Q&A with Novant Health’s Angela Yochem and Lety Nettles, Part 1

By | October 23, 2018

Angela Yochem, Chief Digital & Technology Officer, Novant Health

Lety Nettles, SVP & CIO, Novant Health

When Novant Health created a new position last year dedicated exclusively to digital health, they tapped Angela Yochem, a seasoned leader with extensive experience with technology, and very little in healthcare. A few months later, the organization named Lety Nettles, who held leadership positions with Baker Hughes (a GE company), Walmart, and Dell, as CIO.

Although some may have questioned the moves, Novant Health— an integrated delivery network spanning four states — had a mission to “enhance patient experience through better use of technology,” according to Forbes. And there were no two people more qualified to carry out this digital transformation than Yochem and Nettles.

However, they knew going in that pushing digital to the forefront would require a transformation. “If we want to sit at the table and be a business partner, we have to start acting like one,” said Nettles. It has meant creating a digital products and services office, rethinking the organizational chart, and creating a culture in which innovation wasn’t just encouraged — it was enabled. Recently, healthsystemCIO spoke with Yochem and Nettles about how they’re leveraging IT to create a “consumer-level experience,” the concept of experimentation as a service, and why it doesn’t take a large organization to be innovative.

Chapter 1

  • The role of Chief & Digital Technology officer
  • Leveraging digital products to “provide remarkable patient care.”
  • Consumer experience – “They want clear visibility.”
  • Novant’s unusual reporting structure
  • Agility as a business strategy
  • Experimentation as a service
  • “We can very quickly get our hands on the innovation.”

Bold Statements

This isn’t traditional IT. Our intent is to incorporate a spirit of innovation and agility, not just into our operating model within digital products and service teams, but across the organization.

It’s the duty of the CIO to create an operating model that allows our technologists to work with the other parts of the organization to create a platform where we can collaborate and deliver digitally-enabled capabilities together.

Are we spending our investment well and realizing the outcomes we’re committed to getting? Are we looking at the right things? Do we have the right talent? Are we going fast enough? It’s that whole concept of agility as a business unit. If we want to sit at the table and be a business partner, we better start acting like one.

We can very quickly get our hands on the innovation, put it inside of the sandbox, and determine through actual experience whether there are scalability and interoperability concerns, and if it’s something we can operate within an acceptable cost structure.

It’s not about playing fast and loose with our resources — it’s quite the opposite. We’re gaining real information about things we may incorporate into our estate before taking a big leap.

Gamble:  Hi Angela and Lety, thanks so much for carving out some time to talk with us about the work your team is doing at Novant Health. Let’s start with Angela. As Chief Digital and Technology Officer, what is your primary focus?

Yochem:  My focus, along with the rest of the executive team, is to promote the advancement of remarkable patient care. In my case, that is done through delivery of differentiating digital products and services. I’m working with my senior staff to build a high-performing, interdisciplinary business unit. This isn’t traditional IT. Our intent is to incorporate a spirit of innovation and agility, not just into our operating model within digital products and service teams, but across the organization. We’ve found that there’s a tremendous appetite for leveraging digital means to provide that remarkable patient experience.

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Gamble:  Is this appetite for digital something you’re seeing both on the patient and consumer side, as well as the clinical side?

Yochem:  Of course. And I appreciate you using the term ‘consumers,’ because all of us are consumers — including our team members, physicians, and nurses. We have completely changed the way we bank, the way we travel, the way we engage with our politicians, and the way in which we order our food. These are behaviors we’ve adopted in our personal lives. When we engage with any sort of entity, we expect a consumer-level experience — and that certainly extends to healthcare. Our patients expect the ability to set up online appointments very easily. They want to be able to use their mobile phones to gain access to appointments very quickly. They don’t want to have to wait. They want on-demand video visits. They want clear visibility into the details of their medical chart and their test results. These are all things that we have done and we will continue to do; we’ll continue to push the envelope to provide our patients with the most sophisticated consumer-level experience.

We also have a strong focus on team member productivity. It’s important to recognize that our team members are operating under extraordinary circumstances. That’s just the nature of healthcare delivery; and so, we’ll do anything we can to provide an experience that offers not only advanced insights, leveraging the information assets that we have at our disposal at Novant Health, but also simple tools for making their everyday tasks as easy as possible. So much of what they do for us is very sophisticated, and we don’t want them to have to sweat the small stuff.

 

Gamble:  So the emphasis, it seems, is more on leveraging technology to improve efficiency and care delivery than on the tools themselves.

Nettles:  That’s correct. Technology lives everywhere. That’s the spirit and the heart behind digital disruption — there isn’t a single owner of technology, the same way there isn’t a single owner of the patient anymore. The historical IT and business thinking was that these were all polarized and owned by different organizations. The lens that we bring to healthcare, and specifically to Novant Health, is that it’s the duty of the CIO to create an operating model that allows our technologists to work with the other parts of the organization — the subject matter experts, the team members, the physicians, and the corporate systems — to create a platform where we can collaborate and deliver digitally-enabled capabilities together. In my role, I’m accountable to create that space and enable our teams to do great work together.

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Gamble:  And in terms of the reporting structure, Lety reports to Angela, correct? 

Nettles:  That’s correct.

Yochem:  The team structure is perhaps a little unusual. I report to the CEO, and my team includes Lety, whose role is fairly broad, as well as our chief data officer. That’s actually a business position, as information is considered to be a corporate asset. Our new chief data officer came from retail, but also has a background in telecommunications and energy, which is critical when you have a highly transactional system with large amounts of data. We also have a chief technology officer, who is responsible for infrastructure. We did this because some of the ways in which we’re allowing the infrastructure to evolve requires a full focus on that piece.

We also have a CISO as part of the senior leadership team. Digital security is a consideration that spans the enterprise, and so we believe it’s a good idea to house that outside of the other technology organizations. Lastly, the chief medical information officer also reports in to me. Technology capability and digital enablement are disciplines that extend well outside of our own organizational bounds, and so I find myself working very closely with a number of extended team members who have proven to be extraordinarily creative and innovative, and who have a strong appetite for leveraging technology in a differentiating way.

Nettles:  As you can see, the IT security piece and the tech piece are not all within my organization. When you think about bringing digital to the table, you need to remember that we are a business. We have to transform into more of a business unit, and that requires that we have a business office. And so, in the same vain as the Office of the CIO, we’ve stood up a Digital Products and Services (DPS) office, which looks across all of Angela’s senior leadership team and gives her a readout of how we’re performing.

One of my key responsibilities — and an area in which I collaborate with Angela — is in being able to take a pulse on how we’re performing as a business unit. Are we spending our investment well and realizing the outcomes we’re committed to getting? Are we looking at the right things? Do we have the right talent? Are we going fast enough? It’s that whole concept of agility as a business unit. If we want to sit at the table and be a business partner, we better start acting like one. And so we’re holding ourselves accountable to that.

Another thing we’re doing is experimentation as a service. We’ve seen tech companies outside of healthcare do this, but we’re actually going to inject it into our investment management practice and apply that investor lens. Innovation is happening everywhere across Novant Health, and we want our business partners, our friends and colleagues, and our doctors and nurses to have a place where they can present their ideas and test them. My responsibility is to create that space. And if it aligns with our strategy from a business perspective, we’ll invest some money and get it in the hopper. It’s part of the experimentation mentality — you want to move forward as quickly as possible.

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Gamble:  That’s a very interesting concept. Can you elaborate a little bit on how experimentation as a service is structured?

Yochem:  Sure. When we first started talking about experimentation as a service, it wasn’t entirely clear what we meant by it. As a healthcare organization, we are very careful about things we introduce into the environment. When we use words like ‘experimentation,’ people might think we’re going to start moving on things that haven’t been thought through. But in fact, the closest parallel I can draw to it is our R&D model.

For example, if a team member from another part of the organization identifies a technical solution they’d like to incorporate into their operating model, what often happens is they work independently with a vendor for months to sort out the requirements and define a big-bang rollout, then come to our organization and engage us. We’ll then ask them a series of questions, which they have to answer, and we’ll sit around in a committee and decide whether it makes sense. If and when we commit, it’s a big-bang product. What that does, essentially, is apply resources from Novant Health without sufficient data.

On the other hand, with our model, the very first time a team member presents a potential solution, they can immediately engage our experimentation service. Before spending months and months in academic discussions with a third party, we can very quickly get our hands on the innovation, put it inside of the sandbox, and determine through actual experience whether there are scalability and interoperability concerns, and if it’s something we can operate within an acceptable cost structure — all the things we care about as technology leaders.

We can tease out a lot of the burning questions in a very quick timeframe. And if, in fact, we find that a given solution isn’t going to scale, or it’s ultimately going to be a constraint over time, we can get the answer to that team member within a few weeks, rather than allowing an investigation to drag on for months.

It’s not about playing fast and loose with our resources — it’s quite the opposite. We’re gaining real information about things we may incorporate into our estate before taking a big leap.

Yochem:  I want to add that in addition to all of this, Lety also has responsibility for all of our applications — our EMR, our corporate systems, all of the patient-facing applications, and our web properties. She has quite a few things, both conventional and unconventional, in her domain. We’re very fortunate to have her here.

Chapter 2 Coming Soon…

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