Category: Interoperability

Improving Operating Room Outcomes and Efficiency with Jennifer Fried, CEO & Co-Founder of ExplORer Surgical

Thanks for tuning in to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders. I want to personally invite you to our first inaugural Healthcare Thinkathon. It's a conference that the Outcomes Rocket and the IU Center for Health Innovation and Implementation Sciences has teamed up on. We're going to put together silo crushing practices just like we do here on the podcast except it's going to be live with inspiring keynotes and panelists. To set the tone, we're conducting a meeting where you can be part of drafting the blueprint for the future of healthcare. That's right. You could be a founding member of this group of talented industry and practitioner leaders. Join me and 200 other inspiring health leaders for the first Inaugural Healthcare Thinkathon. It's an event that you're not going to want to miss. And since there's only 200 tickets available you're going to want to act soon. So how do you learn more? Just go to For more details on how to attend that's and you'll be able to get all the info that you need on this amazing healthcare thinkathon. That's

Hey I really thank you for tuning in today. I've got an outstanding guest for you. Her name is Jennifer Fried and she's the CEO and co-founder at ExplORer Surgical. She's a med tech innovator. She's a founder there and what it is it's a workflow management software for the operating room and interventional suite. Now, healthcare leaders listening to this you may want to stick around because she's offering some major value as well as for device companies in this space so she's really passionate about building innovative businesses in the health care industry especially those that use technology to solve inefficiencies and improve healthcare and that's why we have her on the podcast today. She's got a fabulous history in both venture capital as well as consulting and strategy. So I want to open up the microphone to Jennifer to round out that introduction maybe fill in any of the gaps that I missed. Jennifer welcome to the podcast.

Thank you for having me. A quick note it's Jennifer Fried. So don't worry ,lots of people say that all the time.

Jennifer thank you so much. I appreciate that. Jennifer Fried ladies and gentlemen, get ready. Don't be like me.

It's OK. I also let my friends call me Jen but I'm jackpot two Ns which gets very confusing but I never get people mixed it up.

Well Jennifer really appreciate you being on the podcast today. And so let's dive into some of the cool things that you're up to. But before we do, oh folks the other thing Jennifer's base here in Chicago so she's a neighbor here in the in the great Windy City doing some awesome things to represent the med tech industry here which for those of you that don't know is growing. Jennifer, what got you into health care to begin wit?

I became really interested in healthcare when I was getting my undergraduate degree at Northwestern. I was studying math and economics and I think one of the things that really struck me about healthcare is when you look at it from an economic lens, consumers can't make rational decisions about healthcare. So you take something that I believe in essence as a public good. Yet there are so many economic distortions that you can't really look at buying behavior the way that you would. Other types of public goods or private market goods. And so I just became really fascinated with it from an academic perspective. When you say there is this industry that impacts every single one of us, every person in the U.S. is going to consume health care and have either yourself or a loved ones that go through significant health challenges. Yet when you look at the industries surrounding it, there are so many opportunities for improvement. So I just became really fascinated looking at, what are the new models that are coming into health care? What's changing? How can we continually make it better? And while you're looking at technology and innovation and new business models, let's apply it to an industry where it can really make a difference.

That's super interesting. So you really found this this opportunity to to make things better and now you're doing an amazing job. And what you do today. I love if you could just level set with the listeners. Tell us a little bit more about what your company does and if you were to answer it and I have this problem. What can you do to solve it. What's that problem and how does your company fit it all.

Yeah so we started the company to solve a fundamental problem that we saw happening in operating rooms which as a surgeon reaching out their hands and that over procedure and realizing that the tool or instrument that they needed wasn't there and this was something that we started other her research lab at University of Chicago Medical Center where he was studying this problem. And when I first learned about this, this was little over five years ago I was pretty shocked. So my co-founder Alex Lenger men as a head and neck surgeon and what he said to me as John Half-Time I come in the room I have my favorite scrub nurse. I have my favorite wrap. I have an anesthesiologist I worked with all the time. Everything runs so smoothly it's clockwork it's perfect. But the other half of the time they come in. I have a task that's rotated in from another specialty. I have a new anaesthesiologists that I'm working with by wrap isn't there yet and my entire room is chaotic so I literally have my patient open on the table and reaching out my hands and because what I need isn't there we're stopping the procedure and sending somebody literally out of the room down the hall in the supply cabinet to go get and I got them. So I saw I know that you spent time so correct So we're used to being laughed before. But for me,.

I know.

Shocking. It's just it's not what you'd wanting would nudge in if you think about it being you or your kid or your mom that lie on that table you say why is it ever happening? And when we started looking at it academically we said, let's study that and see what's going on and what we saw were surgeons all procedures differently. You have tons and tons of new products and devices that are phenomenal that are coming to market that have the complexities. How do you use them. You are very high turnover and oversack so you constantly have new nurses and new techs that are rotating in and an obsession academic sorry that were rotating around. And so what this means is that in a hospital setting you don't have that high volume. I'm doing the same procedures with the same people day in and day out. You have all this variability,yet there's nothing to actually support. What can be a 5 6 7 hour case. So nurses and techs were literally taking note cards and notepads and writing down OK here as you know the size of instrument that this particular Doc wants. Or take a picture on my phone of how to set up the Naos stand and the best sales reps were doing that themselves too and texting us around insuring our coverage drops. And so we saw all of this and said, this is not at all what we should have if we're trying to think about how we deliver the best care for patients. So how do we take these complex new game changing devices knowing that we have a variable staff and may not always have all the team members that we work with all the time. And how do we put all those pieces together to create the right environment for delivering these interventions. So what we decided to do was to build a software tool that could actually be used in the intra operative part of surgery. So we'll take procedures and break things down step by step. But then also roll by roll. So knowing that what your sales rep needs to know is different than what your scrub techniques know, that's different Noyer anesthesia team needs to know have all of that laid out in a digital playbook that have enough pictures and videos, information to reference and also having a large screen on the wall where everybody can see what step of the teaser we are and where are we going next. So it's a relatively traditional software workflow tool but we're applying it to a very different type of stabbing that has generally been pretty old school when it comes to technology.

That's pretty fascinating Jen and so you've put together a really great workflow solution and tell us a little bit about some of the results you're having and some of the outcomes that you've been able to improve?

Yeah it's interesting. So we we work with field hospitals and also medical device companies on the hospital side. The main points that we look at our time and then also suppliers. So we'll look and say, Can we get cases set up faster on the terms of the preoffset out of time. The answer is yes we've generally seen around a 10 percent reduction preoffset of time and then in the intra operative part of procedures some of the data we've been collecting even just having the data has been a game changer. So what we see is that between 5 and 10 percent of intra operative time is being spent on preventable delays like the one that I described at the beginning of the case at the beginning of the interview so we should have day nobody else has been measuring or capturing that data. So in some of the controlled studies we've done, we've been able to reduce that time and delay by about half. And we'd like to see it get even bigger and start to compose to eliminating it. But we're happy to start to see some results there and even just having the data as a baseline. And the therapies that we look at is the supply spent and we know that hospitals are running on very thin margins. So we see a lot of waste in the OR. We generally see between two and three hundred dollars of disposable supplies that are getting opened and then not used in a particular case and that whole range across specialty and it can be much higher and more expensive procedures and usually that waste is driven by team members trying to be as prepared as they can for procedures. So what that means is they're opening up everything. I'm not sure exactly what the stock wants to use so I'm going to open this version and this other version. So by having the right tool that is easy to use that's available in the sterile field they can prevent those items from being opened in the first place. That's a really going on the hospital side on the device side. We've been working directly with companies to support new products launches so working and position education sales education and market development. So when you take a product that is very new. So for example moving a procedure to a minimally invasive technique that it usually been open we can start to map out that procedure and think about the right way to modify that procedure. Train new physicians that the clinical patents on how to use it and then start capturing that data in the field.

Yeah, and so approaching it from a provider as well as a medical device perspective, you're capturing some pretty important groups here in this space and just thinking through some of the time savings. I mean if you're reducing time by half I mean if you're an elderly patient with a lot of comorbidities and you really could benefit from less anesthesia than less time is better Jen. So I think you guys are doing some pretty awesome stuff and in the conversations that we've had on the Outcomes Rocket, just a resurfacing theme that in health care it's not new products that are innovative it's actually being able to implement them and to you and your partners success. you've been able to do that. So congratulations for putting this and being able to implement it because that's the challenge.

Yeah I agree with you and it's something that we are always still striving to improve. I think there are so many great ideas in healthcare and it's some, it's gotten harder and harder to get innovative technologies in the hospitals. There's a split proliferation of new health curate key company which is so fantastic but I think it's been overwhelming for hospitals to know how do we process, how we manage us and say speak, A permanent governance put around this. So lots of decisions made by committee that can make it very difficult. And then I think also at the end of the day, you're putting in new products and in patient care setting and patients come first. So you have to work really hard early on to capture the data that proves that your product is going to make patient care better or at minimum not interfere with that. And that takes a long time.

It really does. So just congratulations right because half the battle is implementing and for those listening you've heard the episodes right. I mean we as we talk to leaders that have had success in medicine like Jan it's so important that we start thinking about how we operationalize these technologies. So you guys have had success early on. Jen can you share a time when you guys had a setback and what you learned from that if you like we learn a lot more from those setbacks?

Yeah I think one of our biggest setbacks was in our initial go to market. So we launched the company out of the hospital out of their academic hospital and we're very focused on how do we grow our presence in more hospitals. And you know one of the things that we pride ourselves on was thinking about all the different stakeholders. So knowing that you have these big committees that you need to get a approval through and that it really only takes one naysayer to shoot down a new product. We've spent a lot of time designing our product saying how is the surgeon going to interact with it. How is the scrub nurse going to interact with that. How with the OR manager is going to interface with this. How with anesthesia team interface with that. And I think the critical portion that we left out early on was industry and all of the different vendors and I think a part of that was spending more of our time in specialties that had a lighter rep presence but a lot of people early on said you should talk to some of the device companies, you should talk to some of the capital equipment manufacturers. And I initially said no you know I think we really want to be just focused on providers and we don't want to tie ourselves to any one type of company. And now we spend most of our time in the cardiac orthopedic and spine space, that was our all specialties where..

The rep headed.

Yes. And the vendor in the room has a very important role and to be honest,we didn't think about that stakeholder enough early on that was a huge oversight on our organization side and over the last year when we started to work with a number of these companies directly, I think that has really accelerated our path to market and these organizations have been phenomenal customers and partners to us.

What a great story and a great learning that you guys pivoted from an in the business model has has been reshaped and impacting both the vice and and health care so I congratulate you guys for that.

Well, thank you.

What would you say is one of your proudest medical leadership moments to date?

There have been so many amazing moments and they have all come from working directly with our customers. So having surgeons call us and talk about how the app prevented an issue from happening in surgery has been huge. And then you I think touching upon what we're doing now with device companies. One of our hesitations initially, I worked on the best price so how exactly is this going to work. Right if you look at the economics medallion proposition it's totally different with our first big medical device customer. The CMO ended up writing us after we started working with our medical education team and sent us this note saying this is going to completely change the game of how we think about medical education and training for a novel products.

Nice, it's pretty awesome.

It is really exciting and I think it was very validating very sad.


Oh, Got it. That is the right way to enter these organizations and start working with them. And that was a big inflection point for the company.

So awesome that's on that one. And as you guys continue to make iterations work with different providers and device companies, what would you say today is one of your most exciting projects?

I can't talk about all of them publicly. One that is public is that we are working with Siemens health and ears as part of their digital ecosystem. We are one of their 5 inaugural partners.


And so we have an API where we have a single sign on now with their digital ecosystem. So for the new C-arms that have the screens embedded you can log right in and you can access this large surgical through that. And so we have been working with them. Our primary experience was personally Allar and then also in the cap lab and the key lab where doing work with Siemens interventional radiology on some of the more complex procedures like Titos. So that has been pretty interesting and we've also seen working with their large customers that they're moving some complex orthopedic procedures into the IRS sleeve which as you can imagine is a huge change in the workflow when it comes out. Yeah mean our procedures generally can package most of what you need in a pretty small set and you have everything you need from there from the room right next door. And now you're talking operating and big ortho trades and doing this very novel new procedures. That's been really exciting to see that's really kind of an emerging surgical specialty. And then also, now having our technology be so well integrated into a large player where you can just take down some of those barriers and getting started where it's ok we can log on on that we have our C-arm and its right there.

That's pretty cool. So you power up the C-arm, it's right there on one of the screens and you got yourself oriented, you'd do a time out. And now everybody's on the same page.

Yeah that's the vision for it. So you have a digital ecosystem. It would seem as it is going is very cool.

I think that's exciting John and so there's definitely a lot that could be done to continue improving efficiencies in the OR and I'm thrilled that you and your team are just taking the bull by the horns to make this happen.

Yeah it's been a wild ride. So one that's been really exciting and also really meaningful.

So Jen let's pretend you and I are building a medical leadership course on what it takes to be successful in operating room efficiency. Today, it's the 101 of Jennifer Fried. I've got four questions for you. We're going to put together a syllabus in the form of a lightning round. So four questions followed by what you think the best book for our listeners to read. You ready?


All right. Here we go. What's the best way to improve health care outcomes?

Start by capturing the rate data.

What's the biggest mistake or pitfall to avoid?

Ignoring stakeholders.

How do you stay relevant as an organization despite constant change?

Short sprint times so always having customer feedback they can incorporate it and then having an agile technology organization that can make those changes in short order.

Powerful and what's one area of focus that should drive everything in the company?

Patient first. That's the name of the game in healthcare and we talk about it all the time as a company is as it is about designing our product. We say if this was your kid that was on that table having surgery, what is the tool that you would want guiding that? What areas that you want for the team around it.

Beautiful and what book would you recommend to the listeners Jen?

So a book that I read a year or two ago that I really like reckonings my health care friends is a thousand naked strangers. Has anybody brought this up yet on your podcast?

No. So what does it, a A Thousand Naked Strangers?


Okay, first time.

I know people always talk about Gawande and his books are awesome and obviously very relevant to our organization. I thought I'd bring a new one. This is like I named named Kevin Hazzard. He was a reporter and after 9/11 decided he wanted to make a career change and he became a paramedic and then about a decade as a paramedic. So this is a story that talks about his experience on the frontlines of that job and I found it so fascinating. You know I spent a lot of my time in the hospital but I personally didn't know as much about what happens for those first responders. What is that experience like. And I just it was a really interesting read and I would encourage everybody in health care to go check it out.

What a great recommendation. Listeners One Thousand Naked Strangers and listen all the things that we talked about today don't worry about writing them down, if your out for a run, if you're driving. Definitely don't write them down if you're driving.

Unless you have a Tesla, oh accident it's still into it.

Yeah yeah. Even still. Just go to like ExplORer Surgical and you're going to be able to find all of the show notes, a transcript and links to the recommendations that Jen just gave to us today. Jen it's been a ton of fun. Super exciting for what you and your team are doing if you can, just leave us with a best place where the listeners could get a hold of you or follow you.

You can follow me on Twitter. I am @jenn_fried. Also find our website which is

Awesome. There you have it listeners. Best place to get in touch. Best place to follow what the folks at explorer surgical are doing and Jen and her leadership team over there, just doing some amazing things so Jen just want to say thank you for spending time with us today and looking forward to staying in touch.

Sounds great. I will see you around the town for about a mile away.

That's right. Looking forward to it.

Alright, take care.

Thanks for tuning in to the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to And again don't forget to check out the amazing healthcare Thinkathon where we can get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is "implementation is innovation". Just go to that's Be one of the 200 that will participate. Looking forward to seeing you there.

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Recommended Book:

A Thousand Naked Strangers: A Paramedic's Wild Ride to the Edge and Back

Best Way to Contact Jennifer:

LinkedIn:  Jennifer Fried

Twitter:  @jenn_fried

Mentioned Link/s:

Episode Sponsor:

Creating Realtime Access To Health Information with Ryan Howells, Principal at Leavitt Partners

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Welcome back once again to the outcomes rocket where we chat with today's most successful and inspiring healthcare leaders. I thank you so much for tuning in again and I welcome you to go to where you could rate and review today's podcast because he is an outstanding individual and contributor to Health Care. His name is Ryan Howells. He's the principal at Leavitt Partners and the greater Atlanta area. He is a senior healthcare and business development exec. He's focused on a lot of areas including state federal and commercial Klein experiences in health plan claims Operations Program Integrity consulting medicare medicaid insurance exchanges. He's got a wealth of knowledge and his success includes overseeing large scale complex time sensitive political and highly visible tech implementations. I want to open up the mike to this outstanding man and have him fill in any of the gaps of the intro. Ryan welcome to the podcast.

Thanks so appreciate the opportunity.

It's a pleasure to have you. And I just want to know Ryan we heard a little bit of the amazing stuff that you guys are doing during Health 2.0. But why did you decide to get into health care to begin with.

Well when I was in undergrad school I was trying to think of what I wanted to be when I grow up. And there's probably a little bit of that still left in me. Curiosity left but as I was thinking through that I wanted to I think kind of center in the business world but then also focus on trying to make a difference in people's lives. I didn't want to go pure business but I wanted to find a way to make an impact as well and healthcare seemed to be a natural option. But at the time I thought that the only way that I could get into healthcare with actually running a hospital. So I went and got an MHRA degree and said that's where I want to be and recognize that healthcare is far more complex and far more difficult than anybody could imagine and through all kinds of different avenues into that kind of spending most of my career actually in health I.T. over the last 20 years and that has been a nice growing field and continues to evolve over time but it's been great. I love complexity of solving problems and both are significant opportunities here. Specifically healthcare.

Totally agree with you. You don't like complexity or solving problems. Healthcare is not for you.

There you go. That's right. Yeah.

And so Ryan and what a cool story you got in from the provider side. An administrator and now you kind of just gravitated toward I.T.. Plenty of challenges in I.T.. What do you think a hot topic that should be on every medical leaders agenda today.

Well so one of the things that we're focused on here in Leavitt Partners is this idea about interoperability but not necessarily looking in from a traditional perspective of how two different covered entities exchange data with one another via HEPA but we're actually focusing on how consumers can gain access to that data outside of Hippa. It's a project we like to call the Charron alliance and it's an opportunity to actually share electronic data exchange with consumers in a meaningful way and we're we're pretty excited about it.

That is pretty cool and listeners you got to check out the Charron alliance we're going to dive into this a little bit deeper. But if you're if you want to ask your friend Google it's actually carin alliance and so definitely going to hear a little bit more about that from Ryan today. Ryan what do you think now is an exciting project that you're working on.

Yeah. So I guess just to continue Saul the kind of that overview of kind of where things where we think things are moving towards. I think there's. With the recent announcements for example with Amazon and some of the other kind of employer plays that are out there in fact a couple of years ago there was a group called the Health Transformation alliance out there too we see kind of the market shifting towards kind of 3 primary payers Leavitt Partners is it just a little bit of background for your listeners other partners as a group of consultants that were organized by former Secretary Mike Leavitt of public office about nine years ago as secretary of Health and Human Services and so what he told us is that there's this broad arc of 40 year change continuum within healthcare we're about 25 years and that was a 40 year change process. And I think what we see is from especially from a payer perspective when a decision maker perspective kind of three main drivers of the health care economy over the next few years. One is employers. One is state governments and then the other would be the consumer themselves. We see the consumer the individual to be primary in their care. Over the ensuing years and we think that's a really significant opportunity. So from answer your question or project perspective that was one of the reasons why we started this caring alliance is we felt as though there was an opportunity to take advantage of the great the ability for consumers to get access to more of their data. And by so doing they can make better decisions better choices on behalf of themselves and their family. As a result hopefully be able to achieve the triple aim in healthcare which will try and achieve that.

Ryan This is interesting. I love the framework. And thank you for the synopsis there on what it does. I tend to gravitate. And I think a lot of people in general that our health care leaders gravitate toward vision. And you've got to make your own vision but you also have to learn from others and so you painted this picture of a 40 year change that's happening. The three main changes being employers government and consumers. What is the end for only twenty five years into it. What does your 40 look like.

Well I think you're 40 is going to look a lot more in terms of of a value based care continuum or value based care model than it does today with fee for service. I think we have noticed we do a lot of work on the Hill in Peckham in D.C. here today are very close and we find ways where when opportunities we talk to folks on both sides of the aisle both Democrats and Republicans and one thing that they definitely agree on is health care costs too much. So from their perspective no matter who's in office or who's running Congress we see an opportunity for these groups to come together and find ways in which they can reduce costs. Now how they reduce costs is a matter of consternation a little bit but they definitely see that health care does cost too much and are finding ways to be able to make sure that both from a cost and an access perspective they can make health care more affordable but also more accessible to and that's also a passion of ours in trying to find a way to make that happen.

Very cool. That's very insightful. So when thinking about the Carin alliance should the listeners think and associate that with one of the three pillars.

I think so. I think they associate it with the pillar of consumerism. So let me give you I know a lot of your listeners are in the Provider space so just kind of practically speaking how this would relate to their potentially their current life. All the ITAR vendors in accordance with. So there was a law passed. I'm sure your listeners are aware of Macra and specifically within Makro there is a component of MEPs associated with that and MYP actually offer within minutes there's a specific stipulation within the call the payment program that these providers about a half million of them that are participating in this program need to actually exchange data via API with third party applications. And so all of the H.R. vendors got together a few years ago and decided on an approach for how they're going to exchange that data. It's called The Argonaut project and they agreed on what the format would be and how they would exchange it and how the safety would be configured into their systems and so as we speak Cerner was about six or eight weeks ago and they had their kind of certified technology out there Epic's was a little bit last year. But all of them were being implemented as we speak. And as a result a lot of these providers are having questions about well if I saw all these API eyes they give third party access to my data. What does that mean. Is that part of hip. Is it outside his hip. Do I need to actually validate with this is a good application. How do I ensure that the data is secure. How do I syndicate these users that are coming into my system. There's all kinds of questions or policy questions. Business Questions technology questions and so what we do is I mention about two years ago we got a group together and said under the leadership of David Traylor and David Blumenthal and his Chopra and Mike Leavitt who are cofounders and said What's interesting about this new world that we live in is we've always thought about interoperability as it relates to covered entities exchanging data with each other. The optional data exchange it's not necessarily mandated under any law and that's the reason competitors don't share data with each other. But what's interesting is when the API is given SPELD this year there's an opportunity for a consumer to invoke their individual right of access under hippo which actually mandates that that data exchange be sent from a covered entity to a non covered and we don't like calling ourselves covered entities. But we are a consumer and as a consumer we're a non covered entity so our right to request that data is mandated under help. But the exchange itself is outside of Habba. So why does that matter. It matters because we don't have to sign big BSA agreements or Durso like agreements to share data with consumers. We just give them their data. So we are working on the workflow technology workflow the policy workflow some of the operational workflow associated with a data exchange and how we can potentially expedite the ability for these systems to be interoperable using and leveraging the consumer at the center of that data exchange process. And that's kind of the exciting work that we're we're focused on.

Yeah that's super super exciting and we're chatting with one of our previous guests Ryan and I think that to saying that the law was actually going to mandate these API requirements this year but it was pushed to next year is that right.

Yes so under MIPS provider that's actually participating in the program based on the FBI to solve by January 1st 2018. And you're right the previous guest is correct they delayed that for one year primarily because the vendors weren't ready yet so they got a little bit of a delay on that. But hard pressed to believe that they're going to get another delay on it. I think everyone is getting to the point where they are ready and they're moving toward that that point. In fact I think you're going to see this year a significant push by a lot of different individuals both in the administration and other aspects of the hill and other ways of saying that you know interoperability specifically this consumer directed interoperability is giving patients access to their data is a primary important piece of the puzzle is how we actually solve for developing value based care model.

That's super interesting. And listeners if you're like me I like having visuals and they've got some really good visuals. if you click on the what we do link there's a really great picture of the current state versus the future vision. I'll have a link for you all on Again you're going to have all the shots that Ryan and I discuss here today and the insights that he provides as well as links to any of the things that we provide. So anyway just something to think about really shows the current state could be very fragmented and in a future state very neatly organized with access. What would you say one of the highlights and progress points that you would say is one of the proudest. Right now with this project.

I think there's two. One is this breakthrough of what we call must share versus may share. This goes back to the point I made earlier which is hipper related data exchange between two covered entities. They may share situations if I want to do pop health for example and I'm trying to get every single hospital in my civic city to be able to share data with me so I can have a better understanding of what's happening there. It's all about a shared type of greed. I don't have to share it with you. If I don't want to Lesseps obviously mandated by state law. But there is no kind of must share associated with hip related exchange. But when a consumer requests access to the data it is a must share situation in all situations and so as a result of that pothouse starts with the individual. So you could be able to start to aggregate that data through the individual. So that's one big breakthrough I think the other breakthrough is what we have seen and what's called Tascot. So the o n o n c of national coordinator overseas help us see for the country. Just recently in January released what's called the draft trusted exchange lead work and it's a portion of what's called common agreement. And that was a mandate that they had under 21st Century Cures to release that some time last year and they they ended up doing that here in early January. What we like about the test that at least the draft trust of the exchange you can see that in health I.T. Daugava in their home sites or their web their homepages on their website is that they've had an opportunity to be able to hold that information and a lot of the comments we can your listeners can see that on our page and under our own C draft trust we exchange comments that we made back in August. They've been able to incorporate a lot of the ideas that we had about how to exchange data better with patients. And one of the breakthroughs that we had in the common agreement the trust exchange framework collection Incorporated is the fact that on trying to solve the problem of identifying patients across systems. So what we call identity proofing and authentication. One of the last summer as well nisse which is the group that is the government agency that's actually oversees purity and I.D. proofing and other items for the federal government they actually developed a set of principles associated with trying to I.D. proof somebody across a system that is basically saying is Saul truly saw across system a b and c. Think of it almost like a digital DMV now where you can get a digital credential and that digital credential is the same as if you went into a DMV or a TSA for example to get your identity authenticated. Well there's technology now that does that. And there's also guidelines now for myths about how that should be done. And so we were one of the first organizations in the country to request that and seeing look at trying to ID proof someone what's called identity assurance Level 2 and so I won't get into a lot of technical detail probably too far and to this point but I'm pretty interesting. Here's what's great about it. We think that we have it and ability and we can get into more detail later but we think we have an ability to be able to identity proof and authenticate someone across systems at a near 99 percent plus content level. Basically the same as if you would see it kind of at the DMV level. And we have a way to authenticate you without using a username and password harvesting across systems and do it at a secure. Much much more secure way than we do it today with usernames and passwords. And as a result of that we think we can actually start to exchange data more securely with consumers and that alone is obviously going to be able to significantly decrease the patient matching issue that we have today or the record matching issue that we have today we'll be able to do a lot better in the future.

Now I think that's a really great call out and congratulations on those two things I mean really great progress and when you were talking about the patient privacy and matching correctly and think of the unique patient identifier and so what are your thoughts on that and how this fits into it.

Yes. So we don't like say a patient identifier because people start to freak out when you say stuff like that. So we use the term digital credential okay and there's a difference. So when you hear Dr. Rucker from the O and CC he'll say things like you have a national patient identifier it's called a social security number and then kind of healthcare and she says no that's not good enough. We don't. We've already been down that road before so we're not going to have the industry isn't really. There's all kinds of reasons why the industry is never really going to have a national patient identifier. People on both sides of the aisle on the Hill are really ready to do something like that. But what Haddi are willing to do. Yeah. But what they are willing to do is they're willing to be able to establish these digital credentials. So again think about it like this kind of digital DMV you get a trusted credential from a source that is essentially user proof and that digital credential could be used anywhere you need it to whether it's through banking or through telecom or through health care or wherever you see that set because it does a lot more than just having one single number. The folks that I'm speaking to in the ID proofing world and identity and access management world have some pretty amazing technology that talks not only about just the regular identifiers you think about name address date of birth all the things that we normally think about those are all publicly available information. But even behavioral analytics how you hold your phone which applications you select when you're on your phone how long you're actually involved or engaged in a telephone conversation on the phone itself which cell phone towers you hit over the last 30 days they can do some pretty interesting things with your phone now. It's pretty amazing really know that you are who you say you are. Wow. So it gets beyond just having a single number associated with you it actually gets into all kinds of other data elements as well that's associated with you.

Very very interesting right. Sounds like you definitely have been taking a deep dive into this and very intriguing the direction that this will take at this point. On the back end you know everybody's talking about fire and integration to this. Can you touch on a little bit. I know maybe some of listeners may or may not be familiar with it. Maybe you can highlight what it is and how you guys are using it for your program.

Yes. Fire the fast fill in operability resources an API standard that has been developed it's no wonder 7. That is really the standard that these major vendors are using to start to change data. The AIS folks are excited about it because of my kind of reach of 72. It's a lot more flexible. It's a lot more supported and it's a lot more better documentation as well. So within that all kinds of reasons for it. But these RESTful API is providing the ability for data to be exchanged in a very meaningful way. There's been really thousands of them have been created in facings part of.

The uptake is amazing isn't it.

Yeah it is. It really is amazing I think people have been wanting this type of a solution I think for a while. I mean Naypyitaw have existed for a while but physically within health care is having a flexible solution I think is about evil for it. The agency is part of the testier really that they had earlier also released was called the U.S. CD. Yes corrugate and operability set which outlines a roadmap for the different data elements that need to be in place they would like to see in place over the next 10 to 3 years or so. And what's exciting many of them but all of them are actually fire based and they have an ability that start to change this data in a meaningful way. We think that consumers can play a key role in that going forward. And we also think that third party applications and open standards now so play a key role. So we're working with the industry to develop more of those.

That is super fascinating Ryan and I'm excited for the things that you guys have going on there. Obviously we really have limited time on today's podcast so maybe we'll do a part two to this but what would you close this discussion on. Carin as far as like what should the listeners take away from Carin.

As a takeaway I think if you're a provider especially and you're frustrated with just interoperability in general you're frustrated with the fact that you have kind of these patients coming in and the records aren't matched appropriately et cetera. I think this is just a new way of looking at those problems. And they said it's a way in which you can involve the consumer patient the families or caregivers in the process of trying to be able to link their records to them as specific unique individuals. I think definitely the technology is there and it's also a chance for you to be able to share data from your EHR to third party applications to make them meaningful useful relevant have the data analytics that you're looking for as well. I think there's so many of these applications out there. Someone told me at one point there's over 200000 health I.T. applications out in the Apple store. That's a lot but they're all ready to be able to make use of the data they can get access to it. So I think engaging the the application community in some of the work that you're trying to do strategically as an organization I think will help tremendously as we try to accomplish those goals. And certainly if you're a consumer and want to get access to the data I think that's relevant I think and I just leave with this last item which is this is public information the Apple just announced and it was about a week ago now that they have the ability now on your iPhone to go with the 11. 0 3 release to be able to as a beta release to access all of your data that you have from your different providers. So as long as you go and register with the portal and you can access to that you can be able to supply Apple that information and making go out and get your data. And the great news about it is highly secure it's actually downloaded to your phone not from a cloud. So it's on your hardware and you can actually aggregate your data from all the different providers and you can too. So that's a really exciting development and it's an important one and I think you'll see more of that in the future.

Yeah. Ryan thank you so much for that I think you did such a great job of simplifying and explaining a very complex topic. So you know it takes somebody that really is understands it to simplify it the way you have so really appreciate you doing that.

Hey you're welcome. No. You know Ryan one of the things that we do here is is a course we build at a quick syllabus for the listeners. And so it's what it takes to be successful in medicine today. The one on today of Ryan and so we're going to put a syllabus together for questions lightning round style followed by a book and a podcast that you recommend the listeners you ready.

All right I'm ready.

Awesome. What is the best way to improve health outcomes.

The best way to improve health outcomes is to measure it correctly and ensure that you're engaging both the provider and the consumer with the information. The data that they need to be successful and make different decisions more informed decision when they have made in the past.

What is the biggest mistake or pitfall to avoid.

Running after the next big bright shiny object.

I love that. How do you stay relevant as an organization. Despite constant change.

Talk to a lot of people the more that he don't get centered on just the same folks that you talked to previously talked to multiple sectors. We have a really unique business model here of other partners where we frequently talk to multiple sectors within the healthcare industry. We developed like 30 alliance of the year and have this opportunity to really engage with folks from across healthcare. And when you do so you gain some really interesting new fresh insights.

You guys are like a think tank over there.

Well we. We don't like to sit around and pontificate per se. We are like actual results. So what is the difference. That's a big difference here.

That's true.

We love bringing these books together and just trying to actually create solutions. But we've got a lot of freedom and flexibility to do that and we have a great leader that has helped us in navigating the waters associated with that.

Now OK let me rephrase. You're an action taking organization of thinkers.

There you go. Folks who make me think we're pretty smart but we love hanging around other smart people too and solving problems.

But you know I love it right. And one of my favorite quotes is You are the average of your five closest peers so I guess you are who you hang out with that. What's one area of focus that should drive everything else in your organization.

What's best for the consumer the individual themselves. I don't like using the word patient because that assumes they're going to come visit you somewhere and I don't like using the word members. What the health plans but I like using the word either individual or consumer. I think what's best for the person is really what we are we need to get to and healthcare and everything around the drive. The answer to that basic question.

Love it what book and what podcasts would you recommend to the listeners.

Well the book that I love a lot and I've read a few times is a book called What Got You Here Won't Get You There. It's by Marshall Goldsmith. He's a USC professor and he basically he's world renowned to actually be a vizor and essentially a life coach to folks that are uber successful to try to help them get even more successful. And he outlines a series of steps on areas where he's seen super successful people. Not be able to get to the next level that they want to. And I find myself actually picking that list off a number of them from his life I should say. So it's a great reminder about potential areas or blind spots. You may have ways you can improve your life and that's been a good book.

What a great recommendation. Right.

Podcasts wise I've only heard a few of them so far but I like them it's a podcast called healthy dose by bestman Oxfam partners. They're the two guys that actually do some D.C. work in San Francisco and they attacked some pretty interesting folks on their podcast so there's a lot of them out there.

I love it Ryan and listeners take note of these recommendations and the syllabus. But if you're driving or running or doing something awesome which you probably are go to and you're gonna see Ryan Howells thoughts the things that we shared the full transcript as well as links to the book and podcast that he shared and his organization. So Ryan this has been a ton of fun. What would you conclude as a closing thought here and then maybe you could share where the listeners could get ahold of you.

The concluding thought is that over the next few years there is going to be a proliferation of open data in the market both in the commercial side of Medicare and Medicaid as well where data is going to be a plus for the industry. I think that the folks that are going to win the future the folks that actually can be able to incorporate that data into their business make sense of it and make it actionable and really change their business as a result. So data is really going to drive the future and think within healthcare. And that's where you're going to see a lot of this going in and how we shape delivery systems and financial reform to start getting hold of me I'm going on Twitter at @aryanhowells. And then Carin Alliance is actually out there on Twitter too @carin alliance as well out there on Twitter so feel free to follow us.

Outstanding Ryan and listeners. This is definitely a gentleman you want to follow an organization you want to follow. And Ryan I just want to say thank you once again for carving out time in your really busy day to share these insights with us really appreciate it.

Happy to. Thanks for the time.

So thanks for listening to the outcomes rockett podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

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Recommended Book and Podcast:

What Got You Here Won't Get You There: How Successful People Become Even More Successful

A Healthy Dose

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Outcomes Rocket Podcast
Outcomes Rocket - Heidi Jannenga

How This Leader is Empowering the Rehab Therapy Community to Achieve Greatness in Practice with Heidi Jannenga, Co-Founder and President at WebPT


: [00:00:01] Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez

Saul Marquez: [00:00:18] Welcome back once again to the outcomes rocket podcast where we chat with today's most successful and inspiring healthcare leaders. I really appreciate everybody tuning in once again and I invite you to go to where you could rate and review today's podcast because we have an amazing amazing guest. Her name is Heidi Jannenga. She is a physical therapist by trade and also the co-founder and president at webPT located in Phoenix Arizona. They're doing some amazing things to empower rehab therapy community to achieve greatness and practice. They've created an innovative end to end business solutions designed specifically for rehab therapy professionals. They give their professionals the amazing opportunity to target single therapist clinics even multi location enterprises. They give them the tools they need to be successful and performance revenue and patient outcomes which is why we have them on the podcast. And so Heidi has an amazing story. I want to open up the microphone to her and welcome you to the show. Heidi welcome.

Heidi Jannenga: [00:01:25] Thank you. Thank you so much Saul. Really appreciate the opportunity to be here.

Saul Marquez: [00:01:29] So Heidi it's a pleasure to have you here on the show. Why in the world did you decide to get into the medical sector.

Heidi Jannenga: [00:01:36] Well I'm a physical therapist I actually entered college premed and I grew up in a household of science so my dad was a research scientist a research horticulturist actually so I always got taken to the lab and were mixing cool things in it beakers and all that kind of stuff. So I kind of grew up in that sort of environment and worlds. And so when I went on to college I was again premed but then I also played basketball at UC Davis where I went to undergrad and my junior year I went down with a knee injury and got introduced to an amazing physical therapist who helped to prevent me from having to have surgery and being able to return back to sport pretty unscathed. And so it kind of piqued my attention and I went on to physical therapy school at the University of St. Augustine and kind of pushed myself into sports medicine and athletic training after that. So it kind of you know those pivotal moments in your in your life that help to transition you into you know something now that I have so much passion for and so glad that I did.

Saul Marquez: [00:02:43] That is so awesome. How do you guys have done a lot in a very short time I mean ranked 297 on the top 500 Deloitte Technology Fast 500 list guys. Number 7 23 on the ink 5000 list. I mean you've got a lot of really cool stuff going on over there obviously. What would you say is a hot topic that should be on every medical leaders agenda. And how are you guys approaching it there.

Heidi Jannenga: [00:03:08] So yeah we definitely have accumulated the accolades and I think part of it is just bringing sort of a different sort of mindset mindset to health care in general. Right now our hot topic I would say is we're talking a lot about interoperability which I know a lot of others are too. To really help you know physical therapist and rehab therapist so when we talk about rehab therapists we talk about physical therapists occupational therapists and speech lines with pathologists which sort of makes up the rehab community and not being necessarily the most well-known within the medical community. I think sometimes we sit on the fringe and so our sort of goal with interoperability is to really try to draw more of the mentality of a week in which you know a lot of ancillary providers can really make a difference in patients lives. And also as we talk a lot about how much health care costs we tend to be more of a low cost high value provider. And I think that's really important as we transition into this more patient focus center of care model. Part of the other things that we really try to emphasize is sort of maybe my own sort of personal spin on it is really the transparency of cost of care. I think that's critical. Again as we put the patient first and really being much more transparent on how things are happening as we moved into this sort of specialization realm. We have to tend to create more silos in which you well that's not my job it's somebody else's. And so again sort of bringing everything back together to truly put the patients needs first I think is probably the most important sort of hot topic and use of interoperability and technology to do that on our agenda. Currently.

Saul Marquez: [00:04:45] Heidi I think it's a really great example and maybe we could dive in a little bit deeper on that front. What's one way you've been able to take it from merely words to action interoperability and the thing that you guys are doing at webPT

Heidi Jannenga: [00:05:00] So being a technology company it's really the connection and transfer of data right. Being able to push data back and forth between technology platforms and with electronic medical records now being at least from our sector. 80 percent of therapists are now using some sort of ology we own a third a little over a third of the market. So from our perspective is how do we connect with other systems that maybe hospitals are using or large medical practices in which physical therapists can continue to use the platform that is special for them and allow them to document appropriately but yet exchange that data with the referring physician or the hospital system that has the central scheduling hub in which you don't have to have all the technology you just have to be able to exchange their correct information with other systems to make it the most easiest process for not only the patient but also for the provider and allow that information exchange so that everyone involved with that patient has that information readily available at their fingertips. So for example we are integrated with some of the large health systems like an epic and Cerner. We're working on a really great platform right now with modernizing medicine right and they are working a lot with orthopedic surgeons which is one of the top providers or referring providers to physical therapy. And so having that sort of exchange of information more readily available not only to the therapist so that they can see the surgical reports they can see exactly what type of surgery what kind of outcomes are being expected by the physician so that they can you know obviously maximize during the treatment process and plan of care that is being developed on the physical therapy side where we had therapies side and then communicating back right so that the physician knows when they come in that patient comes back in for their checkups that hey this is actually being completed and is moving forward in the timeframe in which they all are working together for that patient.

Saul Marquez: [00:06:59] Yeah. These are some really novel approaches and it makes you wonder why other companies aren't doing it and you guys are definitely paving the way here Heidi. What is it that makes you guys different. Why are you guys taking the bull by the horns while others are not.

Heidi Jannenga: [00:07:14] I don't know. I wouldn't call it necessarily novel. I think a lot of people want to do it. It's really having the nimbleness and also vision to really get it done. We've always sort of taken that approach from the very beginning. We were the very first web based application in the rehab therapy industry. So taking novel approaches I guess but just really at the end of day making it happen. Like a lot of people can have ideas but it's really putting those ideas into action is what makes a company successful but also taking it from the approach as a subject matter expert right. Taking it from the approach of the provider. That is what are their putting their needs first. And we've really taken a lot of time to gather feedback from our customers. We do that today we have advisory groups we have focus groups that before we actually even launch or even start down process of developing software that we're getting input into the process from those who would actually be using it so that it is actually intuitive and it's definitely meeting their needs versus taking their approach from a technology with this is what we think you should be doing or changing their workflow per se. So I think that it's why we've gotten some of the accolades it's why we're one of the fastest growing companies. You know for the past five years on the 5000 list I mean that's top 7 percent of the companies in the country. And so what we're really proud of proud of a lot of those things but at the end the day it's about assembling a fantastic team leadership who truly believes in your vision and your mission that we set out. Actually it's our 10 year anniversary this year so ten years ago to really make an impact and be a game changer. And we you know we're not done but we're definitely have are moving in that direction and continuously moving down that path and keeping that frame of mind as our guiding light.

Saul Marquez: [00:08:58] That's outstanding Heidi and you've definitely shared a lot of valuable pearls here so listeners can make sure you didn't catch some of that go back rewind to be broadcast. You can always do that. Listen to the episode whenever I find myself wanting to release one of a pretty amazing things that one of our guests says just like Heidi just went through. I'll go back and then I'll double time and or I'll do like a one point five X and then he goes a little bit faster. I find exactly what I need. And then boom I write it down. So anyway just a little tip there. Are you listening. Heidi did provide some really amazing pearls there. Heidi you and your team have obviously come this far but I know that it hasn't been without any mistakes or without any setbacks. Can you share a little bit of a setback that you guys had and what you learned from it.

Heidi Jannenga: [00:09:46] Sure. So when I first applied to PT school I didn't get in my first year so I had this big dream of becoming a physical therapist and I thought for sure yeah I was you know on my path to medical school like school sure I could do that. But you didn't get in. And so I had to really and it didn't it didn't stop me right. So the things that I learned was really the value of perseverance and self reflection on making sure you take the time to figure out why something didn't go the way that you thought it sure the way you wanted it to and those lessons have really taken those able to apply in so many areas of my life. Anytime you encounter a roadblock or are going down the path where a year like charging forward with something just kind of stops you or you have to pivot or sort of change the path and seeing those as opportunities I think is kind of my mindset with failure like failure for me is not a dirty word and it's definitely more of an opportunity to say well what could I do differently now and to learn from those. I think you learn more from your mistakes than you do from a lot of successes because you don't tend to just kind of gloss over those over time versus you time. We all tend to sort of dwell on sort of the things that don't necessarily go right. And so also in sort of the early days I also of what P.T. I tended to sort of think that I had to have all the answers that I wanted to take everything on myself and felt like you know kind of a sign of a strong leader was was really to be able to take everything on do everything multitasking. I soon realized as we continued to grow that that it really wasn't sustainable. So when I finally sort of said listen I give it like I don't have all the answers I need to bring people around me that are smarter than me and have the answers in areas that frankly aren't my favorite things to do. For example sort of that financial sort of accounting portion of the business like when we brought people that specialized and were really good at that stuff. Holy cow it allowed me the freedom to then focus on things that I am really really good at. So were Rick proponent's now strength finders which everybody has strengths and areas that you truly have passion for and are good at. Like I'm a huge advocate of just focusing on that. Let's just put all kinds of energy on that and not necessarily work about work so much on your weaknesses because the day those are probably always going to be your weaknesses. And we really had a lot of success with our teams because of that and finding out what are people's strengths and putting sort of teams together that round out a really good mix of different skill sets to allow them to be as efficient as possible. So those are probably two things that I would love. I like to share as far as failures that really turned into opportunities and learning moments that really helped to propel our success.

Saul Marquez: [00:12:29] Some really outstanding shares Heidi. And the thing that comes to mind just top of what you said is failure is not a dirty word. It's what you need feedback you need to take the next steps and then surround yourself with people that have the strengths that are not your strengths that are your weaknesses and build teams that way. I am reminded of a book called principles by Ray Dalio and he went to the extreme he put together. He used the Myers Briggs and put together plainly.

Heidi Jannenga: [00:12:58] Yes yes this is tisk but I mean or straight finders. I mean me. We played between both we actually look at emotional intelligence now too like we dabble in all of these things. I think it's important and.

Saul Marquez: [00:13:09] Cool so finding a way to operationalize that is the best way to get those teams like Heidi has put together in a way that is going to help you break through barriers and overcome those weaknesses that you have as an individual. Heidi amazing share. Thank you for sharing that.

Heidi Jannenga: [00:13:24] Yeah no problem I think it's a so many times you get to hear the end result or the outcome no pun intended. But the outcome of the story right and people don't understand how you actually got there. And so it's one of my favorite things to share. I think you read stories or your or you read you know things about these really uber successful entrepreneurs. The thing that they talk about is all the times that they failed to lead up to that one success. And I have a really I'm an avid reader and I just I kind of took that to heart a lot of times where no one likes to fail. But they definitely can help propel you to bigger and bigger heights from taking the time to really learn from them.

Saul Marquez: [00:14:04] Totally agree. Heidi tell us a little bit about a project that you're working on today a focus area for you.

Heidi Jannenga: [00:14:10] We have a lot of them. So I think a couple of focus areas in 2016 we made an acquisition of an outcomes tool that we are now fully integrated into the sort of platform which is been really important. I think that outcomes obviously right now is super top of mind for the healthcare industry and for too long the therapists in particular have sort of had to settle on anecdotes about the great care that they're delivering and potentially some some testimonials for example but they didn't really give a true broad brush the picture of the great care that we're doing across the entire industry let alone in particular clinics or regions and so we are now collect. We have been now for quite a few years collecting this outcomes data in hopes very specifically creating benchmarks across the nation for our therapists to understand what is it what kind of progress star is showing and what in marrying that 3 sort of big pillars of the financial information and the outcomes information and data with clinical data. So creating clinical pathways to create the greatest outcomes but knowing how much the cost of care really is to deliver those great outcomes is sort of our main focus. So we have the outcomes platform as well as you know we've taken the billing platform we now have not only billing services to where we actually offer billing services to our customers where we do the billing on their behalf or we offer our technology platform in which they can actually do it themselves so. But again the data collection of having all that information and putting it together now in what we launched the end of last year is an analytics platform right which takes all that data creates and really nice dashboard putsch key performance indicators for our therapists to and as clinic owners to really understand what's happening at the clinic level but also for enterprise groups across the entire clinic chain that they have to really allow them again as our mission says to achieve greatness and practice.

Saul Marquez: [00:16:16] Yeah and just think about the importance of owning your data and frankly when it comes down to that if you own your data you own your future. And so it's important for a company like web peaty. I mean this is so empowering to be able to provide this to your constituents. Heidi an opportunity to help them own their data.

Heidi Jannenga: [00:16:37] It's so so true. And every thing that we talk about now really at the end the day starts and ends with data. It's all about injective measurements it's no longer OK just to use US anecdotes. Again sort of feeling like we're underrepresented in the overall medical field. This is the way to really gain your voice when you can come to the table with true data points that are going to make people's had turned and we have those we just need to be able to publish them and get them more readily available throughout the medical community. And one of the groups along with the American Physical Therapy Association and others that are really trying to do that very large scale.

Saul Marquez: [00:17:18] That it's super exciting and I'm looking forward to seeing where this goes because I think it will definitely be very much a technology and a resource that helps. Physical therapists really take their businesses and their outcomes to the next level.

Heidi Jannenga: [00:17:31] For sure.

Saul Marquez: [00:17:31] So Heidi let's pretend you and I are putting together a medical leadership course on what it takes to be successful in medicine. It's the 101 or the ABC of Heidi and I've got four questions for you lightening round style and then we're going to finish it up with a book that you recommend to the listeners. You ready. All right. What's the best way to improve health care outcomes.

Heidi Jannenga: [00:17:57] First I think we have to leverage technology and truly understand how to use it and derive the meeting from the data that we're collecting. I think this again allows us to set up benchmarks for success share important metrics with other providers and truly empower our patients to make more informed decisions which at the end of day is what's happening more and more now.

Saul Marquez: [00:18:16] What's the biggest mistake or pitfall to avoid.

Heidi Jannenga: [00:18:18] Well it's probably the opposite of that of not embracing or sticking your head in the sand and not embracing technology and this collaborative care model everything is really moving towards the cloud. And patients are expecting more and more out of their healthcare experience. So practitioners who sort of turn a blind eye to technology or data I think are not going to be able to keep pace with the changes that are happening in that field and that's going to be at the judgment of hopefully not our own profession but definitely those individuals who are not willing to do that.

Saul Marquez: [00:18:47] How do you stay relevant as an organization. Despite constant change.

Heidi Jannenga: [00:18:51] So we are very very entrenched in our industry. We regularly attend conferences. We contribute a lot to industry publications. We have physical therapists not only myself but others on staff. We have a compliance officer who's really job is to comb and read all of these really interesting quote unquote interesting regulatory compliance issues. I'm also part of the Peetie PAC the political action committee so we're staying abreast of really important legislation that's coming down the pike and helping to sort of promote that within the industry and then at the end of the day doing all those things while staying true to our vision and mission I think is really what's keeping us most relevant and current.

: [00:19:32] Love it. What's one area of focus that should drive everything else in your organization.

Heidi Jannenga: [00:19:38] For me it's about the people we wouldn't be where we are today without our amazing amazing teams of people but all stakeholders are customers. We call our customers members because we feel like we've created a community in which all of them are part of that. Our partners our investors you know fellow community members all those people are truly part of the success in business. When you take this people first approach it's something that we've always done but now kind of has a label that is part of that which is conscious capitalism. If you haven't heard of that it's a good little plug out there for a national organization that is doing really great things. Put a lot of meaning back into business. So yeah for us it's it's definitely about the people.

Saul Marquez: [00:20:22] Beautiful. And Heidi what book and what podcasts would you recommend to the listeners.

Heidi Jannenga: [00:20:29] Wow. So I said I was an avid reader and I absolutely am. So it's hard to narrow it down to one book. I would say from one of my favorites of all time is is a book called firms of endearment and it's really a book written by Raj shows and David Wolfe and they talked about the world class companies and how to how to have profit but still remain truly passionate and have a purpose. And that's one of my favorite books. I like to interesting a push out there on a personal affront. Renee Brown's one of my favorite sort of writer podcasters and folks out there. So her latest I think book daring greatly is also a good one. And then from a technology perspective your audience is probably pretty diverse. I'm a huge fan of 37 Signals and so there's a book rework he has been one that we actually readily reference within our organization often. So those are the ones that probably come to mind the most.

Saul Marquez: [00:21:27] I love it Heidi. There's no doubt you're a voracious reader and you have your read about 100 books a year. So I'm sure you're in that realm.

Heidi Jannenga: [00:21:36] Yeah pretty close. Pretty close. I like the books on tape too while I'm driving or traveling too. So that makes a big difference.

Saul Marquez: [00:21:43] Yeah I totally agree with you. Nice to have the audio version as well and listeners don't worry about writing any of those amazing recommendations down like you. I'll go back and listen to this again and go to That's H E I D I. And you're going to find the show notes transcript for this whole podcast as well as links to the books that she just recommended. Heidi this has been a ton of fun. And before I conclude I'd love for you to just share a closing thought with the listeners and then the best place where they could get in touch with you.

Heidi Jannenga: [00:22:16] First of all thank you so much for allowing me to have some time and to really represent the rehab therapy industry. As far as a closing thought I think we're all in this to truly elevate our health care system and truly want to improve the quality of care. I think the biggest thing is truly embracing collaboration and leveraging the technologies that support that collaboration and technology will will only grow more important in our field. And I think practitioners and providers across the spectrum of care can no longer really turn a blind eye to it. So patients again are expecting more and rightly so and the only way to truly understand their needs and their wants is to fulfill them in a sustainable way and I think that's going to be done through leveraging technology and collaboration. So again thank you. I am on Twitter @HeidiJannenga is my handle. My email address is So love to continue the conversation via social media. We have a pretty big filing not only myself but also deputy also has a great Twitter handle in which where we do a ton of stuff on social media. So left to continue the conversation Heidi.

Saul Marquez: [00:23:24] Thank you so much and listeners tune in and make sure you check out the podcast Schoenaerts because that's where you'll find all the ways Heidi just mentioned to get a hold of her so again Heidi. Just want to say thank you again for taking time to be on the show.

Heidi Jannenga: [00:23:36] You are so welcome. Appreciate.

: [00:23:41] Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at for the show notes, resources, inspiration and so much more.

Recommended Book/s:

Firms of Endearment: How World-Class Companies Profit from Passion and Purpose

Recommended Podcast:

Brene Brown's podcast

Best Way to Reach Heidi:

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