Episode 20: Shaking Things Up with Future Strategist Zayna Khayat

Episode 20 with Zayna Khayat, Future Strategist, SE Health

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According to Zayna Khayat, SE Health’s (formerly Saint Elizabeth Health Care) Future Strategist, the slow pace of change in our healthcare system has nothing to do with a shortage of tools and technology. For innovation to happen, our leaders and policy makers need a shift in mindset.

Today, your host Ellen Gardner, Communications and Marketing at HIROC, speaks with Zayna Khayat, Future Strategist at SE Health.

Her story is not unlike many first generation Canadians. Zayna’s parents, who emigrated from Lebanon in the early 70s, instilled the values of hard work, humility and authenticity. From an early age, Zayna knew she wanted to tackle the big challenges in the world and after a stint in consulting, has been focussed on solving as she says, “the wicked problems in healthcare”. As a speaker, university instructor, innovation sherpa, and for the past two years, future strategist at SE Health, Zayna is the spark that gets people thinking differently. She consistently asks the tough questions and engages in ‘real talk’ that challenges the status quo. 

The experience of getting close to patients through her work with SE Health has convinced Zayna that we’re on the brink of a perfect cocktail of change and what is coming in healthcare is nothing like we’ve seen before.


Zayna Khayat: I hate the word innovation. Other words I'm so exhausted of, transformation, breakthrough, radical disruption. Sometimes, literally I'll get a thing that says you're invited to the radical transformative disruption innovation conference that's patient-centred. Oh, my goodness. I've been using the words future-proofing, reinventing, and even just modernizing. I mean, people can relate to modernizing.

Ellen Gardner: That's future strategist Zayna Khayat. In the healthcare space today, Zayna needs almost no introduction. She somehow manages to be everywhere at once from keynoting conferences, speaking at town halls, to talking about the future with healthcare leaders. Zayna is a force. I'm Ellen Gardner, and today my producer, Philip De Souza, and I sit down with Zayna to hear about the future-proofing of healthcare and where she gets her inspiration. We could not have asked for a better interview as we step into the new year, and the start of a new decade.

Imagine, you could step inside the minds of Canada's healthcare leaders, glimpse their greatest fears, strongest drivers, and what makes them tick. Welcome to Healthcare Change Makers, a podcast where we talk to those leaders about the joys and challenges of driving change in our complex and demanding healthcare organizations. 

Ellen: So at an early age you decided that you wanted to tackle the big challenges in the world, and you ended up in healthcare. What was it that drew you as you say “to the wicked problems on steroids”? What was it that motivated you to try and tackle those problems?

Zayna: I'd say at an early age in hindsight I didn't know that at the time. I just think if I look back at the kinds of things I was attracted to since I was a child that would get my attention it tends to be this pattern so I'd probably say where it formalized was my first real job. I did graduate school after undergrad so I never really had to have a real job until finishing grad school. My first real job was at this firm called BCG, or Boston Consulting Group, where they train you how to think about really complex problems in a structured way. 

Then I just migrated from complex problems, which at the end of the day you can solve them. You just need some brains and horsepower to what I call wicked problems, which are these intractable problems that you can't solve until you start solving them. That's when I gravitated to healthcare and its messiness. I was reflecting that when I was at BCG I helped build our climate change and sustainability practice so helping big organizations around the world plan for this world I was drawn to that. At one point I had to decide do I go the climate change route, or do I go to healthcare, which was much more comfortable because my doctorate was in cell biology. So it shows I just love solving messy problems that are important to society, and that's how I ended up where I am.

Ellen: When you were at BCG, because I know BCG is a very well-respected big company, it sounds like you were in there very young and tackling some big complex problems – did  you learn a lot from that experience of working in that kind of difficult and complex environment?

Zayna: Working at that firm was the game changer for not just my career, but I'd say my life. To get put in that environment where you're learning not just methods to unpack and solve really, really complex problems, but you learn communication, you learn relationships, you learn time management. I got my wizard skills of PowerPoint and Excel. You get it all very quickly in a condensed time. If that didn't happen, if I didn't get that job, I don't even know what I'd be doing right now to be honest.

Ellen: What were some lessons that you learned from your parents, Zayna?

Zayna: So just some context on my parents. I'm probably a typical Canadian. Parents are from Lebanon, immigrated in the early '70s when Pierre Trudeau, the father of our current prime minister, opened up immigration. My mother has maybe a grade five education. She married very young. My father has no education. He was a mechanic. So just the Canadian story, right? Coming here with really nothing, couldn't speak the language, and struggling to lay down their roots. I'm the product of that generation like many. If I reflect on it, I wouldn't have had it any other way. 

Things like absolutely hard work, but never complaining that's just how life is from my dad. And I'd say my mom as a homemaker – selflessness, absolutely, and then that leads to humility. I think part of why I've been able to tread my path and my career is I'm from a town, Windsor, Ontario, where we’ve got an edge in our town, right? Nobody thinks they're better than anybody in that town, and when you're a child of immigrants you really don't. That kind of humility and kind of authenticity I think is really important when you're trying to solve really hard problems that matter to the world because there's just no ego, no power. Just put your head down and get it done, and a lot of real talk. I find that authentic for me. People tell me that they find it refreshing, and a bit easy to kind of get on with things.

Ellen: How does a person develop confidence in their vision, or confidence in the fact that I'm a little bit different, or I'm going to follow my own path?

Zayna: People won't believe it, but I was this shy, quiet immigrant girl, right? Even grade nine, and grade 10, and even grade 11, if I look back I was off the grid, really shy, and then just randomly out of nowhere I remember I just decided to run for student council, which I had never joined before. I ran to be the president of my high school. Who does that? But I just did. I don't know. And then I never looked back in terms of interpersonal speaking, motivating, having energy, my whole personality exploded after that. I don't know that I could have gone that path if I grew up where there's a lot more competition for power.

Ellen: You've had some impressive positions around the world. I'm thinking about working at Radboud University in the Netherlands. Your title there was Innovation Sherpa. At that time you developed a healthcare innovation school also in the Netherlands, and now at Rotman you are teaching healthcare innovation. So I'm thinking about the process, how do you train people to think innovatively?

Zayna: I literally just left a working session at the Ministry of Health today where that was, we all end up retreating to that question. At the end of the day, and I say this every time I'm asked the reason we are stuck in terms of not having an experience of healthcare in the healthcare system that matches anybody's needs, wants, or expectations at the level that they need, want and expect whether you're a patient, a caregiver, or a clinician, or anybody – it’s all mindset. Yes, there are 1,000 other barriers, but the first one is mindset and how you think. 

That was really what my mission was when I got recruited to the Netherlands to build this health innovation school, and that was for the entire health system of 17 million people. It was not around the craft of doing innovation, like how do you take a problem? How do you design? No, you can learn that online, you don't need Zayna. It was about mindsets. 

It was a mindset-changing school, and to have everybody in the system in the room for that course. This was not, oh, here are the doctors, go teach them. We had patients, we had nurses, we had tech companies, administrators, government, insurer, I mean, you name it, big companies, little. So, that’s where I focus.

What’s that about? Well, at the end of the day this stuff it can be learned, too. You just need to practice some muscles to learn how to think in these new ways. Integrative thinking, exponential thinking, a bit of this kind of blue ocean. You don't get a lot of practice doing that in healthcare. If anything, systems have been designed to obliterate that thinking, so it's just not easy to let it come out. That's what I try to focus on in all of my, what I call capacity-building work, whether that's the course I teach at the university or the talks I give. I give a lot of keynotes and speeches. When people tell me you blew my mind it means something changed in their brain. That's my job. That's what it means to do innovative thinking.

Ellen: How does that apply then to healthcare leaders? How can they tap into that thinking in a more regular way?

Zayna: Yes, I'd say they can and they are, right? If I look at what I'm seeing, everybody has trained themselves as leaders and enabled their workforce to shift their mindsets, so it is happening. If leaders know that they need to be thinking differently a lot are taking it upon themselves. Others are just being around people who think this way and it does rub off by osmosis, and then others take it the whole next level. 

For example, at the Rotman Business School we just started the first ever Global Healthcare MBA. Remember, Rotman's positioning as a business school to differentiate it is about integrative thinking. How do they breathe and train the next generation of management leaders to think integratively, not linearly and top-down? Anyway, so this one's a global one. We have 30 or 35 learners from around the world and we take them to Singapore and to London, UK, so you can go that next level and really learn how to work and think this way through Rotman, through Singularity University, and other things, so there are lots of ways to participate.

Ellen: It's exiting when you think about it that what you say, it's like a mind explosion. Suddenly people start to see things in a completely different way. For some people that process is probably a flip of the switch, and for other people it's just a slow process they need time to come around. For some organizations, how can they get that push to move ahead because what you're talking about is we need to grab this and get going?

Zayna: Yeah, so great question. I'd say, again, what I've seen from a lot of the health organizations that we've been working with, or that call me in is a couple ways. One is everybody has mechanisms they have of convening their people – retreats, leadership days, Town Halls. What I'm seeing more and more is, they're calling me to come and open that thing up with 40 minutes to really set a tone. What a keynote does is sets the key for whatever is happening with the orchestra next. 

I've been finding that's been very effective because I'm an outsider, I'm a weirdo. Most of the time it's been hospitals calling me because that’s where most of the resources are in healthcare. I'm not of them. They'll kind of accept these freaky ideas. So that's the starting point. I just did one this week in Ottawa where they had a Town Hall to kick off kind of a future visioning exercise, and I was brought in to shake things up.

The other way is more decentralized. I think you need both, but I love the bottom-up where it's a unit, or a department, or a team, or a project that have found like-minded people, and they're just going to work their way irrespective of where the rest of the organization is, and that's what my team is a little bit here. That’s how it really happens because you're applying the magic to something real in your world, not sitting there didactically listening to a keynote speaker.

Ellen: Is there an example of one that you've seen where it's been exciting to see it take hold?

Zayna: I see them every day. A great one I admire is UHN, University Health Network, one of the big academic medical centres here. I don't know where the decision was made, if it was push or pull, but to really liberate patient data. So anybody who touches that hospital has unrestricted access to every record that was written about them during their encounter through these things we call patient portals. I've gotten to know the team that's making that happen. In my opinion, the people on that team, their way of working, their energy, their slides, the way they're on Twitter, I mean, it just feels like a very different personality, and then you start to attract the same to that team, right? So those are the kinds of things I think are a good way to get at this stuff a bit more bottom-up, and then, hopefully, the two, top-down and bottom-up meet each other at some point.

Ellen: Your title at Saint Elizabeth is Future Strategist which means, as you say, hanging out with the future. What do you think about the pace of change in the Canadian healthcare system right now?

Zayna: Well, I guess looking backwards it's been frustrating. On the one hand you could say there's been a lot of change, but really at the end of the day it doesn't feel like it for anybody. I think part of why I've been recruited into this role, and let's be clear that this is going to be the next role that every health organization has, is this idea of future-proofing, which is the forward-looking rate of change coming is nothing like we've seen before. Humans cannot conceptualize that because we project forward what's been our backward experience. That's human nature, and if your backward experience has been what I call glacial pace then you can't even imagine it going any faster. 

We really are in a different time because this kind of digital is coming to our sector, and we're kind of the last sector. Even construction has emerged to be a digital-first business that happens to have physical capital and labour.

We are not yet a digital first operating model, but it's coming, and it's going to come fierce and fast. You layer on that patient, consumer and caregiver expectations are changing on an exponential curve, and we're out of money like, my God, you have a perfect cocktail of change, so that's what I do. I'm frustrated, but not really, I understand it. 

In my job I don't predict the future. I'm not a futurist. I'm a future strategist which means my job is to keep an eye on the future. What are signals? What are the examples? What are the positive deviants? And then my team's job is to translate those into the actions we're taking right now. That's a very different approach to let's call it innovation – where most of where Canadian healthcare is today: building an innovation team, looking at their strategies, and evolving their current model to the future. We're starting with where the world's going and then working backwards. 

Ellen: Where do you draw your inspiration from?

Zayna: One is first and foremost, I do a lot of reading. I'm constantly mining and sensing and looking and observing. I listen to podcasts all the time. When I'm at a conference I engage in a very different way. I'm not there to consume content because I know the content. I'm looking for signs of different ways of thinking, or different behaviors, or the cool way people present a slide, or cool facilitation methodologies. I'm constantly collecting and refreshing my methods. So that's my ground level inspiration. And then there are the raw materials we get from being in the field. We're with patients, we're with caregivers. I'm with my staff, and that's where I get my inspiration because I can directly connect the dots between the experiences they're having, or lack thereof, what's going on in the world, and how my team is going to try to fill that gap.

Ellen: Yes, because you had said that one of the reasons why you joined Saint Elizabeth was because you wanted to work for an organization that was delivering care to patients. What are you learning from seeing how patients and families interact with the healthcare system, and how does that trigger things in your mind that you think, oh, this could be a new important innovation?

Zayna: Look, I mean, my whole career after my first job at BCG – if I look back, from 2001 until 2018, my working career has been as an intermediary, consultant, academic, agency, always the middle person between the supply of innovation, and it's adoption at scale. So when you're doing that you have a very sterile academic, pretty conceptual framework, very logical view of why this isn't working, and how it can work. Then you get in the real world, and, wow, is that sobering. I think it's just brought a ton of reality, and it takes away the rosy glasses of, oh, this tech can do this, and this can do that. At the end of the day, what has never changed in healthcare is people just want to be cared for. 

It eliminates a ton of noise, whereas, when I was an outsider looking in I would have thought, oh, Saint Elizabeth should this, Saint Elizabeth should do that. Now I'm like, no, we don't need to do that. We just need to do that, so it's great, right? It just keeps us very real. What I love about home care and I just tweeted about this yesterday, is it's a raw, native environment. We are guests into people's homes. It's their lives, and we're a little drop in their life. And it might go up and down the drop, but that's very different from when you're asking them to come to your turf, your clinic, your hospital, your rules, your processes, your ways of working. We're guests in your world, and the world of healthcare is moving to be people-driven. It's been a blessing and an honour to be immersed in that environment, let alone with the largest agency in this space in Canada with I think we do 20,000 care exchanges a day. It's a pretty fun laboratory to be working in.

Ellen: What is Saint Elizabeth Health doing right now to help seniors live their best lives at home?

Zayna: Our society is aging, and we need to be on top of and ahead of what this population needs, wants and expects, so we're recasting. Practically what that means is I'd say there's kind of three big areas we're working in redefining the future. One is the whole experience of home care, the way it's done today. We've got three or four ways we're kind of turning it on its head and testing with new models, and evaluating, and then hopefully scaling. 

The second is a lot of amazing new partnerships with hospitals kind of pre-acute and post-acute. So before you ever show up, and then when you leave getting you out of there faster, continuing the hospital care into the home setting is what I call home-spital. 

We have this thing in Ontario called ALC (alternative level of care) – a lot of largely aging adults are occupying a hospital bed who don't need a hospital, but they have nowhere else to go to get the support. So we have a bunch of projects now to literally be handholding, bring them home, and re-activating them at home. All these kinds of transitions let's call them is the second big area. 

The third area we've just started to work on is housing, affordable housing – that’s healthcare built for seniors. That's a bit new, we're just starting to get into that space now as well.

Ellen: Our whole society has moved towards digital, and yet healthcare is one of the few holdouts where most of our interactions are still face-to-face. What is it going to take, Zayna, for healthcare to adjust its thinking to the digital world? And should we be going in that direction?

Zayna: It's not that one is better. It's that we should be matching the ways we communicate in every other part of our life with the tools we already know how to use every day – text, email, phone, and now Skype, and voice. But instead we're saying, no, it doesn't count other than if you're in person and the same time and place, and the only tools that count are the ones we decided because we encoded them in law called the fax machine, the pager, CD-ROMs, written prescriptions, that's what I'm frustrated by. And I actually think bad care is happening when we decide that the only thing that counts is an in-person visit. That's what I'm trying to kind of beat into people, and that's not just with doctor visits, that's home care, too.

The only thing that counts in government-funded home care is when the nurse, or the OT, or the PSW crosses your door front. And I'm sorry, that's important, but that's not the only thing. Why can't they text you when you're worried at two o'clock in the morning that something's going wrong? That's what I'm trying to get. Again, the problem with this is it's already like that all over the world. Are mammals different in Canada? I don't know. I think we're turning a corner, and the beauty of these tools is the business case is a slam dunk. You're not adding anything that's going to add cost. You're actually going to free up a ton of capacity in the system, so that if you do have freed up clinician time they can focus on the patients who really need the in person, and not have to use a visit for something that could have been done in a text.

Ellen: Do patients have to demand more?

Zayna: One hundred per cent, that's my number one advice. I think the tipping point for Canadian healthcare to modernize and find these efficiencies we're going to get from just taking the friction out of all the communication that happens. All healthcare is is communication – when everyday Canadian citizens demand more that drives choices about resources, or policies, or whatever, and we're not enraged yet. There's a patient revolution happening in the rest of the world I'd say. We're not there yet. We're there in pockets. I think children's health has been amazing, children's mental health in particular. Some palliative are very activated. Some cancer maybe, but that's not the fair share.

Ellen: I wanted to ask you who you have your eyes on now in terms of the future and the trendsetters that we should be watching?

Zayna: In terms of what do I have my eyes on, what signals, what trends, I'd probably put them into three buckets. So the first is topics, hot topics that are just a different way to frame and think. The future of aging is a big one. Shameless plug right now. We just wrote a book we've been working on it for a year called The Future of Aging. It's a pretty definitive bible of all of what we've been learning. 

The second is Hospital at home like I mentioned before – all of this shift out of institutions and into the home and community in terms of business models and care models. 

The third is democratization of access particularly to primary care. So really opening up how people can access our front door to healthcare which is primary care, and then all of the innovation around primary care that's reinvention. Then a couple of technology areas that are pretty hot. Of course, artificial intelligence. Voice as the next interface for all of us in everything in our digital lives not just in healthcare. Voice is the next evolution, so we'll be emancipated from screens and keyboards. 

The last couple of topics: nurse innovation, we call this EntrepreNurse. We say it's just a spelling error of the word entrepreneurs. Big movement. We're hosting an international conference on nurse innovation in May of next year, or April on the 200th birthday of the first EntrepreNurse, Florence Nightingale. We're part of an international movement that we actually launched at the United Nations on nurse innovation. 2020 is the Year of the Nurse of the UN. 

And then finally autonomous transport. I think this is going to be a game changer in healthcare. I think 70% of the activity in healthcare is logistics, moving people, moving bodies, moving supplies, and autonomous transport whether that's drones, or vehicles, I think is going to be a game changer. So that's topics. I'll go faster for the others. 

The next of what I keep my eye on are just certain organizations: Amazon, Walmart, Apple, Google, Uber and Lyft – they will be the top medical transportation companies in the world. BestBuy is becoming a healthcare company. Internationally, more younger up and coming organizations like Buurtzorg in the Netherlands, a reinvention of home care. CareMore Health in the U.S., kind of a social determinants meets primary care meets seniors care in the home. Ping An Good Doctor in China, we’ve all got to keep our eye on. I think they're amazing democratizing access to medical care. Babylon Health out of the UK – they’re just come to Canada so a digital first triage for primary care. 

Seqster, they're actually doing what everybody dreams of – collecting and connecting all the data about you in a very accessible way without costing billions of dollars and taking 25 years to build. They did it in a year. Then locally where I get inspiration are organizations like AlayaCare, modernizing home care. Think Research, kind of big AI data company. Dot Health and then Women's College Hospital. 

I've got a big list of people that I follow, but I won't list them. If you follow my Twitter I have a list called Health Innovation Gurus, so you can go there and you can find my favorite peeps.

Ellen: You do a lot of speaking engagements and there's a lot of buzz right now about healthcare innovation. I'm wondering what's one question that you get asked that does surprise you?

Zayna: I don't know about surprise. I've never been surprised, but I actually just did a comment about this yesterday that pretty much the same seven questions get asked every time. I'm just a little bit exhausted of them because they're at a level of discourse that to me is not where we should be talking. I can't remember off the top of my head, but it's something like what about privacy? Okay, nothing that I just said in my keynote says, oh, we're going to throw privacy out the door, but that gets implied that that's what I said. Of course, you do privacy by design. My metaphor is, if you were building a new curling iron the plug you use for the curling iron has to match CSA standards, so it's a given. Now there's bigger questions about privacy because of the way who holds your data, but that's not what I get asked. That's one. 

The other is around whose going to pay? I'm like what does that mean? It comes from a place of who’s going to pay for digital tools? Well, that's the wrong question. To me, if you're using a digital tool, asking that question is like asking who is going to pay for the telephone line when your doctor office calls you? Well, that's just what they're doing because it's the right way to communicate. That's the wrong question. It's what outcomes are we getting, and what combination of people, technology, hardware, software are you combining to hit the results you want – that's what matters, and I pay for that, so who’s going to pay? Other ones I won't get into the details.

When we enter digital we're going to dehumanize healthcare more. No, we're not. The whole point is we're dehumanizing it today because we're having people with heart, passion and soul and a lot of training spend about 40% of their time on administrative things that could be done by a machine. Or we have a one-size-fits-all model, whether it's an 80-year-old with seven diseases, or Zayna with a kid with a sore throat – that 80-year-old and my kid get the same access to a doctor at the same time with the same amount of time and that's wrong. My message is, no, we're going to increase the humanity of healthcare with this. We're not going to decrease. 

Also, I don't like the way I do a lot of my talks. The traditional way is, Zayna, give a 60-minutes keynote, and then we'll have two minutes for questions. I'm like, nah, we should be flipping that. Let's have a structure and then let's have a structured dialogue, and every now and then I might bring in content. I'd like to see playing around with that. One format I've been dreaming to do is – I forget what it's called, but you don't preset the panel, like how many panels am I on where they've done four phone calls. He will say this, and then you will answer this, and then they will say this, and you will talk for 46 seconds – what the hell is it? So the other version is pick a topic, get a couple of people on the stage, and keep two chairs free, and anyone from the audience can kind of come in and out. There's no moderator and it's not controlled. Have a good conversation. I'm excited about innovation and how we do thought leadership.

Ellen: In the healthcare world there is a built-in resistance to big change.

Zayna: Yeah, sameness is comfortable.

Ellen: Yes, doing things differently like the idea of having a panel with two empty chairs calling people up. So what is your advice, Zayna, on how to guide people and convince them there are different ways of doing things?

Zayna: I don't like to blame and say they're resistant to change. I think there's comfort with what you know. Everybody loves to say that we’re risk-averse in healthcare. No, we're not risk-averse. We're risk-intolerant. We don't try to manage risk. We actually try to exclude risk at the end of the day. There was a great quote at the Children's Healthcare Conference this week from Alika Lafontaine, the doctor, I think, in Alberta, right? That the system we have is the sum of the maximum risk that everybody would tolerate, and that's why we have what we have. 

The point is, I don't really see it that way. I think sometimes you just got to throw it out there in a fresh way, and show an example. I'm going to give you one example just happened today. 

I got invited and selected to be on this council and they call it the Innovation Council for a group for a system. I got there and I looked at the mandate and I was like, respectfully this isn't innovation what you've asked us to do. You're using that word, but it doesn't match the task, so I said let's rebrand this group. It's not going to happen. They looked at me like, ha-ha, but I said it, and you know what? That's already impactful. I'm just going to give one more example. I did a workshop with a big hospital that brought me in for half a day – I did my keynote in a workshop because they're about to build a brand new hospital, and that's a 20-year process. The second you submit your plans for this hospital it's already obsolete. That's crazy in my opinion. Anyway, they brought me in to open their thinking, so that when they design this new hospital it's designed for the future. In the end they literally concluded we have no business building this hospital. What? 

That would have upset a lot of people. Upset, but in the way that they were like, wow, we never had time and space to have a real conversation because we're doing what everybody else does – just get the foundation, go raise money, work your politics. So that's very courageous and I love it, so I don't pooh-pooh the way people think. I'm inspired everywhere I go by how people try to shake things up. I really feel we're at a tipping point, and I'm going to give credit to you – a podcast like this is a great way to get these ideas out that I think is way more powerful than reading yet another report that says the exact same thing.

Ellen: It's time for the Healthcare Change Makers lightning round. We're going ask for a series of comments, so tell us the first thing that pops into your mind. First thing you do in the morning?

Zayna: Turn on CBC Radio One, and then check Twitter.

Ellen: Last thing before you go to bed?

Zayna: Check Twitter.

Ellen: One book on your nightstand?

Zayna: Oh, man, I just bought one, but I can't remember the name. I saw it in the airport, but I've got Harari's Homo Deus, and New Power by Henry Timms. Yeah, that's a rocking book.

Ellen: Your go-to mobile app?

Zayna: I mean, for work Twitter. For life, I don't know. Well, a bunch of them, Instagram.

Ellen: One problem you'd solve if you were going to launch a start-up tomorrow?

Zayna: Oh, I like that question. You know, I don't think there's any real problems left that somebody doesn't have a solution for. When I think of start-up I don't think of a tech company. I'm thinking the problem left to solve is actually a systematic way to efficiently adopt all the amazing solutions at scale. That's the unfinished business.

Ellen: We know this word gets used a lot, especially, in your life, innovation. Maybe we're a bit tired of it. So what is another word for innovation?

Zayna: I hate the word innovation. Other words I'm so exhausted of: transformation, breakthrough, radical disruption. Sometimes literally I'll get a thing that says you're invited to the radical transformative disruption innovation conference that's patient centred. Oh, my goodness. I've been using the words future-proofing, reinventing, and even just modernizing. I mean, people can relate to modernizing.

Ellen: You spend your days looking into the future. I'm going to ask you what keeps you grounded in the present?

Zayna: Honestly, it's our clients every day, and our nurses, and our other staff – their needs, why they wake up every day and do what they do that keeps me grounded because I know what we're doing is the right work.

Ellen: Thank you, Zayna, for a fascinating conversation. It was a pleasure to talk to you.

Zayna: Myself as well. Thanks so much.

Thank you for listening. You can hear more of our interview on our website HIROC.com. Follow us on Twitter @HIROCGROUP, or email us at communications@HIROC.com. Healthcare Change Makers is recorded by Ellen Gardner and Philip De Souza, and produced by Podfly Productions for HIROC.com. Please rate us on iTunes.