Published August 2023 –
Sure, outstanding CIOs can give great insights on what it takes to excel in the role, but those who deal with different health system CIOs on a regular basis also come to discern what separates the everyday from the exemplary. One such individual is MangoApps Co-Founder & CTO Vishwa Malhotra, who does just that. Having interacted with a number of CIOs as prospects and customers, he has sharp insights into what it takes to be successful. It starts with appreciating that the role is about not just using technology to solve technology problems, but also business problems. To do that, CIOs must go beyond taking requirements from users and finding a solution. They must dig deeper, to truly understand the business problems at the core of any issue. After that, it’s a question of getting buy in by building cross-functional teams including everyone who will be touched by the solution. In this Partner Perspective interview with healthsystemCIO Founder & Editor-in-Chief Anthony Guerra, Malhotra covers these issues and many others.
- The Clarity Advantage
- Forming Fusion Teams
- The Digital First Mindset
- Picking up Digital Signals
- Looking for Opportunities to Add Value
- You Can’t Improve What You Don’t Measure
Anthony: Welcome to healthsystemCIO’s Partner Perspective Interview Series. I’m Anthony Guerra, Founder and Editor-in-Chief. Today, we’re talking with Vishwa Malhotra, co-founder and chief technology officer with MangoApps. Vishwa, thanks for joining me.
Vishwa: Thank you, Anthony. It’s always a pleasure talking to you.
Anthony: Good. Well, that’s nice to hear (laughing). We’re going to have a fun chat today. Let’s start out, do you want to tell me a little bit about your organization and your role.
Vishwa: Sure thing. Let me start with the organization first. As a company, MangoApps, we are the leaders in the modern unified employee experience solution market space. We have solutions that are widely recognized for being the modern intranet, employee communication and employee engagement platform for organizations worldwide.
It’s been over a decade now that we have been a trusted healthcare digital partner to over 30 different healthcare organizations in the US. We also have the HITRUST certification as part of our commitment to serving the healthcare industry with the best digital employee experience solution on the market today. Like you said, I’m Vishwa Malhotra, co-founder and CTO at MangoApps.
Anthony: Very good. One of the interesting angles here that we’re going to take in this discussion, we always want to be useful and helpful to our CIO, CISO and CTO readers, all the folks at hospitals who listen to our publication and tune in and it’s interesting – I think we’ll get to a very interesting place here.
To get us there, my first question to you is when you’re approached from health systems, who is the typical individual, what is the role of the individual that is coming to you?
Vishwa: Right. A digital employee experience solution like MangoApps enables multiple use cases that deliver value across the entire employee workforce in an organization. It cuts across departments, teams, frontline employees, so the entire organization gets benefitted with the value.
Therefore, the typical buyer from a company that comes to us I would say is the chief information officer, the CIO. Adjacent to the CIO who has decision-making influence in the healthcare industry I would say would be chief medical officer and the chief corporate communications officer – those would be the adjacent roles to the CIO.
Anthony: They also come in sometimes. You might get those folks, chief medical officer, and what was the other one?
Vishwa: The corporate communications officer.
Anthony: Sometimes those folks, sometimes CIOs. When a CIO does come in from a health system, do you get the sense that they are following up on a mandate they were given or a request from the business – hey, we got a problem, can you go find technology solutions, or do you think sometimes (and we’ll get into a proactive versus reactive mindset), do you think sometimes they have not been given any mandate, perhaps they have been observant in their roles and have understood that this might be helpful to the business – so they say let me go out and do some research and then perhaps I will present this as a possible solution. What are you seeing? Is there a certain percentage on each side? How would you express that?
Vishwa: It’s hard to put a percentage number but we do see a healthy mix of both those categories. I’ll try to elaborate a little bit. If you’re looking at the mid-market organizations that come to us typically with an employee workforce of 500 to say 5,000 employees, they have identified the problem. They understand the business has a problem and they need to do something about it. They generally are in the solution exploration phase as we call it. What’s out there that’s going to help us solve the problem? That’s where they are in their buying journey, so they have a good understanding of the problem.
On a larger enterprise side of, let’s say, companies with employees from 5,000 to say 50,000 or even 100,000 employees, if they completed their problem identification, they’ve done the basic solution exploration phase, they’ve even gone about what we call the requirements building phase. They exactly know what they need for the solution, what should the solution be doing. It typically comes to us as an RFP in their buying journey.
The vendor selection, the validation, consensus building within the business for the right solution still happens later on in the journey but they’re acutely aware of the problem. They have gathered the requirements that they want. They do have a good mandate within the company. It’s either arrived because the business came to them or if the CIO was forward thinking, proactive, active, he or she has figured out the issues that exist within the department and has built that mandate and then they are coming in the market to search for a solution.
Anthony: Yes, what I’ve been thinking about a lot is that proactive versus reactive mindset and there’s a lot that goes into having a proactive mindset. This is a little thing I came up with and you tell me if this makes sense: the average CIO would come up with technology solutions to technology problems, and the elevated CIO will come up technology solutions to business problems. How does that sound? Does that make sense?
Vishwa: Well, it makes a lot of sense. That’s a good way to bucket active versus passive CIOs as well. Typically, all CIOs whether active or passive, they all have an execution model they follow. That’s typically based on their experience and their expertise. They tend to try and find solutions to problems with that background.
From our experience at MangoApps interacting with a lot of the CIOs, some of the characteristics as I would call them for forward thinking CIOs, they have this clarity in their execution model where they’re largely focusing on accelerating the impact that their job, that their profile, can bring in the organization. These three or four characteristics that help them accelerate the impact, which I think is the key for active-oriented CIOs, is they are able to prioritize the digital initiatives that support clear outcomes that their CEO has mandated in a certain timeframe, and they have the capability and the clarity to pause and stop all other digital initiatives. The kind of outcomes you may want could be introducing a new service or improving operational efficiency. Whatever the kind of outcome is, they’re able to prioritize their digital initiatives that connects with that outcome.
Second, I think they have this characteristic of what I call the visual matrix that they’re able to effectively communicate how the outcomes are going to be achieved with the digital initiatives that they are prioritizing. They are able to articulate that well across their C-level peers, across to the CEO; and those two characteristics I think are the foundation that helps them accelerate the impact that their job can have in the organization.
Anthony: So number one is to understand the mandates from the top, right? The CEO is going to give you your marching orders or the business objectives, here’s where we want to be, here’s what we want to achieve, here’s what we want to be known for, here’s where we want excellence.
The CIO has to hear that and really understand that and take it to heart. If they do, that’s going to allow them not only to focus on those things, but to push the other things to the side because you could have voices and perhaps sometimes powerful, not CEO powerful, but users, powerful users in your ear, you have to have the strength to push back on that if it doesn’t fall within the larger mandates from the CEO. Does that make sense?
Vishwa: Yes. I’ll take an example. One of our healthcare customers – who happens to be the largest healthcare organization in the state of Oklahoma – had different departments that were using different technology solutions in their processes. But somehow those technology solutions or the processes were not giving them the desired outcomes.
The head of associate experience, as an example, whose problem was the effectiveness of onboarding the new associates across all their clinics, found the process was inadequate and that was resulting in a poor customer experience when these new associates were made part of the physical therapy team. Then there was the head of HR whose problem was that there were too many disparate systems and typically, the HR team was spending like a lot of time manually updating and keeping information across SharePoint sites, Google sites, legacy intranet, coordinating the tasks over email. A lot of time was being spent.
They had the technology solution, but the desired outcome of efficiency, productivity, reduced employee burnout, et cetera, were not being met. Similarly, there was another corporate communications director whose team was unable to get the adoption on the internal communications projects that they were doing across 8,000 associates to drive engagement towards the organization-wide programs.
Effectively, the CIO had to build this mandate across these different business heads, HR heads, the associate experience heads, the communications head, and understand and seek out these challenges to understand what changes needed to be made in the systems so that it could achieve their outcomes. That was a partnership that the CIO built to look for systems that have to be changed so that these departments can meet their business outcomes.
Anthony: It makes me think. I did an interview with a CISO the other day and he recommended this book – I don’t know if you’ve heard it. It’s called Extreme Ownership. It’s a leadership book written by some Navy Seals. Anyway, this CISO, he said he gives it to everybody on his team, everybody he sees, he’s a huge fan of it. It makes me think when you were talking about the scenario that you just explained about what that CIO had to do, it makes me think how important that extreme ownership is because it’s so easy to make excuses as to why something isn’t working well, it’s this department, it’s that person, they won’t get on board.
But the concept of this book is if you’re going to be a leader, it’s all you. You have to figure out how to get it done and how to convince people. Do you hear back sometimes from your key customer, the customer that’s interacting with you that says Vishwa, I love your product, but I’m having trouble here, there, I’m getting resistance. They have to keep looking at themselves, right, and figure out how to get it done. Because once you throw up your hands, you’re finished.
Vishwa: Right, right. That’s a great point, Anthony. In our experience working with CIOs, we see some of these CIOs, the forward-thinking ones especially who are able to – what we call creating these fusion teams. These teams are usually a mix of multiple parties.
It’s the CIO’s IT team themselves who are bringing the internal IT expertise. Second would be a digital partner like us, MangoApps and others whom the CIO has brought in to be able to deliver this digital solution and expertise; that is according to their prioritized initiatives. But it needs to work with all the internal businesses, allies from different business and functional departments, HR, Operations, Marketing. That’s the third party in this fusion team where these departmental heads, business heads, are bringing their domain expertise to make sure that the outcomes are being met and adjusted and are able to be sustained over a period of time.
We, as a digital partner, need to work with all the stakeholders if we are to truly be an ally to the CIO who has built this alliance across other business and functional departments. It’s what we call the fusion team and they’re all working toward a desired outcome. They are sharing the risk and the rewards that come in the process. But all parties are there and CIO is heading all of this with a strong digital partner.
Anthony: I would imagine you’ve been in situations where the groundwork was not laid properly for implementation, the departments, maybe they didn’t even know what was going on and you get in touch with them and say, hey, we’re going to bring you up on this new product to your organization. We say we don’t know anything about this, we’re not interested in this. I mean, have you been in situations where the groundwork was not properly laid and perhaps that would serve as advice for our listeners that hey, when you’re doing these types of things – I mean, they know that but, I’m sure it still happens where it’s not done properly.
Vishwa: It happens. It happens. In many cases, the success of the project depends on these people being on the same page. They’re believing in the same outcome. We work with these department heads, we bring in the CIO when we need to again to get them all on the same page. But I think if I have to offer my 2 cents here, I would just say it’s important that the CIOs listen to those digital signals and these digital allies that they want to form across their C-level peers inside the company. They should bring people to the table who have this digital first mindset. They are ready to put in the time and effort as opposed to “it’s not my job” approach. They understand the urgency indicators. They understand the value that it’s going to bring to the department.
I think that education to get everyone on the same page is a key component of what a good forward-thinking CIOs should be doing. We’re fortunate to work with many of these CIOs. There are a few where it doesn’t happen, but there are a lot more where it does happen, in our experience.
Anthony: I was thinking, we talked about being proactive. If you’re going to be proactive, and you were going to offer technology solutions to business problems, you have to know about those business problems. In order to really be plugged into how the business is going and the challenges, you need to be in meetings that are not technology oriented, right? You need to be in business meetings that have nothing to do with technology and I’m guessing there’s still a lot of business meetings that happen where somebody says well, why would we invite the CIO, this is not about technology.
Vishwa: Right. Absolutely, absolutely. I think there is this formal IT role that all CIOs are supposed to do. I think there are the forward-looking CIOs, I think they spend – in our experience, over 40, 45% of their time, in business IT areas which are not necessarily formal IT as we know them. This 40, 45% of their time is what’s spent in the – what you’re calling as the non-IT focused business meetings when they are gathering these what we call the ideal digital signals.
One of the topics that these C-level peers are talking about is what is the impact of these topics on their financial performance, their quarterly targets, their yearly targets, what’s their risk tolerance level, how urgent is it for them. They are getting these signals from their C-level peers in these non-IT focused business meetings that are helping them go back and figure out what digital technologies can be offered as solutions.
Then, that helps them with inputs like what’s the financial impact of doing this for this department? It helps them create these digital allies within the company who again – I’ll go back to my earlier term, they have a digital-first mindset and the CIO can come to the party along with the CHRO or the COO to jointly partner and provide solutions to many of the things that don’t necessarily come as a formal IT project.
Anthony: I was thinking there’s probably a lot of parallels between someone like yourself who is serving your customers who are often the CIOs; and the CIOs who are working to serve their customers who are their users and clinicians and whatnot. We did a webinar together a couple of weeks ago, Vishwa, and one of the questions was how are you deciding what to work on? How’s MangoApps deciding what to work on, you have customer request? Can you explain a process by which I think you said it’s half and half. Half of it, we prioritize customer requests and that’s like 50% and then half I think is what you’ve come up internally, what your vision is, right.
Vishwa: Well, I think it depends on the topline and bottomline outcomes you want. If you want an outcome that says you want to have a new service or a product introduced in year 2024, then obviously those need to be met.
I would look out for opportunities as a CIO. Every opportunity that I get, every interaction that I have with my C-level peers, every meeting around the topline and the bottom line objective, I’ll be looking for that opportunity where I can add that value of going above and beyond in terms of what is being asked by the customers to build, to bring in something that’s more differentiated.
I think an example of a healthcare customer and it happens to be one of the largest outpatient therapy providers in the US, I think they’re based out of Alabama. And the CIO of the organization was told that it was difficult for the different departments, different employees, to be able to find the information, knowledge and resources that they had across thousands of SharePoint sites, millions of documents.
The requirement he was given essentially was that we need a better search technology that can provide them the right search results and provide the clinicians better search results, provide the nursing staff what they’re looking for, give the system support team the information that they need. That narrowed down on the requirements set that was about better search technology and what other things it should have. He could have just followed that up and maybe they could have gotten a technology solution for their technology problem.
In our experience, I think he went a step beyond. When he understood the problem, he understood the problem as that they’re not looking to find search results. They’re looking to find an answer. And there’s a difference between asking for something and getting 15 results and then figuring out which one is the most appropriate one that I have to use. You don’t know whether it’s trustworthy, is it up to date, where should I go to verify this information. So search technology requirements may not have really solved the problem and they would be back in the market 12 months later looking for another solution.
As the CIO interviewed the clinicians, the nurses, the support staff teams, as their IT team did that, they found that what they were looking for was an employee experience solution that would directly give them trustworthy up-to-date information from their digital dump, as they call it in the company, which are all these thousands of files and sites. They wanted information in the form of an answer that the clinicians, nursing staff, system support team could use and apply. That’s why they took the technology one level beyond search results to giving an answer and finding an employee experience solution that had a visibility to all these systems using some advanced technology like AI. I think that’s an example of why CIOs need to go beyond the requirements they may be given and really understand the problem and come up with the solution that actually solves the business problem and not just the technology problem.
Anthony: Very good. When we did our webinar, you had one of your customers on, Jonathan Hensley, Director of User Experience with TeamHealth. He gave one of the more glowing recommendations that I’ve heard from a customer of a software provider. My question to you is what are the tenets, what are the principles by which you’ve built and run this business that you think possibly contributed to bringing about such a positive feeling from a customer?
Vishwa: I think one of the things we do as product people is we have to constantly remind ourselves when we’re offering these solutions that you have to have a very disciplined way of measuring the impact that you are making.If you cannot measure it, you cannot adjust it. If you cannot adjust it, there is no way you can sustain that for a long period of time. It’s this measurement model that we have with our community of customers. It doesn’t stop at 80% of the users are active on the system. That’s great but that’s not the measurement that we are looking for. We do want to understand as part of our process the outcomes that they desire from an employee experience solution. We are measuring against those either business outcomes, technology outcomes, or even aggregated outcomes which combine business and technology and take it all the way to the top.
Measuring of these outcomes as part of our community that we have built up with our customers is key. Then, we adjust. We adjust our process, what we have measured, why didn’t it meet a goal or measure (if it didn’t), we interview, we survey. We adjust, go back again, and do it, make the adjustments, put out a release. One of the advantages of being on the cloud is that you can iterate fast, and you can change things fast. It’s not the legacy on-premise model that you can do one release a year; we are literally doing a release every month, sometimes two releases a month. Once you get into that mindset of doing things fast, then you’re also building processes that makes sure that you’re not breaking things as you are building. You don’t want to take two steps forward and one step back.
So measurement, building processes that make sure you’re moving forward, adjusting and then having a sustainable model. No other secret sauce here.
Anthony: Well, that’s wonderful. We’re about out of time, Vishwa. Is there any parting thought, any final thought you want to add about the unique challenges of being a CIO in today’s environment in healthcare?
Vishwa: Well, I would just say my 2 cents here. We are fortunate, firsts, to have worked with great CIOs. I just can’t say enough of that. But my 2 cents here would be there’s a lot happening in the technology space, especially in this year, 2023, and they should especially keep their eye on generative AI technology. So my 2 cents would be – be mindful about that, be strategic about it, see how the opportunity applies to your business context and your technology aspect; and I think it’s a technology that can be disruptive for healthcare organizations and we are super excited about being a leader in the employee experience space especially being HITRUST certified to solve many of these organizations’ problems using these generative AI technologies. I would say that’s an area that CIOs should get a head start in. It’s a technology that’s here to stay.
Anthony: That’s wonderful, Vishwa. Excellent discussion. I want to thank you so much for your time today.
Vishwa: Thank you, Anthony. Always a pleasure talking with you.