HIT Like a Girl - Tjasa Zajc Transcription

Joy Rios:  Hey there, and welcome to the HIT Like a Girl podcast, where we're dedicated to amplifying the career journey, accomplishments and lessons learned of women everywhere.

I'm your host, Joy Rios

Robin Roberts:  and your other hosts, robin Roberts. During the day together, we run a health IT consultancy known as Chirpy Bird Inc, where we get to geek out on all things, healthcare technology, and policy. But along the way, Joy notice that so many women were running organizations, but too few were leading are being recognized.

So we decided to change that.

Joy Rios: We're learning about the puzzle that is healthcare and sharing what we find with you - our listeners!

Robin Roberts:  You can expect us to be talking with some pretty badass women. We will even be exploring how the pandemic is impacting many of their professional lives this season.

Joy Rios: We've also formed a private community of both guests and listeners over on Slack to help make connections. Offer support to one another and share the resources we come across. If you want to join us, check out our website @hitlikeagirlpod.com forward slash community. This week's community shout outs goes to Alana, Stephanie and Marissa, and this week's high five goes out to Ashley.

Who's a huge supporter of women in health it in general, but definitely have the HIT Like a Girl community. So high five Ashley.

Robin Roberts:  All right, enough already. There are too many awesome women to talk with. Let's get started.

Joy Rios: This week, we're sharing our conversation with Tjasa Zajc our first international based guest.

She's a former journalist, podcast, and digital health evangelist based out of Slovenia. We learned a lot about blockchain and about how healthcare around the world is tackling COVID. All right. Let's get started!

Tjasa, thank you very much for joining us today. We like to kind of present to all of our guests and listeners, how complicated healthcare is. We often remark about how it's like a thousand or 4,000 piece puzzle, and it's kind of impossible for any of us to be an expert in everything. So this is our way of. Learning about each of the individual pieces and trying to find ways that they fit together.

So can you please take a moment to introduce yourself and let us know a little bit about your piece of the healthcare puzzle?

Tjasa Zajc: First of all, thanks a lot for having me on the show. I really, I love that you are putting the focus on women because there's a lot of great entrepreneurs and leaders, very inspiring to hear their stories. So about me, I'm actually a journalist by background. I studied journalism and then while I was already working as a journalist. When I was studying my editor suggested that I should specialize for something; I decided that I will do a master's in healthcare management and economics, because I've been a chronic patient since I was 14 years old. And I thought, well, you know, if I'm in the healthcare system on a regular basis, anyway, I might as well try to understand it a little bit better.

So I did that and I also went on a student exchange in friends to learn more about different systems around the world. And then I started working as a medical journalist for a Slovenian medical journal, which was a thing that the doctors and pharmacists. So we mostly talked with doctors to learn more about the new clinical guidelines and novelties in therapy is how is just the progress of medicine happening, and also what are the health challenges that the healthcare professionals are faced with. And after doing that for four years, I started thinking that while I really like how, as a generalist, you can get a really broad perspective of healthcare.

You are still in a way scratching the surface. So I really wanted to dig more into a specific problem. And I was asked to join a digital health startup that was working on a blockchain and we had this big idea of how to solve interoperability and the issue of patients being let out of the equation in monetization of their data - and I did that for a year. So after that I joined the company that I'm currently working at, which is Better. It's a company that, in short, is also designing solutions using an open EHR standard, which in essence means that the data is structured and vendor neutral. And I'm a part of the team that's working on a medication management system for hospitals.

So that's kind of the professional story that I have behind me, but I think one very important part of it is also the fact that while I was still working as a journalist, I started a podcast that was around digital health. So my aim was to connect to different medical journals from Europe, which were owned by the organization that was publishing the magazine. And when I left that company, I felt that I still want to continue this work. This kind of helped me stay in journalism a little bit more and allow me to research digital health. That's not the very short story, but that's the introduction that I can give you.

Robin Roberts: I love your story because in our professional lives, we are health IT nerds like that is what we do. That is where we keep out those in the technology and policy space. And we always love talking to fellow podcasters, but you have to help some of our listeners understand for our, mostly here in the US - talk to us, maybe about some of the biggest realizations or things you've covered. How they vary between countries or between nations, because you just pointed out a great one, even  at Better Care IT, if anyone wants to look, which are the open data standards, or even an EHR, I mean, that's a huge one because here in the U S when we talk about data, everybody wants it shared.

But most of the vendors are saying mine, mine, mine. They don't want to share with anyone have discussions.

Tjasa Zajc: I recently had an interview where an executive from Canada said that she feels that vendors should work more with vendors because everybody is designing this one point solutions. And then you have the user in the middle who needs to learn to use 100 systems that are potentially not connected to each other, so it's terrible. And that her thought really stuck with me because I really started thinking that while everybody believes that interoperability is something that needs to happen, it needs to be encouraged more. It seems like at least to me, a lot of times that vendors are patient-centric until they have to be patient-centric, you know?  To work more together and faster together.

Obviously not everything is grim as it may sound. So for example, the NHS, which is one of the markets that are, uh, medication management system is present in a NHS is doing a lot on interoperability and to increase the connectivity and data and quite recently, Our team won a hackathon where they show that it's possible by using standards to connect basically the GP system, the EPS system that allows doctors send prescriptions to pharmacies directly, which is really, really, really helpful for the patient and for the doctors in the hospitals when they're prescribing medications. So medication, reconciliation, where you would clear it know what the patient is taking and what not, because data is just scattered. There's supplements that people are taking. People might know how their people, how their pills look like, but won't remember the names, so it's an actually a long process to do that.

But just to go back to the differences in healthcare systems, I really am just fascinated by the complexity of the US healthcare system. And that'spartially because our systems; Slovenia is very centralized. One thing that is important to emphasize is that Syria is a very small country. We have 2 million people and that's not something that should not be taken into account when assessing how successful a country is in interoperability.

So for example, Estonia is also a small country. So I wouldn't say that's not an important factor contributing to why they are so successful in their healthcare digitization.It's really unfair to compare, let's say Estonia to acute countries such as US, but to go back to Slovenia for a second, we actually have quite a few things available in terms of digitization.

So for years, we've had an interoperable backbone. So now basically if I go to a specialist, the discharge letter is going to end in that backbone. So at any time I can just use the internet and all the safety measurements for safe login and check which prescriptions I currently have in the pharmacy - what are the diagnoses that I have, what medications I'm taking and all the doctors in theory can also see that. So that's quite something that I take for granted. It has obviously been developed over time, but I see that it's not something that. It's self-evident in many other countries. for example, Germany is a country that especially European countries are looking very closely  at the moment because the latest healthcare minister in spawn, who became the minister in 2018, he managed to shift the development from the political perspective. I think a lot of times, as you've also seen with Obamacare, the big issue, when it comes to, how can you improve healthcare? The big issue is the political real to do so - it's just, it's so difficult. And then you, as a politician, you can't really force healthcare providers to work differently, or if you do decide to do that somehow, you're definitely not going to be looked at nicely. [inaudible] actually managed to make it possible that since last year that a law was passed, that now enables doctors to prescribe apps and they need to be reimbursed by any healthcare statutory health insurance company. CNBC actually did quite a few nice videos about some European systems.

For example, in Germany, you've got 100 statutory health insurances, but the health insurance is mandatory. So in a way you are on the safe side of not being afraid that you're going to be bankrupt by the healthcare costs. And at the same time, you have the choice to choose which healthcare provider you're going to go to. And so, for instance, Linea, for example, it's completely different because we just have one insurance, main insurance company for a mandatory health insurance. It's not a perfect system for it - none of the systems are - but it basically covers enough that you don't have to worry about copays for medications or copays for any medical procedure. It's quote unquote free healthcare.

It's amazing for me to see how unfortunate a lot of people are in the U S with lack of insurance or just having an insurance. Being under-insured - I could like go on for hours actually.

Robin Roberts:  And I will say, when you say you're perplexed by the U S health system, I think that makes three of us.

Joy Rios: Well, it's nice to hear and to talk with somebody who has a perspective like you do, because you're able to clearly see how different countries are working and what is working and what isn't.

And I can imagine from anybody who's got, you know, the quote unquote free health insurance and their countries looking in on the U S system has got to just be completely mind-boggling of like a turn-your-head-upside down. Like, wait, how does it work again?

Tjasa Zajc: Yeah, I always say that I have a huge love, hate-relationship with the US.

 So in 2016 and my boyfriend and I, we went to the US to hike the continental divide. So the trail that goes from the Mexico border to the Canadian border, and that took, so he did the whole trail, the whole 5,000 kilometers, which took him half a year. And I did three and a half months and 3,500 kilometers. Obviously, you are in the wilderness for a long periods of time, but in the meantime, you also meet local people and you meet local people from very small places. And I loved meeting other hikers - I love the optimism that the American culture has. That attitude that you can actually be whatever you want to be and that no matter what you do, it's never too late to reinvent yourself. So that's just really, really, really inspiring.

But then as someone who is working in healthcare and is researching healthcare, I think is just, heartbreaking to see how the system is structured and with the intermediaries and with organized so many organizations that have a say in how the healthcare is structured. That also means that there's a lot of opportunities for startups that are solving small problems.

So, to me, it seems that the system is so, broken. It's so broken that you can think of tons of solutions that are actually going to solve a real problem, but the higher problem.

 The other problem on how it is structured is not being addressed really, because that has to be addressed through the political means and changing the whole health care structure.

It's really, really, really difficult, not just in US, but anywhere because systems get designed through years and years and are influenced by culture. And the fact that freedom is one of the main values in the US, I can't understand why you can't force people to agreed to a mandatory health insurance.

Joy Rios: I think we're all experiencing the unintended consequences of that perspective - of the freedom aspect of the ability to do whatever you want, but then realizing that the system is working almost precisely as it was designed and doesn't necessarily have the best results for the many.

And that's something that we experienced and are experiencing more and more through this time of COVID in particular.

Tjasa Zajc: One thing that I thought was really interesting in this whole story was when I recently heard that, when you're hospitalized, when someone has to sign forms and consents to treatment, there's also consent to payment.

Did you get to sign, but you actually don't necessarily need to sign it and there's restrictions on how much you can be charged if you don't sign that. So that was one thing that I thought was really interesting about useful information for the healthcare consumers in the US.

Robin Roberts: How does journalism come into play with everything that you're doing now, not just with the podcast and talking about these things and then the opening HR, how does that come into your everyday life?

Tjasa Zajc: If I talk like in a professional sense, as in working in healthcare IT, I think it's hugely beneficial because if you are a journalist, you are usually - at least this is why I went into journalism - curious about people. Curious about how they think, how they work, why problems occur, what are the solutions where do improvements or where the challenges arise and what are the barriers to a better world to just put it very broadly.

Going from that perspective into healthcare, it where it's just so important that you understand the users when designing solutions, that you are interested in what they need, and don't just create solutions based on your assumptions.

I think it's hugely beneficial to have these skills. One issue is that every specialty has its own jargon. So for example, healthcare IT people speak in their specific language; medical doctors have their jargon. So I think sociologists or just the soft sciences can be very, very useful in how creative, especially since it's very clear that when it comes to digital transformation, the reasons are rarely technical.

They are more often connected to cultural change, so if you want to lead an understand cultural change and not be frustrated by it, it's useful to have this kind of more humanistic understanding of how people work. So I just, I'm constantly fascinated by the hurdles that occur in healthcare.

And what are the  reasons that things don't happen quicker than  they do. For example, if I just mentioned how much it takes to put a medication management system in a hospital, it's the process that lasts from seven to nine months. If you manage to do that in such a timeframe, you're extremely successful -  so it usually takes a lot longer. And the reason is that first of all, in healthcare, everything is happening fast. Everything has to happen now. It's a stressful environment and it's difficult to find time to teach people how to use an ID solution. And no matter how much it might help them. Secondly, A lot of healthcare IT and unfortunately it's very, very poorly designed so bad user experience is obviously going to hinder adoption of solutions.

It's this kind of issues that I think are really important when you're trying to address solutions and also your own expectations as to how fast you can get something to the market and to adoption.

I also often think that there are things that we can hear, but don't understand until we work with them. So one such thing is leadership or being patient-centric or being user-friendly, but like leadership for example, is something that people hear a lot about, but to actually become a leader and to drive change is a completely different game.

It's difficult to learn and having specific communication skills, having specific understanding helps. T hat's kind of where I think the social part of knowledge can, can be very, very helpful.

Joy Rios: I love all that. It sounds like you have so much experience what, and you've dabbled into so many different areas and your perspective is clearly very comprehensive.

How are you spending your day to day now? What is it that you're working on in this moment to be part of healthIT and health care industry?

Tjasa Zajc: When COVID began and we, when we went to a lockdown, that was in March here.The lock down lasted for two months and then basically we managed to get the numbers of COVID cases down so much that we've basically been working more or less normally since the end of may. Yes. So we are going in the office, we are trying to work as normally as possible, obviously virtually with our clients across the world. But apart from that, it's very close to business as usual.

 So the way I'm spending my days is basically working further on medical management. And I have a small son - he's 16 months old - so that's something that I spent a lot of time dealing with. So yeah, that's kind of it - and obviously the podcast, which I'm doing and trying to research the world further.

 I recently did a series about digital health in South America, because it's one of the rare continents that I haven't been to yet. So I was really curious to learn more about that. I've got four episodes about that coming up.

Robin Roberts:  I just want to remark on what Joy said, which is just the depth and expansion of knowledge. You really seem to have a thirst for learning about all the things you're covering - especially I think just the position of them across the globe and how people are doing things differently in different places.

Joy Rios:  I don't think we've talked about it much on the podcast, but for any listeners who are unaware, we do have a hit like a girl pod Slack community that you are more than welcome to join. So we've been trying to build it up and really just find ways that we can support each other.

So thank you for being part of it, it means a lot.

I have one last question for you, and that's really something that we ask all of our guests, and I'm really curious to know what your answer is because we want to know based on your place and the perspective that you have, which I'm very impressed with all of your knowledge that we've learned about you just to date, if you had a magical wish, based on the problems that you see, the healthcare that we face, what problem would you solve?

If you could snap your fingers or wave a magic wand or take all the barriers solving that problem away.

Tjasa Zajc: My wish is actually truly something that could only be solved with a magic wand. So that is for fake news and misinformation to stop existing because I think that's hindering the health care systems and the health care providers so much we've got the doctors on the front lines that are dealing with COVID patients.

And on top of that, They have to deal with COVID patients that don't believe COVID Israel. They've got patients that think that they're trying just to make money out of them, by saying that they have a COVID diagnosis. We are now in the middle of the whole world, trying to figure out who is going to create a vaccine and are we finally going to get to a better new normal that we so crave for?

And then you've got this huge anti-vax movement that makes you wonder that are all the millions and billions that are going into vaccine development, even going to help. So if that would be solvable, I would be incredibly happy.

Robin Roberts:  The mal-alignmentI think of human perspective against science, I guess it's personal belief, but a very real public threat is if that could all be reconciled and obsoleted or solved, I think that would not just solve COVID it would solve a lot of problems. I like to think there's a simple solution out there that if someone couldn't be vaccinated for medical reasons or chose not to that, we could just do a much better job with this than we're already doing.

And so it's definitely challenging and I feel bad for the people that are the face of science and the face of healthcare that are trying to push forward and do better and educate people while real harm is being done to patients, their families and their loved ones. It is a very challenging time, so I could not agree with your wish more. And I think that's a very important one.

Tjasa Zajc: Not a new problem, you know? When we look at the developed countries, it's the fact that a lot of misinformation comes from social media. It's really difficult to imagine what kind of solution could solve that and unfortunately people believe those kinds of conspiracy theories.

Joy Rios: Yeah, it's unfortunate. And we're seeing a lot of like public health officials who have been lifetime dedicated to their work starting to drop out just because they've received so much backlash around this. It's really disheartening.

Tjasa Zajc:   Yeah. It's terrible. I saw a report about that and everything.

On the positive side - so we don't end up in such a grim tone - I do think there's a lot of positive things that are happening in healthcare. It's fascinating to see how technologies are improving it. I totally am a fan of seeing how natural language processing in combination with voice. Technologies is going to make the lives of healthcare professionals, doctors easier, while at the same time, bringing in better structured data, that's going to enable better analysis and a faster improvements in healthcare.

 So there's still a lot to be optimistic about.

Robin Roberts:  Yeah. It almost becomes an amplifier of their time and them as a resource, not just to keep practicing at the top of their license, but just to really be able to hone in and focus on patients when those tools are well-designed and working for them.

I share your excitement about that because I think the systems and physicians that will be able to leverage that anywhere in any country will just really optimize healthcare, which I truly believe is between a physician and a patient at the end of the day, to allow them to do what they do best, which is take care of people.

So the Tjasa, if people would like to work with you, they want to connect with you, they want to learn more about what you're doing - tell us, tell everyone what is the name of the podcast? What are your Twitter handles? How can they get in touch?

Tjasa Zajc: The easiest way is through LinkedIn. Where they can find me under my name. It's not a common name that you will get the thousands of kinds through it.

The name of the podcast that I do is Faces of Digital Health. And you can go to www.facesofdigitalhealth.com to browse through other episodes - I also always prepare recaps of the show so it's easier to read through something - if you're interested in listening.

And my Twitter handle is @ZAJCTJASA

Robin Roberts: Well, thank you very much. And as I see it looks like you're coming up on your hundredth episode. There is a lot of good stuff out there, some very technical things, but even about spreading information in healthcare and medicine on Tik Tok.

So I feel like if you are a health IT nerd - you like geeking out on this stuff where you're part of the community, you just want to learn more, that your podcast is a great resource to do that with. So. Thank you so much for joining us today!

Thanks for having me. I loved chatting with you and I'm sure we'll continue the discussion in your community.

Joy Rios: Absolutely. Thank you so much!