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Becker’s Healthcare Podcast
Transforming Health Information Exchange in Vermont with Randy Farmer
00:14:53
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- [00:02]
A
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year, those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th for the agenda and event details. Visit Beckershospitalview.com and click on the Events tab in the upper right.
- [00:38]
B
This is Scott Becker with the Becker's Healthcare Podcast. I'm thrilled today to be joined by a leader I've had a chance to talk to several times over the years on the podcast. We're joined today by Randy Farmer. Randall Farmer. Randy for years led up the Health Information Network in Delaware and did an amazing job rolling that out. One of the great health information exchanges in the country. He now has taken a new role as the president and Chief Executive officer of the Vermont Information Technology Leaders. And we'll talk about what he's doing with, with this organization, Vito, and, and the goals for that organization and why he chose to make the move at this time. And again, Randy's a fantastic leader. Randy, let me ask you to take a moment to first introduce yourself and then we'll talk about what you're doing with VITAL and the future of, of that.
- [01:31]
C
Well, you know, thank you, Scott, and thank you again for the honor to be able to join you and speak with you. You guys are fantastic in the healthcare space and it is just a real privilege to be able to speak with you. And so thank you for that. So, yep, joined VITAL back in December. Prior to that, as you mentioned, I've worked as a chief operating officer at Delaware's Health Information Network. And then before that, Scott, I've worked for about 13 years in financial services and had the opportunity actually of working in Chase Card Services. Majority of the time was with JPMorgan Chase. And I got to tell you that in and of itself was a great learning experience. It's a results oriented culture. I got to work with some of America's top brands on the partnership side, got to manage $1 billion P&L and work with just some extremely talented, smart, again, results oriented people. And I'd like to say that that's kind of an unofficial master's degree. I'd like to say I got an unofficial master's degree from JPMorgan Chase because I feel like I learned probably as much there as I did in any other kind of formal Educational standpoint. And it's amazing to me how much the skills that I learned in financial services are really applicable in terms of the health care and health information exchange space.
- [02:53]
B
Thank you. And JP Morgan, one of the great companies in America and one of the great training companies in America as well. So great place to learn and grow. Talk for a second, Randy, about the new role in Vermont and are you living in Vermont now? Because Vermont's beautiful. Tell us a bit about the new role.
- [03:13]
C
Yeah, yeah. Actually this is a really unique opportunity because Den and Vital were very close cousins. They had very similar supplier DNA, if you will. And there's some things that were lined up really well and that the organizations would consult with each other on in terms of like who to work with as on the supplier side. But there were some really big differences in terms of the business model. One of the big challenges at Vital is that currently are highly dependent upon single source support, we'll just put it that way, little single threaded there and it's government related. And we, you know, we drive a lot of value, we drive a lot of value to a lot of different stakeholders. And you know, on, on that we think it's important that we tell an even more effective story in terms of the amount of value that people are getting out of the network so that it can be understood and appreciated. And maybe we can evolve the business model, you know, so that it's, it's not centered in terms of, of a one particular entity, you know, covering the cost for the organization. There's so much more that can be done there to help this organization transition from what it does well and is highly penetrated at in terms of being a connector, being a central nervous system for healthcare data, but to shift to becoming a health intelligence network. And that's the kind of the distinction I think between those two organizations, Delaware's HIE and Vermont's hie. Vermont is at an inflection point of helping of possibly, you know, going forward and making that, that shift where you so many more constituencies can get more insights, actionable insights in terms of how to care and reduce cost because of the nature of the data that's, you know, traversing through the organization on a daily basis.
- [05:16]
B
Thank you. And talk about as you take on this role and you look at this year ahead, what are you most focused on and excited about as you get going here and setting direction and goals.
- [05:28]
C
Yeah, in terms of like what I think is really important here, Scott. And I think these are just basic tenets and I'd like to think that anybody that's starting in a role like this could probably take this away and make it part of their playbook. Number one, I think it's important for us to be, well, relationship centric. An organization cannot maximize its potential and leverage its full capacity if it is not relationship centric. And you know, by that I mean like being in tune with the relationships of like our customers, our board, our stakeholders, but also our employees. If you're not focused on your employees inherently those relationships, they're going to impact the users, it's going to impact our customers and, and ultimately those relationships will suffer. Right. And so we're looking at building a culture that is even more focused on results. Build, let's like out risk compensation plans that are tied to both corporate goals as well as personal goals, help ensure everybody's pulling in the same direction and that they're rewarded accordingly for that. So that's one of the big things that we're looking at. We've also recently launched a really exciting customer experience project and Deep Dive. We've contracted with a firm that has great experience in this area. And there's a six month, it's a six month engagement reviewing and analyzing our customer touch points, where we have winning interactions and where we have pain points. A 2024 Watermark Consulting study found that over the previous 16 years customer experience leading organizations, those, those organizations with like a NPS scores, net promoter score of 65 to 80, they actually outperformed the broader market generating a total return of over 260 points higher than the S&P 500 index. On the other side of the scale, those organizations that had NPS scores of 0 to 20, they were more than 175 points lower than the S&P 500 index. So I mean there's real business implications here for this type of effort. And whether you're a nonprofit or a for profit organization. You know, Scott, you know as well as anybody, we are all in the same business of making money and staying in business business. And this is an important part of making sure that you stay in business.
- [07:42]
B
100%. And if you keep great people and grow with great people, you end up getting better net promoter scores. You get better customer feedback, better service and ultimately the business goes well. Is that a fair sense?
- [07:57]
C
Well, I've. Scott, I know I'm preaching to the choir. I have to say, quite frankly, when I go to a Becker's conference, I'm going to be working with people that are going to be graded in the nine and 10 categories of an NPS score. So I know you and your culture embrace these tenants and it's, you know, it's one of the things that I really appreciate in being able to speak with you about that stuff. So I know if anybody gets it, you certainly do.
- [08:24]
B
Well, we believe in it. We believe that you got to have great, that there's no such thing really as a solopreneur. It's all about great teams and great people and then those great people being action oriented to take care of great customers. And at the end of the business should be pretty simple, great people, great customers and solving a problem for those customers or whoever you're working with and trying to do so. It's hard, but it should be clear and simple. But, but it's hard.
- [08:49]
C
Of course.
- [08:52]
B
Talk a little bit about in the health information exchange world with artificial intelligence, with all these different things going on, what are a couple of the things that you have your eye on that you're watching closely?
- [09:02]
C
Oh boy, that's a great question. You know, in terms of artificial intelligence, I think we're like a lot of organizations and we're looking to do to one, dip our toe into the water, but do it in the safest, most reasonable and responsible way. And I think where we have some low hanging fruit is seeing where we could leverage AI to help us with some administrative type tasks, you know, some basic kinds of things that could help us in with back office operations. Quote, you know, you know, maybe in terms of like helping to facilitate timekeeping, you know, by look, having like AI that can look at like our patterns of behavior with email and our calendars to be able to kind of provide suggestions. Right. In terms of the types of projects that you spent your time on and the types of ways that you spent your time and make it easier for the, you know, the, the organization to complete their time cards on time. You know, it's, it's. I think that that's where we are probably best suited to get good learnings, to have low risk in terms of like applying AI and then can take that and hopefully build on it for some additional, you know, kind of opportunities to make even more substantive improvements that could be more customer facing. So yeah, that's, I think that's where a lot of organizations like mine and I think actually universities and computer science organizations within universities are a great resource for organizations like ours to try and partner with to find ways to do this stuff and again to do it safely, you know, just again kind of dipping our toe in water and refining policies as it pertains to AI. So yeah, that's kind of how we're looking at it.
- [11:01]
B
Thank you. And Randy, besides artificial intelligence, when you look at the information exchange world and what you all do, one other big trend or thought that you're looking at.
- [11:12]
C
Obviously rules at the national level driving policy on how healthcare data can and should be shared. The rules around TEFCA and the overarching rules in terms of interoperability and staying close to what the evolving needs are of our state and stakeholders. How can we help make health data even more useful so that it drives more value to the hospitals and labs and payers and providers and, and ultimately help to advance the cause of medicine? I mean, health data services are to health care what steel is to the construction industry, what steel is to the auto industry and states that have a strong and highly penetrated central nervous system for healthcare. Healthcare data like vital well, they have a valuable asset that helps to improve care and reduce cost and it's a valuable asset to help drive important insights. One of the things that we did at Delaware was look at like the incidences of brain trauma and, and what the outcomes were for brain trauma patients in certain areas of the state and what did we find with those areas that did not have the resources or the services that helped to better support care close to where people were living. They had a trend of having worse outcomes and then higher costs downstream in terms of additional care for those patients. So then the state could make a decision and healthcare providers could make a decision to say, you know what, these are areas where if we put some more resources for care coordination to help support folks that had suffered a stroke or to help support folks who had suffered an accident that involved head trauma, we're going to actually have reduced cost and better outcomes for those patients. And it's a way of spend a little money now to save a lot more money later and then people are going to be healthier downstream. So this is part of the power and part of why me and folks like me that work in the industry are so passionate about the power of our types of networks.
- [13:08]
B
No, and I absolutely love that. Randy, Randy, you've had this great career, terrific person. Give me one or two thoughts. Advice that you would give to emerging leaders wanting to have impactful careers.
- [13:23]
C
I love that question, Scott, and I appreciate the chance to provide that perspective. 1. Change is your companion. Embrace it. It is foundational to growth, learning and success for your organization is dependent upon navigating and supporting and embracing change. It helps to develop dynamic, results oriented cultures that iterate with feedback that iterate with changes in our industry and better enables us to serve our customer needs. Secondly, I would say is that remember this problems don't age well and make sure that your people understand and embrace that tenant organizational cultures need to feel empowered to raise and act on issues, not hide or minimize them and hope no one notices. That's a bad plan. And lastly, you know, in terms of what I've learned over the years, you know, you can't fake it. Be straight with your people, be straight with your boards, your customers, and you will earn the benefit of the doubt when you need it. To do otherwise puts at risk the goodwill that is essential for everyone to believe in the mission and for everyone to pull in the same direction. So, you know, those are three, three things that I would throw out there that I think could be pretty, pretty good tenants for any leader.
- [14:31]
B
No, Randy, I love that. I love this particular concept that problems don't age well. So don't let them simmer, Try and take care of them, try and move forward. I just absolutely love that. Randy, as always, I want to thank you for taking the time to join us in the Becker's Healthcare podcast. You're a phenomenal person, a phenomenal leader. Thank you for joining us.
- [14:48]
C
My pleasure. And we'll look forward to seeing you in April.