (custom)
Haden’s Accidental Journey to Healthcare
John Farkas:
Well, hello everybody and welcome back to the Healthcare Market Matrix where we offer genuine market insights straight from the decision makers who are driving change in the healthcare industry. And the longer I am in this ecosystem, the more impressed I am with the number of people who are passionately dedicating their careers to meaningful change in healthcare. And our guest today is, without a doubt, a great example of that kind of leader. Let me introduce you to Haden McWhorter. He is the chief information officer of Premise Health.
And for those of you who might not be familiar with Premise, Premise health is, I think we’re safe to say, the leading direct healthcare provider to employer populations. And that means that instead of employees going outside to outside providers for healthcare, employers can offer those services on onsite or nearby, which effectively improves utilization. It can result in reduced time away from work, which often translates into lower cost, and ultimately better healthcare outcomes. And I’m going to let Haden dive deeper into that.
But as I mentioned, Haden serves as the chief information officer at Premise. And it is safe to say that he has had a tiger by the tail over the last almost 10 years as he’s presided over what has been really incredible growth, both organic and through acquisitions. And we all know how easy acquisitions are to handle in the CIO role. Right, Haden? No problem.
Haden McWhorter:
Super easy. Super easy. That’s right.
John Farkas:
His career in healthcare information management dives way back into the AS/400 mainframe era, as I would refer to it, but also the dawn of the internet. So his perspective and experience, coupled with the fact that he remains really a determined innovator means he’s got some great insight to bring us in the context that we’re going to talk about today.
So that’s one of the reasons we invited him to join us on Ratio’s advisory board. And the other reason is that, no matter who you talk to that has any experience working with or around Haden, they say he is one of the most kind, generous, gracious, and smart people they’ve had the chance to work with. So Haden, first thanks for what you’re doing to improve healthcare, and thank you for joining us on the podcast today.
Haden McWhorter:
Well, thank you very much, and I hope I can live up to that awesome introduction. I appreciate it. I have been around the industry for a long time. And it’s interesting how things have changed over the many years, but glad to be here and looking forward to the conversation.
John Farkas:
Yeah. Well take us back. Let’s go in the Wayback Machine for a second. And if you know what the Wayback Machine is, you have lived in the Wayback Machine for a while, but just share your journey in how you landed into the healthcare realm, and what are some of the primary steps you took that have brought you to where you are today?
Haden McWhorter:
Well, I would say sometimes people say it’s better to be lucky than good, and I think I was very lucky to land in the healthcare sector. Some have heard this story before, John, I don’t think I’ve ever told you this story, but there is a gentleman who’s retired now who was a local CIO. His name was Mark Farrington, and Mark has been my mentor and friend for many years. So my healthcare days started back when I was at Auburn University. I went to Auburn. I’m from Birmingham, Alabama originally, although I’ve been in Nashville now for about 31 years. So I don’t know if I get to call myself a true Tennesseean, but I’m super close.
But back at Auburn, it was my sophomore year, and I had been a 4.0 student leaving high school and had not become a 4.0 student in college. I joined a fraternity. I learned all about stuff you get to do in college, and I was behind. And so my mom called me one day and she said, “Look, you have spent more money in two years than we thought you’d spend in four. You have to get a job, and you need to come home next quarter and you’re going to work.” So I hang up the phone, and this is, again, John-
John Farkas:
She laid it down.
Haden McWhorter:
My mom was a lay it down kind of person. What was interesting was this was back before cell phones or anything else. I was living at the fraternity house, and my suitemates were next door, so there was four of us to one phone. And as soon as I hung up the phone, phone rings again, and my suitemate picks it up and he said, “Hey, it’s for you.” And it was my neighbor. And my neighbor was like, I won’t say the exact words he used, but sometimes men and women probably are lucky that they have someone in their life that treats them as if they are family but may not be family. And this man treated me like I was his nephew. He felt like an uncle to me, but he was just a neighbor, a friend.
And in a nice way, he said, “I hear you’re on the outs with your mom.” That’s not exactly the way he said it, but he was pretty accurate in the way he described it. And I said, “Yes sir, I am.” And he said, “Well, why don’t you come up to Birmingham, and come up to my office and let’s see what we can do for you.” And so I had no idea what he did for a living. I thought that he worked in a morgue because I knew that he wore a white coat around, kind of that show Quincy, John, we’ll show our age, like Quincy, he walked around, and I thought he did something with dead bodies. But I was like, by golly, if he’s going to help me out, I’m going to go try to take his help.
So I drove to Birmingham, and went to this nondescript warehouse, walked in. And back in the day, at this place at least, you filled out an application and then you waited to be interviewed right then. And so this woman came to grab me, I’ll never forget her or her name because we ended up working together, but she came and grabbed me and sat me down. And she started asking me, “Well, tell me about your background,” and, “How’d you hear about this job?” And I was like, “I don’t even know what job I’m applying for.” I said, “My neighbor told me to come talk to you guys.” And she’s like, “Who’s your neighbor?” And I said, “His name’s Joe Young.” And she said, “Oh, you’re that guy.” Which quickly taught me that networking is important. What you know, who you know. But you know who kind of gets you in the door, what you know kind of keeps you in the door. That’s always my expression with my kids.
And making a long story a little bit longer, I ended up, Joe comes in, he’s wearing the same white lab coat. Again, I have no idea what he does. And we sat down in the VP of HR’s office and he started talking to me about the company. And he’s like, “You’re too young to do a lot of stuff. What can you do?” And this is where luck comes into it. He looks at me, and I have no idea what to say. At the time, I’m 18 years old. I’d started school early, so I was 18, maybe almost 19. And I was like, “I don’t know what to say here.” But my neighbor being the kind gentleman he was, he’s like, “Well, you’re good with computers, right?”
And so it just so happened that he knew in high school that I’d helped with the computer lab. I’d also worked for a computer store. And I was like, “Yeah, I’m pretty good with computers.” And he’s like, “That’s great.” He said, “My DP manager,” so they didn’t even call IT, they called it data processing, “My DP manager’s always looking for somebody. So if you go upstairs, you’re going to take a drug screen, and if you pass your drug screen, then we’ll hire you on Monday.” And retrospectively, I’m a pretty straight-
John Farkas:
Thus were the early days of the computer realm.
Haden McWhorter:
Very early. And what’s really funny there is I didn’t know what a chance my neighbor took on me. Because at the time, I’m a very kind of straight laced person. I never did anything I shouldn’t really. Drank a little bit in college. That was about it. But as we’re walking upstairs, they both look at me, because they were literally like, “Okay, we’re going to go do a drug screen.” I’m like, “Okay.” Start walking upstairs. And they started explaining to me what a drug screen is like. “Yeah, sounds good.” And he kind of pulls me aside, he’s like, “So it’s going to test for a whole bunch of stuff.” I’m like, “Yeah.” So I didn’t even put it together. Years later I thought, oh my gosh, he was probably thinking at that point, I hope he’s as straight laced as I think he is.
But it turned out that that company was a clinical and pathology laboratory. It turned out that my neighbor was actually a histotech, which meant that he worked with tissue that came from surgeries. He would dissect the tissue into slides that the pathologist would read. And so that’s where my healthcare journey started. But Mark Farrington at the time, we would call it the CIO, was the leader of technology for that organization in Birmingham. And so I worked there through school.
And when I graduated from Auburn, I had an offer to stay with the company. And Mark had gone on to a new company here in Nashville called Allied Clinical Labs. They had an opening in Texas, and he called me and said, “If you’re interested, I’d like you to apply and interview for it.” And I did, and I got the job. So I went to Texas for two years before coming here. But I would say in the beginning it was very, very lucky that I rolled into what I did. I don’t actually have a computer science background. I have a finance background. But computers and math have always come easy to me, and that’s kind of how I started. So that’s luck. Luck is what got me into healthcare and I’ve been here ever since.
An Overview of Premise Health
John Farkas:
Well, and having a finance background for a CIO role is not a bad combination when you’re having to balance a lot of the factors you’re balancing now. So that makes sense. So as you look at your role, well first of all, tell us a little bit about Premise. I gave a brief introduction. But this is an organization that is incredibly dynamic, fast moving, fast growing, lots of different equations under your purview. Give us a little idea of what you oversee in the company, the ecosystem, and the information flows that you’re overseeing. Because it’s very dynamic because you are kind of in that in-between space, between employers and providers.
Haden McWhorter:
That is the truth. I mean, I would say we are, first of all, you did a great job of giving the elevator speech as to what direct primary care is. We work with large self-insured employers who are trying to control their healthcare costs and provide great healthcare value to their employees. And many times that breaks down to access to healthcare. So if you look at it, direct primary care, in the old days when I first started in this industry, which Premise can track themselves way back. So Premise was a come together of two of the industry leaders in direct primary care. But a lot of us have worked together for many, many years.
And in the beginning, it was onsite healthcare, that’s kind of what they called it. So it was the ability for a employee to have access to primary care, pharmacy, occupational healthcare, probably 25 or other 30 products they could have access to, depending on the client. But it was really about the access to care on site. Well, as we started to mature, what we realized was that you could serve the employee, and if you hear me say member, in our world, because of the number of services we provide, we call our patients members.
But when you looked at it, it’s like, okay, well we can help the primary employee, but how are we helping the family because we’re there for the family as well. But no one really wanted to drive on campus to one of our locations, have to get through the security guards. Because many times it was manufacturing to start, and access was hard to get to. So really we were driving towards the main employee, the person that was employed by the organization.
Over time we started doing these facilities called near site, which is if you think about it’s where, okay, where is the majority of the population live that we’re serving, and how do we put locations in place that they can have access there? And I think we’ll talk about it a little bit later. Where we did our Epic migration, and we had a lot more access and a lot higher quality virtual care, it really became just meeting the member where they were. So we could do onsite, near site, or virtually. We could meet that member and help them in their health journey.
So that is kind of direct primary care. We do offer a lot more services. As you said, we offer Connected Care+, which is for us, where we take claims information from our employers, we stratify that data in a way that we can help them attack where high claims live, where we have high disease states, and also where we can then have a plan for how we would engage those employees and help those employees find out who’s engaged, who’s not engaged. But there’s lots of things that we do today.
I’m proud of the fact of what we do. We actually here in Brentwood have our own clinic for our office. We also share it. It’s a near site facility, so we share it with others in the community if they have signed up for it. So it’s not an open to everybody, but if your employer has signed up for it, you’re free to go to it. And I had a couple health scare healthcare issues last year. And access to care was really important to me, and I was able to get to my physician when I needed to and speak to him, and now her. And so it’s really important.
And I think as you look at what we see driving next year, healthcare costs and healthcare spend is just going to continue to go up. I think we have seen some conservative values of what we think those percentages are going to be, and we believe, as an organization, they’re going to be higher even than what’s being reported. And ultimately it is becoming a problem that has always been out there for companies on how they help their employees. But now it’s becoming it’s a share issue. It’s an earning per share issue because now it is impacting their stock price and other pieces. And they’re going to have to start making these investments, hopefully with us, but with one of our competitors to help try to control some of this cost. So we believe as an organization, we are set up at a great place to help employees and to help employers.
John Farkas:
So give us a feel for the number of lives. How many companies are you working with? How many people are you charged with helping in the context of their care? How big is the community?
Haden McWhorter:
So roughly 800 wellness centers. We’re in 45 states and Guam. Probably about 2,500 organizations that we work with. And I would say 11 million lives roughly. Now those big numbers, they look at a lot of stuff that looks at the full umbrella of the things that we are supporting from a healthcare perspective. We have two organizations that are under the Premise umbrella that have to do with engagement, and also have to do with health fairs and things like that, that helps broaden the number of lives that we can touch.
So I would say if you look at our health center specifically, we’re probably a little bit under that 11 million number as far as those that we have an opportunity to see in and out in that type of scenario. And also those numbers, for clarity, because someone listening to this will ask is how many of those are engaged and how many of those are unengaged? Meaning what of that are the folks that we’re actually providing healthcare for today, and what are those employees that are potential that we could provide healthcare for? And so all those numbers kind of roll into that greater number.
Haden’s Role with Premise Health
John Farkas:
Gotcha. I’m going to jump off the page here a little bit and just ask, if you look at how you as the CIO of Premise would compare as far as your purview and the kinds of issues and organizational elements that you have purview over compared to your peer in a health system, how would you contrast your role and some of the things that you’re looking at that might differ from a CIO of a mid-size health system?
Haden McWhorter:
Well, I think the health system is looking, that peer of mine, because there’s a lot of folks that I work with, especially when you look at Epic and what they’re focused on, the things that they’re focused on and the things I’m focused on in some ways are very much alike, quality of care, member engagement, patient engagement, health outcomes, those type of things. But then that may be where it splits. If you look at a CIO at a mid-size health system, they’re also looking at tons of other departments inside their one little umbrella. They’re looking at emergency rooms or emergency departments, they’re looking at radiology. They’re looking at all these other pieces that today, for me, because we’re really around ambulatory care, I’m not having to work on those things.
And I think more, for me, my job is to make sure that our centers are powered with the technology they need to meet the member where the member is. But also how my organization looks at how we can provide scalability to reducing costs, which any other CIO’s probably looking at. But also my team is fairly heavily aligned with how we build products and how we deliver those products. And so I would say, and maybe not fair because I would probably want to go ask somebody, but I deal a lot with the business every day and working on the business and what we’re trying to do to do in the business. So that might be some of the things. Thank goodness, there’s a lot of things when I go to Epic and we have the CIO conferences, usually 50% of what they’re stressed about and what they’re dealing with, I’m not having to deal with, which allows me to focus on how we best use Epic, how we best use the tools we have, and how we provide that care.
John Farkas:
My sense is, based on what I understand about Premise, is that in your role maybe you have a little bit more agility and ability to innovate because you have maybe a higher level of control over fewer factors. Is that a fair assessment?
Haden McWhorter:
Well, I think we have to innovate because we are dealing with so many types of employers. So if you look at it, I mean, back in the day, I don’t know this is still fair, but on the East Coast you had a standard employer for us might be really focused on how to keep someone butts in seat. So how do I keep one of my investment bankers here onsite so that I can maximize the work they need to do for the day? Because it meant dollars. In the Midwest, back in the day, it was about manufacturing, and how there was a health component, but it was really also about cost savings. Then you went to the West Coast and it was really about the number of, and this may not be 100% fair, but just in general pieces, how do we stack up, and things that we offer to our employees as far as their healthcare and other pieces.
And so we have such a wide range of employers, we are constantly challenged to see how we put the best products forward that meet them where they are, and how do we help them engage and get their population to a journey of health. So how do you start with them? What we try to do, if you look at it, if we have the ability to fully engage with a client, meaning that we get claims data and all the pieces that go with that, we have a really strong opportunity first to engage the members, get them involved with a health center, make sure they understand what their benefits provide them, and then get them into a loop of making sure they’re having their physicals, making sure they’re having, if they have a disease state, that they’re getting constant care, and then from there they have to leave.
So for me, for instance, last year, and I think maybe I talked to you about this, I might not have, I was diagnosed with not one but two types of cancer. And in that, I was able to not only have my health center here that was helping me, not only get to work with our Connected Care folks who were doing care navigation, but we were able to send my case to Mayo to make sure that the treatment that I was receiving here in Nashville was going to be the right treatment for what I had. And it worked out beautifully. I mean, if you look at, taking out the diagnosis, the whole piece behind the scenes of how we navigated and what we did, it was awesome. So I had my healthcare home next door. I knew the people next door would draw blood and do the things that I needed to do. So that was super important in the journey, and that’s one of the many ways that we can help provide for our customers.
Promoting Member Engagement
John Farkas:
One of the things I like about Premise’s model that I think bears some study in understanding how we can continue it or make it more common is because the US is so employer healthcare focused. I mean it’s a big channel for where people receive their healthcare benefits. The clear alignment between incentive for participation in preventative care. I mean the incentives are really nicely aligned, right?
Haden McWhorter:
Yes.
John Farkas:
In some ways that are not as common in some of the other frameworks that you look at. And so I’m really interested in what you are doing to drive that engagement, and some of the initiatives that you’re putting forward that are helping to mobilize people to take advantage of the services that you’re providing.
Haden McWhorter:
That unto itself could take an hour and a half to two hours to talk about.
John Farkas:
I’m sure.
Haden McWhorter:
If you look at it, I mean, that is one of the things that is going to, and I don’t know if you saw it, we just recently, Milliman just produced a report based on our ROI calculations in how we interact with our clients. It’s the first time in our industry this has been done. And it was really interesting about the things that they showed impacted mostly that ROI. And one of them is member engagement.
And so member engagement is extremely important, and that’s where we probably have the greatest opportunity right now. Because as we were talking about earlier, if you look at that 11 million people that we potentially have the ability to impact, how many of those are engaged, that we’re seeing all the time, and how many of those is there an opportunity to make sure they understand their healthcare benefits as it goes to however we’re providing care. Whether that’s virtually, if that’s near site, if that’s onsite, or all of the above, and how we get them involved.
I think the first thing that we always have to work with our customers on is making sure that we have the ability to market to their employees. Some of our customers, for different reasons, don’t always allow us to market. And so we had to find creative ways to make sure that those employees understand the benefits they have and how they can engage with us in a traditional way. So we do have the opportunity today, and again, the reason I say this could go on forever is that we are knee deep in this right now.
The first thing we try to do is break it up into, and you’ve heard me say this several times, who’s engaged, who’s unengaged? And so who’s engaged? Who are we providing care to? And who’s attributed to a physician that we have there? Because important for us that we have physician attribution, it’s important for us that we’re getting folks in. Then the next thing you have to look at is, okay, where do we have proximity to our health centers, whether they’re near site or there’s a virtual program or whatever, where is their proximity? And starting to look at that low hanging fruit of proximate members and how we engage those folks.
Most of the time, what you do, very similar to other health systems, you find a group for whatever makes them the cohort they are. And then you create a campaign, and through that campaign you’re either doing mailings, you’re doing email, you’re doing texting, you’re trying to reach out and get to folks. And I would say today we do a pretty good job of that. It’s just where we end up having clients who do not allow us to proactively reach out to people who are unengaged. So there’s a big piece about being engaged and being unengaged.
We have a full team though. It’s really great. Over the last year, we have brought in some really seasoned professionals around member engagement. We have a big project that’s going on right now, that it’s going on this year, it will go into next year, about how we’re engaging and tools that we’re using. We’re using Epic as a good bit of it. We’re using Salesforce Marketing Cloud as a good bit of it. We have a data project that has been running now for a year and a half. And that data project, one of the use cases was pulling member data to a point that the analytics teams for our member teams could start to query the data and find new insights that would allow them to see where they could interact with those members. So that is a huge piece of it. Huge piece is that engagement.
Haden’s Value Equation
John Farkas:
No doubt, no doubt. Let’s jump into some of the business of deploying technology that you get to oversee. So you emphasized that equation, clinical security plus business equals value of investment. It’s one of the things that we talked about in preparation for this podcast. And I’m curious, and you talked about how the success of alignment with the CFO is really critical in there. What do health tech companies need to know about that equation, how you look at that, and how they need to present what they’re bringing to address that framework? Because I think that that’s a pretty important idea.
Haden McWhorter:
And I think there’s two things there. I think there is, as we look at it from a Premise standpoint, the quality of the clinical services, clinical operations teams that we have and the work they do. I mean the people in the field are the ones that really make us successful because they’re seeing patients day in and day out. And they really have the relationships with our clients.
When you and I were having that conversation, I think at a higher level, when you’re looking at your entire organization, and you’re trying to figure out where you think you should be making investments that align with the strategic goals and objectives of the organization, it’s really important, one, to have a roadmap and a plan of how you think you can implement those pieces. But the other is to understand what the CFO’s roadmap is as they try to look at things. We are private equity owned, which for those in the podcast world that are private equity owned, you know that private equity is-
John Farkas:
We should put together a support group.
Haden McWhorter:
Yeah, We should. But I will tell you that I got the lucky draw. The private equity group that we work with is out of Canada, so they are not a US-based private equity group. So they don’t have the same normal structure, like the stuff that you’ve been used to and I’ve been used to. You get on the Ferris wheel for a three year or five year run. And at a certain point you’re investing, then you’re not investing in how you do things. That’s not how OMERS, who is our private equity group, does things. They see the value in what we do, and I think they are a great partner in continuing to invest in the things that we do day in and day out.
John Farkas:
That’s awesome.
Haden McWhorter:
That’s been great. But even with there, there is still, you have to find the line of making the right investments for the organization, and tying those to how the CFO sees what his or her playbook is as far as-
John Farkas:
[inaudible 00:29:59].
Haden McWhorter:
… what they’ve laid out for financials for whoever. It doesn’t have to be a private equity group. It can be whoever owns you. Ultimately, they care about your financial health because if you’re financially healthy, you can continue to provide the goods and services that you need to provide. I’m fortunate that in the weird connection of my life that Mark Farrington, who I told you was the gentleman that I first worked for in healthcare, I started working with his wife in 1992. And so she and I have worked together since ’92 at several different organizations. At one time, she was my boss. She and Mark and her sister were a founder of a company called W Squared here that was one of the companies that fell into Premise Health. Well, some of us fell into Premise Health there.
But Shannon and I have worked together for a really long time. And when I first started working with her again, we just sat down and she started telling me, “Here are the levers that are important to me. Here are the things that are important to me strictly from a financial standpoint.” She’s a little bit different and interesting to talk to because she is not your typical CFO. She is very much a strategic thinker, not that CFOs aren’t, but more she could hold multiple roles in our organization, and kind of holds multiple roles in our organization. But she’s balancing that, I would say, fiscal conservativeness with how you grow the organization, how you launch the organization, how you keep things fresh, and how you keep things moving. And so we sat down a long time ago-
John Farkas:
That’s a great combination in that role for sure.
Haden McWhorter:
It is great and not common. And so it’s great when I sit down with her because she has the ability to say, “Here are the levers, here’s what we’re looking for, here’s where I see things going. Where do you see things going?” And from that, we can develop a plan that’s cohesive. So I don’t ever feel like, either with Stu, our CEO, or her, any of my other peers do I feel like we’re an afterthought. Many times we are one of the first thoughts because what we’re doing could impact everything else that we have going on.
John Farkas:
And so as you are looking at making some of those decisions for investment, knowing that there is a lot of factors entering the equation right now, what are some of the primary challenges? What are some of the horizons you’re going after, and how are you evaluating the spend compared to what you’re hoping to see out of it? What are some of the factors entering your world right now, specifically as you are looking to advance your agenda?
Haden McWhorter:
Well, I mean I think it goes back to, from the Milliman study, if you look at that, what are the things that we drive that help-
John Farkas:
And by the way, we’ll look to reference that in the notes for listeners.
Haden McWhorter:
Yeah, that would be great. And I’m glad to send you some links. If you just go to Milliman, you can find it. Or just Google Premise and Milliman. I think again, how we engage our patients, attribution, and a couple other pieces are really the first big pieces that we start to look at. So if you look at what we’re focused on for this year and next year, it started with looking really strongly at how and who we go with to partner and look for from a revenue perspective. We’re looking for folks that aggregate belly buttons together. We’re looking for large employers. We’ve talked to health plans. We’ve just announced some of that stuff. So that was our first thing, okay, where do we see that we’re going to focus on revenue? And from a technology standpoint, I like to say, okay, what are the things that my team needs to do to empower that team?
And then you go to kind of the next thing, which is strategic projects. And we’ve talked about several of those. Member engagement is a strategic project for us this year. How we engage and how we continue to engage, and how do we become the best at that? Data is another big project that we’ve taken on. The joke, I can’t remember exactly how it goes, but if you don’t want to stay a CIO long, do a data project. Fortunately I’ll say that our data project is moving well and it’s understood by our executives.
And so there is a data component because we want to be able to be agile with our data so that we can use that data to make the best decisions at the right times. And today, we just cannot be very agile for lots of reasons. We feel like that Premise has only been around for 10 years or so, but Premise has been around for many, many years. Because we are, I’d say, a culmination of others in the industry that have come together. And so we carry a lot of data with us. We have a lot of, in some ways, you might say data baggage, but others just, there’s a lot of folks here that understand data. And so it’s how do we become more agile with the data?
We looked at Connected Care, that product and how we continue to find ways to identify spin, identifying where we can help our patients, our members, look at ways that we can continue to help our clients control cost. And so those were three big projects, as well as how do we continue to organize ourselves for growth. So that’s kind of stuff we looked at. We looked at products and the products that we were delivering to do those things. And so everything was a building point on the other. And I would say probably at the end of ’22, going into ’23, ’23 into ’24, I would say our full e-team is laser focused on those things. Those are the things that we all talk about. How does my project impact this project? How does this project impact this project? All to come together to have one outcome that betters the organization.
Using Data to Improve Engagement
John Farkas:
So you’re right, Haden, I think we could spend a lot of time here, which we’ll be cognizant of that. But hey, talk a little bit about some of the initiatives that you have moving or what you’re farming right now around member engagement. Engagement is huge. And healthcare in general for Premise, and how you guys are set up and structured, it is extra critical for your business and how you prove value. So talk a little bit about what are some of the horizons and engagement that you guys are looking at in particular?
Haden McWhorter:
I would say, first and foremost, just continuing to improve in our ability to engage members so that at its base level as its foundation, how do we continue to make that a core tenet of what we’re trying to do and how do we improve on it day in and day out, or maybe quarter in and quarter out. From a technology standpoint, there is a lot of data out there that we can provide to our member engagement teams to help them figure out what is the best course of engagement. We’ve done partnerships with others outside the org to look at data, to look at more conventional marketing buckets of where people might be in their engagement lifecycle and ways that we can do those things better. As I said earlier, we have two strong tools. We have Epic as one of the tools, which has a lot of this stuff built in, but we also use Salesforce Marketing Cloud as another way to get our campaigns out.
I think looking into ’24, it’s going to be very interesting because some of the things we’ve had to do outside of Epic in the past. Eventually Epic will catch up with where you are and will pass you very quickly. And so there’s a lot of things that we have been doing for our customers for engagement, microsites and direct reach outs and things like that, that Epic is starting to pull back into their system. So I think the question for ’24 is how those things we’re doing today and the things that we potentially can do with the tools we have, how do we pull those together? But how do we make them easier for our teams that are responsible for that?
Because today, it’s not super easy for our member engagement teams to do the engagement they want to do. They know the questions they want to ask, but it goes back to data agility, it goes back to access, it goes back to how data flows. We are an organization that takes data privacy very, very seriously. So we have to look at how things flow internally and externally, and what that means. One of the things that makes our lives exciting is that we have lots of customers. And so different from a health system, maybe that’s one of the things that really differentiates us is like, I’m worried about 2,500 customers. I’m not worried about one health system. I’m worried about a whole gamut of things that different clients have different concerns about, GDPR versus not GDPR, how we interact with data, how we don’t interact with data.
John Farkas:
That’s where I was going to kind of go next. And knowing that you have 2,500 customers, and a lot of people that you’re taking care of, and you’re interested in data agility.
Haden McWhorter:
Might be a oxymoron. Yeah.
John Farkas:
I’m looking at the vectors here and trying to resolve them, but talk a little bit about the unique challenges of that. Because you are finding ways to integrate in some form or fashion with 2,500 customers and several million humans. So that’s a whole lot of points. And so talk about some of those unique challenges.
Haden McWhorter:
I would say, if you start to look at it, the biggest is you have to balance several pieces. You first have to balance your contractual obligation to your client. So whatever that contract laid out and what they require you to do from a data standpoint or other pieces. But normally for our probably customers, and this goes from most of our customers that are data aware, there’s usually some type of data provision inside those contracts. So our teams have to understand what those individual contracts may have or may not have.
You also have to balance that from a contractual basis, we have customers who have been around for a very long time, and those standard contracts stay in place. And so we may have just done addendums when we’ve renewed with a customer, but our CISO would call me one day, and he is like, “Hey, we need to talk to this customer.” I was like, “Why?” And he said, “Oh, their contract is so old that it limits us from doing something that today no one would even blink at, but it was contractually there.” So our teams have to think about a lot of things. They have to think about what does our clients expect? And then after that they have to go, okay, what state do those clients live in? Are there state guidelines they have to be concerned about? What are the governmental guidelines that we have? It’s not just cut and dry on this is what you can do and this is what you can’t do.
And so sometimes it feels like you’re working a giant jigsaw puzzle. So as we looked at the data project, and as we continue to look at the data project, what are things that we could do today that will make us more agile? And it’s not only where is the puck today, but where is the puck getting shot in the future so that we can try to head off some of the things that limit us today around what we can or can’t do. And lots of times our customers are very understanding, but it takes our security, privacy, and legal teams just a lot of time to go back and say, “Hey, because of this product, now these are things that we want to do.” And many times you’re dealing with an HR team that has to defer to a security team that then has to defer to a legal team.
And so it doesn’t feel like things happen very fast. Even with our customers, we have great relationships, but even the customers that you have the best relationships, you still know that it’s not going to happen quickly. So we’re like, okay, on this side as we do the data project, what are the things that we think we know, from all of our experience, the things we get hit with, the things we get asked, and how do we just plan for that so that if we need to go through and turn certain things off, we can without having everything be a rework. And so that’s the challenge. A lot of times it’s like my teams are doing less, there’s always a technical component, but a lot of times they’re having to think about things more from a legal contractual component.
John Farkas:
That makes sense and not easy. There’s-
Haden McWhorter:
Not easy.
Epic’s BFF Program and Other Premise Health Partners
John Farkas:
… a lot of points there. And I want to be cognizant of our time here, and there’s a lot to talk about. I know that you guys are recently, and I will call it an Epic convert. You went through that migration, and I know that you feel really good about that relationship. And part of what helps you feel good about that is their BFF program. One of the things we talk to our clients a lot about is the critical importance for solution providers of customer success. And knowing that when you jump in and are coming in as a partner, making sure that all the I’s are dotted, T’s are crossed, and if something needs to get re-dotted or re-crossed, there’s an easy path to making that happen. Talk about why that wins for you all and how that’s a differentiator.
Haden McWhorter:
Well, I think with Epic in the beginning, there’s a couple of things. One, as we did the Epic implementation, we said, let’s not do what has happened to us in the past. Let’s not get this awesome tool and then us tell Epic how we’re going to implement. Let’s let the person who does this day in and day out, the team that does this day in and day out, tell us how we should implement. So we took all the feedback that Epic gave us very seriously, and worked with them in the very beginning. They were part of the team that helped us. A lot of teams go to a lot of outside contractors. We hired our own team internally, and then brought contractors in to fill day-to-day jobs.
While our teams got to work on this project, we worked with Epic very closely so they could understand what we did. Because this was new for them to go outside of health systems into something more of what we were like. And so that was super important. So that started the relationship off great. But the BFF program specifically, and why I think this is important for people that provide solutions is, I feel like I have someone who is trusted that I can go to day in and day out. I can email them, I can contact them, and they understand my business well.
I have two individuals, one’s our BFF, her husband, which we just got really lucky, who leads R&D for the development team, and then our technical services person, the technical services person and our BFF understand our business so well that it’s almost like having an extension of the team. As things happen at Epic, as new things get rolled out, they’ll reach out to us and say, “Hey, I think we should look at this. Look more for this, less for this.” But it’s just they have our best interests at heart. And I know that sounds really maybe naive because you can say that’s not really true.
But the things they’ve done, we have a story where we were there with Epic, and we were having a hard conversation about licenses that we had pre-purchased ahead of our implementation. And at the time it looked like we over purchased. And one of our representatives, you could call it an account person, but he’s our technical services guy, when he understood the problem, and I didn’t realize at the time, in front of the CFO of Epic, was basically like, “We should give these guys a refund or credit because,” and he went through this whole thing. I mean talk about flying too close to the sun. And we realized at the time, it was me and one of our SVPs, and I was just looking at her. And she texted me and she’s like, “I hope he still has a job after this.”
But to the credit of the teams that we work with, and I’m sure there’s outliers in every organization, but Epic, the teams we’ve worked with seem to be very driven towards our success, and how they can help us be successful and what’s best for us. There’s always been a time in your career where you’re like, if I could do this the right way, this is the way I would do it. And it just seems like our teams, the Epic teams, at least for us, that’s how it’s always been. It seems like they do it the right way, they don’t do it the shortcut way. They do it the right way.
John Farkas:
Yeah, I think that that’s such an important piece. And it’s to me so easily overlooked or undervalued. Once you have an agreement, that’s the start point. It really is. And understanding that. And I think even starting in the context of marketing and instilling the understanding of how you are going to deliver, and why that’s important, and how that is going to end up manifesting, I think ends up being a critical piece in how you carry that stuff forward. And I think that is not to be undersold for sure.
Haden McWhorter:
No, those relationships are important for sure.
John Farkas:
Other than Epic, have you seen some other good examples of how organizations have done that? Probably looking at maybe in advance of you signing on.
Haden McWhorter:
100%.
John Farkas:
How’s that happened?
Haden McWhorter:
Well, I would say now in a lot of the things that we’ve done, if it’s Trace3, who’s been a great partner for us from a technology standpoint. I feel like this is almost like the Academy Awards. I don’t think you can name all the folks that have been great to work with without accidentally leaving somebody out and someone feeling hurt. But I will tell you, things that we-
John Farkas:
I’m sure they’re all going to be listening to this podcast.
Haden McWhorter:
That’s right. And they’re all going to say, so we love them all. But I would say that after having such a strong experience with Epic, when I get asked, Databricks team reached out to me recently. Another team reached out to me recently. And they are asking us what are things that are important? And to their credit, they said, “Give us an example of a vendor that you work with that does an outstanding job.” And we always go back to Epic and explain-
John Farkas:
No pressure.
Haden McWhorter:
Yeah, no pressure, but here’s-
John Farkas:
The largest healthcare IT company on the planet.
Haden McWhorter:
And probably have pretty good revenues. They can afford to do all this stuff. But if you look at it it’s like it’s really more about having that person that you can go to that understands what you’re doing. It is a relationship. I know that not everybody believes it’s a relationship, but there are a lot of folks here in Nashville that this is about the relationship. Plow Networks does a great job with that. We really don’t buy very much from Plow, but if I needed something, I could call those guys and it’s as if I bought a million dollars from them the day before. The owners will reach out to me, what can we do for you? And it’s just, I think, Nashville, we might be lucky. I talk about this when we’re in Verona at Epic and I talk to other CIOs. And in some ways we might be lucky here in Nashville that we do have a strong healthcare community, and we actually have a very strong technology community of people wanting to come together and really support and help each other. And so those are the examples that we use.
John Farkas:
Yeah, that’s great. I think that some of what I’m hearing, and I think that this is true in my experience, you have to have a team that is ready to engage and understand the business that you are. Your business. So it’s not just understanding how their solution integrates, it’s being willing to jump in and get a macro understanding, or at least an attempt to get a macro understanding, of where you’re going and what your objectives are. So that they can be on the lookout. So they can look at how we are going to optimize and maximize and be your advocate in that. I think that that’s so important. And I see, one of the big errors often that I witness is people are just understaffing that function with people that are just solution supporters, not business-minded, consultant framed.
Haden McWhorter:
I was just going to say, and you hit on it. As I was thinking here, thinking about people that are providing solutions and what they may take away from it is one of the things to understand is that we have been on Epic now since, we signed our deal in 2017, I would say fully integrated at the end of 2018, so five years now. And my BFF is still my BFF. She has had promotions through Epic. So this is not a job where this is her only… She has a day job and then she does this, holds this function. And I hurt her feelings one time because I asked her, I said, “Well, how many people are you BFF for?” And she’s like, “You can only be one BFF.” And so they take the volume of employees that they have that have the skillset to do this, and they apply them to their clients.
And so I don’t have to worry that this is actually her full-time job, and then she gets promoted and I have to get somebody else and train them. So the team that we have has been the team that’s been assigned to us since we went live. And I think that goes to retaining good employees, that goes to investing in them, that goes for us, we’ve invested a lot of time in them so they understand what we do and how we do it. And we’ve always seen fruit from that investment. But I would say really over the last few years, they understand us so well that they provide a lot of value for us. But anybody can do that, to your point. But there is an investment that you have to make, you have to be willing to make.
Haden’s View on AI
John Farkas:
Yeah, that’s a great insight. All right, I’m going to ask the AI question. AI is the hot topic these days. As Premise is looking at the use of integration of AI, it fits into everything we’ve talked about in some form or fashion, but are there any particular initiatives or corners that you’re looking to AI to help solve problems in particular?
Haden McWhorter:
Well, I think first and foremost, how can we take any burden that our providers have today and help them with that burden? I mean, something that we haven’t called out, and something that I think is unique to the way that we provide healthcare is that our providers are not required to see a certain number of employees or patients a day. So they’re not sitting there having to churn through. So we encourage them to have time, have conversations, really get to know that person.
But how do we make Epic, which we think does a great job, how do we make Epic better and easier to work with? And so Epic as a whole has introduced, we were just there in August, they’ve introduced several AI enhancements that will be coming out in current product releases and upcoming product releases. We’ll definitely implement those so that we can help our providers and help those that are providing care. I think other things that we’ll look at are our partners first on, we do a lot of SaaS-based stuff. So there’s not a ton that we host here. There’s a lot of partnerships that we’ve formed. We are dialing into those partnerships to see how they’re going to be handling AI, and what we think is important.
Obviously the way that we do RFPs and ways we can help our legal team, we think there’s great value there. I’m not of the belief that people go away. There’s a whole bunch of people think we’re going to start replacing jobs. I think what we’re doing is we’re providing that person, because we make a lot of our people do a lot of work day in and day out, their desks are wide and they have a lot of… You hear about people doing stuff off the side of their desk. A lot of our people have massive desks because there’s stuff piled on.
So we’re looking at it it’s like, well, how do we help with AI to do those things? How do we help the legal team maybe review contracts better, maybe go through and pull things together? How can we help the marketing team? How can we help RFPs? Because we spend a lot of time on making sure that we’re doing the right responses on these requests for proposals. How do we pull that stuff together? So we’re looking at all that. And we’re looking at how does just a normal chat bot today help our folks work?
I mean, there is a concern, we are much more interested in things that say self-contained so that we know that they’re not breaching, either like Microsoft, they’re not breaching outside of the Microsoft environment or other things. We’re probably a little bit more apprehensive about things like that, but more ready to engage things where we know that our-
John Farkas:
It lives in your ecosystem.
Haden McWhorter:
.. intellectual property doesn’t go someplace else, and it helps enhance what we’re doing.
Closing Questions
John Farkas:
Yep, that makes sense. Great. So if you were to leave a health tech company with one piece of advice, thinking about in the marketing frame, knowing that you look at solutions all the time, you’re engaging, what would be something that you would want them to know that they could use practically as they frame their work in marketing? What would be a single piece of advice you’d have?
Haden McWhorter:
I would say do your homework. I mean, to those that have been in the industry for a long time and do a great job, they’re going to say, okay, that’s what you tell me? But you would be surprised-
John Farkas:
No, I wouldn’t.
Haden McWhorter:
… how many people come to us with solutions that really don’t have an idea of what we do. And I would rather, before you came and presented something, I’d much rather have a 30 minute, 45 minute conversation to at least give you a framework. Because I don’t have time to waste energy. My teams don’t have time to waste energy. And again, it kind of goes back to that partnership is respecting the time and the energy and the things we’re trying to do. We want to find the right solutions. But going into it, thinking about the ways that you’re going to try to help us solve a problem and what that problem is and what’s important.
Because to some, it may be less about money and more about the solution and how quickly you do it. So to some the solution is important, but hey, I’m really in a bind over how I’m going to spend dollars in ’23 and what can I do for ’24? And I think if you do a little homework, it goes a long way. And again, I think relationships matter. Forming a relationship, not having that person on the other end feel like it’s just about a sell, that you have a care in have that tool, application, whatever you might be selling, will impact and help that organization move forward.
John Farkas:
Yeah, makes sense. Okay, curious, final question. I know that peer-to-peer is a primary channel for how you’re hearing about things and taking in information as far as innovation and new horizons. Go outside of the peer network, what are some of the channels that you’re tuned into? How are you hearing about new things? What are you listening to? What conferences are you going to?
Haden McWhorter:
I would say I’m going to less conferences because I’m hoping that my team members, I mean we have a fixed budget on those things, I hope that our teams are going to the conferences they need to go to. I just do a lot of reading. I subscribe to a lot of different newsletters. I subscribe to McKinsey. I subscribe to CIO Magazine. To your point, I do a lot of peer-to-peer type stuff. I feel like after having 31 years in Nashville, I have a great group of people that I can go to to find out about things. Sit on a couple CIO councils. And so I would say it’s kind of a mixed bag.
But mainly I like to read. I like to get out. So as soon as I find a topic we need to hit up on, I’ll do some research. I’ll go out, I’ll subscribe to some newsletters. And then from there I’ll try to do more of a targeted outreach to some of my peers who I think might be trying to implement those pieces. The OMERS’s relationship, our private equity relationship, has been really nice because they bring together all the CIOs for all their portfolio companies quarterly, and we have a chance to talk about things that are impacting us.
So after the pandemic, we were actually an example, as well as a European-based company, on how we were able to switch from basically being in the office to being at home overnight. So there’s a lot of things that we do around stuff like that. I do attend the Epic conference every year, every year that I can, because I do find more and more they are starting to have a lot of great information around Epic and the CIOs. But also just stuff that’s even outside of what Epic is doing, but they’re thinking about their roadmap. And that’s always super helpful too.
John Farkas:
Haden, thanks for the input here and the opportunity to spend this time and get a little window into your world. It is a fascinating place. Is there anything else that we haven’t covered, anything that’s occurred to you here that would be good to bring out as we finish?
Haden McWhorter:
No. I mean, I think we hit a lot of stuff. I think I would be remiss, and you said so many nice things about me in the beginning, and at the end of the day, it’s really not about me, it’s about the teams. I have great teams. I have leaders who have been with us for over 10 years. One of my direct reports has been, I hired her 20 years ago. We have a really solid group of individuals who’ve been with the organization for a really long time, and that makes it a lot easier. I’m not having to do a lot of lifting. There’s lots of folks that can do lifting, and that makes it important. So my team is what really makes us hum.
John Farkas:
Haden McWhorter, CIO of Premise Health. Thank you for your time today, and thank you all for listening to Healthcare Market Matrix.
Haden McWhorter:
Thanks, John.
John Farkas:
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About Haden McWhorter
About Premise Health
Premise Health is the world’s leading direct healthcare company and one of the largest digital providers in the country. We operate over 800 wellness centers in 45 states and Guam for more than 2,500 of the largest organizations in the U.S., serving 11 million people with fully connected care – in-person and in the digital environment. As a premier provider of employer-based healthcare, Premise Health offers an experience that, combined with a deeply analytical approach to employee health, helps maximize the effectiveness of every healthcare dollar spent while ensuring employees have the most proven treatment options.