Kristine Harjes: Rethinking healthcare data, on this healthcare edition of Industry Focus.
Welcome to interview week on Industry Focus! I'm your host, Kristine Harjes, and today
we'll be hearing from Ross Mason, the founder and Vice President of Product Strategy at
MuleSoft, a software company with a heavy presence in the healthcare space. Welcome
to the show, Ross! Glad you could join me today.
Ross Mason: Hi, Kristine. Thanks for having me.
Harjes: So, can you start by giving our listeners a little bit of background on MuleSoft?
Mason: Absolutely. So, as you mentioned, I'm the founder of MuleSoft, so I've been here
since day one. We started in late 2006. What we do for our customers is help them connect
their applications, data, and devices, to enable transformation of their organization.
So, our focus is not just to connect these things, but actually to give our customers
leverage in the way they unlock the assets inside their organization.
Harjes: So, this has applications far beyond just healthcare?
Mason: Absolutely. Yeah. It's a pretty wide ecosystem, everything from legacy apps, SaaS
applications, all the way to the front engagement apps like mobile and web and also B2B channels.
Harjes: So, given that you're working in a variety of spaces, just how important is the
healthcare vertical to the business?
Mason: It's actually very important. It's one of our key verticals. It's a focus area
because it's probably one of the places where it has the most to gain, and the least amount
of progression compared to other industries.
Harjes: Why do you think that is, that there hasn't been as much progression in the world
of healthcare?
Mason: Well, if you talk to anyone who works in healthcare, it's immediately obvious to
them that there's so many conflicting rules and regulations, relationships between providers,
[…], hospitals, and also the government. Then, it just makes it much harder to move
in that realm very quickly. And, of course, you're dealing with sensitive information,
so there's always a bit of hesitancy in doing anything that might compromise the rules or
governance around data safety. Harjes: To what extent is security an issue,
then, given that this is such sensitive information and there's such a variety of rules blocking
the regulatory landscape?
Mason: I think it's hugely important, and obviously, there's lots of standards out there,
things like HIPAA and others. But, I also find that when you start talking around the
challenges, there's a bit of misconceptions, some misbeliefs around security and where
to apply it, where not to. There's a little bit of fear mongering, almost, that, every
time you get a data breach, people are very concerned that any further advancements will
increase the risk of data breaches. And, in reality, I don't think that's true.
Harjes: Okay. So, how is MuleSoft working to block these sorts of security breaches?
Mason: What we do with our customers today is, we help them unlock their valuable patient
and health record information and deliver new experiences, both to the patients themselves,
who are now more seen as customers, whereas before, a patient was probably third on the
agenda when it came to thinking about creating experiences digitally.
To give you some examples, UCSF, one of the major hospitals in San Francisco, a couple
of years ago, and actually more recently this year, created this application called CareWeb,
which is all about bringing the patient into the digital conversation around their care.
Which was a little unusual when they proposed it a couple of years ago, because, patients,
typically, the experience is, you turn up to a waiting room, you fill out a whole bunch
of forms, and if you've been there prior, you still fill out the same form, so that's
one problem. Then, you didn't really know what was going on. And what's happening in
the background, there's all sorts of exchange of information over pagers, which are the
old beeper systems, over written files and people taking notes on notepads. And CareWeb
was all about digitizing that conversation, enabling a faster response to care and diagnosis
for patients at UCFS.
Harjes: How recently was this that they made this transition to digital?
Mason: Well, I mean, I’m talking in the last two years.
Harjes: That's crazy, to think that--
Mason: And actually, to reality -- sorry, go ahead?
Harjes: It's so crazy that two years ago, they were still using pagers and pens and
papers for all of this information.
Mason: Well, most hospitals still do. There's really only two people in the world who still
use pagers, and it's basically doctors and drug dealers. And I think drug dealers have
switched to more modern means as well. So, (laughs) yeah, it's an old technology, but
it's adopted because it's reliable. And it's been around as a communication network for
about 15-20 years.
Harjes: So, with the UCFS Medical Center, how did MuleSoft's solution improve information
flow and patient outcomes as a result?
Mason: What we did there, we enabled them to create this digital conversation. So, the
EMR, electronic medical record system data, they wanted to tap that into other back-end
systems. And they use Salesforce Chatter. Salesforce is, obviously, the leading cloud
CRM. They have this notion of Chatter, which allows you to capture conversations around
customers, products, you name it. In this case, it was around patients. So, what we
did, we did all the switching to enable that conversation to be fed into Salesforce from
the EMR system from the radiology department and the test results coming in through the
lab results, and even the paging system they're using. So, that was a sort of legacy archaic
device. We can actually feed that into a trackable conversation as well.
And then, finally, what they could do is, they could allow the conversation around the
patient to be more visible to the patient. For example, if there are lab results coming
through, they can send a notification to the patient while they're in the waiting room
saying, "Hey, your lab results are ready, they're being reviewed right now by your doctor."
So, keeping the patient in the loop is critically important.
Harjes: And that's clearly a huge betterment of their actual experience, too. Speaking
of Salesforce, I saw that MuleSoft recently, at the HIMSS conference, which, for our listeners,
is the Healthcare Information and Management Systems Society conference earlier this month,
MuleSoft announced a new partnership with Salesforce. Can you talk a little bit more
about that?
Mason: Yeah. Salesforce has this strategy around their health cloud, and we're a key
partner to enable the connectivity of information to and from that cloud. Now, usually, when
you say health, data, and cloud together, people get nervous. The reason why we're the
premier partner there is because we can enable certain data to move to the cloud while other
data stays on premise. So, you meet the regulatory requirements. So, really, for health cloud
to work, I think having a partner on MuleSoft was kind of critical to the agenda so that
they could offer innovation in this direction without encroaching on the requirements around
data governance and security.
Harjes: Makes sense. One of the elements of the tech world that comes up on this show
quite a bit is wearables. I was wondering what your take is on this entire space, and
the whole wearable revolution?
Mason: There's a lot of speak about it, I guess because it's so visible. Somewhere near
to half of Americans now have quantified self devices, if you like. The challenge with wearables
is, the data doesn't go anywhere. You can capture information about your sleep, around
your vital signs, all sorts of things. But if you can't put that information back into
your medical record, and you can't give access to doctors or even third parties to crunch
that data against to your medical record, it sort of lives in another silo. And I think
the challenge that the wearable movement needs to overcome is how to make that data relevant
to your health and your care, particularly your preventive care, to spot things before
they happen. So, I think that's one aspect that hasn't really come to fruition yet. And
it's largely due to the fact that medical information is locked behind closed walls
and is very opaque to almost everyone.
Harjes: Is that a function of different companies being the makers of these electronic health
records? Or is it just a matter of nobody taking it by the reigns and hooking all these
data systems up yet?
Mason: I think there's plenty of people who would like to see things connected. Unfortunately,
I think the barrier to entry is partly due to the vendors who own the big EMR systems.
There are some efforts out there to try and open this up, but it's very slow-moving, and
I think it gets blocked fairly frequently, because the large vendors to have a fair bit
of control over the IT landscape inside these hospitals and in these providers.
Harjes: Is MuleSoft able to get in there and work with them? Or is it its own silo?
Mason: We tend to work with the direct customers, versus with the big vendors themselves, mostly
because they tend to want to control the whole ecosystem. But, doctors, hospitals, providers
are starting to push back and say, "No, actually, I need an ecosystem around this information.
It can't just all live in one place, I need to be able to connect into others things."
And I think the Salesforce cloud initiative is another nod in this direction, both hospitals
and doctors are looking for a more open way to share some of its information that's locked
in the hospital itself.
Harjes: That makes sense. So, tell me about an outcome that you're most proud of.
Mason: We're seeing some glimmers of hope. You mentioned wearables. One of the stories
I'm personally quite excited about is Livongo, which I think we spoke about a little while
ago. What they're enabling is patients to monitor their diabetes condition remotely
and send the data into the doctor for analysis and keeping track of what's going on. So,
what tends to happen with diabetes is that you monitor your own condition, and you go
into the hospital or doctor when you think things have changed or when the current medication
or regime isn't working for you. The problem with that is, people who get it and understand
it are pretty good at managing it. Many who have, certainly type 2 diabetes and didn't
grow up with, have a hard time managing that condition. And, obviously, the condition has
been growing as well. So, having this way of monitoring remotely
and actually having a connected device that allows the patient when they administer their
medication, when they do their tests at home, that getting stored in a central place for
analysis is pretty powerful. So, it's one step forward. I think what we'll see in healthcare
is lots of one step forwards, until there's a critical mass where the obvious benefits
of having this connected devices feed back into your medical record and your doctors
becomes really crucial.
Harjes: To play devil's advocate a little bit, does that not create an additional burden
of responsibility on doctors, if they can access real-time data? Maybe it's the middle
of the night and they're not sitting there staring at this information, so, they miss
maybe that you're having a problem that requires immediate attention. Do you think that's a
blocker here?
Mason: I don't think so, because I still think it's a massive improvement over what's happening
today. In that scenario -- and, I think that's the right devil to play here, because, I think
what happens when these ideas go into the public domain, there's always people on the
far end of the spectrum who will come up with what seem like a very valid reasons not to
progress. But in essence, what you're really saying is, that scenario can still occur whether
it's connected or not. But the other scenario is, there's far better monitoring on someone's
condition from day to day, and better historical analysis, and better research data on how
the disease is progressing in a given region, for a given population. So, I think it provides
way more benefits. And often the downsides are downsides whether it exists or not, so
they're not real downsides.
Harjes: Yeah. I can see it being an area where needs to be a little bit more legal clarity
before adoption spreads. But, you're right, it is about the baby steps and any improvement
is just that, an improvement. One other potential area that I could see being a bit of a stumbling
block -- is it economically viable, particularly for small providers, to incorporate all these
new technologies and try to get caught up to date?
Mason: Yeah. I think that's another big area where there does need to be better alignment
in the industry. You can't expect doctors to be running these types of applications.
They need to be supported by a group, whether within the government or externally, that
provides the facilities and capabilities. What's actually happening a lot is, doctors
go their own direction because they're not getting what they needs. So, some of this
reform has to happen through some of the central bodies that provide some of the guidance,
not just rules and regulations, but guidance on how doctors connect into their ecosystem.
So, I think there's a lot of maturity that could happen there. But interestingly, the
first movers are shining their lights to show that if you have a little bit more alignment
there, you would be provided with a little more support for these types of initiatives,
then people will gravitate to them.
Harjes: And it is, certainly, a long-term investment. Before we wrap the program up,
I would love to ask you to make a prediction for the world of healthcare in, say, 10 years.
Mason: Wow! Well, I can tell you what I'd like it to be. I won't even go that far. I've
got some pretty far-out views on where I'd love it to be. But, I think the key to where
healthcare goes next is not just having a single patient record, which is still an aspiration,
frankly, for a lot of organizations, even though there's been a lot of efforts in that
direction. But, actually having a more open health record, where myself as an individual
or my doctor or the hospital that I check into with a concussion can more readily access
the information around, not my immediate history, but what's happened even in the last 5-10
years. The way we see that happening, and what we're seeing from our customer base is,
rather than hoping for a single custodian of that data, which I think would be one direction,
is that they're starting to open up some of that information through APIs, application
program interfaces. They're basically a way of exchanging digital information between
two or more parties. And we're seeing more hospitals and more providers
look at this as a way to exchange information, at least in their own ecosystems. So, other
hospitals in the states, other providers in the states. And 10 years from now, it'd be
great to have that be the normal behavior across health providers. If you have that
alone, you can actually start to build a much more solid idea or view of a patient, and
become a lot better at analyzing past results, looking for predictive future issues. And
I think having that open patient record would actually really help drive the industry forward
in terms of innovations and also just understanding the way the population needs to have healthcare
delivered to them.
Harjes: Yeah. It's an optimistic vision, but it's a great one. We're lucky to have companies
like MuleSoft working on this, because it's truly an issue that matters to all of us.
Ross, thank you so much for joining me today.
Folks listening, just a heads up, I won't be here next week, but you can look forward
to hearing Michael Douglass and Todd Campbell reunite for an episode. And, if you're looking
for more Motley Fool podcast goodness, I'm going to be on a bonus edition of MarketFoolery
this Friday, which is another one of our podcasts. I'll be there along with the Fool's co-founder
David Gardner and a few other special guests. It's going to be a great episode, I highly
recommend you check it out. As always, people on the program may have
interests in the stocks they talk about, and The Motley Fool may have formal recommendations
for or against, so don't buy or sell stocks based solely on what you hear. That's going
to do it for today. Thanks again to Ross for being here, and I hope everyone listening
is enjoying interview week.