Tiffany Tate (CEO, VAULT Technologies)

Can you explain your job to a five-year-old?

I would say that our goal is to make sure that everyone has the information that they need to be as healthy as they can be, and that is really important when you have a pandemic like you all experienced in your life. We’re just making sure that technology can help people at every level in healthcare or in public health so that they can do their jobs faster, more efficiently, and with greater quality. 

What excites you most about your job?

The most exciting thing about my work is what we're doing around the internship programs and the trainee programs, because, my days in this space are numbered, but I’m able to train other public health technologists—a term that I believe I've coined—people who understand technology and also understand public health and healthcare. There are very few people on this planet who understand both of those industries. And so I think it's really important for the legacy of our company to be able to train young people to be public health technologists to understand healthcare and the challenges and to understand our applications and understand how they are relevant.

So every time we have a session with our developer team, I explain to them why this button needs to be purple, why it needs to be placed here, why we have this workflow. I take them into a clinic. I explain to them why this is the way that it is. So I am excited about bringing together diverse backgrounds, diverse perspectives to create technology solutions that can address health equity, that can address global pandemic issues. If you have just a homogeneous group in a room, a bunch of people who look and think and act the same, we're not going to get the best products. And there's lots of data out there to support that, when you have diverse teams, they are more productive. They produce more responsive technology. So that's the thing that excites me the most is just training the next generation of public health technologists who will be able to see us during normal times and also during the next pandemic into the future.

We're doing our program in Ghana. And we're starting a program in Jamaica where we're training young women to be software developers. It's a nine month program, and at the end, they'll be qualified to be entry level software developers. We're doing this because I want everybody to see that we learned. A global pandemic—it started all the way across the world, and it reached us in a matter of months. And we did not have an efficient way to communicate with people and to share data and to share information to be able to track this better in real time. We had to wait for reports that were being faxed and they'd get lost in emails and all this stuff, when we really should be connected. And so we’re reaching out to other parts of this world and training them and explaining to them how we all are connected and how we can all work together to prevent the magnitude of which we experienced in 2020.

So everyone's throwing this word around—interoperability—but you have to have people all across the world who buy into this concept and idea of the importance of exchanging data. You can't just put a system there. If people don't believe it, they're not going to use a system. And so we're training people to understand why it's important that they understand public health and health care and why it's important and how, why they should be committed.

Which trend will change the future of medicine? 

I think people have been talking about health equity for a long time. And the reality is we haven't made a big dent in it. And it's because people are trying all these different things. People aren't working together and using just common sense. So some of these health equity solutions people are coming up with, they're so sophisticated and they're so rich in data and visually, the products are intimidating. 

So if you think about who needs to use these health equity solutions, it’s public healthcare providers. Historically, healthcare providers are not the most tech savvy people in the world. And so you're presenting them with this technology and it's got all these dropdowns and buttons and menus—they're not going to use that.

So we need to take a step back and just say: we need some sensible, user-friendly, intuitive solutions to enable the work that needs to be done. So, in terms of healthcare providers, their task is to be able to collect data from patients and act on that information from the patient perspective. They need to be able to interface with something that they can provide demographic information, maybe receive information about appointments, or be educated on a service that their provider has asked them to have. Because now there's the shift in public healthcare, where providers just don't have enough time to explain it. So they'll give Miss Smith a prescription for a mammogram, but she doesn't even know what a mammogram is. She doesn't even know that. So then she might not even prioritize that because nobody has had a chance to explain it to her. So we have a program that we're implementing now called HEAP and has a component where it's all automated.

The provider refers Mrs. Johnson to HEAP for a mammogram, makes the effort to explain it, but also Mrs. Johnson can get information on her cell phone written at a fifth grade level that says a mammogram is a breast x-ray, it might be a little uncomfortable, and you might want to take a Tylenol before. She gets that information that then demystifies it and removes some of the fear around it. Mrs. Johnson might then be more likely to get the mammogram. 

So that's just a common sense, simple way of approaching this. But if you look at some of these health equity programs, people are overloaded with data. If the person is between the ages of 27 and 45, and they live here, and their zip code is this, and they have these comorbidities, then you should do A, B, C, and D. How about this? Just make sure Mrs. Johnson knows that this is a breast x-ray. Everybody knows what an x-ray is. We are x raying your breast, and it might be a little uncomfortable, but this can save your life. That's all they need to know. They don't need a brochure, a five page pamphlet and you explaining that to them in medical and technical terms.

They need somebody to say something to them at the right level. So we have technology that we can leverage in a very common sense way. But a lot of times we want to be so sophisticated and it's complicated and it turns people away. So that the keys to addressing health equity using technology—it’s just simplicity and common sense. 

Looking back, which trends have you missed or underestimated? 

We haven't talked about my background, but my background is in public health. Up until 2020, I was just a person on the front lines of public health, going into schools, overseeing clinics where we were administering vaccinations to children, and we'd go into other community settings, long term care facilities, senior centers. So I had no idea what would come of my creating this technology that I did just to facilitate that work. We weren't selling it to anyone. I created it so that it would make my job easier. So I could automate the consent process when we were giving kids shots in schools without their parents being there.

Our first year, we increased utilization, acceptance of vaccinations in schools by 50%. Just by having technology, 50%. We went from 8,000 children in one school district to 12,000 in one just by introducing this technology. It was amazing. So then I said, Hey, we should do this all over. We should share this with everyone. I didn't know that I'd have to build a whole company around this technology. There used to be something called a floppy disk. You’d get a Microsoft Office floppy disk. You put it in your computer. And I just thought I would just download a bunch of these and send them out to all my colleagues. 40 employees later, I was like, Oh, there's a whole business that needs to be built around it. So I underestimated that, I did. 

I didn't have a full appreciation of what running a technology company was, but I also didn't have a full appreciation of the learning curve for people who aren't accustomed to using technology to do their day to day work. COVID required people to do that. Ours was the first mass vaccination application in the United States, if not the world. No one else had one. And other people came along and modeled theirs after ours. And collectively, we accelerated the vaccine rollout response. Had it not been for that, there would have been lines around the block. In the middle of winter, more people would have died because it would have been slower and we were losing people at a rate of 3 to 4,000 people a day at this time. So I credit our company and my team and the products that came after ours with really reducing the time that it took to vaccinate people. But I underestimated the resistance we might experience from people who said, Oh, we like to use paper and pen. And I was like, Wait, people are dying. No, we can't. We can't use clipboards and pens. We can't do this.

In healthcare, we just have to get people to be our healthcare providers. The people who are delivering healthcare have to be more comfortable with solutions. And the way to do that is to make them simple and easy to use. So pre-COVID, I used to train people on something called health literacy, making sure that people understood the information that's being presented.

And the first thing I would say is things have to look easy to read. And then they have to be easy to read. And I use those same principles as we build solutions. They have to look easy to use because somebody opens up a system and it has all these problems. Dropdowns and colors and numbers, and they're just going to close their laptop and be done with it. And that's what would happen if you give someone a brochure and it has all this dense text and big words, it doesn't look easy to you to read, they're not going to read it. If a system doesn't look easy to use, they're not going to use it. So the first thing is, our systems have to look easy to use, and then they have to be easy to use. They have to look intuitive, then they have to be intuitive. That approach was informed by the realization that there are so many people in healthcare who weren't comfortable with technology, and I did not know that and I underestimated that, but our system is very easy to use and folks were able to get up and running within 15 minutes of training.

What's the best advice you've ever received? 

I think that the thing that drives us ultimately is passion, so find something to be passionate about and be unapologetic about that. Because, being an innovator, you have to—it requires courage, and you've got to be brave, and sometimes people are going to think you're crazy.

And maybe sometimes you are crazy. But it's really important. 

That's what got me up in the morning and keeps me going, even in the face of detractors and people saying things, during COVID. We had some bad press and it wasn't our fault, and it was the first article that somebody says something bad about you, and you know that you wake up every morning because you love what you're doing. That you feel like you are serving your profession, you are serving your country, and you're making your family proud, and then someone attacks that. It hurts. But I always kept my eye on why I'm here. I love public health. I live it and breathe it. And so, find something that you are passionate about and go after that. And your days will be easier. Your sleepless nights will be fewer. 

And so the thing that I'm really passionate about is just evolving public health through innovation and technology and also bringing in women, people of color, and people from the LGBTQ+  community—people who are underrepresented in this space, who have so much to contribute, and who can make sure that we have products that really work and make sense and are responsive to everyone. That's what gets me up in the morning. 

And I think for young innovators, you can't chase money. You can't chase prestige. Because that does not sustain you. I'm 54 years old. I don't mind telling people my age because I wouldn't be where I am without the lessons that I've learned. And one of my mentors who's passed away told me to always remember that there is a person at the end of the dollar signs, the algorithms, all of that stuff that we're doing. Remember that who we're doing this for could be just one person. And so always think about how there's a person that's being served or helped or their life could be changed or saved because of something that we do. 

So passion and being unapologetic about that. And I say there's not enough women in this space. There aren't enough people of color in this space. It is sad. I had a person who's transgender on my team, and they said that no one knew what to do with them when they did interviews. But they see these pronouns and they're like, we don't know what to do with this person. And this person is amazing and has gone on to this great position because of the things that they learned when they were with us. I had no awareness around the transgender community and what their experiences were until this person came and shared that with us. And I'm so grateful to them for that, because I really appreciate it. Women experience things and people of color experience things. And then you see that there's another group that's being discriminated against and not valued just for who they are.
And so to have passion and not be unapologetic about that, with our internship, that's who we target: women, people of color, and people from the LGBTQ+ community. And I don't listen—if you don't like it, then don't apply. If you don't like it, don't work here. That's who we are. I'm not apologetic about that. 

And I had someone yesterday ask: why is your program in Jamaica for girls? I said, because that's how I want it. That's because that's how it is. So I don't have to apologize. I know what my experience has been as a woman in this country, as a Black woman in this country. And I don't need to try to explain myself. If you want something for boys, go do a boys’ program. There's plenty of them. And we did all-men in Ghana and we're doing women in Jamaica and I will proceed with coed programming, but don't question me. Go do your own. There is a lot of space to do that. Don't criticize my approach. Build your own or build another space for that. Be a passionate, unapologetic person and just recognize: I'm just so grateful for every opportunity that I've had and to be able to help other people to come into the profession that I just love. I love the work that I do and to be able to introduce other people to this profession and take it a step further with technology, as public health technologists. I'm a happy lady.