Innovating Patient Experience in Healthcare (ft. Dr. Zafar Chaudry)

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.

Everyone, welcome to another edition of Digital Voices. Thanks for listening. I know you have a lot of choices with podcasts, and you've chosen some time with us, and we're going to make it worth your while because as my guest, I have Dr. Zafar Chowdhury. Zafar, welcome to Digital Voices.

Thank you. Thanks for having me. Pleasure to be here.

It's gonna be awesome. You're one of the best leaders that I know in healthcare, and you're such a humble person. I just wanna share a lot of who you are with my audience because I think it'll really inspire them and help them to grow to the next level. And we've known each other in the industry for quite some time. So it's fun to finally have you as a guest on the podcast. But Zafar, before we get too far, the most important question of our time together is what songs are on your playlist?

So I'm an '80s guy. I love songs from the '80s, things like Madonna. So my playlist is pretty much anything '80s.

Yeah, that's good. I, I'm the same way. I'm a child of the '80s, product of the '80s. And so it's kind of fun. I still listen to a lot of that music. And it's fun because some of these artists are still around today touring.

They are. And if you do go and see them, it's a little bit eye-opening because they don't look like they did when I was a kid growing up. And so it's hard to relate. But when you hear them sing, the voice is still there, right? It's kind of amazing.

It is amazing. And wouldn't we all be wanting to do that, right, if music was our jam, to be still playing, you know, so many years later in front of audiences. That's so cool. What about life message or mantra? Are there words that you live by, help guide you?

Well, my dad always taught me that we always need to be a force for good in whatever we do. So I like to live by that mantra.

Yeah, I love that. That's great. And speaking of your dad, tell us a little bit about who you are. Like, take us back to day one, to the very beginning. Where were you born and raised? And, you know, what was your environment like?

So born in Pakistan, came over to the UK when I was 1, grew up in the UK, specifically in Manchester, which is northwest England. That's where I grew up. My dad came to the UK in 1960, became an engineer, and then built a whole series of businesses in the UK. And being a Southeast Asian person, you are required to work with your dad in those companies.

Mm-hmm.

He had a manufacturing company building, manufacturing cooking oil, which we fry foods with.

Yeah.

That's a common thing. Auto dealership, predominantly German cars, and also a chain of Indian restaurants. So I certainly learned all of those things. I like to tell people that I'm a used car salesman, car detailer, mechanic who became a forklift driver. Then a heavy lorry driver to a manufacturer to then now a recovering physician.

No, that's great. Did you have brothers and sisters? Others around you?

Yeah, I've got a sister and she still lives in the UK. She's a podiatrist.

All right. No, that's very cool. And yeah, so that obviously helped shape who you are today. So how did you end up becoming a clinician?

Well, after he taught me all this business acumen, he said, Actually, I want you to be a doctor or a dentist. And I said, well, I think I don't want to do that. I want to be an engineer like you. And he said, doctor or dentist or else. And so I didn't see myself as a person who would be putting their hand in people's mouth. And so I sort of took the physician option and started that journey. The cultural thing is, is that once you have done that, then your parents really don't care what you do after that. But when I did become a physician and practice for a short period of time, they didn't really care what I did. But when I decided to jump into technology, and it was really because I was trying to get off some shifts at the hospital, and they're like, oh, we need clinicians to learn about technology. And this is in the late '80s, early '90s when it was all green screen and you had to memorize keys to do things. I thought it was a good idea. I thought this thing might actually have some value and power in it. getting off some shifts was always a good thing. And as I shifted to technology, I really couldn't explain it to my parents. They're like, what's all this about? They get it now, but it took them a while to get to that point.

Yeah.

And then getting into technology, I realized that this could become quite powerful. And then I tried my hand at dot-com and it somewhat went dot-bomb at the time. And then round about 2002, I actually had to go back home to the UK and I was working, living in Chicago for about 10 or 12 years. And I went back to the UK because my dad had a massive heart attack and he needed bypass surgery. And then I took over his companies, became the CEO, ran those companies for a couple of years, successfully sold those companies to some very big companies in the UK and exited out, made sure that he was financially set. Actually, we were all financially set at that point from the exit, and then was going to come back to the US. And my mother said, you should probably stay and work in the NHS. And I'm like, I don't think I want to. And she said, well, why don't you apply for a role in the NHS? And if you get it, you stay. And if you don't, you go back to Chicago if that's where you want to go. So I applied for a role at the Women's Hospital in Liverpool as their CIO. And really thought they weren't going to give me the job, but they did. And so I lost the bet. And then I spent the next 12 years or so, 13 years in the National Health Service at the C-level, running teams at the women's and then the children's and looking at new hospital builds and building joint ventures and private clouds. Had a lot of fun in the NHS at the time. They were really behind technologically and we did a lot of work to get there. And whilst I was sort of in my 13th, 14th year, the folks at Gartner reached out to me to headhunt me to do a global role. And then I joined Gartner and spent 3 and a half years and a million miles on a plane working for governments and entities from the Middle East, Africa, Europe, US, Southeast Asia, and Asia-Pac. And that was fun, you know, getting to do EMR projects, ERP projects, writing research, magic quadrants, all those kinds of fun things and becoming more specialized in the Epic space. And then one day working for Gartner, we had a client back in the UK, Cambridge University Hospitals. They had just signed for Epic. It was the first Epic implementation in the UK. They'd also partnered with HP on that. It hadn't gone too well for them. They had some real difficulties. So we came, we gave them a presentation, a cost to help them. The chief medical officer pulled me to one side and said, I know you're an ex-NHS guy. I know your parents live here. I was pretty well known. And so he was like, don't you really want to come and help us? Because we can't afford this. What you're offering from a dark perspective, we can't afford it. You just come and join us. We'll pay, pay you well and you just help us out.

Yeah.

And so they, I took their job as the CIO there and we sorted it all out and got it fully implemented and successful and had to change some partners and Things that you have to do contractually, which is interesting because in a socialized medicine model, all approvals have to go through government. So you have to go talk to ministers and get approvals, and that's not the easiest thing to do. But we did it. We sorted it all out, did that about 2 and a half years, and then was headhunted to come to Seattle Children's. And I've been at Seattle Children's now, this is my 8th year. And I've gone through different titles in the process, but happy to be here, happy to serve the mission. I think it's the easiest job because I've worked in pediatrics before. Working in pediatrics is the easiest job because you never have to think twice about why you do this job. So that's sort of my journey.

No, it's amazing. You know, there's a lot of listeners, right? And you have a high profile here also in the US, globally. And so What advice would you give? You know, I'm just thinking, listening to your background, it's varied, right? You didn't just stay in one spot and just do the same thing over and over again. Would you advise other leaders, like emerging leaders, to try different things, not just necessarily stay in like a traditional, like, tech track to become a CIO?

Yeah, I think, I think variety is the spice of life, right? So, when you are working only in healthcare, and this is my 39th year in healthcare, but I'm glad that I have had access to other industries.

Yes.

Because it gives you a different view to how to run a P&L.

Yes.

Right? So I look at IT in a health system as a big L in a P&L business, right? I don't generate revenue, sometimes a little bit, but nothing that can cover my costs. But it helps you negotiate Because remember, our jobs are influencing people. We do a lot of negotiation on a day-to-day basis, whether it's with our doctors, nurses, and allied health professionals, or we're negotiating with the vendors out there that give us a hard time. And it's hard to pick up those skills and be able to have difficult conversations if you're not in the process of learning that in different ways. And There's multiple ways to do that, right? You can get that from going to consultancy. You can get that from working for a vendor for a short period of time. And maybe we describe that as defecting to the dark side, but going to the dark side and coming back is not a bad thing.

Yeah.

You've got to find that balance in your career. And for aspiring people moving forward, This is a tough time in healthcare, right?

For all of us. Yeah.

Things are changing pretty much on a daily basis. Decisions are being made from a funding finance perspective that many of us on the provider side don't like. So if you really are struggling and you're sort of mid-range and you want to grow, you could go and work for a vendor for a short period of time.

Yeah.

And then you could come back with a different mindset, maybe deal with some of that burnout that you might be facing. And then come back re-energized. So I actively encourage people to look at multiple options. And if the truth is you still don't want to leave the provider space, then maybe volunteer to do something different in your business.

Yes.

Right? Don't just do technology stacks. So for example, in my business here, I also run voice operations, which is front of house. And when patient interacts with my voice operations team, that's the team they interact with. And they are very different than any technologist. They deal with people, they deal with crisis, they deal with drama. And I've learned a lot just watching them operate on a day-to-day basis because it's a different way of working. So I— If you're not going to leave the org, volunteer to take on another kind of team and then learn from that team things that you're not used to doing because I would say that most people in health IT are very introverted. I mean, I would tell you I'm the world's biggest introvert, but when you go to work, you have to have a different persona, and you learn those different personas from different levels of interaction.

Yeah, that's brilliant. I'm just catching up on my note writing here because, Zafar, you're just always full of so much wisdom. It's like hard to keep up all these great ideas, and that is so spot on and great recommendations. Yeah, because there'll be some people, yeah, don't want to go to the vendor side, although since I did that and came back and have different experiences, I also believe it's super rich. But yeah, if you don't, there's other alternatives if you stick with just being on the provider side. So that's great. One of the other things that you're known so well for is how you engage patients. And you even, in the last couple months, you and I were together keynoting a conference and you had me in tears and the whole audience in tears talking about the different things that you do. So, share your philosophy generally on patient experience, and then I'll dig down a little bit more on some of the things that you've done.

Yeah, so my overall philosophy is I profess to know nothing about anything. And because I follow that model, I always say I have to find out what I don't know. So, it doesn't really matter who you're engaging with. Instead of me trying to be the smartest person in the room and telling people, this is what a digital strategy should look like, this is what I think my doctors and nurses need, this is what I think my patients' parents and caregivers need. I don't take that approach. I just go and ask them. So we have a patient and parent advisory group. And we meet with them and we ask them, tell us what, what we do well, what we don't do well, what you need, what you don't need. And I found that if you build things technologically to those needs, then you're really serving the purpose that you were hired to do. Don't make it up. Because it's easy to go to all the conferences and see the next shiny toy on the shelf and say, I want to have that. But does your organization truly need it? Right? So example I can give you is patient asked me about gaming.

Yeah.

I don't do a good job because I have not given them tools to survive the pain that they face when they're in hospital. So we built Minecraft. We're the first in the world to do that. And that was because a 12-year-old patient said this was something we should do, and we listened. And now it's been very well adopted, and they're asking for even more games within the platform, not just Minecraft. And on vice versa, we just launched a pathway assistant with Agentic AI. in partnership with Google. And I had 50 doctors work on that project, give their time to build a tool that takes our clinical standard pathways and make it into an interactive experience where you can very quickly get a differential diagnosis, treatment plan, lab plan, imaging plan in real time, as if you're talking to a genius who is your assistant.

Right.

And that's been very well received because it wasn't my idea. It came from my informatics physicians group as an idea, and then they led with it and pulled other people in to test it. And that's now ready for primetime being launched starting in our ED. So this is how I think you have to engage with people. Your job is not to sit in the office, but to walk the floors, ask people questions. Don't try to tell them that you know best. Because as you know, Ed, having worked on the provider side, right? Doctors don't want to be told.

Right.

They want to be engaged. And I always say to people, I was talking to somebody this morning about this, your best advocate is your nursing team if you engage them, because that's the bigger population of clinicians and they do a lot of work and they work directly with patients. They'll also tell you what patients are feeling, experiencing, needing, Because they're with the patients all the time, right? Your attending comes in, sees the patient, does rounds, and goes. But who's left? The nurse for the 8-hour shift, the 10-hour shift, dealing with the day-to-day. What is that kid experiencing, feeling, needing? What works well? What doesn't work well? iPads are great, but who charges them? You don't learn those things unless you ask those questions.

Yep. Yeah, it's where the rubber meets the road for sure.

Exactly, yeah.

You got to be there. You got to live there. So, going back to the Minecraft example, in which you've shared a lot, there's a lot of information out there for people who want to learn more. I thought one of the keys too, and you've hit on this, and again, just getting super practical for our listeners, you actually spent time with that patient because you didn't know. So, you sat with them.

Yeah. And you asked the question.

Right.

And you learned Because you have to put yourself in the shoes of the patient.

Yeah. Right?

I'm not a child and I'm not chronically ill as a child. So I don't know what it means to be in a small shoebox of a room. And then what do you do? Because most times you're in pain or uncomfortable. What are we providing? Well, we're providing a TV on the wall that shows cable TV. Not every kid wants to watch Nickelodeon or Disney all day.

Yeah.

And the new generation of kids who are purely digital that I struggle to understand because I'm just old, right? But they, they love devices. They love engaging. They love having friends in not one place, but different parts of the world through gaming platforms. In this scenario, some of them aren't allowed to leave their, their room because they're on sort of room lockdown because they might have an infectious disease. But then how do they interact with anyone besides anybody who visits them or the nurse that pops in for 5 to 7 minutes or whatever it is? So that's what you've got to go and observe and see. And then you'll see that that's got to be really difficult.

Yeah.

Boredom is a problem that someone has to solve. And also, if you can get people's minds on other things, then it does take away from the current issue that they're experiencing for a short period of time. And our goal, certainly here at Children's of Hope Care and Cure, is not just to treat the child's condition, but the holistic child. So what services are you going to wrap around that? And it's no different for the parent, right? I remember having a conversation with the advisory group and the parents. One parent described this scenario of my kid has quite a few surgeries. Every time my child goes into surgery, I'm sitting outside in the waiting room with bated breath, not knowing what's going to happen, not knowing how long the surgery is going to take. Sometimes these surgeries can take 3 hours, 5 hours, 8 hours, and I won't leave the waiting room just in case something happens. And she said to me, but then if I'm sitting in the room for 8 hours, I have nothing to eat. Nothing to drink. I'm scared to go to the cafeteria because I don't know what's going on. So we built a tool in our Digital Front Door app where you can track the status of your child so you can go—

Brilliant.

And have a sandwich and come back and know where your child is in that surgical workflow and not have to panic that you might miss something so critical. And remember, this is life and death sometimes. So that was what they asked. We said we can build something like that. And so we launched it. And so we know people are pleased.

Yeah.

And they can look that up on their app with a code we give them. So we don't try to use PHI.

Right.

But we put in a code and it says, yes, your child is still in surgery, or your child has just exited surgery and is now in recovery. And so if you are finishing up your sandwich, you could run back 'cause you could see the child, right? So these are really simple things, which honestly in today's world aren't that technologically difficult to deliver against.

Yeah.

But it's because we listened, we built something. So now if we survey the group and say, did we build something that was useful? Guess what you're gonna get, right? Versus me coming in and saying, I'm gonna give you all this functionality in this app. And they're just staring at me like a deer in headlights, right? That's what you shouldn't be doing.

Yeah, that's brilliant. And all these examples reinforce the point that if you serve in technology, you serve in IT, you are part of the care team. Everything that you've been describing, Zafar, is helping to bring wellness, wholeness back to these patients and their families. And so, it's very, very meaningful. We could talk forever about this. I want to sort of end on the topic of leadership. Was there anything early in your life? Well, clearly the Premier Group, you know, when you worked in your father's— in your family business, but even earlier than that, that helped prepare you for leadership roles?

Yeah. So along the way, what I've learned is don't give people work to do that you don't know how to do yourself. So that's always been my mantra is If I'm going to send somebody in to do something difficult, I should at least go and observe and see how it's done first before I actually assign someone to it.

Yeah.

Because so many times leaders give assignments to team members thinking it's just a simple thing to do when actually it isn't a simple thing to do. And they're making that assumption when they actually haven't gone and looked as to what it is. So that's certainly one of the things. And the other thing I've sort of learned is whoever you're leading, whatever group that is, You have to lead humbly. And to succeed in healthcare IT, you have to come with plenty of courage because you're going to take a lot of blows.

Yes, that's for sure. I want to go back to humility a bit because, as I said in the very beginning, you're one of the most humble leaders that I know, and you have every right not to— no one should ever not be humble. But if anyone had a right to not be humble, I mean, you know, all the experiences you described and The things that you've shared, you know, could certainly give you that right. Have you ever thought about why you're humble? Like, is there something that happened early in life or parents or— because, you know, people listening and, and I've tried to work with other leaders and I always try to be humble myself. I know I can go off the rails and I have to like, you know, pull myself back. Is there something that, you know, in your formative years happened that makes you this way? And then Zafar, what I'm trying to do is get practical as well. So, If you're not wired to be humble, how do you instill that in your persona?

So I think I am the way I am because growing up, we grew up really poor in the, in the UK. My dad worked really hard to get educated, to build his businesses. Sometimes we started off by living in one room as a family. Sometimes there was only one meal a day. Sometimes there wasn't. It was really financially difficult. And when you learn to cope with that financial difficulty, and then you're blessed enough to get everything in life, it doesn't matter anymore. I mean, I'm quite comfortable being in a shoebox just as much as I'm comfortable walking somewhere or driving in a fancy car, right? So that's certainly grounded me because I've never really had a need for things. And that was starting off Growing up that way.

Yeah.

But I think if you want to lead and you don't want to— I mean, very kind of you to say, you know, I am a humble person, but I think what people need to think about is always put yourself in the shoes of the person that you are affecting. So when I'm talking to one of my frontline desktop technicians and I decide to go and do desktop work, which I do do. I am tech support sometimes when I have time, and I'm probably not the best tech support now because I've lost some of those skills, but I do try and the nurses do give me the thumbs up. But at the same time, I have to understand what the life of an employee is who makes $50,000 a year and still lives in Seattle versus the life of an employee who makes $250,000 a year And lives in Seattle. And Seattle, for folks listening, it's a very expensive place to live. It's not the cheapest place. And life is difficult for people, right? When I first started at Seattle Children's, I actually lived in Seattle and I took the bus to work for almost 2 and a half years. And I loved it because every time I sat on the bus, I would sit next to nurses who had just graduated nursing school, who would tell me how difficult their life was. Because they were making a very low wage.

Yeah.

Rent was high. They didn't have money for transportation. Hence, it was great that we were providing a free bus pass. And you learn a lot about what life is like for people. So I feel like I'm blessed to be in the position that I'm in and able to lead a team of people and make an impact. But there are many people in a health system, you know, one of the most important people in a health system is the person who works in environmental services, who cleans the bathrooms, right? How important is that? The person who cleans the ED, because how are you going to transact patients if they don't disinfect the units and the ORs and everything else? But those individuals, they don't make a lot of money, but they're very proud of the work that they do.

Yeah.

So I think if you're really trying to understand the mind of every individual. Go and spend some time with those folks. Go and spend some time with the guys that do the catering, that run the cafeteria, who keep you well-fed when you're doing your 10-hour day. And you'll realize that those people are so humble.

Yeah.

So happy. And they live a comfortable life, the best life they can for the $20, $18, $17 an hour they make. Versus you who could be making $300 an hour and then wants to have such a big ego. And that's, that really grounds me and brings me back down to earth every time I have that level of interaction.

I, like I already said more than once, I could spend a lot of time with you. I learned so much from you every time I have an interaction or I see you speak and share. Thank you for being our guest. We, we, we talked a lot about different things about being a force for good. As a mantra. We talked about your upbringing starting out in Pakistan and mostly in the UK and the United States. And then we talked about your whole career and just the varied positions and the importance of that. We talked a lot about how to engage patients. You gave very practical advice that others can follow in their own organizations. And then we talked a lot about leadership and just being humble as one of the keys. Is there something we missed or anything you want to double down on? I'll give you the last word.

No, I think you've captured it well, Ed. Like I said earlier in the conversation, everybody should be a force for good. And if you can do that, you'll be successful in healthcare.

Well said, and a great way to end our podcast. Thank you so much.

Thank you so much for having me.

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