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Saul Marquez:
Hey, everybody! Saul Marquez with the Outcomes Rocket. I want to welcome you back to another fantastic podcast. Today I have an extraordinary leader with us. His name is Steve Low. Steve is the president of KLAS Research and formerly ran KLAS's vendor research business. Steve's passionate about improving healthcare information technology through transparency as well as research insights. He believes that the best way to drive this improvement is through fearless and accurately reporting on the performance realities of health information technology. He's also a keen student of leadership philosophy and loves creating empowered and vibrant teams. Steve, it's such a pleasure to have you here with us.
Steve Low:
Thank you, Saul. It's great to be with you.
Saul Marquez:
It's great to be with you. I've followed KLAS for quite some time now, and I'm really impressed with the work that the organization puts out around benchmarking, and really, it's just a great organization. So I was excited to get you on today's podcast, Steve. And really, one of the questions that I enjoy asking leaders before we get into the main thing that their business does is, what inspires your work in healthcare?
Steve Low:
For me personally, it's really about the providers, and when I say providers, mostly clinicians. I actually have, two of my brothers are practicing physicians, and I just love being in an industry where what we're working on is making positive changes for patients. So a little bit of personal background. I was in financial services for, I call it my exile in financial services. I started my career consulting, … largely in healthcare, went to financial services, and there was a yearning to get back, to be able to be part of improving lives through the patient experience. I will say with what we do at KLAS Research, I'm a step or two removed from what happens with a patient in a clinical setting. But notwithstanding the distance, I think we feel pretty strongly about the positive impact just our reporting can have in the space of KLAS Research. So I love to be a part of just making a patient experience better, even if it's from the sidelines.
Saul Marquez:
That's fantastic, and numbers are important, and your background in finance, I'm sure, drives a lot of the quantitative processes and things that you guys do at the firm. Talk to us about KLAS. For many, I know many have heard of KLAS, but for those that haven't, how are you and the business adding value to the healthcare ecosystem?
Steve Low:
For us, it's really, we see ourselves as truth-tellers and even the founding of the company. So 27 years ago, our founder, Kent Gale, just, he was actually in software sales, healthcare technology software sales, and was a little bit disenchanted with the number of promises out there that just were not being kept. So the foundations of the company was, can we be a voice of truth, a check and a balance on the salesmanship that's out there in healthcare technology and really tell the story of who's keeping their promises, who's delivering impact for health delivery organizations? As far as how KLAS has evolved in the 27 years since its founding, it is still always, and it always will be, founded on that position of, can we find the truth through some pretty rigorous research methods and then tell those stories in a way that really helps providers make smarter investment decisions, helps vendors improve their product and hear the voice of their customer in a way that is hard for them to hear without our help? So that's where we're trying to add value in healthcare, is just being that as loud as we can, a voice of truth, and the way we do it, we try to be humble and compassionate, and kind with the way we do it. But every now and then, we push and prod a little bit too.
Saul Marquez:
Hey, that's great. It's important, right? If you see a problem, call it out, especially when we're talking the end product, which is patient safety, health, and the things that matter most, so that's fantastic. It sounds like what you guys do can benefit providers, but also vendors providing the services. And if you think about what you guys do at the core, how is it done? Is it done through surveys? Is it done through research? And then talk to us a little bit about how what you guys do is different than everything else.
Steve Low:
Yeah, you know what? I think the answer to both of those questions is one and the same. So I'll tell you a little bit about our research engine because it is unique. There's lots of really great marketing intelligence companies out there who will do surveys; we'll talk to customers. What makes us different is the relationship we have with the key decision-makers in healthcare. So the way we've built the research engine KLAS is founded on relationships, and the way we build those, it's all about give back. So we actually, we do thousands of interviews every month, right? We have teams of researchers who, before they ever get on a phone to conduct a research call, they go through what we call KLAS University. And it's a really rigorous education process because it's not good enough to have a script and say, okay, I know these questions to ask this hospital CIO. We need to understand how these different technologies interact, how they're being used by hospitals, where the pain points are, and how the market's evolving. So when we get on the phone, we have quantitative questions that we ask so that we can come up with a score because that's important. People want to know who's first place, second place, third place. We give awards out. But I often think, vendors and providers both say this, that the qualitative feedback we get through these research interviews is sometimes the most valuable part. So if somebody says, hey, I'm giving this vendor a five out of nine on implementation, they really let us down, the interview doesn't move on. We say, tell me more about that. What happened in this implementation with your new ERP vendor, for instance, that was a disappointment to you? So when we write a report, we're not just saying, hey, this vendor didn't do well. It's, here's what the CIO at that hospital said about the implementation: where they were good, where they weren't. And it's great when we hear somebody gets a nine out of nine, and we can share how they've been delighted. But it's great too, when we can write a report that says this vendor might be making big promises, but some of their customers are saying that they're frustrated. Now back to your question about how do we do that, we've got teams of researchers, but something that's really important to KLAS is just about everybody in our company does research. So whether you're on a customer support team, a sales team, or our true research team, even myself, I do 2 to 3 research calls a week where I'm on the phone. Nowadays, we use teams calls, but I'm engaging in a personal conversation with provider executive to say, I want to learn more and tell me about how this software is being impactful for you. The beauty of that, Saul, is that over years, we cultivate these deep relationships where, sure, we're getting helpful information that we can then share liberally with healthcare, but we also seek to really make it a valuable experience for that healthcare provider who's being generous to us with their time. So we say, what do you need from us? Is there a report we can give you? We're publishing reports every week, often every day. And as hard as we try to make those front and center for people, we find providers are often saying, I didn't know you guys just wrote a report on patient portals. Yeah, if you could send that to me, that'd be phenomenal. We're trying to pick a vendor right now. We're trying to make ourselves available and helpful to providers as much as we can, and it goes hand in hand with how our research engine operates. So the two really, it's this virtuous cycle. We would not be able to get our research without the generosity of providers, and we seek to give back so that they're excited to talk to us every ten months.
Saul Marquez:
That's great, and you said a couple things, Steve, that really resonated with me. It's this idea that you guys do over a thousand interviews every month, that everybody at the firm does research. It is really in the DNA of what you guys do to provide this. And then the other thing is you guys, since you do so many reports, daily or weekly reports, making sure that people know about them. So I'm glad you're here on the Outcomes Rocket so that we could get people to know about your reports, like the range of reports that you do and things like that. Give us some understanding of that.
Steve Low:
Yeah, we are constantly seeking to meet the needs that we find out about by listening to the providers we talk to. KLAS Research started with basically just saying we're going to evaluate EMRs, and that was who we were reviewing. And over the years, we've seen it, the technology landscape in healthcare continues to grow and evolve, and we're trying as best we can to keep up with that. So as new tools like artificial intelligence, … speech, patient portals, revenue cycle tools, we're constantly adding these to what we're researching and publishing reports on, and the breadth of the reporting has grown. It's a fun challenge where we've gone from being a small organization with a handful of people doing research to hundreds of individuals and saying, how can we scale the research we're doing for the benefit of healthcare without losing those personal relationships that drive it? And part of the secret sauce we found is that everybody here has to be involved in those. At the same time, we get, we're trying to be smarter and smarter about how can we make it as easy as possible for a busy provider to find the time to work with us. These are people who, their schedules are more packed than ever, so we have to make it easier than ever for them to engage with us. And that means, you know, sure, we still want to have those one-on-one conversations, but if they, if we can give them a way to provide us some of their feedback asynchronously through online tools, we're building those too. Because we feel like healthcare needs us to be that truth-teller, you know, all the technology spaces. Now, I think part of the question that you asked, Saul, was we've got this cadence where we're constantly publishing reports, KLASResearch.com is the kind of the best place to see, are, we, I think, and I'm going to want to double check on this, but I'm pretty confident that just about everything we publish shows up on our LinkedIn feed. So following us on LinkedIn is a great way to see just the pipeline, what's coming out from KLAS. We'll often have interviews with some of the vendors that are doing unique and innovative things, but I would be remiss if I didn't mention that when it comes to what we publish, we make it available for free to providers who engage in the research process with us. Anybody who's out there thinking, oh great, I'll go to the website, I'm going to have to pay for this. Not if you're a provider who's who says, yeah, I'm willing to be part of this virtuous cycle of engaging with your research, I'll talk to some of these. And to be honest, we're, we try to be pretty darn generous. Even if somebody, I've had it where I know a provider is looking for some information, they may not be able to speak to a solution that we're measuring, but I say, let me help you. We have these guiding principles at KLAS, and the very first one is, everything we do must benefit the provider, and if we can find a way to be generous, we're going to do it.
Saul Marquez:
I love that. That's a great North Star there, Steve, and the way that you guys conduct business is very admirable. And at the end of the day, you want to be successful, you got to be a person of value, a business that adds value, and so you guys are doing just that. How would you say, if you have any stories, the business has improved outcomes or made business better for some of your clients?
Steve Low:
Yeah, there's one area that I'll highlight because I love that question. We started, at the beginning of KLAS, we were measuring vendor performance, right? Software vendor performance, it was EHRs. And within the last ten years, we noticed that, we had a theory, we had a hypothesis that you could take the same EMR in two different hospitals and get dramatically different outcomes, clinician satisfaction, user satisfaction, depending on how it was implemented and how it was administered. And we began something we call the Arch Collaborative, where we were measuring the success of the actual implementation of the software. And what we confirmed our hypothesis, that whether you've got Epic, Oracle Health, formerly known as Cerner, Meditech, Allscripts, you name it, you can get a pretty broad performance distribution. And we began measuring not just the performance of the vendors, but the implementation performance through the eyes of the end-user clinician. And we've had, now we've had hundreds of different hospital groups engage us to say, okay, we want you to help us measure our clinician satisfaction with our software. And then what we'll do is we'll do multiple measurements over time, and we've seen hospital systems go from clinician satisfaction kind of in the, we use letter grades often in KLAS, right? So we'll see hospitals that their clinicians are giving them like a C minus on their satisfaction. We do these measurements, and it opens the eyes of administration to where the unhappiness is with their user base. We have best practices we share because we've been doing this with hundreds of hospital groups to say, here's where the best-performing delivery organizations, what they're doing in these spaces and bringing their best peer guidance to the table. And we have hospitals that are going from a C minus to a B plus or even an A in their implementation scores. So that's something we take just a great amount of pride in now, because we try to be unbiased, we love to see a positive impact from what we're doing, but we also make sure that we sanity check those results and say, okay, we're not just telling ourselves things are better because that's what we want to hear. We get independent researchers who haven't been part of the project to check the scores and make sure that they do the bulk of the research where we're involved in helping an organization improve.
Saul Marquez:
That's great, Steve. And ultimately, you got to measure what you want to improve. And what is it that makes it so hard, right, for health systems to get this information? Why can't they do it themselves?
Steve Low:
Yeah, that question, and I sometimes wish I, I shouldn't say I wish, you can always make the time for the things you want to study. But you, like behavioral psychology, there's so much, so many interesting things, with why is it hard for people to both hear and communicate when they are dealing directly with each other? And I think there's something there that has been part of why KLAS has been successful because being a trusted third party can make all the difference in the world. And we find this where we'll have a vendor who worked with us who says we already survey. Most of them do. They do Net Promoter Score, they do surveys, they reach out, and they're doing their best at that. There are messages that their customers will tell us in ways that they won't tell them, and the same is true with hospitals in their users. They can ask the questions, but when somebody knows that they have a third-party, unbiased advocate who's not only going to hear and correctly and they have to trust us to interpret and protect their feedback. And by the way, we always collect feedback anonymously, and that goes a long way. When they know, okay, I'm dealing with KLAS, my feedback is anonymous, I'm going to be as open and honest as I can be. And then the vendors, we build trust with them because they know that we're going to fact-check, we're going to get a large enough sample size that maybe there might be one angry customer, but there's nine really happy ones, right? And we're going to make sure to understand the nuance and to talk to enough people to get a true sense of how they're performing. So I think being that independent third party and then building trust over years has enabled us to build that relationship where people will feel comfortable saying to us what they sometimes won't feel comfortable saying to their partner.
Saul Marquez:
I love that. That's really great. Thanks for mentioning that, Steve. When I chat with my wife about something, and I tell her about it and ask her to do something, and then my brother or something will say it, and then she'll say, yeah, that makes sense. Okay, yeah, I guess I needed a third party to say that.
Steve Low:
Saul, I've been married 20 years, and I can relate to that experience you just shared. I think I remember telling my wife about Chia seeds a decade ago, and she said, that's weird, what are you eating? And then her sister tells her about Chia seeds, and she's, amazing, have you heard of Chia seeds?
Saul Marquez:
That is hilarious. I love it, man. And it's true in our day-to-day, and it's so true in large organizations. So I appreciate you sharing that, Steve. It's those little nuances, the behavioral psychology, like you mentioned, that whether it's in research and surveys or incentives that we're wanting to get behavior change from, that third party is key, so I really appreciate you highlighting that. As you think about some of the work that you've done, what's one of the biggest setbacks you've experienced that has taught you most about yourself and the company?
Steve Low:
I alluded to this earlier, but I really think the challenges of scaling, and I mentioned that really there's, our, the quality of our research is built and depends on trusting relationships, and the ability to scale research that's based on relationships, that's built on interpersonal understanding, has presented challenges for us over the years where there are tools that come along have come along through the course of our company for automated email sends and dialing systems that allow us to reach more providers. But I would say, learning how to use those tools in the right way so that you can't replace quality with quantity. And we're in a position where we need both because we want to have, we're ambitious about the impact we want to have in healthcare. So we need to talk to more people, but we can never, and we talk about the setbacks. So what I'm specifically thinking of is we implemented a few years back like a dialing system to try to get in touch with more providers, and what we found is it was getting us lots of appointments, but the, we found an instance where it was calling the same organization too many times. And these are our friends, right? This hospital says to us, …, why are you calling me 30 times in an hour? What's going on? And we had to look at the way we were using this tool and say, okay, we've miscalibrated this, and we need to take a step back and say, this is about relationships, this is about helping them, not jamming their calling circuits with too many inbounds. So that was a learning for us where we said, okay, we've got to learn how to use these tools the right way so that we're always doing it to the benefit of the provider, and it's been a fun challenge. It continues to be a challenge, I like to say here, and I, this isn't my original, I heard this from Satya Nadella at Microsoft. We're not a know-it-all organization, we're a learn-it-all organization, right? We're still figuring this out, and we still believe, and this is our rallying cry for this year is, how can we serve the provider like never before? So treat them better, give them better information, make it easier for them to engage with us. That's what rallies with, that's what we're rallying around. And yeah, I think part of that is based on some of the challenges that we've experienced over the years and learning how to scale.
Saul Marquez:
That's great, Steve. Yeah, it's, at the end of the day, it's all about relationships. Whether you're doing research, you're marketing, the end goal is those relationships to get to the end goal that you're up to. So we need people, and it's great to hear that KLAS is focused on people and, in particular, the physicians that you guys want to benefit, the providers, and physicians that you guys want to benefit. What are you most excited about today?
Steve Low:
Through the arc of KLAS, we've gone from publishing reports and saying to the world, hey, here's the truth, good luck, to we, then we started engaging more and saying, okay, we want to publish reports, and we want to help you understand what we're seeing. So KLAS started doing things like consulting engagements and what we call deep dives, where we will take four hours with a vendor and really dig into the analysis of what we're seeing in our data. And it's been this evolution of our company where we've gone from, okay, we want to tell the truth, now we want to help you understand it. The next step for us all is we want to help organizations actually change based on what they hear and learn from us. And this is something that people have been asking us to do. We have great relationships with vendors and providers like who say, okay, great, we get it, we know, we understand the takeaway and what needs to change. Can you help us do it? And we've looked ourselves in the mirror and said, okay, we think we can. We want to help organizations actually make cultural changes, make customer service changes, make organizational structure changes that enable them to actually improve the scores and the research that we're measuring, and that's the exciting next chapter for KLAS Research. We've already started doing this in a few ways where we will actually be brought in when a hospital is implementing a new ERP, and they say we need that third-party independent view to make sure that this high stakes, high-cost implementation is on track and that the stakeholders are actually communicating and seeing the same picture of what's going on, and then we get involved and actually help them make the changes to drive a better outcome. So it's exciting for us. I mentioned to you at the outset, I started my career in healthcare. I was a consultant with Deloitte and Touche, and I remember, just I loved those years of consulting, but there were times where I felt like I was finding trouble and not solve it. And you'd go on to a client site, I remember working at some hospitals in Southern California, you would find challenges and present them and then say, okay, good luck to you. And it's exciting for us KLAS now to be in a position to say, okay, no, we want to be part of the solution as well now. And we think that the relationships and the trust we've built up are going to open those doors where vendors or providers and payers alike say, yeah, come on in KLAS, we want you to be part of that driving the change we need to see here based on what you've opened our eyes to.
Saul Marquez:
Love it. Yeah, thanks for helping us understand that. And for me, I never knew that about you guys. I knew the research and the work you guys did, but I never really knew that you guys went into, all right, let us help you understand the problems and opportunities, and oh, by the way, you want to partner to catalyze? We can help you with that, too. So I love that you guys are taking it all the way through the last mile and helping people make change happen. Super exciting for you and the business, and excited for anybody listening that's looking for these types of resources to take advantage. Because at the end of the day, folks, we always say it on the podcast, take action if something today resonated with you, don't just listen. We're going to leave everything in the show notes, all the links to things that we've talked about and best ways to get in touch with Steve, so definitely make sure you take advantage of that. Steve, before we conclude, I'd love if you could just share one last closing thought and then the place where the listeners could get in touch with you and the team at KLAS to talk more and collaborate.
Steve Low:
Yeah, I'll start with the second question. I would say, and this is going to make me sound old-fashioned, but if you were to try to reach me on social media, there's like a 20% chance that I'm going to get back to you within a period of time that's reasonable.
Saul Marquez:
Nice.
Steve Low:
And that's, I'm embarrassed to admit that. So you know what? I'm bold enough to say, all your listeners, Steven.Low@KLASResearch.com, send me an email. I'd love to help start a discussion. Let me know whether you're a provider, payer, vendor, any stakeholder that's trying to get improved technology outcomes in healthcare and you think KLAS can help, reach out, I'd love to hear from you. And that's, I know that'll be in the show notes, but it's Steven with a V, Low is L O W, and I'd love, I always love hearing from new people and especially creative ideas on how we can have a bigger impact. As far as a final thought, I think the call to action that I keep saying, and it's about kind of good-faith engagement. I think that there are areas in healthcare where it's easy to become jaded. It's easy to be skeptical of other people's motives. I think we see this a lot in the payer-provider space where there's a lack of trust, there's a lack of engagement, and a willingness to tackle problems in good faith together, and we are working to build positive momentum in the other direction. KLAS is all about, can we get people communicating and seeing truth on a standard, in a plane that we all can agree is based in fact? And that's where tremendous change can be unlocked. Whatever your role is in healthcare, if you're interested in clarity, truth-based dialogue, we want to engage with you, and that's the type of conversation we're trying to drive.
Saul Marquez:
That's fantastic, Steve. I want to thank you for your time today, and for all you leaders listening to this podcast, we know that truth is what matters, and sometimes it's hard to get to. And so, partnering with folks like KLAS Steve and his team, probably a great way to do that. Steve, can't thank you enough for sharing the work that you guys do, your North Star, and we're excited to stay in touch with you.
Steve Low:
Absolutely. Saul, I'm grateful for the opportunity to be on your show. Thank you.
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