 Good afternoon everyone and welcome back to theCUBE's live coverage of Google Cloud Next. We are here in smack dab in the middle of day two of the conference. I'm your host Rebecca Knight along with my co-host Rob Streche. Rob, one of the things that is just so much fun and so interesting on theCUBE is that we're talking to real organizations what they're doing with their data, how they're moving their data. That's what really keeps the conversation going. Absolutely and I think again, this should be a really fun time talking about this because it's about how applicable all of what announcements have been going on and how partners are really bringing this together with Google and with the customers, with the customer in mind and I think that's really what's great to pull out because it helps other people when they're sitting at home trying to figure out how do I get started with these things, gives them ideas and seeds. And learnings, exactly. Well this is the perfect segue to introduce our next guest. They are Samir Setti. He is the chief data and analytics officer at Hackensack Meridian Health. Welcome. Thank you, Vami. And Brian Dodie, a principal at Deloitte Consulting. Thank you both so much for coming on the show. Thanks for having us. Samir, let's start with you. Tell us a little bit about Hackensack. Sure, so we're a health system based out of New Jersey. 18 hospitals in total. We span all the way starting with Hackensack up North and then spread ourselves down. It's been a very interesting ride for us especially with Google so really excited to have this conversation. Great. Can you talk to us a little bit about your vision and your migration strategy? Absolutely, so I function as a data and analytics officer. My job and function is to make sure that our business units, including clinicians, have the data and the insights that they need to run their business, take care of patients. So my team focuses on bringing the data in from different source systems, normalizing the data and then developing insights on top of that. What that to me means is that we develop the whys and the hows out of the data instead of the worst is just providing the data to folks. And can you just break it down a little bit for our viewers too? What is that data? Bringing it in from all sorts of? Yeah, so our largest data source is what we call EMR, which is an electronic medical record. This is what houses, this is a system that houses the patient information. So this is essentially what the doctor or the nurse or the clinician is punching in as a part of the process of visiting, a patient visiting doctor. That is our largest data source. We have other data sources. We have imaging data that we bring in. We have data related to people. We gather data from outside sources, social media. We have claims data, which is the processing of the payment, which is very rich as well for us. So we bring all that in. We try to create one record of one longitudinal view of a patient that starts to show us where the patient journey started, where it ended, what happened with them. And then we start to use it to take decisions. How, help us understand from a Deloitte perspective and a Google Cloud perspective, how do you get the right, you know, stakeholders on board for these types of transformations and involving, because I mean, again, there's a lot of PII. There's a lot of, you know, sensitive data, especially in healthcare. How do you really work with the customers on that journey? Yeah, well I think the first thing to really keep in mind is, although this is technology enablement, it is not a technology project. But the transformation, even just moving from an on-prem infrastructure into the cloud, there are changes in the way that the organization will access applications, access data. And certainly within the IT organization, there are changes in the way that people work. And so it's really important to engage senior stakeholders early in the process across the organization, set expectations around what they're trying to achieve and ensure that everyone is aligned and that the messaging to the organization is focused on the benefits and, you know, really ensuring that it is a business-driven and IT enabled initiative. Providing access to data is not sufficient. I think what's important is to translate that into insights. I think that's what I think, you know, Deloitte and other organizations help us with. You know, data, for the most part, providing data generally does not achieve an outcome, which is what we're looking for. Okay, so where do you even begin preparing your people? I mean, Brian, you made this great point that this is not just a technology project. This is really a people project in that everyone needs to be on the same page, pulling in the same direction. Incentives, motivation needs to be aligned. So where do you even begin preparing your team for this? Yeah, so I can take that. So, first is customer first, right? But it'd be the patient, for us it's the patient, for us it's the nurse practitioners, it's the physicians, it's the hospital operators, understanding their needs and building something around their needs is most important, right? So I think our approach at Hackensack and the vendors that work with us is primarily first understanding that and then building a product, a data product, around what's needed. And I think that allows us to obviously reach our outcomes, it actually increases adoption quite a bit. So I think that's what's required. And from a migration perspective, what was it actually that you were migrating into Google and what was kind of the scope of that? Yeah, so when I inherited the team, it was a very descriptive team. What that means is that we provided data and we started to show the why, right? But I think over time we have migrated into a mindset and an infrastructure and a technology stack that starts to do some prediction, right? So the migration for us has been an on-prem, very linear, let's provide the data and some insights on top of it and now we're getting into the why's and the how's and what will happen, right? I think that's the migration. Google has helped us with that. Being on the cloud allows us to go to market with that a lot faster. When you work on-prem, you're working with, obviously fixed cost, but you're also working with fixed compute, fixed machine power versus in I think a cloud environment what we have migrated to, you start to use the abilities to increase power, increase speed, increase processing as fast as you need it to. So these projects never go maybe as smoothly as planned. I'd love to bring you, Samir, to start talking a little bit about any challenges you experienced, any roadblocks or obstacles that you faced along the way and then I'd love to get your thoughts too, Brian, about working with Hack and Sack through these. Yeah, I think for us the struggles are really understanding the business. That's always hard. What we have generally seen is what we started off with from a concept of what was needed to what we actually ended up with is quite different. Can you give an example, though? That's really fascinating. Yeah, so I mean the example would be, for example, if we are in the process of optimizing our operation room usage, the OR is the most expensive asset for a health system. We generally start off by identifying where potentially we can actually fit in more procedures, but as a part of that journey, we start to realize there's things beyond that, which impact, which is how do we bring in the factor of the patient being ready, right? How do we make sure that everything else is prepared prior to surgery? So a lot changes in that journey. So I think listening to the business units to our customers is really important. So I'll share a actually very specific tactical example going back to the discussion about this not being a technology project, but being a change to how people consume data and so forth. The simple, theoretically simple process of migrating reports from old technology to new technology in the cloud. There's both opportunity to look at the reports that you've historically been creating for an organization and rationalize that down to really make sure that you're only providing the necessary information, you're minimizing the number of reports. But in order to do that, you essentially need to redesign the reports to make sure that you're taking advantage of the capabilities of the new technologies and so forth. And in doing so, you're often changing some of the data and the way that it is being presented in those reports. And oftentimes, because it is different than what the organization or the individuals, the end users are used to seeing in the past, even if it is better or even if we're able to determine that in fact, some of the calculations that were historically being used were wrong and the new ones are correct, it still is jarring and there's a lot of resistance to that. So back to the change management and really setting the stage early around the benefits of this move, but recognizing that even things that may seem simple are not simple and you have to make sure that you're engaging with the business from day one to make sure that you can streamline those processes and collaborate with them. By the time we will be done with migration, we would have migrated approximately 17,000 assets in whole. They'll not end up being 17,000 assets. The reason that's important is our approach is not lift and shift. We are not going to bring what was already there and probably working well and then reproduce this. Instead, we will go back to business, ask the questions again, do you really need it? Does this solve your problem and then recreate it? So lift and shift is not an approach that hack and sack is taking. And by assets, do you mean servers? Do you mean databases? What do you consider an asset? So when I speak of assets, I speak of assets from what the user uses, right? It could be an alert that gets fired as a part of the workflow. It could be a dashboard. It could be a report that they're getting in their email. No, and it's really interesting and I think like, again, moving to the cloud is always to your point, it's always a difference. And it's also probably a difference for your team and how they actually operate and the people and how they have to kind of change some of their skilling. How have you approached that as well? Yeah, it's definitely an up-skilling exercise, right? How you operate in cloud, the analogy that I use is when you're on-prem, if you leave the meter on, it doesn't cost you anymore for the most part, right? Whereas if you leave the meter on on the cloud, it continues to charge you. So I think optimization of how you use cloud infrastructure is really key and Deloitte and other organizations actually are helping us with that. We don't do it well. At the end of the day, we are a healthcare organizations that care us to need our patients and their families. And I think it's important to have the right partners who can teach us how to do it. Well, speaking of re-skilling and up-skilling, I want to ask Brian about what you were talking about earlier and making sure that it's the senior stakeholders, that the message is coming from top-down that we have set expectations and that people have an understanding of what their role is and how, yes, things will change, change is hard, but we can do this and there's reasons we're doing this. Can you talk a little bit about how you help leaders understand their role and the importance of what they're doing and making sure that that messaging is getting through to hack and sex leaders as well as throughout other organizations too? Yeah, and what you're really talking about is change management and not technical change management but organizational change management. And we spend a lot of time upfront in conversations with the client, really emphasizing the importance of that change management and really discussing the role that every leader in the organization plays in both setting the foundation for that change and frankly, giving folks permission to think about things in new ways and also to ask questions and challenge both the way that things are being done and really just continuing the conversation there. I think the tone needs to be set from the top but it is going to be implemented by the teams and that empowerment and the clarity around decision making and decision rights is a big part of that. We're not going to second guess every decision that the team makes but we want to make sure that the decisions are being made with a consistent understanding of the end goal and that's what change management really is, is establishing the foundation, building the sort of the case for change and then empowering teams to really take the organization through that journey. How did you decide to go down this journey? How did it all begin? So I think two things. One is we are a very large Google partner. We started our journey with Google around five years ago which is when we moved our workspace tools into GCP and I think over time we have seen how being on cloud has helped us through that relationship with Google we got introduced to what cloud can do and for us what that means is being able to go to market as fast as we can. There aren't any limits for us today at least from a hospital perspective on finding the servers and the machines that we need to process data and make the insights available. So I think what's, the decision for us was around being able to find the capability that allows us to go to market fast. That's been the journey for us, right? That was a decision point for us is we no longer wanted to limit ourselves to purchasing servers, managing servers. Instead we'd rather work with organizations that do it much better than us and are able to provide those resources to us by swipe of a credit card, right? So we go online and there's a platform we say we need this machine, this size, this memory, this storage and it gets available to us instantly. That helps us quite a bit because that's one problem that's gone. There are other problems obviously that we have to solve for but at least that's something that we don't have to worry about. And it also gives you a professional development opportunity for your team. You're taking some of the more sort of rogue activities off of their plate and allowing them to focus on the upskilling and sort of moving into the future which I think is a really important sort of retention and training tool as well. It's making their jobs more interesting for them and more satisfying too. They get to focus on really the higher order activities, the more strategically important things as opposed to having to do the keep the lights on sort of activities that can be. Well that's just to piggyback on that. My questions for you are what has the response been both for the team and as well as the patients? It's been amazing for us. I'll speak to this from a perspective of hiring and retaining talent. I think having the right technology in place keeps our workforce engaged. The folks that we generally work with are get very excited over technology so having the leading edge technology through Google I think has helped us retain amazing talent. As you can imagine, these folks that work for us have a choice. They could go across the river and work for the technology companies but if you make that technology available for us there's a bigger mission which is that they have the technology platforms to work on and they're helping save lives, help people live better, sometimes die better, right? So there's an advantage to that. So I think that's been pretty huge for us. From a patient perspective, I think the digitization of data or availability of data or insights has been a lot easier as a result of everything that's happening here. That's been a huge advantage. Usually in the past that was a very large blocker. It took us a really long time for us to put things in place and I think through a cloud journey and I think these technology companies taken a big part in making and enabling that need. I think Sco-to-Market has improved. So we're here in 2024. What do you see as kind of your goals or where you hope to be next year when you're here at Google Next and hopefully on theCUBE with us? For me, I'm hoping that we're now going to have a migration conversation. That would have been done and dusted with. I think with Deloitte's help, I mean, these guys have been really awesome in telling us how to do it and create a factory around it. So I'm excited about that. The second would be, I think AI, that's the theme here. I think we, at Hackensack, we tend to divide our AI use case into three buckets, operational efficiency, decision support, and patient experience. I think we're making some major moves around operational efficiency and decision support. What we haven't done a whole lot is make moves or make AI available that is more patient-facing. So I think next year, I would love to be in a position to say that we have actually deployed some use cases in production where we feel that there's safe AI in place that interacts with patients directly. We will have to create some sort of way by which there's human in the loop that's absolutely needed. Healthcare is a very human-centric business, but I think that's what I'm excited about. Next year is for us is all about creating AI applications that are patient-facing. Do you have any advice for other? Well, I think that the first piece of advice, particularly related to data and the migration of data, is take a look at current processes. I think that this presents a real opportunity to improve upon the legacy data assets that you already have in-house. It is very, very important as you move into the world of AI and more advanced uses of this data that the data is trustworthy, that it is clean, that it is well-governed. So take a step back and make sure that you have the foundational processes in place. And if not, to design those processes to when this migration from on-prem legacy technologies into the new world of cloud occurs, you're ready to make sure that you are appropriately maintaining that new asset and that you won't have to deal with issues of trust and issues of quality as you really take on the next-order opportunities. Yeah, absolutely. And we're taking full advantage of that, by the way. As a part of a migration journey, we're looking at ways by which we can do automation. Instead of doing manual ways by which we were bringing the data in, so I think absolutely. And obviously governance is a big piece for us as well. This is an opportunity, true opportunity for us to look at what we didn't do well in the past and as we built in these new assets or rebuild these assets that we factor all those things in. Wow, wow, that's powerful. Yeah, incredible. Sameer and Brian, thank you both so much for coming on theCUBE. This has been a great conversation. Thank you very much for having us. I'm Rebecca Knight for Rob Stresche. Stay tuned for more of theCUBE's live coverage of Google Cloud Next. You are watching theCUBE, the leading source for enterprise tech news.