The IT Revolution

This episode is a paid partnership with T-Mobile for Business.

Hello everyone.

Malcolm Gladwell here.

Today I'm having a special conversation hosted by my good friends at T-Mobile for Business

how the digital revolution is going to transform everything about the way we do business.

I'm talking to Heather Nelson, the Chief Information Officer at Boston Children's

Hospital, Al LeTerra, Senior Vice President of IT at Tractor Supply Company, and Callie

Field, President at T-Mobile Business Group, who you may remember, by the way, from our

episode at the Las Vegas Grand Prix.

So you might think, hasn't the digital revolution been happening for a while now?

Sure, but it's been unevenly distributed.

And the folks at T-Mobile say that thanks to 5G, businesses are now able to transform

how they do business at scale, which has all these interesting ripple effects, including

IT moving from a support role to a leadership role.

So I wanted to talk to two brilliant IT leaders who are transforming two radically different

worlds, healthcare and retail.

Buckle up, because there's a big technological change happening.

This conversation is for all the CIOs and business owners who are dreaming up new ways

to make things run better.

But it's also for everyone who goes to the doctor or shops retail.

Callie and Al and Heather really convinced me that 5G is changing just about everything.

With me is Al Atara, UNIT for Tractor Supply.

Yes.

One of the grandest, oldest.

It's a tractor supply not far from my home, so I drive by it all the time.

And then we have Heather Nelson, and you are the CIO for Boston Children's.

Callie, we have done this before.

I wanted to start with you, Al, and I wanted you to give me a kind of blue sky picture

of where you would love to be five years from now with Tractor Supply and things digital.

Yeah.

But to us as an organization in service of our customers and our team members,

it's really going to be a consumer and team member-centric strategy that is really taking

into consideration putting everything at the fingertips of the team member and the customer,

so it's right there available to them when they're either shopping, they're working on

their farms, or whether they're working within the communities that they're serving.

It's all the information that they need is at their fingertips.

I'm going to use one of your phrases.

We really are at a tipping point with the healthcare delivery and the enabling technology.

Our patients are consumers, and we have to make it easier for patients to come to us.

We have to make it easier for physicians, care team members to care for those patients.

So self-service and access will be where we need to focus on.

And I know for Boston Children's, it's one of our pillars in our strategic plan

is to increase the access and the self-service for our patients.

You think of this as being a revolution that's equally weighted in those two groups,

or does it tilt in one direction more than the other?

The intersection of technology with the retail industry is not just focused on the customer side.

The team member interaction with the customer is paramount to our success.

If you go back, we've been in business 85-plus years.

The secret sauce of our business is our customer relationship.

So the team members are facilitating that, and without the right tools,

without the right experiences, without the right information,

making them more productive and just giving them access to whatever it is they need to

service those customers is paramount to the success of our overall digital strategy.

I love working with both of these leaders because they are so customer-centric,

which I think really resonates with me at T-Mobile.

But I love the call-out for the digital transformation impacts the way that you're

able to serve your customers and the relationship that you have with them in so many profound ways,

especially given AI and where it's taking the need for data and connectivity,

but also for your employees.

In a digital age, a lot of times people ask me,

why do you need to invest in your employees and or your providers

in the same way because everything is self-serve and digital?

I think of it like Iron Man having Jarvis.

You equip them with the technical tools that make them

the very best heroes for your customers.

And that's something that I appreciate about that.

And yes, we're a children's hospital, but these kids know technology.

They know how to use iPhones and iPads.

And so why not make sure that they have the tools and the apps to do that at home,

to do that so that they're empowered and they feel in control of their care?

that they can't do now.

What if we were able to do more home infusions for our cancer patients

so they don't have to drive to come to the hospital?

And then making sure that that information then gets back into the electronic health record,

seamlessly.

So the physician knows that Heather's getting her infusion that day

and we can call and be proactive with her parents.

That's what I want to see.

I want it to be almost like concierge care for our patients.

Hospitals, for example, we've been so reliant on Wi-Fi.

And Wi-Fi is just not meant for a mobile environment.

It's not meant...

I mean, I have calls dropped from the OR to the ICU,

and that's frustrating for clinicians.

because they had locked me out of my account digitally

and I had to do something, transfer money.

And I went in, transferred money, waited in line, finally got to the teller,

went to all kinds of stuff.

And then she looked at me and she goes, can't do that.

I was like, why can't you do it?

She said, no, I'm not making this up.

She said, Wi-Fi is down.

It's like, all right.

These guys don't deliver.

You lose customers.

which hurt my feelings.

And also, it's not just about the four walls of the hospital anymore.

We want to, one of our other strategies over the next couple of years

is to do as much care at home as possible.

And to have a 5G-enabled environment, that levels the playing field for our patients.

And as we start to learn to use data differently

and we start to see the evolution of how we can take important customer

or patient information and get smarter and provide better solutions or faster,

or whether it's from a cost perspective

or whether it's from a quality of treatment perspective,

the amount of data that is available to us

and us being able to do something with that data

is so quickly and rapidly evolving.

And in a Wi-Fi world, you need more consistency.

You need SLAs.

And you need to be—

So you need to be able to say,

for this type of surgery or using this kind of machine,

if we're going to capture data

or we're going to actually, in the future,

use an automated device to do some important kind of function,

we need to be able to say the latency and the capacity,

that those things are firm and that there's no variation.

And you can't do that on a Wi-Fi network

when you've got hundreds of other kinds of connections all around it.

But with a private network or a designated network slice,

what you're able to do is to say,

OK, these are the guaranteed service levels

that we're going to give this connection all the time.

between individual bits of technology

and some kind of central command post

in a way that I can't do with Wi-Fi.

of the way that her IT organization

serves their ultimate mission as a hospital and for children,

the amount of connections are going to increase.

I mean, it's probably from hundreds to thousands to tens of thousands.

A nurse has his or her own cell phone

plus a device that's provided to them for their clinical shift.

They've got workstation on wheels.

We've got workstations.

At the nurse's station, we've got medical devices.

We've got ventilators.

We have IV pumps.

All of those things are wired, if you will.

And then you have the patients who have their devices,

their iPads, their cell phones,

and everyone expects everything to work perfectly.

aside from the quality of service that you receive,

you think about patient data or HIPAA compliance in your field,

the security measures that are required.

If you have to do VPN and Wi-Fi access for every one of those secure,

there's a lot of room for attack and error.

And one of the things that we've been talking about

and working with all of our customers

is how do we take the very connection and encrypt it?

But before we, I want to talk to you, Al.

Can you do the same thing?

Give me a very specific example of something

you would like your customers or your employees in your retail outlets

to be able to do that you think would make a meaningful difference.

and service of the customers.

It's basically delivering predictability

so that you can make sure that these things all work.

And it's a complicated process that you have to make very, very simple.

So here's an example of it.

When you're dealing with the customer base that we're focused on,

it's the people with farms.

They have animals, livestock on their farms.

It's a very, very important thing.

So we've got to make sure that if they ask information

about what's the right food,

what's the right ingredients that were making up that food,

what's the right food for the right time

in the life cycle of, let's say, a chicken, it's very important.

But we got to take it to another level.

What about the sustainability of how that food was created?

What ingredients go into that food?

is to increase the sophistication of the encounter

between the store and the customer.

In other words, I don't just go in there and say, I want that.

Now the customer is coming in expecting a much richer interaction with the store.

And you need to be able to measure up to that expectation.

And so when you're talking about at their fingertips,

you're bringing all that data forward.

that Tractor Supply is doing?

So I grew up on a farm,

and I remember something would break on the farm.

You're on a farm, you're out 20, 30, 40, 50 miles from where the store is.

Oftentimes, maybe not in a place where Amazon's going to show up

and deliver that same day.

To be able to work with a retailer that understands

when you have to stop and go and get the correct solution

for the thing that broke down,

the timing of crops or the timing of when you've got to get cattle ready for sale

is so important that if you have to go off and spend eight hours to track down,

where do I get the thing that I need?

It really does have an impact on your profitability,

your bottom line as a farmer.

And I think you guys are really helping to bring technology

into a way that really serves your customers.

We're back.

Heather, I want you to dig into this a little more

because there is probably,

when I compare the two worlds that you guys come from,

consumer reactions, feelings about those two worlds are very different.

There's an enormous amount of customer dissatisfaction in healthcare.

It's annoying to go to your doctor or the hospital half the time.

17 million forms.

Doctors hate digital health records.

with the electronic health record,

it was everything that we did on paper,

we're going to now make it electronic.

And I remember talking to some EHR,

electronic health record vendors 25 years ago,

and they're like, we're going to make it faster.

We're going to make it easier for physicians.

And I said, never tell them that

because nothing is faster than a piece of paper and a pen

when it comes to documenting.

And now the pendulum has shifted

with electronic health records,

with ambient AI, with quick...

you know, the Hey Google.

in some of our nursing units

where they come into the room

and they can talk to the patient

and capture that information

instead of sitting there

with their back to the patient typing.

if I can do stuff while I am still engaged with you,

eye to eye makes all the difference in the world.

meeting with customers,

really trying to listen and focus on,

what do they need?

What's the problem that they're trying to solve?

But then it takes 30 minutes,

45 minutes of quiet focused time

to just capture what are all the next steps

and what are the things

that I've got to go and do afterwards.

And so that's less time

that I get to spend with the customer.

And it might mean less time

that I'm really able to focus in

on what the customer is telling me.

But with tools that we have today

that we're already using

and selling and providing for customers,

we're able to take recorded sessions like this

and the AI will summarize the action items

and we'll even set up a calendar appointment.

So I think about in healthcare,

if I were able to get the discussion with the doctor

and they say,

hey, Callie, you're 45.

You need a colonoscopy.

Wouldn't that be great

if it was already scheduled

and that that follow-up was already taken care of?

Because I may not want to schedule that.

I mean, admitting that I have 49, 45

and have to follow up,

it might be more than I can handle.

But if you can use,

and I'm making a joke,

but imagine what that will empower

in terms of healthcare

for us to have tools

that take people from not wanting to deal

with the message

and putting them into the next step.

You're asking a lot more of your retail staff.

They're no longer simply managing a transaction.

Now they're real partners with the customer.

If you upgrade the technology,

you have to start redefining your relations,

the role of your support staff.

I keep bringing up the customer and the team member

and they're intertwined.

That's one of the reasons why

is because you got to think through all this.

As you add more capabilities,

you got to increase the productivity.

Like how do I use AI to actually generate code?

We actually do that now.

How do we use it to generate test scripts

so that we can test things faster,

get it into market?

And the same thing does apply

in the walls of the retail location

is because it's like,

how do I make replenishment faster?

How do I make labeling faster in a store?

What's the process for that?

So anything and everything is on the table now.

The big difference between your world and Heather's

is Heather, you're at one institution.

How many stores does Tractor Supply have?

and 200 PetSense stores.

So when you roll out something,

do you roll it out incrementally

or do you do it in all 2,200 places simultaneously?

What we do is we have labs

within our store support center

in Brentwood, Tennessee

to support those locations.

And we test in those labs typically.

The second thing we do is we work very closely.

There's a group of stores that are considered

like the test stores,

but they're the team members

that have more of that engineering,

that tinkering mindset.

So we've identified roughly 100 stores

and they basically...

We deploy it to them and they test it

and they give us feedback

and then we kind of iterate through it

and then we start deploying it

to larger volumes of the store, of the chain.

which was the role of the CIO

really evolving.

The work that I've done at T-Mobile for 20 years

with my IT teams

is very different today

than the work that we were doing 20 years ago.

And I think you all...

It's fun to hear you talk about your risk takers

or you want to move fast

because of the speed

of what is happening with data

and what is happening with the connectivity solutions

and what we can do with AI.

And I think in retail and in healthcare,

there's people that are willing now to push the limits.

So you're now a culture leader for your company.

Whereas before, I don't know if I thought of my head of IT

as a culture leader for the company per se,

but you're changing the way that people work.

You're changing what they are able to provide

for their customers in profound ways.

And I think that's a really cool part of your jobs.

of a traditional bricks and mortar company?

is to be CEO of a hospital someday, for reals.

It's a big jump

because if you don't position yourself

as a partner with the strategy and with the business,

especially in healthcare,

then you become the order taker.

And my philosophy is,

I don't want my IT teams to be order takers.

I want us to be seen as partners.

the interaction between you

and non-IT people in your organizations.

We spoke about this a little bit.

I want to dig in on this.

Are there parts of your vision for the company

that are difficult to convince others of,

to explain, to...

Do people get how you said, Heather,

you guys are at a tipping point.

Do non-IT people get that?

Is it a hard time convincing them?

I will tell you the introduction

of a private 5G cellular environment,

first of its kind in healthcare,

I really had to sell that to the organization

because they're like, well, we have Wi-Fi.

And they said, then why do you keep calling me

and telling me that your calls are dropping

from the OR to the ICU?

So putting it in to articulate,

not to talk about the bits and the bites,

but to talk about what problems are we trying to solve

and can technology do that?

And if so, are you willing to do that with me?

Because I am not an end user in the house.

I don't use the electronic health record,

but I have to make sure that it works.

And sitting at the table and having the conversations,

because I will tell you,

when I go to do my budget every year,

I don't know how you...

But storage and compute

and a new virtual server somewhere

is not as sexy as IV pumps and MRI machine.

So I'm competing with the same dollars.

And, but yet I have to explain to my peers,

you can't have the cool, sexy stuff

if the foundation, if the infrastructure isn't there.

We have to invest in that.

Your IT team?

How large is your team?

and about a thousand contractors that work for us.

Yeah.

Oh my goodness.

I mean...

there's really only one thing you should be studying.

I mean, we have to market IT

because in healthcare and healthcare IT,

I'm not a revenue generating department.

I'm not a radiology department.

I'm not a surgeon, a surgical department.

I'm a cost center.

So I have to show the value,

whether that's qualitatively or quantitatively,

just about every single day.

And so it's a balance.

when I'm talking to people who are experts

in a particular field

is they see the world differently

than because you have an area of expertise

the rest of us don't have, right?

So this is one of the question along those lines.

I would like every one of each of you

to describe a situation that you're in,

in the world,

where you say to yourself under your breath,

you guys really need my help.

Give me the you guys.

I actually have one.

I'm not an IT person.

I have you guys, not the story of my bank.

Okay.

But I want...

Alan, we're going to go first.

Give me an example of you guys really need my help.

I think there's a lot of opportunity

and I'm not trying to...

Are you a football fan?

What are you...

Yeah.