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[00:00:00] Today's episode is brought to you by EHC Consulting.

If your team is discussing public cloud options for your EHR, EHC consulting should be on your radar. With decades of epic expertise and proven cloud migration experience, they help health systems confidently plan, execute, and support their move to public cloud. Ask about one of their free guides, like where to host Epic or their Hyperdrive delivery decision matrix at this week.

health.com/ehc.

GMT20250714-172930_Recording: I'm Sarah Richardson, a principal here at this week Health where our mission is healthcare transformation powered by community. Welcome to this executive interview, candid conversations about leading with purpose.

Let's connect.

Sarah Richardson: Welcome to this Week Health. I am Sarah Richardson, and today I'm joined by Mitch Duff, founder and managing member at EHC Consulting with a strong background in healthcare advisory transformation.

And manage services. Mitch and his team help health systems and healthcare organizations navigate, change, manage complexity, [00:01:00] and drive operational excellence from mergers and acquisitions to digital modernization. EHC is often behind the scenes, making the hard work look seamless. Today we're gonna get a closer look at Mitch's approach, the mindset that drives his work and where he sees the most impact ahead.

Mitch, welcome to the show.

Mitch Duff: Thank you very much.

Sarah Richardson: Yes. And for those who are just getting to know EHC Consulting, what's the story behind the firm and what makes your approach to healthcare consulting different?

Mitch Duff: Sure. Thank you for having me. So EHC our roots go back about 10 years when the founders all worked for Virtustream a, a Dell Technologies Company to really build out the first Healthcare cloud company to host Epic outside of customers data centers.

Besides Epic Coasting we were able to grow that organization to be the largest host of Epic, outside of Epic hosting boasting 10 customers and some of the largest customers in the country. And then some of us moved over to Microsoft to help found the epic on Azure Center of Excellence.

Over there we had the ability [00:02:00] to build out the epic business inside of Microsoft, which is really cool. And it really allowed us to focus on where we thought hosting EHRs was gonna go. And that is hosting it in public cloud. And leveraging all the different tools and the platform there to really build that out.

And so a scalability for public cloud with Epic customers is, has gotten larger over the years. We really saw that as a place to, to really focus. And so what we saw was that there was a need for folks who understood how to migrate Epic to the cloud. And so we had a lot of experience in going back to our virtual stream days.

So a lot of us left Microsoft and kind of got the band back together to form EHC consulting a couple of years ago. And ever since we've been helping customers modernize, migrate their Epic platform to the public cloud.

Sarah Richardson: How important is that when you consider getting the band back together, as you call it, the types of people that you curate to really create the opportunities to solve for things in healthcare.

When you did that, the intentionality of being with coworkers that you really appreciate and admire again, how has that element been a game changer for your [00:03:00] approach?

[Mic bleed]

Mitch Duff: You can't discount the experience factor there. The ability and experience doing this projects over and over again over 10 years and the methodology that we've developed.

We still follow basically the same playbook that we developed 10 years ago in terms of how to move Epic without breaking it and making sure your clinicians are none the wiser that it moved. It's, it goes down for the monthly maintenance and comes back up and it's in a completely different location and generally runs faster than it did previously.

So the ability to do that you can't really discount the amount of experience that's required in doing that the lessons learned over the years. And what we try to do is be that trusted partner to help customers move it without breaking it and make it run faster.

Sarah Richardson: I always appreciate from the CIO lens, the camaraderie aspect of a team that's working together because they're invested in each other as much as what they're gonna do for you. So thank you for that perspective. And you've worked across a range of strategic initiatives, m and a operational transformation.

Where are you seeing the greatest urgency or demand right now from your [00:04:00] clients?

Mitch Duff: Yeah, so we see a lot of our customers really putting a focus on digital transformation and modernization and looking to modernize their infrastructure rationalize and standardize their application portfolio.

And whether that's their EHR. Trying to modernize how they deliver their applications getting rid of legacy ways of doing that or modernizing their data platform. We really see a lot of focus on getting their organizations skilled up for cloud, building out cloud platforms and being able to manage and maintain those cloud platforms and really be able to respond fast to what they're being asked to do generally with less resources than they would they were hoping for

to be able to do that. And that's where we see a lot of the benefit of working inside of public cloud is you can use the latest cloud platforms tools and be able to build out or be able to leverage those to respond to what you're being asked to do as a CEO these days.

Sarah Richardson: Mitch, are you seeing any resistance to some of the upskilling requirements from some of the executing existing staff? And I think the other piece I'm [00:05:00] curious about is how you're overcoming some of those hurdles and getting people to want to be in a new environment.

Mitch Duff: Yeah, so, a lot of times we're dealing with the CIOs, the CTOs during our, sales engagements and our advisory engagements.

And so the first couple of meetings folks are really learning what our projects that we're gonna be coming in AND doing. And so we do see some resistance from. From some of the engineers and some of the administrators we really work with them to help understand that this is a benefit to their career moving forward.

That these are really cool tools that we're here to help them. We're not here to replace them. That at the end of the day that generally technologists get really excited once they see the newer ways of doing things. And that this will help them moving forward and that we're not coming in there to replace them.

So it does take a little bit of time to form that bond with them to really to work with them during inside of the projects to show them, to help them understand we're there to teach, we're there to assist, and we're there to enable them. And generally over the course of the, the first month of the projects, we see a lot of the [00:06:00] frosty reception that we saw at the beginning change and really become a fully formed team that works kind of as one unit as opposed to a vendor versus a customer.

Sarah Richardson: When an organization does decide to undertake a change like this and you get through that initial resistance, you're working well with the organization. How long does it take on average for the engagement with you to be complete and then after that initial handoff, like, Hey, everything's live, everything's great, team's happy project's on track, et cetera.

What does that relationship with EHC look like? Post implementation, go live.

Mitch Duff: Yeah, so when we move in an epic platform to cloud, it's generally a long-term engagement, generally 12 to 18 months. And, but over that period of time, obviously there's a lot of the skilling up that happens and a lot of documentation and making sure that the customer's empowered to, and to be able to manage the platform long term if that's what they wanna do.

Once we move out of the implementation into kind of a steady state support node or what we call hypercare. We're generally around for at least a month or two [00:07:00] months or longer, however long the customer wants us to be around to make sure that we're there in case they have any questions. And I'll say there are, the first several customers, if they called us today and they wanted us to come back and even after we've been disengaged from them for months or years, we'd still run back in there and help them out and join calls, or do whatever they wanted us to do to help fix whatever issues or answer any questions, anything like that.

We do try to be very helpful with our customers, even if they call us out of the blue.

Sarah Richardson: And you work with a technologist, you're in the rooms where a lot of these decisions are being made with the ones who are keeping the lights on in some cases.

But then you also have to work directly with executive and board level stakeholders. What currently, Mitch, is the tone of those conversations now, and are we still talking recovery and stabilization in some spaces, or are we back to organizations making big, bold moves?

Mitch Duff: Yeah. A lot of what we see with customers are the conversations are still around things like ransomware and cyber events and how to protect against those.

How do I protect my EHR from ransomware [00:08:00] attack? How do I make the most secure environment that I have? So it is still a lot around security and sort of resiliency conversations that we have, but they are looking to the future to try to put position them to be able to make bold moves in the future.

There is some of those conversations where they do want to make big plays into things like data and ai and modernizing the, their platforms for those,

Sarah Richardson: so they may reach out to you to move to the cloud, and yet there's so many more elements of what can be brought into the equation. What are some of the other endeavors that are created from working with your team?

Mitch Duff: Besides just moving your EHR to cloud, we're also working with customers to modernize their data platform build out data platforms in the cloud, as well as modernize non EHR applications and migrate those. We're also working with several customers who are trying to reinvent how they deliver those applications in the cloud, which is very important when you have legacy contracts that you don't necessarily want to keep signing.

Sarah Richardson: And that's not uncommon. I mean, there's things that, especially when you're making moves like this, there's the [00:09:00] contracts you didn't know about, the ahas, the gotchas, et cetera. When those things are popping up or it's like the Jack in the Box moment where you're like, eh, we didn't really expect that. What are some of the superpowers that you and your team enact to be able to overcome the unexpected?

Mitch Duff: So generally we've seen most of the things that can pop up during these things over our years of experience. So there isn't too much that surprises us these days. The cloud is ever changing. So there's always the chance that there's something new that pops up. So we do have quite a number of just experiences in the toolbox that we can go back and leverage to help them out.

Some of it is, bringing in additional staff for different skill sets that we didn't initially intend to need to bring into or didn't plan for. We can always do that. Or kind of going the extra mile, bringing them along for the ride and helping them understand what needs to happen in terms of fixing those or overcoming

[Mic bleed]

Sarah Richardson: I always call that, that you can't make it up moments, and you want that partner who's like, oh yeah, we've seen that before, and you're like, good, because I have no idea what just happened, and we really need your [00:10:00] help in solving that. I have to believe too, an element of what y'all bring to the table is simplification of some of those legacy environments, and so I'm curious if you can share.

An example of that where this just big hairy beast of a project is now something that the team, because let's be honest, we inherit some of these environments that the new world order when you're done is something that is pretty understandable across the continuum.

Mitch Duff: Yeah. So, during the early stages of any of our engagements, we do discovery and design and really look for the skeletons in the closet potentially that a customer might have in their environment, and really try to simplify the environment as much as possible, or in many cases, bring it to best practices.

'cause that there might have been out of alignment with those, there might be extra databases, extra environments that are floating around that don't need to be necessary anymore. So a lot of what we do. Is during that design phase is really come and simplify the environment to the greatest extent possible.

Put things like costs around certain aspects of the environment that you might not have a cost [00:11:00] on-prem to, to run, but that, everything has a cost in cloud that we wanna make sure and surface to customers. So, simplifying the environment, making sure that it's fully documented. We have a roadmap for the project in terms of architecture, diagrams and everything before we make a move, before we build anything with the customer and make sure everybody has a common.

Framework for what we're gonna spend the next 12 or 18 months working on is very important to make sure that the project is successful and that we have a common understanding of what we're about to engage in.

Sarah Richardson: Because nobody actually likes to do the documentation. Really super grateful when your partner delivers it to you and can help you keep it updated, mandated, all the different aspects that are coming into play, so love hearing that.

I also have to ask you, what's the strategic capability you believe health systems should be investing in now to stay resilient over the next few years?

Mitch Duff: Yeah. And for me it comes back to a lot of those cloud skills and the ability to react fast using cloud technologies because that's where everything's being built.

That's where everybody's investing in. So, over the next three to five years, [00:12:00] CEOs are gonna be looking for new capabilities, new functionality that they'll be looking into CIOs to, to develop for the organization. So being able to react fast to those. So a lot of it is being able to build cloud environments, to de develop in the cloud to be able to use new technologies like generative AI to to leverage that for patient outcomes, for clinician satisfaction, for billing reimbursements, all of those different things.

Sarah Richardson: There's been so much conversation recently about, Hey, we went to the cloud. Now we're pulling back OnPrem, or we're gonna do multi, or we're gonna do hybrid, et cetera. When you go into initial conversation with a potential client, how do you help them understand what their true and best options are from that perspective?

Mitch Duff: Sure. Yeah. So, so cloud is really, it's a methodology, it's a mindset, it's a way of looking at things, against a certain features and functionalities that, if you can get those, whether it's on-prem or hybrid cloud or in public cloud. Those are all different places.

You can get the same sets of tools and so you want to try to match the right application and [00:13:00] workload with the right hosting location, with the right tools to get the most value out of it. So there are some things, some applications that might run better in a hybrid cloud setting. If you can leverage the right capabilities and tools against it rather than in, in public cloud.

I generally, most of the applications that I've seen healthcare customers run just lend themselves towards public cloud just because that's where the best tools are. But operationally speaking, cloud is from an operational perspective, a lot of different, tools and mindsets that you can apply to hybrid cloud.

If you're mature enough.

Sarah Richardson: I appreciate you take the time to understand where the client is and then the right dynamic and the architecture to make the best choices for them. Are you ready for speed round? Sure. Okay. What is a healthcare trend you are watching closely right now?

Mitch Duff: I think like everybody else I'm watching AI to figure out how it's gonna revolutionize healthcare.

I don't think we've scratched the surface into what AI is gonna be capable of and leveraging against to, to create better health outcomes [00:14:00] is something that I'm watching pretty carefully.

Sarah Richardson: What's your favorite use for AI today?

Mitch Duff: finding and diagnosing things faster than clinicians in some instances is really interesting, and with sometimes greater accuracy is something that I think is, something that I'm gonna continue to watch and see where that evolves to.

Sarah Richardson: Same those moments like, well, I read it on the internet, or, well, AI told me the validation factor still exists and people go out there and make sure we're using the right information for the right reasons. And my last question for you, what is a leadership principle that you endeavor to live by every day?

Mitch Duff: Yeah. So, the leaders that I've enjoyed working with over my career are the ones that really take a, an interest in you and mentor you and teach you. And so that's something that I try to do with all the folks that work with us is really invest in them and look at this not as just a transactional employment, but actually mentor and help them learn and, develop their career.

So that, that's just something that I try to focus on with the, with all the folks that work with us.

Sarah Richardson: Actually, I do have one more question. [00:15:00] Based on what you shared is that AI is scary for a lot of technologists. They're not so much words, it's gonna take their job, but it changes the way that they do their work.

How are you implementing those conversations with your team?

Mitch Duff: I look at AI as just a way to do more faster and that, like anything else in, in technology, it's something we have to learn how to use effectively. But it will change the way we work and as long as we change with it I don't personally think that it's very scary.

Sarah Richardson: I agree. It's the whole like change curve and impact on the human aspect of what we're doing. And to your point, can we do certain things faster and better? But we've been hearing better, faster, cheaper for probably all of our careers. And this is just one more element that might allow us to do some of that at scale.

So thank you so much for joining us today. It's been great to hear your perspectives. And for those who want to learn more about your work at EHC Consulting, where should they go? To really get a deeper dive into your product.

Mitch Duff: Sure. So, our LinkedIn page is a great place. [00:16:00] We try to post a lot of thought leadership out there.

Though we have a blog on our website, EHC Consulting, that we also update frequently with where we're going and what we're working on and kind of things that we're thinking about as a company where we think healthcare it should go.

Sarah Richardson: And thank you for being a partner.

We look forward to seeing you and the team at an event soon. And for those of you who have tuned in today, thank you for doing so. That's all for now.

GMT20250714-172930_Recording: Thanks for joining this executive interview on Flourish with Sarah Richardson here at this week. Health. We believe every healthcare leader needs a community to learn from and lean on. Join us at this week, health.com/subscribe. Share this conversation with an emerging leader. That's all for now.