As part of my series about the “How Businesses Pivot and Stay Relevant In The Face of Disruptive Technologies,” I had the pleasure of interviewing Andrew M. Smith.
With 30 years of experience in the healthcare industry, Andrew M. Smith is president of Impact Advisors, one of the country’s leading healthcare consulting firms that he co-founded with his brother, CEO Peter Smith. Andrew has spent his career developing and implementing information systems, services, and strategic plans, all aimed at improving the business of healthcare. His extensive experience working with academic hospitals, integrated delivery networks (IDNs), community hospitals and physician group practices enables him to serve as a strategic advisor to many of the industry’s leading healthcare executives. Andy presents and publishes regularly on topics relating to healthcare systems and management. He holds a B.S.A. from Miami University.
Thank you so much for joining us in this interview series. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I have been working in healthcare for 30 years and have only had two jobs. I lucked into healthcare but feel so privileged and honored to be able to serve an industry that so directly benefits communities.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lessons or ‘take aways’ you learned from that?
When I first started as an intern, one of my jobs was to answer the phone when the office manager was out of the office. The office manager was a recent divorcee, and it was no secret that she was seeing several different people. One day, the phone rang, I picked up and was greeted by a heavily accented man asking to speak to the office manager. I replied, “Linda isn’t in right now, but I will let her know you called” and then, since I was so impressed with my prodigious memory, I added “nice speaking with you Nick!” The caller shouted, “who is Nick?!?” and then I got yelled at by non-Nick and, later, by Linda. Lesson learned: pay attention to the details, and don’t assume you know everything. From that moment on I had a note on my desk that read “Nick = no accent.”
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story?
I totally agree that we are all the sum of our parts and that none of us completely succeed solely on our own merit. My career is a very direct example. I have only had two jobs in my adult life, both in the same industry. I got my first job as an intern at the company where my older brother was working, benefiting explicitly from nepotism. Before we get all congratulatory for my big brother, please note that he got the job because our mom played bridge with a spouse of one of the principals!
Extensive research suggests that “purpose driven businesses” are more successful in many areas. When your company started, what was its vision, what was its purpose?
Our purpose is and always was to “create a positive impact.” Being purpose-driven is easy in healthcare; we want to make healthcare safer and more efficient! Our work provides tools and processes for frontline healthcare workers improving how care is delivered.
Thank you for all that. Let’s now turn to the main focus of our discussion. Can you tell our readers a bit about what your business does? How do you help people?
We are a nationally recognized healthcare management consulting and technology services firm that is solving some of the toughest challenges in the industry. We deliver strategic advisory, technology implementation and performance improvement services. In the end, we help healthcare delivery organizations (hospitals, Integrated Delivery Systems, physician groups) use advanced technology and better processes to improve how care is delivered.
Which technological innovation has encroached or disrupted your industry? Can you explain why this has been disruptive?
I would say the most disruptive and beneficial technology has been the introduction and subsequent adoption of the electronic health record (EHR). This technology took a lot of disparate, non-standardized data and created the potential to do meaningful things, such as research, improve treatment, reduce duplication, among many things. I say “created the potential” because the existence of an EHR does not guarantee these things, but it does offer the opportunity. It takes a lot of hard work and change management to realize the potential.
What did you do to pivot as a result of this disruption?
We’ve become much more focused on workflow and change management — becoming an “IT-enabled” process improvement firm. Our work has historically covered the overlap in the Venn diagram between technology and operations, and we have pivoted to focus more on the operating sphere.
Was there a specific “Aha moment” that gave you the idea to start this new path? If yes, we’d love to hear the story.
There wasn’t a specific “aha moment,” but we have spent a significant amount of time and effort throughout the years implementing technology solutions for clients who, in large part, desired to “keep up with the Joneses,” but there hasn’t been an emphasis on using these technologies correctly or efficiently. The “promise” of the technologies was often not fulfilled. Our new path is to make sure that our clients use these technologies to achieve their goals by making information standardized, normalized, and actionable.
So, how are things going with this new direction?
Quite well but there is still a lot of work to be done. The healthcare industry is in a period of significant change. And now that I think about it, that level of change has been present for all of my 30 years, and I would expect it will exist for the next 30! Notable shifts include improvements in the care model, significant changes to how care is reimbursed, an evolution towards consumerism and patient-driven care, and many other factors. To serve this industry, we will be required to evolve our services and continue to innovate alongside our clients.
Can you share the most interesting story that happened to you since you started this pivot?
I was working at an academic medical center implementing an EHR, including physician-entered orders. While the project was successful from a technology standpoint, and delivered on time and on budget, the system was only being sporadically used by the physician community. Without their support, the end goals of enhanced decision-making, reduced duplicative services, and safer care would never be realized. The initial project fell under the direction of the chief information officer, but the subsequent optimization phase was sponsored by the chief nursing officer (CNO). The project’s focus shifted immediately, from technology for the sake of technology to what would most directly benefit the caregiver and the patient. In fact, whenever we were debating the best way to technologically solve a problem, the CNO would ALWAYS ask the question, “what is best for the patient?” Sometimes the answer was decidedly “not technology” … anathema to us “gearheads.”
What would you say is the most critical role of a leader during a disruptive period?
Communication and stability. It is important for people to know that there is someone manning the tiller and guiding the ship, and that can only be done through good communication.
When the future seems so uncertain, what is the best way to boost morale? What can a leader do to inspire, motivate and engage their team?
It is important to be transparent and lead from the front and don’t ask anyone to do something that you wouldn’t do yourself — hopefully, behaviors we are already demonstrating. Transparency is doubly important when times are tough. People are generally ok with bad news with an action plan, as compared to no news and no plan.
Is there a “number one principle” that can help guide a company through the ups and downs of turbulent times?
Be visible. Let people know you are there, and you care.
Can you share 3 or 4 of the most common mistakes you have seen other businesses make when faced with a disruptive technology? What should one keep in mind to avoid that?
- Deny its importance.
- Rationalize why it isn’t disruptive.
- Believe that your product or service is disruptive when there is no real differentiation.
Sometimes we become myopic about our own abilities. It is important to get some outside perspectives.
Ok. Thank you. Here is the primary question of our discussion. Based on your experience and success, what are the five most important things a business leader should do to pivot and stay relevant in the face of disruptive technologies? Please share a story or an example for each.
- Remember that “disruption” is less about the technology itself and more about the new processes and workflows that are enabled by the technology. There exist many, many new and exciting technological changes, but technology needs to serve an end goal. In my career, I have seen many people chase “shiny objects,” cool technologies that would appear to bear significant fruit. However, unless the technology is paired with the process and workflow, my experience dictates that the technology will not achieve the desired outcome.
- Take risks and make calculated “big bets” for the future. Business conditions will wax and wane. We have found that our best growth has been immediately preceded by challenging business conditions. If you have a vision for what you want your company to be long term and have the courage, downturns are the absolute best time to “double down” and make some strategic bets. We have done this in a significant way at least three times in the past 14 years, once during the 2008 Great Recession, once at the end of the healthcare “meaningful use” era, and now during the pandemic crisis. During each downturn, we evaluated our current portfolio of services and made the strategic decision to invest and evolve.
- Invest in people. In our industry (services), the people are the only asset. Our skills and experience dictate how we assist our clients. It is important to attract, retain and develop the best of the best in order to achieve our goals. When we interview candidates, we look for great skills, a strong work ethic, and someone “who you would like to have dinner with.” In my career, I have met many talented people who fail that last test. No matter how talented they are, if they are difficult or not a team player, their ability to be successful will be limited.
- Don’t abandon culture. If people are the most important asset and foundational to success, then culture is the fuel that powers that foundation. Culture develops and retains people and creates synergy whereby people can magnify their talents. We recognized the importance of this very early in our firm’s existence and created a chief culture officer position focused on maintaining and improving our culture. We affectionately refer to this position as our “Happyologist.”
- Be nimble and agile. Flexibility is rewarded in any kind of market. We covet people who are nimble, have great core skills, and can adapt and change. We screen and hire talented individuals who have great foundations and many arrows in their quiver.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
One of my favorite quotes is: “If I have seen further than others, it is by standing upon the shoulders of giants.”This quote is important to me because it is so critical to remain humble and always be cognizant that your work is built on the strong foundation that others have established. None of us stand alone and all our successes are the confluence of hard work, lots of support, and some “right time, right place” fortune.
How can our readers further follow your work?
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