CTO Sessions: James Lloyd, Redox

What has been your greatest career achievement? “Building a fully-remote, digital company when it wasn’t popular or generally thought feasible.”


Name: James Lloyd

Company: Redox

Job title: Co-founder, CTO

Date started current role: February 2014

Location: Denver, Colorado

James Lloyd has 14 years of experience in healthcare technology and entrepreneurial leadership. He is currently the CTO and co-founder of Redox, a developer platform serving more than 1,400 healthcare delivery organisations, including 95% of the US News and World's Report's Top Hospitals and 350 digital health companies in lowering the barrier of adoption of technology in healthcare. At Redox, Lloyd oversees the product, engineering, and security teams, and leads strategy and cultural initiatives. Prior to starting Redox, Lloyd was an engineer at Epic and was a founding board member of 100state, a community-focused coworking space in Madison, WI. When he is not working on healthcare technology, Lloyd is an avid reader and enjoys homebrewing.

What was your first job? My first job after college — skipping over a brief stint trying to be a professional poker player — was at Madison, WI-based Epic, a large enterprise medical record company. There, I was able to work on problems which I characterise as “intrapreneurial,” internal projects that required an entrepreneurial approach. One project was a communication framework to help Epic headquarters communicate with Epic health systems around the country. The projects I was doing before that were just for fun to help out internally. But the communication framework had a big enough impact that then I shifted into working on interoperability and web services - more on the integration side of things. Interoperability and web integration would ultimately serve as the basis for Redox.

Did you always want to work in IT? No. I went to school for math and physics. I got my start with software development as necessary tool to run laboratory equipment and drive simulations and models for complex experimentation.

What was your education? Do you hold any certifications? What are they? Due to my father’s job, we moved around 14 times during my childhood. We landed in the St. Louis area by the time I was in high school, and I attended Truman St. University in Kirksville, MO. I hold degrees in mathematics, physics, and German.

Explain your career path. Did you take any detours? If so, discuss. After working at Epic, which entailed technical implementation, intrapreneurship, and software development, I jumped into the incubator world with Niko Skievaski (Redox co-founder and president) to establish Wisconsin’s largest co-working space called 100state. Then, with Luke Bonney (now Redox’s co-founder and CEO), we founded a healthcare startup incubator called 100Health. It was a very, very early-stage incubator, and it worked really well except for the part where we had to figure out how to pay ourselves.

Questions around investor payout and keeping the incubator’s lights on ultimately forced us to scrap 100Health. But in helping build the member companies, we discovered that several needed EHR integration support, and thus realised a single, reusable tool to support that integration might make sense. This tool represented the kernel of inspiration that would ultimately yield Redox. I think looking back 20 years from now, I would be unsatisfied if I was doing something that didn’t have real world impact. The high impact comes with high responsibility.

What type of CTO are you? I am very focused on our product and user experience. As a platform primarily used by developers, my role tends to be more externally-facing and product/business oriented than the traditional CTO. But I am also internally focused and try to make the technology work with the architecture. And I hire awesome people who can help make that vision a reality. I am a developer advocate inside the company to create great developer experience, while also  providing a great community for healthcare developers at large.

Which emerging technology are you most excited about the prospect of? I think no/low code is helping to transform healthcare. Instead of relying on developers, healthcare providers can use no/low code technology to create their own tools to address the challenges that are unique to their organisations. People who understand their organisations’ problems inside and out are now armed to create the solution. That’s incredibly empowering, and it positions healthcare organisations to be more innovative and efficient.

I’d like to add one more - AI is quickly becoming a mainstay in healthcare technology. At  Redox, we’re seeing use case after use case where AI is a default technology for everything  from workflow tools, to sleep apnea tests and diagnostics.

One of the things I care about from a developer standpoint is overcoming AI data bias. Data, like anything else, can be tinged based on preconceived notions of those collecting it. When that inaccuracy percolates through an AI process, the effectiveness of your results can often be problematic. I think a lot about how software developers work past this bias problem.

Are there any technologies which you think are overhyped? Why? I think blockchain falls into this category. I don’t know if we’ll ever get to a point where blockchain is fully embraced or used in healthcare. For example, conducting interactions where you don’t trust the other party is one problem blockchain helps to solve, but that’s not really an issue in healthcare.

What is one unique initiative that you’ve employed over the last 12 months that you’re really proud of? Tying together workflows and verticals. The way people think about integration is typically centered around specific data models. This puts a lot of burden on the software developer to know the sequence of events for each patient’s journey, understand what the workflow of the doctor and patient is, and stitch together resources and fields to make it work. We have come up with common workflows we see our customers using, and we associate those workflows with the vertical market they’re in. It’s really evolved from data, columns and rows to the actual interaction organisations are programming around.

We’re also quite proud of how we’ve been able to help solve challenges related to COVID-19. Since the pandemic began, we’ve connected to all 50 states' public health registries, some regional health registries and the CDC. We are currently transacting around 10% of the country's COVID test results through partnerships with 20 different testing companies.

Are you leading a digital transformation? If so, does it emphasise customer experience and revenue growth or operational efficiency? If both, how do you balance the two? As a cloud-native organisation, we provide a developer platform to cloud-based applications, and we’ve been instrumental in guiding customers through digital transformations. The pandemic drastically accelerated the role of technology in healthcare, and our mission is to reduce barriers when it comes to technology adoption and access to care.  

We’ve also seen healthcare become more consumerised, with patients exercising greater choice in all areas of their healthcare experience. A good analogy would be the demise of shopping malls. Malls used to be the default for shopping, but with the advent of online options like Amazon, consumers have gotten very comfortable with getting what they need with a quick tap and a swipe.

Similarly in healthcare, we’ll continue to see more apps that simplify the healthcare process, bringing telehealth directly to devices, and allowing people to collect and share health data with clinicians. As well, coupled with price transparency, consumers should be able to own and manage their health information for preventive and chronic care.

Also, the recent strides in interoperability regulation have crystallized the mandate for healthcare organisations to share data without friction to ensure accurate, timely care. This is all part of the digital transformation of healthcare, and Redox is squarely a part of this revolution.

What is the biggest issue that you’re helping customers with at the moment? Our customers are innovative software developers looking to reduce the internal and external friction related to the healthcare experiences, and our goal is to help build the infrastructure to make that happen. One of our customers’ biggest challenges is the length of the typical sales cycle for selling into a healthcare system, which is typically about 18 months. Our customers lean on us to help shorten the cycle, and we’re helping them to do that by matching supply and demand better, getting them the contacts they need, and making sure their demos are effective and other sales enablement processes.

Also, there are a number of emerging regulations and standards in the healthcare industry—like FHIR and the America Cures Act Final Rule—and our customers are asking us to help them understand how they will be directly impacted. 

How do you align your technology use to meet business goals? We’re putting a lot of R&D investment into processes—like automation of VPNs and implementation tools— and how to use technology to automate and standardise those processes to gain greater efficiency in everything we do. The end goal, from a customer standpoint is to give them quicker, easier access to our services. From a Redox standpoint, automation frees up our staff to focus on areas that utilise their talent and skill sets, which, in turn, gives us a greater gross margin.

Do you have any trouble matching product/service strategy with tech strategy? No, quite the opposite. We’ve worked really hard to create a culture that embodies a spirit of inclusivity and collaboration across all departments, and our product and engineering teams are a perfect example of this effort. The folks in these departments communicate brilliantly, so when a problem arises, they immediately dive into collaboration mode to solve it.

What makes an effective tech strategy? Collaboration is at the heart of tech strategy. It means gathering input from across the company. When we’re inclusive, we uncover new challenges that we can help our customers solve—challenges that might have otherwise been hidden if our input was only pulled from a limited pool. Tech is only as powerful as the human thought behind it.

We’re also focused on understanding the appropriate time horizon for the decisions we’re making. What it comes down to is this: The more customers expect from you the less they want things to change. So for startups that horizon is probably a few months, while mature companies that have stable customer relationships may be planning for the next 5 or 10 years.

It’s also important to understand areas where a company can take risks and where it cannot. At Redox, for example, there are parts of our infrastructure that must be highly redundant and can never fail, but there are others where, if you weren’t more cutting edge and experimental, we’d never provide value for our customers.

What predictions do you have for the role of the CTO in the future? The role of the CTO who is internally focused and looks more like a CIO is probably not going to translate in the wave of post-digital transformation. For digital-native companies, IT teams aren’t a traditional operational cost center that deals strictly with technology. Instead, they tend to be a more well-rounded group that has insight into a wide variety of business considerations, like product strategy and data science.

What has been your greatest career achievement? Building a fully-remote, digital company when it wasn’t popular or generally thought feasible. From the beginning, Redox was intentional in creating a culture that doesn’t rely on everyone working in the same place, or even living in the same place. As difficult as the pandemic has proven to be, our original vision allowed Redox to easily navigate the contention most companies faced last year with regards to their workforce. What’s interesting is that even though we’re not physically centralised, we’ve developed a culture that feels very connected, even over Zoom.

Looking back with 20:20 hindsight, what would you have done differently? My literal answer is I would have gotten Lasik sooner. But from a business standpoint, we started bringing in executive coaches within the last year, and I wish we would have done it earlier. They bring in a breadth of experience working with different companies and can offer an objective view into things your leadership is doing right and identifying areas of improvement. At Redox, the experience helped give us good insight into company operations and product and technology-related matters.

What are you reading now? The Bullet Journal Method, by Ryder Carroll; Platform Revolution, by Geoffrey G. Parker, Marshall W. Van Alstyne and Sangeet Paul Choudary; 15 Commitments of Conscious Leadership, by Diana Chapman, Jim Dethmer, and Kayley Warner Klemp.

Most people don't know that I… I’m fluent in German and lived in Munich for a year. I was there to witness the World Cup in 2006, which was pretty amazing. Zum Wohl! (Cheers!)

In my spare time, I like to…I love brewing beer. My favourites to make are lagers, stouts, and sours.

Ask me to do anything but… Karaoke and tuck a fitted sheet.