Revisionist History - The IT Revolution

Episode Date: February 1, 2024

The digital revolution has been happening for a while now, but with 5G, it’s about to reach a whole new level. IT departments are about to rule the world. So in this paid partnership with T-Mobile for Business, Malcolm sits with leaders in the world of retail and healthcare to discuss how their industries are changing.See omnystudio.com/listener for privacy information.

This episode is a paid partnership with T-Mobile for Business. Hello, everyone. Malcolm Gladwell here. Today, I'm having a special conversation hosted by my good friends at T-Mobile for Business about how the digital revolution is going to transform everything about the way we do business. I'm talking to Heather Nelson, the Chief Information Officer at Boston Children's Hospital,

Al Latera, Senior Vice President of IT at Tractor Supply Company, and Callie Field, President at T-Mobile Business Group, who you may remember, by the way, from our episode at the Las Vegas Grand Prix. So you might think, hasn't the digital revolution been happening for a while now? Sure, but it's been unevenly distributed. And the folks at T-Mobile say that thanks to 5G, businesses are now able to transform how they do business at scale, which is all these interesting ripple effects, including IT moving from a support role to a leadership role.

So I wanted to talk to two brilliant IT leaders who are transforming two radically different worlds, healthcare and retail. Buckle up because there's a big technological change happening. This conversation is for all the CIOs and business owners who are dreaming up new ways to make things run better. But it's also for everyone who goes to the doctor or shops retail. Callie and Al and Heather really convinced me that 5G is changing just about everything. With me is Al Latera, UNIT for Tractor Supply. Yes. One of the grandest, oldest.

There's a tractor supply not far from my home, so I drive by it all the time. And then we have Heather Nelson, and you are the CIO for Boston Children's Hospital. I am. And then we have the president of T-Mobile business group, Callie Field. Callie, we have done this before. We have. I really look forward to this conversation. Al, and I wanted you to give me a kind of blue sky picture of where you would love to be five years from now with Tractor Supply and Things Digital.

Yeah, five years from now is really going to be 18 months from now, because it's going that fast. But to us as an organization in service of our customers and our team members, it's really going to be a consumer and team member centric strategy that is really taking into consideration putting everything at the fingertips of the team member and the customer. So it's right there, available to them when they're either shopping, they're working on their farms, or whether they're working within the communities that they're serving.

It's all the information that they need is at their fingertips. Heather, do you have a, give us a vision. A vision. I'm going to use one of your phrases. We really are at a tipping point with the healthcare delivery and the enabling technology. Our patients are consumers and we have to make it easier for patients to come to us. We have to make it easier for physicians, care team members to care for those patients. So self-service and access will be where we need to focus on. And I know for Boston Children, it's one of our pillars in our strategic plan is to increase the access and the self-service for our patients. Al, you talked about both customers and people who work for Tractor Supply. You think of this as being a revolution

that's equally weighted in those two groups, or does it tilt in one direction more than the other? No, it's equally weighted. The intersection of technology with the retail industry is not just focused on the customer side. The team member interaction with the customer is paramount to our success. If you go back, we've been in business 85 plus years. The secret sauce of our business is our customer relationship.

So the team members are facilitating that. And without the right tools, without the right experiences, without the right information, making them more productive and just giving them access to whatever it is they need to service those customers is paramount to the success of our overall digital strategy. I was going to jump in, and I love working with both of these leaders because they are so customer-centric, which I think really resonates with me at T-Mobile. But I love the call out for the digital transformation impacts the way that you're able to serve your customers and the relationship that you have with them in so many profound ways, especially given AI

and where it's taking the need for data and connectivity, but also for your employees. In a digital age, a lot of times people ask me, well, why do you need to invest in your employees and or your providers in the same way? Because everything is self-serve and digital. I think of it like Iron Man having Jarvis. You equip them with the technical tools that make them the very best heroes for your customers.

And that's something that I appreciate about that. And we want to empower our patients. And yes, we're a children's hospital. But these kids know technology. They know how to use iPhones and iPads. And so why not make sure that they have the tools and the apps to do that at home, to do that so that they're empowered and they feel in control of their care. Heather, give me a concrete example of something you would like a patient to be able to do that they can't do now. I would say any of the wearable devices.

What if we were able to do more home infusions for our cancer patients so they don't have to drive and to come to the hospital? And then making sure that that information then gets back into the electronic health record seamlessly. So the physician knows that Heather's getting her infusion that day and we can call and be proactive with her parents. That's what I want to see. I want it to be almost like concierge care for our patients.

Is there an obstacle to getting there right now? Well, we are starting to break down those barriers with our 5G cellular network. Hospitals, for example, we've been so reliant on Wi-Fi. And Wi-Fi is just not meant for a mobile environment. It's not meant, I mean, I have calls drop from the OR to the ICU, and that's frustrating for clinicians. I went into my bank yesterday where I banked for 20 years because they had locked me out of my account digitally, and I had to do something, transfer money. And I went in to transfer money, waited in line, finally got to the teller, went through all kinds of stuff,

and then she looked at me and she goes, can't do that. I was like, why can't you do it? She said, Wi-Fi's down. I was like, why can't you do it? She said, no, no, I'm not gonna do that. She said, Wi-Fi's down. It's like, all right. Anyway. See, that's what happens, right? These guys don't deliver, you lose customers.

You lose customers. By the way, no one seemed to care at all that they had lost me as a customer, which hurt my feelings. Wi-Fi's not going away, but it doesn't have to be my primary focus anymore. And also, it's not just about the four walls of the hospital anymore. One of our other strategies over the next couple years is to do as much care at home as possible.

And to have a 5G-enabled environment, that levels the playing field for our patients. Wi-Fi was a great solution in the 4G era. And as we start to learn to use data differently and we start to see the evolution of how we can take important customer or patient information and get smarter and provide better solutions or faster, whether it's from a cost perspective or whether it's from a quality of treatment perspective, the amount of data that is available to us and us being able to do something with that data is so quickly and rapidly evolving. And in a Wi-Fi world, you need more consistency. You need SLAs and you need to be… SLA is? Service level agreement. So you need to be able to say, for this type of surgery or using this kind of machine,

if we're going to capture data or we're going to actually, in the future, use an automated device to do some important kind of function, we need to be able to say the latency and the capacity, that those things are firm and that there's no variation. And you can't do that on a Wi-Fi network when you've got hundreds of other kinds of connections all around it. But with a private network or a designated network slice, what you're able to do is to say, okay, these are the guaranteed service levels that

we're going to give this connection all the time. In other words, I can build bespoke digital connections between individual bits of technology and some kind of central command post in a way that I can't do with Wi-Fi. And the other thing is, as Heather does more and more transformation of the way that her IT organization serves their ultimate mission as a hospital and for children, the amount of connections are going to increase. I mean, it's probably from

hundreds to thousands to tens of thousands. What do you mean when you say amount of connections? I mean, every physician has their own cell phone. A nurse has, you know, his or her own cell phone, plus a device that's provided to them for their clinical shift. They've got workstation on wheels. We've got workstations. At the nurse's station, we've got medical devices. We've got ventilators. We have IV pumps. All of those things are wired, if you will. And then you have the patients who have their devices, their iPads, their cell phones, and everyone expects everything to work perfectly. In addition to that, aside from the quality of service that you receive, you think about patient data or HIPAA compliance in your field, the security measures that are required. If you have

to do VPN and Wi-Fi access for every one of those secure. There's a lot of room for attack and error. And one of the things that we've been talking about and working with all of our customers is how do we take the very connection and encrypt it? I want to come back to that point in much more detail. But before we, I want to talk to you, Al. Can you do the same thing? Give me a very specific example of something you would like your customers or your employees in your retail outlets to be able to do that you think would make a meaningful difference.

The big focus for us is on our team members right now and service of the customers. It's basically delivering predictability so that you can make sure that these things all work. And it's a complicated process that you have to make very, very simple. So here's an example of it. When you're dealing with the customer base that we're focused on, it's the people with farms. They have animals, livestock on their farms. It's a very, very important thing, right? So we've got to make sure that like, if they ask information about what's the right food, what's the right ingredients that were making up that food, what's the right food for the right time in the life cycle of a, let's say a chicken,

it's very important, but we got to take it to another level. Like what about the sustainability of how that food was created? Like, what ingredients go into that food? So the idea is that what we're trying to do is to increase the kind of sophistication of the encounter between the store and the customer. In other words, I don't just go in there and say, I want that. Now the customer is coming in,

expecting a much richer kind of interaction with the store, and you need to be able to measure up to that expectation. So your team members, are your team members, I mean they have their handheld, their devices and so when you're talking about you know at their fingertips you're bringing all that data forward. Can I offer something that I think is really incredible that Tractor Supply is doing? So I grew up on a farm and I remember something would break on the farm. You're on a farm, you're out 20, 30, 40, 50 miles

from where the store is. Oftentimes, maybe not in a place where Amazon's gonna show up and deliver that same day. To be able to work with a retailer that understands when you have to stop and go and get the correct solution for the thing that broke down, the timing of crops or the timing of when you've got to get cattle ready for sale

is so important that if you have to go off and spend eight hours to track down, where do I get the thing that I need? It really does have an impact on your profitability, your bottom line as a farmer. And I think you guys are really helping to bring technology into a way that really serves your customers. We'll be right back after a short break. We're back. Heather, I want you to dig into this a little more

because there is probably, you know, when I compare the two worlds that you guys come from, consumer reactions, feelings about those two worlds are very different. There's an enormous amount of customer dissatisfaction in healthcare. It's annoying to go to your doctor or the hospital half the time. Yes. 70 million forms. Doctors hate digital health records. When you think about where healthcare started with the electronic health record, it was everything that we did on paper, we're going to now make it electronic.

And I remember talking to some EHR, electronic health record vendors, 25 years ago, and they're like, we're going to make it faster. We're going to make it easier for physicians. And I said, never tell them that because nothing is faster than a piece of paper and a pen when it comes to documenting. And now the pendulum has shifted with electronic health records, with ambient AI, with quick... What do you mean by ambient AI? I can talk in the room, you know, the Hey Google. Oh, I see. Okay.

And, you know, we've been piloting that in some of our nursing units where they come into the room and they can talk to the patient and capture that information instead of sitting there with their back to the patient typing. Yeah. So the simple act of

if I can do stuff while I am still engaged with you, eye to eye makes all the difference in the world. Because, you know, in my world, meeting with customers, really trying to listen and focus on what do they need? What's the problem that they're trying to solve? But then it takes 30 minutes, 45 minutes of quiet, focused time to just capture what are all the next steps and what are the things that I've got to go and do afterwards and so that's less time that I get to spend with the customer and it might mean less time that I'm really able to focus in on what the customer is telling me but with with

tools that we have today that we're already using and selling and providing for customers we're able to take recorded sessions like this and the AI will summarize the action items and will even set up a calendar appointment. So I think about in healthcare, if I were able to get the discussion with the doctor and they say, hey, Callie, you're 45, you need a colonoscopy. Wouldn't that be great if it was already scheduled and that that follow-up was already taken care of? Because I may not want to schedule that. I mean, admitting that I'm 45 and have to follow up with might be more than I can handle.

But if you can use, and I'm making a joke, but imagine what that will empower in terms of health care for us to have tools that take people from not wanting to deal with the message and putting them into the next step. It's the concierge care. Well, this brings a question I have for Al. You're asking a lot more of your retail staff. They're no longer simply managing a transaction. Now they're real partners with the customer. If you upgrade the technology, you have to start redefining the role of your support staff. If you notice, I keep bringing up the customer and the team member, and they're

intertwined. That's one of the reasons why, is because you got to think through all this. As you add more capabilities, you got to increase the productivity. It's like, how do I use AI to actually generate code? We actually do that now. How do we use it to generate test scripts so that we can test things faster, get it into market? And the same thing does apply in the walls of the retail location is because it's like, how do I make replenishment faster? How do I make labeling faster in a store? What's the process for that? So anything and everything is on the table now. So when you, when you rule out the one, the big difference between your world and Heather's is Heather, you're at one institution. How many stores does Tractor Supply have? We have 2,200 Tractor Supply stores and 200 PetSense stores.

Yeah. So when you roll out something, do you roll it out incrementally or do you do it in all 2,200 places? Some days. We do it in an incremental fashion. What we do it in all 2,200 places sometimes? We do it in an incremental fashion. What we do is we have labs within our store support center in Brentwood, Tennessee to support those locations, and we test in those labs typically.

The second thing we do is we work very closely. There's a group of stores that are considered like the know, like the test stores, but they're the team members that have more of that engineering, that tinkering mindset. So, we've identified roughly 100 stores and they basically, we deploy it to them and they test it and they give us feedback and then we kind of iterate through it and then we start deploying it to larger volumes of the store, of the chain. I think we were talking about it earlier, which was the role of the CIO really evolving. The work that I've done at T-Mobile for 20 years with my IT teams is very different today than the work that we were doing 20 years ago.

And I think it's fun to hear you talk about your risk takers or you want to move fast because of the speed of what is happening with data and what is happening with the connectivity solutions and what we can do with AI. And I think in retail and in healthcare, there's people that are willing now to push the limits. So you're now a culture leader for your company. Whereas before, I don't know if I thought of my head of IT as a culture leader for the company per se, but you're changing the way that people work. You're changing what they are able to provide for their customers in profound ways. And I think that's a really cool part of your jobs. How long before an IT person becomes the CEO of a traditional bricks and mortar company? That's my ultimate goal is to be CEO of a hospital someday for reals.

It's a big jump because if you don't position yourself as a partner with the strategy and with the business, especially in healthcare, then you become the order taker. And my philosophy is I don't want my IT teams to be order takers. I want us to be seen as partners. I'm curious about the relationship between, the interaction between you and non-IT people in your organizations. We spoke about this a little bit. I want to dig in on this. Are there parts of your vision for the company that are difficult to convince others of, to explain? Do people get how you said, Heather, you guys are at a tipping point. Do non-IT people get that? Is it a hard time convincing them of that? Sometimes. What's hard about it? I will tell you the introduction of a private 5G cellular environment, first of its kind in healthcare, I really had to sell that to the organization because they're like, well, we have Wi-Fi. And I said, then why do you keep calling me and telling me that your calls are dropping from the OR to the ICU. So putting it into some, you know, to articulate, not to talk about the bits and the

bites, but to talk about what problems are we trying to solve and can technology do that? And if so, are you willing to do that with me? Because I am not an end user in the hospital. I don't use the electronic health record, but I have to make sure that it works. And sitting at the table and having the conversations, because I will tell you, when I go to do my budget every year, I don't know how you, but, you know, storage and compute and, you know, a new virtual server somewhere is not as sexy as IV pumps and an MRI machine. So I'm competing with the same dollars, but yet I have to explain to my peers,

you can't have the cool, sexy stuff if the foundation, if the infrastructure isn't there. We have to invest in that. How large is your team, your IT team? I have over 400. You have 400 people? Mm-hmm. How large is your team, your IT team? I have over 400. You have 400 people? How large is your team? So we have roughly 400 team members and about a thousand contractors that work for us. You're talking just about the IT? Yeah. Oh my goodness. Yeah. It's a

complicated enterprise. A lot of different skill sets. Five years ago, how large would... Probably half the size. Is that the same for you, Heather? Yeah. In other words, I should be telling my daughters there's really only one thing you should be studying. Dentistry. Dentistry. CIOs have to prove

the value of IT. I mean, we have to market IT because in healthcare and healthcare IT, I'm not a revenue generating department. I'm not a radiology department. You know, I'm not a surgeon, surgical department. I'm a cost center.

So I have to show the value, whether that's qualitatively or quantitatively, just about every single day. And so it's a balance. One of the things I love when I'm talking to people who are experts in a particular field is they see the world differently than, because you have an area of expertise the rest of us don't have, right? So this is one of the questions along those lines. I would like every one of each of you to describe a situation that you're in, in the world, where you say to yourself under your breath, you guys really need my help.

Give me the you guys. I actually have one. I'm not an IT person. I have a you guys, not the story of my bank. Okay. But I want, Alan, we're going to go first. Give me an example of you guys really need my help. Honestly, experiences at concert events, sporting events.

I think there's a lot of opportunity. And I'm not trying to... So what do you... Are you a football fan? What are you? Football, concerts. You go to a Titans game. Yeah. What is it you want that you're not getting?

I mean, I want to be able to have the connectivity, be able to interact more with the stats, with the, you know, what's happening on the field. I want to be able to be at a position where I don't have to leave my seat because I actually want to watch the game. You know, if I'm at a concert, I want to be able to, you know, is there a way I could zoom in to webcams to see closer if I have bad seats to the show, if I want to know the song that they're playing or the number of times they've played it, depending on the type of music you like. I just see a much more interactive experience. Heather, your choice. My choice.

I'm going to stick with healthcare. It would just be lovely if every, if a patient that moved either between hospitals, moved between states, that we didn't have to fill out the forms again. How nice would it be for that? Kelly? Yeah, I have a dear friend that has cancer, and watching her try to figure out how to become an expert in the medical field just so that she could get the appropriate treatment and coordinating all of the different doctors that were required,

I think was really tough to watch. And I think, unfortunately, lots of families have gone through kind of that experience. I think one that I do every day or it seems like every day is I get on an airplane and I think airlines have come a long way to make it more digital and more self-serve and more connected but I still think there's an awful lot that they could benefit from in both your experience and being able to focus on the experience of a person that's flying all the time and what that experience could look like. I think we've all decided we're going to sit to make what it's like to try and manage a travel schedule through flight and connect with people that you love or business could be stellar, I think. What I just came up with listening to you, which is, it's just about deplaning from the airplane. Oh, my gosh. Which drives me up the wall, right? So we have an AI system that creates an algorithm.

What's the fastest way to deplane this thing? And it looks and sees where you are, how you're sitting. All you have to do is punch in how many bags you have and where they are. Yeah, yeah, yeah. And then you sit in your—no one moves. You sit in your chair with your phone. And the AI says, your turn. Malcolm, get up now.

I swear to God they would make it. Okay, here's my other one. I had the same thought. I was on a vacation with my family. We went to some hotel. We go down to the restaurant in the morning. A person looks at me, and they go, what's your name? They type it in. What's your room number They type it in. What's your room number? Type it

in. What's your telephone number? Type it in. And then they stare at the screen for what looks like 45 seconds. The place is half empty. And then they print out a piece of paper and take it and put it on my, it's like, is this 1985? Like, what is going on here why can't the person all i want to your point about health care i mean this is way way lower stakes but i just want someone to look me in the eye and say welcome to the restaurant that's all i want yeah yeah like this this is i feel like would you give me your cell number at the end of this so i can just call you next time i had this experience i just hand the phone down I have someone you should talk to. Yes, Malcolm. Okay. Thank you. Well, this has been incredibly fun. Thanks to all of you. Good luck with what you do. And may you,

someday we can do this in a couple of years. And I hope I'll be talking to the CEO of Boston Children's and of Tractor Supply. This episode was made in partnership with T-Mobile for Business and iHeartMedia. Special thanks to Callie Field, president of T-Mobile Business Group, Heather Nelson, chief information officer-Mobile Business Group, Heather Nelson, Chief Information Officer at Boston Children's Hospital, Al Latera, Senior Vice President of IT at Tractor Supply, and the entire production crew at iHeartMedia. This episode was produced by Nina Lawrence and Ben Nadaf-Haffrey, editing by Sarah Nix, mastering by Jake Gorski. Our executive producer

is Jacob Smith. I'm Malcolm Gladwell.