Episode 8: How do you make 300 IT vendors work together? Healthcare operations and GRC with Brian Fugere of Symplr

Justin Steinman:
Definitively Speaking is a Definitive Healthcare podcast series, recorded and produced in Framingham, Massachusetts. To learn more about healthcare commercial intelligence, please visit us at definitivehc.com.

Justin Steinman:
Hello, and welcome to the latest episode of Definitively Speaking, the podcast where we have data-driven conversations on the current state of healthcare. I'm Justin Steinman, Chief Marketing Officer at Definitive Healthcare and your host for this podcast. I'm joined today by my longtime friend, Brian Fugere, who's currently the Chief Product Officer at Symplr. Brian and I worked together for a brief time at GE Healthcare IT and since then he's gone on and done some amazing things. First at Virence Health, the GE Healthcare IT spin out, then at Athenahealth, before he joined Symplr in 2019 as CMO and CPO.

Justin Steinman:
Symplr is a hot, hot, hot company in the relatively quiet space of healthcare governance, risk management, and compliance, also known as GRC. I say it's a relatively quiet space because let's be honest, 15 years ago there weren't a lot of people talking about GRC. But today it seems like everyone in the healthcare space is talking about GRC, and if they're not, then they should be.

Justin Steinman:
Symplr is the industry leader in healthcare GRC, so I thought it'd be fun to invite Brian to join me today to talk a little bit about the space, about Symplr's plans and also talk a little bit about his career path, because this is a guy who's gone across the healthcare IT industry, across the United States and across all different kinds of roles. Brian, welcome to Definitively Speaking.

Brian Fugere:
Hey, good morning. Pleasure to be here.

Justin Steinman:
Excellent. Excellent. All right, so let's get started with an easy question here. Many of our listeners have probably never heard of governance, risk management and compliance, much less about the role of GRC and healthcare. What is GRC?

Brian Fugere:
Yeah, that's a really good question. GRC is actually a really big thing in other industries like the financial world. When they talk about GRC, they know exactly what it is. In healthcare, you are right that most people don't think of it in those terms, but governance, risk management, compliance really has to do with how you operate on a day-to-day basis and what controls you have in place for your processes to make sure that you're doing things the way that you should be. If you think about how the healthcare industry is regulated and monitored, there are a lot of bodies who have a lot of interest in how you do what you do.

Brian Fugere:
The governance, risk management and compliance part of it is all around living up to those standards. What we found actually over time is that the GRC moniker doesn't really resonate within healthcare, because like I said, people just don't talk about it that way. But if you talk about it in terms of healthcare operations, it becomes a little bit more interesting and people start to resonate and understand, "Oh, well you're not an EMR, you're not an ERP, and you don't do rev cycle. You're kind of like everything in between." If you can frame it up in that way, people start to really understand what it means.

Justin Steinman:
Got it. Talk to me more about healthcare operations. What does that mean? What's the next level of detail there?

Brian Fugere:
Yeah. It's interesting. It's a lot of everything. We provide solutions for credentialing, for physicians, for vendors, for your janitorial staff. We can do it on the payer side, so that physicians can be enrolled with the plans themselves. Then you talk about the day-to-day operations of contract management, spend management, so how do you spend your money? Just general compliance processes, patient safety, all those types of things all fit into that sort of healthcare operation space and the biggest one, which is really the biggest cost driver for the hospitals, is just workforce management. How do you recruit your talent? How do you manage your talent? How do you schedule and staff? All of that is changing and evolving so quickly. So that whole big picture of everything in between, not EMR, not ERP, not rev cycle. On a day-to-day basis, that's the guts of how a hospital operates and all of those systems add up to that hospital operations, that GRC space.

Justin Steinman:
Got it. But everything that you just said, hospitals have been doing for 300 years, 200 years, right? What suddenly changed, really over the past 36 months or so, 48 months, past three to four years. All of sudden there's this big focus on this space. Did people wake up? Did they need to consolidate? Or it was just stuff just kind being done ad hoc on the side of their desk? What changed?

Brian Fugere:
Yeah, everything. It's exactly what you just said. What we found in talking to our customers is that they have somewhere between 50 and 300 individual point solutions that fit into that category, hospital operations category.

Justin Steinman:
Wow.

Brian Fugere:
If you're the CIO and your staff wakes up every day thinking about, "How do I manage 300 different vendors? How do I manage 300 different vendors? How do I manage the upgrades associated with 300 different systems, especially if they're on-prem or in the cloud. Some of them I have control, some of them. I don't have control." It's like your iPhone and the upgrade just shows up. How do you manage that with your staff in the hospital?

Brian Fugere:
All of a sudden, the CIOs and the leadership in the hospitals are looking at this category saying, "Hold on, there's a better way to do this. Can we gain some efficiency by having a partner or vendor who can provide more than one of these solutions to us? And what would it be like if we could actually integrate all of those together and share data across all these disparate systems, can we gain some efficiencies there?" And so given how tight the margins are in healthcare right now, any way that you can gain efficiency and save some money, that's a huge impact.

Justin Steinman:
I know you keep saying you're not ERP, but it really sounds like you're kind of what you're doing now for operations what ERP did for back office 20 years ago.

Brian Fugere:
Yeah, that's right. I haven't really figured out how to put a really tight descriptor on it. If I put my marketing hat back on and you and I, we're just shooting it around, what does it look like and how do you make this something simple? We haven't figured that out yet, but the reality is, it's a very fragmented part of the healthcare market that hasn't gone through the historical consolidation that we've seen with the EMR space, which was 15 to 20 years ago when that started. ERPs went through a similar consolidation and now there's just a handful of really well-known vendors.

Brian Fugere:
Rev cycle has certainly gone through a bunch of consolidation with now Waystar, Availity, Change as being an optimist, sort of being the four big players there. There's a couple new ones that are coming up, but the reality is it's still just a handful of really big vendors. Possible operation space hasn't gone through that historically and now it is, so Symplr is leading the way, RL Data seems to be following a similar strategy, and even HealthStream seems to be pursuing a similar strategy and maybe the three of us will emerge as sort of those bigger, dominant, wide, broad portfolio type companies.

Justin Steinman:
Got it. I have to imagine interoperability, that is a huge part of your business strategy. You've got to work with Epic, you've got to work with Cerner, you got to work with SAP, Oracle, and all that kind of stuff. Talk to me about them, this is the data driven podcast, so talk about how you're managing some of that data, the interoperability, and do you have a partnership with Epic and Cerner and stuff like that?

Brian Fugere:
Yeah, we do with Epic, for sure. We're working on one with Cerner and we exchanged data with Workday today, and it really comes down to the customer driven needs. And what we're hearing from them are two things. One, we've got to be able to exchange data with the EMR so that we can pull, or the customers can pull data out of the EMR to help guide how they do what they do operationally. They also want the data to flow back into the ERP, especially around spend management, scheduling the impact of time and attendance so that they can do payroll appropriately. So there are a lot of interfaces that require integration at the edges of what we do. We definitely bump up against those bigger vendors and we are trying to desperately not compete with them, but we do want to be partners with them where it makes sense for the customers.

Justin Steinman:
Right. Because I think Epic does have some operation software, right? I know they're kind of trying to go beyond the EMR and get into operation software. How is with their definition of operations different than your definitions of operations?

Brian Fugere:
I think everybody's going to eventually end up defining it the same way. What will happen is that everybody's going to approach that space in the middle from a different starting point. The core of our company started in the credentialing space, data started with patient safety. Workday is encroaching, because they're now offering time and attendance. So they're coming out of the ERP space. Epic's coming out of the clinical side of the house. And so everybody, I think we're eventually just going to kind of meet in the middle and some will be stronger with certain aspects in different flavors of what they do than the others. And there's so much space there. There's plenty of room for everybody to play. It's just we're going to have to play together nicely for the customers benefit because if we don't work together, then it's going to hamstring our customers and will probably cost them more money than save them, which is the opposite of what we should be.

Justin Steinman:
Not good. Definitely. Definitely not good. So who are you selling to? Who's your customer, what's their job? Who's the person who wakes up in the morning goes, "Gee, I got to get myself some GRC today."

Brian Fugere:
It's interesting. We have lots of different buyers because it kind of depends on the product. We talk to the CMOs, we talk to CNOs, CMIO, CNIO. So that whole sort of, how do we manage the physician and nurse staff? We talk to the CFO and the supply chain people because they will purchase a lot of our different products. Sometimes the COO gets involved and then depending upon the scale and the scope of the deal, even all the way up to the CEO. And it really depends upon who has the driving need and it all wraps around of course, into the world of the CIO.

Brian Fugere:
We're also seeing sort of a change in the CIO role, they're becoming much more of an enterprise perspective than they have in the past, which is really interesting. The CIO historically has been, "Let's manage the systems, we'll keep things up and running." Now they're much more of an enterprise partner with sort of the rest of the operators and enabling them to be successful in what they need to do. And so in our engagements, it's typically CIO, plus CMO, plus CMO. Those types of conversations are what really goes on.

Justin Steinman:
Got it. And for our listeners out there, when he's saying CMO, he's talking chief medical officer, not chief market officer.

Brian Fugere:
Yeah. [inaudible 00:11:56].

Justin Steinman:
I'm the kind of the no-specialized CMO, the marketing guy, it's all the medical guys who got the training and are making the real difference in the world out there.

Brian Fugere:
That's right.

Justin Steinman:
Brian, it's interesting to hear you talk about the changing role of the CIO at the hospital. Because a couple of weeks ago we had on our podcast, Tim Bosse from System One and he does healthcare staffing and recruiting. You and I are going to talk about that too and lot of workforce management in a second, but Tim said, he was telling hospitals and all his customers that they need to hire chief talent officers and start looking more like a software company in order to keep people there. And you're talking about the CIO taking a more of an enterprise approach. And the first thing that rang out in my bed is a guy who's been in software for 20 years is well, that's how a CIO operates in every technology company.

Justin Steinman:
And so I'm connecting a dot here between what Tim said about staffing, to what you said about CIOs. And it's almost like we're seeing a transformation of hospitals from non-technology based businesses or older school organization, business models to very much 21st century business models that look almost like a software company for lack of a better phrase or another way to think about it. Because every software company I know has a chief talent officer, we got to keep the people here involved. And so we're seeing this big evolution of how hospitals are structured and organized. What do you think about that?

Brian Fugere:
I think you're right. I think it's being driven by the margin pressure that they're feeling, and they're looking to other industries for inspiration on how to operate more efficiently and to preserve whatever margin they can. If you think about the history of healthcare market, the running joke was this is where a technology goes to die. And the adoption of new tech, well, it's just it's the truth. The adoption of new technologies into healthcare, outside of care delivery, which was always very innovative, was slow. And so that's changing now.

Brian Fugere:
And a perfect example is that 12 to 18 months ago, talking to our really big customers about moving from some of the legacy on-prem systems to the cloud, they're like, "Whatever, come back to us when you're ready. We're not in any hurry." 12 to 18 months later, they're pulling us saying, "Oh, I want to go now."

Justin Steinman:
Interesting.

Brian Fugere:
And that's a major shift.

Justin Steinman:
Yeah. Yeah. You say hospital's where technology goes to die. I'm having PTSD back to our day sale and EMR software together. Good Lord. Yeah, well.

Brian Fugere:
But it's changed. It's very different now.

Justin Steinman:
I'm sure all of our EMR listeners out there are having the same PTSD that you and I are going to right now.

Brian Fugere:
Right. Right.

Justin Steinman:
Let's talk a little bit about HIPAA and healthcare privacy. Because when you talk about compliance and governance and risk management, there's got to be a big intersection between what you are doing and HIPAA.

Brian Fugere:
Protecting data is the thing that keeps me up at night. It is the only thing that really worries me about what we do and what our colleagues do across the industry. Patient data is the most important thing, the safety and management of it is crucial to any of our businesses and any of our colleagues across the industry. And we've recognized this and years ago made a ton of investment in our security. And I know a lot of our peers in the industry have done the same, but it's still an issue.

Brian Fugere:
You still see the ransomware attacks that hit our customers. They hit other vendors in the industry. And the impact that's had on our customer's ability to operate, it's just been catastrophic. And so I can't even imagine trying to operate a facility when your systems are just unavailable and that's just not acceptable and it's like the worst possible nightmare. And so the only good thing that has come out of these is that I think every vendor in healthcare has taken a minute to do a little self-reflection on their own systems and said, "Here's what we need to do to beef up our security, to make sure that this doesn't happen to us. And it doesn't happen to our customers." Because in the end, it's the patient that gets hurt and nobody wants that to happen.

Justin Steinman:
Let's just talk a little bit about workforce management, which you mentioned earlier. Supplying workforce management, you must have some pretty interesting insights as to what's going on in the healthcare workforce right now around trends. What do you see in there?

Brian Fugere:
It's evolving rapidly as the demands of the workforce change. And so I was talking to a CNO a couple weeks ago about how they think through their scheduling processes and what she was telling me was that historically it was, "Hey, we had all these nurses on staff. We'd schedule them on their regular schedules. Maybe they do some shift swapping. That's the level of complexity and that's it." Today, the nurses are saying, "Hey, I want to work Tuesday from 10:00 to 2:00, Wednesday from 3:00 to 7:00, Thursday I'll work the whole day, Friday I need off because of my thing for my kids. I really don't want to work the weekend. But if I have to cover for somebody, you can put me on call. That is incredibly non-traditional. And when you take that and you multiply that across five, 10, 15,000 nurses, depending upon how big the hospital is, now you're looking at a scheduling and talent management challenge that is just-

Justin Steinman:
Massive

Brian Fugere:
... or is a magnitude, more difficult. So what we've come to the conclusion of that our customers have been asking for is maximum flexibility for finding talent, managing that talent, developing it, retaining it and doing it in a way that meets the talent at least halfway. And so that means you need recruiting capabilities to go after, let's just stick with nurses. You need to be able to get travel nurses. You need to be able to get basically gig economy type nurses, where they work maybe three or four hours, at a time you need full staff that you can recruit. And then once you get them all in the door, you got to be able to schedule them. You need to be able to manage them from a human capital perspective. So you need to do their performance assessments. You need to develop them as individuals from their talent and skills and experience perspective. You need to do all of the long term retention and then eventually maybe you need to exit them.

Brian Fugere:
And so workforce management has gone way beyond the traditional time and attendance scheduling that is now a much more complex end-to-end sort of challenge for the hospitals. And it's forcing us to rethink how we do what we do, and our systems have to become much more flexible. We have to be open to partnering with different types of providers. We have to be flexible enough to deal with different types of business models, because what we're starting to see now is that rather than paying an outside agency to go find short term talent, the hospitals are standing up their own internal staffing agencies.

Justin Steinman:
Wow.

Brian Fugere:
That's different, that's new. And so we need to be able to provide them essentially a staffing agency in a box software because how you operate a staffing agency is very, very different from how you would operate a normal, when we go hire somebody and bring them on full time kind of a deal.

Justin Steinman:
Yeah. Nursing just feels to me, we have a massive nursing shortage in this country, as I think we all know here. 2 million nurses, the latest data that I saw is the shortage of what we have. And I think that's probably underestimated, frankly. And then the second thing you think about it, you can do nursing remote, but only a certain kind of nursing remote. You can do the checkpoint, the patient, the remote patient monitoring of it. But the reality is the nurses are the people literally on the very front lines doing the majority of patient care in between the periodic check-ins from the doctors or the surgeries or whatever. But the nurses are the people who have to be there and they get the long shifts and they get a lot of the patient complaints and they've got to make everybody comfortable and deal with all the triage.

Justin Steinman:
And you're right, it's a high stress job, but the world of work has fundamentally changed over the past 24 months. Right? And I think nursing is trying to change with it. I had never heard anybody use a gig economy nurse phrase before until you just used it. But yeah, what if there be a gig economy nurse. Right?

Brian Fugere:
Right.

Justin Steinman:
But then how do you manage the credentials of that?

Brian Fugere:
That's right.

Justin Steinman:
That's a huge thing. And I could go be gig economy nurse, I have zero training, zero credibility, but you got to find a way to go check out that Justin is who he says he is, right? Before you start letting me lay hands on patients.

Brian Fugere:
That's right.

Justin Steinman:
That's a whole new set of problems for hospitals to deal with. So how are they thinking through that kind of problem?

Brian Fugere:
Yeah. It comes back to our discussion we had earlier about integrating. And so there are centralized nurse credential sources of information that you can integrate with to make sure that information goes along with them. And it's much like when a physician changes hospitals, the credentialing process starts all back over again and you have to credential them on the physician side or the facility side, you have to credential them on the payer side, it's very inefficient. And so we need some sort of centralized management of credentialing for both physicians and nurses to facilitate the movement of talent around the industry.

Brian Fugere:
Because I think the days of, "I'm attached to this one facility," are coming to an end. They have the ability to do telehealth now, if you could practice in a facility, you could be a telehealth physician at night and you can treat a patient that's halfway around the world. Well you got to manage those credentials as part of that process. And the same for nurses, they can do the same thing. It definitely is changing the paradigm of how we've thought about managing the caregiver provider type talent in the industry.

Justin Steinman:
I have a question I'm curious to hear your perspective on. We're 12 episodes into this podcast series. One of the things that has emerged, a kind of common topic of conversation has been the difference between the big academic medical centers, primarily in the urban areas versus the challenges that many of the rural hospitals are facing around staffing, around organization, around finances. We've talked about that with a number of our guests. You're in this operation space, are you seeing a difference in how these AMCs are operating versus the rural hospitals? Or are there unique challenges faced by some of these rural hospitals that are out there?

Brian Fugere:
Yeah, the first challenge is just budget. Their budget versus the big centers is just, it's so different. And it forces us as a vendor partner to really think creatively on the financial side of how can we help them achieve what they need to achieve so that we can still get paid to do what we do, but we want to do it in a way that's friendly for our customers. The other big thing I've noticed the difference of is that the rural hospitals and their leadership are often much more open to hearing best practices and different ways of doing things and are willing to experiment and try if they think it's going to gain them even a point in margin, because that's a huge impact on how they operate their business.

Justin Steinman:
Yeah. You keep coming back to this margin. Some of the data that we were looking at recently here is that over the past two years, hospital expenses on average have gone up three points where revenue's gone down two points. And so that is a five point swing in profitability, pretty much across the board and already a tight margin business that's out there. So this really interesting pressure people are under.

Brian Fugere:
Yeah. I was talking to a CIO from the West Coast at HIMSS a couple months ago. And he said that their whole system, which is 10 to 15 hospitals, is running at a 1% [inaudible 00:25:00].

Justin Steinman:
I can't imagine that either. That's just crazy. It's like life and death every day on a financial, much less dealing with a life and death every day of the patients who you're trying to take care of. Because you don't want to cut corners, delivering that patient care. And every available dollar you need to route to that patient care and every dollar you're not spending on patient care, you're spending someplace else is you're wondering, "Well, could I spend that on patient care? How can I get it over there?" And that's just a tough balancing act every day for that entire hospital executive leadership team to think through.

Brian Fugere:
Yeah. Exactly.

Justin Steinman:
So I want to ask you a little bit about something. I was surfing your website and I saw this fancy phrase, a provider data management platform, what's that?

Brian Fugere:
It's an end to end collection of solutions or platform in this case, that enables a facility to manage the data associated with their providers from the minute the provider shows up, through their entire duration with that particular hospital. As an example, my son's a physician at NYU. He shows up and has to immediately go through the credentialing process. And so that requires him to provide information where he went to school, his training, et cetera. Then the staff takes over at that point and runs through the credentialing process with joint commission and everybody else who wants to go look at it and then provides that information to the payers so that you can do pay enrollment into the plans so that they can get reimbursed. That's the first, most important thing, get them credentialed and get them enrolled with the plans so they can get paid because if they do anything prior to that, get reimbursed for it.

Brian Fugere:
And then you want to let the people know, the patients know that physician is actually there. And so we have a directory product that enables patients to search for physicians, schedule appointments, and figure out what plan coverage they have. And so you've now created an opportunity to manage the information around that provider, from the minute they walk in the door, all the way through to their engagement with patients. And that information, then you can extend to what is their contract structured like, how do they get reimbursed by the payers? Is there leakage from a referral perspective? And so there's a lot of downstream implications from how you manage that information as well. So it's really all about managing the information around your most important people asset in your hospital, and then everything that kind of streams off of that.

Justin Steinman:
So let's talk a little bit about Symplr and your sky strategy in the market. Not to ask you too bad as a question, but what's your point of differentiation here? What makes you guys special?

Brian Fugere:
Today, it's interesting, we're taking our customers on a journey with us. Today, we're an enterprise provider of hospital operations and GRC solutions. What does that mean? It means we have a broad portfolio where you have a single vendor who can provide you multiple solutions, when you buy multiple solutions from a single vendor, you oftentimes get a nice, healthy discount and you have one [inaudible 00:28:21] and one person to call when there's something going wrong. There's a lot of value in that, but it's not a sustainable differentiating value by any strategy.

Brian Fugere:
So the strategy that we've embarked upon is what we internally call the connected enterprise strategy. And for me as the product leader, it's how do I take all these disparate products and integrate them in a couple different points. The first one is a common look and feel. Everybody knows that Symplr has grown through acquisitions. We have really modern software, we have some legacy software that we've acquired that's 25, 30 years old. So they all look and feel very differently, but we have a design system that we've created that we will put on top of every one of them to create that integrated look and feel across the entire solution set. This is not rocket science by a new strip.

Brian Fugere:
Then we can tie them together at the workflow level. And this is where I think there's some really neat differentiation, opportunities. If you can tie these solutions together at the workflow level and one, an action in one triggers an action in another, but it doesn't automatically, think about how much time you could save. So let's take a patient safety instant, for example. Something happens to a patient, unfortunately, and there's physician and a care delivery team involved.

Brian Fugere:
The patient safety incident happens, it gets recorded in the patient safety management system. It reaches the threshold where a peer review process has to happen. So theoretically you could automatically trigger that peer review to kick off. Well in the peer review process, you're going to want to go out and get a bunch of information so that you can have it all in that review process for everybody to take a look at. Like, "Hey, what's the schedule for that day, for not only the doctor, but for the nurses, what vendor representatives were on site that day, and were they involved in the delivery of care when this incident happened?" So you can go and you can see what vendors were on site and are they credentialed to be in the facility where they actually were. You might want to know what's the contract that's involved with that physician. And what are the terms that their employment is associated with? You might want to know the talent profile for each of the people involved. What's their training background? Have they completed all the requisite courses, and so on, and so on.

Brian Fugere:
Today, whoever's managing that peer review process has to go and make phone calls or emails to go solicit all that information. Sometimes it shows up, sometimes it doesn't. If it does, maybe it's in the right format, maybe it's not. If I can connect all those systems and I can automatically make all that information flow, I'm going to save hospital a ton of time, make them far more efficient and far more effective. So that's at the connective workflow kind of level.

Brian Fugere:
And then the last place we want to connect everything up is at the data level. So we talked earlier that in this operation space, most facilities have anywhere from 50 to 300 different systems. Imagine trying to integrate all that data into one single data mart, data lake, whatever you want to call it. That's a challenge. But if we can do that, if we can suck the data out of all of our systems, put it in one place and make it available to our customers, either through our own visualization tools or through theirs. Nah, that's pretty cool. And now you have an opportunity to take a look at your data in a way that you could never do it in the past. And we can start to serve up some really cool analytics insights, and we can support them with whatever their reporting requirements are to the government.

Brian Fugere:
There's some value if you can pull off all three of those things, that's a differentiator that Epic and Cerner have today in the EMR space on the clinical side, that the ERP vendors have because of the consolidation that they all went through years ago. This is the type of consolidation that the operation space is going to go through now.

Justin Steinman:
Got it. And so you talk about operations. I feel like every time I return around, I read another press release, saying, Symplr bought a company. How many companies have you guys bought?

Brian Fugere:
In the three years that I've been here, I think we've done 11 acquisitions.

Justin Steinman:
Oh my God. So that's like what, three a year? Four a year?

Brian Fugere:
Yeah, one a quarter, I think.

Justin Steinman:
One a quarter?

Brian Fugere:
I think last year it was one every other month.

Justin Steinman:
Oh my God, it's going to be high stress.

Brian Fugere:
Yeah. It definitely puts a strain on the organization, but it's a muscle that we've developed and feel pretty good at flexing. Like anything you do, you get better with it, the more times you do it. And I think our latest sort of two acquisitions that we closed earlier this year have gone exceptionally well. The teams are happy and excited to be with us and they see the opportunity of what we're doing and really want to go join us on that journey.

Justin Steinman:
So we're coming to the end here, but I did tease earlier that we'll talk about your career journey, and I usually don't go too deeply into my guest professional backgrounds, but yours, I've always found it interesting, right? I'm just going to walk through and this is nuts, right? So you started out as an intelligence officer in the US Air Force and then you did technical product development for America Online, one of the first major consumer internet service providers. Then you decided to go to a stint in marketing at GE Healthcare and Virence Health, and now you're running product that's Symplr. So A, that's really impressive. And B, how the heck does the US intelligence officer go to AOL to GE Healthcare, to running product, that's Symplr. What's the red thread here, man?

Justin Steinman:
It's interesting, when I look back now, I think I'm old enough to look the mirror and say, a third of my career was in marketing, a third of it was in product and a third of it is sort of executive leadership type roles. And the ability to move back and forth between the different types of jobs within the software industry, especially within healthcare software has given me a unique perspective on how we can make our products, services, offerings, whatever the case may be better for our customers than I would if I had been sort of a single stream product person, because the amount of customer contact that I've had over the years and really understanding what they're going through and helping to create and deliver things for them has been just a unique opportunity that I'm really so thankful for because I know that some of the things that I've created along the years are still in use today, even though they've been bought and sold multiple times.

Justin Steinman:
Software that I created back at AOL is still available today. During my time at Stryker, I built some systems that have been sold two or three times, but are still... In fact, my wife's orthopedic surgeon uses software that I created 17 years ago. It's really kind of rewarding to see it when that happens. And I don't think I'd been able to do that unless I had the ability to go back and forth between marketing and product and really understand what's going on in the market so that we could deliver some really cool compelling products and services.

Brian Fugere:
Yeah. I agree, because the guys' floated between product and marketing. There's really just two sides to the same coin. All right. So thanks for a great conversation. But I just want to know in closing here, what's next for Symplr and what's next for Brian?

Brian Fugere:
For Symplr, we're going to continue building out our portfolio for sure. There's a ton of opportunity in the spaces that we're in today, there's a ton of opportunity in the adjacencies that we're looking at. So I'm really looking forward to seeing sort of how we continue to transform, how we continue to consolidate this operation space and really bring and deliver value to our customers. And that kind of partnership is what I'm looking forward to. For me, who knows, this is such a fun ride right now. I'm enjoying every single day of it. And then we'll see where it goes after this. I was a CEO years ago and wouldn't mind getting back to that. But even if that never happens, just being able to deliver for our customers, that's what gets me out of bed every day.

Justin Steinman:
I hear you. Well, Brian, thanks for taking the time to talk with it. This is a lot of fun.

Brian Fugere:
Yeah, my pleasure.

Justin Steinman:
And thanks you all for listening to Definitively Speaking, a Definitive Healthcare podcast. Please join me next time for a conversation with Scott Seidelmann, Chief Commercial Officer at Omnicell, about the next generation of pharmacy and medication management and why a robot may soon be filling your prescription. If you like what you've heard today, please remember to rate, review and subscribe to the show on Apple Podcast, Spotify, Google Podcasts, or wherever you get your podcast. To learn more about how healthcare commercial intelligence can support your business, please follow us on Twitter @DefinitiveHC or visit us at definitivehc.com. Until next time, take care and please stay healthy.