Why Healthcare Needs the Practical Innovation of No-Code

Lindsay McGuire: Okay, you ready for a little peek behind the scenes? I'm always looking out for guests who are going to give you the best tips from their personal experiences. The ones who are putting the practical in practically genius. And every once in a while I come across someone while scrolling through LinkedIn that I know I have to get on the show. This episode's guest was one of those people. When I saw his extensive experience and passion for implementing no-code tools and healthcare organizations. I knew I had to get him onto an episode of Genius Spotlights. He put out a post that just really spoke to some of the challenges and some of the successes I think lots of people want out of no-code today. So I might have followed up with him on LinkedIn and guess what? It worked. He said yes and he's today's guest.

Kody Johnson is a nurse informaticist and innovation project manager. He spends his time being a technical liaison between different clinical departments as well as championing innovation projects like no-code and low-code development. Kody is sharing some stellar information from the front lines on how citizen development is transforming the teams he works with. And affecting not only the patient experience, but also the employee experience as well. Take a listen to my conversation with Kody.

Hey Kody, thank you so much for joining us on Practically Genius today.

Kody Johnston: Oh it's an honor to be here. Thanks for having me.

Lindsay McGuire: As you know, this show is for innovators who are championing digitization within their organization. You are champion for low-code and no-code. Can you tell us why?

Kody Johnston: Really my inception point with no-code happens when I was able to start a technology company and we really focusing this technology company on a enterprise grade no-code tool. And through that experience my eyes were really just opened to not only the landscape of what no-code is, but the viability it has in enterprises across, I would say the job sector, in the world. And so going for it further and then coming back to healthcare as a nurse, there's a burning theme inside of me to really see the benefits of no low-code really injected into it. And I would say the short answer to what you said is I've just seen its benefits and I've seen it work. And so I want healthcare to have those benefits and reap the success of it.

Lindsay McGuire: Well, before we get too far into this low-code and no-code conversation, I definitely want to talk about just what you do in your role and at the organization you work with, because you have a really fascinating title. I'm probably going to say this wrong, but your title is nurse informaticist innovation project manager. That's mouthful, but that's really cool. So tell us about it.

Kody Johnston: Good job. Good job saying that. That's awesome. So you're correct. I'm a nurse informaticist by skilled trade and I also service as a innovation project manager. And technically what I do at the healthcare organization I work at, we really sit in the post-acute care sector of healthcare. So you have acute care, you have post-acute care. And the acute care is the hospitals and post-acute care is like the home delivery of healthcare. And so really what I do on a day to day basis is really help any innovation projects we have with our partners, with our external vendors, even internally, how we're improving things, project managers, but I'm afforded the opportunity to be a nurse informaticist as well, which what that is in nursing is a specialized vein, where you are pretty much little liaison between IT and the clinical departments of the company.

You're serving clinicals saying, "Hey, these are needs we have, these are maybe processes that need to be automated. These are system changes that need to happen," process improvement at its core. And then you can go to IT and you're aware of their processes like, "Hey, IT, this is what needs to happen. Let me help with data normalization. Let me help with data warehousing, even infrastructure." The whole vein of nursing informatics in and of itself has so many unicorn and specializations you can really focus on. And so I would say, at least in my role currently, I'm more on that infrastructure side attempting to help as much as possible in the data and the automation side of it.

Lindsay McGuire: And why healthcare? Why do you think there's an opportunity in healthcare for no-code and low-code to make an impact?

Kody Johnston: Ooh, that is a good question, a loaded answer too. So currently healthcare is in a transitional landscape and a volatile one. And what I mean by that is very similar to other job sectors, healthcare has to account for many things that aren't unique to it. Some of those are regulations with data privacy, HIPAA, HITRUST. If there's any InfoSec people listening to this, you get what I'm saying. And then some of it is the fact that healthcare has to deal with patients. The very livelihood of individuals are what end-users of no-codes and healthcare organizations, if they're clinicians, they're dealing with on a day-to-day basis.

And because of that and other things, like the COVID-19 pandemic, no-code is a strategically placed tool that can meet many solutions as it pertains to clinical solutions, patient solutions, operational solutions and health and life science solutions, I would say, that healthcare can really reap from that personally, I just haven't seen too much in healthcare. I really think they're at a discovery stage of it and it's progressing via the advent of technology vendors really investing in it and also organizations and healthcare institutions themselves really starting to get on the train.

Lindsay McGuire: What is innovation in healthcare to you and then where do healthcare organizations go forward to being more innovative as well?

Kody Johnston: I'll give the albeit, at least in my studies, there's not one universal agreed upon definition of what innovation is. Sometimes I see it siloed into process innovation, continuous innovation aspects that I do think comprise the greater whole. But to me what it is in healthcare is I actually look at it from the lens of practical innovation. So in 2021, West Monroe, their national digital service firm, they created this definition of what practical innovation is. And it's really solving problems that matter with real commercial applications is how they coin it. And it's not like just creating an idea to create an idea. It's not about thinking of that cool thing, "Hey, technology can meet this," or "we can use this to fix this problem." It's attacking issues whether it's our patients in healthcare or our internal issues. And I recommend focusing on internal at first with new ideas that actually provide meaningful value and leveraging successful technologies out there for that practical innovation sense.

And as clinicians, something that's not known by the greater public is clinicians in general in healthcare, wherever they work, each vein of it has their own code of ethics. We have the Hippocratic Oath that really services doctors, but what no-code can do in how I see innovation as practical innovation, merging those two things, it lets our clinicians truly have something practical to operate at the top of their licensure, because a lot of our clinicians don't know. And you can find articles about this is they're innovating every day and they don't even know it. They might have to do something in healthcare to give a treatment modality a way that's individualized for the patient. We actually have regulation we have to adhere to with that. But there's not a lot of technological advancements such as no-code, such as citizen development and low-code, I'll throw into that, that really service the clinicians to be innovators in a technological vein and do it successfully. So long-winded, but that practical innovation since really partnered with letting our clinicians operate at the top of their licensure, I would fuse those things into a definition of innovation.

Lindsay McGuire: I think that's a brilliant way to think about it, especially because a lot of the times I see people when they hear the word innovation, or it's brought up in a conversation, they do automatically revert to that pie in the sky, big, huge, monumental ideas and things that are going to "change the world". But if you bring it really far down, like you said, into that practical innovation, which is perfect, because our podcast is called Practically Genius. So yes, love it.

Kody Johnston: Hey, that was not planned, so there you go.

Lindsay McGuire: But the way that you've talked about that, it really is a genius way to think about it, because then that level sets and allows everyone to see themselves as their own innovator. And I think that is powerful and it enables people to see themselves in a different creative light and then they can actually see what you said, that meaningful value of the things that they're doing. You also talked a little bit earlier in that segment about automation and looking for ways to automate within your role. And so I think there is a lot of that practical innovation in automation. So you talk a little bit about either some of the projects you've done on your own, or just things you've seen in the healthcare market about where automation can play a role in the next year or two.

Kody Johnston: So again, healthcare's unique in every healthcare institution will have to tailor per their need. I think that goes without saying. I'm just going to give three examples where I see high viability, high yielding, no and low-code possibilities. And they're going to be really specific to healthcare. But I would say the first of those three is really regarding our case management and our care transition capabilities in healthcare. And just to describe what that is, if you're a healthcare worker, you'll understand listening to this on the podcast, but care transition from a clinician point of view is like when we have someone in the hospital and they're being discharged but they have to go on service to another location. So in post-acute, it might be that skilled nursing facility, it might be that home health agency in some ways it might be hospice or whatever it is in that handoff there's documentation in healthcare, lots of documentation of its redundant.

And because it's normally involved with external parties having to integrate somehow with each other and communicate and care coordinate, it just makes it really redundant. And so where no and low-code, where I'm seeing it is leveraging successful tools, enterprise grade no and low-code tools, is how I would put it. And using it as an integration hub in many ways to connect maybe with that EHR via APIs to connect with some external tools that we use, that we maybe can't replace, because we have too much critical factors into it. And building a communication mode within it. Building that automation of processee mode where it frees up the capacity, we're talking about workforce burden, really freeing that up to allow case managers to allow clinicians to do more of what they were made to do and really care for the patients and handle this in a great way.

And so case management kind of filters into that. But there's lots of tools that I would say are much quicker when it comes to giving no-code tools that can be a face and an automation of an existing EHR and letting people dissect information quickly and then act on it appropriately and maybe get that integration where that DME provider, they click the button and cues something to the DME provider, or to the doctor, here's a button and it cues to them if they have that bidirectional communication. But in that domain of case management care transition, there's a lot of viability.

Related: 3 Reasons to Use No-Code in Healthcare

Lindsay McGuire: You make a huge point. My husband actually is a doctor and he works as a consult liaison in psychiatry and I see it all the time in just the very tiny little window of his work I get to see of how much time he has to take on transferring that data, ensuring everyone on the care team knows what's happening, especially because he's working in a general inpatient experience and he's not just in the psychiatric ward, or the behavioral health unit. And there are so many different people within that process and they spend so much time on collecting that data, sharing that data, making sure that everyone has the correct data. And there's just so much opportunity to automate so much of those processes. And like you said, that workforce burden, I mean the amount of time our healthcare workers spent on paperwork is bonkers.

Kody Johnston: Healthcare, again, just getting on the uniqueness of it. Clinicians, they're really involved with patient centered care. And so the second of these three archetypes I'm presenting is using no and low-code to enhance patient experiences and really leverage them to enhance patient journeys. Those are things that it touches on the workforce board. And because our clinicians subsequently are giving care, if we can do things to help patient engagement and drive those factors that are going to help quality scores that now healthcare institutions have to account for and honestly the bottom line's either being taken away or given more of from the quality initiatives, they support each other. And that's what I love about no-code in the use cases in healthcare, is because normally when you're touching a case management or a care transition tool, you're also in some ways touching patient engagement, maybe secondarily.

And it's not something a lot of people are cognizant of or vice versa. If I'm focusing on a patient journey, this patient with CHF comes in, I now am using low-code to automate communication pathways. But whenever we're doing that, we're freeing up our workforce and we're making their life better. And especially if we're making them citizen developers where they're ideating these scenes and they're helping build these scenes at the inception point, that culture practical innovation, it's all just feeding itself. And sometimes we don't do a good job, I would say, as citizen developers or no and low-code users of creating that value systemically of what all of our creations are doing. And so I just want to call that out. I just see it affecting multiple modalities of care, at least in healthcare along the continuum.

Lindsay McGuire: I really like that idea of creating a culture of practical innovation, because I even see what you're talking about correlating to the data that we found through our state of digital maturity report. We found that the less digitally mature organization, the more resistant they are to change and the harder it is to change. And so what advice do you have for those organizations that might be a little bit more behind the curve? They're not as open to that innovative thinking and that trying new tools and bringing in things like no-code and low-code, how can they change that? This is the way it's always been done kind of mentality.

Kody Johnston: I just remember in my early days as a clinician being a innovative mind coming across these burdens, but almost not feeling like I had the authority, if you will, in certain areas to do what I wanted to do. But in reality that statement wasn't as true as I thought it was. And so advice I would give to people is really start with relationships, especially if you're listening to this podcast and you're a manager. If you're in a place where you have some decision making power, start with the relationships and truly try to help people solve their problems. A question I love to ask with no-code and low-code is what tools are you equipping your employees with to problem solve and to problem solve successfully? When you ask higher level managers that question, it really gets the wheels spinning or especially we're in innovation department.

So you know that first part being relationships. But the second part is I really advise anyone that is passionate about knowing low-code that is truly in an enterprise setting that is in a business, whether it's matrix or whether it's a top down hierarchy, start investing in citizen development. Start gathering education in what citizen development is, which is to put it in layman's term, it's really the governance strategy and the tools and documentation you need to be successful and the enterprise buying in to no and low-code and doing things successfully where the business unit partners with the IT unit, but in your relationship, talk with it. Start talking to them about this stuff, picking their brain. And then as you're investing in citizen development and building a culture of, "Hey, what is a citizen developer?" "Oh, it's just someone who can use no-code technologies to build automation in these applications," and you're starting to get movement with that, then you're already knocking out two huge tactical things that are necessary as you gather the value.

Maybe as you're allowed to prototype, if there's existing no and low-code tools in the organization in painting that success use case that you can then go to the executive stakeholders of a company and say, "Hey, not only is this our value prop, but this is what we built. Here's a couple prototypes and IT was with me along the way. Here's the documentation we have from citizen development best practices to actually show you that we're not just introducing shadow IT, which is a risk that IT consider." And with certain no and low-code tools, there can be that change management resistant factor, but using relationships, citizen development and then just starting somewhere, being that third one, just be courageous, don't leave your vision, don't leave what you're convicted about, just continue the way no matter how many nos you get. I think if you just do those three things, you're going to find yourself in a successful place.

Lindsay McGuire: Going back, kind of big picture, is there a competitive advantage that organizations have when they invest in no-code compared to orgs that might not invest in no-code?

Kody Johnston: Well, my answer is 100% healthcare institutions that invest in no and low-code, they do have a competitive advantage. But I do want to start off by giving this disclaimer, that I think the starting point of the advantage they have over their competitors are really the healthcare institutions that start with the easy wins first, the minimum viable products, that in some ways, address the peripheral business processes of the operation and they work closer to the core, where we find a lot more business critical applications that you do have to have it maybe assistance with the no and low-code tool at stake. But we've already touched on some of the factors that are unique to healthcare. Talking about the edge, capacity burden and workforce constraints being one. No and low-code is ripe to create solutions and to digitize paper processes and to leverage really big integration wins to help the workforce have less burden and to answer those constraints and especially if they're buying into it, if they're helping create it.

Because that's something I don't think personally, or I'll just say this, healthcare has a lot of room to grow to really involve the end-user into the ideation process of technological creations. We're oversaturated with EHRs that are good, they serve a purpose, but they also might be clunky, or clinical applications that are very siloed in their usage and the ceiling's not high. That's not the case with no and low-code platforms to me. Because we're creating custom applications that are a skin over the internal business organs so to speak, it adapts with us. The usability, the accessibility, the scalability, it adapts with what we need it to be and the change of the volatile landscape that healthcare is in. So those are automatically things that give you the edge over your competition. If healthcare institution one does not invest in no and low-code, but healthcare institution two does, they have all those things I just said.

And even from a cost benefit analysis, you're going to find that as you start advancing in citizen development and great no and low-code technology usage, you're going to find it can actually replace some of those third party technologies, which are good. I'm not knocking them, they're needed and we need to pinpoint when we're using them successfully. And I say that as a nurse informaticist, but we're going to find that, "Oh wow, we have a lot of cost savings we can use by actually replacing this maybe with the industry cloud, no and low-code platform tool." And the value just ends up perpetuating on itself, because at the end of the day, if that healthcare institution one that's not investing in a no and low-code, if they don't change what they're doing, if they don't look into other technologies that are going to alleviate that gap or really, really structure their processes successfully, the cost, the burden and the negative implications that come with that, that perpetuates on itself.

Lindsay McGuire: So let's keep that conversation going about that org A who has yet to take the leap into no-code and let's say that they've heard about it and there're some employees that might be advocating for it, or might have even convinced their managers or teams like, "Let's do a trial of this," or "let's see what we could do with this." What are some of those business processes, or those easy win workflows that they could approach first to really advocate and show that minimal viable product, like we talked about before, that can really have the senior leaders say, "Wow, okay, this is a worthwhile investment and it is a worthwhile risk to take."

Kody Johnston: Here's a couple things I really learned from my PMI certifications in citizen development. Ask some of these questions. Are there paper forms that are requiring manual data input? Are there spreadsheets with formulas, tabs to track critical business data if you will? Are you collecting data from numerous sources, either internal or external with other tools? Is there data and communication that's shared across departments? It frequently gets out of date. Are there auditor and compliance needs where you're required to check that every month, or every two weeks? Whatever it is. Those checklists, the tracking processes, start with those places. If you're listening to this, you probably use an Excel or a Google sheet to track information and it takes you a long time to do whatever you're doing. You've even probably had informaticists like myself, or tech guys optimize it. They're doing the Excel coding, the VLOOKUP, whatever it is to make it to where it works the best for you.

I lovingly say stop. Stop, stop the exercise of futility and look into no and low-code, because they're built to solve those scenes from very, very inception point. And so those are the quick wins, digitizing the paper process. If you're in a certain healthcare org, or maybe just this last example is you might have time clock things. These are really elementary use cases. Or just inventory management for clinical supplies. "I just took this gauze out of here, we don't track it's on an Excel spreadsheet. Let me just throw that thing away." And at the end of the day, you're wasting money if you're doing that. And so customizing no and low-code to fit many of those scenes, I said, you're going to save money, you're going to save headache. Bring the people in that actually do it from the ground up. Do successful ideations sessions, which are applicable to your org and you're going to find yourself find some really cool solutions and really start getting ears perked up through successful small peripheral wins as you move to the core that I was mentioning.

Lindsay McGuire: Yeah, you make some really good points about just the money that's left on the table, because it's a spider web of things that intersect that are losing organization's money. There's the manual work that's causing so much more time that if you automated it, I could have an hour and a half, two hours back of my day to work on those more humanistic parts that require my full attention, my full focus, my full brain, my creativity. But there's also cases you said where you are tracking something but you're not maybe tracking it efficiently, or effectively, or the data's not actually accurate.

Even if you have tools like Salesforce sometimes, where you're using for your data collection, if you don't have those systems and processes in place to ensure that that data is getting in there correctly, you're going to have such huge issues. So there's all these things that can add to the cost of not having no-code. But I think there's the flip side of that conversation where, if you are just strictly thinking budgets and you're thinking about the money and the line items, you might not automatically think, "Well I'm going to go and invest in another piece of technology to save money that doesn't make sense." So can you speak a little bit about how does no-code actually save organization's money?

Kody Johnston: This is absolutely critical, because when you go to the executive sponsor, you really need to have that ROI and that strong compelling case to show the success of what you did with the no and low-code. And you're normally always going to start with the capacity burden that's alleviating. So hours saved, maybe clicks reduced, siloing of where you have to go now to process the information, or do data inputs. And what I mean by that is you might have gone into three tools. So healthcare, I'll just use a real example. You might be looking at your EHR and manually auditing or transcribing, you're in two systems right now. What if you can leverage no and low-code to be the face and that automation capability. You now taken the redundancy of time away from that. And those are the baseline things you start with to call out a couple other value streams. Depending on how you leverage the use case of no and low-code, think about that time to value, time to deploy, time to learn and scale, the IT backlog, acceleration, a revenue, like enhancing your products.

When you create a no and low-code tool, how are you innovating and enhancing that. When you further improve it, what savings are you getting from that channel or customer expansion saturation, that's a revenue stream. Some of them is the cost. We've already alluded to. The people productivity, the process productivity, the technological savings I mentioned. And the other two in healthcare where it gets a little bit more hairy but it's worthwhile to invest in these two categories is really your clinical workforce, your employee workforce, and then your patients, or your customers, if you're leveraging no and low-code for that. So areas I would look for that are employee retention. Are you tracking in your app? Maybe there's an about button in your app they click that gives the email the citizen developer business architect to email them a problem, they don't have to leave the application. Those are little things that help satisfaction of no and low-code implementation and then supporting the tool that will help employee retention.

Lindsay McGuire: And I want to touch on something you said earlier. You were talking about how no-code enables employee engagement and retention and we actually found mind blowing statistics about that in our digital maturity report, where a majority of employees at those most optimized organizations, the ones that are using no-code, have digitized, have automated, they do not struggle with employee retention. I think it was something like 30 or 35% of them say they do not struggle at all to hire and retain employees. So there is that direct correlation between investing in the next wave of technology in digitization and empowering your frontline employees and how happy they are and how satisfied they are with the work they're doing day in and day out. But I would love to see more and more organizations really thinking about this isn't only a move for our bottom line as far as customers and patients and retention externally, but internally too.

Kody Johnston: Sometimes some of the most frustrated people in your organization are your greatest leaders, your greatest apostles of no and low-code. And I've seen this before and can testify to it. Really no and low-code when you give people that, it sounds ridiculous, it sounds so small, but when they have that autonomy, that authority, that honor placed on them to fix problems and do it successfully, I really just think in some ways the sky's the limit with those. And we find those people staying in the organization, benefiting from them, because in some ways we've just given them a right seat. Maybe they weren't in the right seat, but we switched them over here and they're taking off. So those are wins I think we can find in no and low-code as well like you mentioned.

Lindsay McGuire: Opening the door for them, right?

Kody Johnston: Uh-huh. Come on.

Lindsay McGuire: Well, so I just have a few more questions to wrap up our conversation. And so why should innovative leaders care about low-code and citizen development?

Kody Johnston: If you're not innovating your time as an organization, especially in healthcare, when there's insurance involvement, when there's pay or payee government regulations, we have to account for, we are always going to have to be nimble and we're going to have to find ways to adapt. That innovator that's listening to this why they should consider it, you are rarely going to find technological movements and waves that can offer multiple modalities while affecting your culture, while making it easier to support and implement and then change on itself.

Touching the finances, touching the operational enterprise, and then touching your people. Not all SaaS products, not all third party tools out there are going to answer that. They're going to fit a need. And so as an innovation leader and even like a CIO, you need to find those scenes that set yourself up for the greatest gain in the future and let you manage the disruption that's coming to manage all the changes that are coming that I've already alluded to, that healthcare is in to set yourself up for success. And I believe no and low-code [inaudible 00:26:58] some development is the best scene you can do right now to do that.

Lindsay McGuire: It's all about aligning the people, process and technology. And I think no-code is the key that can open that door for sure. So if you could give one piece of advice to innovative leaders on how they can get started with citizen development, what would it be?

Kody Johnston: Start with what you have. Don't wait. If you're in an organization, or enterprise and they already have something, even if you don't like it, just start with it. Learn it. Go along the process of getting the relationships again and the tool getting knowledge of both those scenes, because what you're going to find is one, it's going to make you a better citizen developer, but for those innovative leaders, if you are afforded something already within your cloud stack, you're going to meet solutions. Whether you do the RFPs and look at other vendors or not. You have something that you can leverage, though there will be some optimization. So I would just say start with what you have. Start easy, start simple. And once you start scaling from that place, you're going to find yourself really mastering a lot of the benefits and the things you can reap with no and low-code.

Lindsay McGuire: I think that is an excellent way to close out the episode. So Kody, thank you so much for joining us today. This is excellent. And I think if anything, the one thing people should walk away is act out on no-code, or else you're going to be left in the dust.

Kody Johnston: Exactly. Thank you for having me. It was an honor.

Lindsay McGuire: Thank you so much for joining us for this great conversation with Kody. I'm taking away tons of insights from this conversation and applying them to our Practically Genius insider newsletter, which you should definitely sign up for. You can do that by clicking the link in the show notes. And as always, rate, review, share in LinkedIn and tell another innovator about this show. You never know. You might just get your next practically genius idea right here.

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