Renee DeSilva  0:06  

Welcome back to The Academy Table. I’m Renee DeSilva, CEO of The Academy and your host and I’m delighted to have you with us this week. The Table is a podcast where we try to serve up real conversations with healthcare’s best leaders and thinkers. Our intention is to broaden who is at the table while covering the issues that are critical for driving our industry forward. In that spirit, I’m excited to welcome Terry Myerson to the table who’s a relatively new face in healthcare. Terry is an entrepreneur at heart. He was a member of the executive team at Microsoft playing a key role in shaping and driving the strategy. Over his 21 year career, he led the development of Windows, Surface, Xbox, and the early days of Office 365. Today, Terry serves as CEO of Truveta, a new healthcare technology company whose mission is “to save lives with data.” Truveta is co founded and co owned by 14 of the largest not-for-profit health systems, many of whom are members of The Academy. Their vision is that the next meaningful leap in how we care for patients is tied to how we aggregate massive amounts of data, and no single system can do that alone. Two things that I took away from my chat with Terry. First, Terry’s relentless vision orientation. Both from his time at Microsoft and now Truveta, he understands the importance of finding meaning in the work and translating that for team members and for customers. Second is Terry’s comment around balancing the imperative of transforming healthcare through data while maintaining a principled approach to assure appropriate use of that sacred information. So with that, join me at The Table.

Hi, Terry, welcome to The Table. So happy to have you with us this afternoon.

Terry Myerson  2:00  

Thank you for inviting me. I’m honored to be here. 

Renee DeSilva  2:02  

So to kick us off today, I’d love if we could start with a moment of reflection. You’ve had an amazing career journey, elevating to the most senior levels at one of the world’s best technology companies, at Microsoft. Before we get into your latest work with Truveta, I’d love to start there. Can you tell us a little bit about how you became interested in technology and more broadly, what were some of the early forces that shaped you?

Terry Myerson  2:25  

Let’s see. I mean, my first role started in college and evolved into my role of first job after college was, I was doing scientific data visualization for the US Environmental Protection Agency. You know, there was all this environmental data on acid rain, ironically, so I’m dating myself there. And there wasn’t a really good way to analyze that data and visualize that data. There was this new computing platform from Silicon Graphics. And it was just so exciting to visualize this data in this whole new way and how it brought insights to such important public policy. And ironically, that brought me to Washington, DC where I saw the internet for the first time. But I mean, I remember visiting the National Institute of Health at, I think, in Maryland, or in DC in that area, and it was, you know, seeing this website for the first time. And at the time, people were thinking about AOL and CompuServe and Prodigy and here was this, this website that was, I probably had seen the web prior to that, but seeing it being used for exchanging some research and actually some marketing was being done by Silicon Graphics to the scientists. That certainly shaped who I am. It caused me to start the first company with some friends and colleagues. Certainly when Microsoft acquired that company that certainly shaped who I am today very much. I moved to Seattle in 1997 and really didn’t know what was ahead of me. But then certainly having the opportunity to work at Microsoft for twenty-one and a half years and ultimately build these platforms that are used around the world, I think that had a tremendous impact upon who I am today. In many ways, I feel like that early exposure to technology and data shaped me, the internet shaped me, starting a company shaped me. But joining Microsoft, I think in many ways I grew up there.

Renee DeSilva  4:17  

So let’s spend a second on that. So you’re sort of an entrepreneur in that you founded a company, you sold it to Microsoft, as you mentioned, and then you said you spent twenty-one years there. I’m curious, did you intend to stay that long? And if not, what kept you there?

Terry Myerson  4:30  

I absolutely did not intend to work there for twenty-one and a half years when I started. I mean, I moved to Seattle really just open minded to what I would learn and what would be there. But what I found was just this incredible environment where, you know, you move from a small company, you’ve got finite resources. And then you come to Microsoft and there’s such a passion for innovation. There’s such a passion for impacting the world. And there’s support for great ideas. There’s, there’s teams ready to come together and form around great ideas, build platforms, deliver them to the world. And it was just eye opening to me. Honestly, I had never left the United States prior to joining Microsoft and now you’re building technologies for the world. And I think the biggest team I worked on was tens of people at that time and you joined a team that’s hundreds of people in size. And, and obviously, there’s complexities working on larger teams, but you have an appreciation for what can be done with that investment.

Renee DeSilva  5:27  

That’s great. Terry, one thing that I know made you an effective leader at Microsoft and will translate well at Truveta is leveraging your skills and pattern recognition. I’m curious, what is your process for evaluating data and finding important signals in the noise?

Terry Myerson  5:46  

I will share one thing that I learned. I had a manager named Robbie Bach 10 years ago, I don’t know, maybe more, 15 years ago. But I remember him breaking down the problem on these three dimensions that I do still think about today in terms of looking for the patterns. He would say, “Look at all these things on three dimensions. Look at them in terms of the business model and the business impact. Think about the user experience or the customer experience that they’re going to have with it. And think about the fundamental underlying technology.” And things tend to get very entangled across those three dimensions, but when you tease them apart and say, you know, what are all the economic forces that are going on here? What are all the customer satisfaction, delight opportunities that are here? And technology, what does it take to do this? What’s the breakthrough? Where’s differentiation technology? What’s really hard?

Renee DeSilva  6:38  

I think that’s great. So search for signals by isolating the economic, customer, and technology implications. That’s a great takeaway. Your career at Microsoft spanned the period that we call big tech. During that time, the market became more competitive than ever. We know that our health systems are currently facing their own well-funded disruptors who are providing niche services, often at a significantly lower price. What were some of the lessons that you learned about fending off competitors that might be applicable to our healthcare listeners today?

Terry Myerson  7:11  

Well I think it’s very important to have a vision, have a vision that is out in front. It needs to be a differentiated vision, it needs to be a vision that you can actually achieve. But having a bold vision that, of where you want to go. I think that’s just super important. And then you use customer feedback to tune your path towards that vision. And there’s always competitors. But I think at the core, you need to have this very customer-centric vision of what are you going to try and do and why does the world want you to do it? Why is it good to achieve that vision? Why is your team going to want to work hard to achieve that vision? And I think it just starts with that vision. And you can tune your vision over time, but having that vision that’s out in front, that’s going to define who you are, I think that’s sort of, as a leader, whether it be a team within a larger team, but having that vision of where you’re going is, I think, the most important thing.

Renee DeSilva  8:06  

What you’re describing is essentially the principle that is often attributed to you, “Mindshare over market share.”

Terry Myerson  8:12  

Well, I mean, it’s a lot of complicated things going on there. Coming back to the competitive strategy or customer strategy, I think, who you are and what you stand for, and why the world should care that you achieve what you’re doing. I think once you have that defined, you then start telling your story. And I think building up momentum behind your story, I think, is just a lot of, I think, good things. Momentum is just something every team wants to feel at all stages. The mind share market share thing is a little bit of a momentum thing that sort of follows the vision.

Renee DeSilva  8:46  

Let’s switch gears a bit and talk about the vision for your latest project. You are now CEO of Truveta, a company that was co-founded along with 14 health systems to use data to accelerate our intelligence around addressing big problems and questions in healthcare. In your own words, how would you describe Truveta?

Terry Myerson  9:07  

Typically, what I, in terms of describing Truveta, I tend to tell the journey I went through to be now on this mission with the team. After I left Microsoft, I became very fascinated with this intersection of data sciences and life sciences. I just met so many innovators that saw all of these incredible ways to bring artificial intelligence to improve human health. And I definitely saw a pattern where there was brilliant ideas, but there was a lack of data to pursue those ideas. And I was looking at that more from helping those innovators be successful. And then the pandemic happened. And the Providence team, you know, here locally in Seattle, invites me in to be part of this effort to try and understand how to respond to the pandemic and it opened my eyes. Whereas I had been focused really on kind of the biotech side and how data can be used to facilitate innovation there. And what I saw was, there was just no ability to ask and answer questions like, who should be intubated? How long someone should be intubated? We know we have people trying out hydroxychloroquine on patients like. How is it going? Can we get like a real time clinical trial of sorts of what the results are from this? You know, we’re hearing about loss of sense of taste or loss of sense of smell, what other symptoms can we surface from the data? There really was no good way to ask and answer those questions, put the data together at scale across health systems, so we can look for those sparse signals. And you just get to this place where you’re like, you know, I saw the recruitment for clinical trials and how hard that was to do. And then I learned about this project Truveta, which, frankly, you know, HMA was super critical in, you know, bringing together some of the fundamental ideas for it. And you get this conviction, the world needs Truveta. The world needs this data whether I got the opportunity to be part of it or not. This vision for Truveta which had started, you know, within the health systems already. To me, the entire experience with the pandemic just gave me conviction, I had to do anything I could to make Truveta happen. And then if I was lucky enough to be part of it, that would be great.

Renee DeSilva  11:11  

You’re very clear on why Truveta and sort of the mission that you felt like could be achieved through this partnership coming together. I’m curious, so this is your first entree into healthcare at scale? I think I have that right. And I’m curious, what surprises you most about our industry? What observations have you had about six months in?

Terry Myerson  11:32  

Well, I’ve met some just incredible people. This industry is filled with just amazing talent. That’s my first reaction. I mean, I’ve met incredible engineers, I’ve met incredible scientists, I have met incredible caregivers, business leaders. It’s just, there’s amazing talent in healthcare. And I think that, you know, it’s ripe. If there’s one thing if I reflect back is, I think over the last perhaps decade, we’ve watched data transform retail, we’ve watched data transform travel, we’ve watched data transform finance. But what was one thing I would reflect on, is, I think there’s definitely an eagerness for now data to transform health and healthcare. And now’s the time. I think we have the opportunity to do something really special to just improve outcomes in all respects for everyone who’s working so hard in this space.

Renee DeSilva  12:29  

That’s a great insight. I wonder if your insight around, despite the last 15 years of pretty sizable effort and both sweat equity and financial effort to aggregate data and to digitize the overall experience, it’s been slow moving. Is there anything that you note immediately around what’s harder, different about healthcare relative to other industries that has made this more slow moving?

Terry Myerson  12:55  

The first thing that comes to mind is ethics. This idea that this data should be used for the good of the patient. You know, it’s very much at the core of all of the Truveta founders. And I think that is unique. I think so many big data engineers and big, you know, all the big data technologies, really all that has been developed to do a lot of personalized advertising. That’s what all these big data technologies, this talent, it’s been selling ads for the last 20 years. And that’s not what I think this data should be used for. And I think that ethos is some of what’s held back using some of these technologies or working with some of these partners to unlock this data. And so I think, as I reflect now being inside Truveta and I’ve been working on Truveta feels like for a year now, I think there is something there where using this data for the good of the patients, not for selling more stuff to the patient. I think that’s a very meaningful ethos. It does put constraints on the data. It does put constraints on the partners you work with with the data, the technologies you use. And as I reflect on a lot of the decisions we’re making and how we work with everyone, that was something that I now see so crystal clear. And I think it’s critical. I think it’s really important. This data is very personal and I think we should be using this to improve the lives of all of the patients.

Renee DeSilva  14:27  

Terry, that’s a great insight. The ethical considerations surrounding patient data and the cautious approach to how it ought to be used have perhaps unintentionally suppressed our ability or even willingness to aggregate data and be more innovative around it. I think, and I’m excited about health equity as a core opportunity for Truveta to help inflect. I think, when you think about the gap in health outcomes by zip code, by certain demographic groups, it feels like that area is really ripe for a way to aggregate and call attention to how do we start to fix that? I think COVID has certainly shone a spotlight on the disparity gaps. And I think, as I talked to our Academy members, there’s many other examples of that, whether it’s infant mortality or uncontrolled blood pressure or chronic care management where there’s an opportunity to really be specific with those populations that need greater investment to close gaps and outcomes. And so, I wonder, you have the pleasure of working with 14 partners, many of whom I know, and I think many of them are committed to health equity as well. I wonder how you, there’s no lack of maybe opportunity that you all could run at and I’m not going to ask you what you’re prioritizing. But I’m curious for the the process that you all are putting in place to figure out where you want to activate Truveta in the near term. How do you just go about sort of coalescing around those major areas of focus?

Terry Myerson  15:49  

Well I think the key is for us to create transparency. I don’t know that honesty is solving anything in particular here. But I would like to be able to use data to highlight where there are inequities. Is there a different initiation of drug based upon color of skin? Is there a different death rate based upon, some of this data is just so amazing to me. When I saw, you know, there is this one statistic, I think it was like 1/3 of the nurses which died from COVID were Filipino, but only 4% of the nurses in the US are Filipino. You hear data like that and you’re like, you just want to like double click and start asking, “Why?” What is different in the care that was received from those that passed away versus those that survived? And the same thing in each of those examples you cited, Renee. I think the idea that, again, we facilitate the ability to ask and answer these questions. Not necessarily to change societal forces or to change the deployment of resources. But at Truveta, I think we can create transparency to what’s going on and allow people to double click and say, “Okay, I’ve got another question. I’ve got another question. Help me to understand what’s really going on.” And it requires bringing together a tremendous amount of data to do that. And what’s exciting with Truveta, you know, we have data from Hawaii to Alaska to New York, LA, Florida. We actually have a broadly representative data set of the United States’ diversity. And so I’m optimistic that very soon we will have transparency on many of these questions we all have.

Renee DeSilva  17:23  

I think it’s great. Truveta as an ingredient or as a catalyst to drive the right conversation and then to where you end, it’s not going to necessarily be the solution. but I do think there’s a broader ecosystem or groups of partners that, I think, once we can shine a spotlight in a sort of evidence based way, my hope would be that that really does start to build that momentum as we talked about early on. So exciting to track how that rolls out. Just curious, in the sort of year or so that you’re into this and just the structure that you’ve built within Truveta, what have just been some of your early priorities in terms of building out the team, getting sort of structure and governance together. I’ll ask you later about what it’s like to work for 14 different CEOs, but I’ll save that for a moment.

Terry Myerson  18:06  

Well, I mean, the hardest days of Truveta certainly was the day that I was like, all by myself. The day you sort of say, “Okay, I’m in. I’m employee number one.” And it’s lonely. Although you have your health system partners and, you know, great support from HMA and others. You’re by yourself. So you quickly go into team building mode and you start saying, okay, we need to build a platform to structure, normalize, and de identify a lot of data. We need a team of people that can work with these partners and, you know, so we can stay in sync. We are committed to being health system governed and led. Okay, we need a team of people to engage with these health systems and create a governance structure and process where the guidance and decisions and ethos of these health systems can lead us. And it’s pretty exciting now. I mean, I don’t know the exact number of people. We have 60-70 people right now from where we were with just one person. It’s been very exciting. We have an incredible team. I feel very fortunate and blessed to be working with every one of them. But in terms of like, you know, when you start as one person. It’s a very much like, oh, wow, there’s a lot of work to do. You know, the mission, the vision we have is, it resonates with people and people, you know, the team’s excited to have this impact on the world.

Renee DeSilva  19:23  

And do you imagine, I am sure that you do, so 14 founding partners within Truveta, there’s, I’m sure, a broader appetite for folks to continue to get behind it. Anything to share on how you sort of think about the next group of organizations who may have an interest in getting on board with this initiative?

Terry Myerson  19:41  

I think everyone involved in Truveta would like to see this group expand. I mean, this ability to learn from the data will only get better as more and more people are engaged, you know, with the data and with the learnings. And so we announced with 14 and, you know, I look forward to 15, 16, 17, and more joining so we can get more insights into health inequities, more insights on how to learn across all these different physician experiences. Because it’s exciting. I come back to this. I feel like the world needs Truveta and the more people participating in this Truveta community, the more learning we will have.

Renee DeSilva  20:18  

Certainly. Getting more data through the pipes is a major priority and success factor for Truveta. What do you see as the biggest risks to success?

Terry Myerson  20:27  

Right now I don’t think of it as risks, but things we just need to do a really good job of. Because I come back to, I think this is something important for the world to do so, you know, we need to do a really good job of privacy and security and ethics and, both in terms of what we do and in terms of telling our story to all the stakeholders and listening to all those stakeholders and taking their input and incorporating that input into all the things we’re doing so that we’re doing the right thing. The governance, you know, making sure this is true to being a health system governed company and serves the purposes of taking care of patients. You know, we’re trying to use this data to take care of patients better. Not just understanding the right journeys patients should go on, what with therapies that patients should be taking, but also making sure new therapies get developed for each and every one of us. And so, is that a risk, opportunity, hard challenge? I don’t know. But, you know, I do think those are the two things, I guess I come back to security, ethics, and privacy, not in that order, privacy, ethics, security. All three of those things I think are just very top of mind for me.

Renee DeSilva  21:35  

I love that. And that’s just sort of the stakeholder comment. Of course, a big part of your stakeholder group are the providers that are engaging. I know from your, even your Microsoft work, you have always defined team and stakeholders broadly. So other parts of the maybe orbit that are key to success and realizing that mission, have you given any thought to who those folks might be from the Truveta lens or types of entities that you might think about being on the team more broadly outside of the provider community?

Terry Myerson  22:07  

We have definitely given some thought, but there’s nothing really I can share today, Renee. I mean, we’re thinking about everyone involved. You know, everyone from patients to clinicians to health systems to regulators and politicians and biopharma, payers. I mean, there’s a lot of people that, I think, care a lot about health and doing the right thing. And I think data can be a grounding force for all of us. And so we have the opportunity at Truveta to democratize a lot of information here. But we’ve got to do it in the right way. And we’re still learning what the right way is. And so we’re open minded. I welcome anyone to reach out to us with great ideas or interest in being part of this mission to save lives with data.

Renee DeSilva  22:54  

I love that. That’s perfect. All right, I’m gonna go wrap up, different direction. Two closing questions for you. The first is just this notion of leadership. You’ve had an opportunity to work with some very well known leaders in your tenure – Bill Gates, Steve Ballmer, or Satya Nadella. Any inspiration, you don’t need to attribute it to any one of those gentlemen, but what inspiration do you draw from that experience and body of work that you apply now?

Terry Myerson  23:17  

I think having a clear vision that’s meaningful, that resonates with you deeply and your team, I think it all starts there. Don’t start with a competitor, don’t start with a product, but start with a really differentiated vision of how the world could be different if you’re successful and that will just motivate all kinds of great work from all kinds of people on the team, customers, partners. People get behind a big, meaningful vision. And saving lives with data does that for me, for the Truveta team, and for our Truveta partners and that’s what comes to mind?

Renee DeSilva  23:52  

That’s great. Final question, totally different direction. So the Academy’s podcast name is The Table and the maybe principle or spirit behind that, for me, is twofold. One is, I think it’s important to amplify voices, both those folks that are known and maybe newer voices that just need a platform to share ideas about how we continue to transform this industry. So I love the idea of curating that and having folks come to this table and share what their big ideas are across healthcare. And then the second piece for me is around, I think one of the things that we all miss most in this pandemic environment is that so much joy and connection and good conversation, oftentimes good debate happens when you’re around a table with people who you respect and whose company you appreciate. And so I wonder, if you had an opportunity to curate your ideal table, one or two people that you’d invite to join you at that table.

Terry Myerson  24:48  

Two people come to mind, Renee. And they’re, Dr. Fauci. I think I would love to talk to him. I mean, this intersection of public health with, you know, what goes on with the care with every individual, each and every one of us with a clinician. To me, this idea of saving lives with data is very much about public health. It’s very much about thinking about how can we learn from all the individual experiences to understand what’s going on in our communities around us. So I would just love to talk with him about that idea of saving lives with data and public health and how they intersect. And I guess on the other side of it, I would say, if there’s one privacy advocate who I’ve really found incredibly thoughtful to, I think she’s just got a terrific point of view. There’s a lady named Natalie Banner at the Wellcome Trust in the UK. And she’s written some great work and she’s actually done, I listened to a podcast from her just the other day, really thoughtfully thinking about what patients really want from a privacy perspective or how it should, how their privacy should be treated. Because I think that is what we need to balance here with Truveta, very much so, is doing the right thing for the individual patients and respecting who they are and their privacy, but also thinking about the public good and the public health. And I think that would just be an awesome table to be sitting at and have a really thoughtful discussion.

Renee DeSilva  26:12  

I’d like to crash that table. That sounds like fun, especially Dr. Fauci. We’ve been trying to get him connected to some of our Academy conversations. But I agree with you, that would be a good discussion, preferably outside someone with a glass of wine in my opinion.

Terry Myerson  26:24  

I’d love to be there.

Renee DeSilva  26:26  

Great. Well, Terry, it’s been so nice getting to know you. I hope that at some point we’ll be able to meet in person, but really appreciative of you joining us this afternoon. Thank you so much for your time.

Terry Myerson  26:35  

Thanks for having me.

Renee DeSilva  26:37  

Thanks again for joining me at The Table. The Table is a podcast produced by the Health Management Academy. Make sure you catch future episodes by visiting our website, theacademytable.com or by subscribing on the podcast platform of your choice. And if you have suggestions for topics or guests, I’d love to hear from you. Please drop me a note at renee@hmacademy.com. I look forward to talking with you soon.