Navigating Digital Transformation in Healthcare & Societal Impacts

In this Q&A edition of Healthcare’s Data Innovation, we are delighted to welcome Jenny Bartlow, a prominent figure in the intersection of healthcare and technology. With over three decades of experience in tech, including her current role at Microsoft, Jenny has been at the forefront of driving transformative changes across the technical and healthcare landscapes. Her insightful contributions not only shed light on the integration of new technologies in healthcare but also reflect her deep commitment to community involvement and empowering vulnerable populations. Join us as Jenny shares her experiences and perspectives that continue to shape healthcare and technological innovation.

Top 3 Takeaways:

• Using a first principles approach to solve complex challenges in highly regulated technical environments. Define the mission, define what stands in the way and make your way to technical decisions that meet or exceed the necessary outcomes.
• The highest ROI for AI projects right now appears to be found in addressing the “lowest hanging fruit” automation opportunities. Generative AI is especially well positioned for manual processes in human interactions.
• The importance of driving meaningful societal impacts through your position as a leader.

Jake: Jenny, thanks again for joining this Healthcare's Data Innovations Q&A. Our listeners won't know this but this is our second attempt at your Q&A as we had some recording and technology issues last time. I appreciate you coming back on as you are a fixture in the Healthcare space here in St. Louis. We’ve been to conferences together, panels, and I’m glad we have this opportunity to connect and let you share your wisdom and experiences with our audience.

Jenny: Yeah, well, thanks for having me. It's great to catch up and do something a little different from kind of the day-to-day. I’m excited, this is great!

Jake: We all need a little bit of break for the normal, right? Just a bit of time to a quick newsletter / podcast in the week!

Jenny: That's right!

Jake: I'll let you do your introduction to our audience and tell us a bit about yourself and your work.

Jenny: I’ll start with I’m here in St. Louis and I’ve been here long enough that I always have to say I’m a Cardinals fan! But I'm not really sure that you want to admit that this year as it’s been a rough couple of years.

Jake: You could say that, we’ve seen some ugly baseball recently!

Jenny: You know, I actually grew up in Milwaukee, WI…do I need to say sorry for that? The Brewers are on top of central division right now…but back to St. Louis. What I love about this city is that it’s a tight community and the people here find ways to support so many different community and innovation based organizations along with the institutions that are staples in our community.

So, I’m a Cardinals fan, but that is what I really love about being here. I've been in technology in Saint Louis for about 30 years. I’ve worked for a number of different local companies like Maryville Technologies, Savvis (now LUMEN), Monsanto (now Bayer), and now Microsoft. I've spent a lot of my technical career focusing on service management – I love a good process and a well-defined approach to managing technology. Managing technology through smart approaches has always been something that's been a passion of mine professionally because I feel like if you do that well so many other things will fall into place.

I just love technology and marrying that with my love of being in healthcare and it’s pretty easy for me to be happy and excited about the work I do at Microsoft. Healthcare has been a bit of a new space for me, I found this impactful work and space when I came to Microsoft. Monsanto (now Bayer) was certainly life sciences and I enjoyed the biotech and agro / chem mix…but I’m really loving what I do here at Microsoft within healthcare.

Jake: It is interesting that we have this very vibrant technology ecosystem for startups, mid-size organizations, and even enterprise companies…it’s something we don’t talk about enough when it comes to St. Louis in the national conversation. You mentioned Bayer, we have had this wonderful accelerator channels and innovation pipelines for Agro-science for maybe a decade now. It feels like we are on that same pace for health care within our region, with organizations like BioStl and others…certainly we’ve got this geospatial center of excellence and community as well.

Jenny: I can tell you that for us at Microsoft, it’s a meaningful opportunity to do great work within these communities. It’s incredible how much the innovation scene in the Saint Louis area has grown, especially within Cortex, where the Microsoft St. Louis office is. The deep connection to Washington University and their school of medicine certainly is a big part of that healthcare innovation space.

Jake: Can we hop to your career? You are in this very interesting position – working at Microsoft and leading technology change and transformation within healthcare by partnering with a healthcare company that’s in the Fortune 25. I’m so curious to hear about your role navigating the system level challenges that exist within healthcare while also navigating an extremely large and complex enterprise you’re charged with supporting.

Jenny: You know, it can feel like the challenges can be countless and you’re right that there are system -level impediments that are larger than both Microsoft and the organization I support – but, these are exciting times to navigate and deliver digital transformation in very meaningful ways. It’s hard to get wrapped around challenges when you work for Microsoft who has countless smart and caring people and you’re working with a partner organization who serves a large population of at-risk individuals.

Jake: Well, you have to tell us a bit about that experience!

Jenny: So, for me it’s important that I came from industry. I had led and managed technology strategy and implementation in organizations that I knew well, I understood the challenges, and you pick up a lot in a 30 year career that serves you well.

I’d start with the challenge of the cloud – it will sound so familiar to your audience, but these are not impossible to problems to solve, we have roadmaps and best practices and moving the cloud has proven benefits for many use cases – but, within the healthcare industry there’s just a different set of challenges for things that should be simple in many other industries.

We’re presented with the known challenges in the regulatory space, protecting and securing data and privacy while also extracting more value from that data to drive better healthcare outcomes. So yes, you could say the curve is a bit longer for healthcare organizations – we are highly regulated and we want to move fast and we have a fractured healthcare ecosystem. Our perspective does have to be a bit different, for many of us in this space it hit’s us like “Oh, boy, we are really behind.” But you know you and the team can navigate it because the importance of the work drives you every single day.

My first role at Microsoft was a technology strategist and it sounds crazy to say this now, but I had about 12 accounts from St. Louis to Kansas City. It was hard but it was so valuable because I got a really good view of different sub sectors of healthcare. I saw providers, payers, specialty, pharma and it was easy to feel like each and every case was another organization far behind – remember, I came from industry where we moved fast. I was used to cloud migrations for the last 6 years and it still sounded foreign to these organizations I was now charged with supporting…they didn’t want to hear about the cloud at that point, it was a huge challenge to help those organizations truly understand the infrastructure, the scalability, flexibility, and availability that came with well architected cloud solutions.

We are going through some of those same challenges when it comes to data right now, I’ll call it the “fortressing of data”, just like organizations now know the value in cloud and it almost seems out of touch to think on-prem first…organizations know that they want to be learning organizations that improve efficacy and efficiency through data…but democratizing regulated data brings about some doubts still. Just like the cloud journey, we’ll work through it but healthcare is still on the lower end of that maturity curve right now compared to financial services and other sectors.

Jake: There are many organizations still working to thoughtfully make decisions around what to migrate to the cloud, how to modernize the digital front door of healthcare and now there is the huge opportunity for data sitting in their lap. It’s certainly a lot and a bit of a scary roadmap for many organizations, but the ones I see succeed have leaders versed in digital transformation. They are focused on providing those safe spaces to test, iterate, develop and hopefully the drive the business forward.

Jenny: They have to do a lot at the same time – you’re right. There’s a bit of a lack of inertia at times right? You have to make a challenging decision and mitigate the risk through smart strategies and build up your confidence as you go – it’s hard to merge the reality of making basic cloud decisions and thinking about how to integrate AI at scale?

Jake: I see that – mostly with organizations that have a mission to become a learning health system. That’s a deep and broad question – “How do we become a learning health system?”. You can’t learn from every patient interaction and focus on improving systems across the board when you’re focused on maintaining that on-prem postgres server. That virtual machine in the server room is not going to give you the tools you need to be a true learning health system.

Are there examples you could share where you had to help steer a modern outcome when the organization you support just wasn’t feeling quite “ready”, which I think is another word for comfortable.

Jenny: Oh, sure I can. Let’s use the organization I currently support as an example – again Fortune 25 organization in healthcare. We’ve had this explosion in AI with general pretrained transformers and Microsoft has publicly been one of the leading faces in AI and an advocate for thoughtful integration…that doesn’t mean that every company leader, decision maker, or even potential user is immediately on board. It’s important recognize there is more than enough room for controversy and controversial conversations.

But, if you pick the problem apart – really break things down to a first principles approach – you’ll find that healthcare organizations move slow because they have regulatory compliance that mandates adherence to rules that are not modern in nature or can be easily navigated when considering things like generative AI.

Once you abstract the conversation to that fact – you aren’t talking about technology anymore. You’re talking about (in this case) how to be a dedicated health plan provider to some of the most vulnerable individuals across the country. The people that the organization I support serve are on Medicare, Medicaid, and marketplace programs.

Now, you can move to what does it mean to be the best organization you can be for those individuals, how do you show up for them every day? This is not a technology conversation, or an AI conversation – it’s a conversation about doing your best work for those that need you most – starting the conversation there with use cases that are truly impactful and then backing up into the right, mature, safe, and compliant technology solution is really the path forward. We can’t start with AI for the sake of AI – it’s irrelevant, what’ relevant is that we get the implementation so perfectly right that we add more value for every end user and ultimately organization.

Well, here’s the actual example you asked for. As a plan provider there are so many manual processes taking place, let’s look at the fact that some pieces of supporting the population you serve, again vulnerable populations of people leveraging Medicaid and Medicare, involve a person receiving and reviewing a fax and then entering that information into a separate system.

That sounds so foreign, right? You would never design that process in 2024 – you just wouldn’t, but how do you tackle a process that’s supporting millions of people right now that can’t afford for you to get it wrong? First, it’s likely very important to recognize what are we getting wrong right now in the current processes, where are human errors causing havoc, where are delays stemming from, what negative consequences are coming from this process?

We have this tendency to look at our current processes as “working” or satisfactory, but once you dig deeper to explore what’s broken you may find a compelling case to innovate so you can indeed do your best work for those you serve and those that serve within your organization.

In this case, you’re not talking about generative AI use cases even, this is classic process automation. Sure, we can leverage cognitive services in Azure – but, is that the right step? We really just needed character recognition to pull off this system to system automation. Beginning with the organizational values, impactful use cases, and smartly balancing innovation and feasibility brought this solution to life.

Jake: I certainly appreciate a simple approach – find areas to do your best work in the most meaningful ways and it’s hard to not unlock value or add new value to every engaged stakeholder.

Jenny: It is simple but it applies to very advanced use cases – we are starting to see the payoff for organizations embracing AI technologies for human interactions. This is across industries but I’ll keep it to the healthcare space, think about how many interactions the people in your industry are having with customers, clients, and those you serve. It’s a lot of people, a lot of processes, and a lot of technical debt – that’s a lot of weight to drag into a conversation about innovation, but it has to happen.

• Do you want to schedule an appointment? Let’s automate that in secure and reliable way.
• Do you need to know something about your plan? Let’s get you that information right now.
• Get a summary of the next steps from visit? Let’s deliver that ASAP.

Jake: May of the use cases you mention are thoughtful balances of prediction and judgement – if you can predict something with high recall it does bring about a discussion on automating judgement. There is no perfect framework for that balance, but truly what you’ve mentioned above is about allowing people to operate at the top of their license and helping them do their very best work. We see the same in very advanced institutions focused on precision medicine, so the principles hold up.

However, many of the highest ROI opportunities for generative AI and automation continue to be addressing the lowest hanging fruits of operational, repeatable, and highly predictable tasks. It’s rarely the best start to take on the most challenging use case first!

Jenny: We are on the same page here – extract value where you can with the “lowest hanging fruit” use cases first. You’ll get the additional benefit of being able to learn from other organizations and individuals in academia, public sector, and industry who have likely taken on a very similar use case.

AI in medicine isn’t new – the folks leading precision medicine have been using AI for 30 or 40 years in some form. They are advanced users, they likely aren’t the ones that need the most help framing and rethinking the business problem or end use case. I’m somebody who has had the very good fortune of being with Microsoft and seeing this play out daily.

Jake: You're implementing technology in one of the most complex spaces, not only in healthcare but I in the health benefit space with vulnerable populations. I’m curious how you find your pace every day and establish what work is coming next.

Jenny: Well, for me, it’s first and foremost on my mind to think about healthcare in general and recognizing that the system is far from perfect here in the United States. I can’t lose my motivation because of those challenges – my goal is support my partner organization to support those that are generally less fortunate, period. That’s a lofty mission but it creates simplicity for me and a focus on equitable health for everyone served, and by the way, we aren’t there yet. There’s a lack of medical information that is not fully digitized, captured, and made interoperable – not for people that have health insurance, good access, and a primary care doctor, but that’s not the story for everyone.

I stay focused on the relevant goal of serving and that’s keeps me going. I’d be lying if I said there was never a hard day or it can’t be a struggle – but those struggles are small compared the ones that the population I’m dedicated to serving must face.

Jake: You know, it’s interesting for me to hear this. People generally assume I am the most motivated or driven using the most cutting-edge technology solutions. Those folks are usually pretty surprised to hear that my biggest motivation is my son who has Trisomy 6 – within our healthcare work, I’m driven, and our team is driven to enable everyone from researchers and translational scientists to direct care givers to do their very best work.

That doesn’t mean I’m not proud of this latest project with an open-source LLM or that latest win powered by deep learning – I’m just more proud of the outcome than I am the technology. Technology can’t be the end, it is indeed a means to an end.

Can we transition to your work in the community? I see you everywhere in St. Louis and your efforts to move equity in the community not just in your transformative efforts at Microsoft.

Jenny: I have a lot of passions outside of work. I mean it when I say I love Saint Louis, I love the community. It kills me to hear about St. Louis always being portrayed so negatively both in our region and nationally. For me there are a couple of really important agendas, one is rising women’s opportunity to build a sustainable and stable life through technology.

I've been a female in technology for a very long time and I've been in some of the pretty deep technology areas where I've been the only woman in the room, sometimes even the only woman in the technology organization. Quite frankly there are still times where that doesn't change in certain areas or pockets of IT.

For me it’s incredibly important to continue to support our young girls and make sure that they have opportunities to learn how to be leaders and to excel in STEM. I'm a huge supporter of Girl Scouts of Eastern Missouri, which not only supports the Saint Louis city and county, but it also supports the surrounding rural areas. It’s just incredible and amazing to see what the girls of Eastern Missouri are capable of. I helped recently establish their women’s leadership organization, so that we have continuity for girls that are exiting the Girl Scouts – how do they have a safe place to land after Girl Scouts?

Women need to and want to support other women. Another organization I love working with, is Rung for Women. Run helps support women are not in an economic position to support their families through offering them no cost skilling and learning that will effectively allow them to support their family through better professional opportunities. There’s a startling fact of something like 38% of female led, single parent houses are living in or near poverty.

These women are a more than viable part of our community, but we need to more than just talk about closing the wage gap, we have to make those investments in people.

Jake: Jenny, we are coming up on time and I want to respond firstly with thanking you for the work you are doing in the community to invest in women and girls – we can’t lose sight the most profound ROI is found in people, you can’t make a better investment. Secondly, I want to thank you for the work you are doing in the health space and lastly, I want to thank you for doing this Q&A, now your second one with us. I guess you could say you are our first repeat guest, right?

I sincerely appreciate you taking the time and I look forward to continuing to find ways to work and partner together within our region.