Ed Collins, a digital healthcare innovator, technology strategist and fractional technology executive with over 25 years of experience in the industry, talks about the evolving role of technology in patient care, fostering a culture of innovation in tech teams and excelling as a healthcare CTO in this exclusive interview.
1. How do you see the role of technology evolving in patient care over the next decade?
Technology has already increased patient involvement in their care with patients having access to a wealth of information about conditions, treatment options, and general wellbeing which has created a shift in the dynamic of the patient-provider relationship. I think this benefit will continue to improve as access to data and information continues to accumulate.
We have been widely gathering patient data for nearly two decades since most healthcare organizations started adopting electronic health records. The mountains of data that we have collected will improve research and outcomes and lead to better longitudinal views of patient health as we start to see the first patients experience a lifelong journey that is digitally captured.
Imagine a world where the entire encounter (in-person or virtual) where everything is captured and transcribed. Orders are automatically placed. Referrals happen automatically. Prescriptions are sent to the pharmacy, or better yet, waiting at home when you return from your visit (if in-person).
Healthcare has always been a pull system. The patients go to the care versus the care being brought to them. What if we could complete visits virtually? A wireless connected kit could be deployed to the patient’s home that could capture blood pressure, temperature, weight, vitals, etc. A mobile phlebotomist could come to the patient’s home to draw blood for testing. I think the future of care delivery will be more push than pull making it more convenient for patients because of technology. This shift is already happening today.
Technology will improve the speed with which we develop new treatments. Virtual clinical trials exist today where patients can participate in trials where they capture and submit their experiences with new treatments from the comfort of their home. Our ability to capture the necessary data to determine efficacy and approve new treatments so they can become available sooner will continue to improve. With large data sets from these current trials, we could potentially use AI to understand potential efficacy before human trials even begin! I believe that technology and AI has tremendous value in this area.
As we layer in technology, providers will be able to treat larger patient populations with less effort. Armed with the most current data and automation behind the scenes bringing the most relevant information to the forefront, providers will be able to spend more time treating patients and less time on non-value-add tasks. Our ability to eliminate the noise created by clunky workflows and mountains of irrelevant data will change drastically with AI and ML.
Within ten years we should be able eliminate 90% or more of the processes that are completed by caregivers that are not directly related to patient care. A great example of this is all the information that is documented so that providers can be accurately paid for providing care. The documentation and coding and billing process is a perfect candidate for automation. I fail to see why reimbursement for care delivered is not a real-time process. In some care settings it takes 30, 60, or 90+ days for providers to get reimbursed. In the future, reimbursement will occur at the moment delivery is completed.
Lastly, I believe that the connected consumer devices that capture health data and accumulate that data for analysis and guidance for providing care will improve exponentially. My smart watch can do an ECG, measure blood oxygen, take my temperature, measure my heart rate, and more! I have a smart bed that tells me how well I slept last night. It captures my breathe rate, my heart rate, when I was in rem sleep, etc. In addition, we have wireless connected clinical devices to manage chronic conditions like diabetes and pain.
Over the next decade these consumer and clinical devices will feed large data sets that make managing the health of individual patients seamless. Instead of capturing a moment in time, we will be able to look and the longitudinal health of the patient in a seamless fashion resulting in improved outcomes and better overall condition management.
2. Which emerging technologies do you believe will have the greatest impact on healthcare in the near future?
This is very clear to me. Artificial Intelligence, Machine Learning, and Large Language Models. We have gathered two decades of clinical and non-clinical data on hundreds of millions of patients. This enormous data set can be used to train AI models to simplify both clinical and non-clinical aspects of care delivery.
3. What role does/will artificial intelligence play in your current and future projects?
Currently, I’m seeing AI used mostly for process automation. I’m working with organizations that are looking for ways to use AI to eliminate waste and to become more efficient. That efficiency may be gained by freeing up clinician time to focus on care delivery, or from inefficient process automation surrounding coding and billing, or improving access to care and scheduling, or patient communication, and more. The opportunities to eliminate waste from healthcare delivery seems endless today.
I am also working on the game changer ideas as well. Expediting new treatment approval through better clinical trial management. Using clinical data to predict patient outcomes. Consolidating quality and outcomes data to allow patients to make better informed decisions about where to seek care, building massive data sets to train models, and more!
4. Can you share an example of a major project or initiative in healthcare technology that inspired you?
I’m inspired by continued industry adoption of virtual care. It’s highly unfortunate that it evolved out of necessity during COVID, but its continuation in the post-pandemic era gives me hope that the way we deliver care and making care more accessible to a larger patient population is happening today.
The hospital at home models that are evolving are another great example. Patients can receive inpatient care in their own homes! There is a future where we will not need as many hospital beds, or better yet, those beds will be available for only the highest acuity care! I’m truly inspired that our industry is using these examples and others to make care more accessible and more convenient for the patient.
5. How do you foster a culture of innovation within your technology teams?
This is easier than you would think. Innovation is about breaking down barriers. My least favorite words are “we can’t”. Sometimes there is a “because” at the end of that statement.
Working in large organizations for most of my career I learned quickly that those same organizations are sometimes hard places to innovate. Everyone is so caught up in keeping the train on the tracks that there is little time to innovate while doing your day job at the same time.
I try to find ways to eliminate or reduce the amount of time my team spends on certain tasks. There is obviously a day job component that must be done. There is time off which is completely necessary for everyone to refresh and regenerate. There is also time spent on other administrative tasks.
Think of how we talk about clinicians and the desire to eliminate wasteful activities (or reduce them) so they practice at the top of their license. I want my team practicing at the top of their license. I want coders writing code. I want data engineers building models. I want leaders leading their teams. My goal is to eliminate or reduce the time they spend on other things. Now, these “other things” are sometimes very necessary, but I have found that we can usually find a way to find common ground regarding how we spend our time and making sure your team has capacity for innovation is a high priority.
Start-ups are great at innovation because they are not hindered by years of organizational evolution. I hold regular “jam sessions” with startups where we just toss around ideas. We limit them to one hour and anything is on the table. It’s a great way to dream big without limitation and a way to identify barriers quickly. We take turns pitching ideas and then ask ourselves one question. What is preventing this from happening today?
You can quickly identify the barriers to entry and determine if an idea is worth a second conversation. By the time you get to a third conversation regarding a particular idea, start to bring in some of your team. Invite the engineers, coders, product team, and others to see if they can identify barriers. If you make it past this step, you might have a good idea!
6. What are the key skills and qualities you believe are essential for a successful CTO in the healthcare tech sector?
If you make it to the CTO level, I will assume that you already have enough technical know-how to do the job, so I’ll skip that part. Instead, I will focus on the softer side of the job. The side that I believe is most often overlooked by CTO’s. You must have a passion for helping others and resilient desire to succeed.
Some CTO’s have a story or a connection that brings their passion to healthcare. Others do it because they feel a strong desire to serve. Whatever the reason, bring it with you to the job every day. Make sure your team knows what motivates you and surround yourself with others who have strong motivation.
I’m also a big believer in transparency. Sometimes too much of a believer! I am a very sincere and genuine person, and it takes some “seeing is believing” from new teams to develop trust. Say what you mean and do what you say. Your team shouldn’t have to guess or interpret your messages to them. If you are unhappy with a result, say so and explain why. If you are thrilled with an outcome, deliver genuine praise. Speak and write plainly and clearly but again, be sure to remember the “why”.
Teams are more likely to follow you if you lead them with a high level of transparency accompanied by the reason why you are doing something. A great example is a deadline. We need to finish this work because it is a patient safety issue, or we will lose a key customer or whatever the reason. Explain it in terms that your team will understand so they appreciate the importance.
Build C-level relationships. Make sure your executive partners see you as someone who can and is willing to help. Some might argue that the CTO role is one of the toughest in healthcare. So much depends on technology and it is often the source of much frustration.
Be sympathetic, lay out your plan for improvement, execute, and don’t sugar coat anything. Change in healthcare is hard. Make sure you prepare your peers for bumps in the road and make sure they know you will be there to help them navigate the technical world that is sometimes hard to understand if you don’t do it every day. Educate your peers whenever possible so they can keep their teams informed and be consistent. With consistency comes calmness and rationale. Make sure you are viewed as someone who is calm, level-headed, and capable.
Don’t be afraid to fail. Failing is part of learning but be certain that you fail fast. If something isn’t working, don’t hesitate to change course. One of my favorite exercises is start, stop, continue. I try to go through every major initiative and decide what we should stop doing, start doing, or continue doing to be successful. Do this with the team. You will be surprised at the healthy debate it generates and having the consolidated input out in the open helps everyone align as one team.
Lastly, you should always be seeking ways to improve. I’m a big believer in continuous process improvement. I have been involved in some highly successful strategic initiatives and some not so successful. It is crucial that you and your team are equally critical of both. There is always room for improvement and even the most highly successful initiatives have lessons learned. Make it a point to carve out time or post project reviews. Make them formal, document the results, and share them widely with the organization. Better yet, bring in other parts of the organization for your post reviews and seek their input! They will value your transparency and it will strengthen your external relationships.
Ed Collins is a fractional technology executive with nearly 25 years of experience in the industry. He led technology for large integrated provider organizations for decades and on the payer side, he led technology for the largest credentialling data company in the US. Additionally, Ed serves as an advisor to start-up CEO’s, to boards, and to other industry leaders. He is highly regarded in the healthcare industry as a strategist, visionary, and driven leader with a strong desire to improve care for all. You can connect with or follow him on LinkedIn here.