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This is Laura Dierda
with the Becker's
Healthcare podcast. I'm thrilled today to be joined
by Stephen Michaels,
vice president and chief technology officer at Baylor
Scott and White Health. Steven, it's a pleasure
to have you on the podcast today.
Yeah. It's a pleasure to be here.
Well, thank you so much for joining us,
and, you know, I'm really looking forward to
learning more about how you're thinking about technology
at Baylor Scott and White and certainly some
of the cool things that you have on
tap. But before we dive into that discussion,
can you tell me a little bit more
about yourself and your background?
Yeah. Absolutely. I think the the best way
to kinda describe who I am is,
I I try to live a life of
purpose.
And so for me, that's that's kinda 3
chief categories of of my faith and my
family and my and my profession.
And, you know, you know, balancing those,
the best that I possibly can. You know,
I I've started my career,
off in the United States Air Force. So
one of the best decisions I ever made
because it really helped build a foundation that
I've used
throughout my career,
you know, from just
a a whole mindset of continuous
improvement
and, you know, being creative
and and and, you know,
structured and disciplined about,
you know, what I do.
And, you know, whenever
I came into health care
a little more than 15 years ago, I
just fell in love with kind of this
this serving,
the health
community, our patients, and patient families,
and just love what I do. As much
as I loved when I was serving in
the air force, it was almost like I
found a new way to serve
when I when I joined health care, specifically
whenever I got into hospital systems. It's just
such a,
an amazing environment to be in. And,
you know, if you don't love what you
do and you're in health care hospital systems,
you're in the wrong place
because, you know,
every day when I go into work, you
know, it's it's not unusual to hear a
helicopter coming overhead and and people aren't riding
those helicopters for joy rides. And it but
it really helps,
set your mindset as as having a real
purpose about what you're doing.
And I tell people that right now, as
we're talking
at Baylor Scott and White somewhere, and really
any hospital system, someone is having
either their best day or their worst day.
They're either, you know, welcoming a new baby,
which is amazing,
or they are saying goodbye to a loved
one. And so we have to keep that
in mind every day, and and it really
helps keep us grounded.
But it's just something that I love. I
love giving back.
Oh, that's amazing to hear. And, certainly, you
know, what a great perspective to have in
knowing, you know, just the wide variety of
experiences people are having in the hospital setting,
you know, in being able to meet them
where they are and understand how each particular
journey can be just a great opportunity to
support the community and support patients and and
really serve and give back as you said.
Now from your vantage point as chief technology
officer, what are some of the opportunities you
have your eye on right now as well
as the headwinds that you have to keep
front of mind?
Yeah. Absolutely. I think everybody in my position
and and probably generally across health care,
I think of this as there there's really
3 for me. 1, 1st and foremost, that
that is really in across
health care is the cybersecurity
threats.
And, you know, they're they're they're increasingly more
and more sophisticated,
you know, the ransomware
data breaches,
our supply chains, you know, being attacked and
and that sort of stuff. A a lot
of our 3rd party,
partners are are being hit, and so it's
it's it takes a lot of our,
effort and,
focus to to, you know, try to protect
those patients like we were just talking about.
Additionally, you know, across health care, there are
talent shortages, and,
you know, it's one of those things that,
you know, is is really probably going to
hit a lot of industries, especially for roles
that, you know, require people to, you know,
physically come into an environment, every day, like
our nurses and physicians and things like that.
And so, you know, a lot of,
jobs now, even my own, has a tremendous
amount of flexibility. You know, I could work
from home. I can come into the office.
I could do, different things. I I prefer
to come into the office, but, but that's
just because I like I like being around
people.
But, but, you know, challenges shortages are a
real deal,
specifically in nursing, and and it's even more
so in rural areas. That that's a real
health care challenge for us as a country,
something that we'll have to focus on and
and and deal with. And then, you know,
there's the technical debt. And from from a
hospital consolidation that has happened over, you know,
the last 20 years or so, what's happened
is, you know, some various technologies have been
incorporated into a larger enterprise. And those, I
think,
constant
focus on
really rationalizing the technology,
modernizing it, and, you know, trying to absorb
and overcome some of that technology,
debt.
I think that makes a lot of sense.
You know, it is really a fascinating array
of challenges and things you're keeping your eye
on from, as you mentioned, cybersecurity, not only
for,
Baylor Scott and White, but for your vendors
and third party partners as well. It's just
so crucial to,
make sure everything that's
happening, you know, and that you can control,
is controlled, but then to just being prepared
for the moment when it happens as well.
And then, you know, looking across the workforce
and talent shortages,
I can imagine on the clinical side and
to some degree, you know, the technology,
skills and and advancements in the technology just
makes it hard to keep up sometimes. And
so, you know, really a lot to think
about.
But in particular, when you're looking at the
technical debt that you just mentioned,
how do you try to stay on top
of that at Baylor Scott and White? Is
there processes that you put in place or
or or a certain philosophy that you think
about things so that you're putting yourself in
the,
best position to optimize that in the future?
Yeah. Really, it it it has a lot
to do with, you know, 1st and foremost
aligning to the organization and what the organization's
goals are.
For someone in my position,
you have to think of any dollar I
spend as
taking a dollar away from patient care potentially.
Right? So
so we have to be careful
about, you know,
misinvestments,
you know, putting money towards a technology that
maybe doesn't prove out to be what it
what it, needs to be, but also, you
know, being, conscious of, you know, that debt
that is aging technology that is going to
become increasingly, increasingly problematic either from a
reliability perspective,
and certainly from a cyber perspective because you'll
end up with technology that is no longer
supported, and that becomes
a a real problem.
And so then you're you're,
you know, investing time and and tech and
efforts around trying to protect it. So so
that's that's a real challenge. You know, for
for us, you know, we we kinda have,
you know, a structure
around,
strategic partners. So, for example, we are an
Epic shop.
And when we rationalize technology, what we're trying
to do is take advantage of some of
those strategic partnerships because there's a lot of
things that Epic can do that maybe we
are,
providing today with some other third party.
And so it's it's it's really simplifying the
environment and kinda bringing the technology into some
of those larger investments. And so that kinda
becomes a win win because it makes the
environment a lot more streamlined and simple for
the organization, but it also,
allows us to deliver the technology in a
more,
economical,
way for the organization.
That makes a lot of sense, you know,
and I truly appreciate you digging one bit
deeper there. Now how are you thinking about
growth and adding value to Baylor Scott and
White over the next few years or so?
How do you do that from the technology
side, especially as you mentioned, you know, thinking
critically about health care dollars, the investments that
you're making, and and truly understanding the support
for clinical care and caregivers?
Sure. You know, it it's it's really critical,
like I mentioned earlier, that I align to
the organizational,
objectives,
which,
for for any technologist,
means that you need to understand them. Unfortunately,
sometimes in, IT,
we
kinda become really good at technology,
and we become increasingly
disconnected
from the actual businesses that we support.
And that's that's a problem because, you know,
you kinda think about, like, you know, if
if I want to expand, you know, kind
of my horizons,
you know, beyond of just maybe being good
at technology and understanding that, in my world,
I need to become a health care professional
first.
So, you know, if you think about, like,
if if, you know, you and I worked
for a car dealership, for example, and I
could be amazing at technology. But if I
don't know the first thing about how to
buy and sell cars,
then my technical abilities are gonna bring limited
value.
And so if you think about the, you
know, the challenges that the health care systems
are facing today,
you know, the ability to provide quality care
and operate efficiently. You know, we've kinda talked
about staffing shortages,
but there's also financial pressures, you know, of,
you know, you know, kinda declining reimbursement rates,
from, you know, the payers,
you know, our increased operational costs, like what's
happening to everybody with, you know, the cost
of goods, going up the way that it
is. And that financial strain is is really,
you know, putting a lot of pressure,
in in health care. But and and, ultimately,
I guess, the last one I would say
is, you know, patient care and safety. Right?
So so that's the paramount at at everything
we do. That's that's the, the zero fail
mission. Like, we we can't have patient safety,
put at risk or whatever. And so, you
know, so so for me to kinda get
to your question about adding value, I have
to truly understand,
those impacts to the organization. And so whenever
I'm making a decision about, like, okay. I
wanna do a new contact center, for example,
because maybe my existing contact center is end
of life or whatever, I have to think
about, like, well, we have challenges with staffing,
and I need to make sure that, you
know, from a cost perspective, I'm bringing the
right model, the right model that makes sense,
like, whether I'm gonna capitalize expense or I'm
going to go with some sort of subscription
model or whatever. And then, ultimately, at the
end of the day, like, what is the
impact to patients? And am I improving that
impact,
to to patients? And,
you know, otherwise, I could just go and
pick a solution and kinda be oblivious to
what's happening to my, organization or the the
health care
population as a whole
and and just really not be that effective,
frankly. And and I think that's something that
as, you know, technologists are kinda going through
their career, you really need to think about
that. You need to there there is a
point at which, you know, you'll reach a
level that it is more and more critical
that you understand your business and, you know,
not always just look through the lens of,
you know, technology.
That's such a fascinating point. And especially, I
can imagine for, as you said, people who
are are raised with that technology background to
really just think first and foremost on,
the logic of of technical,
capabilities. And from that perspective, thinking more globally
and understanding the business impact is not always
an easy transition to make, but certainly a
crucial one, especially in health care as the
business
margins are are getting tighter and others are,
you know, really needing to
find support, with technology for the broader health
system. So it's fascinating to hear.
From your perspective, in in along those lines,
what are is one risk or investment that's
still worth making this year, especially
given, you know, those challenges
in the idea that, you know,
budgets and spending isn't unlimited?
Yeah. So,
you know, there is one risk,
or investment
that in from my perspective
is always worth it, and and that is
the investment that we make in our people.
You know, the,
the solutions that we deliver and all of
the opportunities and problems
that we face,
all the stuff we talked about today, right,
every single one of those
are solved by people.
So, so in my world, when I say
people, I I'm not just specifically talking about,
you know, Baylor Scott and White employees. You
know, people that get a paycheck from the
hospital system. That expands into all of our
various partners, you know, whether it is, you
know, you know, managed services that we have
or technology professional services
and and and beyond, frankly. And so,
you know, if I'm going to take a
risk and, you know, give something a chance,
it's I'm gonna lean towards, you know, people.
And, you know, technologies are are changing so
fast. I I heard a statistic that
now, like, if you were a specialist
in technology so for example, I'll update myself.
One of the very first platforms that I
supported in an enterprise was Lotus Notes.
And so I got really good at Lotus
Notes. I, like, understood how the databases work.
I understood how the whole platform work.
And who knows? Like, maybe I could still
be doing a job out there as a
Lotus Notes administrator somewhere.
But, but it changed. And so I had
to evolve into Microsoft Exchange, and then I
had you know, and I basically kinda went
on to do the other things in my
career.
But, what I've heard is that that window
is now, like, 18 months. You know? Whereas,
you know, maybe when I started my career,
I probably could have been a Lotus Notes
administrator for maybe a decade. Right? You know,
I would have probably been totally fine and
not had any pressures. And so you think
about that window shrinking more and more,
and these technologies are ever evolving. They're bleeding
into each other. You know? So if you're
gonna have, like, a Genesys,
contact center and you have ServiceNow and you
have a platform like Epic or whatever, there's
a lot of things that those three platforms
do that bleed over into each other.
And so
how do I how do I solve that
as as a, as a CTO
is it doesn't make sense that I would
constantly just go out there and try to
find, oh, let me go get a a
Genesis talent. Right? Well, let me go get,
like, whatever top or whatever is going on.
It's really better for me to invest in
my people
and trust that they're gonna have the ability
to kinda learn and evolve as we evolve
as an organization.
And, you know, it it doesn't always pay
out like any other investment. You know, some
some folks, you know, just really enjoy what
they're doing, and they may decide to go
elsewhere. They may not want to learn a
new technology.
But what I found is is that more
times than not, people are excited about that,
and it's a well,
a well, worth investment.
That's really cool to hear. And definitely, you
know, I I appreciate you
digging a little bit deeper and and thinking
about, the the people side because I think
so much, you know, we hear that as
a mission or a strategy is being able
to,
invest in, you know, the workforce and the
talent and upskilling and all those kinds of
things. But what that really looks like or
the impact that it could make,
you know, sometimes is a little bit more
nebulous. So it's cool to think about it
and hear you talk from the technology perspective,
the different ways you can,
really make a difference along those lines and
and,
moving forward. So, that's cool to hear. Now
before we wrap up our conversation, I was
wondering if you could talk about,
some of the best opportunities for growth and
development in the future. Where do you see
some of the ways that, growth is gonna
be happening for you as well as Baylor
Scott and White?
Absolutely. So I I would say, you know,
health care as a whole,
any
any any well, any business, frankly, but but
I'll just speak specifically to health care. It,
any business that evolves will grow,
and we are,
going through a significant
evolution,
in health care,
much like a lot of industries that are
being disrupted and and so forth. But, you
know, we kind of went through a period
of consolidation, and some of that is still
happening where hospital systems are going through acquisitions
and things like that, and they're kinda kinda
growing that way. But
but, really, it's it's now shifting, and we're
shifting more towards things like the experience and
kind of empowering people,
to,
you know, control their own health care outcomes.
And that's a big thing for us at
Baylor Scott and White is to focus on
the patient, the patient experience, but but, more
importantly, kind of empowering the patient,
to be a part of,
their their own outcomes and stuff like that,
in partnership with us. Yeah.
You know? The the point of care is
changing at a rapid pace. You know? It's
it's, no longer kind of exclusively to brick
and mortar facilities. You know? My my grandparents,
when they went to the doctor, they went
to the doctor's office, which was a building,
and that's what they did. They would have
never even imagined,
a virtual care. Like, they might have talked
to a doctor over the phone or something
like that, but but virtual visits, as they
are, are kind of no longer an experiment.
You know? You just, you know, pre COVID,
they were kind of this experiment that people
were trying to, you know, figure out whether
they work or not. They're they're here to
stay. And so that is an opportunity
of of of growth for sure.
I think we're gonna see more and more
care to be given at the home.
And from a technology perspective, we really need
to think about how we're going to support
that model, you know, you know, patients in
the home, hospital at home initiatives, and things
like that, and making sure that,
we're able to meet the standards of care,
which puts a lot more pressure on the
technology, frankly. Right? Because,
if a patient is in the hospital,
the, caregivers
have downtime procedures and stuff like that, and
so, you know, technologies
have issues, they're able to kinda make up
the difference. If we have a technology issue
with a patient at home,
then we've now completely isolated that patient, and
and that is that is, kind of an
unacceptable,
outcome for us, and so we really have
to to think about that. I also think
that you're gonna see a lot of growth
in medical devices
merging with consumer devices.
You know, it's kinda funny. I think the
Apple Watch is only the tip of the
iceberg, but it's kind of amazing what is
happening with, you know, wearables
and, how that is really benefiting,
the benefiting society, frankly, but but, benefiting, you
know, outcomes with a a lot of solid
data. You know, if you think about your
interaction with family members that have wearables,
you like, common phrases today are, like, oh,
I, you know, I I I got my
steps in, or, you know, gosh. You know,
my you know, I I guess my heart
rate's up up or whatever. So you kinda
hear these things that are that are happening
and are normal in society, so I think
that that's gonna continue to be,
to to be a growth opportunity. But I
think what it ultimately comes down to is
in health care, we need to think about
how other industries have been disrupted.
So think about
the music industry and how they were disrupted
by digital downloads.
They used to make a lot of money,
you know, making in, CDs and albums and
things like that, and their whole world got
shifted to digital. Think about
the the taxi driver
pre Uber
versus now. And and and then, of course,
the biggest one, is Amazon and what it
has done,
to retail. It really has changed how we
as a world consume
products.
And,
you know, so
think about those examples and what do they
all have in common. Well, what they did
was is they met their consumer where they
were,
every one of them. And so they kinda
removed,
the either, hey. I have to go to
the music store at the mall, or I
have to go to the mall to
buy something,
you know,
tennis shoes that I can now order on
on Amazon,
or, like, I gotta, you know, wait or
go find a taxi versus that taxi coming
directly to me where I am.
So each one of these disruptors are meeting
consumers where they were, and we have to
think about the fact that patients don't live
in our brick and mortar clinics. They don't.
And so I think the disruption is gonna
happen with us having to move care to
where the patients are.
Fascinating. And and, you know, really just interesting
to think about all those different industries that
have been disrupted over the years, and then
to see it happening right now in health
care,
is just really a lesson in, adapting and
adjusting. And then, like you said, figuring out
what patients want and need and and being
able to deliver it. This is a really
exciting time, to be in health care.
Absolutely. Well, thank you so much for joining
us today. It's been, a pleasure speaking with
you. I've really appreciated
hearing your perspective, and I look forward to
connecting with you again soon.
Absolutely. We'll see you in Chicago soon.