If you ask Kent Gale what he thought KLAS would look like in 2016, he envisioned a room with 10 people “high-fiving each other after we got some great information.” What he never imagined was having the CEOs of the top health IT companies flying into town in corporate jets for a summit, or lawyers threatening to shut down his shop. No doubt it’s been quite a ride for the founder of KLAS, has has become an industry presence that is looked upon to rate the best vendors. In this interview, Gale talks about how KLAS was conceptualized, the early tweaks that ended up being game-changers, and how he leveraged his relationships to get providers talking. He also discusses his passion for interoperability, what he loves most about his job, and the role that mission work plays in his life.
- 3 advisory boards
- Tackling interoperability — “There was a lot of misinformation.”
- Standardized data sharing
- 11 CEOs in 1 room — “I was grateful they had the courage to do that.”
- Partnering with CHIME on security
- KLAS’ journey — “This is so different from what I ever expected.”
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It became apparent which vendors really have a passion and an appetite for this, and which ones don’t. The big players really have to share with each other, and the better they share, the quicker the standard gets up to a level that everybody can follow.
Most of those who came got past that barrier and were really engaged and serious about getting this solved. And that was refreshing. It was exciting and I was grateful that they had the courage to do that.
We have all kinds of rules we set and boundaries — it slows everything down, and it’s just wonderful to see vendors who have pure intent really get the job done. And their customers know and believe in them.
It’s just fascinating to think back at how that felt when we knew we were being threatened, and how much better it feels today being accepted by the industry and have providers excited to have us in the mix.
Gamble: As far as getting the ideas for what topics to cover in the reports, I’m sure you have never-ending stream of ideas, but is there any specific method you use for that — for example, we’re going to tackle this next?
Gale: Yes, actually. The stream of data that comes in, it’s almost overwhelming — it is overwhelming. We could be asked to do all kinds of things. So we have an advisory board — in fact, we have three of them. Our main advisory board is made up of executives in the industry that give us guidance around that space. We also have a medical equipment and medical imaging advisory board. When you look to the imaging space, it tends to have its own specialty area. And then we have an international advisory board because, based upon the fact that the US is the font of a lot of what happens of the knowledge that goes out in the world, they want to know how the vendors are performing here and how that ties internationally, and so we have an international board. And these executives volunteer to direct us and to critique us, and it’s just fascinating and wonderful to work with these great individuals as they tell us what they think we ought to be doing.
Gamble: Now, in recent months and maybe a little further back, KLAS has taken up interoperability with the summit and the reports. Obviously this is a really hot topic in the industry. What was it that made you want to focus on that in particular?
Gale: I think it’s a great subject as you bring it up. Connecting different IT systems, in and of itself, is just really hard because there are so many nuances around our own health and you or I don’t want to have our health damaged. We don’t want to physically be damaged by bad information moving around or by the lack of information.
I think it’s interesting because out in the industry, there was a lot of misinformation about what was going on. There were vendors who would aggressively attack other vendors for what would appear to be a lack of passion or intensity or integrity around sharing, and behind the scenes, we already knew that most of the vendors literally had to share with each other. They had customers who said, ‘I’ll sign the contract with you if you’ll connect with our competitor down the street and you have to connect to your IT competitor.’ And so as contracts were signed, most of these solutions were in place, but they were all custom.
And so some of the vendors start to reach out in ways of doing it on a more standardized basis, and that was working to some degree, but what was really going on was not clear. So as we went out and interviewed 250-plus organizations, it became apparent which vendors really have a passion and an appetite for this, which ones don’t. The big players really have to share with each other, and the better they share, the quicker the standard gets up to a level that everybody can follow. If the four biggest vendors literally shared aggressively with each other, that standard would be the standard, and everybody would have to map to it.
There was just a lot of energy around let’s start getting this right so the government doesn’t have to come in and tell us what to do. Certainly it would be wonderful if some wizard came out and said, ‘This is the standard.’ When you get something like ICD-10, you end up with a standard that really causes some people grief because the standard isn’t adaptable to the extent it needs to be to their individual business. I feel like a standard needs to be operationally pure and that needs to come from the inside out. It can’t be superimposed by an outside party. And that’s what we see happening now with these vendors getting together.
Gamble: In speaking with the vendors and in watching what went on at the summit, was there anything in particular that stands out that really surprised you when it comes to interoperability and the vendors’ interactions with each other?
Gale: For anyone who sat in the room and watched the 11 biggest, probably the most prominent players, first off was the angst between the vendors as to who was really going to show up. Because if one CEO of a large corporation showed up and the other one didn’t, what message did that give? Did it say that one CEO got duped into coming and the other was smart enough not to show up, or was it that one did show up and the other one wasn’t smart enough to show up. It was fascinating to watch the energy around whether so-and-so is going to come or not. And it turned out that virtually all of those that really played a role in the industry showed up.
There was one CEO that I was incredibly disappointed opted out at the last week or two. Literally all of these CEOs had to tell us right at the beginning if they were going to come or not, and then they got to test their own integrity to see if they showed up, because to sign up and say we’re coming to the summit, the CEO had to say ‘I will personally be there,’ or we wouldn’t let them come. And when they said, ‘I will be there,’ and then in the last week or two they were talking about potentially not coming, that made my heart hurt to see. What kind of integrity is this?
And so, it was really amazing to watch them show up and debate and step up to wanting to get this right. There were several that came, showed up, said things but really their heart wasn’t in it. They were just going to let other people arm wrestle and then they’d ride along on the wave.
Gamble: That’s really fascinating. It would seem obvious at least from the outside perspective that the one thing that needs to happen is more communication, but actually facilitating that is no easy feat.
Gale: Well, there are emotions involved, and when you have people’s emotions, they act either irrationally or in a way that’s not as effective. Most of those who came got past that barrier and were really engaged and serious about getting this solved. And that was refreshing. It was exciting and I was grateful that they had the courage to do that.
Gamble: It’s going to be really interesting to see how things keep progressing. And there’s going to be another summit coming up, right.
Gale: Yes, in fact, the summit produced a new questionnaire that’s going to go deeper than ever. We’re going to do about double the number of interviews this year as last because the vendors said they wanted it bigger, which we agreed. It’s all a matter of resource when it comes to doing something like this.
And so we jumped into that, and in the fall, we’re going to have, instead of a summit, it’s going to be a cornerstone, because at this point, we’re going to look at where we are and potentially adjust as we go in the next year on interoperability. As we come up with a report for this year, we’re going to have a major discussion around it, and it is not going to be the CEOs in the room — it’s going to be their second person down that’s operationally making this work. There are some things that are great for the CEO to give commitment to and then the rest of it’s really getting their butts in gear and getting it done. And that’s the group that is going to show up in the cornerstone.
Gamble: And another topic that you had mentioned as being really big right now is security. I’m sure that it’s been really fascinating for you guys to hear some of the perspectives from the users and to really listen to their fears, which are understandable.
Gale: Yes. The energy level is incredibly high, and to have rouge bandits, if you would, hold hospitals hostage with their data to get blackmail — the world’s never heard of this electronically as publicly as it is today, so that throws a wrench in the whole thing. We have partnered with CHIME to do a deep dive for the next eight or nine months together on flushing out some of the most important things to know about the vendors playing in this space and the consultants. We’ve got this underway, and it’s going to be exciting. It will rival interoperability for emotion, if you would, because of the damage it can do to an organization if there’s a breach.
Gamble: I’m sure that from your perspective, it’s been really interesting to see how this industry has changed and evolved, in many ways for the better. I’m sure it’s been a heck of a ride.
Gale: It is, and it’s all people. Our lives are made up of people and how we treat them with respect, love, and kindness and gain trust with each other — or we don’t, and then it becomes super ineffective when we’re trying to operate with people or work with people we don’t trust. We have all kinds of rules we set and boundaries — it slows everything down, and it’s just wonderful to see vendors who have pure intent really get the job done. And their customers know and believe in them, versus having to report on vendors who don’t and the customers are trying to understand why and what options do they have and what vendors are and what ones aren’t.
So, there’s a lot of opportunity for KLAS to bring value. There’s an opportunity for KLAS to get better — we look for great criticism of what we’re doing so we can critique ourselves. That will help us get better, and that’s kind of exciting. And around security, we don’t want to screw up and mislead people, so we’re trying to learn as fast as the market as we go out and have some questions around security.
Gamble: When you think about the early days and what the founders had originally envisioned, do you think you could have imagined things going this way for the company, and to be really be thriving after all this time?
Gale: You know, Kate, this is so much different than what I ever expected. I anticipated there’d be 10 of us in a big open room with gentle music playing in cubicles and we would have calls and we’d high-five each other when we found great information and we’d put together these wonderful reports. All of a sudden we had corporate jets flying into the Provo airport and executives were coming on riding up in a limousine and coming up to either try to get rid of us or learn from us, one of the two. I remember when one group came and they said they had seven attorneys in Philadelphia that were figuring out how to sue us out of business. It’s just fascinating to think back emotionally at how that felt when we knew we were being threatened, and how much better it feels today being accepted by the industry and have providers excited to have us in the mix.
Back then, I had no idea that we’d ever have senior executives from these industry giants come together in the mountains of Utah to discuss interoperability, or magical thinking, or as we go into this year, it’s going to be population health. That’s what our summit’s going to be about in October of this year; we’ll have CEOs from pop health companies getting together and having a conversation about delivering real stuff, and many will be flying in. I remember when one of the vendors flew into the Heber City airport for the summit last time, and I was just wowed by the fact that this was of that level — that there would be that interest and commitment to making it happen.
Gamble: I’m sure.
Gale: Plus, I’m kind of a country bumpkin. I was never the superstar student or anything, and so to be able to rub shoulders with these brilliant people has just been a great blessing and a cool thing.