In our latest interview in the series, we spoke with Drew Ivan, Chief Product and Strategy Officer from Lyniate. The company recently formed from bringing together two widely used global interoperability platforms: Corepoint and Rhapsody.
We asked Drew a few questions about the company, how it has responded over the past few weeks to the Covid-19 pandemic and to hear about some of their customer projects and learnings.
Could you tell me a bit about Lyniate and how your organisation responded to the Covid-19 pandemic?
Lyniate is a software product company, so we are not moving physical goods from point to point. We don’t have anything to deliver to a customer in a physical space, and we don’t really require a lot of consultants on site to deliver out product. So from that perspective, it has very much been business as usual.
Our customers are still buying and upgrading our products and working with them the same way they always have. We’ve had to make some adjustments, obviously. One of the big ones has been the idea of working from home. Many of our developers are office based, and although it was on our radar to increase our ability and capacity for working remotely and virtually from any location, we’ve obviously had to accelerate those plans pretty rapidly once the lockdown orders went into effect.
Another way we adapted was to have an executive situation room, which is obviously not a physical room but rather a virtual meeting every morning. The senior leadership team get together and review any news and information that came out. We have a briefing segment where we map those news items to how it impacts our business, and we keep track of certain metrics on dashboards to run the business on a real-time basis. We have that conversation every morning, which is a new thing that we’ve started in response to Covid.
I think we will continue to use these methods when the Covid situation has subsided, because although the agenda was originally intended to be specifically focused on Covid response, what we found was that there are a lot of things that come up that were useful to discuss on those daily meetings. We have trimmed it back a bit from 5 days per week to 2 or 3 days, but I do think we will continue this going forward. The regular cadence of a morning meeting has turned out to be very useful even beyond a Covid response.
The theme that I am perceiving is that crises like this will either accelerate trends that were already in process or put a stop to trends that were already in process. We are not going to invent anything new. That takes too long. Maybe in 3 or 4 years there will be a new trend resulting from the pandemic, but in the next 12 to 24 months what we will see is an acceleration of trends like Telehealth, value-based reimbursement for healthcare, virtual visits — these things were already happening but they are going to develop at an accelerated rate as a result of Coronavirus.
If you think about some of the other trends that were happening in healthcare, such as a shift towards outpatient procedures and elective procedures, those have been stopped in their tracks by Coronavirus. They’re likely to resume at some point, but I think there are the only two possibilities: either accelerate or stop.
The third path of ‘let’s invent a new big programme in response to Coronavirus’ is just not practical on a near term timeline; that’s the theme I’m watching for is the trends that were in process 3 or 6 months ago, which ones are beginning and which ones are stopping.
Could you tell me about one of your customer projects that you’ve been engaged with over the past 12 months?
A lot of our customers are implementing technology as a way to integrate their internal systems with one another. For example, a lot of our customers are hospitals or health systems. They’ll integrate the Rhapsody or Corepoint integration engine in order to tie together their internal systems: their EMR, their billing systems, their laboratory systems.
What we’ve found more recently is that there is a move to expose that data outside their organisation’s boundaries— so sharing data either with other providers, payers, public health, with the patients themselves. We are starting to see a shift away from integration within the organisation to a more broadly defined version of integration that includes those external entities, and the Covid pandemic has really actually accelerated some of this.
One of the things we found was that there’s not a good way for hospitals to communicate with one another or with public health agencies about the inventories they have of ventilators, PPE or the number of beds they have on any given day. These are all concepts that hospitals keep track of themselves, but in a pandemic situation, you may need to shift some of that inventory around or direct patients to places where there’s more capacity. There hasn’t been the capability to do that because there hasn’t been a way to communicate that data between hospitals.
There have been a number of approaches to help solve this problem, and what we’ve been working on involves developing a new standard based on the FHIR standard from the HL7 organisation, to be able to capture that data and communicate it with other entities. That’s a project we have in-flight right now which came on the radar in response to Covid, and was something we weren’t working on beforehand.
What’s next for you?
At Lyniate we have just finalised our 12 month strategic plan at the beginning of March, right before the Covid problem really became significant in the US. We had just finalised this plan but we had to adjust it in response to Covid. The good news is a lot of what we were working on, although not directly aligned with the Covid response, but at least generally aligned with it, and so we had to do some reprioritisation.
One of the big areas this came through, and one of the other big stories in health care these days, are the new rules that just came out from CMS and the Office of the National Coordinator about interoperability and prevention of information blocking. This is really something that we might have expected to get de-prioritised as a result of Covid. The rules were just finalised March 9th — so around the time that conferences were getting cancelled —and what we found was that these rules are still going strong. They were officially entered into the federal register on May 1st, so they actually become enforceable rules.
The only twist in regard to Covid is that some of the implementation deadlines have been relaxed a bit; 3 to 6 months depending on the specific rule you’re talking about. So, the CMS and ONC rules that were sort of at the front of our work list anyway seem like they’re still very much in the spotlight. So that’s the main thing we are addressing at the moment for the U.S. market and our customers and that really hasn’t changed in response to Covid.
Some of the other things that we have later in the year are being accelerated by Covid, so I think they’re going to stay as they are in the plan. These are trends around things like cross-organisational interoperability of the ONC CMS rules, better movement of data between organisations as well as patients and members. So, that was our plan going into this year, and except for some reprioritisation at the margins, I think we are going to stick with that.
What are you most proud of over the last 12 months?
One thing we are proud about is to actually be in the healthcare sector; compared to other sectors like transportation or retail, the healthcare sector is somewhat protected from the impact of the lockdown orders from Covid and the economic impact.
Proceeding along a track that’s rather conservative but still with the growth plan we had in mind, part of that is the focus on our workforce. We had planned going into the year to expand strategically within our workforce in terms of hiring people into certain departments.
We’ve deferred a few of those until later in the year, but for the most part we are still maintaining our hiring schedule, and more important than that we are making sure we are taking care of the people that already work for us. This includes things like rapidly enabling a work-from-home environment. This involved quite a lot of effort to make sure the equipment and endpoint security was in place for people that work from home. There’s a lot of considerations around the benefits, flexible time off, scheduling. Our employees aren’t the only ones that work from home. It is their spouses, their school-age children, who are creating a new work environment that demands a bit of flexibility and we even did things like obtain disposable masks for our workforce. We are really proud of our focus on the people that we have in the team during this time of crisis.
What do you think will be the challenges transitioning from the lockdown situation back into normal working life?
There’s nothing like a pandemic to put strain on companies and people. It is something we haven’t dealt with in anyone’s memory that’s alive today, so it is a unique situation. In cases where there are unique situations like this, you get a lot of news articles and opinion pieces that speculate what the world, or market, or workplace will look like after the crisis has passed.
You see things like ‘this is the end of the physical office’ because everyone is getting used to working from home, developing better technology and techniques and really what do we need an office for in the first place. That’s a headline you can find pretty easily circulating these days. From my perspective, that might be true but we don’t know yet; it’s way too early to speculate on what the post-pandemic world will look like, so my best advice on that front would be to wait and see but also to think through it critically. I’m sure there will be organisations that move away from physical offices but not all will, and there are reasons for it that are more nuanced than ‘we’ve tried it and it worked out ok’.
There are reasons for both accelerating that trend and stopping that trend. I think you need to critically think about it and how it applies to your situation because it is not going to be the same for everybody. I’m reading what people are saying on what the market and industry will look like after coronavirus. But are they right when they say that? Or, what are the interesting ways they could be wrong?
What’s the best piece of career advice that you’ve ever received?
For me it has been to focus on doing the right thing rather than doing the high-visibility thing. In the end those are going to end up being the same. You can exchange some of one for some of the other in any point in time. You can work on the projects or work on them in a way that’s going to bring more attention to you, and that may have a short term benefit for your career or for your standing in a team, but actually that’s a really short term outlook.
The better way both in terms of long term success but also in terms of just being a good team mate, is to focus on the long term — not just work on the important projects that are most significant, but do it in a way that emphasises the relationship with your teammates and emphasises long term outlooks rather than short term gains. In the end, that’s what will be recognised.
What is your go to entertainment during lockdown?
The University of California and San Francisco (UCSF) has a program called ‘Grand Rounds,’ and they post it to YouTube on Thursday nights. It’s doctors and epidemiologists at UCSF talking about what they are working on, the research they are doing and the trends they are seeing around the pandemic.
I’ll watch that on Saturday morning rather than watching the news all week because watching the news leads to a lot of exaggerated feelings around everything that comes out. This is more a methodical approach to pandemic information. It’s higher quality, less of-the-moment and more thought out.