As the clock winds down, this week marks the end of my tenure at Kaiser Permanente. With mixed emotions, it has been a time to reflect and contemplate. Wide swaths of emotions come to the forefront: happy, guilt, joy, sad, elation, sorrow, anticipation and many more.
The last several years have been a story book for me reminiscent of a mix of fun like a P G Wodehouse novel, romanticism of a Hemingway, excitement of a Grisham and laissez-faire capitalism of an Ayn Rand – sometimes feeling the excitement of doing something never done before, and sometimes feeling the pains of doing something never done before but always believing that what we as Kaiser Permanente are doing will set the stage for improving the health of millions of people in this country.
A decade later I am amazed and humbled at the changes that have occurred in the teams that I was part off, the company, and for me personally. Not just that, the industry has gone through tectonic shifts. You all enriched my life personally and professionally and taught me what it meant to be ahead of the curve in healthcare.
Kaiser Permanente is an incredible place tied to a mission. I love the passion and energy our people have around our mission. Very few companies transcend from being a place to work to becoming about the people to work with. Being able to move from the bricks and mortar to the hearts and passion of the employees. Finally being able to not be a bystander but to lead an industry.
Growing up with Bollywood, going down memory lane we do well. Each memory is an ACT, a learning experience – some were hard, some were humorous, and some were honestly “Oh geez! what were we thinking”.
Act-1 : Courage to Start – Resolve to finish
I recall the first time we met with Epic on what the design of the EMR would be – which eventually turned out to be – largest commercial EMR deployment in our nation, involving multi region roll-out, 300 plus go lives, 400 plus environments and thousands of servers, hundreds of thousands of square feet of Data center space – major disruptor but we primed it for the the rest of the industry.
I vividly remember the first go live in Hawaii April 19th 2004 – command center full of anxious nurses, doctors, engineers working together on knurly issues, interfaces throwing errors, and time to cut over running out before the clinic opened to see patients. But we made it on time !!
Fond memories of the day we reached a million electronic email messages through KP Health Connect Online, when we touched a billion encounters in Northern California, the first night when Kraemer Rx went live on Pharmacy Outpatient application, – all have memories tattooed of the team that worked together in making magic happen.
Countless production bridges followed by overnight recoveries, few pounds weight gain, caffeine addiction and tons of friends later – we have built something we are all extremely proud of against the skepticism of so many. It has revolutionized healthcare delivery in the country and is a proud beacon of impossible is possible, just takes longer.
Act-2 Unsung Heroes – Guardians of our technology backbone
The teams may have obscure names (IMG, API, SI, TSS, Services, Data Center, Infra program etc.) but when the earthquake shakes us up, streets flood and the monitors go dark, these unsung heroes prepare us to answer the call and make all of us proud – and our members able to sleep through the calamity.
Can we build the first health care Continuously Available (CA) system; while continuing to deploy KP HealthConnect across 8 regions was the question we were not prepared for when signing up for it. Well imagine now replicating the entire KPHC platform 3 more times – was it back to the 2am calls? Cliche’d but the solution for CA was done on a hotel napkin on a Friday evening. The “discussions” with our physician partners, the ability to break the largest Citrix Farm in the world, and designing a storage system for hyper scale – fun, suspense, tension – great elements of a Bollywood film.
Going live with Cloud on Valentine’s day and giving our developers self-service – well that felt like cupid came to visit our data centers. In 2009 we were the first to bring private cloud into healthcare at the enterprise level. Yes there was much work to be done, but we were already on the first mile while others weren’t even at the starting line.
Act-3: Presence of an absence
Year was 2011.Mobile was fast becoming the new battleground for consumer engagement. It was time for KP to move to the next frontier of member engagement – Digital. I remember the first meeting in Napa, where the concept of the cloud, mobile, analytics and online all became part of the same sentence. Late into the night, time was spent, figuring out, discussing, arguing, and strategizing.
All night code-a-thons became standard practice – seven of them in two years , clickable prototypes, monthly releases : rapid-fire innovation. Without a single app in 2011, today we are at a million downloads, we receive frequent accolades and awards on our digital transformation and our members love it. KP.org continues to drive digital usage, and Interchange, our first API is blossoming.
With a robust digital strategy in place now, we are only poised for success. Digital Health best days are still ahead, and we will once again extend the white space with the rest of the industry.
So many memories and experiences – life wasn’t work but work became life. We pour our heart and soul into it and it becomes something we love and cherish.
This is not a good bye! Ironic but not sure where is the “good” in a good bye. This is about taking a part of you all into my next journey and leaving a part of me behind. I am fortunate to be with people that make writing this letter so dang hard. However, I’m old enough to have had a wonderful career in Health Care, and young enough to be excited about charting a new course on a new coast in a new industry. In the next stage of my professional life, I want to focus on one of my passions – to build enterprise and consumer products in a global context. I will be joining AIG as their CTO for Data, Innovation and Advanced Technology.
I am excited about what’s next but this isn’t the note to talk about that. Now is the time to celebrate the 10 years, the three acts and be thankful for your friendship and support. Now is the also the time to pause and look back at our collective accomplishments and reminisce fondly the road we have traveled together to get here. As I often say marathon running is about a state of mind; a state of mind that says anything is possible.” For me that summarizes the state of mind of Kaiser Permanente – anything is possible.
With humility and awe I am earnestly looking forward to watching you all lead the next wave of health care.
I wish you and your loved ones well. I am forever in debt of you all.
Coordinates : Tweet @madhu_nutakki, Connect at : http://www.linkedin.com/in/madhunutakki/