The Future of Healthcare With Rick Wilminko, Business Process Reengineer and Consultant with netlogx

Taking user experience into consideration is something I don’t think the healthcare system in America is as concerned about as they should be, in turn leaving patients feeling confused, angry, and uncomfortable. There are things that state and federal agencies could do to simplify processes, but instead they remain complex for seemingly no reason at […]

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Taking user experience into consideration is something I don’t think the healthcare system in America is as concerned about as they should be, in turn leaving patients feeling confused, angry, and uncomfortable. There are things that state and federal agencies could do to simplify processes, but instead they remain complex for seemingly no reason at all.

Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Rick Wilminko, a Business Process Reengineer and Consultant with netlogx. Rick is a consultant with over 20 years of experience in Business Process Consulting. At netlogx, Rick works on Medicaid System Replacements for states looking to become compliant with the Centers for Medicare and Medicaid Services (CMS). In his previous positions, Rick worked in the field of Enterprise Mobility Software, mapping clients’ end-user processes to develop solution specifications and application wire-frames used by software engineers for the creation of enterprise iPhone and Android applications. Most recently, he conducted process workshops and developed the software specifications and application design for the mobile application currently used for SCAPE Suit Maintenance by the Propellants and Life Support Branch of NASA at the Kennedy Space Center in Florida.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

As a child, I watched the 1950’s movie, “Cheaper by the Dozen,” and it was clear to me how the father in the film was well-versed in making businesses and his family more efficient. I knew I wanted to do that when I grew up. I’ve always looked for ways throughout my life and my career to do things faster, better, and more efficiently. When I get up in the morning, I’m always thinking about how I can get ready for work in a more efficient, faster, and cost-effective way. Truly, it’s what I’ve done all my life, and everything I do is related to that idea. In one of my roles, my boss recognized this trait and put me on the course to become a business process engineer. Helping state agencies do the same thing with Medicare and Medicaid systems seemed fitting for me, especially because of the complexity within those systems.

While I’ve worked in multiple roles in a variety of industries before coming to netlogx, I have a strong personal interest that helped fuel my passion to help create meaningful change in the healthcare industry. For the last 53 years, I have lived with Type 1 Diabetes, so I’ve gathered a wealth of experience with doctors, physicians, and hospitals in addition to my work with healthcare administrators and industry leaders at netlogx. I work with individual states that are updating technology systems used to manage Medicaid and Medicare for its residents. When states move to upgrade these systems, they must also meet compliance regulations set by the Centers for Medicare and Medicaid Services, or CMS. In addition to assisting with process mapping and organizational change management, I also assist these state agencies to become compliant with CMS regulations. My ultimate goal is to provide state agencies with a Medicaid system replacement that is far more efficient and gives states better access to data and information needed to manage care for Medicare and Medicaid recipients.

Can you share the most interesting story that happened to you since you began this role?

When I began my career with netlogx, I originally helped the team with Medicaid Information Technology Architecture (MITA), which is essentially a framework for states to support improved technology systems for healthcare management in the Medicaid enterprise. The goal is to deploy seamlessly integrated technology that communicates well through interoperability and common standards and processes. Another part of MITA includes State Self Assessments (SS-A), which all state Medicaid agencies must complete any time they want to make system improvements. I helped to ensure that the state agency meets the criteria outlined by the federal government so that it can continue receiving federal funding.

Immediately, I realized the complexities of this system would mean I’d need some time to become acclimated to all of the idiosyncrasies and regulations. In a former job, I worked with NASA to develop software that would calculate how propellent move and are transformed as they move from a storage location to the rockets themselves, yet this task was far easier than attempting to wrap my head around all of the intricacies of MITA, SS-A, and the CMS agency.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

It is not necessarily funny, nor a mistake, but something I find funny about the workforce in general is how unwilling people are to say, “I don’t know.” Often, I have to respond in this way because of the incredible complexities regarding the federal healthcare system. I think it’s perfectly appropriate to say “I don’t know right now, but I’m willing to find out.” This trait is perfect for my role in the healthcare system because those that don’t understand the process are the best ones to examine the system as it is and ask the powerful questions that enable us to reengineer what the system will be in the future. The most powerful question anyone can ask is “Why?,” and I think by and large, many of us — especially in healthcare — are afraid to ask those types of questions or admit that we just don’t know or understand something.

What do you think makes your company stand out? Can you share a story?

As an employee, when I see two co-founders who want to give 110%, it makes it easy to also give my best to the company and my clients. An organization will follow how its leaders lead, and Audrey and Nick Taylor’s vested interest in their employees and the examples they set with customers speaks volumes. They care about employee health and well-being, and they’re genuinely curious to learn about their employees and their work style. This is why it’s easy for me to call netlogx “family” and why it is a marked difference from how most other organizations operate.

What advice would you give to other healthcare leaders to help their team to thrive?

Once, while working for a different company with an open-door policy, I walked into my CEO’s office, who looked like he was reading a book. I asked his secretary what he was reading and she told me he was looking at a photo album of all 1,600 employees because he wanted to memorize faces and names. When a CEO actually abides by an open-door policy and is out in the office day-to-day observing employees, employees are much more likely to come to them with information. Every CEO should be asking “If you were me, how would you fix this challenge, and what would that solution be?”

When I am tasked with identifying obstacles and challenges for a state agency, I don’t start by asking the CEO. The employees on the front lines are where I start my inquiry because I know they’ll tell me what should be improved or fixed in their business and technology ecosystem. Too frequently, employees don’t feel comfortable approaching the CEO or other leaders in their organization because the workplace culture doesn’t foster that kind of environment. To help teams thrive, it’s imperative that industry leaders and CEOs get out and talk with their team in order to promote change. Healthcare today is far too complex, and if the industry wants to foster real change, it has to start with their front line staff.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high-income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. Healthcare organizations haven’t done enough to create a workplace culture that allows employees to share what the problems are so that the problems can be adequately addressed.
  2. The systems used are antiquated, and as a result, can be rife with security vulnerabilities. This is typically because managing change in healthcare is challenging and difficult, causing delays in system updates. Using outdated software results in lost productivity, accessibility, or even complete unavailability at times. Not only can employees of these organizations not do their jobs well, but consumers or patients can have difficulty getting the information they need.
  3. Federal, state, and insurance agencies may hinder doctors from being doctors. Complex regulations, taxes, and admin tasks make doctors busier than ever, but they see patients less. Doctors are frequently unable to order tests and labs they need right away because of obstacles in the existing billing and technology infrastructure they use to communicate with insurance companies.
  4. The Centers for Medicaid and Medicare Services, as an agency, needs a lot of improvement. Leaders in this agency have to take a hard look at the processes they use and why. By seeking expertise from consultants in IT and organizational change management, CMS can begin asking itself hard questions like, “Why is this being done this way,” and “Why is there so much discrepancy between how things are managed from state agency to state agency?” Sometimes it takes a third-party — like a consultant — to home in on the challenges that are preventing efficiency and productivity.

You are a “healthcare insider.” If you had the power to make a change, can you share 3–5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

The biggest change that needs to be made, as soon as possible, is an evaluation of the processes within the CMS agency. Many state agencies hire consultants to uncover issues and map out new, more efficient technology deployments, but I think that the federal CMS agency itself could do the same thing. Someone needs to ask those hard questions and get to the bottom of why things are done the way they are. Further, a third-party consultant can introduce new, secure, efficient technology tools and services that would significantly benefit the federal healthcare system and how Medicare and Medicaid services are provided today. There are myriad solutions from the tech industry that would save healthcare agencies money, make their work more efficient and accurate, and improve the lives of patients nationally.

For example, I personally use an insulin pump called an OmniPod. It’s a self-contained unit about the size of a key fob that self-injects insulin. I’m able to control it wirelessly and the user experience is far superior for my needs compared to other options on the market. I discovered that Medicare Part B doesn’t cover that pump, and they wanted me to move to a less satisfactory pump that directly impacted my user experience and comfort level.

Taking user experience into consideration is something I don’t think the healthcare system in America is as concerned about as they should be, in turn leaving patients feeling confused, angry, and uncomfortable. There are things that state and federal agencies could do to simplify processes, but instead they remain complex for seemingly no reason at all.

The second change I’d like to see is a nationwide system for healthcare records. There are some companies like Epic Systems that do this on a smaller scale, but nothing that covers the Medicaid/Medicare system as a whole. By adding blockchain technology — as an example — these records would instantly be available to patients and their team of physicians. This would help alleviate discrepancies and miscommunication.

Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

Due to their sheer size, many healthcare agencies don’t have the bandwidth or knowledge to manage a digital transformation effectively. A recognition that they can’t do it on their own is one of the first ways we’ll create real change.

Second, individuals working at federal and state health agencies should ask more questions and discuss processes that are currently in place and how those processes could be made more effective. Sharing ideas is the basis of innovation and change.

Third, corporations need to welcome an open-door policy that is truly open-door. Fostering a comfortable workplace environment where employees are encouraged to speak up and share ideas only helps fuel the changes that so many of these agencies need to make. I think we’ll find that those working in the front lines of healthcare in a federal and state level have serious ideas and actionable ways to be more productive and helpful in their work with patients and stakeholders. Industry leaders outside of these corporations must be diligent about supporting digital transformation for government and health agencies.

Finally, healthcare technology companies today are perfectly poised to create and manage systems that house customer data in a way that enables doctors to be more effective. What I’d like to see is an overall customer relationship management tool strictly for federal and state agencies working with CMS. I think we’re far closer to that reality than we think. There is a companies like Pegasus Healthcare and Salesforce that have begun involvement with Medicaid and Medicare systems to do customer relationship management, but unfortunately the information is not cross-pollinated between states. Therefore, if a patient moves, that important information is lost in translation.

I’m interested in the interplay between the general healthcare system and the mental health system. Right now, we have two parallel tracks, mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?

Mental and general physical health used to be connected many years ago. We called it neuropsychiatry. Slowly, those two fields separated to become psychiatry and neurology. I firmly believe the two are interconnected more than we realize. For example, if we can improve our mental health, our physical health also improves. If our physical health is compromised, our mental health can also falter. In an effort to simplify the healthcare system, these two focuses should be combined again. It isn’t mental health or physical health, but overall, the general health of a person that really matters to healthcare professionals.

How would you define an “excellent healthcare provider”?

In my experience, great doctors are becoming fewer and farther between. I would argue the doctor who manages my Type 1 Diabetes is an important person in my healthcare journey. This is also a physician who uses the Epic System to provide information to all of my doctors. For example, I see my cardiologist, who is in another state, only once a year, but he can easily communicate with all my other, doctors, specialists and general practitioners on a more frequent basis. The key differentiator is that these doctors are using technology to better serve their patients and my hope is that we can eventually broaden this capability to include all healthcare agencies.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

Keep it simple and smart, or as some know it, the KISS method. I have an innate need to look for the fastest, most efficient, and cost-effective way to do absolutely everything in my life. I think the “KISS method” is a great example of the work I do for state healthcare agencies as they move through a digital transformation. It’s also good advice for leaders and corporations as they look for ways to better serve patients, customers, and stakeholders.

Are you working on any exciting new projects now? How do you think that will help people?

Right now I’m working on a Medicaid Management Information Replacement System. My specific role is to develop modules that can be deployed in a larger architecture. Another project I am working on involves procurement for a consolidated contact center that will initially combine support for Medicaid, income support, and child support clients and providers in one place. The second phase involves adding other State agencies call centers to this state of the art consolidated contact center.

What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?

John C. Maxwell’s “Five Levels of Leadership,” is particularly interesting to me. I’m a leadership geek, and I enjoy his work because of his modicums of influence. Every leader, or anyone that influences another, should read this book.

Another book that I recently finished reading is one by Mark Batterson called “If.” He talks about how we say to ourselves, “If only I would have done something.” Instead we should say, “ I can do things as if,” or “what if?” and “How much influence can I have if I do this?” Truthfully, as humans we can do anything, anything is possible if we believe in ourselves. Don’t get stuck in the “if only.”

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