Live @ Vive Partner Perspective Q&A with Guillaume de Zwirek, CEO, Artera: Health Systems Must Bring Governance to Patient Outreach

In an effort to better engage with patients, many health systems have gotten themselves into a pickle by going overboard. Today, with almost every department running its own patient engagement efforts, those at the end of all that attention are feeling overwhelmed. But there’s a better way, and it starts with governance, according to Guillaume de Zwirek, CEO, Artera. In this Live @ ViVE interview with healthsystemCIO Founder & Editor-in-Chief Anthony Guerra, de Zwirek makes the prediction that, in order to get their arms around the problem, most health systems will have patient engagement committees in the near future. He adds that, when it comes to apps seeking to consolidate and streamline patient outreach, success is all about getting the operations right. Finally, de Zwirek talks about Epic’s introduction of texting, and why there’s still plenty of room for organizations like his to continue innovating around it.

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… (hospitals have) adopted so many different technology tools over the last decade and many of them are engaging with patients, and we’ve got a massive problem. We’ve got patients that are getting over-communication. They are getting the wrong communication.

… there’s this whole universe outside of Epic that the vast majority of health systems also need to manage. They might have other EHRs. They might have a call center. They might have a CRM vendor. They probably send out regulatory surveys. They probably send out patient education. For as formidable of a company as Epic is, they don’t solve 100% of healthcare problems yet, and I don’t believe they ever will, not because Judy and her team can’t, I think they can. I just think the FTC will come in at some point and say, ‘hey, you have too much market share.’

I think the key is being really honest with yourself about where you have the right to win and where there might already be somebody that’s a good option for them, and then focusing your time on everything that’s differentiated.

Anthony: Welcome to healthsystemCIO’s Live @ ViVE Interview with Guillaume Zwirek, CEO with Artera. I’m Anthony Guerra, Founder and Editor-in-Chief. Gui, thanks for joining me.

Guillaume: Thank you, Anthony.

Anthony: Very good. Let’s start off with a little bit about your organization and your role there.

Guillaume: We founded Artera nine years ago, and we help hospitals have great relationships with their patients. We solved the legacy reality that the vast majority of communications in healthcare happen on the phone. The world has evolved and most folks want asynchronous communication, on their time, and on their terms, and we have the infrastructure that connects all of the different pieces of software, departments, people at a hospital, and allows them to deliver a seamless experience to their patients when they’re not using their app.

So everything outside of the app, your doctor saved as a contact on your phonebook, you can text them about anything you want, get an answer very, very quickly, most of it is automated and we do this for organizations in all 50 states, in Canada and for about 100 million patients every year.

Anthony: Very good. We did a webinar together a little while back. It was very interesting, covered a lot of areas here. How would you describe the core difficulty that health systems face that you address?

Guillaume: Let me start with an analogy and I’ll give you the answer. I know people aren’t going to see this on camera but I’m a skinny guy and I guess I’m built that way and when I go to the doctor, the nurses always tell me that folks like me are the dangerous ones because we don’t know if something is wrong with us, right? We don’t know we have diabetes. We don’t know that we have cardiac issues because you don’t see those signs in an outward fashion.

The same thing is going on, I would argue, with every single practice physician, hospital group in America today which is we’ve adopted so many different technology tools over the last decade and many of them are engaging with patients, and we’ve got a massive problem. We’ve got patients that are getting over-communication. They are getting the wrong communication. Things aren’t converting. Not only is that bad for patients, bad for patient experience, it’s bad for conversion. Patients are unlikely to do what you tell them and it’s a massive legal liability. Because you’re not allowed to over-communicate with patients according to TCPA. I think that’s the biggest challenge that most folks aren’t aware of today.

I’m starting to see folks think about governance committees for patient communication, that is starting to gain steam. I have a prediction that that is going to be commonplace in the next 12 to 18 months. The vast majority of hospitals will have governance committees, managing the inflow and outflow of communications to patients.

Anthony: Usually these problems have a technology component and a human-based component. You mentioned governance and committees that can be extremely difficult, complicated to work through. They want to keep using what they’ve been using as opposed to getting on something that’s streamlined across the board or used in different departments. That’s a big challenge, and there is the technology challenge. Do you see it as a two-part issue? You need the right tool, and then there’s a lot of work to be done on that human part?

Guillaume: As with all things, I think most vendors under sell how much operations work is going to be behind the scenes. It’s always mostly operations. In fact, I tell my team before we ever buy technology, we need to do it ourselves. We need to do it manually. We need to know what’s going on and then, once we know how to fix the problem, then you bring in technology to automate it and save you time.

Operations is first. I mean, our conversations that involve our customers right now stem around building that right governance structure and understanding how we’re going to get the data to see what’s going on; how we’re going to extract those insights and then how we’re actually going to solve for the problems that are happening across the portfolio. Operations is the most important thing. Technology is going to play a supporting role in making people a lot quicker, saving time, saving money. You get the idea.

Anthony: Internally, we talked about that being a huge component of it – the operations, maybe the biggest component. How do you structure, or how do you run the company, so that you don’t just sell the tool but bring something to the table in terms of assistance with this really complicated implementation.

Guillaume: Well, let me tell you how we’ve done it internally. You may or may not know, I started my career at Google, and we had the saying back then which was you eat your own dog food. We were the first users of every application we ever made at Google. This is true with Artera. The very first users of our application were us internally. We were effectively pretending we were an enterprise health system and we had people at our organization who are playing the role of staff members and patients, and that’s how we communicated. Literally, we did not use Slack, we used Artera and simulated the state of a health system, that’s going back 9 years.

More recently, the way we’re eating our own dog food is we are literally spending hundreds of hours looking into the data from our close to 1,000 customers now. We’re actually combing through that data manually, extracting the insights, and we’re actually handing these manual insights to our customers every single week. Like no joke, Anthony, health system in Texas, I’ve got somebody on my team who is sending them an email every single week with the 5 problems we have observed across their universe of patient engagement technologies and how we recommend that they fix it.

We’re doing this manually, on purpose. Because once we’ve understood all those problems – which ones are most important and how to fix them – then we can figure out how to tweak it and fix it with technology and scale it. We’re literally eating our own dog food today. We are doing un-scalable work to make our health systems better. This stuff is easy to scale now with large language models and ML and all the stuff coming out of open AI and so on and so forth. But for us, it’s truly eating our own dog food. That’s how we’re understanding what to build and what to change. We’re doing that in concert with customers.

The second piece I tell you is, yes, I think being the experts takes you a very long way, but the holy grail in today’s technology universe is data, and we just have this really large head start when it comes to data. We were, I believe, the first company to support conversational communication in healthcare, asynchronous conversational communication. We’ve been really fortunate to make a lot of friends along the way who wanted to do business with us and stay in business with us.

We got a lot of customers. We got probably the richest trove of data. I think it’s close to 2.5 billion engagements that we process every single year. We’re just seeing everything. You’re at Children’s Hospital, we’ve seen it. You’re an FQHC, we’ve seen it. You manage mostly Medicaid patients and you’re in South Carolina, that’s going to be different than a group in Atlanta. I think that’s the other really critical piece that makes us better on the consultative partner dimension.

Anthony: I would say probably one of your main roles, if not your main role, is to have that vision of where you want to be the best. And then to mobilize the resources of the company so everyone is working towards it. Does that sound right?

Guillaume: First of all, you’re spot on. You’ve described how I see my role pretty well. I don’t think that’s true for every company founder, right? There’s a whole other strategy which is, let’s fast follow when technologies are proven, and build a version of that and be second best, and be second best at a lot of things. That’s just not the way I’ve lived my life. I think we’re on the planet once and I want to deliver unique and differentiated value and I do want to be the best, and the day we’re not the best at something is the day we should stop doing it. You’ve described how I see my role to a T.

In terms of our mission and what we want to be the best at, it rolls up to our mission which has been unchanged from day 1 which is making the healthcare industry number one in customer service. What I mean by that is the experience that patients have when they engage with their healthcare providers, I want that to be a better experience that they get in any other industry, better than checking into a Marriott, better than anything of that nature. That is the mission.

Specifically, I want to be the best at patient communication, and I want to do it in an open manner. You’ve seen a lot of folks layering in other point solutions, billing, scheduling, intake forms, things of that nature. My point of view is really simple. There are best-of-breed companies, and we have those dimensions, and I have no interest in building a second rate version. I believe in open ecosystems. I believe in APIs. I’ll partner with anybody and, like I said, the day you do something better than me is the day I stop doing it and try to deliver differentiated value around it. I think you’re aware of this. The market is aware of this.

Epic is a huge player in healthcare. They’ve recently introduced texting capabilities and I think it’s great. Epic has the right to introduce texting. Epic owns a lot of different applications, frankly, the best applications in healthcare for a bunch of different things. Their market share is growing – you can’t deny the absolute force they have been in healthcare, and they’re going to make things a lot easier when you’re in the Epic ecosystem, if they own those workflows.

But there’s this whole universe outside of Epic that the vast majority of health systems also need to manage. They might have other EHRs. They might have a call center. They might have a CRM vendor. They probably send out regulatory surveys. They probably send out patient education. For as formidable of a company as Epic is, they don’t solve 100% of healthcare problems yet, and I don’t believe they ever will, not because Judy and her team can’t, I think they can. I just think the FTC will come in at some point, right, and say, ‘hey, you have too much market share.’

I think it’s great that Epic introduced texting and what that changes for us is just, let’s focus on everything outside of Epic and make it play really nicely in concert with whatever traffic you have flowing through your Epic environment. I think it presents a formidable opportunity for the market. I think it’s going to take the market forward and I really view it as an opportunity to double down on the areas of our platform that enrich what Epic is doing and plans on doing over the next couple of years in their roadmap.

Anthony: Very good. Your agenda for a show like this I would imagine it’s a mix of meeting with current customers, potential customers, anything else beyond that or is that pretty much the majority of your time there?

Guillaume: So candidly, customers are my priority. They always will be. When you do business with us, you deserve my attention above anything else. Every customer has my phone number. Spammers love me because I answer every unrecognized call. That’s the thing.

Anthony: That can be painful, right.

Guillaume: It is very painful (laughing). I tell our customers, call me anytime. I’m on vacation, it’s midnight, I like it. This is my existence. Second is prospective partners who have problems that we might be able to solve, and then we have a rich ecosystem of partners. I think that is the endgame here. This is how we make healthcare way better. We need common infrastructure to unify all of the engagement that happens across all the different tools and solutions in healthcare, and we built that infrastructure.

I spent a lot of time talking to other healthcare IT founders who are building out amazing pieces of technology and helping educate them on how they can use our tools, how they can use them for free to drive differentiated value, right. If you’re an intake company, you can focus on being the best intake company in the world and use Artera’s engagement stuff and deliver a better solution for the end market.

Anthony: Just as a final question, I’m not going to keep you too long. We’ve spent a good amount of time together in different venues and one of the things I noticed about you is you’re quite the listener and you have a notepad out a lot, and you’re talking to people, and you’re writing things down. How do you take those ideas and get them in the mix with everything else?

Guillaume: Well, I think the first piece to what you pointed out is curiosity. I think it’s the most important thing. When I hear something in a meeting, on a call or with a prospect that might be off putting, I dig in. I go, ‘it’s interesting that you said that, Anthony, tell me more. You don’t like the way we built this tool, why?’ I always tell people you can call my baby ugly, it’s okay. I want to know if you think it’s ugly. I want to know what part of the baby I need to fix.

 We were just talking about Epic. I think they’re one of those companies that do that really, really well. They have the whole system with the TS reps and their customer service people who are with their accounts every single day. They build the things that their customers ask for. We’ve tried to emulate a similar model while paying attention to what the rest of the market is doing. I will be the first to tell the customer, ‘this thing you want is adjacent to what we do, but there’s already somebody who does it really well, can I introduce you?’

I think the key is being really honest with yourself about where you have the right to win and where there might be already somebody that’s a good option for them, and then focusing your time on everything that’s differentiated.

AI in LLM, huge themes everyone is thinking about. That’s not a product. That’s a concept that you can apply to the product. We’ve been really careful about trying to build the applications that make unique sense for Artera in the market that aren’t already being done. Without going deep into our roadmap, that’s our approach. I also talk to customers every day. I talked to three customers today. I spent a lot of time in conversation with our partners, and that’s my favorite part of the job.

Anthony: Did you use the notepad or type it in the computer?

Guillaume: Well, now I just press the voice thing on my phone. It transcribes everything for me. My mental capacity for remembering things is about a month which is perfect. Because if I’ve heard it enough times in a month, it should be something. Then, I actually – we have an experiments engineering team, we can actually rapid prototype something in a week, and I’ll sit down with a customer and say, ‘hey what do you think? I don’t think I can deploy this to production just yet, it will break everything. But do you like it, what don’t you like, will you use it?’ We’ve done this with conversation summaries with LLMs. We’ve done this with data integration for vendors. We do this all the time. It’s fun.

Anthony: You’ve to be curious, right?

Guillaume: Yes.

Anthony: If you’re not curious, you’re in the wrong line of work.

Guillaume: You got to be curious, and you’ve got to be okay with somebody calling your baby ugly. I think that’s the recipe for success.

Anthony: We covered a lot. We got the baby ugly in and there was a lot of mentions of dog food. We’ve really covered quite a bit (laughing)

Guillaume: Right. We definitely did (laughing)

Anthony: We got it all.

Guillaume: I’ve got children and we have customers. That’s the recipe for happiness.

Anthony: Yes, and people can call you in the middle of the night.

Guillaume: That’s right. Oh, boy (laughing).

Anthony: Okay, good. Your wife will like that.

Guillaume: I hope my wife doesn’t listen to this.

Anthony: Your wife will enjoy it. Very good, Gui. Thank you so much for your time today. I really appreciate it.

Guillaume: Likewise, Anthony. Take care.