#8: Every size organization has a role to play | Morgan Hart, Founder of Hart Health Strategy LLC

Published on February 14, 2022

Give your clinicians a seat at the table for developing new healthcare solutions. In the new episode, Morgan Hart, the founder of Hart Health Strategy, shares her experience as a consultant working with large and small clinics, hospitals, and insurance providers. We discuss how to optimize the purchase timeline, how healthcare organizations measure the performance of consultant work, which EHRs are the most popular in the market nowadays and why. Also, if you are creating a healthcare startup right now, there is some good advice for you in this episode. Enjoy the listening!

In this episode, we will answer the following questions:

01:13 background of the current projects

02:47 how healthcare organizations measure the performance of consultant work

06:11 how healthcare providers rein in the spending in the industry

09:30 optimizing costs with technologies

16:31 main issues in technology that providers face (EHR functionality, etc)

22:20 Epic and Cerner: usage pros and cons, what system is better to choose

30:48 the purchase timeline optimization involving clinicians

33:29 reducing multiple clicks and other main tips to consider implementing technology for clinicians

36:31 the investment situation in the healthcare field

38:32 telehealth will stay on the top: leading technology trends in 3-5 years

40:53 main advice to startups who are building telehealth or other health solution

42:42 Rapid Fire Round (3 questions)



Morgan Hart email: morgan@harthealthstrategy.com 

Morgan Hart LI: https://www.linkedin.com/in/morganehart/

Hart Health Strategy website: https://harthealthstrategy.com/


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Ivan Dunskiy: Hello everyone. And welcome to another episode of the HealthTech Beat podcast. The mission of our podcast is to show the real-life challenges of implementing technology in healthcare. And the podcast is sponsored by Demigos, a company that develops IT solutions for startups and companies. You can check for more information on demigos.com. My name is Ivan Dunskiy, and I'm joined by an honored guest Morgan Hart, the founder of the Hart Health Strategy LLC. Morgan works as an independent consultant for hospitals, systems, and insurance providers. Morgan's work with clients focuses on strategy for care transformation and business tactics to remain at the forefront of the industry. Her experience touches healthcare systems, government, healthcare payers, commercial insurers, and health startups. Morgan, thank you for joining. 

Morgan Hart: Thanks for having me. I'm doing well, and always a pleasure to talk shop with others in the industry. 

[01:13] background of the current projects

Ivan Dunskiy: Of course. We can start with the first question. Could you please give a brief background of the projects you're currently working on? 

Morgan Hart: Absolutely. And like you said in your introduction, I work with a number of different types of organizations in the healthcare space, but primarily health systems, hospitals and providers, and then health insurance companies.

At any given time, I work with several clients who have a challenge that they need help with: whether that is it's a short-term project that they don't want to have to bring on a full-time employee for, or they're looking for an external party to help with executive conversations, board presentations, etc.

So often, I work with organizations on our challenges around how they are thinking about transforming their business approach to care delivery. So that is everything from addressing value-based care, what resources, what data, what technology they need to do that - and understanding what the others in the industry might be doing.

That's where a consultant has a lot of value. And that we have a comprehensive perspective because we work with so many different types of organizations. And often, I also work with smaller organizations who are just really looking to say: Hey, we have an idea. Let's make sure we're crafting this in the right way.

Whether that is a technology product or a go-to-market strategy, I come in to help bounce ideas off folks and provide an external perspective again. So really, it's a strategy at the highest level, but also moving pieces together and making sure that the picture is well-rounded.

[02:47] how healthcare organizations measure the performance of consultant work

Ivan Dunskiy: Could you please explain what kind of parameters or how you measure or how organizations that hire you measure the performance of your work? For example, that advice was good and like, ROI is there, and so on. 

Morgan Hart: It's a good question. And I think with any type of project. Often, you have planning upfront where part of my job is to say: Okay, how do we want to look at the end of this journey?

Whether it's a six-month or multi-year project, and we define success, we being myself and my partners, we defined success together. You know, what kind of design, what we want our goals to be, our metrics to be. And sometimes we want to increase our revenue by X percent, and that's a really easy way to measure success.

It didn't a consultant Morgan and her company help us do that. Other times it's a little softer because there are so many factors that go into strategic projects in healthcare that your success might be a little bit more qualitative. It might say, can we look back and say, we made a perfect chance. Were we able to put a new process in place? Was this easy to do? Was this hard to do it? Could we have accomplished this without our consultant's help? So, the ROI is a little intangible in some cases. And part of my job is to understand my clients upfront; what do you want the outcome to be, and how can we work together to get there?

And so I always will look back at the end of a project and kind of review and say, did we do what we said we were going to do? And we met for implementation. And if we did great, and if not, let's talk about how we could do a little better next time. I hope that answers your question. With many things in healthcare, it's nebulous, and you always have to be flexible and willing to say, okay, maybe this isn't going to be a hard number we can look at. If it is, that's great. But if not, sometimes you have to think outside the box. 

Ivan Dunskiy: The answer is, it depends, right? 

Morgan Hart: It depends. 

Ivan Dunskiy: Absolutely. To give more sense of the types of clients, you work with. How big are the organizations? 

Morgan Hart: I have a range. My current clients represent almost $20 billion in revenue between all of them, pretty big companies, a couple of thousand employees dealing with either whether they're insurance companies or health systems, either, payers that are covering certain lives. They cover five six-figure a thousand lives. And then put hospital systems. The footprint is also into the thousands of patients they cover across their area. So right now, I work with a couple of regional-based organizations. I'm located in Washington DC. And so it's organizations who have a footprint around, around the east coast and kind of work in the east coast, mid-Atlantic region. I have done some consulting for super small startups and less than five employees, super early startups, and some smaller, one to 200 person companies with a product offering in the healthcare space. So the short answer is size totally varies.

I try to keep my doors open to any type of organization that wants to work with me. Because I think every size organization has a role to play in this industry. We can't only look to the giants to be able to do things because sometimes change happens most quickly at small organizations that are uncovered by large policy or large leadership divisions that would kind of make change difficult.

[06:11] how healthcare providers rein in the spending in the industry

Ivan Dunskiy: Of course. Maybe that's a kind of general question, very general. Can you classify some categories of main challenges that you see that your clients face? I mean, the health care providers and startups. 

Morgan Hart: Sure. From the provider perspective, and I think you see a little bit of this when I talk about my clients, and certainly more broadly in the industry, we have two huge players. We spoke to providers, hospital entities, physicians, care delivery organizations. And then we also talk about payers, insurance providers, like the government, Medicare, Medicaid, and commercial insurance companies, big names like Aetna, United, Blue Cross names that most in the industry would know.

So, the payer and provider-centric approach to this question means challenges. I think there are a couple. I believe they are related, first, above all else. And this is something that anyone would tell you. One of the biggest challenges that provider entities and payer entities are trying to solve, my clients absolutely, is cost.

This is something not new in the past year or two to the industry costs are continuing to grow. Especially as we see more and more patients having high deductible health plans, more risk is being put on the patient themselves to pay out of pocket for care. And in general, trends, where there is a higher and higher number of patients with complex conditions, need high-cost treatment.

As you think about trends, just in general with the population, we have thousands of people every day from the baby boomer generation aging into Medicare, shifting from a commercial plan coverage to a government plan that many American taxpayers pay into that we hope will be there for us one day when we reached Medicare age.

But the numbers are astounding how many folks are starting to draw from that program. So, the big challenge is cost. How do we rein in the spending in the industry for cost? And that has some trickle-down challenges that others are trying to address: the rise and value-based care.

Thinking about new ways to address those costs increases. Are we thinking differently about reimbursement strategies and trying to save money while increasing value? And how do we work to manage that in a world where we have a lack of transparency and interoperability and technology, which I'm sure I've been? We'll dig into more with our time together today.

And certainly, with the COVID pandemic, staff shortages, that's a huge thing in the American health care industry right now, nursing and physician shortages, labor shortages, folks who are burnt out after the past 24 months of caring for patients in the pandemic and leaving the industry and less bodies that are in our hospitals taking care of patients. And it does put a strain on the industry as well. So there is a myriad of challenges that really kind of come together from that kind of high-cost driver, more and more people using healthcare systems in a world where we have to have the people to provide care for them, the systems to support that care and, and the technology to make good data-driven decisions around the care people need.

[09:30] optimizing costs with technologies

Ivan Dunskiy: Digging more into the cost issue. What are the main categories in this cost that could be optimized with the technology or maybe not with the technology? So what is the biggest problem?

Morgan Hart: I think technology can solve a lot of it. And that goes back to being able to provide good data to make decisions.

But to answer your question specifically, wherefrom a category standpoint, I think one of the biggest providers and payer organizations see utilization, right? How are patients using the healthcare system? And when we say using that is not just, are they coming to the healthcare system, whether that's the ED or the inpatient setting, where they're staying for a couple of days, elective surgery, urgent care, et cetera, are they using the system. But also, this is the way that the patient utilizes the system appropriately. And so, many times, the industry leaders will look to say: how do we shift utilization in a world where we know people are going to be sick? We know people are going to need healthcare services. How do we think about where those patients are using the system and is it appropriate for the care that they need?

Often we hear about high-cost drivers about unnecessary utilization in the industry. And what that means is, did the patient need the type of care they received in the location where they received it? You can think about a classic example of someone who goes to the emergency room because they have no transportation.

They need to call an ambulance to get there. Still, their condition is very mild. It would have been more appropriate for that patient to be seen in an urgent care or even a primary care setting, typically far less costly than an ambulance ride and an admission to the emergency department. But if that patient felt they have no other option, that's where they go for care.

And so you're faced with the cost that could have been avoided and put in a more appropriate setting of care, that would have resulted in a lower cost for that patient and probably better experience for that patient as well because I'm sure, Ivan, if you've ever been to an ED if it's not a totally emergency situation. It's often hours of time waiting to be admitted and triaged to the right place. So, utilization is one of the biggest categories we often hear about. And I think a number of technology solutions a number of consulting strategies are all around; how do we make sure that utilization is appropriate? And that utilization is necessary when we think about the cost.

Ivan Dunskiy: Are there any technology solutions on your mind that address this problem most efficiently? 

Morgan Hart: Absolutely. I think there are many technology companies out there today that have whether their entire solution is built around this, or they're an EHR or electronic medical record company that has an ED on. I think a lot of tech companies have definitely realized this.

And it's a big opportunity for technology firms. A lot of times utilizations challenges, folks are looking at data that is claims-based. You get utilization reports or claims reports that are often after that patient has seen the physician in that setting of care, hard to redirect them in a place where the care has already happened.

Many technology solutions I've seen in my experience are thinking about predictive analytics to help target patients who may have a condition that may cause them to present in the ED that they might not need to. And couples that with historical claims and historical utilization data to see if they have utilized that setting of care.

And it flags those patients for at the point of care providers to see if they're coming in. Can we triage them? So technology-wise, I know, that is certainly there as well. 

The CMS innovation center, a branch of CMS created about 12 years after the Affordable Care Act is also testing a model called the ET3 model, which puts triaged lines in certain places where patients are calling in to get an ambulance to the ED. The systems allow those answering the phone to assess if that patient should be redirected to urgent care instead of an ED. So certain technologies can look into how patients access care and triage them to the appropriate care setting and get them treated right. So definitely something I know is. Also, there's no perfect solution out there yet.

But many technology companies are looking into this and using some combination of natural language processing, predictive analytics, claims, and utilization data, and kind of creating some system, whether that puts it in an alert or a flag for the end-user to sort of say, could we put this patient in the right place?

I think that that's not a piece of functionality that will go away anytime soon and certainly think it's a good investment area for technology companies who might be looking into that. 

Ivan Dunskiy: And I'm curious when you work with your clients, do you suggest some technology solutions to them when you co-develop the strategy for the company? 

Morgan Hart: Certainly, I am very unbiased in the types of tech solutions I recommend, but often if there is an opportunity, I might say to a client, have you thought about a care management solution integrated into the EHR. And more generally, will recommend workflow tools or technologies that might help an organization think about how they can improve efficiency or reduce time to kind of do that work or reduce manual labor from the data analyst teams who are already looking at this claims data or looking at this utilization data and looking for a better way to kind of mind through it.

So, my experience is typically in working with health systems and insurance companies on processes and operations. As I'm aware of technologies or as I'm aware of solutions that might make sense, I certainly will kind of ask the question of what's the point solution we've thought of? Do we have something in place? Are we happy with it, and does it do what we want it to do?

And that's something that I think many organizations have been going through over the past 20 years, modernization of records, moving away from the Manila folder with the last first three digits of the last name, right, that has your patient chart to an electronic health record. But how are we also thinking about making that data within the health record usable?

And how does it communicate with other systems that we need it to? With the explosion of funding in the health tech space over the past five to 10 years, there are so many solutions out there. It's a question of what do my clients need? What are their biggest challenges? And do they have something that works well for them or do they need to do some shopping?

And so, it is not my place to ever specifically recommend a particular solution but more to be able to provide advice and guidance if my client's going through an RFP process and kind of bring some opportunities to their decision-making process. So they pick the best solution for what they need.

[16:31] main issues in technology that providers face (EHR functionality, etc)

Ivan Dunskiy: And could you outline some challenges, like main categories? I think that you did a great job when you explained the major challenges of the providers, but could you please outline the main problems in technology that providers have? 

Morgan Hart: I'm not a clinician, I don't practice, but I work alongside many of them and work alongside physician leaders. So I hear a lot of the successes and challenges. I would say a couple of the challenges, and I mentioned this as one of the categories earlier is lack of interoperability with data and transparency with data.

There has been such a good movement towards using data and technology in the healthcare space over the past couple of decades. But the systems are not designed to talk to each other automatically. We see this a lot with the lack of interoperability between EHR. If you have an EHR in your inpatient setting and a different EHR vendor in your specialty clinics, that is common where a system might not be on the same DHR for every site.

Do those systems talk to each other? Is it easy to transfer patient records, is direct messaging set up the capability? Users from one system can directly message users about a shared patient on another system. All of these things are not, in my experience, out-of-the-box offerings. It's a frustrating point where clinicians and clinician leaders feel like they have to pay extra to get the systems, to talk to each other.

And many systems do invest in that, and you often see many systems will scrap multiple EHR systems. They have a disparate system across their system.

They'll scrap it and do a big implementation to get everybody on the same system. So that lack of interoperability is a challenge.

The data's there. The systems are there, but they're not configured to talk to each other without extra lift and extra costs on the provider side. So I think that's a frustration that organizations continually work to solve, and they found workarounds and found solutions. But until we get to a world where we're on a single EHR system for the entire patient population in the United States, which is a pipe dream for many of us, that's going to be a challenge that's here to stay. And we have to think creatively about how to work around that. Is there an extra solution that we implement that aggregates the data for us? Do we have an enterprise data warehouse we're using? What are those solutions where we have one place for all of our data to live, and can we use it?

And one of the other challenges, when we think about transparency and interoperability, is the system's functionality. I often have seen in my experience that leadership understands from a theoretical and a strategic standpoint for the system. And what the end-users are doing with the system, whether from a capability or a user usability standpoint, sometimes differs greatly.

And what I mean by that is the C-suite of leadership in a hospital may have months of meetings with a sales team and leadership from a technology company to talk about what they want out of the system. But through 12 to 24 months of implementation and then end-user use a refinement of the tool, there may be technology pieces that the leadership felt were really important, an extra widget or an add-on that they paid for.

That is really cumbersome for the end-user to use, whether that's an extra dropdown or a multi-click reporting function that isn't easy to use. And so you find that leadership will say, well, we bought the system to do X and the end-user say, gosh, that takes so much time. We don't have time to do that.

So we don't even use that functionality. And that's a frustrating point, I think, for both sides of the coin here, and then certainly for the technology company, right? You want your tool to be used at its very best. You want it to be providing value for your client. But, if your client teams have a different perspective of how the tool is being used, that's a challenge.

So those are two of the big things I see: interoperability and the tool's actual functionality and usability. The number of times I see dormant dropdowns that somebody paid extra for because they wanted the ability to do that data field mining and in a report, but nobody uses it because it's really hard to find.

If I had a dollar for every time that happens, I'd be a millionaire. I don't know if that resonates with your experience and what you all are trying to address. Still, certain things are how do we communicate with the end-users, and how do we make sure that the tools are optimized and used at the best of their capacity?

Is it doing what we said it would do? And is it really doing what our end-user needs it to do.

Ivan Dunskiy: I spoke with several physicians where in the hospitals Epic, or Cerner was implemented, and basically, they said they had it. 

Morgan Hart: Cause I'm sure the executives got super excited about it, but the chief clinical officer or the chief financial officer who's in those meetings, getting pitched, is often not using the tool every day.

Right? So the people who bought the tool and signed on the dotted line are not the people who are using it day in and day out. And so, how do you communicate that and share feedback up through the organization, but also make sure that that feedback gets back to the EHR company? I think EHR has got a lot of brunt of frustration because they're not perfect, but they're certainly better than, as I mentioned, the Manila folder where we had to fax or put patient records in the mail.

I mean, there's improvement there, but again, nothing's perfect. I know you and your organization are often working with others to try to solve those frustrations and figure out how to create custom solutions that can maybe bridge the gap or turn something from "I hate it" to "it works pretty well, for what we need it to do."

[22:20] Epic and Cerner: usage pros and cons, what system is better to choose

Ivan Dunskiy: Absolutely. And what do you think about these solutions like Epic and Cerner? Because I believe the part of their strategy is to consolidate all the data so that you don't need to switch between different systems. You just set up Epic, and it covers all the things that that provider needs.

What do you think? Because I think a big portion of your clients uses that systems. 

Morgan Hart: Epic, Cerner, eClinicalWorks. We see Athena in different pieces, it's a bit different being cloud-based, but I think it's a good and challenging thing.

Right. When you think about software solutions in healthcare, that aspect of the industry from an actual commercial and true entrepreneurial standpoint is no different from any other good or service. So there's always the argument of is consolidation and monopolization of a technology or solution good.

Or does it not allow the customers and the users to have enough choice to do those, the things they want to do. So I think certainly in some vein having a full suite of products in one operating system, as an Epic or like an eClinicalWorks. Suppose you can have every module turned on, and everything sits in one platform with one login, one single sign-on, the ability to do all your reporting within one system, I think from a clinician, and it needs your perspective, that would be amazing. I know that I hear a lot of frustration from end-users: wow. We have five different logins, and we have to go to five other websites to get various pieces of the reports we need or different reports for different things because the EHR does one thing. Still, the claim system does something else, and our provider directory lives somewhere, somewhere else.

I know from an ease of use standpoint, having a single log in and a single source of truth for that data would be great. But I also think there's always the capitalist argument that lack of diversity in offerings allows for growth and innovation. If we only have two or three offerings versus hundreds that we can choose from.

And, what does that do for competition, and how does that help hold us all accountable to be better? I am not a buyer of these products. I think there's value in having them all in one place. But I also believe that we live in an industry in the United States where competition is a good thing.

And the continual innovation in our technology products is only helping keep at least the very lowest performers better. That the statement of a rising tide raises all ships. Well, if we're only as good as our worst product when there are only two or three choices, Where does that leave us when it comes to frustration, and it comes to opportunities.

If you don't have anywhere else to go, you're kind of stuck with what you're given. So I know that's, that's, an another "it depends" answer, but I think there are two ways to look at it. And I think that we'll continue to see the big tech EHR solutions offering more and more add-ons.

But I think that that does not mean our smaller. Point solutions will go away. And I think that that's a good thing. I think that that keeps innovation going. That means there will always be a good, good, healthy, competitive space. And that's ultimately good for our providers because they're able to do what they need to do to ultimately give patients the best care at the lowest possible cost and the highest possible quality.

Ivan Dunskiy: But from the practical standpoint, not the philosophical, do you think these systems cover a lot or most of the providers' needs?

Morgan Hart: From a practical standpoint, I'd say - sure. 

Ivan Dunskiy: Why then do we need other systems. 

Morgan Hart: And I think the reason that I would say sure, and not yes, is because the bare minimum of accessing patient records, submitting orders, looking at, utilization. When were they last in? What, how long were they here? The systems do what they need. But as the industry continues to move towards managing costs and improving value, we will need better and better solutions that allow us to look to the future. And I don't know if EHR is so focused on being an electronic health record can also be off.

Right. Is it better for us to have one system that does everything kind of good? But it's all in one place, or is it better to have specialties where 90% of what we need is in one place, but we still want an add-on for these other more innovative and forward-looking things. So practically, I would say EHR solutions in their add-ones are good. Still, they're never going to solve every problem because there are always new problems that are being created or emerging, and the healthcare system, as we move more and more towards risk and we move more and more towards value.

So I think the answer is EHR to do a lot. They don't do everything, and they probably never will. So I think there will always be that space for the smaller technologies. 

Ivan Dunskiy: So a question I have, so let's imagine the situation when the provider wants to have a more proactive way of dealing with patients.

And they're looking at kind of a predictive analytics tool. And they have two choices. One choice is to bring in a small brand new solution from the market connected to your Epic to their existing Epic, and it analyzes and gives some predictions. On the other hand, we have an offering from Epic, where they offer the same thing - that you need to install the plugin, and the plugin will take all the data from your EHR and make your predictions. So, how do you see the situation? What solution would you choose? 

Morgan Hart: If the solutions were truly equal in their functionality and the solutions were equal or close in cost, knowing what I know about technology implementations, the widget, or the add-on solution in your existing EHR.

If I were, a health system would probably be a better fit. Because I'm betting because it's not a new implementation, it's using existing data, and it's turning on functionality, I think that is overall an easier process. I think all things being equal, having the additional ability to kind of turn on a widget or turn on something that isn't an additional lift on an implementation side is always going to be valuable.

But it goes back to the question of, is the solution truly equal? Does it really do every single thing that the other small on-shelf solution will do? And if the answer is yes, then great. That's a win for epic. If the answer's no, then is the implementation cost and the financial cost enough to justify staying with Epic to do it, or is the extra functionality truly worth the extra investment from the health system. You have to make a business decision there. Ease of use all again, not having multiple logins for the same thing. It's always going to be, I think, a win for the end-user, but the question is, is this a true apples-to-apples comparison?

Or is it not? And how do we weigh those things? So that's something I often will kind of talk about with my clients to say, can our EHR add-in do this? Do we think that it can do it? If the answer is yes, that's an easy box to check. And if the answer's no, then that's where I think it is always good to kind of look towards other solutions to say, our EHR is really good, but it's not all things.

And if it can't do that, that one thing we need, then it is time to go outside the EHR and add an additional product in. Maybe one day, again, we'll be on a master EHR for every patient in the world. Medicare has been trying this for years. We're just seeing it in the military with the new Genesis EHR that's going live right now.

I think we're years and years away from that in the industry. But until we get there, we'll continue to see. There is always going to be a business case. These smaller companies start because they see an opportunity in the market. EHRs don't do it. So let's create a company that does.

And until we get acquired or get big enough to have our kind of challenger here, small companies continue to emerge and continue to get funding because they're doing something unique that the big guys aren't doing. 

[30:48] the purchase timeline optimization involving clinicians

Ivan Dunskiy: It definitely makes sense. You touched on a very interesting topic that not always the vision of decision-makers and clinicians are equal when they use systems. So what is input? How do you see the process optimized and more efficient, especially during the purchase timeline? What is the best approach to involve clinicians at the point where the decision of purchase is made, or how do you say this?

Morgan Hart: I would advise most purchasers of products to involve your end-users upfront. If you do not already have a listening session, collect feedback, understand the biggest gaps, the system we need, and the big pieces you as an end-user want.

And I think as many times as you can to include your end-user leads if one or two folks are kind of stepped up to represent the medical department, have them involved in demonstrations, let them ask questions of technology solutions and sales teams. So you don't get to a place where you get a solution, you've bought it, and then the end-users say, well, nobody asked us if this would even be helpful or nobody asked us what we wanted. That's a really easy way to evolve those pitfalls to involve end-users early and often in the sales process. I've also heard many times, and I'm sure, Ivan, you've seen this too, where the leadership gets sold functionality that doesn't exist in the product today.

We're told in the sales process it'll do this, and then we implement it, and everyone's frustrated that it doesn't do that. 

Ivan Dunskiy: But they will add this year, so. 

Morgan Hart: It's on the roadmap, which is great. But I think in that sense is how do technology companies overcome that to say, okay, it is on the roadmap.

You're not going to get it for 12 to 14 months, but what is the problem today that the end-users are frustrated about not doing it, and how do we create a workaround solution that helps get us there. Well, that functionality is still in production. And I think a lot of times if technology companies are willing to come to the table and maybe not be a development partner, but really listen to end-users, not just those that are signing on the dotted line to say, how can we solve this issue then ultimately, it leaves everybody feeling like they're winning.

And so, if you're a technology company or you're a purchaser of a product, think about your end-users. Think about what they want. Not just what's going to look good to the board. Not what's just going to kind of check the boxes at the C-suite level to make sure that you're buying a product that's going to get used and that you're paying for the things that are getting used on the end-user side.

[33:29] reducing multiple clicks and other main tips to consider implementing technology for clinicians

Ivan Dunskiy: And next question on this topic. Could you give some tips on created or implemented technology that clinicians would accept? What are the main things to consider?

Morgan Hart: Like I mentioned earlier, reducing the number of places that clinician has to go. Whether that's multiple logins or multiple clicks, I think streamlining where information input goes is always a win.

Ivan Dunskiy: What do you mean by "always a win"? 

Morgan Hart: If you're asking a clinician who is charged with doing patient care and spending time with their patients and they have to do 27 clicks in the tool to get from tab to tab, to tab, to input data, while they're asking patients questions, I think that's the frustration.

And you hear a lot of times, clinicians will say, I didn't go to med school to click in a document. I want to do patient care. As a technology solution, how can you create a streamlined, easy-to-use solution that minimizes where someone has to go to put information in. I know that's not always perfect or easy to do, but the easier it is to put information in a single place, the more it will get used by a clinician. Because they are charged with getting this data in and helping make it usable and meaningful for those trying to analyze it and deliver excellent patient care. And it's frustrating as a patient too. I'm sure to be sitting there trying to talk to your physician, and they're sitting behind a computer and not talking to you because they know they have to get the documentation done.

They have to submit these things, and it's really hard for them to use. That's one thing is just thinking about ease of use and usability. Not to get wooed by, we could do this, but it's going to be cumbersome. I think that's where you start to see people not use things because it doesn't make sense in the workflow.

And from a clinical documentation standpoint, they're going only to do the bare minimum. I'd say that would be my biggest tip or advice and what I've heard from working with clinicians on tools. If you have an add-on, if there's a way to create a single sign-on system and do SSO and get that built in the tool, that's also a win.

I know from hearing it from my clients. Nobody likes to have five or six places they have to enter different logins. And people forget the logins, and then they don't use them. Cause they forget their password. If you have one way to do that, and you can do a single sign-on for your solution with other systems, that will also lead to more use and more satisfaction with the tools.

[36:31] the investment situation in the healthcare field

Ivan Dunskiy: As a person on the technology side, I would say that the problem is that clinicians are not always involved in the development process when the product is developed. People like engineers and developers create products, but they don't understand how exactly these things are happening in the real world.

So that's an issue that results in this challenge that you just explain. Do you see that healthcare providers and organizations want to invest more and more in technology than in previous years? 

Morgan Hart: Absolutely. As a perfect example of the COVID pandemic, we have seen an explosion of telehealth in the US healthcare industry.

And remote patient monitoring digital solutions to deliver care that was not used nearly at the volumes that they're used now. You can look up any data that shows that the percentage of visits done via telehealth before 2020 in the pandemic was very low, less than 10%, whereas you saw a huge rise in that.

More and more systems are realizing that again, going to that challenge around costs, around is this the right place of care? Is this the best way for our patients to access our system? Investing in a digital health platform is a short-term investment that will pay off in the long run because there is an increase in access, decreased in cost, typically, and overall satisfaction for patients to be able to join a zoom for a call that they didn't need to go into the doctor's office to do.

If it's an acute enough condition that can be managed over a video chat. And especially for our patients who have access challenges, mobility challenges, and may be in a position where they cannot get in a car and drive themselves to the urgent care or primary care setting. Digital health solutions are huge when I think that's just one example.

There are billions of dollars, as I mentioned, that are being pumped into the VC and investing space when it comes to digital health because payer and provider organizations are seeing the value in investing in technology and having data and having rich data that are usable and can be mined from really slick solutions or create meaningful dashboards.

That is a huge value add. I don't think that that investment is going to go anywhere anytime soon. That's a trend that will continue. At least for the providers in the industry. 

[38:32] telehealth will stay on the top: leading technology trends in 3-5 years

Ivan Dunskiy: And what kind of technology trends do you see in healthcare in the next 3-5 years? 

Morgan Hart: I think telehealth will continue to be a top of mind. I don't think that'll wane. Especially as we continue to see the COVID, variants, kind of waxing and waning, and kind of fits and starts, is it safe to travel? Is it not safe to travel? I think that's definitely a big one of telehealth solutions.

Wearables continue to be something that the industry is looking to invest in. More and more organizations are exploring partnerships with remote patient monitoring tools. So a little different than telehealth, where it's a visit, a video visit. Are there solutions that you can invest in that allow a device, a small device to be sent home with a patient to do basic monitoring like If you need to do, a chest, a scope or an ear or anything that's kind of a minor, a scan or is there a wearable or RPM technology you can send home.

That is low cost to a provider but allows you to kind of get data, those sorts of things I think in the next three to five years, we'll see a lot of. And I believe specialty care will come. We'll see a couple of smaller companies and even larger companies where it's not just primary care or access issue. Still, it's specific conditions like maternal health, mental health, and behavioral health solutions.

There's a huge rise in those that will continue to raise investment and money from the VC space. I think, tools to help with obesity, musculoskeletal challenges, et cetera, you see a lot of smaller or growth companies emerging. And I think that trend will continue to see investment in that space because, across the industry, we realized that there's complexity in people's care.

And, typically, it's not just the flu, or I don't feel well. It's a specific chronic condition that needs to be managed. And if we can do that and empower the patients with technology, that makes our jobs easier as clinicians, and we can kind of have a true care partnership with our patients because they have a tool to help them be successful.

That's kind of my outlook, and I think there's plenty more where that came from. But given, I know, we don't have five hours to talk through this today and keep it at a high level. 

[40:53] main advice to startups who are building telehealth or other health solution

Ivan Dunskiy: Basically, we're coming to the end of an interview. And I have probably the last question before our rapid-fire round.

What kind of advice that you give to your clients, your startup clients who are startups? To somebody building and using telehealth or health tech solutions, what kind of advice can you give these people? 

Morgan Hart: I would say, and you mentioned this just a bit ago, Ivan, is give your clinicians a seat at the table and development.

I think it is not good to be really excited about a tool that gets good funding that will never get sold or used because it doesn't make sense. Having a great idea, good technology experts, and good professionals who can develop a tool is great, but having a subject matter expert or a kind of advisor is a clinician. 

I'm not a clinician, so I'm more on the ops and strategy side, but having a clinician who has practiced and has used these tools is a great investment. You don't have to have them on your payroll full time. You can just pay them for just a little bit of advice.

That is a very sound investment that I would encourage small companies who want a tool to be user-friendly for a clinician to use. I know it seems a little intuitive and should go without being said. Still, you'd be surprised again, like you said, the number of tools that go to development without really having that user testing and that user acceptance from a clinician's perspective.

And I think always having a pulse on the industry, having conversations, and making sure that you. Someone who is out there, networking, listening, talking is always a good idea to just make sure that as the tide changes and it does rapidly in healthcare, your organization is well-positioned to make those changes.

I think those are two small investments that a small company can make that would pay off big time. 

[42:42] Rapid Fire Round (3 questions)

Ivan Dunskiy: Thank you. I think we covered a lot during this interview. And I'd like to end this one as always, as we always do. A light exercise called Rapid Fire Round. I will ask you several questions, and you give answers, whatever you like. Do you have a hobby?

Morgan Hart: I do. I'm a competitive horseback rider. I do showjumping. It's a big one, more of a habit than a hobby, but I love it. 

Ivan Dunskiy: So, are there any competitions or just for yourself? 

Morgan Hart: Well, I do to compete, but I actually take the winter off.

I hate the cold. And I usually wait until it gets above 50 degrees to take my horse out again. So it's just trading for the winner, but yes, I do compete. 

Ivan Dunskiy: What is the location that impressed you the most? 

Morgan Hart: I would have to say Florence, Italy, and specifically the Piazza de Michelangelo during sunset, you can kind of lookout and see the entire city.

You see the Ponte Vecchio and the Duomo, and it's just so gorgeous in such a slice of Tuscan heaven. It sits with me today, even though it's been years since I've been back there. So definitely. On a cold winter day here in the DC region, I consider warmer, more beautiful times, but definitely a bucket list item for anyone who hasn't gone to Florence. I love Italy as well, but I loved Milan more, more industrial.

Ivan Dunskiy: What is the one piece of advice you would give to your 20-year-old self? 

Morgan Hart: I would say, don't be afraid to fail at something new. I'm a small business owner myself now, and I love the work I do. I have my own company, and at 20 years old, I probably would have never imagined that.

And for anyone who's starting their career, you want to be successful and build a good professional career. Sometimes perfect is the enemy of good. And we get scared of stepping outside of our comfort zone because we're doing well where we are.

But I think that advice was given to me by a mentor. Don't be afraid to fail and fail forward at that. Take what you suck at and learn from it and be better. And I think it's only helped me kind of address where I can continue to grow professionally and be better for my clients and people I work with.

Ivan Dunskiy: Thank you, Morgan, for your time, and I think that things that we discovered during this conversation could be valuable for decision-makers and healthcare providers as well as for health tech startups. What things to consider when they build or promote their solution.

Before we're finished, what is the best way to get in touch with you? If providers want to reach out to you and would be interested in your services. 

Morgan Hart: Absolutely. Thank you, Ivan, for having me. I think this was a great conversation. And if anyone's interested, my email address is the best way to get in touch with me. It's morgan@harthealthstrategy.com, not like the heart in your body. But that is the best way to reach out to me, and I'm pretty responsive there. Certainly encourage anyone with questions or interest to reach out. 

Ivan Dunskiy: I will add that in our resources section. Sounds good. Thank you, Morgan. Thank your listeners, and catch you on the next episodes.

Who is behind the HealthTech Beat podcast

We are a team of IT professionals who like sharing technical knowledge with healthcare industry people.

At Demigos, we generate ideas on how to improve product performance, design, and positioning based on our experience building complex health tech solutions.

Check our blog with articles on the related topics, and our cases in healthtech. Also, connect the podcast host and the CEO of Demigos Ivan Dunskiy on Linkedin.