 Live from Las Vegas, it's theCUBE. Covering Informatica World 2019. Brought to you by Informatica. Welcome back everyone to theCUBE's live coverage of Informatica World 2019. I'm your host Rebecca Knight, along with my co-host John Furrier. We are joined by Adam Mariano. He is the Vice President Health Informatics at High Point Solutions. Thanks for coming on theCUBE. Thank you for having me. So tell our viewers a little bit about High Point Solutions, what the company does and what you do there. Sure, High Point is a consulting firm in the healthcare and life sciences spaces. We're, if it's data and it moves, we probably can assist with it. We do a lot of data management. We implement the full Informatica stack. Been an Informatica partner for about 13 years. We were their North American partner the year last year. We're part of a much larger organization, IQVIA, which is a merger of IMS and quintiles. Large data asset holder, a big clinical research organization. So we're very much steeped in the healthcare data space. And what do you do there? As Vice President of Health Informatics. I'm in an interesting role. Last year I was on the road 51 weeks. So I was at over 100 facilities. I go out and help our customers or prospective customers or just people we've met in the space, get strategic about how they're going to leverage data as a corporate asset, figure out how they're going to use it for clinical insight, how they're going to use it for operational support in payer spaces, and really think about how they're going to execute on their next strategy for big data, cloud strategy, digital re-imaginement of the healthcare space and the like. So we know that healthcare is one of the industries that has always had so much data, similar to financial services. How are the organizations that you're working with, how are they beginning to wrap their brains around this explosion of data? Well it's been an interesting two years. The last arc of two years there isn't a single conversation that hasn't started with governance. And so it's been an interesting space for us. We're a big MDM proponent, we're a big quality proponent, and you're seeing folks come back to basics again, which is I need data quality, I need data management from a metadata perspective, I need to really get engaged from a master data management perspective. And they're really looking for integrated metadata and governance process. Healthcare has been late to the game. There are about five or six years behind other industries. I think now that everybody's sort of gone through meaningful use and digital transformation on some level, they're now all arcing towards consumerism, which really requires a big deep dive in the data. Adam, data governance has been discussed at length in the industry. Certainly recently everyone knows GDPR is one year anniversary, et cetera, et cetera. But the data role of data is really critical in applications for SaaS and new kinds of use cases. And the term data provisioning as a service has been kicked around. So I'd love to get your take on what that means, what is the definition, what does it mean, data provisioning as a service? So the industry has changed. We've sort of gone through that boomerang, right? We started deep in the sort of client-server standard warehouse space, everything was already be a mess. We then, everybody moved to appliances. Then everybody came back and decided Hadoop, which is now 15 year old technology was the way to go. Now everybody's drifting to cloud and you're trying to figure out how am I going to provision data to all these self-service users who are now in this sort of bring your own tool space. I'd like to use Tableau, I'd like to use CLIC, I like SaaS, I have people who want to write code to build their own data science. How can you provision to all those people and do so through a standard fashion with the same metadata, with the same process? And there really isn't a way to do that without some automation at this point. It's really just something you can't scale without having an integrated data flow. And what's the benefits of data provisioning as a service? What's the impact of that? What does it enable? So the biggest impact is time to market. So if you think about warehousing projects historically a six month year long project, I can now bring data to people in three weeks, in two days and a couple of hours. And so thinking about how I do ingestion from a, if you think about the Informatica stack, something like EDC, using enterprise data catalog to automatically ingest data, pushing that out into IDQ for quality, proving that along to axon for data governance and then looking at enterprise data lake for actual self-service provisioning, allowing users to go in and look at their own data assets like a store, pick things off the shelf, combine them, and then publish them to their favorite tools. That premise is going to have to show up everywhere. It's going to have to show up on AWS and on Amazon and Azure. It's going to have to show up in Google. It's going to have to show up with regards of what tool you're using. And if you're going to scale data science in a real meaningful way without having to stack a bunch of people doing data munging, this is the way it's going to have to go. Now you are a former nurse and you now, I'm still a nurse. Technically, once a nurse, always a nurse. Don't get the nurses. I got an ear thing going on. Can you help me out here? So you have this really unique vantage point in the sense that you are helping these organizations do a better job with their data. And you also have a deep understanding of what it's like to be the medical personnel on the other side who has to really implement these changes and these changes will really change that how they get their jobs done. How would you say, how does that change the way you think about what you do? And then also what would you say are the biggest differences for the nurses that are on the floor today in the hospital serving patients? Well, I think in America, when we think about healthcare, we often talk about doctors. We only talk about nurses and nursing shortages. Nurses deliver all the care. Physicency, at this point, the way that medicine is running, physicians see patients an average two to four minutes. And you really think about what that translates to. If you're not doing a surgery on somebody, it's enough time to talk to them about their problem, look at their chart and leave. And so nursing care is the point of care where you have a lot of opportunity to create deflection in how care is delivered. I can change quality outcomes. I can change safety problems. I can change length of stay by impacting how long people keep IVs and after they're no longer being used. And so understanding the way nursing care is delivered and the lack of transparency that exists with EMR systems and analytics, there's an opportunity for us to really create an open space for nursing quality. So we're talking a lot now to chief nursing officers who were never a target of the analytics discussion. They don't necessarily have the budget to do a lot of these things, but they're the people who have the biggest point of control and change in the way care is delivered in a hospital system. Care is also driven by notifications and data. So you can't go into a hospital hearing all kinds of beeps and things. And AI and all the things we're hearing is that there's now so many signals. The question is what to pay attention to. This becomes a really interesting thing because you can get notifications if everything's instrumented. This is where kind of machine learning and then understanding workflows, outcomes, play a big part. This is the theme of the show. It's not just the data and coding. It's what are you looking for? What's the problem statement or what's the outcome or scenario where you want the right notification at the right time or a resource? Is the operating room open? Maybe get someone in. These kinds of new dynamics are enabled by data. What's your take on all this? Well, I think you've got some interesting things going on. There's a lot of signal to noise ratio in healthcare, right? And everybody is trying to build an algorithm for something, whether that's who's going to overstay their visit, who's going to be readmitted, what's the risk for somebody developing sepsis, who's likely to follow up on a pharmacy refill for their medication. We're getting into the space where you're going to have to start to accept correlation as opposed to causation. We don't have time to wait around for a six-month study or a three-year study where you employ 15,000 patients. I've got three years of history. I've got a current census for the last year. I want to figure out when do I have the biggest risk for falls on a hospital unit? Low staffing, early in their career, physicians and nurses, high use of psychotropic meds. There are things that, if you've been in the space, we can pretty much figure out what should go into the algorithm. And then being pragmatic about what data hospitals can actually bring into use as part of that process. So what you're getting at is really domain expertise is just as valuable as coding and wrangling data and engineering data. In healthcare, if you don't have SMEs, you're not going to get anything practical done. And so we take a lot of these solutions as one of the interesting touch points of our organization that's I think where we shine is bringing that subject matter expertise into a space where pure technology is not going to get it done. It's great if you know how to do MDM. If you don't know how to do MDM in healthcare, you're going to miss all the critical use cases. So really being able to engage that user base and those SMEs and bring people like nurses to the forefront of conversation around analytics and how that data will be used to your point which signals to pay attention to is critical. Supply chain is another big one. Impact there. Well, it's the new domain in MDM. It's the one that was ignored for a long time. I think people had a hard time seeing the value. It's funny, I spoke at 10 o'clock today about supply chain. That was a session I had with Nathan Rain from BJC. We've been helping them embark on their supply chain journey. And from all the studies you look at, it's one of the easiest places to find ROI with MDM. There's an unbelievable amount of ways. We're laying fruit. 24.5 billion dollars in waste a year in supply chain. It's just astronomical. And it's really easy things. It's about just-in-time supplies. Am I overstocking? Am I losing critical supplies with tissue samples that cost sometimes $100,000 because a room has been delayed? And therefore that tissue sits out. It ends up expiring. It has to be thrown away. And I'll bring up Nathan's name again but he speaks to a use case that we talked about which is they needed a supply at a hospital within the system 30 miles away. Another hospital had that supply. The supply cost $40,000. You can only buy them in packs of six. The hospital that needed the supply was unaware that one existed in the system. They ordered a new pack of six. So you have a $240,000 price that you could have resolved with a $100 Uber ride. And so the reality is that that supply could have been shipped, could have been used, but because that wasn't automated and because there was no awareness you couldn't leverage that. Those use cases abound. You can get into a length of stay, you can get into quality and safety. There's a lot of great places to create wins with supply chain and the MDM space. One of the conversations we're having a lot in theCUBE and we're having here at Informatica World is centers around the skills gap. And you have an interesting perspective on this because you are also a civil rights attorney who is helping underserved people with their H1B visas. Can you talk a little bit about the visa situation and what you're seeing particularly as it relates to the skills gap? Well, we're in an odd time. We'll leave it at that. I won't make a lot of commentary. I'm a civil rights and immigration attorney and on the immigration side I do a lot of pro bono work with primarily communities of color but communities at risk looking to help adjust their immigration status. And what you've had is a lot of fear. And so you have, while you might have an H1B holder here you may have somebody who's on a provisional visa or family members and because those family members can no longer come over, people going home. And you're getting people who are now returning. So we're seeing a net negative immigration to places like Mexico. You're seeing a lot of people take their money and their learnings and go back to India and start companies there and work remotely. So we're seeing a big uptick in people who are looking for staffing again. I think a last quarter or so has been a pretty big ramp up and I think there's going to continue to be this whole. We're going to have to find new sources of talent if we can't bring people in to do the jobs. We're still also, I think it just speaks to our STEM education, the fact that we're not teaching kids. I have a 28 year old daughter who loves technology but I can tell you that her education when she was a kid was lacking in this technology space. I think it's really an opportunity for us to think about how do we train young people to be in the new data economy. There's certainly an opportunity there today. And what about the, when you said you were talking about your daughter's education, what would you have directed her toward? What kinds of, when you look ahead to the jobs of the future, particularly having had various careers yourself, what would you say that the kids today should be studying? That was two questions. So my daughter, I told her to do what makes you happy. But I also made her learn SQL. For kids today, I would say, look, if you have an affinity and you think you enjoy the computer space, so you think about coding, you like HTML, you like social media, there are a plethora of jobs in that space that none of them require you to be an architect. You can be a BA, you can be a quality assurance person. You can be a PM. You can do analysis work. You can do data design. You can do interface design. There's a lot of space in there. I think we often reject kids who don't go to college or don't have that opportunity. I think it's an opportunity for us to reach down into urban centers and really think about how we make alternate pathways for kids to get into the space. I think all the academies out there that you're seeing rise you to me in a lot of these other places that are offering academy-based programs that are three, six months long and they're placing all of their students into jobs. So I don't think that the arc that we've always chased which is you've got to come from a brand named school to get into the space. I don't think it's that important. I think what's important is can I get you the clinical skill so that you've understood how to move data around, how to process it, how to do testing, how to do design, and then I can bring you into a space and bring you into an entry-level employee. That premise, I think is not part of the American dream but it should be. There's an opportunity. Absolutely, looking for talent in these unexpected places. College is not the only endpoint. We're back to having, I think, vocational schools for the new data economy which don't exist yet and that's an opportunity for sure. And you said earlier, domain expertise in healthcare as an example points to what we've been hearing here at the conference is that with data, understanding outcomes and value of the data actually is just as important as standing up the wrangling data because if you don't have the data beating in. You make a very point. The other thing I tell young people in my practice, young people I interact with, people who are new to the space is, okay, I hear you want to be a data scientist, learn the business. So if you don't know healthcare, you get a healthcare education. Come beyond this project as a BA. I know you don't want to be a BA. That's fine, get over it. But come be here and learn the business, learn the dialogue, learn the economy of the business, learn who the players are, learn how data moves through the space, learn what the actual business is about. What does delivering care actually look like? If you're on the payer side, what does claims processing look like from an end-to-end perspective? Once you understand that, I can put you in any role. And digital for is new non-linear ways to learn. You've got video, I see young kids on YouTube. You can learn anything now. And scale up your learning at a pace. And if you get stuck, you can just keep getting through it. No, no. And there are free courses everywhere at this point. Google has a lot of free courses. Amazon will let you train for free on their platform. It's really an opportunity. I think you're right with this vocational specialism is actually a positive trend. And look at the college university scandals these days and I was like, is it really worth it? I got my nursing license. I got my nursing license through a vocational school originally, right? But the nursing school, they didn't have any technology at that point. Well, you're a great use case. Excellent, Adam, thank you so much for coming on theCUBE. It's been a pleasure talking to you. Thank you. I'm Rebecca Knight for John Furrier. You are watching theCUBE.