Cadmore media player playing video Digital Education Gets an Upgrade
Video Player
Accessibility
Using forms mode, you can utilize keyboard shortcuts to make usability more efficient.
Space bar will play and pause the video. Pressing escape will close all displays and pressing it again will jump to the end of the player.
You can press A to open the Keyboard Shortcut Dialog which also provides an audio description of the player and all of its features.
Language
1x
Play Speed
Adjust Volume
Transcript
Search
Result Count
of
Click to jump to result
Search
Re-center
Segments
Result Count
of
Click to jump to result
Search
Name:
Digital Education Gets an Upgrade
Description:
Digital Education Gets an Upgrade
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/2f82f5b9-428b-4afa-b100-0a27dd55e74e/videoscrubberimages/Scrubber_3750.jpg
Duration:
T01H05M14S
Embed URL:
https://stream.cadmore.media/player/2f82f5b9-428b-4afa-b100-0a27dd55e74e
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/2f82f5b9-428b-4afa-b100-0a27dd55e74e/Platform Strategies 2018 - Digital Education Gets an Upgrade.mp4?sv=2019-02-02&sr=c&sig=9w1pL%2Fmo%2B9VI8G2l32dC9bKilpBTdoPtLUZqKShgQiE%3D&st=2024-11-23T13%3A00%3A27Z&se=2024-11-23T15%3A05%3A27Z&sp=r
Upload Date:
2020-11-18T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
PAIGE WOODEN: Michael Clarke and I met over 15 years ago. We were prodigies. This was an elementary school project, of course, when I was implementing AAP's Pediatrics Journal peer review system. And it was a really wonderful experience for me, because it was at a point when there weren't a lot of people who were moving online. They were a little afraid of it. They were taking baby steps.
PAIGE WOODEN: But Michael had been with UCP before, and he had done a lot with online and developed some of the first online publications, so it was really interesting for me to work with him and to learn from him. So since then, Michael has served as the executive vice president of product and market development at Silverchair, and he still is with us on the board of directors, where he continues to influence.
PAIGE WOODEN: He has also been at AMA, where he was the director of marketing and product development and the director of international business. And he is the co-founder of Clarke and Esposito, which is a management consulting firm focusing on strategic issues related to professional and scholarly publishing. So please join me in welcoming Michael Clarke. [APPLAUSE]
MICHAEL CLARKE: Thank you, Paige. So today, we're going to just talk about education. And just to give you just a very brief background about myself and where I'm coming from, I'm a partner in a boutique consulting firm. We're based here in DC, though we have staff and in New York, and Philadelphia, and Boston as well. We work largely with professional associations as well as universities and other organizations that are working with professional scholar information in some way.
MICHAEL CLARKE: And what kind of provoked this session is really thinking about maturing revenue streams. And we heard a little bit-- Alison at Duke, I don't know if she's still here. She talked a little bit about peak subscription yesterday, which is a term I love. And certainly we're many associations, many organizations and publishers are experiencing some form of maturing revenue stream around journals, these subscription journals.
MICHAEL CLARKE: Open access is a different story, and as well as some maturing revenue streams about around books. And so a lot of organizations are starting to think about diversification of revenue, and other places to look, and kind of thinking about all the various different things that associations do. And this is a frame that we at our firm use a lot to kind of think about markets and different approaches to the markets along sort of a horizontal and vertical axis.
MICHAEL CLARKE: And the horizontal axis is really about economies of scale around one or two product lines. So a lot of the large publishers will do thousands of journals, tens of thousands of books, and get very efficient at doing that. And other organizations, of which professional associations are exemplars, focus in a single topic area or a set of topic areas and try to do a lot of different things for the communities.
MICHAEL CLARKE: And so we're going to focus a little bit. We're going to focus entirely, actually, on this last area here, which is the education. And our speakers today are going to come at this from some different directions. We have Mike Mutka, who is CEO at Straightaway Health Careers and Chief Innovation Officer at Relias. And Mike used to be at Silverchair in a division called Silverchair Learning, which was sold.
MICHAEL CLARKE: And he still sort of heads up what was the division into a new company. And we have Anna Troise, who is a Chief Education Officer at the American Academy of Orthopaedic Surgeons, after a career in many other places, most recently Wolters Kluwer. And Paul G., also at the WK alum, correct? Yeah, he's currently VP digital product management and development at American Medical Association.
MICHAEL CLARKE: And so going back to this access a little bit, Mike is going to talk about education from kind of a horizontalist perspective at his organization. And Paul is going to be talking about the AMA strategy, which is a vertical strategy, but it's a little bit broader than, say, the AAOS strategy, which was in a specialty. So we're going to get some different dimensions of an education strategy from different organizations, both in a for-profit and not-for-profit context.
MICHAEL CLARKE: So moving along, we'll start with Mike. Let's see if we can find your slides here. No. I'm not sure where the slides are.
MICHAEL CLARKE: We didn't cover this in the other area. There we are. There we go. [COUGHS] There we go. Right.
MIKE MUTKA: Thank you. We have slides, always a good start. All right, so I'm with Bertelsmann Education Group, part of Bertelsmann Company, a 180-year-old privately-held German company, 20 billion a year, very global. Bertelsmann has three pillars to their business. There is media, and that's the sexy pillar. That's Penguin Random House Books, and BMG Music, and RTL Broadcasting.
MIKE MUTKA: And they're always having parties with Beyonce, and signing parties with the Obamas, and all that kind of stuff. So they're the really sexy, cool pillar. There's a services group. It's a really dull pillar. We not going to talk about that one. [LAUGHTER] And several years ago, Bertelsmann decided they needed to develop a third pillar to their business.
MIKE MUTKA: And they wanted to develop something for the next few decades, and they decided to focus on education. So in 2015, Bertelsmann Education Group was formed. Bertelsmann has made about $2 billion worth of strategic acquisitions. They acquired a company called Udacity, that created kind of the nano degree, the online technology certificates that are paired with companies and employers with guaranteed jobs, basically, if you complete the curriculum.
MIKE MUTKA: They acquired Alliant University in California, which is a bricks and mortar and online university. Hot Chalk, which focuses on developing online degree programs turnkey for smaller, more regional nonprofits, and then the two companies I'm involved with, Relias, which was formerly Silverchair and then Straightaway. And so I came about, as Michael said, in 2005, this guy Thain Kerner came to me and said, if you take this really small salary with these questionable stock options, you can be employee number five in this little company called Silverchair Learning Systems.
MIKE MUTKA: And I'm really still not sure what-- I think he spiked my drink or something. [LAUGHTER] But he got me to do it, and I really do thank God he did. It was the best thing that ever could have happened, because it was a terrific ride. I became president of Silverchair. We took it in 2012, sold it to Vista Equity Partners. Two more years, turned around and got a permanent home with Bertelsmann, and it became Relias.
MIKE MUTKA: I've been chief strategy officer at Relias, and we've gone through 12 acquisitions consolidating our education business. I am now Chief Innovation Officer, CIO. I believe that most of the team calls me COI, Chief Organizational Irritant. [LAUGHTER] They have not copped to that, but that's what I'm pretty sure is going on when I'm not around.
MIKE MUTKA: One of the things about Bertelsmann is if you have less than two jobs, you're not doing it right. So about two years ago, they asked me to start up another company called Straightaway. And so I'm involved in two companies, Relias, online learning programs for health care organizations. And Straightaway provides an online training program to allow skilled nursing facilities to train their own CNAs, Certified Nurse Assistants, which is a high turnover, high demand job there.
MIKE MUTKA: And it gives them, basically, the ability to strategically take control of their own supply of the workforce rather than subject to the whims of the market. Overall, our strategy across all of the businesses is start first by focusing on the organizations. Identify big, big pain points they have in business processes. Create a scalable SaaS solution that can address that business process more efficiently than they've been doing it manually in the past.
MIKE MUTKA: Focus on getting really good ARR through longer-term contract commitments from our clients, and high retention, very high touch support. Many of our clients have been lower-tech in the past. Very, very user-friendly, scaled-down, super simple interfaces that can be used by a nurse who breaks out in hives if you say "spreadsheet," and make it very, very easy for them to use.
MIKE MUTKA: With that ARR that we generate from these relationships and we reinvest in a product differentiation strategy, try to stay out in front of the market and make everybody play catch-up with us, and that's worked very well. Relias will, by the end of this year, we recently last week announced the acquisition of a company called OnCourse, which was in that health care. It will make Relias the largest health care online education company in the world, which still boggles my mind a little bit.
MIKE MUTKA: So that was all really, really cool. And then what happened, what we have happened to us was from 2005 to 2012 at Relias, we were able to really focus on a simple origin problem. Low-tech health care providers had mandatory training they had to deliver for their employees in high volume, and they needed to make sure nobody slipped through the cracks, or they would get clobbered, sued, fined, whatever.
MIKE MUTKA: That solution worked really well for us from 2005 to about 2012. Those were halcyon days. It was nice. Life was much simpler. And then life intervened, and the world changed and dragged us kicking and screaming with it. And really, what had happened was health care reform, which had been brewing since perspective payment in the '80s, and HMOs, and everything, just kept continuing to percolate with more and more pressure.
MIKE MUTKA: And Obamacare really kind of brought it all to a head. Obamacare was the thing-- you know, we've been kind of mud wrestling with health care reform for a long time here. But with Obamacare, that created the need for costs reason to shift from paying based on activity to paying for accomplishment. And don't ask me to pay for all of these other tests or things based on how much activity you did.
MIKE MUTKA: This is the outcome I want, and I'll pay you for this outcome. And that kind of rocked the world. That shift in payment meant that health care organizations now had to get much better at analyzing their results, assessing their people's skills and ranks relative to those results, and creating learning that drove meaningful behavior change in a way that would impact those metrics. So from our standpoint, different from sharing information on mandatory regulatory training to, how do we help facilitate change management in organizations with the big problems that they're trying to solve?
MIKE MUTKA: And so we started to hear a lot of executives in the industry saying, we know our employees need to think, behave, act differently than they have before. They need new skills. We just aren't really sure what those are, but we know we need them. Help us. And so we began to work on that.
MIKE MUTKA: And what it really kind of did was it surfaced a misalignment that existed between education and-- [LAUGHTER] Yeah. So I'm not sure. I'll leave it to each of you in your individual mind to decide which one is education and which one's employers. But the disconnect that's long brewed between education suppliers of graduates and employers, the consumers, it's long been there.
MIKE MUTKA: But it's now really, really starting to come to a head, and it's no longer tenable. And the workforce is changing at the same time, so we don't have time for new programs and things that take decades to bring people through. We need to figure out, how do we reskill our workforce for what's needed right now? The real challenge is organizations need people that can reinvent health care, but the people don't always have the skills needed to do the job.
MIKE MUTKA: So I'm trying to pass the potatoes. Remember, my forearms are just as useless as yours, so they've got a problem here. They don't have the skills to do this job. So, for example, in the future, is the best way to select doctors by choosing the folks that have the highest MCAT score that were able to do the best on organic chemistry, and anatomy, and physiology? Or what about doctors that have creativity, empathy, listening skills, team building skills, the ability to think systematically about how to create a better environment for the patient?
MIKE MUTKA: Jefferson University in Philadelphia, I was just there talking to their CEO last week. They purchased Philadelphia College of Design and have merged it with their medical school. And they're adding courses on creativity, and design, and systemic thinking into their med school program, because they need doctors that think much differently than they did before.
MIKE MUTKA: So same thing-- nurses with the NCLEX or masters, are those the best nurses versus some of these other skills? Creativity, teamwork, empathy, systematic thinking becoming more and more important. So we've tried to shift. So we've gone from what we were, post-acute mandatory regulatory training in North America, just online training. We're serving the whole health care continuum now. We're global.
MIKE MUTKA: We're trying to focus beyond mandatory regulatory on, what are the big problems you're dealing with, and how can we help you with your performance improvement with measurable behavior change, personalized learning? So that's created some interesting challenges. When I was doing the M&A work, I started going out and saying, well, how do we know what things to help? Our clients are saying, we know our people need different skills.
MIKE MUTKA: We know they need to be able to do things differently. We just don't know what it is. How do we help them figure that out? So I started approaching some analytics companies saying, we'd like to buy you. So it's really fun to sit down the first time with the CEO of an analytics company and start talking about why you, an online learning company, would like to buy them, and watch the look of confusion.
MIKE MUTKA: I think most of them took the meeting just because they were curious what the heck I was talking about. But after about 10 minutes, the light bulb went on. And they would say, you know, our clients keep telling us you've done a great job pointing to what the insights are, but the now what, you're not helping us. How do we merge that together? And they'd get it.
MIKE MUTKA: So we bought two analytics companies, we bought an assessment company, and we've redefined our business. And now, the focus of our business at Relias is analytics tools for us to help identify the key metrics where an organization's underperforming, assessments where we can then go in and assess the skills of the individuals in the underperforming area, and then being able to share data amongst them so as a team they can improve, and then provide learning interventions that help them get better, with the idea of focusing, again, on the big problems.
MIKE MUTKA: So an example of this is C-section birth rates, OK? Anyone want to guess what the birth rate is for C-sections in what percentage of births in the US happen to be a C-section? 33%. What does the World Health Organization say is the likely necessary birth rate of a C-section? 20%. We are at 33%.
MIKE MUTKA: In hospitals in the US, that ranges from 7% to 70%. That is what we call irrational variation. Some of that is medically necessary. Some of that is not medically. How do we drive that down? By providing data, assessing people, doing changing behavior. We drove that from 33% to 23% down. By the way, people say, well, C-sections, that's because we have better health care.
MIKE MUTKA: We're 47th in the world in infant mortality, so that doesn't really wash. So this is an example of a problem where we can help give an organization the tools to try to create that change. On the Straightaway side with our career program, the big thing we're doing is the student is the product, not the course. I don't care how many courses I sell.
MIKE MUTKA: That's irrelevant. What I'm selling is a well-trained CNA that will stay for more than a year. That's what I'm trying to sell. So I need to sell more than just the content, because what happens is a lot of people become CNAs. They don't really have a good idea of what's going to happen when they get to the job. So kind of like this guy.
MIKE MUTKA: Hahaha, biff. Guess what? After we go to the drugstore and the post office, I'm going to vet's to get tutored. So Biff doesn't really understand what's going to happen at the vet. That's what happens with a lot of CNAs. They get on the job. They don't really have the skills.
MIKE MUTKA: They didn't really understand what they were getting into. They have what's called a hell no moment. Oh, hell no. I don't want to do this job. And so what we're trying to do there is try to prevent that, because the problem we have is employers and the staff get frustrated. Both of them are kind of going, how are we going to get there? The employees want to get a job.
MIKE MUTKA: They're willing to invest in training that gives them job prospects, but they don't want to incur a bunch of debt and then have no job prospects. The employers are willing to pay and invest in training, but they want employees that are really ready, that they don't have to reteach when they get them there. And so what we've focused on in the case of Straightaway is looking at three drivers of turnover. One is inaccurate expectations coming into the job.
MIKE MUTKA: One is the traditional training doesn't prepare the folks correctly for the emotional aspects of the job that cause turnover, dealing with death and dying, things like that. And in the first 90 days, they don't get support. So if you look at this, the real challenge for us, educational content is really just one part of the picture. It's a much more holistic, systemic thing. We're helping them with recruiting and expectation standing up front, different kind of training and support in the first 90 days.
MIKE MUTKA: So those are kind of the two ways that we're approaching this a little bit differently. We hope in both cases that we give our employees the ability to go attack their jobs, conquer the problems that they're dealing with. [APPLAUSE] [COUGH]
ANNA TROISE: I'm pretty short, so-- hi, everybody. So I'm Anna Trois. I'm the chief education strategist for the American Academy of Orthopaedic Surgeons. The AAOS is a mission-driven organization. We have about 30,000 members. We're predominantly US-based. And we have been going through a massive amount of change. So this presentation is going to be completely different than the one that you just heard, and I'm going to be focusing a little bit more on the organizational change aspects of what we've been doing in education to drive our strategy forward.
ANNA TROISE: So I've been at the Academy for about nine months now. My background, as some of you may know, and Michael said earlier, is commercial publishing. So I worked at Nature. I worked at Blackwell, never Elsevier, most recently Wolters Kluwer. And I had an opportunity to join the Academy and do something totally different. There was so much change going on there.
ANNA TROISE: They had a new CEO. They'd had a new COO. They had a new chief membership officer. They had a new chief HR director. And then they brought in me to run education. I knew nothing about education, so that was sort of a chance. But our CEO really wanted something different. And what he was looking for was a different type of skillset within the Academy, and people who are much more focused on business and strategy as opposed to some of the traditional ways that associations have recruited for staff over the years.
ANNA TROISE: And they wanted this because the world is changing. The demographics for a membership organization are changing. We know dues is stagnant and flattening. We know that there are new competitors popping up all the time, particularly in the education space. We know you can get all of that education for free anywhere. So how do you stay relevant and how do you make yourself as an organization sustainable going forward?
ANNA TROISE: So like I said, so this talk is going to focus a little bit more on the organizational aspects of what we've been going through. So I know that there are a lot of words on this slide. And as my old boss who is in the front row over here-- so no pressure-- would tell me, there's too many words, Anna. Cut it down. So this is intentional.
ANNA TROISE: And the reason is because I started, like I said, in February. And I was charged specifically with implementing this strategy, which had just been approved by the board the previous December. So how was I going to do that? So the Academy used the classic framework for our strategy to figure out what our winning aspiration is, where do we want to play, and how do we want to win?
ANNA TROISE: Also, looking at, of course, key capabilities we need and systems critical to achieving the strategy. So this, therefore, I mean, I got a pile of paper about this stack that I had to go through and figure out. But this is more or less the strategy on one slide. So our goal overall is to be the trusted preferred learning source for every orthopaedic surgeon throughout their career. We want to be the partner of choice for subspecialty societies to develop and deliver education.
ANNA TROISE: We want to build our program to connect us to the wider ecosystem and be the hub of education. I think you're going to hear the word "hub" a lot throughout the course of this presentation. I don't have another word for it yet. So afterwards, if you can come up to me and give me other words, I'd really appreciate it. The hub is to host content from us where we're strong and where we have strength in our membership or skill sets, and then partner with societies and industries where we're not as skilled.
ANNA TROISE: We want to build more content and tools, create more loyalty with residents, because without them, we're completely irrelevant. We'll use our brand to establish credibility, establish better and stronger relationships with partner. We'll look at mix and matching some of our current offerings to have more relevant products. We'll drive innovation and investment through our flagship products.
ANNA TROISE: Makes sense, logical, right? I thought so. No one understood this at all. People did not get it, and it frightened them. So I walked in on my first day, and I had a line of people sitting down saying, I don't know what on earth we're trying to do. So I had a really great professor who once said, strategy can be beautiful on a slide.
ANNA TROISE: However, if the staff have no idea what to do when they go to the desks, it's ridiculous. It doesn't mean anything. So I kind of took a step back and looked at the sort of state of the team overall. And what I saw was an incredibly siloed organization. So under education specifically-- and I know associations handle it differently all over-- but education at the Academy is the annual meeting in live courses.
ANNA TROISE: So we have a cadaver lab in our basement where we can, like, do all kinds of live, cool courses with cadavers. It's awesome. We have practice management solutions. We have our publications program and our books and journals. We have our assessments and our examinations. We have our online learning, and we have our international education program.
ANNA TROISE: So we do a whole bunch of stuff in various local regions with orthopaedic surgeons. No one talked to each other. No one works together. It was so siloed, and everyone was incredibly focused on what they do and what their silo was. Innovation was undervalued. Resources were really process-oriented. They were not strategic.
ANNA TROISE: There wasn't an emphasis on data-driven decision-making. There was a small, but not as much of a use of business planning. There was no project management techniques. Fiduciary responsibilities were sort of limited. There weren't really budgets. People just built things and did stuff. And most importantly, it was a culture of acceptance. No one challenged each other.
ANNA TROISE: Nobody actually had any kind of discourse about, how can you make things better? How can you improve? How can you grow? The governance structure-- and I will say, coming from a commercial publisher, I did not have an appreciation of the governance structure at an association like I do now. As an example, the governance structure for education in itself has 518 individuals on it who are all part of the council or the various committees.
ANNA TROISE: So there's a lot going on with it, and it seems a bit unwieldy. However, the staff are awesome. They have a huge amount of experience, they have a huge amount of capabilities, and they have a real interest in learning. So we started asking the questions, how do you get the right people to do the right things? How do you support the desired future state of where we wanted to go?
ANNA TROISE: We knew that we wanted a state and an environment that was centrality of customer focus, tolerance for innovation and experimentation. We want people to take risks. We want people to not be afraid to fail. And, of course, if they fail, fail fast. But we want people to do that. We really wanted collaboration across departments. We needed to get education, talking to technology talking to the PMO office talking to operations talking to marketing.
ANNA TROISE: And that was something that was really important. We wanted a proactive communication with that. We don't want people hanging each other out to dry. We want a team culture. We want strategic thinking, future orientation, vision, supporting goals and results rather than tasks. And we want continual professional development, sharing and learning from other associations, other businesses. Get out of your own little silo, whether it's a medical association.
ANNA TROISE: Go see with the consumer electronics group is doing. Go learn something new and bring it back to the Academy. So we really tried to simplify the approach. So our CEO is very, very clear on what our values are within the organization, and we constantly are reiterating them. So empowerment, accountability, teamwork, and learning. And then we step forward a bunch of immediate priorities, so one being used language the team will understand to communicate your strategy so that they know how to support the direction.
ANNA TROISE: So frankly, we stopped speaking like a group of MBAs. We actually spent a lot of time to think really carefully about how to use language to empower people to understand what we're trying to do. We did classic deep dives into all the different businesses. What are quick wins? What should we stop doing? What should we start doing? What are we doing well, and what are some of that training we need?
ANNA TROISE: I mean, we have a group of staff that really have a can-do attitude, but none have actually ever been tasked with putting together a budget, so they need some financial and training skills to be able to do that. So we worked through this and we reimagined our strategy. And there is a card that keeps being held up over there and I'm running out of time, so I won't walk through this. But this is the way that we started to really reimagine what our strategy is.
ANNA TROISE: And coming from a commercial company and now saying that members are a priority still is kind of funny to me. But members are a priority. If we don't continue to attract them, we're completely irrelevant. Education is something our members keep telling us that is important to them. But with so many options and they can get anything they want for free, why should they keep coming to us?
ANNA TROISE: So our hub strategy enables us to deliver the best offerings so the members are satisfied. They renew. And it provides a sustainable revenue stream so it continues to fund the overall ecosystem. We have to provide information that enhances what we're already good at, is financially sustainable, is accessible, it connects us, and it prioritizes our offerings.
ANNA TROISE: It needs to be engaging. It needs to give us eyeballs so that we can continue to be able to provide member value. And if we can provide more valuable content, it leads to higher renewal rates and gives us more opportunities to expand. So I keep saying this within-- thank you. There's zero minutes.
ANNA TROISE: So I keep saying to my team, content is content is content. Who cares if it's live? Who cares if it's an exam? Who cares if it's a journal? It's all something that people need in various different formats and delivery mechanisms wherever it is. It's not about the product formats. It's not just about access.
ANNA TROISE: It's about providing personalized needs-based content to customers and stakeholders how and when they want it, and ensuring that our digital relationships are built on frequency, emotion, and convenience. We need to optimize our partners' experiences with the Academy, and we need to work to meet their needs, and create a strong foundation to support our offerings. So we created a new team to try to cut across all the silos.
ANNA TROISE: I'll keep going. We have our priorities. So this is really what we're trying to get to, and this is a work in progress. But we're turning our education team, at the end of the day, into a product strategy and product development organization. This may look a little bit like agile, but you can't really just adopt all of agile in our world because CME is probably the least agile thing that exists.
ANNA TROISE: So we've kind of adopted our own little way of kind of going through this using some of the Academy processes before and teaching people what we need. So the pyramid really here is trying to evolve and think about the operational workflow. So what is the infrastructure, what are the technologies, and what is the data you're collecting for the analysis of whatever you're trying to build? So whether it's a platform, so our LMS, our exams platform, our annual meeting submission system, our video platform, what we do live, what is that infrastructure?
ANNA TROISE: How is it working? What is the workflow for that business? Moving it up, what is the problem we're solving? Are we just building something because we need to? Are we trying to actually solve a problem that people have so that they use it? I mean, ultimately, that's really the goal. What is needed? How can we meet their needs?
ANNA TROISE: What's the market telling us? Then from there, building. So what's the product being built? What's the delivery mechanism? How do you fail fast? How do you test the market to know you're building the right thing? And under this build, this is where people are starting to identify, and they're starting to think, oh, well, if I'm building annual meeting, I fall into that.
ANNA TROISE: I need to do everything that's underneath here and think about all of these different things. Why would somebody want to come to the annual meeting? How do we continue to make that engaging experience? How do you have the infrastructure to support that? So we're trying to flip the thinking a little bit. Go to market strategy-- one of the things I noticed that we really didn't do is we were launching tons of content on LMS on a regular basis, but nobody knew about it, so no one's going to come in and use it.
ANNA TROISE: So what is the actual message? How do you get that content to market, something publishers do so well? They make their content discoverable, and visible, and accessible. And we were sitting on all this stuff, and no one knew. So as soon as we started to actually change this approach, we're seeing our usage increase. And then, of course-- and I think somebody said it in an earlier session-- learn.
ANNA TROISE: So what are we measuring? You can't just launch something and let it sit there. So was it successful? What's the feedback from the market, and how do you feed that back in so it's a continuous feedback loop? So this is really where we're trying to get to. Obviously, we want to be meeting the needs of all of our different customers and not just thinking about the members, but thinking about the wider ecosystem of everything the Academy touches, and using that feedback from them also to feed into our overall product strategy as well.
ANNA TROISE: We want to be building things regardless of what it is, whether it's live or whether it's a product, that meets certain functional needs and certain emotional needs. And then, I think we'll be able to be pretty successful. So we're off to a kind of crazy start. It's been a wild nine months, but it's been a lot of fun, and it's starting to work. So thank you. [APPLAUSE]
PAUL GEE: Hi. Hi. I'm Paul G. I've worked with probably 70% of you here, whether it was at WK, or whether it was at the AMA, or whether it's through Silverchair. So whatever lens you're at, I can say I worked with Jane for maybe under a year. But you'll see very few words on the slide, so maybe-- [LAUGHTER]
ANNA TROISE: He listened.
PAUL GEE: I don't know how I got that from you, but maybe that's where it came from. I managed the product management and the development team and our digital marketing team up until about a year ago just for the JAMA Network at the AMA. I like to say I moved to Chicago for the J. I'm a journalist person. I've always been a journalist. I don't know much about education. I've been getting an education in education.
PAUL GEE: But the way that my team is set up, it's to serve the strategy of the business unit we're assigned to. And JAMA has a very specific goal. It's to be a journal, to run a good business, and to deliver that layer of profit back to the nonprofit so they can fund mission. What's been really exciting is transitioning where I am now working directly alongside my counterpart on the education side, Julie Gill, working to build for a mission.
PAUL GEE: One of the things that differentiates the AMA strategy right now from some of the other things you've heard is we're not out to try to build our members through this education strategy. We're trying to bridge gaps with customers. There's been a couple of themes that we've heard throughout the day, and I've been noting and been pretty excited that I've been talking about these things for two years.
PAUL GEE: How do we see our content as a society being in two different channels from two different groups? Why is it in two different platforms? Why is it managed differently? Why isn't it seen as one strategy? Because the end user, they have different things that they want. But physicians, whenever you go to physicians and you do customer research, whether I did it at WK or whether I did it at AMA, they say the same thing.
PAUL GEE: I just want to be able to get to content. I don't care what type it is. I want the barriers to be gone. I don't want paywalls there. I don't want a publisher URLs to change. I want the experience to be the same. You can't solve all those problems. And definitely within the context of each project you work on, you can solve-- there's certain things you have an ability to solve.
PAUL GEE: You solve for those, and you move on. We've been able to align our teams, kind of bridge that gap, bridge how we create content or think about content, and also take some of the successes that we've built at the JAMA Network over the last couple of years and extend it to a different set of content. We've made a hub. And for us, the hub is actually more of a trademarked term that we're going to be launching in October.
PAUL GEE: And the hub is actually there to swap out and stand for this idea of center. Like, center is a very inward-focused word. It sounds like control and command, kind of. That's not what we're trying to build. We're trying to build a place where we can solve a physician's problem. I need to find everything I need for CME for my state, and I need to be able to track and see it pushed to my boards.
PAUL GEE: One of the other contacts, the AMA is a little bit different than the other societies. Were composed of a house of delegates, which has members of all the societies, and they vote on measures. And one of the measures was solve the tracking problem. Make it so that all content that's taken for CME gets pushed wherever it needs to go. Shouldn't you be able to do that at the AMA?
PAUL GEE: And we're going to try. And we're not doing this to grow our membership. We're trying to do this to solve problems for the positions. And that is really exciting for me, because as a product manager, one of the hardships you hit is when you have constraints. You have constraints on brand. You have constraints on business model. You have constraints on technology.
PAUL GEE: Working on a fully mission front is really exciting. We've been taking it head-on and trying to figure out, how do we solve the internal issues that all societies feel, the breakdown between journals and education? And I think we've done really well doing that. Internally, we're working together really well. We've come up with a strategy that this works for the AMA. We have 10 different floors at the AMA, uniquely 10 different business units.
PAUL GEE: They all make education. The people even in the AMA don't know what education or opportunities are being built by the different floors. Silos are within silos. We're trying to create a single place where users shouldn't have to feel those silos. We have a team that brings the content in and can push it out. We also have JAMA Network publishing.
PAUL GEE: And in a three-year period, we have about 1,100 CME articles that are just always sort of flowing in and out and expiring. How do we marry those experiences for the end user so they can go to a topic, find the topic they need for their state, take it, and go away? Because that's all they really want to do. We've taken the journals platform and we've extended it to contain mirror images of all of our journals that are only uploaded once on the journals platform, but appear in a different site that is branded AMA Ed Hub, and then all the other channels.
PAUL GEE: As you saw yesterday from Duke University, using Site Builder, they're able to just roll out a different site with no development, configure it, change the brand. We've made that part of our strategy so we can create a platform within our educational platform that can handle traditional LMS content. It can handle journal article content. It can handle stubs. So we can port things in from our LMS, just the header, and link out to that LMS.
PAUL GEE: And we can kind of create a hub whether we host the content internally or not that serves that end user's goal of finding and discover. It's indexed by Google. So unlike a lot of LMSes, we're able to take advantage of passive discovery. Google can send us traffic. We can automatically alert and send emails out to the constituents.
PAUL GEE: The enhanced discovery portion of our strategy is really the portal strategy that we are building in a sort of very normal journal way. We also have this idea of assigned activities, which is very much along the lines of what Mike was talking about. We know we need to be able to go into health systems, give them tools where content is assigned to change measures of care. One of our goals-- that is a huge goal-- is, how do we bring down cost of care?
PAUL GEE: That's what we've been tasked to do. We're looking for ways to do that more and more. The integration on the back end allows us to transcript that information, keep the site connected, know that user's journey. If that user is a student that becomes a doctor later, we should know what they're good at. So we're looking for ways to hub that information as well. Friction-free learning, we have a little team called the Dev Lab looking to solve other end user problems.
PAUL GEE: How do I automatically give credit when learning occurs? Most of the time when you go and do customer research, one of the bigger complaints is, I already did the learning, but actually claiming it is such a pain in the ass. I won't do it. So how do you break that down? How do you actually deliver the credit the minute the learning occurred, even if it happens in a practice situation?
PAUL GEE: Someone treats a patient, they actually look up information-- not through research or other ways-- but we find a way, absorb that, and give them a credit for doing it. We are not able to do that right now, but that's the kind of question we're asking ourselves. How can we find real learning, and reward it, and have that transcript information automated? It immediately gets pushed out to wherever it needs to go to tell people.
PAUL GEE: And finally, automatic reporting. We had to build a system to permit JAMA Network a couple of years ago. It got accepted as an activity for MOC with the Internal Medicine Board, and we built out a system. One of the things we wanted to do in this sort of friction-free learning philosophy was make sure no one ever has to look up their diplomat idea in order to get MOC.
PAUL GEE: If you took CME, you should just get MOC. The AMA has the ability to develop relationships. So we developed a relationship. We make these data sharing agreements with the AVIM that allows us to automatically match any diplomat ID-- sorry. I need water-- and then push it back out to the board. They take a CME course. They can take it on our app. They can take it on our website.
PAUL GEE: They don't see or feel anything more than CME, and they get MOC the next day. And we're looking to try to grow that and build that out so we can meet the goal that the delegation has really assigned to us, which is streamline the physician experience. All those things are difficult, but one of the things that was the trickiest, we sort of did technical analysis. We thought through, how can we resolve a lot of the technical barriers?
PAUL GEE: How can we build these services? Well, one of the things we had to get over is that division between journals and education. And at the AMA, that J is very, very important. Thank you. So the J means that we're editorially completely independent from the AMA, and we take that seriously. It's kind of funny and a joke.
PAUL GEE: But, like, some people on my team, now that we're working on both the AMA products and the JAMA products, they have two cards. John has a purple card and a red card. It helps get things done. So how do we actually-- if I have an employee with two cards, how do I build a website with both of those colors in it? And if we are being tasked with trying to bridge the gaps between the federations, the AMA, and the end users, how do we create an area of trust?
PAUL GEE: We're not trying to take over brands within our own house. We're not trying to do anything that would disrupt the experience of that end user. And when you do customer research, and users say, I don't want to see colors. I don't want to see pictures. I want to see topics. I want to click on a topic, I want to take the topic in that area, and I want to get CME.
PAUL GEE: So we designed a very neutral territory landing area. We came up with the AMA Ed hub. It doesn't use the bright purple. It uses a little off-color purple. That, in itself, if you've done branding discussions, was a war I have bruises from. [LAUGHTER] The interface itself is not meant to be glitzy. It's supposed to allow the user to actually just get to the content they want.
PAUL GEE: Our goal was to bridge these barriers, the barriers you see and the barriers you don't see. That gave us the ability using the tools that we have available to us to create different sites for the brands within the AMA. I can launch those sites. I can build a new one tomorrow with website builder. I was thanking the people from Duke University for demonstrating that for me.
PAUL GEE: So if you can remember back, that's what we do. I don't think it works as quickly as that video did. [LAUGHTER] But it allows us to get here, and it allows us to do things without having to plan development. We have a front-end web designer who knows how to use these standard modules. We can affect this different visual for any product, and they're the same technology, the same widgets that are designed, so the user's experience is the same.
PAUL GEE: They know where things are. They click, they get the same experience. It gives us the ability to bridge these barriers as well. And getting through to the point of approval where every element of the branding within our house was approved gave us faith that like, OK, we've gone in the right direction. So we pulled this together.
PAUL GEE: We're able to resolve a lot of issues. And we're looking to bring this hub out into a space where we can completely follow through on those missions to automate discovery, to create a single channel of discovery, whether we host or actually provide that experience or not. To provide a single transcript that all parties can consume and can automatically push out to the parties that need to know, and to create an integration model that makes it really easy to choose what is complementary to the mission of the association we're working with?
PAUL GEE: What is complementary and not competitive? And we will figure out all of those different barriers together. We've planned everything so it's really just a series of options we already have, because we plan for ultimate flexibility. It's been a really fun project. It's an exciting time at the AMA. You know, we talked about change organizationally. JAMA changed a lot in the last five years, and it was really fun to be part of it.
PAUL GEE: And it's really fun to be part of this change as well, because the AMA'S reputation is going to dramatically change as we effectively meet these goals. Thanks. [APPLAUSE]
MICHAEL CLARKE: Do we-- we'll use the [INAUDIBLE] rule of live questions as a priority. Does anybody have any questions to kick off the discussion? All right. While people think of questions, I have a question. So, you know, education-- and you've all alluded to this-- it's a messy process or it's a messy area because it is a process as opposed to a format.
MICHAEL CLARKE: It's not like journals, which are journals, or books, which are books. Education could be anything. And it cuts across the organization. And Mike, in the case of your enormous organization, it cuts into all sorts of different companies. How do you bring together stakeholders and sort of manage the process such that you're able to get some forward momentum across so many different organizations or divisions?
MICHAEL CLARKE: Have you struggled with that? Have you had to create new processes and structures?
MIKE MUTKA: The short answer is with great difficulty.
MICHAEL CLARKE: Yeah.
MIKE MUTKA: Yeah. The biggest thing in the organizational culture is-- and we learned this in good, bad, and ugly from our private equity owners, Vista Equity Partners, who are really cutting-edge SaaS company operators. And that was that it sounds like a cliche, but perfect really is the enemy of greatness with this stuff. And so you can plan the heck out of it, and try to get it 95% right.
MIKE MUTKA: Number one, you won't. Number two, it'll all change by the time you're done planning. So getting it 75% right, and being very nimble, and correcting, and then collaborating very, very closely hand-in-hand with your customers are the key. But we've created a culture where you have to just move forward very, very quickly and make mistakes, and that's OK. But it's tough.
MIKE MUTKA: It's increasing. So for example, we've acquired 12 companies. We've in four years' time merged all of those platforms into one platform. And the first time, we went much slower than we did the 12th time. The first time was, you know, go slow. Be careful. By the 12th, we're like, no, no.
MIKE MUTKA: Go, go, go, go. So just pushing ourselves to go really fast that way.
ANNA TROISE: So I think from our end, a really good example would be practice management. So in April, all of a sudden everyone looked at me and said, you're going to run practice management. And I said, great. Like, show me the P&L. It just was everywhere. And if you ask anyone about what is practice management to a doctor, they all have their different answers. And so it was interesting.
ANNA TROISE: We underwent a big strategic review of our practice management portfolio. And what we ended up seeing is just we have this very important coding book. And outside of the coding book, no one really thought we had anything, but it was totally untrue. We ended up seeing it across the entire organization that we actually were able to populate all the different areas of practice management.
ANNA TROISE: It was just scattered. And the way it was organized on our website was by our governance structure, not how a user wants or how they would come in and look for it. So really, I would say that be able to manage that, and it's all educational products. It's getting buy-in, and then figuring out, what do you have, and what do you want to be when you grow up? And then doing some simple organization to put it in a place that is in a manner that the actual end user wants it as opposed to, it needs to be in the advocacy section.
PAUL GEE: There's no-- there's no messiness at the AMA. Look at how clean my slides were. [LAUGHTER] No. I have the luxury of not having to work on what content goes where. That's something that my counterpart Julie's team works on, and it is messy. But one of the things we do is we have been going out and doing user studies.
PAUL GEE: So we show the interfaces, we show the content in the stages as we build them and after we build them. And we've taken it to heart that what the user says goes. And we've changed those topical arrangements. We have topical arrangements, which is something different than how we presented some of our products in the past. And we've sort of doubled down on topic because they said to. And we go through constant negotiations about how to effect changes in the interface in the model.
PAUL GEE: But we do also have a system of accountability, where just a couple of people can make decisions and then get the bruises for the bad ones. [COUGH]
MICHAEL CLARKE: A question over here.
AUDIENCE: Hi. It's kind of a general question, but I was wondering if the panelists could talk a little bit about how you're addressing or thinking about personalization for individual learners within sort of the bigger, broader structure of your hubs or organizations.
PAUL GEE: Well, a lot of what we're doing for the education is building on the strategy we had for journals. That's fundamental, and it was actually one of the reasons I started working with Julie. We just launched the ad hub-- I'm sorry. We just launched the JAMA Network, or relaunched it. And when we did, we took advantage of a lot of Silverchair's semantic functionality, even to bring topical associations to anonymous users, which I kind of talked about before, and we really said.
PAUL GEE: And that's been working really well for various aspects of our business. And one of the things that the education center wanted to do was all the things we've heard goals around for education is, how do I align an educational topic with someone coming in? Well, I've got a very successful-- you know, we've got millions of page views a month amassing interest base interest on JAMA Network.
PAUL GEE: If I build the education center on the exact same platform, we have those affinities intact. So it gives us a jumpstart. We have email programs which we can immediately plug into. So personalization, we've made progress in a lot of the concepts that people have talked about today. And we've also worked on how we harvest that, and have our own database, and how we sort of can use it for different things, like in our LMS to equate to effective GAAP measures.
PAUL GEE: We haven't executed on those, but that's in our strategy to try to get there. The baby step was discovery, that pedal about discovery on the front-end web.
ANNA TROISE: So we're just starting on that, and it's exactly what we're trying to do. And basically, in starting with the LMS, but you can look at lots of different, whether it's our live courses as well, in a way, about who is the person that's coming in? What courses are they taking? What exams are they? What are they getting wrong? Why are they getting it wrong, and then how do you guide them into the appropriate types of content sets that they need to be able to do whatever it is they're trying to do?
ANNA TROISE: So we have lots of different data, but it hasn't been aggregated in a way that we're able to really make those types of insights yet to be able to push it out to our membership. But that's exactly the next stage, and we're trying to sift through it and make sure that the data is making sense and we can collate it all together. But that's the golden goose.
ANNA TROISE: I mean, that's, I think, what everyone's trying to do.
MIKE MUTKA: It's a great question because I had a little chart that said, analyze, assess, learn. And what we've learned is we're going to lose a bit of credibility with our provider and clients if we help them analyze the data and where they're underperforming, assess everybody individually, and say, now, the answer is assign 10,000 people this course we've got. And magically, the behavior change fairy will come and make everything better.
MIKE MUTKA: So ideally, we want our assignment plans for each individual to feel kind of like when you go on Amazon, and they recommend five new products, and you're like, how did they know I would want that? And it's got to be like that, where the person comes on, and the learning has been really well-curated for them based on their individual strengths and weaknesses in the assessment and their performance. But the course is only one small part of it.
MIKE MUTKA: It's also giving them access to the performance data, because a doc whose cost is 50% higher and their outcomes are 20% lower than the other docs doesn't want to be given a course on how to get better. But if you show them privately how the other people their peer group are performing, they will go consult with them, find out what they're doing differently, and use that data, along with other tools, to figure out how to learn.
MIKE MUTKA: So it's more than just the course, but it all does have to be personalized. That's where it's going.
AUDIENCE: Has accessibility raise an issue, accessible content? Are you having to address accessible content? And if so, what are the challenges in medical practice in health care?
MIKE MUTKA: Yeah. It's just kind of a table stakes given. Accessibility is real-time, 24/7, content snacks, five-minute learning opportunities here and there, all kinds of different formats. Meeting people where they're at, whatever device, whatever time of day, wherever they're at.
ANNA TROISE: Agreed.
PAUL GEE: I couldn't make out the question. I'm sorry.
MICHAEL CLARKE: Accessibility, importance of.
PAUL GEE: Yeah, I agree with everything said. We're all following on that same path of trying to meet every objective.
MICHAEL CLARKE: OK, I'm going to give you guys one last question, because it's time for lunch. We have a wonderful lunch, I hear, waiting for us. So because this is platform strategies, I have to ask the platform question. So it sounds like all three of you, your organizations are moving from a product orientation or an activity orientation to a platform orientation, even if it's just finding content.
MICHAEL CLARKE: But I'm curious as to how organizationally you've been able to make that shift, and what that's done in terms of thinking about how you develop future products. In other words, are you continuing to think about it from, here's a product. Put it on the platform. Or has platformization really changed the whole way in which you think about education, if that makes sense?
MICHAEL CLARKE:
PAUL GEE: From my perspective, it's a little tricky. There isn't one platform. There is a place where the bulk of the content's hosted, and it is the shiniest thing that you see, and that's the journal's platform, or the new platform or relaunching for Ed Hub, and that is a platform. But all the things that run automatic reporting is an integrated system I'm also responsible for with other vendors or internal. We have apps that are integrated with it.
PAUL GEE: Really, what's important is a strategy or to build an ecosystem that builds that conceptual platform and makes an end user feel served with the right need at the right time. And I have the ability to pick partners, vendors, or internal developers to do the thing based on cost and need that needs to be done. And it took five years to get that into I wouldn't say the perfect scenario for JAMA Network, but it's a good one, and we're building on that for the Ed Hub.
ANNA TROISE: So I think the Academy is shifting a little bit. Initially, it had been we wanted absolutely everything to be coming in and out of our LMS, because that just seemed like it was the appropriate thing to do. At this point, the way with the total shift in culture, really, the philosophy seems to be, we can work with lots of different vendors and lots of different technology solutions, but it's about the user experience and the single sign-on.
ANNA TROISE: Does it feel like you're all within an Academy product? We have our LMS. We have a video platform. We have our exam engine. We have our journals. We have our books, and all of those are on different platforms. And so the philosophy is that when we want to do something on our team at this point, it's, what are the business requirements?
ANNA TROISE: What do we need to do? What's the problem we're trying to solve, and then who's the right vendor to be able to do that? If it's one, that's totally on the table. But right now, it's been lots of them so we can have a plug and play approach.
MIKE MUTKA: Yeah. It doesn't necessarily have to be one platform, but it just has to feel like one seamless platform to whomever the user is. We're in the process of combining analytics and assessment with our learning management system so that that data, that actual results data and skill stuff will then trigger the learning assignments and everything, and that will all be integrated together seamlessly. The big thing is our platform is just much more than content delivery.
MIKE MUTKA: That's one small part of what it's got to do.
MICHAEL CLARKE: Thank you. Thank you, all three of you. And we'll continue the discussion over lunch. [APPLAUSE]
Segment:0 .
PAIGE WOODEN: Michael Clarke and I met over 15 years ago. We were prodigies. This was an elementary school project, of course, when I was implementing AAP's Pediatrics Journal peer review system. And it was a really wonderful experience for me, because it was at a point when there weren't a lot of people who were moving online. They were a little afraid of it. They were taking baby steps.
PAIGE WOODEN: But Michael had been with UCP before, and he had done a lot with online and developed some of the first online publications, so it was really interesting for me to work with him and to learn from him. So since then, Michael has served as the executive vice president of product and market development at Silverchair, and he still is with us on the board of directors, where he continues to influence.
PAIGE WOODEN: He has also been at AMA, where he was the director of marketing and product development and the director of international business. And he is the co-founder of Clarke and Esposito, which is a management consulting firm focusing on strategic issues related to professional and scholarly publishing. So please join me in welcoming Michael Clarke. [APPLAUSE]
MICHAEL CLARKE: Thank you, Paige. So today, we're going to just talk about education. And just to give you just a very brief background about myself and where I'm coming from, I'm a partner in a boutique consulting firm. We're based here in DC, though we have staff and in New York, and Philadelphia, and Boston as well. We work largely with professional associations as well as universities and other organizations that are working with professional scholar information in some way.
MICHAEL CLARKE: And what kind of provoked this session is really thinking about maturing revenue streams. And we heard a little bit-- Alison at Duke, I don't know if she's still here. She talked a little bit about peak subscription yesterday, which is a term I love. And certainly we're many associations, many organizations and publishers are experiencing some form of maturing revenue stream around journals, these subscription journals.
MICHAEL CLARKE: Open access is a different story, and as well as some maturing revenue streams about around books. And so a lot of organizations are starting to think about diversification of revenue, and other places to look, and kind of thinking about all the various different things that associations do. And this is a frame that we at our firm use a lot to kind of think about markets and different approaches to the markets along sort of a horizontal and vertical axis.
MICHAEL CLARKE: And the horizontal axis is really about economies of scale around one or two product lines. So a lot of the large publishers will do thousands of journals, tens of thousands of books, and get very efficient at doing that. And other organizations, of which professional associations are exemplars, focus in a single topic area or a set of topic areas and try to do a lot of different things for the communities.
MICHAEL CLARKE: And so we're going to focus a little bit. We're going to focus entirely, actually, on this last area here, which is the education. And our speakers today are going to come at this from some different directions. We have Mike Mutka, who is CEO at Straightaway Health Careers and Chief Innovation Officer at Relias. And Mike used to be at Silverchair in a division called Silverchair Learning, which was sold.
MICHAEL CLARKE: And he still sort of heads up what was the division into a new company. And we have Anna Troise, who is a Chief Education Officer at the American Academy of Orthopaedic Surgeons, after a career in many other places, most recently Wolters Kluwer. And Paul G., also at the WK alum, correct? Yeah, he's currently VP digital product management and development at American Medical Association.
MICHAEL CLARKE: And so going back to this access a little bit, Mike is going to talk about education from kind of a horizontalist perspective at his organization. And Paul is going to be talking about the AMA strategy, which is a vertical strategy, but it's a little bit broader than, say, the AAOS strategy, which was in a specialty. So we're going to get some different dimensions of an education strategy from different organizations, both in a for-profit and not-for-profit context.
MICHAEL CLARKE: So moving along, we'll start with Mike. Let's see if we can find your slides here. No. I'm not sure where the slides are.
MICHAEL CLARKE: We didn't cover this in the other area. There we are. There we go. [COUGHS] There we go. Right.
MIKE MUTKA: Thank you. We have slides, always a good start. All right, so I'm with Bertelsmann Education Group, part of Bertelsmann Company, a 180-year-old privately-held German company, 20 billion a year, very global. Bertelsmann has three pillars to their business. There is media, and that's the sexy pillar. That's Penguin Random House Books, and BMG Music, and RTL Broadcasting.
MIKE MUTKA: And they're always having parties with Beyonce, and signing parties with the Obamas, and all that kind of stuff. So they're the really sexy, cool pillar. There's a services group. It's a really dull pillar. We not going to talk about that one. [LAUGHTER] And several years ago, Bertelsmann decided they needed to develop a third pillar to their business.
MIKE MUTKA: And they wanted to develop something for the next few decades, and they decided to focus on education. So in 2015, Bertelsmann Education Group was formed. Bertelsmann has made about $2 billion worth of strategic acquisitions. They acquired a company called Udacity, that created kind of the nano degree, the online technology certificates that are paired with companies and employers with guaranteed jobs, basically, if you complete the curriculum.
MIKE MUTKA: They acquired Alliant University in California, which is a bricks and mortar and online university. Hot Chalk, which focuses on developing online degree programs turnkey for smaller, more regional nonprofits, and then the two companies I'm involved with, Relias, which was formerly Silverchair and then Straightaway. And so I came about, as Michael said, in 2005, this guy Thain Kerner came to me and said, if you take this really small salary with these questionable stock options, you can be employee number five in this little company called Silverchair Learning Systems.
MIKE MUTKA: And I'm really still not sure what-- I think he spiked my drink or something. [LAUGHTER] But he got me to do it, and I really do thank God he did. It was the best thing that ever could have happened, because it was a terrific ride. I became president of Silverchair. We took it in 2012, sold it to Vista Equity Partners. Two more years, turned around and got a permanent home with Bertelsmann, and it became Relias.
MIKE MUTKA: I've been chief strategy officer at Relias, and we've gone through 12 acquisitions consolidating our education business. I am now Chief Innovation Officer, CIO. I believe that most of the team calls me COI, Chief Organizational Irritant. [LAUGHTER] They have not copped to that, but that's what I'm pretty sure is going on when I'm not around.
MIKE MUTKA: One of the things about Bertelsmann is if you have less than two jobs, you're not doing it right. So about two years ago, they asked me to start up another company called Straightaway. And so I'm involved in two companies, Relias, online learning programs for health care organizations. And Straightaway provides an online training program to allow skilled nursing facilities to train their own CNAs, Certified Nurse Assistants, which is a high turnover, high demand job there.
MIKE MUTKA: And it gives them, basically, the ability to strategically take control of their own supply of the workforce rather than subject to the whims of the market. Overall, our strategy across all of the businesses is start first by focusing on the organizations. Identify big, big pain points they have in business processes. Create a scalable SaaS solution that can address that business process more efficiently than they've been doing it manually in the past.
MIKE MUTKA: Focus on getting really good ARR through longer-term contract commitments from our clients, and high retention, very high touch support. Many of our clients have been lower-tech in the past. Very, very user-friendly, scaled-down, super simple interfaces that can be used by a nurse who breaks out in hives if you say "spreadsheet," and make it very, very easy for them to use.
MIKE MUTKA: With that ARR that we generate from these relationships and we reinvest in a product differentiation strategy, try to stay out in front of the market and make everybody play catch-up with us, and that's worked very well. Relias will, by the end of this year, we recently last week announced the acquisition of a company called OnCourse, which was in that health care. It will make Relias the largest health care online education company in the world, which still boggles my mind a little bit.
MIKE MUTKA: So that was all really, really cool. And then what happened, what we have happened to us was from 2005 to 2012 at Relias, we were able to really focus on a simple origin problem. Low-tech health care providers had mandatory training they had to deliver for their employees in high volume, and they needed to make sure nobody slipped through the cracks, or they would get clobbered, sued, fined, whatever.
MIKE MUTKA: That solution worked really well for us from 2005 to about 2012. Those were halcyon days. It was nice. Life was much simpler. And then life intervened, and the world changed and dragged us kicking and screaming with it. And really, what had happened was health care reform, which had been brewing since perspective payment in the '80s, and HMOs, and everything, just kept continuing to percolate with more and more pressure.
MIKE MUTKA: And Obamacare really kind of brought it all to a head. Obamacare was the thing-- you know, we've been kind of mud wrestling with health care reform for a long time here. But with Obamacare, that created the need for costs reason to shift from paying based on activity to paying for accomplishment. And don't ask me to pay for all of these other tests or things based on how much activity you did.
MIKE MUTKA: This is the outcome I want, and I'll pay you for this outcome. And that kind of rocked the world. That shift in payment meant that health care organizations now had to get much better at analyzing their results, assessing their people's skills and ranks relative to those results, and creating learning that drove meaningful behavior change in a way that would impact those metrics. So from our standpoint, different from sharing information on mandatory regulatory training to, how do we help facilitate change management in organizations with the big problems that they're trying to solve?
MIKE MUTKA: And so we started to hear a lot of executives in the industry saying, we know our employees need to think, behave, act differently than they have before. They need new skills. We just aren't really sure what those are, but we know we need them. Help us. And so we began to work on that.
MIKE MUTKA: And what it really kind of did was it surfaced a misalignment that existed between education and-- [LAUGHTER] Yeah. So I'm not sure. I'll leave it to each of you in your individual mind to decide which one is education and which one's employers. But the disconnect that's long brewed between education suppliers of graduates and employers, the consumers, it's long been there.
MIKE MUTKA: But it's now really, really starting to come to a head, and it's no longer tenable. And the workforce is changing at the same time, so we don't have time for new programs and things that take decades to bring people through. We need to figure out, how do we reskill our workforce for what's needed right now? The real challenge is organizations need people that can reinvent health care, but the people don't always have the skills needed to do the job.
MIKE MUTKA: So I'm trying to pass the potatoes. Remember, my forearms are just as useless as yours, so they've got a problem here. They don't have the skills to do this job. So, for example, in the future, is the best way to select doctors by choosing the folks that have the highest MCAT score that were able to do the best on organic chemistry, and anatomy, and physiology? Or what about doctors that have creativity, empathy, listening skills, team building skills, the ability to think systematically about how to create a better environment for the patient?
MIKE MUTKA: Jefferson University in Philadelphia, I was just there talking to their CEO last week. They purchased Philadelphia College of Design and have merged it with their medical school. And they're adding courses on creativity, and design, and systemic thinking into their med school program, because they need doctors that think much differently than they did before.
MIKE MUTKA: So same thing-- nurses with the NCLEX or masters, are those the best nurses versus some of these other skills? Creativity, teamwork, empathy, systematic thinking becoming more and more important. So we've tried to shift. So we've gone from what we were, post-acute mandatory regulatory training in North America, just online training. We're serving the whole health care continuum now. We're global.
MIKE MUTKA: We're trying to focus beyond mandatory regulatory on, what are the big problems you're dealing with, and how can we help you with your performance improvement with measurable behavior change, personalized learning? So that's created some interesting challenges. When I was doing the M&A work, I started going out and saying, well, how do we know what things to help? Our clients are saying, we know our people need different skills.
MIKE MUTKA: We know they need to be able to do things differently. We just don't know what it is. How do we help them figure that out? So I started approaching some analytics companies saying, we'd like to buy you. So it's really fun to sit down the first time with the CEO of an analytics company and start talking about why you, an online learning company, would like to buy them, and watch the look of confusion.
MIKE MUTKA: I think most of them took the meeting just because they were curious what the heck I was talking about. But after about 10 minutes, the light bulb went on. And they would say, you know, our clients keep telling us you've done a great job pointing to what the insights are, but the now what, you're not helping us. How do we merge that together? And they'd get it.
MIKE MUTKA: So we bought two analytics companies, we bought an assessment company, and we've redefined our business. And now, the focus of our business at Relias is analytics tools for us to help identify the key metrics where an organization's underperforming, assessments where we can then go in and assess the skills of the individuals in the underperforming area, and then being able to share data amongst them so as a team they can improve, and then provide learning interventions that help them get better, with the idea of focusing, again, on the big problems.
MIKE MUTKA: So an example of this is C-section birth rates, OK? Anyone want to guess what the birth rate is for C-sections in what percentage of births in the US happen to be a C-section? 33%. What does the World Health Organization say is the likely necessary birth rate of a C-section? 20%. We are at 33%.
MIKE MUTKA: In hospitals in the US, that ranges from 7% to 70%. That is what we call irrational variation. Some of that is medically necessary. Some of that is not medically. How do we drive that down? By providing data, assessing people, doing changing behavior. We drove that from 33% to 23% down. By the way, people say, well, C-sections, that's because we have better health care.
MIKE MUTKA: We're 47th in the world in infant mortality, so that doesn't really wash. So this is an example of a problem where we can help give an organization the tools to try to create that change. On the Straightaway side with our career program, the big thing we're doing is the student is the product, not the course. I don't care how many courses I sell.
MIKE MUTKA: That's irrelevant. What I'm selling is a well-trained CNA that will stay for more than a year. That's what I'm trying to sell. So I need to sell more than just the content, because what happens is a lot of people become CNAs. They don't really have a good idea of what's going to happen when they get to the job. So kind of like this guy.
MIKE MUTKA: Hahaha, biff. Guess what? After we go to the drugstore and the post office, I'm going to vet's to get tutored. So Biff doesn't really understand what's going to happen at the vet. That's what happens with a lot of CNAs. They get on the job. They don't really have the skills.
MIKE MUTKA: They didn't really understand what they were getting into. They have what's called a hell no moment. Oh, hell no. I don't want to do this job. And so what we're trying to do there is try to prevent that, because the problem we have is employers and the staff get frustrated. Both of them are kind of going, how are we going to get there? The employees want to get a job.
MIKE MUTKA: They're willing to invest in training that gives them job prospects, but they don't want to incur a bunch of debt and then have no job prospects. The employers are willing to pay and invest in training, but they want employees that are really ready, that they don't have to reteach when they get them there. And so what we've focused on in the case of Straightaway is looking at three drivers of turnover. One is inaccurate expectations coming into the job.
MIKE MUTKA: One is the traditional training doesn't prepare the folks correctly for the emotional aspects of the job that cause turnover, dealing with death and dying, things like that. And in the first 90 days, they don't get support. So if you look at this, the real challenge for us, educational content is really just one part of the picture. It's a much more holistic, systemic thing. We're helping them with recruiting and expectation standing up front, different kind of training and support in the first 90 days.
MIKE MUTKA: So those are kind of the two ways that we're approaching this a little bit differently. We hope in both cases that we give our employees the ability to go attack their jobs, conquer the problems that they're dealing with. [APPLAUSE] [COUGH]
ANNA TROISE: I'm pretty short, so-- hi, everybody. So I'm Anna Trois. I'm the chief education strategist for the American Academy of Orthopaedic Surgeons. The AAOS is a mission-driven organization. We have about 30,000 members. We're predominantly US-based. And we have been going through a massive amount of change. So this presentation is going to be completely different than the one that you just heard, and I'm going to be focusing a little bit more on the organizational change aspects of what we've been doing in education to drive our strategy forward.
ANNA TROISE: So I've been at the Academy for about nine months now. My background, as some of you may know, and Michael said earlier, is commercial publishing. So I worked at Nature. I worked at Blackwell, never Elsevier, most recently Wolters Kluwer. And I had an opportunity to join the Academy and do something totally different. There was so much change going on there.
ANNA TROISE: They had a new CEO. They'd had a new COO. They had a new chief membership officer. They had a new chief HR director. And then they brought in me to run education. I knew nothing about education, so that was sort of a chance. But our CEO really wanted something different. And what he was looking for was a different type of skillset within the Academy, and people who are much more focused on business and strategy as opposed to some of the traditional ways that associations have recruited for staff over the years.
ANNA TROISE: And they wanted this because the world is changing. The demographics for a membership organization are changing. We know dues is stagnant and flattening. We know that there are new competitors popping up all the time, particularly in the education space. We know you can get all of that education for free anywhere. So how do you stay relevant and how do you make yourself as an organization sustainable going forward?
ANNA TROISE: So like I said, so this talk is going to focus a little bit more on the organizational aspects of what we've been going through. So I know that there are a lot of words on this slide. And as my old boss who is in the front row over here-- so no pressure-- would tell me, there's too many words, Anna. Cut it down. So this is intentional.
ANNA TROISE: And the reason is because I started, like I said, in February. And I was charged specifically with implementing this strategy, which had just been approved by the board the previous December. So how was I going to do that? So the Academy used the classic framework for our strategy to figure out what our winning aspiration is, where do we want to play, and how do we want to win?
ANNA TROISE: Also, looking at, of course, key capabilities we need and systems critical to achieving the strategy. So this, therefore, I mean, I got a pile of paper about this stack that I had to go through and figure out. But this is more or less the strategy on one slide. So our goal overall is to be the trusted preferred learning source for every orthopaedic surgeon throughout their career. We want to be the partner of choice for subspecialty societies to develop and deliver education.
ANNA TROISE: We want to build our program to connect us to the wider ecosystem and be the hub of education. I think you're going to hear the word "hub" a lot throughout the course of this presentation. I don't have another word for it yet. So afterwards, if you can come up to me and give me other words, I'd really appreciate it. The hub is to host content from us where we're strong and where we have strength in our membership or skill sets, and then partner with societies and industries where we're not as skilled.
ANNA TROISE: We want to build more content and tools, create more loyalty with residents, because without them, we're completely irrelevant. We'll use our brand to establish credibility, establish better and stronger relationships with partner. We'll look at mix and matching some of our current offerings to have more relevant products. We'll drive innovation and investment through our flagship products.
ANNA TROISE: Makes sense, logical, right? I thought so. No one understood this at all. People did not get it, and it frightened them. So I walked in on my first day, and I had a line of people sitting down saying, I don't know what on earth we're trying to do. So I had a really great professor who once said, strategy can be beautiful on a slide.
ANNA TROISE: However, if the staff have no idea what to do when they go to the desks, it's ridiculous. It doesn't mean anything. So I kind of took a step back and looked at the sort of state of the team overall. And what I saw was an incredibly siloed organization. So under education specifically-- and I know associations handle it differently all over-- but education at the Academy is the annual meeting in live courses.
ANNA TROISE: So we have a cadaver lab in our basement where we can, like, do all kinds of live, cool courses with cadavers. It's awesome. We have practice management solutions. We have our publications program and our books and journals. We have our assessments and our examinations. We have our online learning, and we have our international education program.
ANNA TROISE: So we do a whole bunch of stuff in various local regions with orthopaedic surgeons. No one talked to each other. No one works together. It was so siloed, and everyone was incredibly focused on what they do and what their silo was. Innovation was undervalued. Resources were really process-oriented. They were not strategic.
ANNA TROISE: There wasn't an emphasis on data-driven decision-making. There was a small, but not as much of a use of business planning. There was no project management techniques. Fiduciary responsibilities were sort of limited. There weren't really budgets. People just built things and did stuff. And most importantly, it was a culture of acceptance. No one challenged each other.
ANNA TROISE: Nobody actually had any kind of discourse about, how can you make things better? How can you improve? How can you grow? The governance structure-- and I will say, coming from a commercial publisher, I did not have an appreciation of the governance structure at an association like I do now. As an example, the governance structure for education in itself has 518 individuals on it who are all part of the council or the various committees.
ANNA TROISE: So there's a lot going on with it, and it seems a bit unwieldy. However, the staff are awesome. They have a huge amount of experience, they have a huge amount of capabilities, and they have a real interest in learning. So we started asking the questions, how do you get the right people to do the right things? How do you support the desired future state of where we wanted to go?
ANNA TROISE: We knew that we wanted a state and an environment that was centrality of customer focus, tolerance for innovation and experimentation. We want people to take risks. We want people to not be afraid to fail. And, of course, if they fail, fail fast. But we want people to do that. We really wanted collaboration across departments. We needed to get education, talking to technology talking to the PMO office talking to operations talking to marketing.
ANNA TROISE: And that was something that was really important. We wanted a proactive communication with that. We don't want people hanging each other out to dry. We want a team culture. We want strategic thinking, future orientation, vision, supporting goals and results rather than tasks. And we want continual professional development, sharing and learning from other associations, other businesses. Get out of your own little silo, whether it's a medical association.
ANNA TROISE: Go see with the consumer electronics group is doing. Go learn something new and bring it back to the Academy. So we really tried to simplify the approach. So our CEO is very, very clear on what our values are within the organization, and we constantly are reiterating them. So empowerment, accountability, teamwork, and learning. And then we step forward a bunch of immediate priorities, so one being used language the team will understand to communicate your strategy so that they know how to support the direction.
ANNA TROISE: So frankly, we stopped speaking like a group of MBAs. We actually spent a lot of time to think really carefully about how to use language to empower people to understand what we're trying to do. We did classic deep dives into all the different businesses. What are quick wins? What should we stop doing? What should we start doing? What are we doing well, and what are some of that training we need?
ANNA TROISE: I mean, we have a group of staff that really have a can-do attitude, but none have actually ever been tasked with putting together a budget, so they need some financial and training skills to be able to do that. So we worked through this and we reimagined our strategy. And there is a card that keeps being held up over there and I'm running out of time, so I won't walk through this. But this is the way that we started to really reimagine what our strategy is.
ANNA TROISE: And coming from a commercial company and now saying that members are a priority still is kind of funny to me. But members are a priority. If we don't continue to attract them, we're completely irrelevant. Education is something our members keep telling us that is important to them. But with so many options and they can get anything they want for free, why should they keep coming to us?
ANNA TROISE: So our hub strategy enables us to deliver the best offerings so the members are satisfied. They renew. And it provides a sustainable revenue stream so it continues to fund the overall ecosystem. We have to provide information that enhances what we're already good at, is financially sustainable, is accessible, it connects us, and it prioritizes our offerings.
ANNA TROISE: It needs to be engaging. It needs to give us eyeballs so that we can continue to be able to provide member value. And if we can provide more valuable content, it leads to higher renewal rates and gives us more opportunities to expand. So I keep saying this within-- thank you. There's zero minutes.
ANNA TROISE: So I keep saying to my team, content is content is content. Who cares if it's live? Who cares if it's an exam? Who cares if it's a journal? It's all something that people need in various different formats and delivery mechanisms wherever it is. It's not about the product formats. It's not just about access.
ANNA TROISE: It's about providing personalized needs-based content to customers and stakeholders how and when they want it, and ensuring that our digital relationships are built on frequency, emotion, and convenience. We need to optimize our partners' experiences with the Academy, and we need to work to meet their needs, and create a strong foundation to support our offerings. So we created a new team to try to cut across all the silos.
ANNA TROISE: I'll keep going. We have our priorities. So this is really what we're trying to get to, and this is a work in progress. But we're turning our education team, at the end of the day, into a product strategy and product development organization. This may look a little bit like agile, but you can't really just adopt all of agile in our world because CME is probably the least agile thing that exists.
ANNA TROISE: So we've kind of adopted our own little way of kind of going through this using some of the Academy processes before and teaching people what we need. So the pyramid really here is trying to evolve and think about the operational workflow. So what is the infrastructure, what are the technologies, and what is the data you're collecting for the analysis of whatever you're trying to build? So whether it's a platform, so our LMS, our exams platform, our annual meeting submission system, our video platform, what we do live, what is that infrastructure?
ANNA TROISE: How is it working? What is the workflow for that business? Moving it up, what is the problem we're solving? Are we just building something because we need to? Are we trying to actually solve a problem that people have so that they use it? I mean, ultimately, that's really the goal. What is needed? How can we meet their needs?
ANNA TROISE: What's the market telling us? Then from there, building. So what's the product being built? What's the delivery mechanism? How do you fail fast? How do you test the market to know you're building the right thing? And under this build, this is where people are starting to identify, and they're starting to think, oh, well, if I'm building annual meeting, I fall into that.
ANNA TROISE: I need to do everything that's underneath here and think about all of these different things. Why would somebody want to come to the annual meeting? How do we continue to make that engaging experience? How do you have the infrastructure to support that? So we're trying to flip the thinking a little bit. Go to market strategy-- one of the things I noticed that we really didn't do is we were launching tons of content on LMS on a regular basis, but nobody knew about it, so no one's going to come in and use it.
ANNA TROISE: So what is the actual message? How do you get that content to market, something publishers do so well? They make their content discoverable, and visible, and accessible. And we were sitting on all this stuff, and no one knew. So as soon as we started to actually change this approach, we're seeing our usage increase. And then, of course-- and I think somebody said it in an earlier session-- learn.
ANNA TROISE: So what are we measuring? You can't just launch something and let it sit there. So was it successful? What's the feedback from the market, and how do you feed that back in so it's a continuous feedback loop? So this is really where we're trying to get to. Obviously, we want to be meeting the needs of all of our different customers and not just thinking about the members, but thinking about the wider ecosystem of everything the Academy touches, and using that feedback from them also to feed into our overall product strategy as well.
ANNA TROISE: We want to be building things regardless of what it is, whether it's live or whether it's a product, that meets certain functional needs and certain emotional needs. And then, I think we'll be able to be pretty successful. So we're off to a kind of crazy start. It's been a wild nine months, but it's been a lot of fun, and it's starting to work. So thank you. [APPLAUSE]
PAUL GEE: Hi. Hi. I'm Paul G. I've worked with probably 70% of you here, whether it was at WK, or whether it was at the AMA, or whether it's through Silverchair. So whatever lens you're at, I can say I worked with Jane for maybe under a year. But you'll see very few words on the slide, so maybe-- [LAUGHTER]
ANNA TROISE: He listened.
PAUL GEE: I don't know how I got that from you, but maybe that's where it came from. I managed the product management and the development team and our digital marketing team up until about a year ago just for the JAMA Network at the AMA. I like to say I moved to Chicago for the J. I'm a journalist person. I've always been a journalist. I don't know much about education. I've been getting an education in education.
PAUL GEE: But the way that my team is set up, it's to serve the strategy of the business unit we're assigned to. And JAMA has a very specific goal. It's to be a journal, to run a good business, and to deliver that layer of profit back to the nonprofit so they can fund mission. What's been really exciting is transitioning where I am now working directly alongside my counterpart on the education side, Julie Gill, working to build for a mission.
PAUL GEE: One of the things that differentiates the AMA strategy right now from some of the other things you've heard is we're not out to try to build our members through this education strategy. We're trying to bridge gaps with customers. There's been a couple of themes that we've heard throughout the day, and I've been noting and been pretty excited that I've been talking about these things for two years.
PAUL GEE: How do we see our content as a society being in two different channels from two different groups? Why is it in two different platforms? Why is it managed differently? Why isn't it seen as one strategy? Because the end user, they have different things that they want. But physicians, whenever you go to physicians and you do customer research, whether I did it at WK or whether I did it at AMA, they say the same thing.
PAUL GEE: I just want to be able to get to content. I don't care what type it is. I want the barriers to be gone. I don't want paywalls there. I don't want a publisher URLs to change. I want the experience to be the same. You can't solve all those problems. And definitely within the context of each project you work on, you can solve-- there's certain things you have an ability to solve.
PAUL GEE: You solve for those, and you move on. We've been able to align our teams, kind of bridge that gap, bridge how we create content or think about content, and also take some of the successes that we've built at the JAMA Network over the last couple of years and extend it to a different set of content. We've made a hub. And for us, the hub is actually more of a trademarked term that we're going to be launching in October.
PAUL GEE: And the hub is actually there to swap out and stand for this idea of center. Like, center is a very inward-focused word. It sounds like control and command, kind of. That's not what we're trying to build. We're trying to build a place where we can solve a physician's problem. I need to find everything I need for CME for my state, and I need to be able to track and see it pushed to my boards.
PAUL GEE: One of the other contacts, the AMA is a little bit different than the other societies. Were composed of a house of delegates, which has members of all the societies, and they vote on measures. And one of the measures was solve the tracking problem. Make it so that all content that's taken for CME gets pushed wherever it needs to go. Shouldn't you be able to do that at the AMA?
PAUL GEE: And we're going to try. And we're not doing this to grow our membership. We're trying to do this to solve problems for the positions. And that is really exciting for me, because as a product manager, one of the hardships you hit is when you have constraints. You have constraints on brand. You have constraints on business model. You have constraints on technology.
PAUL GEE: Working on a fully mission front is really exciting. We've been taking it head-on and trying to figure out, how do we solve the internal issues that all societies feel, the breakdown between journals and education? And I think we've done really well doing that. Internally, we're working together really well. We've come up with a strategy that this works for the AMA. We have 10 different floors at the AMA, uniquely 10 different business units.
PAUL GEE: They all make education. The people even in the AMA don't know what education or opportunities are being built by the different floors. Silos are within silos. We're trying to create a single place where users shouldn't have to feel those silos. We have a team that brings the content in and can push it out. We also have JAMA Network publishing.
PAUL GEE: And in a three-year period, we have about 1,100 CME articles that are just always sort of flowing in and out and expiring. How do we marry those experiences for the end user so they can go to a topic, find the topic they need for their state, take it, and go away? Because that's all they really want to do. We've taken the journals platform and we've extended it to contain mirror images of all of our journals that are only uploaded once on the journals platform, but appear in a different site that is branded AMA Ed Hub, and then all the other channels.
PAUL GEE: As you saw yesterday from Duke University, using Site Builder, they're able to just roll out a different site with no development, configure it, change the brand. We've made that part of our strategy so we can create a platform within our educational platform that can handle traditional LMS content. It can handle journal article content. It can handle stubs. So we can port things in from our LMS, just the header, and link out to that LMS.
PAUL GEE: And we can kind of create a hub whether we host the content internally or not that serves that end user's goal of finding and discover. It's indexed by Google. So unlike a lot of LMSes, we're able to take advantage of passive discovery. Google can send us traffic. We can automatically alert and send emails out to the constituents.
PAUL GEE: The enhanced discovery portion of our strategy is really the portal strategy that we are building in a sort of very normal journal way. We also have this idea of assigned activities, which is very much along the lines of what Mike was talking about. We know we need to be able to go into health systems, give them tools where content is assigned to change measures of care. One of our goals-- that is a huge goal-- is, how do we bring down cost of care?
PAUL GEE: That's what we've been tasked to do. We're looking for ways to do that more and more. The integration on the back end allows us to transcript that information, keep the site connected, know that user's journey. If that user is a student that becomes a doctor later, we should know what they're good at. So we're looking for ways to hub that information as well. Friction-free learning, we have a little team called the Dev Lab looking to solve other end user problems.
PAUL GEE: How do I automatically give credit when learning occurs? Most of the time when you go and do customer research, one of the bigger complaints is, I already did the learning, but actually claiming it is such a pain in the ass. I won't do it. So how do you break that down? How do you actually deliver the credit the minute the learning occurred, even if it happens in a practice situation?
PAUL GEE: Someone treats a patient, they actually look up information-- not through research or other ways-- but we find a way, absorb that, and give them a credit for doing it. We are not able to do that right now, but that's the kind of question we're asking ourselves. How can we find real learning, and reward it, and have that transcript information automated? It immediately gets pushed out to wherever it needs to go to tell people.
PAUL GEE: And finally, automatic reporting. We had to build a system to permit JAMA Network a couple of years ago. It got accepted as an activity for MOC with the Internal Medicine Board, and we built out a system. One of the things we wanted to do in this sort of friction-free learning philosophy was make sure no one ever has to look up their diplomat idea in order to get MOC.
PAUL GEE: If you took CME, you should just get MOC. The AMA has the ability to develop relationships. So we developed a relationship. We make these data sharing agreements with the AVIM that allows us to automatically match any diplomat ID-- sorry. I need water-- and then push it back out to the board. They take a CME course. They can take it on our app. They can take it on our website.
PAUL GEE: They don't see or feel anything more than CME, and they get MOC the next day. And we're looking to try to grow that and build that out so we can meet the goal that the delegation has really assigned to us, which is streamline the physician experience. All those things are difficult, but one of the things that was the trickiest, we sort of did technical analysis. We thought through, how can we resolve a lot of the technical barriers?
PAUL GEE: How can we build these services? Well, one of the things we had to get over is that division between journals and education. And at the AMA, that J is very, very important. Thank you. So the J means that we're editorially completely independent from the AMA, and we take that seriously. It's kind of funny and a joke.
PAUL GEE: But, like, some people on my team, now that we're working on both the AMA products and the JAMA products, they have two cards. John has a purple card and a red card. It helps get things done. So how do we actually-- if I have an employee with two cards, how do I build a website with both of those colors in it? And if we are being tasked with trying to bridge the gaps between the federations, the AMA, and the end users, how do we create an area of trust?
PAUL GEE: We're not trying to take over brands within our own house. We're not trying to do anything that would disrupt the experience of that end user. And when you do customer research, and users say, I don't want to see colors. I don't want to see pictures. I want to see topics. I want to click on a topic, I want to take the topic in that area, and I want to get CME.
PAUL GEE: So we designed a very neutral territory landing area. We came up with the AMA Ed hub. It doesn't use the bright purple. It uses a little off-color purple. That, in itself, if you've done branding discussions, was a war I have bruises from. [LAUGHTER] The interface itself is not meant to be glitzy. It's supposed to allow the user to actually just get to the content they want.
PAUL GEE: Our goal was to bridge these barriers, the barriers you see and the barriers you don't see. That gave us the ability using the tools that we have available to us to create different sites for the brands within the AMA. I can launch those sites. I can build a new one tomorrow with website builder. I was thanking the people from Duke University for demonstrating that for me.
PAUL GEE: So if you can remember back, that's what we do. I don't think it works as quickly as that video did. [LAUGHTER] But it allows us to get here, and it allows us to do things without having to plan development. We have a front-end web designer who knows how to use these standard modules. We can affect this different visual for any product, and they're the same technology, the same widgets that are designed, so the user's experience is the same.
PAUL GEE: They know where things are. They click, they get the same experience. It gives us the ability to bridge these barriers as well. And getting through to the point of approval where every element of the branding within our house was approved gave us faith that like, OK, we've gone in the right direction. So we pulled this together.
PAUL GEE: We're able to resolve a lot of issues. And we're looking to bring this hub out into a space where we can completely follow through on those missions to automate discovery, to create a single channel of discovery, whether we host or actually provide that experience or not. To provide a single transcript that all parties can consume and can automatically push out to the parties that need to know, and to create an integration model that makes it really easy to choose what is complementary to the mission of the association we're working with?
PAUL GEE: What is complementary and not competitive? And we will figure out all of those different barriers together. We've planned everything so it's really just a series of options we already have, because we plan for ultimate flexibility. It's been a really fun project. It's an exciting time at the AMA. You know, we talked about change organizationally. JAMA changed a lot in the last five years, and it was really fun to be part of it.
PAUL GEE: And it's really fun to be part of this change as well, because the AMA'S reputation is going to dramatically change as we effectively meet these goals. Thanks. [APPLAUSE]
MICHAEL CLARKE: Do we-- we'll use the [INAUDIBLE] rule of live questions as a priority. Does anybody have any questions to kick off the discussion? All right. While people think of questions, I have a question. So, you know, education-- and you've all alluded to this-- it's a messy process or it's a messy area because it is a process as opposed to a format.
MICHAEL CLARKE: It's not like journals, which are journals, or books, which are books. Education could be anything. And it cuts across the organization. And Mike, in the case of your enormous organization, it cuts into all sorts of different companies. How do you bring together stakeholders and sort of manage the process such that you're able to get some forward momentum across so many different organizations or divisions?
MICHAEL CLARKE: Have you struggled with that? Have you had to create new processes and structures?
MIKE MUTKA: The short answer is with great difficulty.
MICHAEL CLARKE: Yeah.
MIKE MUTKA: Yeah. The biggest thing in the organizational culture is-- and we learned this in good, bad, and ugly from our private equity owners, Vista Equity Partners, who are really cutting-edge SaaS company operators. And that was that it sounds like a cliche, but perfect really is the enemy of greatness with this stuff. And so you can plan the heck out of it, and try to get it 95% right.
MIKE MUTKA: Number one, you won't. Number two, it'll all change by the time you're done planning. So getting it 75% right, and being very nimble, and correcting, and then collaborating very, very closely hand-in-hand with your customers are the key. But we've created a culture where you have to just move forward very, very quickly and make mistakes, and that's OK. But it's tough.
MIKE MUTKA: It's increasing. So for example, we've acquired 12 companies. We've in four years' time merged all of those platforms into one platform. And the first time, we went much slower than we did the 12th time. The first time was, you know, go slow. Be careful. By the 12th, we're like, no, no.
MIKE MUTKA: Go, go, go, go. So just pushing ourselves to go really fast that way.
ANNA TROISE: So I think from our end, a really good example would be practice management. So in April, all of a sudden everyone looked at me and said, you're going to run practice management. And I said, great. Like, show me the P&L. It just was everywhere. And if you ask anyone about what is practice management to a doctor, they all have their different answers. And so it was interesting.
ANNA TROISE: We underwent a big strategic review of our practice management portfolio. And what we ended up seeing is just we have this very important coding book. And outside of the coding book, no one really thought we had anything, but it was totally untrue. We ended up seeing it across the entire organization that we actually were able to populate all the different areas of practice management.
ANNA TROISE: It was just scattered. And the way it was organized on our website was by our governance structure, not how a user wants or how they would come in and look for it. So really, I would say that be able to manage that, and it's all educational products. It's getting buy-in, and then figuring out, what do you have, and what do you want to be when you grow up? And then doing some simple organization to put it in a place that is in a manner that the actual end user wants it as opposed to, it needs to be in the advocacy section.
PAUL GEE: There's no-- there's no messiness at the AMA. Look at how clean my slides were. [LAUGHTER] No. I have the luxury of not having to work on what content goes where. That's something that my counterpart Julie's team works on, and it is messy. But one of the things we do is we have been going out and doing user studies.
PAUL GEE: So we show the interfaces, we show the content in the stages as we build them and after we build them. And we've taken it to heart that what the user says goes. And we've changed those topical arrangements. We have topical arrangements, which is something different than how we presented some of our products in the past. And we've sort of doubled down on topic because they said to. And we go through constant negotiations about how to effect changes in the interface in the model.
PAUL GEE: But we do also have a system of accountability, where just a couple of people can make decisions and then get the bruises for the bad ones. [COUGH]
MICHAEL CLARKE: A question over here.
AUDIENCE: Hi. It's kind of a general question, but I was wondering if the panelists could talk a little bit about how you're addressing or thinking about personalization for individual learners within sort of the bigger, broader structure of your hubs or organizations.
PAUL GEE: Well, a lot of what we're doing for the education is building on the strategy we had for journals. That's fundamental, and it was actually one of the reasons I started working with Julie. We just launched the ad hub-- I'm sorry. We just launched the JAMA Network, or relaunched it. And when we did, we took advantage of a lot of Silverchair's semantic functionality, even to bring topical associations to anonymous users, which I kind of talked about before, and we really said.
PAUL GEE: And that's been working really well for various aspects of our business. And one of the things that the education center wanted to do was all the things we've heard goals around for education is, how do I align an educational topic with someone coming in? Well, I've got a very successful-- you know, we've got millions of page views a month amassing interest base interest on JAMA Network.
PAUL GEE: If I build the education center on the exact same platform, we have those affinities intact. So it gives us a jumpstart. We have email programs which we can immediately plug into. So personalization, we've made progress in a lot of the concepts that people have talked about today. And we've also worked on how we harvest that, and have our own database, and how we sort of can use it for different things, like in our LMS to equate to effective GAAP measures.
PAUL GEE: We haven't executed on those, but that's in our strategy to try to get there. The baby step was discovery, that pedal about discovery on the front-end web.
ANNA TROISE: So we're just starting on that, and it's exactly what we're trying to do. And basically, in starting with the LMS, but you can look at lots of different, whether it's our live courses as well, in a way, about who is the person that's coming in? What courses are they taking? What exams are they? What are they getting wrong? Why are they getting it wrong, and then how do you guide them into the appropriate types of content sets that they need to be able to do whatever it is they're trying to do?
ANNA TROISE: So we have lots of different data, but it hasn't been aggregated in a way that we're able to really make those types of insights yet to be able to push it out to our membership. But that's exactly the next stage, and we're trying to sift through it and make sure that the data is making sense and we can collate it all together. But that's the golden goose.
ANNA TROISE: I mean, that's, I think, what everyone's trying to do.
MIKE MUTKA: It's a great question because I had a little chart that said, analyze, assess, learn. And what we've learned is we're going to lose a bit of credibility with our provider and clients if we help them analyze the data and where they're underperforming, assess everybody individually, and say, now, the answer is assign 10,000 people this course we've got. And magically, the behavior change fairy will come and make everything better.
MIKE MUTKA: So ideally, we want our assignment plans for each individual to feel kind of like when you go on Amazon, and they recommend five new products, and you're like, how did they know I would want that? And it's got to be like that, where the person comes on, and the learning has been really well-curated for them based on their individual strengths and weaknesses in the assessment and their performance. But the course is only one small part of it.
MIKE MUTKA: It's also giving them access to the performance data, because a doc whose cost is 50% higher and their outcomes are 20% lower than the other docs doesn't want to be given a course on how to get better. But if you show them privately how the other people their peer group are performing, they will go consult with them, find out what they're doing differently, and use that data, along with other tools, to figure out how to learn.
MIKE MUTKA: So it's more than just the course, but it all does have to be personalized. That's where it's going.
AUDIENCE: Has accessibility raise an issue, accessible content? Are you having to address accessible content? And if so, what are the challenges in medical practice in health care?
MIKE MUTKA: Yeah. It's just kind of a table stakes given. Accessibility is real-time, 24/7, content snacks, five-minute learning opportunities here and there, all kinds of different formats. Meeting people where they're at, whatever device, whatever time of day, wherever they're at.
ANNA TROISE: Agreed.
PAUL GEE: I couldn't make out the question. I'm sorry.
MICHAEL CLARKE: Accessibility, importance of.
PAUL GEE: Yeah, I agree with everything said. We're all following on that same path of trying to meet every objective.
MICHAEL CLARKE: OK, I'm going to give you guys one last question, because it's time for lunch. We have a wonderful lunch, I hear, waiting for us. So because this is platform strategies, I have to ask the platform question. So it sounds like all three of you, your organizations are moving from a product orientation or an activity orientation to a platform orientation, even if it's just finding content.
MICHAEL CLARKE: But I'm curious as to how organizationally you've been able to make that shift, and what that's done in terms of thinking about how you develop future products. In other words, are you continuing to think about it from, here's a product. Put it on the platform. Or has platformization really changed the whole way in which you think about education, if that makes sense?
MICHAEL CLARKE:
PAUL GEE: From my perspective, it's a little tricky. There isn't one platform. There is a place where the bulk of the content's hosted, and it is the shiniest thing that you see, and that's the journal's platform, or the new platform or relaunching for Ed Hub, and that is a platform. But all the things that run automatic reporting is an integrated system I'm also responsible for with other vendors or internal. We have apps that are integrated with it.
PAUL GEE: Really, what's important is a strategy or to build an ecosystem that builds that conceptual platform and makes an end user feel served with the right need at the right time. And I have the ability to pick partners, vendors, or internal developers to do the thing based on cost and need that needs to be done. And it took five years to get that into I wouldn't say the perfect scenario for JAMA Network, but it's a good one, and we're building on that for the Ed Hub.
ANNA TROISE: So I think the Academy is shifting a little bit. Initially, it had been we wanted absolutely everything to be coming in and out of our LMS, because that just seemed like it was the appropriate thing to do. At this point, the way with the total shift in culture, really, the philosophy seems to be, we can work with lots of different vendors and lots of different technology solutions, but it's about the user experience and the single sign-on.
ANNA TROISE: Does it feel like you're all within an Academy product? We have our LMS. We have a video platform. We have our exam engine. We have our journals. We have our books, and all of those are on different platforms. And so the philosophy is that when we want to do something on our team at this point, it's, what are the business requirements?
ANNA TROISE: What do we need to do? What's the problem we're trying to solve, and then who's the right vendor to be able to do that? If it's one, that's totally on the table. But right now, it's been lots of them so we can have a plug and play approach.
MIKE MUTKA: Yeah. It doesn't necessarily have to be one platform, but it just has to feel like one seamless platform to whomever the user is. We're in the process of combining analytics and assessment with our learning management system so that that data, that actual results data and skill stuff will then trigger the learning assignments and everything, and that will all be integrated together seamlessly. The big thing is our platform is just much more than content delivery.
MIKE MUTKA: That's one small part of what it's got to do.
MICHAEL CLARKE: Thank you. Thank you, all three of you. And we'll continue the discussion over lunch. [APPLAUSE]
Form Title Download
Transcript
Form Title Bookmark
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Share
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Form Title Accessibility and Keyboard Shortcuts
The cadmore media player is a professional video and audio player experience designed to deliver media as well as relevant transcript, segmentation, and metadata. On the screen is a traditional html video player with buttons such as play, pause, forward, captioning, language and play speed selection and more. Adjacent to the video player are generally tabs, one of which shows a scrolling transcript of the video and the other shows any segmentation of the media, sometimes referred to as chapters. At the top of the video is a menu bar containing an Explore button and Tools button. The Explore button allows you to dig deeper into the video by opening up an explore dialog which contains tabs for a visual navigation of the video using thumbnails, an about tab which contains rich metadata about the media, a segments tab which contains further information about the video, and a related tab which contains links to other media related to this media. The tools button opens a menu with options for sharing the media on social media, creating bookmarking links, creating embed codes for your website, generating citations, and more.
Keyboard Shortcuts
Keyboard shortcuts only work while you are in forms mode. By entering forms mode, you will be able to quickly access portions of the media player with single key commands.
Spacebar: Play/Pause Toggle
I: Info Menu,
O: Tools Menu
T: Transcript Tab,
S: Segments Tab
F: Forward 15,
R: Rewind 15
L: Languages,
P: Playspeed
M: Mute Toggle,
V: Volume Bar
N: Video Only Toggle,
B: Full Screen Toggle
C: Captions Toggle
Escape: Closes dialogs and menus / Exits Player
Z: Next Transcript Chapter
X: Previous Transcript Chapter
Q: Next Transcript Paragraph
W: Previous Transcript Paragraph
Entire Media
Segment(s)
Custom Clip
Start At:
End At:
Embed Size
-
You Size - Responsive
-
We Size - Responsive
-
Picture Overlay Popup
-
400 x 225
-
512 x 288
-
400 x 700
-
768 x 1024
-
1024 x 512
-
1280 x 608
Form Title Cite
No citation provided.
Info
Segments
Related
Thumbnails
Exit Clip Mode
You have requested to see a portion of the video outside of the clip.
Click OK to switch to the full video or click if you would like to stay inside the clip. You can always go back to the clip with Tools and Clip Mode