SINC’s Director of Content Annie Liljegren spoke with Kenneth McGee in October 2021 for this interview, which has been edited for length and clarity.

I recently sat down with Kenneth McGee, Research Fellow at Info-Tech, who’ll be featured at our 2021 Canada IT & Security Leaders Virtual Forum, November 15th-17th, delivering a keynote presentation entitled “The Digital Economy.”

Ken’s notable career includes 29 years as a VP at Gartner, and VP roles at Goldman Sachs and later Salomon Brothers, where he served as VP International Communications Director in London, and VP IT Budget Director in New York.

Great to have you here, Ken. I’d like to start by asking about digitization. It’d be a silly question to say, would this have happened without COVID, but as companies move into that space or embody it more fully, what would digitalization–and specifically, this whole idea of the digital economy–what would that have looked like without the recent acceleration?

Kenneth McGee: We’re going to first establish a digital economy’s definition. And therefore, there’s fodder for disagreement and debate. But having said that, no—COVID did not bring about this idea. Claude Shannon did in 1948, when he wrote the first paper on converting physical atoms to digital bits. So we have to blame Claude. 

Tongue in cheek, of course, but no–it’s been going on for decades. But, we are at this level (indicates gap between thumb and forefinger) of completion so far. It’s been an initiative that’s been undertaken for decades, but we have a long way to go.

There have been recessions, there have been pandemics throughout history. This is the first time that we are coming out of a recession where there is a digital economy, a fundamental change in economic principles, waiting for us. Never happened before.

The last time we came out of a recession we were still doing manufacturing, we were still doing services. This is brand-new stuff.

COVID, and the need to recover from it, and therefore the recession, is accelerating digital transformation. And the way it’s doing that is digitally transforming manual things to electronic things–things performed by humans will now be performed by non-humans. Digital transformation is nothing if not that.

“There have been recessions and pandemics throughout history.

This is the first time where, coming out of a recession, a fundamental change in economic principles is waiting for us…”

When you used that thumb-and-forefinger gesture just now, to indicate we are ‘here’ with digitalization, you obviously meant that as a percentage of a whole.
What is the “whole” you had in mind? Is is the entire hand spread out, is it arms-wide? What’s the ratio of that thumb-and-forefinger gap to full completion?

KM: That’s a very fair question. And let me let me see if I can take it this way, because it’s very, very fair question.
Michael Hammer used to say: A good question is wrong, and you can muddle through. A very good question is one you can actually answer, and a fabulous question is one where you can show a slide.

An economy is is predicated upon some fundamental occupations, activities, task processes and procedures: we have to advertise stuff. The world of advertising is heading towards one trillion dollars of global revenue. It is the only category in commerce that has passed 50% from being manual–from being atoms like newspapers, magazines, etc.—to “digital.”

But when you look at all the wholesale trade, all the resale trade that takes place on Earth, that’s why I held up a small number, un peu, because it is many decades underway since Claude wrote his paper, but we have a long way to go.

Is this a permanent trajectory? Do you see the potential for any sort of backlash or are we committed to full digital, as in, digitalization on and on in that direction?

KM: I certainly don’t see backlash, but there is an element here that’s worth considering: once you go past this line you’re never coming back. You’re never coming back. And therefore you see things like blockchain and disappearing intermediaries.

But here is the point: I do not believe in the merit of the comment that technology is changing all the time. I think that’s rubbish. Products change all the time, and therefore it’s the difference between discoveries and inventions. Inventions change a lot of things, but there are only 107 things on the periodic chart, for example. We don’t keep discovering fundamental elements.

And therefore, there are things that come along that—like on the periodic chart—are so distinctly different they forever change things, and will forever change the future, and from which you will never return. One of them is the telegraph, another is penicillin: fundamentally changing the course of the human species. And we are saying the aspects of the digital economy are similar to that. They are of this ilk. They are ‘realm’ changes that will change humans forever and from which we will never return.

To that idea of an event horizon: Clearly we can see this happening with tangible products, with IoT or whatever else, but at a deeper level, what does the world look like past that point of no return?
You have a deep background in the financial vertical, and now in addition to your work at Info-Tech you’re also an adjunct professor—as we consider that point of no return, what are some tangible ideas of how the world fundamentally looks different–financially, for the educational sector, or maybe in ways of which we’re not even fully cognizant yet?

KM: First of all, Annie, you did your homework–thank you. A couple of things, but I think most profound amongst them is the first time, perhaps in the history of commerce–and that’s at least 7000 recordable years of evidence of humans conducting commerce–the first time in the history of that commerce where transactions can take place in a trusted fashion.

Where once you identify the most verifiable version of the truth–a transaction, for example–and it is locked in blockchain, it can’t be changed…yet. Or can only be changed with evidence. It will be the first time where we have an environment of perhaps unprecedented degrees of trust within transactions. We can’t say that we’ve had that in the past.

It is also the first time in history where we no longer need intermediaries as much. We don’t need literary agents, we don’t need real estate agents, we don’t need attorneys, for example, in order to make smart contracts and such. So the demise of intermediaries, for the first time.
And then the third and final–of many, I would propose–is the ability to have equal status with peers, even though those peers may be banks, even those peers may be people who supply retail matters with wholesale matters, whatever the entire definition of commerce. We can conduct those trades not in a slave/master relationship in terms of computing, but of equal ability because everybody has the same database everywhere—period, end of sentence.
Those are three pretty big ones. But because it’s so nascent in the history of our experience, we just don’t have enough people yet who have fully internalized what the heck that means, certainly.

One of my favorite questions to ask in these interviews: What’s top-of-mind for you right now, as far as either something that you wish was being discussed at all, or something that gets a lot of buzz but you feel the conversation needs to be different, needs to be deeper, needs to take a different approach. What are you thinking about, Ken McGee, that we should all be thinking about?

KM: I’m going to perhaps give an adjacent answer, though I think it’s in the same zip code.
The whole world of commerce in a digital economy has to face one reality, and it’s something that I do not believe anybody in the IT advisory industry are willing to say, and that is the fact that we have had so many profoundly important breaches in cybersecurity.

It is time to call out the cyber security world as a profound, abject, and complete failure, and to arrive at a better solution than having individual companies, individual agencies, and individuals use their limited resources to combat what is very obviously state-sponsored cyber terrorism.

We have to reach a point where we can say: what other example can we cite where so many failures have occurred, on an ongoing basis, and yet we continue to spend money on it?

Keep talking about spending money–you’re wasting your time. Blow it up, and let’s start over.

“It’s time to call out cybersecurity as a profound, abject, and complete failure, and arrive at a better solution than having individuals use limited resources to combat what is, very obviously, state-sponsored cyber terrorism.”

Okay, one response–some might call this a cynical view–but one response to that might be to suppose that, as consumers, we’ve allowed that as an acceptable risk: that we’ve accepted the holes in cyber security, the abject failures, as you put it, as acceptable in exchange for everything that is afforded to us.

So to what degree would that sort of radical change necessarily need to have the consumer involved? Is that going to happen from within industry alone, or does it need to come from from other stakeholders as well?

KM: The answer is that is not going to come from the industry. Secondly, it is not going to come from anywhere more potent than for nations to realize they are already at war, and they are–as in the common adage complaining about generals–they are preparing for the last war. The next war, I don’t yet see it on the radar screen, being formulated and compiled by anybody.

Now if it is, I’m not even sure I would be amongst those who would detect it. But I know this: my daughter works at the White House. She had her name stolen by a foreign government, this was all over the papers, and the fact that they could reach in to this kind of secure domain and have her name, among many thousands of others, from the other side of the planet is so not acceptable that I cannot see the scenario that could accommodate: Well, we have to get used to it.
That is against nature, it is so wrong. And yet we are continuing to use the 1980s and 90s book of how to prepare, and how to protect your data. For the love of God, let me get in my DeLorean.

So, as important as training is, it’s not as simple as to say training is the problem; we’ll just teach people not to click malicious links and be done…

KM: Yes, of course. Of course it is. But to have the Death Star so vulnerable to a little flying machine is not an acceptable option, and nor is it acceptable destination.

The principle is the funding. The principle is not the techniques to prevent attack. The principle is to recognize that we will spend the country’s money to protect our people when a country physically invades our border. But when they do so via ones and zeros, we’re going to be stupid about it and expect everyone else to prepare for that kind of onslaught.

No, it requires funding from the national level, no different than it requires funding when they come across our borders. And any country would feel that way. So let’s not ask companies to be the sole source of funding for security. Let’s take a look at what it is–it is war.

Because, in a digital world, a breach is a border invasion.

Kenneth McGee: And what is the difference? Claude Shannon told us in 1948 what the difference is, and we haven’t caught on yet.

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SINC’s Director of Content Annie Liljegren spoke with Jennifer Jones in September 2021. This interview has been edited for length and clarity.

Our partnership with Info-Tech provides SINC community members with multiple means of access to expert research, including featured speakers at our live and virtual events.

Info-Tech’s Jennifer Jones will deliver a keynote at our Healthcare IT & Security Leaders Virtual Forum. The title of her session: “Building & Communicating Your CIO Strategy Post COVID-19.”

Great to have you, Jennifer. I’ve got your abstract here, and there’s just such a genuine affection for technology. Healthcare was of course a particularly impacted vertical over the past 18 months, so we’re looking forward to hearing what you are seeing. What are you looking forward to about the speech, or just your own take on the virtual forum versus the live forum–are there things made easier by a virtual setting?

Jennifer Jones: There’s a bit of a mediated experience in virtual that is easier from a delivery perspective; when you’re in person it’s much more visceral. Whereas I can mediate it a little bit more through virtual, which is both good and bad—you can’t see the full experience until we do VR, which I’m sure we’ll get into someday! So from the physical landscape perspective, that’s how I’m approaching it.

From the delivery perspective, related to health care and all the different members I work with in the healthcare vertical, it’s been a really tough year, almost two years now. I think at the beginning we may have thought: Okay, it’s a straight line, we’ll go through these phases and it’ll be fine. That’s literally not the case. It’s in waves, so it comes and goes and different challenges have emerged. And people from the healthcare perspective intersect with us, and with me directly, at different phases due to the nature of whatever they’re dealing with day-to-day. My talk in general, will reflect on the sheer amount of those waves.

So what does that look like for healthcare? Obviously there’s been a lot of bonus in terms of advancing things that were on a roadmap before but were sidelined—like virtual health—and have now taken the forefront. But what does that look like from a workflow perspective, what does that look like from a patient care perspective?

What does it look like further on? I meet with a lot of acute care executives, and they say How do I reuse my physical infrastructure?

They don’t have the same amount of people coming in, or people are coming in for different reasons. So I think reflecting on some of those points will be important.

At the beginning we may have thought:
It’s a straight line, we’ll pass through these phases and be fine.
That is not the case…

Right, I understand Info-Tech really focuses on practical application, and one of the elements you’ll be addressing is developing strategies into tactics. What’s the definitional difference between the two terms, as you use them?

Jennifer Jones: Strategy usually has a longer term, so there’s a wider image supported by a mission or vision or some sort of guiding principles. Whereas tactically, you get down to the initiative level or the project level. And those tactics boil up into goals, which roll up into your overarching strategy. That’s how we coach our members on it.

And we’re always coaching our members to have alignment with their organization or their business. We’re always emphasizing getting your business-side stakeholders aware and informed and participating in the IT strategy.

From an Info-Tech perspective, we try to offer very practical research that’s actually oriented around professionals engaging with our research—to have that “do-it-yourself” component.
We do have a consulting arm, but typically my calls aren’t strict consulting: there’s a lot of collaboration between the members that I deal with, and they takeaway a lot of the components of our research and work on it independently.

Healthcare is uniquely suffused with ethical issues, certainly now more than ever. I was speaking recently with Shahidul Mannan (from Mass General Brigham) who made this point about tech and regulation: that it’s not an “us versus them” scenario, it’s about the betterment of human society. That’s a great phrase, and in your own career there’s this definite theme of societal betterment–you’ve worked on behalf of brain injury survivors and homeless youth.
What role can, or should, tech play toward that betterment? I realize that’s almost an existential question…

Jennifer Jones: No, that’s okay—that question goes to the core principle. I’ve always been interested in more of the social side of not only health care, but technology.

There’s forever been this sort of optimism around technology as creating more benefit and more value and more connectivity among people. I think the jury’s still out as to whether that’s been successful or not—the past few years, have been pretty rough on that side of things.

But taking it back to the healthcare lens, things that I find encouraging are more investment and more understanding of the social determinants of health, and how that plays a role in changing institutions and policies: to recognize where we’ve stumbled and to become more inclusive and more aware of of the frameworks we’re dealing with.

Speaking from more of a North American context, obtaining the research documenting social determinants of health and how those impact health delivery is really a society-wide challenge, even an institutional challenge. In my prior work I’ve dealt with organizations that were really using technology as a mediator format to connect people to both health and social services, and to acknowledge the wider impact of society in the delivery of healthcare.

And that’s where I see the macro benefit of healthcare: connecting the social determinants with the delivery.

Patients are often complex and have a variety of mitigating factors that bring them into a doctor’s office, and then they still take those away from their appointment or procedure.

Documenting social determinants of health and how those impact delivery is a society-wide challenge, even an institutional challenge…

What’s top of mind for you as far as something you either wish we were talking about at all, or something that gets plenty of buzz, but you find the focus of the conversation incorrect or insufficient.
What are you thinking about that we all should be thinking about?

Jennifer Jones: This is again a bigger question, but I think we’re putting a lot of stock—and rightly so—into things related to artificial intelligence, in particular machine learning and natural language processing.

So we’re creating these data sets, but back to my earlier point, are they configured taking into account the larger society and context? I don’t necessarily believe from an ethical or even societal standpoint that we’ve got that right yet. There’s a lot of money and emphasis into these big platforms that are going to potentially do wonderful things. But we haven’t yet scoped out society in the right way, and so the output we’re going to get from that can potentially exacerbate some of the disparities we’re already seeing.

So that’s my big concern: whether those at the helm of those wheels fully get the complexity. I think we could be running into some greater issues around entrenching disparities and that makes me a little worried.

Yes, we hear from our executive community that aversion to doing technology for technology’s sake, but instead to have form following function. We’re hearing that and also conversations about the responsibility of industry.
And something like the pandemic really butts those two up against each other, particularly with the acceleration we’ve seen.

Jennifer Jones: 
Exactly, and the other piece I would add to that is there’s been a tremendous amount of advancement around genomic sequencing. And by no means am I a scientist, so take this for what it’s worth, but the evolution of things like CRISPR and some of these other services could really change the way, from an ethical perspective, how people respond to severe chronic illness or neurodegenerative illnesses—how those are treated and what are the ethical questions around that.

Similar to AI, I think you’re going to encounter issues with things like CRISPR and genomic sequencing that we’re not necessarily prepared for. So while I don’t mean to be a bummer, those are my thoughts.

Not at all, it’s an important point and well-articulated. And anyway, so much of what we do at SINC is create opportunities and environments where people can spark and hold that deeper level of conversation.
And that’s what this piece will be used for—to get that conversation going into the Healthcare forum and looking ahead to hearing from Info-Tech at future events. Thank you so much.

Jennifer Jones: Yes, I love that idea. It was a pleasure to talk to you. 

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SINC’s Director of Content Annie Liljegren spoke with Shahidul Mannan in September 2021. This interview has been edited for length and clarity.

Shahidul Mannan is Head of Data Engineering and Innovation, DAO at Mass General Brigham (formerly Partners HealthCare).

Shahidul will be joining us for the upcoming 2021 Healthcare IT Security Leaders Virtual Forum (Oct. 4-6) and will also lead a Roundtable at the Northeast Forum in Washington D.C. (Oct. 3-5).

Thanks for being here today. I’d first like to ask what the last 18 months have been like for you, or if you could walk us through where you’ve been lately. It’s difficult to think of a vertical more blatantly impacted than healthcare.

Shahidul Mannan: Yes, you’ve got that right. So when I came in we started this digitization journey. It’s a huge program—enterprise-wide, hundreds of millions of dollars–to digitize through data and our various telehealth and other platforms. An entirely game-changing plan. We started working on that data analytics part of it, building our cloud-enabled analytics footprint, building our next generation data analytics platform, and I was leading that from strategy to execution. Then suddenly COVID came for all of us, and hit healthcare immediately of course.

And what we did was: we didn’t fully stop our strategic mission and vision. We continued to work on it but slowed down some areas and refocused. Obviously, we wanted to do all the tactically and strategically necessary things for COVID-related digitization and support, including telehealth and various analytics required for our insights into operations and how we can tune it better. But we also aligned some of those areas that ensured we could use our strategic mission to help with COVID immediately—we basically rolled out the larger platform and digitization vision on a small scale for the COVID use cases.

For example, this was the first time we were going live with our real-time analytics. So we could constantly monitor our hospital situation or bed sensors, our supply chain, all of those. We didn’t have the real-time capability before, so with this cloud and new footprint that I’d put there with the new infrastructure, we immediately used it for COVID.

Actually our first use case for real-time analytics on the new platform was to monitor, alert, and project across our system to provide real-time insights into our bed capacity, ICU capacity, ventilator and other supply chain capacities, as well as a whole bunch of other analytics. That was tremendously helpful to managing challenges operationally.

Managing our workforce was a big one too—we constantly monitor our workforce, so the entire gamut of operations is very much data-driven in the corporate space, thanks to marrying that with our strategic vision and work.

Right, so particularly in healthcare there’s this problem with the data being so unstructured, and there’s harvesting or managing it as opposed to actually using it. What did we learn during the crisis that’s going to remain useful as we get back to the everyday—takeaways that will stick for normal times?

Shahidul Mannan: Some of our desired transformation started happening sooner: we wanted to have use some of the new technologies, we wanted to use cloud, we were heading towards a new platform, so all these we started to do, immediately almost, for COVID solutions. And a lot of those.

Then, we were gearing towards becoming more agile in our process, in our project management and order product delivery, from bringing in innovation, design thinking and also becoming more data driven, becoming more innovative in AI and predictive power utilization.

So all those again we started to do quickly because of COVID. We needed to be agile, we needed to face day-to-day challenges and accommodate, so all those adoptions actually came in quickly. The takeaway is that those things we had on strategy, but we quickly learned they work and we’re seeing the benefits. It’s helping us to enhance our mission and our work.

When you spoke at the Global AI/Big Data Virtual Conference in the fall of 2020, you cited some Google data stating the average number of digital interactions per person per day was 600 at that time, and was projected to be close to 5000 by 2025 (about 4800, I believe). What is that going to look like? What does that kind of world look like, but also specifically as pertains to healthcare?

Shahidul Mannan: Oh that’s a great question, and thank you for doing some research on that.
So first of all, it is going to exceed even what was projected then, and especially in healthcare. It’s going to be significant change.

I may not have the exact numbers right now, but our digital health/telehealth utilization has gone through the roof during COVID time. We were in almost the single digits and now we have between 40% to 60% of our patient population who are using telehealth in one way or another.

Some of it also is because of training and other things, low-income groups not having that digital advantage–that’s kind of restricting it. But there’s an exponential curve in the digital interaction level, from telehealth to data to remote monitoring and remote healthcare devices. All of those are kicking in. So you can quickly see that if pre-COVID digital interaction was 2% to 8% for telehealth and now it’s gone to 40 to 60%, and then adding all these other devices across the board, it’s just going through the roof, and that will be the new normal Because people are seeing that benefit and advantage.

Even now post-COVID, everyone’s innovating while keeping that in mind, and us too.

I can tell you in our original roadmap we were thinking of adopting some of these—remote monitoring, IoT-driven data that comes from bedside devices or patients’ wearables—in our year three, for example. But now we are pushing, saying we should probably do that in year two…(laughs). So it has changed the paradigm quite a bit.

“Digital interaction for telehealth was 2 to 8% and now it’s 40 to 60%— it’s just going through the roof, and that will be the new normal.”

Looking at the Roundtables for the Northeast forum, I was told the top two discussions you were interested in leading were as follows: “Business Strategy and the Changing Role of the CIO,” and “On-Prem versus Cloud.”
What excites you about those specific topics?

Shahidul Mannan: Two reasons that stand out: One is that I’m at the intersection of strategy and technology for business. So, when I see how we can influence the business strategy, or align the larger minds running the business with the technological innovations and what’s going on: what the capabilities are, what are the new cutting-edge things that can help enhance that cause—that excites me.

And then, I’m a technologist at heart. So when I see there is a technological focus, a cloud versus on-prem or a specific security in the technology space or maybe in self-service analytics, that also excites me. I kind of navigate both, you know, wearing the technology hat and then enhancing that for business with right strategy and right transformation engagements.

What you’ve just said echoes this question we hear from our executive community: the question of to what degree practical skills translate into leadership skills (or I should say, “technical” rather than practical).
For you, being there at the intersection of those two spaces and still really enjoying the technical side of things: are there specific skills gained on the technical side that directly translate into good leadership?

Shahidul Mannan: That’s a great question, I think. On the technology side, you have to work with the team, you have to lead the team influence people, to get aligned, so that definitely is transferable.

But to relate to your question at the strategic and C-suite leadership level: Where I see the biggest value as a technologist is when we can relate the business world and build that value proposition out of technology. As a technologist, that is the biggest leadership role we can come in with. And then, lead with that, forming and influencing the business strategy.

And it is tremendously valuable, I think, because business, obviously, is focused on business and now the immersion is very evident.  You’ll now hear the JP Morgans of the world calling themselves technology companies; technology is part of business, the immersion will only continue to happen, and so business needs to be better equipped and better integrated.

And I think that is more likely to happen in health care in many ways, because it’s such an enabler–that’s where the technology is. As a leader, we can build and bring those values from the technology hat. The more we can understand the value proposition and align it with a business goal and business strategy, that would be a success for everyone, as a leader and as a company.

I must add that one challenge I sometimes see is that technology should have a purpose, and we have to align it well.  It should always have a purpose to apply in solving some problem or achieving something for business or for our patients or customers. Our mission and goal has to be at the heart of it—not technology for technology itself.

What’s top of mind for you as far as something you wish the industry was talking about at all, or maybe something where there’s a lot of discussion but you don’t feel the conversation is taking the right focus? What are you thinking about that everybody else should be thinking about?

Shahidul Mannan: There are tons of bright minds out there, and everyone is focused on a lot of important things. Such a vast range of things happening in our industries that it’s difficult at times to keep the focus on and prioritize, as you rightly said.

One thing that I think we are realizing, but we’ll need to get our heads together soon enough, is the implication of the intersection of digitization with our personal lives and how we can better manage it. Whether it be privacy, whether it be cyberbullying, whether it be data breaches or ransomware.

We keep doing better and better in our technology, and we will handle it, but it has a social impact, and it has definitely a regulatory impact. Our regulators are looking at today’s technologically-advanced companies to able to understand the problem and target it.

And to be honest, I think sometimes the regulations, even the newer proposed regulations, look like they’re talking about yesterday— they’re talking about 10 years ago.

“How do we regulate without restricting innovation? That is the question we need to answer…”

So how do we regulate without restricting innovation? That is the question we need to answer and for that we need the right focus and to have the right conversation. It’s not ‘us versus them’ or any of that—it’s for the betterment of us as a human society and how technology can participate in that. But I think the discussion hasn’t matured to that level yet.

I was speaking with Les Correia from Estée Lauder last week, and he emphasized the role of moral courage in industry, tech in particular.
Where is it incumbent on industry to make deliberate choices rather than having ‘technology for technology’s sake,’ as you put it? Certainly that that plays a role in health care—ethical choices through and through of how and when and where you apply technology.

Shahidul Mannan: Absolutely. First off, I think we need to always keep that in mind when we build new capabilities. We are always excited about doing newer, greater things: using AI, data, cloud, all the other cutting-edge technology that’s coming in, but we also need to keep a social impact aspect to it. And have that built in into our culture to some extent.

And maybe sometimes it comes through evangelism, or sometimes through a larger consensus across the technology world and technology leaders. These are some of the foundational things we always want to keep in mind, because we all agree that this has social impact—it certainly does.

Now it’s easier said than done, because everyone has their own focus, their own profitability, their own competition and all those together. So if someone else is getting way ahead using consumer information or a certain set of data, and if that means I have to go back or stay behind in the competition, obviously that doesn’t always work. The market has its own forces.

There’s a lot to unpack there, but I think by evangelism and making those norms part of the business model as well—that the work goes to the ones who are more responsible, who are acting and innovating more responsibly—I think that would also encourage that behavior. 

Yes, so many different ways to go with the conversation—we’ll keep this sort of dialogue going at Northeast in D.C. as well as virtually.
Thanks so much for your time.

Shahidul Mannan: No, thank you. I’ve enjoyed the conversation.

Engage with Shahidul and other peers at the Northeast Regional Forum and the Healthcare Leaders Virtual Forum!

Healthcare IT & Security Leaders Virtual Forum, Oct. 4-6

Northeast Regional Forum, Oct. 3-5 in Washington D.C.