DGTL Voices with Ed Marx - The Power of Global Collaboration in Digital Health (ft. Michael Nusbaum)

Episode Date: September 11, 2024

On this episode of DGTL Voices, Ed sits down with Michael Nusbaum, an independent healthcare consultant and a true pioneer in the digital health space. Michael’s journey is anything but conventional—starting as an engineer, he found his way into hospital administration, and ultimately became a global consultant shaping initiatives like the International Patient Summary. As they dive into his story, Michael reveals the leadership lessons he's gathered along the way, with a strong focus on communication, collaboration, and the value of being a lifelong learner. But beyond the professional accolades, Michael gets candid about something many overlook: work-life balance. He shares how prioritizing personal well-being has been key to his success and longevity in such a demanding field. The episode wraps up with an inspiring conversation about the power of your inner circle—how surrounding yourself with smart, driven, and influential people can shape not just your career, but your entire perspective on leadership and growth. This episode is not just a discussion on digital health; it’s a window into the mindset of a leader who's still learning, evolving, and prioritizing what matters most.

Thanks for tuning to Digital Voices podcast, where we chat digital transformation, challenges, and opportunities across healthcare and life sciences. And now, your host, Ed Marks. Hey, everyone. Welcome to another edition of Digital Voices. Thank you for listening. I know you have a lot of different choices. I listen to a lot of other podcasts as well. And you've taken the time to be with us. So thank you for that. And as always, no commercials, no commercials, no sponsors, just pure content. And I get to have another friend on today, so I'm super excited. I want to welcome Michael Nussbaum to Digital Voices.

Michael, welcome. Thanks, Ed. It's great to be here, and it's really great to see you again. It's done a long cut. Yeah, we're just reminiscing before we hit the record button. And we served together on the Hymns Membership Services Committee. And I want to say, because I know I wasn't a CIO yet when I started that. So it was early 2000.

So like 2002 or so. So we've known each other well over 20 years. We haven't aged at all. We're still super handsome. You got that right. I knew I liked you from the start. And then we got to connect again. There's no time to tell the story, but I remember it vividly.

But we connected again in the Middle East. We were in Riyadh. And then we had a sudden opportunity to meet, you know, some government official. And again, no time for that story. but I still remember that day quite well. But anyways, and I followed you, Michael. You're just fantastic success. So we're going to get into all that.

But the most important part of our entire podcast is this question. And that is, what is on your playlist? What kind of music do you like to listen to? Well, I have a pretty wide range of musical taste. My very favorite all-time band was Crosby-Silliv Nash and Young. I'm a Canadian. Young is a Canadian. But even better, I play bass guitar in a couple of bands, and we play all that stuff.

So whatever music I love to listen to, I actually find a way to play it. I love that. I wish that's a talent I've tried, and I wish I had it, and I don't. I wish I could play an instrument well, and so I'm sort of jealous. That's really cool in terms of the bass. How long have you been playing the bass? Since of high school, I played the stand-up bass in grade seven. Dang, a stand-up base.

That is even... No, but I play based. I play based. I like to it. It's the same thing, actually. It's just a little... It's a little slow. Yeah.

No, that's awesome. That makes it even more fun. I can definitely visualize that. What about your life mantra or message? Is there like a purpose statement or anything that sort of helps guide your life? Boy, there's so much. But in terms of life, I'm a big advocate of work-life balance. I talk about that to students.

all the time. And I've managed to design my career so that I really have maximized that balance. I live in a great place. I live in Victoria, British Columbia, on the west coast of Canada. It's a beautiful place. And I've got all the work I could ever want since I started my career. That balance to me has given me a really peaceful and happy life. Yeah, that's cool. And I want to jump into that. So you can tell everyone a little bit about your We'll start on the personal side, but then on the professional side, because one of the things that makes you unique in the industry is you've been independent for a long time. A lot of times people have sort of an established career like I have, and then they become independent. But you've been doing this for some time and obviously for great benefit, as you alluded to. So before we get there, yeah, tell us a little bit about yourself. We know you're Canadian. We know you play bass and we know you live in a beautiful, yeah, up in Canada, Victoria. Yeah, so. Well, in terms of my, I come from Toronto. I grew up in a big city and then moved to Victoria, which is a small city, but still on the map.

A lot of people come here, and it's great. I love to have a sailboat. We've had four sailboats, and I go sailing in the summer, and I still, even though I'm becoming rapidly an old man, I still ski. So skiing in the winter, sailing in the summer and everything in between. Dang. And Victoria, for those who have not been, you have to go. It's one of the most beautiful parts of North America. And you don't know that I knew about the sailing part,

but now I'm inviting myself over. Of course you are. And you're perfectly welcome. That sounds pretty amazing. Yeah, so tell us on the professional side. Like, what happened? You played base in high school, but then you went to health care. So tell us about that journey.

Well, it's interesting about digital health. I came at it from a completely different perspective. And back in the late 70s, there was those such things as digital health or healthcare IT. So I, after high school, I went to the University of Toronto and studied industrial engineering. I thought I wanted to be an engineer. And I started on electrical engineering and flunked electricity in my first year. So I went to industrial engineering, which doesn't exist very much anymore.

And then I worked as an engineer in a hospital. And I thought, you know, I really don't want to be an engineer. And the hospital administrator, I'm a renowned guy. He said, well, why don't you try hospital administration? So that's what I did my master's in. I took a master's in health services administration out in Alberta, which was one of the primary schools at the time. And so I'm trained as a household administrator.

But I married that with my engineering background, which was quite technical, and started working, I guess, from the early days, and we're talking now late 70s, 1978, 79, in what has become health informatics or healthcare IT and now in digital health. So I was kind of, I guess you consider me a pioneer in the field. The discipline came around, you know, later, sometime later into the 80s, mid-80s, I guess. And so I hooked up with universities. I was teaching courses in health informatics because I guess I was playing around in the sandbox from a pretty early day. So, yeah.

So, and then I worked for two governments. I worked for the Alberta government when I graduated in the health administration role. and I worked for the British Columbia government when I moved out to Victoria. But I hit the wall. I found that although it was great opportunity working for government, they run on a political agenda, not on a business agenda. And so I thought I could do better on my own. And I had an opportunity to establish a consulting firm, which I did in 1983.

So I've been doing independent consulting. I am not in transition. I am an absolute... Career Center in the Bennett Consultants since 83. So I've done a ton of different kinds of projects. It's been a very rewarding career. And not too many days have I not had a full slate of work in front of me in all those years. Yeah, you're clearly a pioneer and also pioneer in creating your own world,

creating your own business. And it's quite a lot of kudos to you for doing that. And that's definitely one of the things we're trying to unpack with you here today. because I know there's a lot of people listening who are like, hmm, you know, I wonder what that's like, what that world is like and, you know, how I can enter that world. So we talked a little bit already about how it's sort of involved since its inception. Can you give like one or two examples of customers that you are either helping now or helped in the past? Sure. Well, I started off most of my work fairly localized in British Columbia. And I, you know, Lebanon was a hospital-centric industry.

You know, most of the work was in the hospital. So I worked in every single hospital. in the province of British Columbia. Before I started branching out across Canada and then across the world, I'm very much international now. I've done different roles. I did a lot of strategic planning. My contacts were primarily the CEO, not the CIO. And so the CEOs would have that relationship with me because I come from their world, the health administration world.

I participated and eventually led the health administration association for British Columbia. So I got to know all these guys and many of them were having trouble with their, with their IT departments and with their leadership in their IT department. So they would bring me in to do interim CIO work. I did lots and lots of that. And this was all during the time when there was a big transition from the big iron mainframes, those that worked, you know, that lived in the basement of large teaching hospitals and cost millions of dollars to the PC environment where you had your desktop was at all the

sparts you needed at the time. There was a huge transformation going on at that time. And that launched me into all kinds of opportunities in the early years. That's really cool. I mentioned some of the international work. So I know that you're doing some things with international patient summary. Can you share a little bit about that? That's pretty exciting.

Sure. Well, digital health has become very globalized. So I've been working with a lot of standards development organizations, SDOs over the years. I'm on the IHE International Board currently. and do a bunch of things with ISO, the ISO, the Checkic, Many of Health Informatics, and other things. And one of the initiatives that has come about in the last four years

is the development of the International Patient Summary, which is done as basically a very unique collaboration amongst SDOs. Many of the development organizations that are building standards have been competitive. This one was collaborative. And they built the infrastructure for a patient summary that could be transatlant, across borders. That border could be international, but could also be domestic across provincial orders or state borders. And it could also be organizational where it's across the street, for example, between two different health systems. This thing has really taken off. It's being

adopted in countries all around the world. And it's been a tremendous journey. And that's been occupying a lot of my time in recent years. It's something that's going to bring the world together in terms of digital health. It will be the very first thing that will bring the world together. Yeah, I love it. And we'll definitely drop a link to that in the show notes for those who are interested. And you have mentioned a few times already sort of this global perspective. And I want to go down that route just a little bit. But before we get there, tell us also, because this is part of that global reach that you have, you got super involved with HEMS, like at the board level. So after we were on this membership services committee, you got even more involved with HIMS. And talk to us a little bit about your HIMS involvement, the sort of things you've been doing and sort of the global level.

Yeah, yeah. Well, this has also been a very rewarding experience for me. I joined Hymns basically as soon as I graduated and Hymns was just new at the time. And I found myself, I did volunteer for committee work, as you know, and then I applied to join the board. I was the first Canadian on the Hymns board. At that time, it was global, the Hymns board. And I joined it. And then Hymns changed it the way it was organized and it became HIMS North America and HIMS Global. It was a time. It was global. It was global. It was global. It was global. segmented a little bit. But when I left my stint on the board, which was four years, I was vice chair. And my chairman was one of your very good friends had Chris Ross and we all used to get together, old friends from the day. But it was a tremendous opportunity and experience. Boy, did I learn a lot. And the smartest people I've ever met in digital health were on that board or around that board, people like yourself, of course. So it was great. And Hymns is a wonderful organization. And it really does bring together the world in this industry. And it's really important to stay connected to the expertise around the world when you offer it in digital health. So Michael, would there be one thing

that you've learned from outside of North America that might be beneficial for North America? Because sometimes, as you know, some countries or some region of the world may be more advanced, maybe doing something a little different that we can learn from. And so in addition to the international patient summary, which again is a global initiative, bring everyone across borders, Is there anything else that we might learn? Well, there's so many things. And, of course, Canada has been an innovator as well over the years. But currently, it's like a horse race.

Different countries are doing different things. And we're now seeing some regional initiatives. And my favorite is the European Union, where you have a large number of countries that are working together to establish interoperability of health information across borders. And they're working together. They've got a lot of tremendous initiatives. And I think most of us around the world can look at what they're doing and think, well, why can't we do something like that here?

Why can't Canada in the U.S., for example, have complete transportability of having your digital health record follow you wherever you were? And so there's a lot of innovation coming in that region, but not to single out that region. There's initiatives all around the world now. And, you know, there's all kinds of collaboration that we've never seen. People are reaching out to share experiences and work together, and it's been great. I've been very much part of that and very proud to have helped contribute to some of that, the collaboration, the globalization. Yeah, that's cool.

I want to dive into leadership, but before we get there, also want to ask one last question. You know, based on oldest experience and global and, but the answer may be more regional. What's like one of the coolest things you've ever been part of? Maybe it was a specific situation or maybe it was more sort of high level. But with all this experience, what was like one cool transformation or something that you were? Well, I worked on an initiative that's very close to your heart. And you might remember that I worked on something called Ohai, which is the Olympics health information environment, which was to try and build an environment and infrastructure to support athletes and visitors to Olympic games that come from all around the world,

who obviously are going to have some coffee issues. So I worked. I had some funding from Hymns and from others to develop a perspective, which we did. That took that from the International Olympic Committee for their consideration and still waiting for some good response there. But I know, Ed, you were an Olympic athlete. And there's initiatives like that. Another one is the Hodge, which is bringing together people from around the world, along with their health records. That's something very recent. And so we're now seeing a lot of these large global gatherings that can take advantage of some of the innovations in technology and in understanding the data, which is the biggest issue now, is getting good data, to be able to bring that together to support a common purpose.

So Ohio was really cool. I really like that. Yeah, I really like that too because, and I did spend a fair amount of time in Paris this year with Team USA, the triathlon cohort. and, you know, they were raving about health care at the Olympics because for access, right? And it applies to many different countries, but, you know, they had great access to health care. And so a lot of athletes, they use that opportunity to get all their annual checks, different things like that. And it's great that if we could make that a reality in the fabric and that way their record could be there, you know, as opposed to starting to scratch, stuff like that. So I think that's great.

I think we're going to see a lot more of that over the years. You know, there's all types of opportunities that are going to come up. So, be tuned. So as we talk about leadership, there's a lot of listeners, Michael, that are in generations below us, up and coming. What's one thing that you would advise someone, just in preparation to become a more senior executive? Sure. And I talk about this a lot to students all the time. in some of my teachings.

But first of all, there are certain skills of leadership that you can't overlook. Don't become a technical expert without understanding leadership skills. You have to know how to write, to write down something that makes sense to your listener. You need to be able to stand up in front of an audience and give a coherent presentation that works true to your audience. And the audience can be at many, many different levels. And the broader your perspective is, the more successfully you'll be. If you want to talk to a technical audience, talk tech.

If you want to talk to a leadership audience, go to the things that matter to them. Leadership also is about how to work with others. Collaboration is something that is now instilled in most of us now. We're trying to get rid of the competition and increase the collaboration. We have to know how to delegate and empower. at the same time. So to all of you people that want to get into this field, you need to be empowered to see how to test your chops,

to see how well you would do. And my leadership style is not very top down. It is very collaborative in nature. It's very flat. And so what I see is I think there's a big need for people to start to develop those kinds of skills. And so I encourage that kind of learning. Yeah, that's really good.

Is there anything in your childhood that you remember that sort of prepared you for leadership? You know, I kind of backed into it. I didn't ever see myself as leader in my child. But when I got into my, actually, when I got into my master's program and health administration, that's when I kind of thought to myself, well, I guess there's some opportunity here that I'd never even considered. I aspired to be a technologist when I first started my work as an engineer. I would stand in front of a series of dials and levers and push buttons and be a really smart guy, maybe launch a rockmanship to the moon.

I don't know. But over time, I became more important for me to start to look at becoming a leader. And so I really started that journey in my late 20. You already talked about this from a different perspective, and I want to bring it back as we sort of come to a close, and that is because it's so important. And you talked about it without me even asking, and that's the whole work-life balance or integration.

And you talked about how you ski and you sail. Talk to us a little bit about why that's important and what you can do to confuse the question. you and I'll maybe ask it again based on your answer. But what would you say to someone who says, well, yeah, I get that. But right now I just need to do a lot of work and I'll get to the work-life balance later. So talk to us a little bit about your philosophy there and how you came to it. It's really funny.

One of my kids has been through this journey where, you know, they basically work to live. And I try to counsel her to live to work. Yeah. And, you know, it's, it's, and that's one of the reasons I moved to the beautiful West Coast, because if I was in the downtown infrastructure, I was getting caught up. Even in my consulting work, I'd consult in the downtown, you know, metropolitan centers for various places. And the stress levels were huge. And I'd step away from that, I go, you know, this is, you know, I forgot. I'm really working to live. So I think there's a balance there. I think good hard work is really important. And don't get me wrong. I work very hard. when I am working. I work very hard. But when I'm off in my sailboat and I want to just unwind,

I can do that, but then I can pull up at an anchorage and I can trim on my satellite system and I can be involved in a podcast from wherever I am. So what I've done is I've leveraged technology and I've leveraged my leisure life to be able to accommodate the necessary things to be able to work. And so I would counsel people to really, Work to live. That is a huge mantra there. Yeah, that's good counsel. It's so easy as you talked about to get caught up into the work thing and lose perspective

and think, oh, someday I'll get to it, but you may never get to that someday. So definitely incorporate it like you suggest. Hey, what's your favorite baseline that someone would know, like from a popular song because you might have a little baseline. Like, I'm curious, like, because I've got to go and listen to whatever you tell me. So like, that's a bass riff. Well, to follow the gist of our conversation, I want to give a baseline that isn't necessarily my favorite,

but it's one of the great ones, and that is the beat goes on. The beat goes on. It was a song by Sonny and Cher way back in the day, and it's got a great baseline. And so go listen to that and think about how we're on a journey. We're not at a destination. We've got a lot of work that yet to be done.

The beat goes on, and we get better at it as we move forward and pass on the skills to the next generation. Was Getty Lee a base? Did he play bass? What did he in the band, Rush? Yeah, Rush, Canadian band from Toronto. Getty Lee, he was a bass player, is a base player, and a very, very falsetto voice, too. Yeah, go listen to Rush. He's pretty amazing, too. But that's a little heavy rock, a goal for me. I like a little bit of R&B and the blues. That's kind of a little bit. my style. So go go go go drop in the buddy guys bar in Chicago next time you're there and you can hear some incredible blues. Yeah, I'm going to I'm going to do that. Yeah, it just came to mind as you were answering about Getty League because Russia also has some good some of their songs.

They have some good, good bass lines. So we covered a lot. Michael, we talked a lot about bass and music and then just how you got into healthcare and again, one of the pioneers, not just because of longevity, but because of the impact. And also that you were independent almost from the beginning. So that's sort of unheard of. And so a lot of great wisdom there and obviously a testimony to the work that you do globally. So we talked a lot about global perspective. We talked a lot about life balance.

We talked a lot about leadership, you know, and some of the lessons there for people, like know how to communicate. It was brilliant what you were saying. Know how to write. Know how to present. Because you could be the smartest person, as you know, if you cannot communicate your smarts, it's not going to go very far. And then collaboration and delegation, things like that.

Michael, what did we miss or is there anything that we talked about that you want to double down on? I'll give you the last word. Well, thanks. And again, one thing we kind of touched on, but let me just state it directly, lifelong learning. There is no end of job here, or always have an opportunity to learn more. I surround myself with very smart people by design, you put yourself at and others who I know I can learn a lot from, and that's very much a part of the fabric of my career has been and continues to be.

People ask me for my advice because they want to learn more and I'm happy to share it, but surround yourself by people that you can learn from and recognize that you're never at the end. There's always more to be learned. Yeah, beautiful. Lifelong learning and surround yourself. You are basically who you, you know, the four or five people, they say that you surround yourself with. And you dropped a couple of names with us of people that people would be familiar with.

And you're right. Without them in your life and influencing, you know, we don't get the maximize ourselves or maximize our impact. Michael, this has been awesome. I love catching up with you. I love what you're doing. I love your spirit. I love how you're helping in the global perspective. Thank you for being my guest on digital voices.

It's an absolute pleasure. Thanks for having me, Ed. And that wraps up another edition. Again, thanks for listening. Thank you for listening to Digital Voices Podcast with Ed Mart. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.