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Pamela Spence

Hello and welcome to EY's Health Sciences and Wellness podcast today I'm sitting here with Nancy Flores. Nancy is the Executive Vice President and Chief Information Technology Officer for McKesson Corporation. We're going to focus today really on data, the importance of health data and how can we unlock the power of data by connecting data sets better, combining data sets, driving insights to deliver actions, to really drive a better health outcome, health experience for the many patients that the health ecosystem serves. But before we get stuck in, Nancy perhaps you could tell our listeners a little bit about yourself and your career journey and then we'll go into the nitty-gritty so to speak of our data conversation today.

Nancy Flores

Sure, Pamela. Thank you for having me, excited to be here and I would say, my background for most of my professional career has been in the healthcare industry, 20 plus years in pharma-manufacturing, and my most recent role at McKesson as our Chief Information Technology Officer. And through the course of my experience, I have had opportunities to support work and enable a number of business outcomes and healthcare outcomes that are based on technology and data. So, lots of lessons, lots of learnings but always from a healthcare standpoint when you're in the business of supporting healthcare and the quality of a patient's life technology and data become quite exciting.

Spence

Brilliant. I mean we're certainly very delighted Nancy to have you with us today. I think really let's try and focus our discussion today on some practical aspects and some heartfelt aspects that perhaps our listeners might not have heard before. I talked about healthcare data and unlocking the power of data by connecting and combining data search driving in science to deliver actions but turning to you Nancy as the CIO and the technology officer at McKesson, how do you see the role of data and technologies changing both at McKesson internally and in the wider pharma and healthcare ecosystem?

Flores

Yeah sure. it's a great question. I think it's no secret in today's role data and technology is fundamental to just about every company's business strategy but when you look at healthcare specifically there is, there are some unique complexities that we need to manage through and when you look at the world of healthcare it continues to become increasingly complex with new entrants, new regulations, consolidation of systems and you have also pricing pressures, you know, just the higher cost of healthcare. You have an aging population that needs more healthcare.

And then you have, in my opinion, a growing area that we need to address the unmet equity of healthcare in under-served communities and all those things bring both complexities and opportunities to disrupt and make a difference. And that's where when you think about data and technology, data serves as the underpinning of any automation, any device, any technology that can improve the experience of a patient or improve some healthcare outcome and I look at it in three areas when you think about healthcare.

There's changing the patient experience and in today's world many healthcare systems, many patients interact with some sort of technology, but the secret sauce is how can we connect across the patient care and actually improve your experience to make it simpler, to make the data more easily digestible and to make their whole experience as they come into one area of the healthcare system very seamless from going to a doctor's office to have to go to a pharmacy to purchase their prescriptions. In today's world that's very complex, very manual, and very patient intensive for them to take responsibility to carry their information.

Another example is improving outcomes. With the care coordinators, there's a lot of data that is collected in today's systems across the healthcare systems. There are many opportunities to take that data outside of the physician's office and look at whether real-time it’s the physical factors of a patient, whether it's environmental factors whether it's other lifestyle factors that can influence their health outcomes. and lastly, which is also exciting, is really the IoT of healthcare where you have increased devices that now have come out of the labs or the hospitals that can now sense more real-time and sit on a patient, sit near a patient whether it's telehealth, remote monitoring, all those things data's fundamental to that. And it's how we can stitch and connect that data to drive and change an experience or understand another level of insight that can improve an outcome of a patient.

Spence

Thanks, Nancy. I'm delighted that you brought up the IoT just now. I think the Internet of things and the ability that we have now, and we will continue to do so with sensors either inside us, on us, around us will be able to collect an awful lot more data in almost a continuous stream and real-time and then, of course, we have 5G to, to transport that data and some very clever algorithms to interpret that data. there was an interesting statistic I saw the other day that mentioned that the future of health data is going to be one and the IoT that you've mentioned plays a significant part in that, 80% of data, or health data is likely to be generated outside of the hospital setting and I think that gives an interesting perspective on how EMR systems, records, in situ in a clinical infrastructure will have to adapt and flex to interconnect with that 80% that's generated outside a traditional clinical setting.

Flores

Yeah, and it's an interesting statistic I had not heard that, but it makes a lot of sense to me because when you think about the healthcare of an individual many people say the majority of your health is influenced by factors outside of the doctor's office. so that's where real evidence becomes important whether it's for a certain disease that you're being diagnosed with or it's just the general day to day health outcome and I think one of the things COVID-19 pushed the healthcare industry is to take a bigger look across the ecosystem of health that sits outside of a hospital or a physician practice and leverage some of those IoT devices to help monitor the health of an individual and you know what, it's not as simple as everyone thinks. I think when you look at IoT it's a huge opportunity to increase the sensing of a patient to be able to have access to a lot of populations outside, of a city in remote areas. There are many devices that are more real-time that today, save lives compared to having to take a patient into a hospital and get a test run. So, I think that's key, but that statistic makes a lot of sense to me.

Spence

Thanks, Nancy. You've just mentioned COVID-19 and I often think about, you know, COVID-19 in all its horror over the last two years, if I may say that a positive coming out of COVID-19 is arguably the jolt that it forced the health system to treat patients through virtual interfaces or certainly triaging and start to make available care outside of that traditional setting, I think that McKesson has talked about = patients at the center, humans at the center, that's certainly at EY we're thinking about a human at the center of healthcare or really any other industry as consumers, users, patients, I'll use those words inter-connectively, they become more demanding and have an opinion about how, when and what they're treated with. But that, of course, has a massive implication on supply chain and operations and that's obviously one of the sweet spots of McKesson.

So how may McKesson be thinking about this COVID-19 jolt and what does that mean to supply chains and operations and not wanting you to give any insights outside of what you're able to share about McKesson's future strategy, but how is that sort of thinking, translating inside of McKesson and what do you see the future being in supply chain and operations?

Flores

It's a great question. I believe there are a lot of silver linings that came out of COVID-19. COVID-19 has been challenging for the world and we're very proud to be a big part of the public safety focus of addressing COVID-19. But a lot of things, you know, when history shows that when you have mass disruption innovation comes out of it and we are a 190-year-old company.

We have always been proud of the innovation we've done historically, everything from pioneering gelatin-coated pills in the 1870s to the 1990s wrist-mounted bar code readers in the distribution center. We thought, those were great innovations but going through COVID-19 in the supply chain, when you have an industry that just runs and you can predict when the flu season comes, you can predict, the number of diseases, you have a lot of data that has been predictive.

One of the things we learned about, with COVID-19 is how do you take data and technology and use it to dynamically adapt to something that's not predictable and that was speed became important. We had technology innovation does not necessarily happen on new technologies and we had innovated overnight on supply chains that were standard and predictable and overnight it was critical for us as a company to be able to get the right medical supplies to the right healthcare systems so they can address their patients. And so, we had several groups and were very proud of my team to support the business in solving problems where we had to recreate and come up with ways to dynamically allocate and redistribute products overnight within hours. we had several teams focusing on, pre-authorization of prescriptions that people were no longer able to walk into pharmacies and we have a big business in specialty care where we work with payors and providers and even the pharma-manufacturers to get critical, critical drugs to patients that if they don't have drugs within hours it impacts their health.

We really learned a lot about how to pivot and take existing technology and data and instead of changing it to be a predictive model, how do we use that to drive speed and dynamic agility. So, we ask ourselves now as if we've done this for the last two years, how do we take that culture and continue to drive that through our company.

It's been exciting to really think about innovation and when you have a company that's not digitally, digitally native that culture of innovation is probably one of the more fundamental focused areas to get right.

Spence

I think the challenge is, like let's just capture all the goodness of the last two years and you mentioned the innovation, the speed, the dynamic-ness of how you have had to operate and the innovation around that, and let's just make sure that we pinch ourselves and don't go back to how we were, and I think that's very, very true. But linked to that, of course, is this whole question around talent, Nancy right and, we hear of the Great Resignation, we hear of talent shortages just more generally, and then on top of that, in this area that we're talking about some significant opportunities to really make a difference in the future require some really distinctive and specialist skills, but I guess everybody is after those specialist skills. So how are you as a leader in McKesson managing this whole talent conundrum and challenge?

Flores

Yeah, talent is a big topic these days and I think through the last few years you have been so many changes in the environment, in how we live, how we work. I think there's a population that has re-thought their values in what they do. there's also that changing of what is required for a company to be successful and to me, a lot of that is around the foundation of new capabilities that understand data, how do you take insight and run a business using data and that's driven a whole new need. we not only have a talent gap of just not enough workers. we also are looking at what are the right capabilities we need and some of the biggest areas that all companies are challenged with is hiring a data scientist or a pricing analyst that knows how to read and understand data.

There's a big shift in really using data and applying it to be much more innovative in how you run a business. One of the things we try to link it to, there used to be the talk about to be innovative you need to hire that younger generation with the sweatshirt and the hoodie, we look at it in a combination of two areas, and really, it's three areas. a lot of what keeps our employees excited to come to work is the overall mission of what we do for healthcare and that is fundamentally important when you can tie that to being able to create something with technology that ultimately helps a patient. That's a powerful message.

We also believe that the talents we need, how do we teach some of our employees that have been around and loyal to us for years, how do we teach them some of the newer skills because I think some of those skills that drive innovation are not just around technology it's solving that business problem of the experience and often times it's that person three, four or five levels down knows the business, knows the experience and if we can train them and give them a new opportunity, that's been pretty successful and then we have a younger generation that really gets excited about solving a problem and working in a company where they can get experience.

Those are some of the things we focus on. I think the general population all of us across, not only the healthcare industry but the world, it's a challenge and I think the things we need to think about is how do we keep our aging population, train them on these new capabilities, keep them excited about the mission that we're at and then with our newer employees, how do we give them the flexibility to learn and grow.

Spence

Nancy that's interesting and you refer to a few times about the importance of purpose whether it be recent hires to McKesson or people being at McKesson for a while and maybe a bit older, but what seems to have been a common theme in what you've just said is really the importance of purpose and how you, attract, retain, retrain, help people acquire new skills but the stickiness of the talent challenge is really all about purpose.

Flores

Yeah, and I would agree. I think the purpose of any leader that can link to, I call it a segment of one to an employee, the purpose of what they do as far back as, you know, in the organizations they can is the power that keeps, in my opinion, an employee and I will use a couple of examples. If you're in the technology field, EDI is technology is an integration platform that's been around for years, EDI is transactional, it's not the sexiest technology but for McKesson, it's fundamental to our customers. We process a million dollars a minute in orders and our EDI team is critical to our business and I want my EDI team to know that the uptime of that platform, the connections they do on behalf of our customers are so critically important to provide critical pharmaceuticals to the healthcare system. They know that and any time that system's down it's urgent till it's not and we've got a great team around that. Another example is we support the network for over 1,200 oncology offices in the country and when that network's down, my team knows that our oncologists can't download PET scans, and our oncologists can't download blood test results. And they understand the criticality of that and when you can make that connection it might be a technology world, but they understand they're making a difference in the healthcare industry and they're making a difference positively for every day they come into work.

Spence

Those are brilliant examples and one of the phrases that I often reflect on is, that the purpose is the point, a profit is a result and profit only exists to be reinvested in the purpose and I do stand by that. let's switch gears slightly.

You've just given some great examples about how I would say important to the data or the infrastructure backbone of the health ecosystem is the part that McKesson plays in that and it really makes a difference and examples that you cited, the downtime means that you know, people aren't being able to be treated as best as they might be.

So, talk to us a bit more about cyber and we hear a lot about cyber-attacks and cyber procedures to protect and risk. I guess probably what I'm interested in is the proportion of your time or your team's time that has gone into cyber defense more proportionately than perhaps historically.

Flores

It's a great question about cyber security and when I think about healthcare, we've always been an industry that has been regulated and there are some good things about regulations where there have always been discipline standards around data privacy, data controls, and security. Cyber security is fundamental to what we do and to what, for the support of our healthcare industry and we've continued to increase our focus. So, we have spent a lot of time in we call it seven pillars but just to highlight the top three on just the fundamentals of understanding our technology environment, we connect to a big portion of the healthcare system. We have a strong collaboration on our endpoints and an understanding of where they connect with our customers. we spend a lot of time on third-party suppliers and working across our partners to make sure we are consistently robust across the board, all the way through our government. we have a very close relationship with CISA and our US government we are a big supplier to our government. It’s important that we have a very strong cyber policy in place. And then the last thing we continue to support is just our general awareness with our employee population. it's not uncommon for companies to run tabletop exercises, we do a number of email exercises in terms of malware and click rights but I'm very proud of the team. This year alone we have done 25 tabletops across our management team. So, it's important, we spend a lot of time investing in that and we do also elevate focus around our products and so we'd spend a lot of time on security by design. Anything we introduce to ourselves and we want to make it secure anything we introduce to our customers who want to make sure it's most secure and robust.

Spence

Brilliant. Thank you, Nancy. I'm going to close with more of a personal question if I may. What advice with all the experience that you have now, would you give to your 25-year-old self?

Flores

I think the first one would be to lighten up a little. I think the best advice I would give to my 25-year-old self is to focus on doing the right thing, focus on the right outcome and when you do that and understand what that is and you can lead people, make the decisions that are best for your company and that outcome, those are ultimately the right decisions for the department, the team, the organization you're running and those in the long term will ultimately be the right decisions for you. They may not look like it, they may not seem like it but when you focus on doing better for the goodness of the whole, ultimately it always works out to be good for you. And that's what I would leave anybody and everybody. You can't predict the world, just focus on that and things tend to work out.

Spence

That's great Nancy. Thank you very much. I've certainly learned a lot recording this podcast this afternoon. Thank you, Nancy, for being so practical, frank, open, and transparent, and an interesting conversation and a real delight talking to you today. Thanks very much, Nancy.

Flores

Yeah, thank you, Pamela.

 

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