A Human-Centric Digital Experience (ft. Jonathan Butz)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation, challenges, and opportunities across healthcare and life sciences. And now, your host, Ed Marx.

Ed here. Welcome to another drop for Digital Voices. And one of my favorite topics when it comes to digital is really talking about human-centric digital experience, and I can't think of a more qualified guest than Jonathan Butz, who will be joining us today. So Jonathan, welcome to the Digital Voices podcast.

Thank you so much for having me. Great to be here.

Yeah, it's going to be pretty awesome. Before we get started, DJ Megan, sometimes with our guests— and Jonathan is one of them, and I'll explain in a second— have some very interesting LinkedIn taglines, like a little description about who they are. What does yours say, Meaghan? What's your tagline?

Oh gosh, Ed, you know, I really need to work on mine. I don't have a custom one right now. If I were to create one today, it might say, marketing and communications manager at Divergent, podcast producer, moving the needle in healthcare IT one click at a time. Oh, love it, love it.

That's good. I like Jonathan's. We're actually gonna ask him some questions later on. But for Jonathan, and I'll give you this high level and then we'll jump in and you'll hear from him directly, but healthcare IT advisor, and you see that when you hear about his background, family man, love that, philosopher, explorer, technologist, and human-centric IT. So we first met actually only recently and it was through a mutual acquaintance who said, oh, you two are really like-minded and you think a lot the same with digital and you really need to connect with one another. And we did and yeah, definitely, have a lot in common. So really happy to introduce Jonathan to the audience. And of course, Jonathan, the thing that everyone wants to know first is, what are the songs on your playlist?

Yeah, so as I get older, finding new songs becomes increasingly difficult. And I think there's some books on neurology that help understand why that is so. And sometimes I find songs that are new to me but are not new at all. And one that I stumbled upon recently, a song by Paolo Nutini, called New Shoes, and New Shoes is a metaphor for just discovering that something is not right about your life and working to make one change that can have a significant impact on how you feel overall. In my back catalog, I have, you know, a lot of classic and progressive rock. I have a decent amount of punk. I like singer-songwriters a lot, Donovan and Billy Joel. I have a decent classical collection. There's tons of electronic music from over the years. But also, if it would be okay, I would like to share also 2 books.

Yeah.

That I think folks might find valuable. One is a 2011 book by a fellow named Woodward called American Nations, which discusses how the United States is actually 11 distinct cultural regions. And it discusses the unique nature of their cultures and the origin stories that led to their unique cultures. And there's a wonderful map that accompanies it. And to me, it helped me understand why this is such a challenging nation to govern. And how these cultural regions are not bound by state boundaries. So it creates challenges both at a national and a regional level governing the many different cultures that persist within our nation. And then the other one is a 2016 book by a fellow named Manson, The Subtle Art of Not Giving an F, which is a provocative title on purpose, and there's provocative language in the beginning, but it is truly An academic text about what it takes to be happy and helps to— it helped me reframe some things and goes into concepts like, you know, you think you want a promotion or a larger house or a new car. And the happiness that you get from those things is very often fleeting. And the best way to create permanent happiness in your life is to structure your life so that the challenges you face on a daily basis, both personally and professional, operationally are within your ability to solve. And if you are able to achieve that, you have a much greater chance of finding lasting happiness and meaning.

Yeah, no, those are all 3 awesome. That's what's kind of fun is hearing what's on other people's playlists. I've learned so much about different music genres and styles and new songs. So I'm going to look up New Shoes for sure. And yeah, the books both sound awesome. Like, we could spend an entire podcast, I think, on each one. And it makes total sense. I just got back from Europe and, you know, It's a conglomeration of tons of different countries and cultures and, oh my gosh, and the deep history. And it's similar, although much younger. United States is a conglomeration of— yeah, you could think of them as many countries and cultures. And for sure, I'm going to get that book and I'm anxious to see the map and how that map maybe changes a little bit over the years as people migrate from place to place. But yeah, both. And then the book, it makes total sense, your summary of it. The Cliff Notes that you just shared makes total sense. So, I have to look that one up too. That's also the hard part of this role in the podcast is I get so many new ideas and so many different things to think about and read. And, it's like, oh my gosh, my brain's exploding. When can I make the time for all this? So, the other thing we always ask, Jonathan, as we jump in is what is your passion or life message mantra, words that you live by?

I try to live by principles of science and compassion. I'll explain a little bit what I mean by that. Then I think giving back is also another important element. I think I'll share a little bit more of that when we get into why I was drawn to healthcare in the first place. Science is the set of tools that we use to know what we know and to understand what else we can know and maybe what we can't know. Science gave us the modern age and, with it, we've connected the world. We've dramatically improved the quality of life, especially for the most vulnerable around the world, through innovation in agriculture, medicine, economics. That's great. We've definitely enlarged the pie. Compassion then is the social force within all of us that must guide how we apply that science to improve the quality of life, advance our civilization, and to appreciate the full consequences of our choices. We have so much information and knowledge, but I think we still struggle to leverage both science and compassion in our policies, especially with regard to sensitive issues, because when compassionate forces are inadequate, neglected, what have you, societies favor aggressive and privileged people over the vulnerable. And that reduces— unfortunately, that reduces the prosperity of our societies overall. And healthcare as a discipline is a wonderful fusion of science and compassion. We have such great potential to further the impact of all of that, especially by giving greater attention to the most vulnerable.

So much to unpack, Jonathan, everything you said already, and, and we haven't really even started to jump in. So I'm really excited about Getting deeper with you. So let's start by telling us a bit about your story, and you can certainly weave in there, and you've alluded to it already, sort of how you chose healthcare or how maybe healthcare chose you.

So, I mean, I'm from eastern Pennsylvania. I grew up in the Lehigh Valley. My ancestors settled there hundreds of years ago. I was drawn to technology very early. I majored in marketing at Penn State, but I always had computer roles. I started with a startup in Pittsburgh that gave me responsibility for literally everything in the data center, including phone system voicemail, at least at one point. So, like, I understand all of the technology that we use from the wires up, having actually had my hands on it at one time or another. Then I held various roles throughout the course of my career. I spent a decent amount of time at VMware. That's where I got— I started paying attention to healthcare at VMware. I built the healthcare practice at Veeam for a number of years, got the solution validated on Epic. That was a significant— that was a great achievement. I'm very proud of that. I spent some time as a part-time CTO. for 2 hospitals, gained a real appreciation and love for the people who work in healthcare IT and a real appreciation for the challenges that they face. Now, here I am at Nexthink doing digital experience. Healthcare, so it's sort of on the topic of giving back. Healthcare is unlike other industries. It's not in the business of shipping widgets or producing new products. Its outcome is ultimately the health and wellbeing of our community at large. And it is a finite set of pool of resources, finite pool of resources that we use to deliver that care. So, and technology has become such a vital aspect of the delivery of that care that using what I know and what I love to do, I saw it as a way to have a direct impact on the health and wellbeing of our communities at large by bringing solutions that truly do add value. to the delivery of that care. It's not something that many people are comfortable talking about, but we needed some assistance starting a family. You know, 20% of people, of families have trouble getting started. And we— I'm so grateful to the medical science that helped us do that because that has become, without a doubt, the most important aspect of my life. So doing this work is an important way that I give back.

Yeah, that's very, that's very cool. I've had similar experience in my own life and can appreciate That. So thank you for sharing. Your philosophy also embodies sort of this human centricity, and you could already tell from the way you speak how you're wired that way. But it's something that most people generally don't really think about. And certainly healthcare has been kind of late to the game when it comes to sort of human centricity or human-centric design, or what do we call it, consumer or patient experience. So, and maybe you've already sort of answered it, but how did you sort of get there to be thinking about that and that you actually put it on your tagline?

It was VMware that I started to gain a real appreciation for that, spending actual time with clinicians and observing how they consume technology. VMware was the first place I saw a set of technologies specifically designed to facilitate the clinical consumption of applications. They had a program. We called it Always-On Point of Care. This was when Frank Knighton was running the healthcare program at VMware. It was a combination of several technologies from Improvada especially and VMware. You would walk up with an RFID badge at each terminal, tap your terminal, and It would automatically log you into the terminal and open Epic or whatever the EMR the hospital was using. In some cases, it could even use understanding about where the terminal was and what patient was in the room at the time and go right to the patient record. There were architectural things to do. But observing that and then to move from room to room, you would tap out and then you would tap in again. Since it was a virtual desktop on the backend, it was very quick to bring it with you. I started to gain a real appreciation for what might be possible. in having this human-centric approach. And that ultimately, not directly, but that ultimately led me here to Nextthink to focus on digital experience directly.

Yeah, that's awesome. And I do wanna talk to you a little bit about that in a minute here. It's clear that you're a very intentional, focused person, Jonathan. And I also ask people a lot about leadership 'cause most of the audience are leaders in healthcare and digital. How do you keep yourself sharp? How do you keep yourself on point so that you're always learning and growing?

I like to use a combination of lists and deadlines to keep me going. I also think mentors are extremely important. You need mentors in your life, and they are likely to change over the course of your career. Mentors that you need earlier in your career may well be different from mentors that you need later in your career. The other flip side of that, I think, is mentoring others. I have gotten so much satisfaction over mentoring others, whether in an official or unofficial capacity. the course of people's careers. Somebody reached out to me just in the last couple of months thinking I was still somewhere else. I made introductions for that person and gave them some advice, and that person now has that job that they thought I could help them get thinking I was still there. It was so rewarding, just that little experience.

For listeners, I just want to double down on that point about mentoring because a lot of times we think, oh, once we've achieved a certain level of title or experience that we don't need mentors anymore, but here you have Jonathan who's Very well, uh, you know, established leader in the industry. And he still, you know, you're still talking about having a mentor and I'm wired the same way and giving back. And so that's really key. I just wanted to double down on that point. Once you think you're done growing, you're in big trouble.

There will always be people. I mean, that's one of the essences of, of good leadership is an understanding of the things that you're good at, but also the things that you're not good at and the things that you don't enjoy. Those are the things that you're either going to give to other people or surround yourself with people who can take care of those for you, or you're going to find mentors who can help you develop those things that you bring.

Going back to the byline, we talked about it a couple of times on LinkedIn. A couple of things that you mentioned that are a little different than the average are philosopher and explorer. Can you unpack that a little bit for us?

Sure. I think it's loosely coupled to science and compassion. Ideas are extremely important, and there are so many big questions in our lives that have incomplete or unsatisfactory answers, and it takes a ton of courage to admit that we don't know and maybe can't know as we continue to explore our place in the world and even the universe at large. But then there are things over which we do have control, like the structure of our governments, the region or nation in which we live, and the choices we make. And underpinning those choices, generally, whether it's formal or not, is some sort of philosophical outlook. And I devote a great deal of energy to considering the foundation of that philosophy. You know, what are, what are the things that I value? What do I really strive for? What would I fight for? And I think that we should all do such things. We have this wonderful gift of analytical thought from our cerebral cortex that is unique. It's certainly unique here on Earth, and it may well be— we have no idea whether it's rare or ubiquitous in the universe, and we hope to understand that one day. But we have to, because we have that capability, that it is our responsibility to use it, to consider what is right in the context of what we know. And we must always be aware that what we know now is quite different than what we knew in the past, and that must shape how we behave and how we evolve our cultures.

Jonathan, what would you say to someone who's listening? And you clearly think deeply on things, whether we talked about the label philosopher and explorer and the reasons why. And clearly in your answers, you've thought things through and you take time. So for someone who's listening and saying, oh, I would love to take time to do this, but how do you actually Do it? Do you set aside X amount of time each day for reflection or going back to your list of books? Or what practical steps might a listener take that says, man, I like the way this person thinks. I want to get that discipline?

I think it's a good question. The root of it all is asking questions, asking hard questions, and questioning yourself. We are pattern-seeking machines. So I said— so let me— before I get into that, there's a book that I read that really got me started. It's called The Dream of Reason by Anthony Gottlieb, which is the history of philosophy from the dawn of thought, as we might— the dawn of critical thought, as we would consider it today, with the ancient Greeks and the dawn of classical civilization, through the— up through the Renaissance. It's a very interesting study of how thought has waxed and waned throughout the history of civilization. It got me thinking about what happens to us as people. So we're, we're pattern matching seeking machines, and we end up a lot of times by accident distilling a set of beliefs. And where we run into trouble is where we forget what was the input to that set of beliefs. What were the facts and reasons that led us to those beliefs? And have those facts and reasons changed that should inform a change in our belief? So the root of it to getting started is just asking questions. When we discover we believe something, why do we believe that? What caused us to believe that? And are those precepts still valid? And is there an opportunity to revise? So I think that was how I started.

Do you have a friend or someone who thinks similarly so that you can challenge one another?

Yes, I have a couple. I have a couple of them. And then there are some podcasts. There was one— I should have brought a list of those podcasts, but there are some philosophy podcasts. That are, that are quite good.

Yeah.

Yeah.

I, cause I, you know, when I hear you speak, I know that what helps me in this area, I'm not nearly as well thought out and disciplined as yourself, but one of my sons, you know, is sort of a Stoic. And so he's always challenging the thought and the patterns. And I love it because, you know, it's sort of this iron sharpens iron. And if there's no one in your life to challenge you and to force you to ask the why questions, why do you think that? Why do you believe that? You're stuck for your entire life. It's really important to have someone in your life that you can have that sort of honest dialogue with.

And a diversity, I think, of community is important too. I mean, if you are— the concept of echo chambers is very real. If you surround yourself with people who believe exactly as you do, there's very little opportunity to make any sort of progress or change.

Yeah, for sure. There's a whole other podcast right there on that topic. Let's talk about your career a little bit. So you already mentioned a few of the companies that you've served. And you've done a lot of cool things. What are 2 or 3 things that may be related to that human centricity or maybe not, but what are 2 or 3 cool things that you've done that have helped in healthcare and move the needle forward?

Yeah, so I wanted to tell one story in particular that connects the real impact of technology to the outcomes of care. And this was in my first leadership role at VMware. we were assisting a hospital that had a significant outage. They had a storage outage that took down a great deal of their infrastructure and a great deal of their applications besides. And because VMware has become such a hub of platform, we were directly involved in their recovery efforts. And the member of my team who supported this children's hospital was directly involved. And there was a point where they asked for us to change the priorities of the systems we were bringing back online to focus on a set of surgical systems that they needed to be back online As soon as possible. We said, sure, we could shift the focus. We elevated their priority in the recovery list and got them back on and satisfied all their other dependencies. It was a joint effort between the hospital, my engineer, and the larger support organization. The issue was, we got them back up and running successfully, but what we learned later from a rather emotional conversation with the CIO of this children's hospital was, when that request came in, There was an inbound helicopter with a child, a boy who needed emergency surgery, and there was no other place for him to go. And there was no more time. And they needed those surgical systems back online because they couldn't do the surgery without them. And she says that our efforts and our ability to help get them back online were instrumental in saving that boy's life. And I have always been hesitant to discuss the impact of healthcare technology in terms of lives, because I think it's disingenuous in many ways. But, that certainly was one instance where the direct connection between the critical nature of technology and the impact on the life of an entire family was direct.

That's a great example and something that you and your team clearly were part of the care team, if you will, an extension of the care team in helping. I know many other stories similar, and I'm sure you have more as well where What we do in technology, especially when we make it human-centric, can really impact, if not save lives, it certainly helps improve the quality of life. And also for the clinicians, helps the clinicians when we do our work right. Like even the example you were giving earlier with sort of the functionality of tapping in and not having to recertify, recredential every time, saving time, making the experience for— for clinicians better. And clearly there's gotta be some sort of correlation between the clinician experience and the patient experience. Um, the, the less frustration, the less, uh, obstacles, the better for everyone. So—

There definitely is. And that is very much the essence of human-centric IT and digital experience. Yeah.

So tell us about your current work with, uh, NextThink and, and sort of the things that you all work on. 'Cause I'm super interested 'cause you're really interesting and smart person. So you, you, you gotta be onto something here.

So NextThink is specifically is a software as a service platform that enables the delivery of excellent digital experience. And, you know, just in case people are not familiar with NextThink, you know, we have about 950 employees globally and Gartner and Forrester are starting to pay attention to the digital experience space and they've recognized us as leaders in the space. And also 8 of the top 10 managed service providers use our platform on the backend to deliver outsourced service agreements. And also I think it's interesting, our largest customer is a consulting organization that has us on over a million devices because they understand the value of productivity and the outcomes thereof. Let me unpack digital experience just in a general strategic way.

Yeah.

Digital experience is about understanding the analytical and perceived quality of individuals' consumption of technology. Here, generally, we're talking about employees, employees who have to use technology to do their work. In healthcare, obviously, we have clinical staff who rely on clinical applications and other applications to deliver care. Then, in the context of the broader healthcare ecosystem, we have people conducting research, Optimizing manufacturing, and, of course, we have leadership and a whole ton of other clerical and general staff roles who rely on technology to do all of their work. As we've gone through digital transformation over the last decade-plus, we've put a ton of energy into the patient experience, giving them access to their records, letting them schedule appointments, giving them access to follow-up, extending the reach of the hospital analytics capabilities into the home through metrics-gathering devices and wearables and things like that. But, I believe we have neglected the clinician and other clinical staff in the delivery of this technology. The technology they use is not always smooth. In fact, it's frequently not. The electronic medical record system is a bit of an imposition on the clinician. They have to use it. Anybody who is consuming care, which is basically all of us, has encountered a clinician Whether a doctor, a nurse, et cetera, who is not having a positive digital experience. It affects the quality of the encounter directly. First, it affects productivity. It affects the mood of the clinician, but it ultimately affects the quality of that encounter and the care received. The other side of this is people are busy. These clinicians are busy, so they don't have time to report the issues that they're encountering. They're definitely too busy to work with support to resolve these issues in the traditional way that we generally consider. Our largest hospital customer is a large, Very large integrated health system on the West Coast that you've definitely heard of. They told us that 70% of IT issues experienced by clinical staff go unreported. Our model of reactive support is fundamentally broken when serving the needs of clinical staff and their need for a positive digital experience. When we consider this, clinical resources are finite. It's a finite pool of resources. Even if we grew it, it would still be finite. IT support, the people supporting the clinicians and their consumption of technology, is another finite pool of resources. We really need a good way to optimize both the delivery of support to support clinical staff and the experience that clinical staff is having. This brings us to— this is sort of a high-level concept that's starting to percolate in the industry, the concept of a service-level agreement versus an experience-level agreement. A service level agreement generally focuses on output, timelines, and quantities. How many tickets are we closing on a daily basis per support engineer? What's the rate of close by certain levels of support? How many can level 1 handle versus level 2 and level 3? But none of that, meeting an SLA, and generally, we structure those to hold other groups accountable. It becomes much more important when we outsource functions, but we still have SLAs internally too. Meeting an SLA doesn't mean that people are happy with the service they're consuming. It just means we met a bunch of benchmarks that we set for ourselves. An experience-level agreement is a strategy to incorporate outcomes into our measurement. An essential element of an experience-level agreement is measuring sentiment, measuring how people actually feel about their technology experience, and then looking to improve that. Over time. When we put this now, put these high-level concepts in a healthcare context, because technology consumption is necessary and critical, we need to know everything about how clinical applications are working and about how the endpoints that our clinicians, researchers, executives, and other critical staff are using. We need to monitor hard metrics that give us information about how things are working in a way that we know affects user experience. That's what our platform does. Is it performant? Is it responsive? Is it capable? Do apps crash? Do they load slowly? Are different facilities facing different issues? Are there resource constraints? Do we need more powerful hardware? Are some app versions more stable than others that would inform changes? Do we have expensive software licenses deployed that are not actually being used that we can reclaim and achieve some savings? Can we optimize our hardware refresh cycle driven not on a calendar cycle but by actual need? These are all things we can do if we have the right kind of intelligence. These are the kinds of questions that digital experience seeks to answer. That's the hard metric side of it. Then we really need a way to understand how people feel about the technology they're forced to consume. Is it meeting their needs? Does it take too long to do certain things? Are they having issues working remotely? Are they satisfied with the aspects of those experiences? When we can flexibly probe those aspects of digital experience and score them and track them over time, we can dramatically improve the efficacy of IT on the backend. Because we can focus them on the problems that we know will have the greatest impact instead of merely responding to the problems that are reported, which we've already decided is inadequate because there are 2/3 of the issues that aren't reported in the first place. When we combine all of this, the hard metrics and the sentiment data, into the essence of digital experience, we can make much better choices as an IT organization in a way that will have much better outcomes. We can remediate unreported issues, and we can maximize the potential of everyone using technology to deliver care or advance treatments. The bottom line is, this is simply a better way to approach the challenges of delivering healthcare technology to healthcare staff.

Yeah, love it. No, it makes total sense. I think healthcare and other industries, but certainly we're all about healthcare here, needs that sort of rethinking and design in terms of how we look at Experience and, and customer sat and things like that. So that's great. Wow, Jonathan, we covered a ton of topics and areas from like really some, some good books that everyone should be reading. I loved your life message and really it's sort of sprinkled, which is appropriate, through everything that we talked about. And, you know, this, this concept of science, having the data is very important to understand that, but also with empathy. With sentiment, with human feeling. I heard that and I took copious notes in everything we talked about, whether it was how you got into healthcare tech or how you benefited from it, how you reinvent yourself in terms of the philosophy and exploration and thinking deeply and asking questions. And then you dropped us another book that now I have to read as well. So now I'm 3 books, at least 3 books behind with The Dream of Reason. And then, you know, some of the things that you've been able to accomplish with your teams throughout your career. And what you're doing today. And I love this whole concept of the experience level agreement versus service level agreement. You might find that in a blog coming up that I put out. I love that concept.

I'm gonna have to research that a little bit more, but I love it.

It really resonates with me. So we talked a lot of, tons of different things. Jonathan, is there anything that we may have missed or anything we should double down on as we end our time together?

I think your recap was quite good. You touched on all the things that I think I would've Well, thank you so much for being our guest.

I learned so much from hosting the podcast, and I know our audience just, just loves to hear from insightful individuals like yourself. So thank you so much for giving us a gift of your time and sharing your insights, Jonathan.

Thank you for having me, Ed. It was, it was a pleasure.

All right, that wraps up another Digital Voices, and a thank you shout out to our DJ, producer Megan Aylesworth.

Thank you for listening to Digital Voices Podcast with Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.