Live @ HIMSS Partner Perspective Q&A with Mike Reinhart, Chairman & CEO, Quisitive: The Cloud Offers Significant Upside; but a Good Guide Sure Helps

The cloud can be a magical place of value and optimization – but only yields its secrets to those with the expertise to master it. The problem is that many health systems moved in too quickly or without that expertise, leaving IT executives in the position of having to go back and retro fit important elements like security. What’s more, “the cloud” is not one thing, but at least three, with distinct environments from Amazon Web Services (AWS), Microsoft Azure, and Google Cloud Platform (GCP) that each demand a different skill set. Microsoft Azure happens to be Quisitive’s sandbox. In this Live @ HIMSS Partner Perspective Interview with healthsystemCIO Founder & Editor-in-Chief Anthony Guerra, Mike Reinhart, Chairman & CEO at Quisitive talks about why operating in the cloud can be tricky business for the untrained, how proper configuration can break down on-prem data silos, and how AI will eventually turn mountains of data into actionable insights.

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… one of the big challenges in the healthcare system is all these data silos, and how do you really start to bring it together to derive meaningful insights.

One of the challenges – and you saw this during the pandemic – is that there was this mad rush to move to the cloud as people were looking for operational and other efficiencies. In that movement, a lot of what happened was not thinking through what should go to the cloud, and so you had a lot of things just get moved there out of necessity. What they found was you have to rethink whether this is about data or applications or others – not everything legacy should be moved in its current form into the cloud. It may not operate efficiently or doesn’t really unlock the benefits of the cloud. A lot of what has to happen is rethinking how data is brought together.

It’s an absolute necessity on the front end and, if you haven’t, you’ve got to go back. We’re seeing a lot of rework happening in that very space today to make sure that security is done right because of the threats that are increasingly related to hacking events.

Anthony: Welcome to healthsystemCIO’s Live at HIMSS Interview with Mike Reinhart, Chairman & CEO with Quisitive. Mike thanks for joining me.

Mike: Great to be here. Appreciate the opportunity to connect.

Anthony: Very good. Mike, why don’t you start out by telling me a little bit about your organization and your role.

Mike: Yes. Quisitive is a partner with Microsoft that provides services and solutions across many industries, with one of the key areas that we focus on around healthcare. But we have depth and breadth of expertise across the capabilities of Microsoft and their cloud across their Dynamics platform, their Azure environment that includes everything around infrastructure security, data and AI and the things that they bring to light there, as well as their end user footprints around Microsoft 365 which is a key component of their Copilot strategy in AI.

We work with enterprises across many different segments, working to deploy those technologies, build custom solutions on those technologies to enhance their interaction, whether it’s with patients or operationally inside the organization.

Anthony: A key characteristic of the company is the relationship with Microsoft, correct?

Mike: Absolutely.

Anthony: With that, is it safe to say you don’t really play with companies that are not Microsoft shops?

Mike: Yes, interestingly, every company has some component of what they’re doing with Microsoft, in particular some of the things that they’re doing with AI. While we don’t have deep expertise in some of the other cloud strategies, we know and understand how they need to interact with Microsoft as a component of a strategy. For larger enterprise organizations where they are multi-cloud strategy or multi-technology, we bring the expertise about how to really leverage the Microsoft platform in that context and help customers make sure they know when and where to use that technology, as well as when not to.

Anthony: It’s really interesting. I’ve spoken with another company and they specialized in helping people use a different cloud, one of the big clouds – very, huge, global, well-known company. It’s interesting you have these massive cloud providers and then you have companies that help you figure out how to leverage them and work with them.

Mike: Exactly. You think about organizations needing the skill and capacity to deal with and address the ever-changing environment we’re in today. We’re focused on bringing that expertise about how to apply new technologies and where to leverage them. For mid-market players, they are more often than not choosing a single cloud provider and, quite honestly, Microsoft has a significant footprint there.

When it comes to large enterprises, you see a little bit of both single and multi-cloud strategies, but they’re looking for the expertise to understand how to set up and to establish the environment. Secondarily, they’re looking for how to activate new modern workflows and, as we think about AI, which is the catalyst for many of those discussions, it’s something that we’ve been working behind the scenes with Microsoft on for 9 to 12 months. We’ve already have established best practices that we can bring to those organizations and help them take advantage of that learning, so that they don’t have to do it on their own.

Anthony: Can you give me some examples of the kinds of requests you get from health systems?

Mike: Yes, a great example is we worked with a healthcare provider who’s leveraging some of our technology. We’ve got our own first-party software around patient care management. But they’re running in the Microsoft cloud, we provide all their managed services capabilities. We run and operate their cloud environment for them. We also run and establish their security footprint. We’re continuing to coach and advise them on how to stay secure.

But recently, one of the big challenges in the healthcare system is all these data silos and how do you really start to bring that data together to derive meaningful insights from that data. Microsoft has a new platform they call Microsoft Fabric which is really centered around this, synthesizing data. This is going to be a key component of AI in the future. In doing so, we were brought in to actually be the first healthcare solution using Fabric for this provider and really bringing that platform together.

We brought the expertise of this new capability, synthesized it, develop a set of dashboards and portals for the business to be able to interact with the data. All of that was done as an extension to the work we are already doing, where we’re operating their entire platform that runs in Microsoft.

Anthony: Let’s talk a little bit more about data silos. In previous discussions, it’s been mentioned to me that moving to the cloud is an opportunity to remove some data silos that are present in the on-prem environment. So don’t just replicate everything exactly as you have it, use that as an opportunity to remove some of the silos. Is that correct?

Mike: Very much so.

Anthony: Tell me about that.

Mike: One of the challenges – and you saw this during the pandemic – is that there was this mad rush to move to the cloud, as people were looking for operational and other efficiencies. In that movement, a lot of what happened was not thinking through what should go to the cloud, and so you had a lot of things just get moved there out of necessity. What they found was you have to rethink whether this is about data or applications or others – not everything legacy should be moved in its current form into the cloud. It may not operate efficiently, or doesn’t really unlock the benefits of the cloud.

A lot of what has to happen is rethinking how data is brought together. The great thing is we’ve been dealing with this challenge in healthcare and other places for the last 30 years around data warehousing, whatever it is, but this idea about bringing data together and the tooling in the cloud is simplifying that, or you can bring structured and unstructured data into the cloud environment and now have these tools that allow you to interact with it and, again, it will be a catalyst for AI activations as we go forward.

But those tools now simplify that process. Data storage costs have come down dramatically which was the other challenge is replicating or putting that data in the cloud. All these things are about taking these operational systems and bringing that data in a combined way together, and then creating mechanisms to reason on it and derive insights to make better businesses.

Anthony: When people are going into the cloud, are they always hiring a company like Quisitive to help them? Is anybody trying to do it on their own? I guess maybe if you’re a very, very large shop, you might have the talent.

Mike: Yes, there are certainly some organizations that have very advanced IT functions. But I’ll say, in our experience in working with Microsoft, I’ll say a high percentage of organizations use some third party to assist them in that journey for setting up and establishing the environment. And that’s only step one, getting your cloud environment, getting security established, getting all those things put in place, and getting workloads. But then there’s the whole, how do you build and modernize applications in the cloud? All of those things are new and different, and you have to make sure you know what you’re doing. Oftentimes customers will bring somebody like us in to help them establish how to build applications in the cloud in partnership with them.

A lot of the work we do is what I call collaborative projects where it’s not just a turnkey to us; we are actually doing it side by side with their teams, building and helping them learn how to do it while also extending and complementing where they have a capacity gap to get it done.

Anthony: Do you try and teach them so that they can do themselves at some point?

Mike: Certainly, the goal is for us is to help them be successful. If we do that well, we believe there’ll be an ongoing opportunity for us to engage with them in other things as we go forward. But our job is to help establish the right platform for them and help them learn how to do it with us. Again, a part of the big partnership we have with Microsoft is doing that cohesively together with Microsoft in our accounts.

Anthony: You mentioned security, and that’s probably one of the biggest risks of moving to a cloud environment – making sure that you set it up properly.

Mike: For sure. It’s an absolute necessity on the front end and, if you haven’t, you’ve got to go back. We’re seeing a lot of rework happening in that very space today to make sure that security is done right because of the threats that are increasingly related to hacking events. With all the things that we see in market today, securing the enterprise is a primary objective of everyone.

Anthony: I mean we don’t want to scare people, but is it the kind of thing where some folks try and do it on their own and they think they can figure it out, but that’s risky.

Mike: No question that it’s a complex thing, depending upon your size and scale. And what happens is – and this is changing thankfully – but it’s like insurance, it’s hard to make the investment in security posture because the benefit of it isn’t necessarily some measurable outcome, it’s preventing a disastrous outcome, right? And companies often, unfortunately, until they’ve had an attack, they don’t prioritize it properly.

And what’s happening, you’re seeing this with some recent healthcare-related security attacks, it is heightening awareness again for every board to talk about, how do we take further steps to make sure that we’re securing our environments and making the investments that maybe were on the budget list but didn’t get approved but are now being done.

Anthony: We went through a period when everyone was moving everything to the cloud; then there was pullback and people did some rethinking. Now things are back to the middle. What are your thoughts?

Mike: Back to what I mentioned earlier, there was this, what we call, lift and shift to the cloud. Everybody just took everything, picked it up and dropped it into the cloud with minimal remediation just to make it work. What we really try to work with customers on is part of this whole wave of what big cloud companies call optimization. To your point exactly, things got moved to the cloud and the consumption costs, the data costs, were 2x or 3x what they had contemplated in the modeling of it. And the reason being is that they didn’t re-engineer the application or the data workload to actually be using the benefits of the cloud. It was just basically moving a server into the cloud. That’s what we’re seeing a lot of, and a lot of the work we’ve been doing over the last 18 months or so has been about that optimization. And that optimization, to your point, is sometimes saying this thing shouldn’t be in the cloud, and here’s how you can move the data into the cloud to take advantage of that, but leave the operational piece.

But in most cases, it’s a re-engineering effort to re-platform or redevelop it cloud natively, which then enhances and removes that cost because it’s an efficient application leveraging the benefits of the cloud, and we’re seeing a lot of that. That wave has been a big part of investment over the last 18 months.

Anthony:  it’s interesting, you come to a show like HIMSS and you realize, or you think about, buckets of vendors, organizations competing with each other. What do you want your organization to be the best at in relation to your competitors?

Mike: First, it starts with this unique position of Microsoft, unlike most of the competitors who are trying to support all of the cloud providers. It’s my belief that if we want to be experts and be really good, step 1 is narrowing that, so we’re deep experts, and we work side by side with product engineering teams at Microsoft. We’re embedded in their architecture and capabilities in a way that gives us that expertise. That’s step 1.

Secondly is we’re not only bringing our deep expertise in the technologies of Microsoft and how to build and do those things, we are also bringing industry experts and subject matter experts as well. For example, within healthcare, we built a platform called MazikCare, which is a care plan coordination platform for providers. It sits and integrates with all the EMR solutions and helps facilitate the patient journey and care path planning and things like that.

We come in with this bundled approach around our expertise in the industry, unique offerings of software, combined with very sophisticated systems integration services to bring all of that together, and that’s where we are very successful in competing and winning against other providers in the market.

Anthony: That’s very interesting. Not just a technology play in terms of helping people run the Microsoft cloud; you’re actually building healthcare-specific applications as well. So as you said, that’s pretty comprehensive. You compete on a pure technology level with some companies that are facilitating the Microsoft cloud and you also complete at an application layer with people doing care coordination.

Mike: For sure. We’re really trying. We think that’s the future of what systems integration services need to be – more than just technical skills. You’ve got to have capacity to do those things and integrate, but also bring solutions to customers, and it’s something that we’ve been investing in. We have a whole part of our business that is a product development team that builds software for us.

We also do that for customers who are experts in building software. So if a customer is looking to build a product that they’re going to take to market in a SaaS offering, we apply those disciplines that we do internally and bring that to them as well. We also build software solutions for them that they’re going to sell and license to the marketplace, whether it’s in healthcare or other industries.

Anthony: You have to have really strong healthcare operation folks on your team because you’re building applications. If you’re just doing some horizontal play, you could say, ‘hey, listen, we could put it in the Microsoft cloud anywhere,’ but you’re going beyond. What’s the DNA of the company? Is it healthcare – you said you’re in many verticals, is it the technology cloud facilitation, and then you’ve built out the verticals over time?

Mike: Yes, the foundation is the expertise in the Microsoft cloud and the capabilities. We were instrumental in building Microsoft’s cloud for healthcare with and for Microsoft. Again, our DNA is building stuff, we build that with and for them. But then on top of that, we have built out a team of clinicians and former CIOs of hospitals that are part of our advisory team, working with our customers, as well as product management over our products that we’re building that sit on the Microsoft Cloud for Healthcare and their Dynamics platforms and things like that. Yes, we’ve assembled this unique combination. You’ll see other big firms doing that. We’re building that scale play but also complementing it with industry expertise which we think is an important part of the future.

Anthony: Right. You can work with Quisitive in any number of ways that can be, ‘hey, we just want you to help support our cloud, we don’t need your applications. We’ve got plenty applications. We use Epic and Epic has got something.’ You say fine, than people may say, ‘we want your support of the cloud and we want your apps,’ and some people may say, ‘we want your support of the cloud, we’ll take that app, and we want you to help build something else.’

Mike: Exactly. It’s really engaging where the customer needs us and bringing enough capabilities, but not trying to be everything. Like if somebody’s got an Epic platform, we’re not experts in Epic. We know and understand how to interact and integrate with Epic, how to consume data from Epic. Our MazikCare care planning platform fully integrates with Epic and Cerner and others. We create a very synergistic experience for the user base. But we’re not trying to be that expert for them. So yes, that’s the way the customers in the healthcare space use us, and it’s all about what is the business outcome that they’re trying to create, and then how we’re best suited to help them directly. Our partnership with Microsoft is often a component of that conversation as well.

Anthony:  Back to our discussion about competition. What do you want to be the best at?

Mike: First of all, one of the things you noted, saying no is really important and very hard. The customer may have a great opportunity, and it might be monetarily rewarding, but it’s a distraction from the future. Staying focused is one of the key disciplines I’ve been talking with my leadership about. We can’t be everything.

But back to what we want to be the best at going forward, we think about the transformational opportunity presented by AI. You think about the challenges that healthcare has today around nurses and physicians reaching burnout. You’ve got an aging population that needs more care and the supply of caregivers is not there. There’s this increased amount of need to be able to free these clinicians and caregivers from administrative activities and focus on patient care. This is where we’re excited about the future and how AI is an enormous opportunity to really impact those kinds of things and that’s where our partnership with Microsoft and their Copilot capabilities comes in.

We just launched today our MazikCare Copilot which is a generative AI offering embedded in our care planning coordination platform that we’re showcasing in the Microsoft booth here at HIMSS. All of those things are around removing the administrative time and improving workflow and operational efficiencies for caregivers to be better able to do that. Directionally for us, we see that as a really important opportunity.

Anthony: When we talk about health systems doing AI, I’ve been saying that’s really going to come from the vendors. I mean the health systems other than the largest of the large are not doing AI.

Mike: Correct.

Anthony: They don’t have – there are some with chief AI officers and those are the biggest of the big.

Mike: Yep.

Anthony: Otherwise, the way a healthcare operation is going to do AI is by using products from a vendor that has AI in them, right?

Mike: For sure, and this was the conversation I had yesterday with Microsoft leadership and their healthcare business. Look, to your point, the major players have teams and people dedicated and focused on this. But if you think about the scale play in these providers, they’re not going to have the ability and are going to be dependent upon us, and so Microsoft is doing some interesting things, and we’re in partnership with them around creating a network that vendors, that they’re going to facilitate through their systems. There’s two waves to it, in my opinion.

One is the operational efficiencies and productivity enhancement wave and those are low risk, high-impact opportunities for AI that I think can be very quickly embraced and adopted. There’s a whole bunch of things around people, process and technology you have to do to make sure that that happens properly.

Then there’s this stuff that scares the heck out of everyone at the moment about how to use it to do better diagnosis and things like that, over time, that will become a great tool. I’m a big believer that it’s not about AI doing the diagnosis, it’s about AI providing enormous net-new insights to caregivers, to better arm them with doing diagnosis, and that is the digital assistant or Copilot construct that everybody talks about. We’re seeing that.

Gartner talks about how healthcare generates 50 terabytes of data annually and 97% of it today goes unused. That data and insights, if you think about all the telemetry that exists, and all the devices of various types in the healthcare ecosystem, that data has great power to better enable diagnoses, to better streamline medical image diagnostics for MRIs and x-rays, and all the kinds of things that can, again, enhance productivity, but also better arm caregivers with guidance on decision making of a personalized care path.

Those, to me, are these enormous opportunities. Wave one to me is going to be around this operational productivity, but wave two is really where the opportunity lies. But that’s really getting into all the things around ethical considerations and preventing bias and all the things to make sure that we don’t go there too fast.

Anthony: Yes, I interviewed one CISO recently at a health system who said that’s the only thing that the clinicians are not allowed to use AI for.

Mike: Yes. And it’s smart, you’ve got to put the right governance structure in place but opportunities to improve outcomes are enormous. Through an orchestrated process, I believe that in the coming years we will see that become a major component of how care is given, but it’s going to have to take some time. Near term, just giving them back time to do care is a huge benefit.

Anthony: Mike, well, that’s about all we had time for. I want to thank you so much for catching up with me at the HIMSS conference and I hope to talk to you again in the future.

Mike: Fantastic. Thanks. Appreciate it.