Click here to read interview on HIStalk.
Tell me about yourself and the company.
I started my career talking to surgeons about the benefits of minimally invasive surgery and the impact on patient care. Way back then, 25 years ago, health IT was an afterthought. Now I’m back talking to health systems and the IT departments about the impact on patient care from an IT perspective. It’s interesting how things have come full circle and healthcare has changed so much.
Goliath Technologies focuses on creating software to ensure that when clinicians or healthcare workers attempt to access electronic patient records, they can do so without struggling with application access. We want them focused on patient care, not fumbling around with applications.
We sell tourniquets at Goliath Technologies, not vitamins. If you are an IT pro — and those are our customers — and you’re having problems with end user experience issues, especially as it relates to clinical and business applications in a healthcare setting, we may have software that can help stop the bleeding.
What kinds of performance issues do you see with EHRs and hospital infrastructure such as Citrix?
I would say about 90 percent of the performance issues occur at one of three stages of the user experience. One is logon initiation — they’re having trouble accessing the application. Two, the logon is slow — they’re trying to log on to the application, they’re getting through a few screens, but the overall process is slowing them down from accessing the application. Then, it’s in-session performance as we call it, whether it’s Citrix or VMware Horizon, which we’re seeing more of. Regardless of what the clinical application or the EHR application is, whether it’s hosted or on-premise, they have problems in the same three key areas.
About five years ago, we started bringing out technologies that focus very considerably on helping folks anticipate, troubleshoot, and then prevent issues in those three areas. We dig very, very deep and get tremendous amounts of metrics and data to try to be able to help them solve the performance issues in those three key areas — initiation, logon duration, and session performance.
I would assume those system vendors are happy that you can either fix the problem or at least prove that their application isn’t the cause of it. How do your customers work with those vendors as they try to get to the bottom of the issue?
It has really taken off. We have two very forward-looking vendors, Cerner and Epic. Cerner now resells Goliath Technologies products, so they can sell our technology into Cerner hospitals. We have a lot of very large Cerner hospitals. UHS, which I believe is a top 10 for-profit health system, is a big Cerner customer. I believe they’re the top 15 in Cerner, but they’ve been a customer of ours for years.
Epic has started the Epic Orchard program that gives performance vendors like ourselves access to Epic application data and information to correlate that with end user experience and IT delivery infrastructure data.
These forward-looking vendors realize that performance issues — standard, everyday IT performance issues, whether you’re on-premise with Epic or hosted with Cerner — impact the end user experience. A lot of the finger-pointing goes to Cerner.
I can give you one very good example with UHS. They were having downtime at a particular hospital. They opened a support ticket with Cerner. There was quite a bit of frustration. They had our technology on-premise, and there’s a real key component here — they had a problem with WiFi. It had nothing to do with Cerner. Of course, everybody sees Cerner on the console, so that’s who they blame. We found out that it was an on-premise WiFi issue that was causing the downtime.
We have situation after situation where that occurs. Our technology looks at things outside of the application that can cause problems with accessing the application or using the application.
You’ve introduced a cloud monitoring product for AWS and Azure. What healthcare demand are you seeing for it?
That remains to be seen. If I could make a statement about movement to the public cloud, we’re seeing a lot of adoption of cloud-based services, but your formal IT organizations are doing a lot of moving to internal cloud, centralizing applications for efficiency and things of that nature. We’re just starting to see hybrid clouds in the enterprise, where Viacom is a big customer of ours and BBVA. They are moving small amounts of their infrastructure to the cloud.
At Viacom, for example, they’ve been using technology in the cloud to build websites for movies for years and years. They’ve used AWS, but traditional IT is moving slowly. It’s even more so the case in healthcare IT. They’re worried about other things. Not only do you lose a bit of control when you move to the cloud and there’s a cost associated with it, but then there are all the concerns around privacy and security. We’re not seeing the move to the cloud in healthcare that we’re even starting to see in the enterprise. I think it’s probably going to move a little bit more slowly.
What’s it like selling technology to hospitals versus other industries?
What’s very interesting about healthcare IT is that they are much more traditional in terms of their approach, and very pragmatic. Things tie back, oftentimes, to patient care. So when you think about the challenges in healthcare IT, there are three critical things that we see across the board in relation to their enterprise counterparts.
Budgets and headcount. Almost always, they’re about a half to a third of what their enterprise counterparts would be. If you’re a health system and you’re supporting 5,000 users, your IT budget and your staff is probably about half of what a similarly-sized enterprise would be.
Desktop virtualization. A huge challenge. Healthcare uses desktop virtualization in a considerable fashion to access the clinical and business applications that they use because it provides them with secure access. But that also adds complexity, on top of the fact that they have smaller IT staffs.
Patient care is at the root and gives a little bit different focus. You may have a marketing person, a salesperson, or a developer who can’t access their application in an enterprise, and that’s one thing. But when you have a surgeon, physician, or clinician who can’t access patient records when they’re trying to have an interaction with the patient — or, God forbid, the patient is on the table, so to speak, in a clinical setting — that adds a considerable amount of focus.
When we deal with healthcare versus enterprises, there seems to be a little bit more focus and a little bit more sense of urgency to solve these particular issues. The underlying current is that everyone is concerned about patients. It’s a little bit more critical on the healthcare side than it seems to be on the enterprise side.
You were described in a 2002 profile as being an aggressive leader who pushes employees hard, puts performance monitoring in place, and then gets results from companies that were previously struggling. Have you changed your approach? What problems do you most often see in companies?
That was an interesting article. You have to take an article like that and put it up against the common sense and logic test. That was Silicon Valley, and Silicon Valley certainly went through the dot-com boom or bust for awhile. But things have not changed a whole lot in Silicon Valley. If someone doesn’t like where they’re working or they believe they’re being pushed too hard, they can always go work somewhere else.
I’ve done five other companies since then, Goliath Technologies being the latest. All of those five companies were successful turnarounds. Some led to exits, built a lot of shareholder value, and launched a lot of careers for people.
What was missing in that article, and what I’ve seen consistently — and I’m talking about taking over companies in New York, Israel, Canada and different parts of the United States — is that regardless of generation, there are people who are extremely driven and want to prioritize advancing their careers, for whatever reason, over doing other things. It’s talked about in terms of being aggressive and hard-driving, but really I was very lucky to be engaged with teams where there were lots and lots of hard-driving people.
I honestly don’t philosophically think that you can drive anybody. You want to find driven people and then create the type of an environment where those types of driven people want to come and have a long-term career.
Do think it’s your personality or the rigor with which you approach the business with an end goal in mind that makes you successful?
I say to people all the time when we’re interviewing them that we are in the people business at Goliath Technologies. When I was taking over venture capital-backed businesses, I used to get pushback from the boards many times for the amount of money that I would spend on training, ongoing education, and my focus on promoting people from within. My father brought this up to me one time. He said, you’re in the software business. There’s no plant. There’s no equipment. There’s no collateral. There’s people. You’re in the people business. You just happen to build software.
People come up with the ideas. Other people take those ideas and turn them into workable products. Other people then market, sell them, and then support those customers on an ongoing basis. We are in the people business. We just happen to sell software.
Do you have any final thoughts?
As an organization, we will be very successful if we focus very intently on two things — the careers of our employees and solving problems for our customers. The marketplace is moving in our direction. There’s an increasing reliance on desktop virtualization. The major EMR/EHR vendors are coming to the realization that outside of their application, there’s a tremendous amount of IT infrastructure that can impact the end user experience with their application, and therefore, their brand and reputation. Organizations like Cerner and Epic are working with us now in a formal partnership.
We will focus on employees and customers and ultimately be proud of what we’re doing to positively impact patient care.
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