How One Tech Company is Reimagining the Future of Healthcare

In a world where people can do things like photograph a document with their smartphones, email it to their printers, and have a copy waiting for them when they walk in the door, most hospital staff are still using notepads and pagers to communicate patient data to each other. Why is this sector still so far behind?

On this episode of Industry Focus: Healthcare, Kristine Harjes interviews Ross Mason of MuleSoft -- a software company that helps businesses update their processes -- about how MuleSoft is enabling doctors to use healthcare data in more meaningful and productive ways.

A full transcript follows the video.

This podcast was recorded on March 14, 2016. 

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 (CRM 0.42%) 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 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 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 there 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 need. 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 five to 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.