A Q&A with John Halamka, Executive Director of the Health Technology Exploration Center

 

John Halamka calls himself the Forrest Gump of healthcare IT.

“By utterly random chance, I’ve been at every major event that has shaped the industry since the 1960s,” he said.

It might be just a touch more deliberate than that. Halamka taught himself computer engineering as a kid, built an early version of a patient portal, and wrote the code for an EHR while a medical resident in the 1990s.

Whatever he’s working on, it’s all to further the same goal: “Since the ‘90s, my whole focus has been making organizations work better, whether that’s the hospital or the medical school or the young faculty that I supervise,” he said.

That’s meant occupying a series of innovation-related roles. Currently, as of Beth Israel Deaconess Medical Center’s brand-new merger with Lahey Health, Halamka is the executive director of the Health Technology Exploration Center. Regardless of his job title, there’s no getting around it: he’s one of the most influential figures in healthcare IT today.

WELL sat down with Halamka to learn more about his problem-solving process, his advice for getting others on board with new ideas, and where that all-consuming interest in technology originated.

Your training and background are as a clinician. How did you fall in love with technology, and why did you decide to make it your life’s work?

I moved to Torrance in 1968. Torrance was a place where you combined industry, commercial establishments, and residential [neighborhoods] into a single community. So I, as a young kid, was able to go to businesses that offered technology and go through their dumpsters, and I picked throw-away electronics out of the dumpsters.

I was able to teach myself discrete circuitry, resistors, capacitors, inductors, and then integrated circuits, and then microprocessors. And I started designing systems and built a computer for a hospital, Harbor-UCLA, to acquire signals from the eyes and ears of the disabled and provide digital reports about their functioning.

Then, though I did major in political science, economics, and microbiology, I was running a software company from my dorm room while I was at Stanford. Back then, it was considered very weird. Now, of course, everybody does it.

I’ve always been on the parallel tracks of technology and biology. I’ve found that, when you work at the intersection of two fields, your promotion goes much faster than if you work in just the core of a single area.

There are so many issues in the industry right now—issues of inequity and lack of access, spending and transparency. Why is healthtech the right thing to focus on?

Technology is just an enabler. I was in India a few weeks ago, working with the Gates Foundation on a tracer exercise. (In this case, the word “tracer” means you go into the field and you ask yourself, “What are problems to be solved and how can we best solve them?”)

What I found in Northern India in Bihar State, which is the area in India with probably the most disease, pollution, and poverty, [was that] they didn’t necessarily have good access to medical care, but they had good access to 4G, and cell phones were $35.

And so coming out of my week in India was a plan for, potentially, how Gates could fund a cell phone-connected machine-learning approach to diagnosis and treatment that would extend the ability of doctors in India to reach the more rural areas.

If you give me a business problem, we’ll solve that however is best appropriate. And if there is a technological solution or an emerging idea that can really radically transform a social issue, then I’ll definitely choose the technology approach. But I’m more into solving a problem as opposed to implementing a technology per se.

You’ve argued that the future of healthcare involves focusing on wellness, not sickness. How can health systems help patients make that transition? What tools and approaches should they use?

In the past, clinicians were paid for the amount of healthcare they delivered as opposed to the wellness or quality of the healthcare they delivered. As we move to value-based purchasing, there’s already this risk contract approach: Clinicians are being paid for keeping you healthy in your house.

Therefore, what they’re recognizing is, “I can’t keep you healthy in your house unless I know how you’re doing. Are you walking? Eating? Taking your medications? Are you appropriately warm or cold?”

It’s pretty clear that the incentives are aligned appropriately, and that using these digital tools to assist a patient and family with wellness is going to be the next generation of healthcare delivery as opposed to more hospital beds.

Doctors frequently complain of feeling disconnected from patients—in no small part due to the EMR. Does technology have the potential to rehabilitate the relationship between doctor and patient or bring us closer together? How?

Do you remember Google Glass? Google Glass was an interesting idea but not so well-engineered. It had a short battery life, didn’t have security patches, so it didn’t ultimately catch on. (Although it’s being revised and potentially, we’ll see it rise again.) Beth Israel was the alpha test site for Google Glass and healthcare.

We used Google Glass as a heads-up display to show the patient’s history, medications, problem list, care plan, all the rest. What happened as a result of that study? The patient said, “Oh my God. That was wonderful. The doctor looked at me instead of a computer.”

From the doctor’s perspective, the doctor was using a computer. But from the patient’s perspective, the doctor was interacting with the patient. If technology is appropriately deployed, it can meet both needs.

In a recent article in Harvard Business Review, you said that “third-party innovators have the most potential to dramatically improve both the user experience of clinicians and the health of patients.” But there are a wealth of options out there. How should health systems decide which to employ?

In the world of startups, there is often a lot of hype. There’s a lot of overpromise and under-delivery. And so what you have to be careful of is what I call present-future tense: “We have a product that will.”

Either you have a product that does or you will have a product that will. You can’t have a product now that will. So when I do partnerships with third parties, I really go deep with the companies there and figure out what works and what doesn’t work, what’s real and what’s not real. And when it’s real, we adopt it.

Don’t buy the PowerPoint of brochureware. Buy results based on personal experience of going deep with companies and maybe even do some co-development.

Hospital systems are famously slow to accept change. How do you convince your colleagues to go along with new ideas, accept new processes, and adopt new attitudes?

Do you remember Rahm Emanuel? He was Obama’s chief of staff. And his brother was Zeke, who wrote a fair amount of the Affordable Care Act. Anyway, these guys basically said, “Let no urgency go unused.” What do I mean by that? Imagine a hospital system has a privacy breach—and it happens. No matter what you do, people, unfortunately, are human. They’ll click on that link, and they’ll introduce ransomware. Or they’ll find a USB drive and put it in their computer. If you have a major malware or ransomware problem, what a great time to bring in enhanced security software or partner with a company working on new security innovation.

Or let’s imagine a patient has a bad outcome and it’s very public. What a wonderful opportunity to think about artificial intelligence or tools that can better watch what a patient’s progression might be through a hospital and raise a red flag if it’s going off-plan? Use every sentinel event as an opportunity for change.

Then a second bit of advice: In a healthcare system, you will find that there are a fair number of strongly opinionated people. If you tell the leaders of a healthcare system that, by implementing a technology, we will satisfy some of these more local people who might also be naysayers, they will say, “That sounds really great.”

It’s a lot about figuring out the alignment of incentives. Sometimes the incentives are monetary. Other-times they’re political. Sometimes they’re social. But by figuring out how you can take your project and its features and align them with something that decision-makers need, you’ll be successful. ♥

This interview has been edited and condensed for clarity.

Meet the Team: Jamey Christensen, SVP of Sales

 

WELL’s brand-new SVP of Sales, wears a lot of hats

Jamey Christensen is an accomplished manager with a strong background in healthcare. A historical-fiction aficionado. A father of seven. And he’s as comfortable four-wheeling his way through the Utah mountains as he is running a meeting with WELL’s (sometimes boisterous) sales team.

We sat down with Jamey to learn more about how he got into business (he started young), his proudest achievements, and his advice to industry newcomers.

What does your role at WELL involve?

My role is to ensure that revenue is flowing into the company, so we can hire more people and we can grow this thing!

What’s got you excited about working at WELL?

The product, for one thing. There’s this major pain point in healthcare, and we’re fixing what’s broken out there. Then helping team members to grow and scaling the company are exciting to me. And it’s a fun culture; people are excited to be here, which is great.

Then there’s being able to hang out with the pups all day. It’s my first time at a dog-friendly office!

Where do you live?

Orem, Utah—an outdoor heaven. It’s basically a desert floor with beautiful mountains around it.

Who lives with you?

My wife and four of our seven children. (Three of my daughters are currently in college.) We also have two dogs: a Pomeranian and a brand-new Shih Tzu.

 

First job?

I worked on the family farm growing up. My dad bought a farm in Colorado, and my brother and I raised hay on it to earn money as kids.

Then, when I was 14, I owned a skateboard shop. My mom loaned me $250 for my business license, and I ordered all the supplies myself, marked them up, and sold skateboards to the kids in town.

Worst job?

I didn’t want to work on the farm one summer, so I decided I would try the Norbest turkey plant. I literally lasted four hours. Stinkiest job I ever had.

Where can we find you when you’re not at WELL?

Home, a lot of the time, or out on the mountain. I love four-wheeling, and one of my favorite things is to take my ATV out.

Then I go to a lot of track meets. Two of my kids in college run; so does one who’s in high school, and two of the little ones run for fun.

And finally, I love to read—especially business books and historical fiction.

 

Your top pet peeve:

When people make commitments and fail. If they struggle and fail, that’s one thing, but if they commit and then just don’t do it, that bothers me.

Proudest achievement, personal or professional?

Personal: Being a dad. My family. That will be my greatest accomplishment—although my wife deserves a lot of the credit.

Professional: I’ve had opportunities to help a lot of people. A lot of my reps are now Head of Sales or VP of sales at different companies, and I helped them get where they are.

Do you have a motto or mantra that defines you?

We have a statement in our house: “Kindness is where it all begins.” I think it’s really important to be kind first.

We wouldn’t know it to look at you, but…

I danced in the Nutcracker back when I was young. I played Mother Ginger. The kids loved it, but it was a little embarrassing.

I’ve learned this: The more things you try, the more life is a wonderful adventure. Sometimes you do things for others—like dancing in the Nutcracker—and it’s a wonderful experience.

The people you admire most are:

One of my former mentors taught my a lot about how to treat people and how you can help people as you do your work. Then I did my master’s thesis on Abraham Lincoln, and learned a lot by studying him.

But the two most influential people in my life were my grandma and my mother. My dad died when I was 15, and my character was really developed by the two of them.

What advice would you give to someone starting out in the field?

Be the person in the room who works the hardest. If you jump in and you learn everything you can about the product and the industry you’re in, you’ll always find a path forward.

Also, be a student. You can’t ever stop learning. Things change, business models change. You have to be able to adjust to what’s happening around you.♥

 

Meet the Team: Thor Clark, Chief Technology Officer

 

For our first installment of WELL’s Meet the Team Feature, we’re excited to interview Thor Clark, WELL’s CTO. Thor is approaching his one-year anniversary at WELL (he joined in March 2018), and is especially proud of the rockstar product engineering team he’s built.

What do you do at WELL?

I’m responsible for product, engineering, technical security, and technical operations.

Where do you live?

We live in the Westside area of L.A. I love that Southern California weather—it’s great for getting out with the kids and dogs.

Who lives with you?

Two kids, two French bulldogs, one wife.

A typical day in the life looks like…

There are no typical days! WELL is growing fast, so there’s generally recruiting activity, whether it’s interviewing, sourcing, or working with recruiters. There’s always a team-building component, whether that’s one-on-ones or training activity. There’s some customer engagement or prospect engagement, vendor relationship management, product activity, architecture discussions, and planning. Sometimes there’s travel—visiting customers and partners, that kind of activity.

There are always big rocks and little rocks: there’s making progress on big, long-term projects and also dealing with short-term issues, making sure both are moving forward.

First piece of code?

I wrote an assembly language version of Conway’s Game of Life when I was 12.

First job?

Delivering newspapers–that ages me, right?—in Paradise, California.

Worst job?

I once spent half a day selling vacuum cleaners over the phone. I’d literally take a page out of the phone book and start calling people.

Your top pet peeve (or three)?

Self-driving car technology should be better than it is! In general, I’m frustrated by things that aren’t well designed.

Your proudest achievement, personal or professional?

Professionally, I’m proud of having been part of three successful startups with good outcomes: Investools, SignNow, and Tabula Interactive.

More personally: I dropped out of school to do my first startup, and then I went back and finished school. I went out in the world and did stuff, but I still got that degree. I feel pretty good about that.

We wouldn’t know it to look at you, but…

I played trumpet, then baritone, then tuba, then sousaphone in high school. I worked my way up to bigger and bigger instruments over the course of a few years.

And I was a firefighter! I spent a summer fighting forest fires in Northern California.

The people you admire most are…

My mother, definitely—she put herself through Stanford Medical School late in life. Tom Brady’s pretty impressive, too.

What advice would you give to someone starting out in the field?

Be passionate about learning. Be focused on people—users and coworkers—and think about what drives them and what they’re trying to accomplish. It can be fun to brain-tease and problem-solve, and don’t lose sight of the end goal.

Find work that you genuinely enjoy. “Finding your passion” is an overused and vague phrase, but find a role, team, and mission that make you enjoy going to work every day.


Thor Clark leads a team of 20 engineers, Product Managers, and Program Managers.

To see current opportunities to work at WELL, see our Careers page.

 

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