[Music] good afternoon and welcome to this month's show i'm luke mccormack during today's show we will discuss critical issues facing government and industry leaders and using information technology to improve health care and health care services with me on today's show are ryan dempsey argentieri deputy director office of technology at the office of the national coordinator dr neil evans senior advisor to the cio and chief officer connected care at the veterans health administration carl matthias chief information officer health and human services mur ali gandarajan healthcare field cto at snowflake jonathan album federal cto servicenow and seth kindly principal data architect u.s public sector pure storage we're talking healthcare we're talking federal healthcare ryan we're going to start with you and maybe just a couple of minutes on you what is the office of the national coordinator what do they do and then of course what do you do and then what's the state of the state there sure thing thanks so much for having me um for those who don't know the office of the national coordinator for health i.t is primarily charged with driving standards and programs that improve interoperability across the healthcare system and we do that in a few ways one with the identification of standards that are adopted and and ideally used by industry primarily electronic health records vendors and developers of uh really a number of the supporting products that support those ehr vendors and that kind of universe is expanding especially since the pandemic we can talk about that a little later two we do that through policy coordination primarily with cms and cdc in terms of with cms to make sure that the payment regulations and incentives are tied and correspond to the certification of health it products and then third is the coordination of the this approach across our federal programs and partners to ensure that for example with the use of what's called fire standards uh which are primarily and very prevalent in other industries such as uh the financial services industry that uh our our programs across government are leveraging the latest innovations and not recreating the wheels so um for those who don't know fire stands for fast healthcare interoperability resources and we're seeing um a really large uptick in the adoption and harmonization of fire standards across that certified health i.t landscape we are really proud in this in this calendar year to say that the 900 plus developers who are part of our program have uh attested to the new requirements and regulations that were introduced in approximately march 2020 there was a two-year compliance timeline and we had a hundred percent uh at a station which is pretty amazing so that means that those developers have to uh attest that they are going to make that functionality available to providers which includes clinicians hospitals health plans federally qualified health centers and increasingly more community-based health organizations so that will really we think be a game changer in the future for true interoperability of healthcare so that data moving seamlessly across different vendor platforms and different networks um which is you know certainly a lofty goal and there are some challenges and hiccups that we still have to work out uh but it's it's pretty incredible a patient empowerment and uh reduction of clinical burden from those two perspectives a tremendous amount of coordination coming out of the office of the national coordinator no doubt about that uh dr neil evans uh tell us what's happening at vha what's the state of the state there sure luke um i'd love to talk about that in the department of veterans affairs and specifically in the veterans health administration obviously health i.t is a core part of how we deliver our mission of caring for more than six million veterans a year through our health care facilities by our healthcare providers across our large healthcare network and technology it was a part of what drives those workflows a lot of exciting things happening in vha and supported again i also serve as a senior advisor to the cio in our office of information and technology and so this is really a partnership between the veterans health administration and the office of information technology and delivering value to both um veterans the veterans that we serve millions better across this country and then the more than 300 000 staff come to work every day to deliver care to those veterans i think maybe i just highlight um here in some initial remarks you know we still are dealing with the effects of the pandemic and you know we have seen just a huge transformation in how we're able to support care leveraging health information and technology in the va um as of july 25th so just you know a week or two ago more than 20.7 million telehealth visits have taken place during the pandemic in the va um we've seen why the 2.3 million veterans use telehealth to access their va healthcare that's 39 of all veterans who receive care through va are connecting to us at some point in time using telehealth which is really remarkable when we add in digital access through our mobile app um through mobile apps through the our our patient portal um it's more than five million more than one million a month who are connecting with us uh digitally so what's exciting to me is how healthit is really directly impacting and allowing veterans to engage in improving their health and their experience of receive receiving health care from the va as a result of our investments a real confluence of events there um i just i can't let that number go uh that many touches uh sort of as we currently sit what was it just roughly prior to the pandemic in comparison yeah i you know we would do um so we would just to give you kind of a sense for the scale we would do maybe 2 000 to 2 000 to 4 000 video visits per month before the pandemic uh to the home and we're we're now doing uh 30 000 plus per day um incredible that is amazing um well it's amazing just from the scale but it's amazing that uh the the outreach to the healthcare it's uh impressive i'm sure you'll have more to elaborate on that but uh hats off to all of you for enabling that for all the veterans carl you've been over at health and human services now at the mantle there for what three or four months i think maybe five uh tell us about uh what you're what you're discovering over there in the state of the state as i love to say congratulations on the appointment by the way yeah thanks luke uh well i i think uh you know i if i could talk about previous jobs for a second it's it's gone from uh working department of defense where you know air force where i talked about the mission to be summarized is putting ordnance on targets and then you go to the u.s marshals where it's catching violent fugitives you know my staff goes then why did you come to healthcare and i think the summary version of that is we're saving lives of health and human services i mean this is a great mission and what i've discovered luke is i completely did not understand the scope and the size of the department uh so in since march when i've been here uh what i've had to do is go through and i'm still going through learning what every everything does because it's so big for example we've got uh the operating divisions and examples of those are the food and drug administration national institutes of health uh you know cdc and then the staff divisions for example ryan with onc and my job is to make sure that i enable their missions from an i.t perspective so i go from managing you know a 100 million dollar i.t budget to now providing oversight to 7.2 billion dollars of i.t spend across the department and you dig into that what i'm discovering is you go to nih and you go well this is one operating division then you discover nih has 27 different institutes underneath it each with their own cios and their own operating budgets not just one operating division so the the scope and the breadth of the things that are happening at the department of health and human services is just uh astounding to me and fun uh digging into it they're you know i'm sure we'll talk about along the way but there is a lot of exciting things going on in terms of what's being done with the data that we have uh cyber security initiatives uh artificial how artificial intelligence is going to be used is being used so it's been exciting it's been fun i'm still learning i will probably be learning uh four to five years from now i will still be learning what's going on in hhs through the scope but lots lots of exciting things going on fantastic and uh i think it's a culmination of the various uh different experiences in your career that's brought you to this point i'm sure you're gonna do fantastic and you are doing fantastic so once again congratulations there mara lee of you know when we think about health care we think about an incredible amount of data and then i think about the analytics and i think about snowflake so tell us what you all are doing in this space and just give us a state of the state about what you're seeing what your customers are asking for what you all have yourself involved in to provide these solutions and capabilities to these various entities thanks look for having me absolutely um i want to touch upon couple of uh topic areas today one is uh we launched our healthcare life census data cloud during teams conference earlier this year the goal here is to enable healthcare organization seamlessly collaborate on their health data in a secure and governed way if you take a healthcare data cloud um you know a healthcare organizations have various amounts of data right as you rightly pointed about um the way if you look at it they have first party data which essentially is a patient data and as they start interacting with other stakeholders in the healthcare ecosystem they started changing data right and that generates significant amount of third-party data now with the data cloud they have ability to bring all of them together combine that with any sort of publicly available data sets in snowflake marketplace and generate whole patient view and generate insights that they have never been able to do before right the other area where we have made some significant progress is that we have built solutions jointly with our uh uh with our partners that helps with ingestion of various health data formats such as health servant fire resources ccda natively into snowflake like what do i mean by that is uh we bring processing of the data to where the data is thereby bringing efficiency making it simple for healthcare organizations to adopt um and and implement you know you talked about snowflake marketplace and that's an interesting concept there and i think a real valuable one that you all have been able to lay out that capability and allow that type of environment to ingest all this information and process it so we really do appreciate that jonathan servicenow this platform never ceases to amaze me and i know that there were a lot of folks that were using it for simple things like coveted tracking et cetera et cetera but i certainly know that you all are doing much more comprehensive things in a health care space give us a top line there thank you luke you know when you think about the challenges that health care organizations have disconnected systems silos those are the kinds of things that servicenow is perfectly positioned to help them overcome so we're doing this across government we're doing this across private sector healthcare organizations and in the past year or so we've taken these sort of core concepts of connecting data and connecting systems and connecting organizations and we've built them directly into the servicenow platform so we created a healthcare and life sciences capability you know that's that's in use in in the in the commercial uh in the commercial area to really help streamline operations uh help healthcare organizations become more proactive and predictive more resilient and provide capabilities to the providers and staff of these organizations to really unlock productivity you know when you look at those processes that have a lot of manual steps if you're able to think about how the work and the data flow and how you want them to flow and then you know using servicenow and pre-built workflows or custom workflows that you can build can really change the way the the organization operates and when um you know when those workflows are really thought through and the way the work gets done the way people are served is you know front and mind the experiences and the outcomes of people the providers and the patients uh we find that those experiences improve and just one one other thing real quick look that you know we're able to provide is a consumer kind of experience to a to uh to a patient you know whether it's it's um pre-visit management or it's uh support services if you can access those on a mobile device or you can provide consent or fill out the forms before you see a provider online that digital documentation uh you know we find makes a big difference in the experience and when all the data is available you can provide reports to the to the providers or to the patients that help them be more in control of their of their healthcare data we're we're finding a lot of um a lot of very positive response from these kinds of capabilities now we're applying those into the government space no question that that platform has made to order for that and i certainly heard ryan talk about customer service experience and and dr neil as well uh we'll call it patient experience here super important uh part of the evolution of this capability seth how about pure storage once again when i think about healthcare i think about a lot of data i know you all are well beyond just storing data give us a state of state thank you luke uh the state of the state is that pure has evolved much like everybody else has had to evolve especially with the pandemic and how things have changed so instead of focusing on just storing data we've become a solutions company that allows you to automate and orchestrate a number of disparate applications whether it be next generation sequencing and having to do pre and post processing of sequencing or your ehr to neil's point having the influx of telemedicine and virtual conferencing coming in you have to store that data and that data needs to be stored effectively with an idea around volume versus velocity and if you can do both of them to help accelerate the patient's experience you know faster is always better essentially and safe and secure storage of all that data has really become paramount a lot of people have started paying attention to regulatory and statutory compliance with a sort of an eye on all of the detail as opposed to it being something where you'd physically go and obviously that was private you were in a closed room now you're doing it potentially from anywhere with the advent of obviously smartphones and tablets you can do it from the beach while you're on vacation so you have to basically secure the data end to end be able to prove so and do it without negatively affecting the speed so pure excuse me has really pivoted to focus on automation orchestration security and the availability of all the data no matter what discipline it came out of like we said could be all the way from sequencing to just a table entry in your ehr for the last time that you went to the doctor a very interesting concept there about extending that type of uh technology capability and once again we're focusing on the patient the citizen super important to do that all right we're going to wrap it up here for this segment and we'll be right back you're listening to the federal executive forum on federal news network welcome back to the federal executive forum on federal news network we're talking about healthcare i'm going to start getting into specific programs that we'd like to highlight dr evans i want to start with you over at vha give us an example of a specific program you'd like to uh highlight for the listening audience sure luke well i just wanted to come back briefly to what i mentioned in the first segment about telehealth and i wanted to just provide one sort of adjustment to the data that we were doing about 2 000 video visits per day before the pandemic which was quite a lot we were one of the leaders in delivering telehealth to the home and that increased to more than 30 to 35 000 per day now and just to give you a sense to follow up on that that's um over a 1200 percent increase in fy 20 compared to fy 2019 so from before the pandemic um to beyond and what we're seeing in in vha is that that desire for connections where there's a seamless uh in intersection between both virtually delivered care whether that be through secure email whether it be through telehealth um or what you know the virtual capabilities connected capabilities are increasingly part of care right alongside face-to-face care both of them matter and it's that that sort of seamless connection seamless combination of both it's really appealing um to those who are receiving care for ba um on the topic of a specific project to sort of take that the next step right relationships are super important in healthcare and telehealth technologies let us connect veterans and their caregivers with the staff members va staff who are there to care for them but without the data to support clinical care delivery we're missing something and i think one of the things that really excites me and this um follows some of ryan's comments in the in the first segment is the volume of data interchanges occurring across the health sector that continues to increase and the real opportunity as we increasingly are leveraging some of the standards that onc is is is um helping to to promulgate across the industry um the the the potential is really significant but i'll just highlight um our um joint health information exchange this is a shared effort between the department of defense and the va and the dod and the va as a shared joint health information exchange are sharing data with now with more than 65 of private sector hospitals and by the end of 2022 we're going to also connect to the care quality network which will increase our sharing to more than 90 of private sector hospitals to give you a sense of what that means from a volume perspective va and dod are delivering nearly five million documents to community partners that means private sector health providers are able to see um records of the care that we're delivering in the va dod to support the care of the of the veteran or service member who's in front of them and we're retrieving more than 40 million documents per month for va and dod providers to have access to that information that's occurring in the private sector health care system for the delivery of care to the patients sitting in front of us in the in the federal healthcare system so super exciting to me and the opportunity there and i'm sure ryan probably has some comments on this further as we implement fire as we continue to push this data engages we start to meaningfully insert that data into providers workflows and into the hands of patients i think there's a real tremendous opportunity in front of us over the next couple years absolutely and we're going to hold on brian for a minute i'm going to jump over to jonathan because i again i thought about the scale of that customer experience and i think about things like iot devices and some of the things that are going to come maybe maybe that's your answer to your futures question but give us an example jonathan of some of the stuff that you are doing right now that you'd like to highlight in sort of the healthcare segment sure um you know it's a hard question to answer because servicenow is doing important work at agencies all across hhs uh doing important work at the va um you know it at cms for example we've built an employee portal where we can consolidate access to services at the va i.t service management alone has helped make the office of information and technology a lot more efficient saved millions of dollars in the way that they uh do their efforts uh we say help them save lots of money with through software asset management and you know reduce clinician time just through simple things like self-service for for piv exemptions and password resets but you know you mentioned in the beginning a lot of agencies used servicenow as part of their coveted response exactly and that was uh that was a game changer in so many places because you know very quickly we were able to create emergency response capabilities and vaccine management capabilities and vaccine status reporting i think over 300 000 federal employees vaccination statuses were captured in service now during a very short period of time when that was a really critical uh really critical uh action for the administration but when when kovet hit originally and we're trying to figure out why some people became more sick than others agencies and offices at the national institutes of health took on a lot of these challenges and we worked with the national cancer institute in that case to build a portal where patients and doctors could securely share samples of coveted results and related data patient data so researchers could start to think about um factors genetic factors that may increase one's likelihood for severe covid and you know we we use the servicenow platform to quickly deploy that kind of capability and then in a very agile manner continue to update it and and modified so we could capture information related to um to changes that were occurring like once the vaccination was vaccines were introduced and how would that impact spirit cope and other things so that's just one of many examples where the service down platform was deployed quickly and securely and positioned in a way where both doctors and patients and researchers could collaborate so it's very customer focused but also employee focused kind set of workflows and capabilities to streamline a really important operation at a time where you don't have a lot of time to design and redesign and deploy and redeploy and you know think through um every aspect of things you have to go really fast and we were able to go really fast with the national cancer institute in this case it made a big difference really fast and very secure and all the sort of the the platform environment comes to bear you're able to stack these applications on top of it and develop them very quickly it's fantastic what you all have been able to do with that platform all right ryan we're coming over to you to talk about uh well whatever you'd like to talk about as far as highlighting a program sure sure so uh several times here so i thought you're you're skipping because the data the data integrity is not the not the most uh sexy conversation um topic to to get into but we um um but just uh just a few points to add so we have um really a prioritization on the on that data quality and on the integrity of the data and we've been working in earnest on that for several years through our u.s core data for interoperability which we believe has uh been one of our more successful programs to date just in the sense that uh it's established that minimum data set for the healthcare delivery system and while it is not comprehensive um by design because we want to make sure that again the playing field is level and it makes sense from a provider burden perspective so if you're in in the context of a telehealth visit you might not have time to um add all of the different features and and the narrative text and all the different components that a lot of people are really interested in across the continuum but um we don't want to you know enforce anything and require anything that doesn't make sense um for for the majority of the system so that is uh really sets the standard for the data elements and the corresponding vocabulary standards it's agnostic to format which is really helpful and it is updated on an annual basis through a transparent in the sense that anyone we get hundreds and hundreds of submissions and comments from all across uh the the country so not just our federal partners but um you know non-profit organizations and advocacy groups and provider organizations and that has been uh not only helped create the foundation so that you can move quickly so we talked about speed and the need to move quickly and the need to be able to move the data the data as fast as possible but you can't do that um without first building a strong foundation so i used to be in the commercial building industry um and my i had colleagues who had been around for decades who built you know the largest skyscrapers in the world and they always said you know you can't build a skyscraper on a pile of sand it's cliche but i think it holds true in healthcare and i think about it all the time when i um i'm trying to encourage people to care about the the semantics of a data element um but that has also led to the an extension of that program to make sure that where we need to be more thoughtful and more expansive and what we're covering and the use cases and the problems that we're trying to solve through data we're doing that in conjunction with our federal partners through something called uscdi plus and that's going to allow us to get into more of the granular needs specific to lab interoperability health equity and risk drivers which is huge for the va and and really for all patient populations across the country and there's a number of other subsets that there's lots of information on our website you can go check out um and all of this just some real life examples as how things have played out in in the course of the pandemic uh we've been able to leverage uh the smart health card standard which many of you know and have utilized likely very often especially when you think about having to show proof of vaccination for example but also with your if you have an app that's based on whether it's an apple or some other type of health card platform to get your records and to see that information more seamlessly i would say it's still relatively um new from kind of the bell curve of adoption and in terms of how many consumers who of course have to have that higher technical capability in their smartphone for example but that has really started to promulgate as dr evans said and and be something that developers and industry providers and partners um snowflake's a great example of where uh we're seeing that when we look at the standards that are have already been tested and are tried and true we can really apply them to harder problems that that require pharmacy providers and and other non-traditional uh health it actors to leverage those standards to move large amounts of data accurately securely and quickly um we did that through behind the scenes standing up vaccinefinder.gov we're doing this now through the capture of over-the-counter cova test results these are the things that you know people don't wouldn't know about necessarily because they're not you know headline news per se um and then hopefully we'll be extending some of that those successes to uh programs with our with partners like nih jasper of course with um cdc fda and others just to leverage and make sure that anyone whether it's the rise of the number of telehealth visits and how to make sure that that information is captured properly or continued and expanded interoperability of networks and will uh you'll some of you might be hearing more about this and have strong opinions about it but the trusted exchange framework and common agreement uh has is another success from this year in terms of the the draft requirements uh being published and made public for all different types of developers including core infrastructure providers and companies to really be at the table to start to weigh in on what the security requirements are to make sure whether it's a patient consent issue or a network security issue that the permissions are in place and that we are being really thoughtful and thorough in what we are requiring of industry moving forward a lot of coordination activity there and uh good catch on uh look you can secure the data but if the quality of the data is not there then you don't have the foundation to work off of your reference snowflakes i'm going to go to you uh marley and uh give us an example of a program you'd like to highlight um absolutely uh um luca and great uh points from uh ryan from omc i want to double click on the data collaboration and the need to consolidate all of the data and eventually generate insights that will drive patient experience that came up in the discussion today from a context of two different use cases one is uh accountable care organization uh who are participating in our cms medicare side savings program can hugely benefit from such a data collaboration and data interoperability participating providers in an aco can now seamlessly come together exchange data and with our technology they can bring all of them together to build a view of the patients that will help them understand the um the the gaps that may exist within their patient population the agos can then effectively use to that data information to close the gaps and thereby uh performing well in an aco model right great use case and again greatly ties to ryan what you spoke about in terms of the interoperability how uh you know organizations are going to come together the second use case is from a context of value-based care if you take a look at healthcare providers who are getting into a value-based contract with health plans they often rely on member attribution data claims data from health plans the way they have traditionally gone about doing this is they'll request for a file uh the plan ships a file to them through an ftp uh the provider gets them um goes through a quality process check uh but during the process if you look at it um it's very time consuming and if there are any quality issues they have to go back and redo the whole cycle with the help plan but with our data collaboration and data sharing technologies they can now seamlessly come together onto our platform um and change that data and cut down that time to insights right and and this will greatly help uh any any healthcare organizations to be successful uh in delivering the promise of value-based care a very interesting concept there and a lot of uh coordination behind the scenes so to speak to make that uh that it's that patient experience if you will carl i'm going to roll up to you i know you've only been there for a short amount of time but no question you all are involved in several different programs over there can you highlight one i'm gonna cheat luke i'm gonna i'm gonna mention two i'm gonna deep dive one so uh and i think jonathan could identify with this that as a department cio you own nothing you're responsible for everything and uh that's what i'm discovering we got a smile out of jonathan yeah so but you know so i'll mention a couple programs but uh you know my job is to enable the operating divisions and staff divisions to do their job and so you look at a couple of these things some really exciting things going on for example with vid the cio of the food and drug administration uh he's working some ai projects to improve our health inspection program some exciting things happening there with ai and how they select what should be inspected if you go over to andrea norris national institutes of health she's done some fantastic work in putting together data storage solutions amongst the cloud service providers to get better rates and come up with ways to do mass storage we're talking 170 petabytes of research information here and allow researchers to share so you know when you dig into what the operating divisions to do are doing there's a lot of really great projects going on that have been going on for a while but there is actually one that i own that has been going on for a while i think is doing some great work uh runs out of my shop and that is uh associated with the risk management across the healthcare sector of the united states and we don't uh i know we're you know you think health i.t you may not think about this but you know when we talk about critical infrastructure of the united states a lot of people think of the energy grid but i'm sure ryan would agree what we really also have to think about is that it infrastructure that keeps our hospitals our clinics the pharmacies all running and so that is one of the things i take care of through two different uh programs one of them is called the health sector cyber security coordination center hc3 and what this does is it goes out and analyzes threats to the public health infrastructure and develops alerts and analysis and reports so that we can let you know partnering institutions know about possible issues we also go through and look at new urls as they're published and if they're healthcare related we'll look to see if they're scams or they're putting out malware giving example i've got the stats right in front of me last week alone we looked at about 1300 1400 urls we sent down 162 takedown notices to the internet service providers because they were position out nonsense and so we partner also with the office of the inspector general so that when there are data breaches we assist with sending out victim notifications like last week there were five of them sent out for issues that acros happened across the sector additional program we run is one that is really effective is a government industry partnership program it's called the 405d program that's because of the statute it's section of it but we've got 230 over 230 industry leaders that represent over a thousand hospitals clinics pharmacies you name it that participate in this and we work together to develop guides procedures things like that to enhance uh the security of the health care infrastructure and so the primary product and you can go out and look at this you can go to hc3.gov the 405d dot gov is also out there you can look uh there's a guide called the health industry cyber security practices guide which my staff effective affectionately pronounces hiccup uh but that guide has been cited and used all over the place in the last 12 months on social media we've made we've done 450 posts uh kind of broadcast the procedures and best pr practices uh received 400 000 hits on it uh 370 000 were this year alone uh the program's just gained interest and is starting to roll even stronger and stronger working with omb working with the white house on improving this cyber security across the health care sector so there's i think this program is having a true real effect on security and i think there's a lot of exciting things are going to continue to happen and of course we're partnering with onc so you know ryan knows all about this but just lots of good things happening there luke sounds like there's a lot of moving parts going on all good and we really do appreciate all the work we're going to take a small break and we're going to be right back you're listening to the federal executive forum on the federal news network welcome back to the federal executive forum on the federal news network we're talking about healthcare we're just getting into specific programs i'm going to toss it over to you seth at pure storage give us an example of a program that you all are working on in this sector that you'd like to highlight yeah thanks luke i think one of the largest one and it's somewhat purposefully nebulous is just the data center modernization and data center consolidation whereas ryan talked about foundationally we have to have the fastest infrastructure available and the most secure infrastructure available to really augment these sort of higher in the stack applications so if we're talking about analytics sometimes it's more advantageous to run it closer to the data set if it's gigantic for instance so there's certain data sets where gravity and locality is certainly something you have to pay attention to as well as you know security has been thematically one of the biggest things we've talked about having a secure infrastructure that allows for legally non-repudiatable sort of evidentiary uh immutability is is certainly an important thing right you want to be able to prove that these data sets that are maybe not reproducible right it came off telemetry that is not going to be can't be reproduced will never happen again you want to ensure that when it lands on that infrastructure that you can prove definitively that it hasn't been modified that the golden set is there and of course we all want to be good stewards of taxpayer dollars and the uh the other piece of the infrastructure which is energy as carl put out so having this infrastructure that is power efficient that is effective and is secure is one of the biggest things to foundationally set it up for success because these are no longer silos of excellence as i like to call them this is a collaborative investment that everybody has to make there are pieces of this puzzle where you need the service now you need the snowflake you need storage on-prem if you can't go to the cloud underlying all of it that helps facilitate patient care and speed so we have to work in concert not in lieu of one another anymore so that's been the biggest thing is just evangelizing that this is no longer necessarily a one-shot solution you're going to have to team you're going to have to collaborate and we're all going to have to work together to have all the pieces in the right place otherwise it may not work or it's going to work in a fashion that wasn't any different or better right status quo is not what we need data is getting much larger and time to results need to be much faster so how do you do more with less you build a better foundation as ryan put it uh absolutely all right we're gonna uh roll into top priorities ryan we're to start with you your very number one top priority for this year okay tough question our top priority for this year is interoperability of networks based on robust health i.t standards that i already talked about that are then certified and required and and that we see come to life in the marketplace whether it's through the advancement of api based systems or just inclusion of all the new innovations like seth talked about um that those workflows are taken into consideration up front and everything is well coordinated across our federal partners and decision makers coordination coordination coordination dr evans top priority for youth this year a hard question but an easy question uh the top priority for us is always the veteran focused on delivering services and care of the veteran and i think maybe i would um highlight the executive order um that was signed by the president in december on transforming federal customer experience and server service delivery to rebuild trust across the government otherwise sometimes referred to as putting our people first by improving customer experience and government services right this is really important this is a happening really across all of the federal government um all agencies but it's something that's really really important um has been important for us in va for a long time and remains a priority how do we a lot of what i was talking about with connective care connecting digitally with veterans delivering services letting folks engage with us and receive the care that they need anytime anywhere top priority enhancing the customer experience for the veterans sounds fantastic and we all appreciate it carl top priority for you at hhs uh that's an easy one i was hired because i talked about data we've talked about data all throughout this so far and so the top priority at hhs is develop a comprehensive department-wide data strategy and we are in the middle of doing that we've got engagement uh from the deputy secretary on down and to my chief data officer we're looking at how can we improve the the people and the culture associated with how you manage data bringing in people who are experienced data scientists who understand this kind of thing we see a lot of pockets of supreme excellence like nih cdc uh we want that to be more comprehensive we want data sharing across the department so the researchers are sharing information you know cms is able to securely share information but maintain privacy of the individuals involved we want our internal operations to be efficient as we do this so how do you manage the data how do you govern the data you know just the comprehensive look at how we manage and control our data across the department and secure it along the way i mean that's a huge concern so all kinds of things factor into it but over the next uh let's see where the schedule we've got is pretty aggressive here but the next two two and a half months we're moving at light speed to get that data strategy together and begin to develop implementation plans to make parts of it work all hands on deck on the data and i love the pockets of supreme excellence very well said there all right um we are going to uh wrap it up here we'd love to talk all day but we don't have all day uh but we have a few short moments and i want to start with you seth and uh we always like to end with painting a picture of the future two to three years uh what does it look like from pure storage's standpoint what is it that you all are developing maybe it's out of the petri dish maybe it's still in the petri dish what's the demand signal that you're getting as far as positioning for this segment to deliver the goods yeah the i would say that the ultimately the the biggest signal that we've seen so far is customer experience right ultimately and that's what everybody on this panel has spoken about and we have to deliver a better product uh that allows people that work on that product to do it effect basically effectively and efficiently so that everybody above it above and beyond can do their part of the workflow so as everybody on this panel has talked about there are a lot of moving parts ryan does more with coordination before lunch than i think most people have done in their life and you have to have everything basically in line for that to take place so pure is doing a number of things to increase the physical storage without increasing the footprint so keeping the same form factor the same power draw but making devices larger we're making things faster right you can't you can't make it larger and slower that just doesn't equate anymore so we're trying to be good stewards of power cooling taxpayer dollars our own technology and then enabling folks to stop focusing on infrastructure so to speak a happy infrastructure owner that doesn't have to give up nights and weekends that's providing a service to everybody that's effective and efficient is a great solution and we're trying to solidify the fact that whether it's today or ten years from now not even two or three it will be ultimately the same platform the same processes so once it's ato'd once you have your standard operating procedure it can be something that is just lather rinse repeat and quite frankly it could be automated and orchestrated without having to have human interaction absolutely and i would say uh you know sort of uh moving up that uh that stack if you will uh in comes servicenow jonathan um two to three years from now uh in this sector i always like to sort of stay with this segment i i think i think in uh over that period of time it's really about the connected clinician having health care providers that have access to the data that they need we've talked about data a lot have uh processes that are workflowed that are automated so it's very simple for people to do their jobs and when they when the data tells you something actions can happen on the back end without a human having to take them and we can really streamline the way we provide health care and you know underlying all of that i think is a focus on um low code capabilities putting the ability to create workflows and applications at the hand of uh in the hands of business users you know you can't have every uh health it requirement flow through the office of a cio the the the low code capabilities on the servicenow platform allow people with program knowledge with with the practical experience to build the systems and applications and workflows that they need to get their jobs done so let's put those technologies in their hands build things that work for the patient you combine that with these ideas of hyper automation where we can take low code plus ai plus rpa and other kinds of uh very very powerful technologies have put them together in ways that can digitize and automate end-to-end processes and suddenly it's much simpler to provide healthcare and that clinician has access to the information in the palm of their hands they can provide exactly the health care they need things can happen on the back end so medicine is ordered or supplies are ordered and people don't have to wait for the health care that they so desperately need at times and that's what i think the future is and servicenow is a big part of that absolutely and that whole citizen development i think you're referring to there big topic these days and uh certainly servicenow really enables that uh murali uh snowflake two to three years from now where are you all in regards to delivering these types of capabilities to this healthcare segment absolutely um yeah if you look at the themes that are uh popping up in this discussion right it's about coordination it's about collaboration um and it's about how we are connecting physicians and clinicians so they they take better informed decisions right now if you look at it there are there are two things that are so critical for this right one we need ability to bring the data together right faster and then to generate insights uh at a rapid pace right um so the time to insights is so critical um now with this context i want to talk about one of the interesting um features or capabilities that we are working on called native application framework what those frameworks let healthcare organizations do is um build and deploy data applications um on snowflake and and let me let me break this down for you right uh you know let's say that if there is an academic organization or a health technology firm that has built a better disease prediction model they can distribute that model securely through snowflake marketplace um and share with other health system provider the other health system provider can take that algorithm or model and deploy it onto their environment and run it on top of their patient data without having to ship their data out of their environment now this opens up lots of possibilities in terms of how quickly a healthcare organizations can collaborate not just on not just with the data but also with algorithms and applications and thereby cutting down the time to insights and deliver better care for patients very interesting concept and we certainly look forward to that capability and sort of unlocking a lot of the uh environment carl two to three years and now uh you obviously you're gonna have your whole data structure in place uh what do you expect to see when you look around let's say three years from now in your environment what i hope to be seeing is researchers sharing research data to improve their results particularly if we look at national institutes of health centers for disease control you know they're already working on this but i'd like to see that dramatically enhanced where we're seeing that sharing it's a common issue amongst research labs in the government of uh having to facilitate that we worked out that when i was at the air force research lab that was my job to facilitate it there so i've done it before i think we can do it again like i say we've got some absolutely outstanding cios the operating divisions the other thing i'd like to see is with our service providers getting the and by that i mean the health care service providers getting the right information in a secure way that protects patient privacy uh to the various points of service whether we're talking clinics hospitals pharmacies if you look at what indian health services is doing with mitch thornborough their cio there they're working on a very large modernization program to modernize the indian health service medical records capability and that's going to be some great work i'm hoping to help him facilitate that so that's those are the things i'm looking to see and it all comes back around the data and if i could tell just slip in a challenge here luke the challenge i think we will face over time is how do we get that qualified highly skilled i.t workforce data research data scientist workforce in and attract them to government i think we have a compelling mission but there's probably more things we're going to have to work on as a government to attract and retain that talent a bit of call to action there thank you carl and once again congratulations dr evans uh tectonic shift with vha over the last two to three years fast forward two to three years what can we expect i think i'm just in following the theme of the comments here i'll i'll follow on with the data theme i i think um as we move forward we've already talked about over the course of the panel today um the immense amount of data that we're generating within our health care systems we've also talked about interoperable health data where we can start to share data between healthcare systems um the the type of data that i don't think we've talked as much about that i think really we're going to we're already seeing the impact but we're going to see an increasing effect over the next two to three years is patient generated healthy the data being collected from devices or being entered by uh patients in between their visits with the health care system [Music] what's exciting to me is to think about all of that data coming together the opportunity we have over the next two to three years to take healthcare system data data that is shared across the healthcare system for the benefit of um individual patient care as well as the term you know finding new insights in that data and adding patient generated health data inserting that into clinical workflows to drive clinical decision support for providers to empower patients in better understanding their own health and their health journey and frankly to enhance the care or the relationships that we can provide in our clinics basically improving the provider experience and the customer experience allowing healthcare to become healthcare because the data is already there delivering the insights to drive to drive that care delivery fascinating and we're certainly really looking forward to that ryan take us home uh two to three years you've got a lot of moving parts uh going on there incredible amount of coordination that's what your office does what do you what do you expect to see two to three years from now well this is what i want to see so i'll start with that caveat but uh and we want to see it omc so we as i touched on earlier we want to see that patients and providers have a better health healthcare experience no matter the setting and without any special effort or stress and just total empowerment of their information to do that we want to see and and expect to see that standards affecting consent will be will be established and widely adopted that we will extend the successes that we've had in the true clinical health record context to public health systems and public health information through efforts like the data modernization initiative and partnerships with uh the ocio at hhs just to make sure that advancements and innovations through machine learning and other algorithmic based care are are fully leveraged uh and extended to um all users who are ready to access those uh and to um finally make sure that the research needs across the country are met again making that data available to anyone who can who can take advantage of it and just specific to the workforce that we're both um making sure that no one is left behind from an equity perspective and also that we take and capture the lessons learned especially from the past two years and uh provide that kind of integrated holistic learning and and uh knowledge base for the future so taking a health i.t and combining it with true traditional i.t but also some of the community-based service needs that clearly are going to be more important in the future and really unlocking this fantastic experience i want to thank each one of you for taking time out of your busy schedules today to join us on this program and doing the important work that you're doing uh for all the americans most notably the the veterans and everyone else and i'd also like to thank the sponsors for supporting us on the show i'd like to thank the good people here at federal news network that make our program so successful and enjoyable and most of all i'd like to thank you the listening audience that tune in every month you're listening to the federal executive forum part of the federal news network