Mitigating the Risk of Using Patient Data in the Cloud
Episode 432

Dave Levin, Chief Medical Officer at Datica

Mitigating the Risk of Using Patient Data in the Cloud

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Mitigating the Risk of Using Patient Data in the Cloud

Episode 432

Recommended Books:

Orbiting the Giant Hairball

Venture Deals: Be Smarter Than Your Lawyer and Venture Capitalist

A Confederacy of Dunces

Best Way to Contact Dave:

DaveLevinMD@gmail.com

Linkedin

Company website:

Datica

 

Mitigating the Risk of Using Patient Data in the Cloud with Dave Levin, Chief Medical Officer at Datica transcript powered by Sonix—the best audio to text transcription service

Mitigating the Risk of Using Patient Data in the Cloud with Dave Levin, Chief Medical Officer at Datica was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

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

Saul Marquez:
Welcome back to the podcast. Today, I have the privilege of hosting Dr. Dave Levin. He's a Chief Medical Officer at Sansoro Health. He's a physician executive with over twenty five years of experience in health care, information systems, clinical operations and enterprise strategic planning. Prior to co-founding Sansoro, he served as chief medical information officer for the Cleveland Clinic health system, where he led the Clinical Systems Office. Dr. Levin has founded several health care I.T. startups and served as an advisor to many more. He's a nationally recognized speaker and has appeared in academic industry and consumer media. He currently serves on multiple industry and private equity advisory boards and nonprofit governance boards. He received his medical degree and bachelors from Brown University. And with that has created an enormous amount of value in health care through the many companies he's created and roles that he's served in. And so without further ado, I just want to welcome you to the podcast, Dave. Thanks for joining.

Dave Levin:
Well, thank you. That was incredibly generous introduction there, maybe a little bit over the top.

Saul Marquez:
So, Dave, what got you into health care?

Dave Levin:
Well, you know, your introduction was really kind, to be honest. I think of myself as an often say, I am the Forest Gump of health care. I feel like a lot of my career has simply been wandering around and into the frame where other really cool, smart people were doing things. And I was fortunate enough to be there when it happened. And my entry into my medical career kind of reflects that Saul. As a very young man. I had a first career in I.T., really came of age in the dawn of the personal computer era and believe from from early on that there was going to be a great opportunity to combine the power of computers and information technology with health care. It's taken a long time for us to get from that young man's little vision to a place where we're actually doing it. The Forest Gump part of the story is I was applying to college and there literally was a checkbox on the application check here if you want to go to medical school. And as I said, I thought at the time, yeah, that maybe someday I'll combine these things. And what's the harm of checking the box? That's literally how I launched my medical career and ended up in my school. Fortunately, Brown was a place that was a good fit for me in that regard.

Saul Marquez:
Oh, my gosh. What it. What a story. Dave and hey, you know, Forest Gump is one of my favorite all time favorite movies, right? I love it. And I just kind of envision you there with your application. Medical school, OK, exit you're in. And now here you are. All things work for him somehow and they've worked for you. So as you've taken a tour of health care through your various roles and companies, what do you think today is a hot topic that needs to be on health leaders agenda. And how are you and Sansoro approaching it?

Dave Levin:
Well, there's many of them. I've got a focus on health care information technology today. And what's going on is we're in the midst of the next great transition in health I.T.. You know, I always say health I.T. 1.0 got us to put down our pens and start using keyboards was the basic digitalization of health care. We definitely needed to do that, particularly on the clinical side. And it sounds kind of silly when you say it that way, but it actually was a giant step forward. Its position does for what I think of as health IT 2.0 which is going to look more like the experience we have pretty much in the rest of our lives. So it's it's going to be more about mobile, more about cutting edge technologies, about the ability to really leverage data in new ways and to connect and collaborate in ways that we haven't before. And most of us know this. I mean, if you compare your experience of the typical health care encounter with what you experience when you go shopping or do banking or whatever. It's as I like to say, every day I work in health care. Then I go home and live in the 21st century. So there's a real opportunity. Yeah, I think it's true. And at the core of this and where my company is focused, it's on the infrastructure for creating this new ecosystem, this app economy, if you will. And a lot of that is about interoperability. And increasingly, it's about moving to the cloud. So our focus has been on really powerful cutting edge solutions that let applications connect, exchange data and collaborate just like they do outside of health care. This is all based on API technology. And that's really what we've been focused on for the last five years, is bringing this very powerful, proven approach for creating that kind of capability to health care. And we don't do specific applications. What we're focused on is enabling others to take their great ideas and implement them in new and more powerful ways. And we can go deeper on that if you'd like.

Saul Marquez:
Now, I'd it's absolutely would like to. And maybe we could touch on that here as an opportunity for you to talk to us about an example of how Sansoro, you and the team over there have created results by doing things differently.

Dave Levin:
Sure. Well, I think our key insight was over five years ago when we looked at how application programming interfaces or APIs have changed the rest of the digital economy. This is how companies like Facebook and Google and Amazon have really thrived and it's also how they collaborate. So that's how Amazon and UPS collaborate. So to deliver a package to your front door and allow you to track it the whole way. So at its core, this is a technology, as I said, that lets applications connect, exchange data and collaborate. And we saw that power and we recognized this as a as a major gap in health care. And so our focus has been on building a really powerful API for data exchange and health care and. OK, well, that's so. So what what does that really mean? Why is it different? And it really radically alters the way you develop the POI and scale applications. It delivers a much more robust data, does it in real time. And these are all attributes that allow you to build much more powerful and much more user friendly applications. I like to say we were doing this before people in health care could spell API. And in five years we've gone from this kind of being the newest thing to we're about to see the federal government mandated as part of the new Office of National Coordinator rules.

Saul Marquez:
Well, Dave, there's there's no doubt you guys are ahead of the game on this one. And I do want to take a moment to recognize your work, folks. Dave also is the host of a podcast. It's called 4×4 Health. If you go to Samsara Health dot com, you'll see a little tab there on the top 4×4 Health podcast. It is an incredible resource for anybody looking to get educated on on health tech APIs I mean, he's got some great episodes on API, one to one where he had John Roscoe, the CTO there at Sansoro. Incredible work Dave and I mean incredible content that you're putting out here.

Dave Levin:
Well, I really appreciate you highlighting that. And we do see ourselves as evangelists for this technology. I mean, obviously, we're trying to build a successful company, too, but we're very mission driven. We have something on our Web site called the API Learning Center. And I really recommend it to anyone at any level. We've actually structured it for someone who's brand new to this, but we've also provide resources for very advanced users as well. It's a great starting point. We've brought together not just what Sensorial thinks about this, but contributors from health level seven. We've actually got content and interviews from government officials about some of the new regs and how this all plays out. So I very much appreciate you highlighting that. I also just want to take a moment to talk about, well, so what why does any of this matter? And I'll give you a really concrete example. We partner with a company that does real time clinical surveillance and decision support. Essentially, their software sits in the background in a hospital setting and is looking for clues about patients that are either getting into trouble or have had an important change in condition or lab result or something like that. And in real time, looks for this and can alert the appropriate clinician and also provide guidance about what to do. A classic application of this is to the problem of sepsis, a widespread infection. This is there's a major effort underway in nine states to improve our recognition and treatment. And this tool basically can sit in the background and look for signs of impending sepsis and draw the clinicians attention to it. So obviously really powerful. It starts to bring together the elements of clinical decision support and even to some degree, augmented intelligence. The challenge is you've got it takes a lot of data. You need this data in real time. You don't want to find out three days from now that the patient's developing substance, Ryan, and you need to be able to inject yourself back into the clinical workflow so the clinicians can get to this easily. From a business perspective, this means you are going to integrate to the electronic health record and perhaps other systems. And so you also need a way to deploy rapidly and scale to enterprise that's still going to deliver the data you need legacy technologies just don't do that. And this is really where the API shine. So this partner firm of ours has gone from a model that required hundreds of hours of interface build and really only worked with one or two of the EHRs to a model that allows them to deploy and ours can scale essentially infinitely. And because our API is designed to be universal, it also has allowed them to now enter markets and service other EHRs that they couldn't access before.

Saul Marquez:
Well, that's certainly powerful, right? And with the growing number of devices that, you know, patient monitoring devices and monitors and information flowing out of the patient's room, how do you connect to it all? And so API is make it easier.

Dave Levin:
Oh, absolutely. And and likewise, you know, as we've seen over the last few years, there are these emerging niches, if you will, population health applications, unified communications. We're starting to see some really practical applications of robotic process automation and artificial intelligence. What all of these applications have in common is they need rich clinical data. They work better real time and from a go to market company perspective. They need a solution that they can deploy and scale rapidly.

Saul Marquez:
Love that. And so is how does that cloud fit into all of this? Right. I mean, and what are you guys doing to leverage the cloud or help your clients leverage the cloud?

Dave Levin:
Well, so that's a really perceptive question. And the whole world has basically moved to the cloud and it's often the case. Healthcare is just lagging a few years. We're starting to see this as well. And what my engineering and product colleagues have taught me is you just can't do these modern applications and provide the kind of data and the user experience that people expect unless it's based in the cloud. So I kind of look at it as sort of simple. You need a secure place to put your applications and your data and you need a really rough. Best way to pipe data in and out. And so it's very what we do is very complementary and our solution can be cloud hosted and in a number of our customers, take that approach.

Saul Marquez:
Got it. So some if current infrastructure is using the cloud, give it a go. If it's not, give it a go. You guys could apply to both scenarios.

Dave Levin:
That's exactly right. And again, we've we've tried to build flexibility into our approach because we recognize people are different places on that journey and they have different needs and and different thresholds around security and privacy. But the bottom line is health care is moving to the cloud. It's gonna happen. And and fortunately, there are some really terrific solutions out there to help people do that in an effective and secure way.

Saul Marquez:
Fascinating. So not everything works. And so I like to hear from you, Dave, something that didn't work and and how you've learned from it and how it's made you and team at Sansoro better.

Dave Levin:
Well, I love this question. We could devote a whole podcast or probably several episodes to all of my failures and mistakes just in general. Saw what I've come to appreciate as mistakes and failures are a good thing. You know, hopefully there's a little thought into what you're doing. Yeah. But there really are opportunities to learn. And so I've I've certainly embraced failure and I think our corporate culture does. We basically see everything as an iteration. It kind of flows naturally from our our sprinting scrum approach to software development. You try, you learn, you iterate. So failure is not a bad thing. It's a good thing eventually going to probably surprise you. I'm a talk about one of the biggest failures in my career that was also the most helpful was when I had a 360 leadership evaluation done and when the results came back, much to my surprise and it was a very humbling experience. Dave thought he was doing an amazing job of being a coach to his various teams when their perception was that I was actually pace setting, which is a very different thing. And it was a real important moment in my professional development, both because it it allowed me to see that what I aspired to do was not what I was actually doing. And the process that I went through, the executive coaching and other things that I went through in order to kinda understand that and learn and practice other leadership styles has been a lifelong journey since then. I feel like it's it has been one of the most important failures, if you will, in my. Among a in a career that's filled with all kinds of interesting.

Saul Marquez:
I love it. And, you know, I think it's a great thing to call out, you know, if you stop trying to improve yourself, if you live in a vacuum, you're really just not helping yourself or your team. And I think it's great that you did this 360 evaluation and uncovered what you uncovered. And how has it made a difference?

Dave Levin:
Well, I'm a huge believer in this idea that great leaders have mastered a range of leadership styles and that the real art of leadership is knowing which style to use in which situation. And so that's been the benefit to me. And hopefully the puplick best fit from that as well. I'm sure if we polled them, we'd get a mixed response because this is this is… But I think it's the right aspiration to put a really fine point on this sort. Look, when the house is on fire, we're not going to hold a debate and a roundtable about what to do. I'm taking charge and I will tell you to grab the hose and you're gonna grab the ladder and let's go. But the house is usually not on fire. And there are other leadership styles, coaching, pace setting and the like that it's important for us to master. And I want to be really clear. This applies to every person in an organization. It applies to being part of a family or any other community. This is not just about the C-suite. It's about all of us.

Saul Marquez:
It's a great call out. And I think it's a great thing to highlight here for other leaders listening, striving to be better and to serve their customers and people better. I'm glad you went there, Dave.

Dave Levin:
Thanks.

Saul Marquez:
So what's one of your proudest leadership experiences that you've had a year in your career?

Dave Levin:
Well, I believe in the rule of three. Somebody give you three really quickly.

Saul Marquez:
Let's hear them.

Dave Levin:
So the first was when Sentara Healthcare won the Davie's award after deploying their electronic health record. It was just was kind of the cherry on top. And so it's recognition from the industry and your peers that your organization has done a really exceptional job.

Saul Marquez:
Congrats on that.

Dave Levin:
And health care I.T.. Yeah. And again, that was very much a group effort on the clinical side of the world. I was part of a team that launched an enterprise wide palliative care program several years ago. That group got on to win a national award of recognition for that program as well. Very terms of clinical work. Was was a very proud moment for me.

Saul Marquez:
And Dave, was it was the program tech enabled there?

Dave Levin:
No, no. I mean, remember, I'm a bit of a unicorn. So I've I've had it actual clinical practice that I led operations in a large health system. So this was really from this was not a technical in any way I can recall.

Saul Marquez:
But nevertheless, you scaled it across the enterprise and it's it's worked well.

Dave Levin:
Yeah. It was really one of the first sort of continuum wide. It was not just an inpatient program, but looked at at ambulatory work as well. And in our community, it was it was really a first of its kind. My absolute proudest moment and this will make may sound kind of odd to you, but but I think it represents in my mind a moment of real authenticity and courage, if I may be so bold to say it. So we were launching a patient safety initiative across our health system. This was when this was really kind of new and groundbreaking in health care. And I was part of a team that was launching this at a particular hospital. And we had our first all staff meeting to talk about this topic and why it was important and to make it real. And because my mentors had told me this would be effective to kick the meeting off. I stood up in front of most of our medical staff and our employed staff and told a story about where I had committed medical error. And fortunately, the harm that was caused was short term. And it was not. It turned out in the long run not to be serious, but I basically had to stand up in front of all these people and say I'm Dave Levin made this mistake as a physician. Let me tell you what happened, that how I almost hurt this patient. I'm not proud of the episode with the patient, but I am proud that I was in a place and with a group that allowed me to stand up that way. And I can tell you there was not a dry eye in the room when I was done and we had people's attention. And it allowed us to, I think, began a much more authentic and honest conversation about medical errors.

Saul Marquez:
Yeah. And what would you say to leaders listening on that note? What's the lesson out of that experience?

Dave Levin:
Well, I think there's just a general lesson about authentic leadership. And this is, you know, you're going to get me started on this will do a whole another podcast.

Saul Marquez:
That's why you have your own podcast.

Dave Levin:
And when you talk about some of these issues, I've just become a big. Lever in that and that this, you know, we've got this sort of false notion in this country, I think, about what leadership actually is, and, you know, we can I think too often we romanticize it. As you know, it's the the white knight on the horse and the leader has all the answers. And we just need to follow that leader. I don't think any of that's true. And I think, you know, great leadership starts with being authentic, and that means being vulnerable in front of the people you lead. And it's been remarkable to me the impact that that can have. It just totally changes the dynamic of a.

Saul Marquez:
Strong message.

Dave Levin:
Yeah.

Saul Marquez:
Very strong message. So what would you say is the most exciting project you're working on today?

Dave Levin:
Yeah, it's a little techie and we touched on it a little bit. But, you know, we've spent five years building what I would argue is one of the most powerful custom API is in health care. There's an exciting development around this, which is the emergence of a standard API. It's a more limited functionality because it's being built as a consensus standard, but it's started to become really substantial. And so we have now sort of added this to our strategy and we'll be offering what we think is a really powerful combination of this standard API to be used where that will will work. And there are obvious advantages of standards coupled with this extremely powerful custom API to fill the gaps and allow you to do things that may be more out on the cutting edge. So I think this both/and strategy that the standard is referred to as fire. So I think of this as sort of fire plus, if you will. The other thing that we touched on earlier is just the role of health care cloud, if you will. And we're taking a really hard look at that and looking at some ways that that we can enable that for other companies as well.

Saul Marquez:
Love that. It's an incredible task to take on and highly impactful. So I applaud you and your team for tackling that. So it's happening, folks. You know, cloud is coming. APIs are modernizing the way we're doing things. Don't wait. This is a call to action. Do not wait. So let's pretend you and I are building a leadership course in health care. And with that, I've got a lightning round for you, Dave, followed by a book that you recommend to listeners. You ready?

Dave Levin:
Yep.

Saul Marquez:
All right. What's the best way to improve health care outcomes?

Dave Levin:
So the title of our course would be the ABCs of how to measure advantage culture. And the reason I choose that is it's high leverage. It's underappreciated and underutilized. Where it's done, it's shown really hard outcomes bring real returns in terms of dollars and other things and it can be done. But most of us are a bunch of amateurs. You know, we sit around and talk about it, but we don't know how to really professionally measure and manage it. The good news is those tools and techniques are out there if we're willing to embrace them. And I see this as fundamental. I'm kind of extreme about this to be on honest, Saul. I think culture and the work culture is the work and everything else is kind of a byproduct of that with the culture Right. and amazing things will happen as a result.

Saul Marquez:
Powerful. And what would you say the biggest mistake or pitfall to avoid is?

Dave Levin:
I think the biggest mistake people make is they think they know what they're doing. They talk about it and raise people's expectations and then they do a bad job and people go, great. Just another waste of time and other flavor of the month.

Saul Marquez:
And as true as things change and, you know, we work through the change, how do you stay relevant?

Dave Levin:
Yeah, well, what we've done is I think our insight was that this was really important and a powerful way to build a great company and that we had no clue how to do it. So it and we get we engaged professionals that, as I said, have proven tools and techniques on a track record of actually moving the needle, showing improvements in in performance as a result of these activities. And so we were really we really rely heavily on them. It's clearly a multi-year journey. And we've tried to map some of that out and we keep going back to that and working our way through it. But to be extremely concrete, we have what we believe are well established and proven ways to actually measure and manage and improve culture.

Saul Marquez:
That's super interesting. And what's one area of focus that drives everything at Sansoro?

Dave Levin:
Well, I think our focus is that we believe that we're providing a critical enabler to help drive health care forward. And, you know, I like to say we don't do the thing. We make it easier for others to do the thing. So that I get. Everybody's got an app now. Everybody's got amazing ideas. Some will be good, some some wall. What we're trying to do is provide the infrastructure that knocks down those barriers to innovation and allows these other companies to really flourish.

Saul Marquez:
I love that. And so these next two days are more on a personal note for the listeners to get to know you. What's your number one health habit?

Dave Levin:
Oh, that's a really good one. Well, I'm fortunate to loved being a gardener, so I spend a whole lot of time out in my garden. To me, this is this is the way you you kind of integrate things in your life. So about in the garden that I'm getting physical exercise and there's clearly a mental Zen. Yes. Yeah. Well, all of this clears my head. I've had some some pretty good ideas while doing that. And I'm a vegetable gardener. So at the end of the day, we eat more healthy and we eat fresher stuff because we just walk out back and pick it out.

Saul Marquez:
That's so great, Dave. And what's your favorite thing to grow?

Dave Levin:
Oh, well, in season, you can't be at a tomato. Right off the bat.

Saul Marquez:
Yeah. That's awesome. That is awesome. Yeah. You know, the other thing, too, is like you spend time in the garden. We like to go for walks and make the forest preserve, you know, and and just it just integrates you with nature. Right. I mean, it just it's something to be in the computer and everything that we do day to day. But to be in touch with nature, just there's something to that.

Dave Levin:
Oh, I think that's exactly right. We underestimate how much external conditions influence our internal operations and feelings and the like. And if you don't believe it and you're having a crappy day, get up and go take a nice walk outside and see if you don't feel better.

Saul Marquez:
That's great advice. And Dave, the second one that that I will touch on is what is your number one success habit?

Saul Marquez:
Well, my number one success habit is that I focus on what I'm good at and I make sure that I'm surrounded by people that are good at the things that I'm not good at. But our guests success is one of my colleagues used to say staff to your weak side. And then he would wink and say, that's 360 degrees for me.

Saul Marquez:
I love it. I love it. David, book, would you recommend?

Dave Levin:
All right. So, again, rule of threes. So.

Saul Marquez:
Let's hear them

Dave Levin:
what I got to give you three. Orbiting the giant hairball. Everybody who works in a large organization must read this book, Orbiting the Giant Hairball. For Entrepreneurs, my favorite read is Be Smarter Than Your Lawyer or venture capitalist. And for life in general, I highly recommend Confederacy of Dunces.

Saul Marquez:
Some great recommendations on all the fronts of life that you care about and that our listeners care about some great alignment there. So, folks, if you want links to the books and also the full transcript of our discussion with Dr. Dave Levin, go to outcomesrocket.health and in the search bar type in s a n s o r o. You'll see all of the show notes there. So, Dave, I love if you could just leave us with that closing thought. And then the best place for the listeners could continue the conversation with you.

Dave Levin:
My closing thought is that nature gave us one mouth and two years. And one of the things that I've personally been working really hard on is being a better listener, less multi-tasking, more focused man. It is a struggle for me, but it pays remarkable dividends in both your personal and your private life. Pay it forward is my other you know, as I started by, say, I'm the Forest Gump of health care. And people have been incredibly kind to me and helpful. I go out of my way to try to do the same for others. I welcome the opportunity to do that. And I encourage others to do the same. Feel free to reach out to me. DaveLevinMD@gmail.com. Or on Twitter at @DaveLevineMD.. I'm also on LinkedIn.

Saul Marquez:
Outstanding, Dave. Well, listen, an incredible conversation, folks. Again, I just want to remind you that if you if you want to learn more about APIs and and the work that Sansoro is doing, just go to SAN a health dot com and check out the four by four health podcast. I mean, this is like an incredible resource. So we'll leave a link for you in that in the show notes as well. But Dave just wanted to say thank you again for your time and for the work that you guys are doing.

Dave Levin:
Saul, thanks for the opportunity and for the work you're doing to bring these important messages to our community.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resourses, inspiration and so much more.

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