Dr. Rasu Shrestha, chief innovation officer at UPMC, describes how we can be data rich but information poor, and how health IT vendors can create a competitive advantage by aiding in the simplification of health data. He describes what messages to focus on and which to avoid related to big data in health IT marketing and gives an insider look at how his team at UPMC selects vendor partners. Just as clinical teams need to advance past the culture of analog, health IT marketers need to evolve their messaging and empathize with the voice of the clinician to tell the story of innovation. Dr. Shrestha’s insightful look at the future of care sheds a great deal of light on how to successfully craft marketing messaging.
Show notes
Air Date: May 4, 2016
Guest: Dr. Rasu Shrestha, Chief Innovation Officer, UPMC
| 1:14 | Quantity vs. quality of content |
| 5:09 | Introducing Dr. Rasu Shrestha |
| 7:28 | Coming over to the Dork Side |
| 8:34 | We are data rich but information poor |
| 9:50 | Drowning in data |
| 10:23 | Health IT vendors focusing on insights as a competitive advantage |
| 11:02 | Taming the data beast! |
| 12:31 | Petabytes and exabytes and zettabytes, oh my! |
| 13:00 | HITSM Panel at HIMSS – Technologies that liberate the data are a key to innovation in health IT |
| 16:45 | How do health IT marketers tell the story of innovation? |
| 19:55 | How do you communicate to clinicians who are still skeptical? |
| 21:32 | ED docs spend 44% of their time entering data into the EMR |
| 23:15 | How do you decide which vendors are the right vendors to partner with you to innovate? |
| 24:26 | Healthcare shouldn’t just be about not dying. Healthcare should be about living. |
| 27:02 | Bonus question: If you could join a rock band or music artist for a day, who would it be? |
About Dr. Rasu Shrestha
As chief innovation officer for UPMC, Dr. Shrestha plays a leading role in driving UPMC’s innovation strategy, serving as a catalyst for transforming the organization into a more patient-focused and economically sustainable system.
Dr. Shrestha also serves as the executive vice president of UPMC Enterprises, the innovation and commercialization arm of UPMC. As the leader of a team of over 200 technology professionals, Dr. Shrestha works to facilitate new health care intelligence, technology expertise and entrepreneurial drive to solve complex health care challenges. Through strategic partnerships, joint development agreements and investments in promising health care startups, Dr. Shrestha champions the development, implementation and commercialization of these innovations.
Dr. Shrestha has been recognized by Becker’s Hospital Review as one of the 26 “Smartest People in Health IT,” and InformationWeek named him one of the “Top 20 Health IT Leaders Driving Change” and a “Top Healthcare Innovator.” He is a frequent speaker at national and international health care, innovation and technology conferences.
Prior to joining the team at UPMC Enterprises, Dr. Shrestha served as the vice president of medical information technology and medical director of interoperability at UPMC. He previously served as the informatics director at the University of Southern California (USC), where he was also a professor of radiology research at the Keck School of Medicine.
Dr. Shrestha received his medical degree from CCS University in India, completed his fellowship in informatics at the University of London, and earned his master’s in business administration from USC. He serves as the chair of the Informatics Scientific Program Committee at the Radiological Society of North America and is a board member of several innovative organizations, including Omnyx, a UPMC/GE joint venture. He is also a longtime member of the Advisory Board of KLAS Research.
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Full transcript
Jared Johnson: Hello, my friends, and welcome to the Health IT Marketer Podcast, the podcast that tells the story of innovation in health IT. I am your host Jared Johnson of Ultera Digital, healthcare influencer and content marketing. This is the first and only podcast dedicated to the health IT marketing community. Welcome aboard.
If you want to keep up with the trends, voices and marketing tools involved in Health IT and healthcare technology, you’re in the right place. This program is on iTunes, so you can leave a review there. We are also on Stitcher Radio and Podbean. If you haven’t gone back and caught up on previous episodes, I encourage you to do that because we have really had rock star guests all along every week.
You can check out previous episodes at HealthITMarketer.com. There, you can also find full transcripts of episodes. As always, tweet me and let me know what you think about each week’s episode. I love to hear feedback. I love to hear what you like and don’t like. You can find me @JaredPiano on Twitter.
This morning I had a quick thought about quantity versus quality of content. In fact, this was one of the topics at HITMC, the Health IT Marketing and PR Conference that we just recently attended. Don Seamons, from Lumeno Marketing facilitated what was called an unconference session on content. One of the topics was quantity versus quality. Many of us work through this challenge on a regular basis. So my thought for today is on losing the quantity battle but winning the content war.
Here’s what I mean by that. See, the majority of businesses really have increased their quantity of content in the last two or three years. Many of you have seen the SEO benefits of increasing your search rankings by publishing a higher volume of content that’s targeting certain keywords. Recently we’ve seen more businesses facing this dilemma of content for content’s sake, which is mainly publishing is on the schedule for that day or that week.
The trouble is a critical mass of your competitors have also likely seen those benefits of a higher volume. Some of them, quite frankly, they’re able to crank out more content than is every possible for you. So your search rankings me be dipping back down because there’s so much content out there. There is a crazy amount of content out there now. I really believe that few marketers have solved the debate between quality and quantity because the answer really isn’t necessarily mutually exclusive. It tends not to be just one or the other.
Think about it. Quantity is an important factor of your content strategy. How often should you publish and in what media? It looks good on the surface and tends to increase your topline traffic. Quality, on the other hand, can be a little more difficult to assess. It often takes more effort or at the very least more complex platforms or more expensive platforms to assess how well you address customer pain points or made it easy to engage with your content through measuring things such as shares, comments, likes, etc. that tell you that a customer liked what you had to say.
So I often recommend focusing on two things. First, finding your content tilt and second, finding an unsaturated channel. First, your content tilt, as Joe Pulizzi has coined this phrase and described it for us all, that’s your angle. That’s your sweet spot. That’s where your expertise overlaps with a unique way of telling your story or a unique way to solve an audience pain point or simply a unique audience, a segment of your audience.
And second, an unsaturated channel. Take, for instance, Chuck Webster, @wareFLO. He’s the health IT workflow guy. We all know it. We all know him. He owns it. Anything about workflow that is mentioned in a Twitter conversation, we tend to ping him, we direct message him, we mention him. Typically he will join a conversation and have something positive to say, something that is insightful about that conversation.
I would also go to him for most questions I have about Blab or Periscope because he video streams constantly, often several times a day. So in my mind, he owns that channel, at least in health IT and certain audiences. At this point, those are still unsaturated channels. Personally, I still think there’s room for other players in other channels such as tweet chats depending on the topic.
But one way or the other, I encourage you to give that a shot. Don’t fall victim to the myth that your success in content is solely based on matching a competitor’s quantity. Don’t add to the noise and publish content just for content’s sake. Spend that same effort clearly defining in writing your content tilt and identifying potentially unsaturated channels and then own that space. You will ultimately find more success that way.
So my guest this week is Dr. Rasu Shrestha, the Chief Innovation Officer at UPMC. Dr. Shrestha, how’s life in your corner of the country?
Dr. Shrestha: Hey, it’s wonderful. It’s a beautiful day outside in wonderful Pittsburgh, nice and sunny. So I can’t complain.
Jared Johnson: Outstanding. Well, first and foremost, I want to catch up on your sports loyalties. The most important question here, are you Pittsburgh fan through and through?
Dr. Shrestha: Well, you’ve got to be. You’ve got to bleed black and gold if you spend more than five minutes in Pittsburgh and I’ve been here more than five minutes, so yes.
Jared Johnson: Very nice. Yeah, I asked because I know the Steelers are one of the odds on favorites to win the Super Bowl this year. They’re tied with the Patriots and the Seahawks. They’re all at 8:1 odds. It’s not that I check that kind of thing too much. I just had to find out who I was dealing with here.
Dr. Shrestha: Absolutely. All the way, man.
Jared Johnson: Very good. Well, I’ll give you a chance to tell us a little bit about your background, your prior experience and a little bit about what you’re doing at your current role at UPMC.
Dr. Shrestha: Thanks, Jared. So background. I’ve always had a burning desire to make a difference in the life of patients. That’s what’s really driven me and motivated me through the years. Early on, even as a child I remember I always wanted to be a doctor. I went to med school.
I volunteered at every opportunity I could and really sunk into clinical care and loved every moment of it. Those tireless days and nights in the ED or the operating room, helping the surgeons out and really sort of looking at healthcare just unfolding in front of you, this life that’s on the bed that’s really dependent on you making that next move or deciding on a specific treatment protocol.
Then I went into radiology and spending all that time in the radiology reading room. Those were my formative years. I then had the good fortune of doing a radiology informatics fellowship, pretty much at the turn of the century. That had a huge impact on my career trajectory. So even before it was cool for physicians to jump over to the dark side or perhaps to the dork side with health IT, I decided to go beyond radiology to the field of healthcare informatics at that point after doing that fellowship.
So I’ve been in this field now around informatics and innovation for the last 16 years. I like to think that I get to have a broader impact, not just one patient at a time, but working with my team here, really impacting hundreds if not thousands of patients at a time. I work with a great team here to push the limits of innovation in the space of trying to transform healthcare from what it was and what it is today to really where it needs to be.
I’m a translator. I’m a bridge builder. I’m an entrepreneur. In my heart of hearts, I’m still that guy with a burning desire to make a difference in the life of patients.
Jared Johnson: Well, we’ll keep that in mind at the heart of everything we’re talking about today about truly impacting patients because I think that’s a great thing to keep in mind all along. Well, one of the first things I wanted to dive into was a blog you recently posted for Applied Radiology about the concept that we are data rich and information poor. Why don’t we start there? Can you talk about that concept of how health IT vendors should approach big data?
Dr. Shrestha: Yeah. So it’s really interesting where we are as an industry in terms of how we’ve progressed over even the last couple of decades. The last decade has been transformative for us in healthcare as we’ve moved from analog to digital. What I was trying to point out is it’s really important for us to connect big data to big insights. It’s not just about having data because often times we’re drowning in data that we’re generating across the board.
So that article that I wrote was really a wakeup call for us in healthcare to comprehend the power of data and to actively seek insights that can be garnered from all of the right purchase to primarily the big data technologies and things that we have at hand. In healthcare today, we’re data rich and information poor. I say that as a clinician, I play more of a role of a detective than I do as a clinician because I’m always trying to piece information together.
So we’re drowning in data, right? What’s really interesting is 90% of all of the data in the world, even outside of healthcare has really been generated over the last two years. We’re seeing a tremendous influx of data. So how do we really leverage that data. How do we manage to go from data to insights and make sure we’re able to put that data to work for us? Data is a big asset. So I’ve tried to really demystify what big data means and really try to look into the future of how we might be able to transform healthcare leveraging big data technologies.
Jared Johnson: So it sounds like health IT vendors who realize that and try to actually focus on data and insights in their marketing, for instance, can actually differentiate themselves that way. Is that a good assumption? Are there ways that health IT vendors can focus on insights and actually use that as a competitive advantage in their marketing?
Dr. Shrestha: Yeah. So I think intelligent insights at the point of care or the point of decision making, that’s sort of a goal and it’s good to have goals. But it’s really important not to be blinded by buzzwords. You hear a lot of buzzwords out there. Big data, unfortunately, has become a buzzword and so have a lot of other things out there, like pop health, for example. So when we think about big data, this need for us to tame the data beast is real. I draw analogies to us being gardeners of big data.
I think it’s really important to have, much like how a gardener sows his seeds and cares and nurtures his garden, it’s important for us to manage that data, especially when it’s data at scale, with some level of discipline and a good deal of passion, right? It’s important for us to have discipline methodologies around data integration, data governance, data quality and security and information lifecycle management. We have a lot of data stewards at UPMC as we’re trying to do the weeding and the pruning of the data.
As we look at these data farms, to take that analogy even out further, and we look at how the crops of data may yield insightful ingredients that we then cook up in the care processes that we’re putting in place, it’s important to make sure that we nurture the data in the right way. So it’s not just a matter of let’s go live with as many systems as possible and end up with all these silos of information systems that literally aren’t talking to each other. It’s really about this discipline of managing data intelligently and then get to that goal of having meaningful insights at the point of decision making.
Jared Johnson: So not just terabytes, but we’re talking exabytes and zettabytes after that?
Dr. Shrestha: Yeah. Right, if you’re keeping track, it’s really exploding out there. I think data worldwide is projected to explode and reach 35 zettabytes by 2020, which is a 44-fold increase from 2009, which wasn’t that long ago.
Jared Johnson: Yeah. That wasn’t very long ago at all. When I’m also talking about data itself, I recall at the HITSM, the health IT social media panel that you spoke at at HIMSS, the panel was about innovation and health IT as you recall. You used a phrase about technologies that liberate the data as being an important key to innovation and health IT. I’d love it if you could expand on that concept where there are some specific technologies or directions you were thinking about and why did you list those as your response?
Dr. Shrestha: Yeah. So I think it’s really important for us to really take a step back, perhaps, and comprehend where we are as an industry. As we’re looking in the space of health IT, it’s important for us to understand the things we’re able to dream up today could not really have been dreamt up even ten years ago. What we have today is we’ve moved from analog to digital in large parts. There are still areas of focus that need to really embrace the digital form factor.
But we’ve got all these zeroes and ones in our servers, in the cloud, in our data centers. So it’s really important to understand that data is an asset. But it’s also important to understand that we need to liberate the data. Data liquidity is a phrase I use quite a bit to really draw upon the notion that data needs to be freed.
It should not reside or be held hostage to whether it’s specific vendors or specific silos of information repositories, we celebrate when we go live with an electronic medical record or a specific system that we’re employing. There’s good reason to celebrate, but I think that’s the beginning of the journey, turning that system on and going live with it starts the data collection process. What’s really important is to make sure that we’re able to move up in that pyramid.
So at the bottom of the pyramid, which is really where we are in healthcare today, we’ve got all these siloes of information systems that aren’t truly talking to each other in many ways. We’re still trying to push the boundaries of interoperability.
So the specifics of what I was talking about was how do we move from syntactic interoperability, which is pulling all of these systems together and connecting the pipes to semantic data interoperability, where we look at semantic data harmonization and ontologies and the language behind these standards, whether it’s SNOMED or LOINC or all of these systems that we have at the back end and translate and get the meaning behind the data.
So semantic data harmonization becomes important. But beyond that, it’s also leveraging technologies like natural language processing. In healthcare, 80% of the data is unstructured data. So how do we go into the nitty-gritty details of radiology reports and discharge summaries and pathology notes and post-op notes. Beyond that even leveraging technologies like machine learning, where we have pattern recognition capabilities and deep learning capabilities to really decipher the signal from the noise and look at trends.
So that’s how we really get to really adding intelligence and insights to the data. So liberating the data, achieving that state of data liquidity has to become a strategic imperative for healthcare organizations across the board and that’s really what I’m really passionate about.
Jared Johnson: So I’ll try to put it in terms that I use here on the program pretty regularly. One thing I say is that this podcast tells the story of innovation in health IT. It’s kind of a phrase that really resonated and floated to the surface, especially after attending HIMSS this year. So how do health IT marketers do that? How do they tell the story of innovation that’s going on, like you’re describing some of the technologies that really do liberate the data?
How do they tell the story of innovation that’s going on in a way that resonates with those across the care spectrum, with clinicians as well as patient communities? It seems like it’s a pretty complex story to tell and there are a lot of different viewpoints of how quickly or how slowly are we actually innovating in healthcare.
Dr. Shrestha: Yeah. So it’s interesting. I believe we’re really in a smack of the dawn of this new era in healthcare, where the power of digital is just being comprehended. We’re just at the dawn of that era. You remember when we had the dial up modems and the irritating yet satisfying sound of that dialup modem trying to latch onto the internet and squeeze them away. Then you make that connection and then you’re online.
You open up a web browser and type in Hotmail.com. After a couple minutes, that first page opens up and you’re like celebrating. That’s where we are in healthcare today when it comes to leveraging digital and leveraging the power of these algorithms and computerization today. We’re just at that dawn.
So it’s important for us as we look at innovation to really say, “All right, how do we invent the future?” That future is not coming in ten years, the future is coming in the next two years. The future is coming at a much quicker pace than it’s ever come before. That makes it really interesting.
But it also brings these challenges of how do we make sure that this progress that we’ve made in the last decade-plus and moving from analog to digital and moving from film to filmless and paper to paperless, how do we make sure we don’t repeat what we’ve done in the past, which is we’ve really hung on to this culture of analog.
We still call it electronic folders and files. It’s a wet read for radiology where hanging film, it’s called a hanging protocol for radiologists, which we double click on a study and bring it up on a diagnostic monitor, we’re not hanging film anymore. There’s nothing wet about that film. It’s not even a film anymore. So we’ve hung onto this culture of analog even in the way we’ve described the things we’re doing in health IT.
So I think it’s really important to understand that as we look at this dawn of this new era, there’s also a cultural shift that’s required for us to comprehend the power of digital. The power of digital isn’t just in replicating analog. It’s in connecting the dots, getting to a whole different level of magnitude in the way that we’re able to leverage intelligence in our care processes.
Jared Johnson: Well, you’ve brought some definite memories to mind there. I remember our 14.4 modem dialing up and our AOL account that was like $10 for like 10 hours a month of connecting. I remember that very vividly, lots of fun there. But that puts it in perspective, doesn’t it?
In terms of the types of innovation that are happening right now, I think that’s important to remember. Innovation definitely doesn’t happen if everyone outside of the clinical team says, “Here’s what you need to do, clinical team. Here are all the things you need to start implementing,” and don’t give them a roadmap. So how would you communicate that to other clinicians who maybe aren’t quite on the same page as you, those who may be skeptical about using digital health tools or empowering patients?
Dr. Shrestha: So I empathize with them. Being a clinician myself, I really do empathize with them. I’m not just saying this because we’re on the same team. We’re all in the same team. We’re in the team that hopefully is on the side of the patient. So they have reason to be skeptical. They have been burned. They’re seemingly less productive today. They’re spending precious hours into the evening starting their days really early.
It’s not just technology that’s to be blamed. We’re also in an era of doing more with less. Costs continue to escalate and reimbursement continues to decrease. There are all sorts of pressures coming at us from every which angle. But the technology and the way that it’s been deployed doesn’t necessarily help either. So I’m not complaining. What I’m saying is it’s important for us to comprehend that it’s great where we are, but we need to do so much better.
What I tell them is we need to give it a chance. I think it’s important for us to work with IT and with innovators and with companies to really think outside the box. For clinicians, just to bring it home in terms of their experience right now, I think it was Becker’s Health IT that wrote emergency department physicians spend 44% of their time entering data into the electronic medical records, clicking up to 4,000 times during a 10-hour shift. So 44% of their time entering data into the EMR as opposed to, perhaps, looking at the patient or talking to them or empathizing with them or treating them right.
So that’s wrong. It absolutely is wrong. I think for clinicians, they have reasons to be skeptical, but I think it’s important for them to really work with IT, leverage their background as clinicians and what’s important providing care. They’re in the business of doing the right things for patients that are in front of them, embracing the good and then embracing too this notion of simplicity, which is I think really important and sometimes a bit of a cultural shift for clinicians or anyone in healthcare in general.
We’ve traditionally been brought up with the notion that complexity is a good thing. We embrace complexity like this blanket that we hold close to us, but it’s not necessarily a good thing. In fact, more often than not, if we’re able to make things as simple as possible, that really takes things to a different level.
So for clinicians, technology should really be invisible. Today we’ve come to really tolerate technology. We’re dealing with these clicks all the time, with windows that pop up all the time. We’re dealing with alert fatigue all the time. So technology shouldn’t really be something that we tolerate. Technology should be an enabler. Technology, at the end of the day, should be invisible. So we should get to the notion of fewer clicks and more moments because that’s what healthcare is really about.
Jared Johnson: So how do you decide what vendors are the right partners to help you innovate?
Dr. Shrestha: I think it’s a bunch of different factors. It’s really about what the right fit might be. I truly believe that the future of healthcare is going to be built on the shoulders of the strongest of partnerships. So no one entity really should be going at this alone. They should be looking to foster the strongest of these partnerships to create the future of healthcare. Here, what we do is we have a process by which we really vet out the specifics of not just what our partners would talk about, but the meat behind those statements. So enough talk, more action.
So how do we really leverage the assets the we each bring to the table so it’s more of a one plus one equals three type of a partnership? That’s what we really go after is to make sure that we’re able to leverage the power of each other’s strengths in really trying to take whether it’s a specific problem statement or business plan and make a tremendous success in the way that we’re transforming care.
Jared Johnson: As we start to wrap up here, is there any other topic we haven’t really addressed yet that you’d like to share just with the health IT community in general, those that are working on the messaging and the marketing itself and exploring all these new ways of telling their stories. Anything else you’d like to share with them?
Dr. Shrestha: So for the longest time, I’m speaking both as a clinician and as someone who’s involved in innovation in the space of health IT, for the longest time, healthcare has really been about curing disease and managing illness and preventing death. Nothing wrong with that. It’s a very noble pursuit. It started off many, many years ago with all sorts of different experiments and things that we tried. We tried to cure polio and invented antibiotics.
So what I’m saying is healthcare shouldn’t just be about not dying. It’s a noble pursuit. I think it’s good. But healthcare should really be about living. It should be about not just curing disease, but it should also be about wellness and enjoying life.
So this focus is important because that’s really, I think, at the end of the day, how healthcare continues to evolve. It shouldn’t just be about the 20 minutes and that encounter in the doctor’s office when you in for your annual physical. It should also be a focus on the 525,585 minutes that year. What you do then or don’t do then, how you’re motivated then or not really has an impact in what happens in that 20 minutes that you spend in your physician’s office or perhaps you ending up in the emergency department and all of that.
So healthcare really should be thought about as this evolving spectrum of a continuum, from managing disease to curing illness, which is really important, even as we talk about population health and precision medicine. But the spectrum continues and it goes on to things like engaging consumers and behavior change and ensuring that we’re able to liberate the data and empower the patients to take charge of their health and wellness.
So at the end of the day, it really should be about living. It’s a different focus if we think about where healthcare has been for the last couple of centuries versus where it needs to be in the next couple of years.
Jared Johnson: Well put. We’ve got time for our bonus question here. Quite simply, if you could join any rock band or music artist for a day, who would that be?
Dr. Shrestha: Awesome. I love this question. Definitely for me, Jared, it would be Mr. Gordon Sumner himself, Sting. Always a big fan of this multitalented artist. I draw analogies to how we’re sort of experiencing healthcare all together, whether sometimes we feel like an “Englishman in New York” or a “Desert Rose” as we try to move from surviving to thriving in healthcare. But we do this with passion. To take one of his other songs, it’s “All for Love.” It’s for this love of transforming healthcare from what it was and what it is to what it needs to be. So Sting all the way, baby.
Jared Johnson: Man, double bonus points for incorporating at least two of his song titles into your response. Very well done. That’s good stuff. So Police Sting or solo career Sting if you had to pick one?
Dr. Shrestha: I don’t mind some of his Police material and in fact, I enjoy it, but solo career Sting. I think he had a lot more artistic freedom, for sure.
Jared Johnson: Right on. Well, we sure appreciate having you on the program. If there are listeners that would like to get a hold of you or have a question for you, what’s the best way for them to do that? I know you’re on Twitter.
Dr. Shrestha: Yeah. So @RasuShrestha, that’s my first name, last name. I try to be as accessible as possible. People can reach me anytime via social media or LinkedIn or just reach out directly as well.
Jared Johnson: All right. Hey, thanks again. We appreciate you just helping us understand the story of innovation in health IT a little better. Hopefully we’ll be able to have you on the program again soon.
Dr. Shrestha: Thanks very much, Jared.
Jared Johnson: Well, that wraps up the program this week. Let me know what you thought by reaching out on Twitter, @JaredPiano. Also, if you enjoyed this episode or even if you didn’t, especially if you didn’t, actually, if you have some feedback on how I can improve, please consider leaving a review and subscribing on iTunes, Stitcher Radio or on Podbean. Ladies and gentlemen, remember, it is up to us to tell the story of innovation in health IT. Remember to build your audience one gig at a time.
Until next time, I’m Jared Johnson and you’ve been listening to the Health IT Marketer Podcast. This program is sponsored by Ultera Digital, healthcare influencer and content marketing. For a full archive, you can go to HealthITMarketer.com. That’s HealthITMarketer.com. Thanks again for tuning in as always and I’ll talk to you again next time.