Visualizing Health Sciences Education - Andrew Dos-Santos, Founder, President & CEO of Fenix Alma Solutions

Derek Apanovitch: Hi, I'm Derek Apanovitch, Chief Operating Officer at Osmosis, and today I'm happy to welcome Andrew Dos-Santos to Raise the Line. Andrew is the founder, president and CEO of Fenix Alma Solutions, an edtech startup which recently launched a curriculum management platform called VidaNovaVLE. The system helps educators track and deliver health sciences education through data visualization and curriculum mapping tools. Users of VidaNovaVLE can also see where learners excel and where they are struggling. 

Before launching Fenix Alma Solutions, Andrew led edtech initiatives within health sciences education and hospital networks for over twenty years. Thanks so much for being with us today, Andrew.

Andrew Dos-Santos: My pleasure, Derek. Thanks for having me. I'm really happy to have the opportunity. 

Derek: Yeah, you're very welcome. Well, we'd like to get started with learning more about you and what first got you interested in technology and healthcare. 

Andrew: Sure, absolutely. I really enjoy problem solving and I like tech. So, when it came to determining my career path, I gravitated towards software development as a way to satisfy both those interests. I worked towards an education as a computer programmer

analyst, and in the final year of that program, we had a placement requirement. The academic teaching hospital here had a position available that I targeted and was successful in getting, as I was intrigued by the potential for developing software that can solve healthcare-related problems. During that placement, I was able to do some development on a surgical waitlist solution. So, that was really rewarding for me, knowing that I was able to help solve a serious healthcare-related challenge through software development. 

Derek: Do you have any healthcare providers in the family that you looked up to? 

Andrew: No, I don't actually. It was just a very organic situation where there were other opportunities as far as not just healthcare education, but education as a whole. There were some other startups in the area that had positions available in different verticals or realms, if you will. But I'm not sure what it was that really made me think that healthcare is the place to be, other than trying to maybe do some good through that problem solving versus just maybe a typical or a different situation where you might just be trying to create a solution that's going to be the next unicorn kind of thing. 

Derek: You've had a diverse background. You've worked as a programmer, you've worked at a school, at a technology company, and now you're starting something new. How have all these experiences come together to lead you to where you are today? 

Andrew:  I guess I’ll give a bit more background on what you just spoke to. After graduating and my placement ended, I was hired as a web developer working for that hospital. I was charged with developing a solution for tracking faculty research contributions, along with the physician credentialing platform. So, two very different problems to solve, and both were very rewarding in their own way. Obviously, one was more education and research focused and one more administrative focused. 

Once development of those solutions was completed, the ownership of those platforms was actually transferred to the faculty of Health Sciences. So, the faculty of Health Sciences within the university and I took ownership of that. I was hired to continue developing those platforms. Over time, my role responsibilities grew. As you mentioned, I was able to work my way up through different roles, including senior business analyst. I then became manager of the EdTech unit. Then I was also the competency based medical education technical lead, which was a pretty cool experience. 

Then finally, I was the director of IT for the faculty of Health Sciences. And so through those roles, I was able to work closely with many different stakeholders -- including learners, staff and faculty -- which ultimately really provided me with intimate insight into the problems they faced on a daily basis within the healthcare education space and how important it was to provide solutions to those problems. 

So, working so closely with the range of stakeholders we had, I really developed a passion for healthcare education and for solving the challenges they face and anticipating their needs so that we are developing not only solutions to problems that already exist, but also for ones that we see coming thanks in part to those close relationships with the learners and physician educators. 

Derek: That's fantastic. Now, the healthcare economy is so large and a lot of people who work in the healthcare economy, including myself, are not clinicians. We didn't go to medical school. What are the advantages and maybe disadvantages in your career of not being a clinician, but being so involved working with doctors and faculty members at medical schools? 

Andrew: Yeah, I mean, obviously in terms of disadvantages, I could never truly put myself in their shoes, right? I didn't have that exact experience that I could draw from, to get an even better understanding of the problems they face. But, you know, being able to work so closely with them embedded within an institution -- and then working with external other institutions who were collaborating with us over the years -- was really a huge advantage for me as an IT professional and a software developer at heart. I was able to learn intimately about what they do, and the curriculum, etc., that allowed me to sort of think outside the box of just a typical, “Here are our requirements, now go build the solution.” I was able to have the conversations with them, and not necessarily challenge what they thought they needed, but ask why, and really get to have that intimate knowledge transferred back and forth.

There was a funny moment where at one conference one year, a clinician educator from another institution came up to my booth and we had a great conversation about competency-based medical education. By the end of it, he said, “So, you are a clinician, right? A faculty member?” I said, “No, no, I'm just a software developer.” 

Being embedded in that institution really allowed me to learn through osmosis, if you will. I was able to learn things that maybe someone trying to solve a problem from a tech perspective wouldn't necessarily be able to get to. 

Derek: That's very insightful. I appreciate that. Over this twenty-year interaction with physicians and medical schools, how have things evolved? You know, if you look back on time over this two-decade period to where you are today, embarking on a new venture,

what has changed and what has remained the same in terms of the needs of these medical schools? 

Andrew: I think we're probably going to talk a bit about trends a little bit later, but I might be touching on a bit of that now. So, I'm born and raised here in Kingston, Ontario, Canada -- a little small town --but our university was one of the first ones to transition all of its GME programs, all twenty-nine of them, to a competency-based medical education model. That is a huge change. I know that model has been around for a long time, but not necessarily implemented. So, having been through that and worked through to develop a solution to support that, that was a big change, just from a pedagogical perspective, that we saw.

I think as far as what's remained the same is a lot of the institutions are still faced with the same challenges on a day-to-day basis. There's never a perfect solution, but there hasn't been necessarily a great solution available for them to help overcome some of the challenges they face that are as a result of basically having disparate systems that aren't connected, that don't talk to each other very well and result in a lot of manual data processes and, of course, because of that, some manual errors that happen. So, in everything from facing accreditation to trying to go through curricular reform, they're still struggling with a lot of the same challenges they've faced for decades. 

Derek: So, with this new venture, I’m very curious about the name of the company and how that came to be. Maybe you can give us a little bit of background on that for the audience. 

Andrew: Yeah, absolutely. So, basically, I am of Portuguese descent, and when I decided to create the company with my team, we struggled to come up with a unique name for both the company and the product. It's very difficult to do these days as there are so many companies and products out there in different spaces that already have some names taken. So, again, because of my Portuguese descent, I thought, “Let's try to think of words that we really believe in and that help speak to what and who we are as a company and see if we can find some translations there from another language.” It just so happened that Portuguese worked out really well, and obviously is close to home for me. 

So, Fenix Alma actually translates to phoenix soul. Phoenix because we are trying to breathe new life into this space -- this health sciences education technology space -- and alma for soul because we are truly passionate about this. Again, having spent twenty years, give or take, embedded within an institution and working so closely with learners and physician educators, it was something that's really dear to me and we're passionate about. 

So, we put those two things together. And then from the product perspective, our product is called VidaNovaVLE.  Vida nova translates to new life, again, speaking to breathing new life into this space. The VLE stands for virtual learning environment. 

Derek: Okay. And maybe talk a little bit more about your platform, VidaNovaVLE. How is it distinguishing itself in the marketplace?

Andrew: Yeah, that's a great question. For us, both the product and the company are what distinguishes us in the space. So, for one, it's our customer-first approach, being able to basically continue on with that approach that works so well for me and the team in working so closely with faculty and staff and the learners themselves. Being able to continue that type of approach is key for us, because we know it's gonna allow us to develop “through the windshield” of health sciences education versus just in the rear-view mirror, if you will. 

For VidaNova itself, it's more than just a learning management system and more than just curriculum management system. We're striving to make it the complete solution for delivering health science education. So, again, over the last twenty years working in the space so closely with faculty and staff it became absolutely clear to me that those disconnected, disparate systems weren't the answer that we spoke about a little bit earlier, and this is the landscape most institutions are still working within. So, ultimately, that approach sets institutions up to struggle when it comes to things like accreditation and understanding where when their curriculum is taught, assessed, resulting in poor experience for all involved, especially learners and the faculty. 

So, having built a bespoke solution previously that later we tried to implement for others, I learned a lot about what works and what doesn't and the barriers that can sometimes be created by building an enterprise-level platform that's developed in a confined and sort of reactive way versus building an extensible solution using a proactive methodology. That's really what speaks to our customer first approach and our current focus of selecting a few flagship institutions that will help continue to inform our development as we continue to proactively grow the platform. 

So, being able to build VidaNovaVLE in that proactive way with respect to our health science education expertise and secret sauce, if you will, while leveraging an established modular, open-source learning management system really gives us the best of both worlds. We've got that already well-established functionality baked into our core product and us adding in and weaving in those different health sciences-specific pieces is really the takeaway, I think, as far as what separates us. 

Derek: At Osmosis, we always look at utilization rates of our learners and faculty and how much are they using the product. We send them information and data. And when it's really humming, we kind of know. Those utilization rates are high, the faculty are engaged. What's been the difference for you when you have a partnership where it's doing everything you'd like it to be doing versus one that might be struggling to get moving? What is it about an institution or your sponsor at that institution which just makes that partnership really hum? 

Andrew: Ultimately, it's what I like to call an iterative collaborative approach to basically anything we do. Whether it's developing a new feature or working on identifying priorities, that's actually a process we go through when we're first on board a new institution as we work through what are their high yield targets and priorities and issues or obstacles that they're looking to overcome. We develop our work schedule off of that and create a custom implementation timeline. 

That's really what makes it hum is having a partnership there with the folks on the ground at the institution who really know the real issues. Because oftentimes, issues are the same or similar, but the priority of those issues can differ between institutions. We work closely with them and what really gets it humming is that iterative collaborative approach to “Hey, I know we identified this as a priority three weeks ago, but actually, we now see this as more of a pressing issue that we'd really love to handle right now by implementing this feature from VidaNovaVLE.” So, being able to pivot and work closely...that really is what makes it hum.

Derek: In terms of tracking student performance, maybe give an example for the audience on what your platform can do compared to some other options that could be out there, and what are the faculty and administration asking for in terms of tracking student performance in this setting? 

Andrew: One major problem we've encountered over and over again, prior to developing VidaNovaVLE, was the inability to visualize curriculum in an intuitive way that can ultimately show learners how they're performing and how various curriculum or curricular taxonomies relate to one another. So, one of the first things we did is we've developed our taxonomy management module, and that will allow institutions to build out their curriculum in a very visual concept map-like view. Instead of just a table with list of items, they can actually see how these things are physically related and connected to each other virtually. So, when curriculum mapping is done at the course, the session assessment, and even resource level within VidaNova, all levels of users -- including learners -- will understand how the curriculum relates at both the big picture, but also down at the very granular level. And we are allowing tagging of resources so that learners can understand exactly which resources can be used to help them from a content perspective as it relates to their curriculum.

We also know that schools need to be able to demonstrate how their curriculum spirals. That's another big, big ask. Actually, I went to your Raise the Line podcast and I saw you guys covered some of the spiral curriculum conversation. Our taxonomy management module and innovative cross tagging functionality not only allows for learners to understand how the specific curriculum they're being taught on a given day relates to the rest of the curriculum, but ultimately, at what level they're being taught. 

So, for example, if an institution wants to track a Bloom's like taxonomy, they might want to know if they are teaching this topic at a foundational knowledge level, or an advanced application level. That's just one example. In that case, users can cross tag to any taxonomy they wish. So, maybe it has nothing to do with Bloom’s at that point. Maybe it's something completely different that they want to sort of track as a meta piece of data, if you will. 

Having these data points is what really allows us to continue building on our foundational taxonomy management module to visualize learner performance, identify learners who might be struggling, and at which outcome or objective they're struggling with. That's obviously another piece that people ask for is to be able to visually see that data, to be able to do what we just talked about with the cross tagging, etc. We plan to leverage that capability to integrate with content providers such as Osmosis, for example, so that we can serve content to learners based on their performance on an outcome or objective or patient presentation, as an example, and then be able to pull in content that might be beneficial for them to help supplement their education in those areas where maybe they need some help. 

So, that's the key point to make is that we've laid the foundation for us to now pull the data points to visualize learner performance via that concept map I talked about, and that, I believe, is the first of its kind in this space. I haven't seen anything like it before in my last twenty years. That will allow for all levels of users within VidaNova to be able to see and understand entire curricular framework and their overall performance within the program while also being able to drill down to those most granular levels to really focus in on their performance in those specific areas. That's the goal really is to ensure educators, learners can see where improvements can be made with ease. That was probably a long-winded answer to your question. 

Derek: No, that's very helpful. I mean, that's something we focus on quite a bit, too, at Osmosis. Maybe you can talk a little bit about how the systems can talk to each other. That's always a challenge in these environments where schools may have three or four different platforms and there might be multiple logins. The data is not necessarily shared and often faculty and administrators and even students can get very frustrated by the complexity of having those multiple systems. What are you trying to do at Fenix Alma to resolve that frustration? 

Andrew:  Yeah, having had experience in being responsible for the faculty at the IT level, trying to have disparate systems just doesn't work. I found in my experience it set us up for a lot of trouble in different areas. Now, we did build a bespoke solution that ended up becoming that sort of all-in-one, if you will, and it worked well for that institution, but ultimately, it was tough to transition it to others. 

So, what we've done is try to basically create the foundational pieces. I keep referencing foundational because as an example -- having had discussions with Osmosis previously about how you guys track your content and at what level they're supposed to sort of engage the learner at, whether it's the foundational or the advanced application level, being able to actually support that type of, as I called it earlier, sort of metadata around the curriculum -- that was key for us to build that in early because if we didn't, we wouldn't necessarily be able to have that type of integration that I envision and hope for as we continue to grow and move through to the future. 

Some schools, I think, probably will continue to have those disparate systems. Sometimes they think the best of breed for a given problem they have is the best approach, but at the end of the day, it does set them up with, sometimes, multiple logins, which is definitely an annoyance, but you can overcome that. But the bigger problem is the disconnected data. I mean, it really is hard if you don't have that platform that can connect all those data points for you, that you have the redundancy of cross-entering or exporting and importing to other systems. That really gives you the best chance, I feel, at understanding those things we talked about. You know, how does the curriculum spiral? Where is it being taught? When's it being assessed? How are learners performing, most importantly? Those are the pieces that I think are maybe not unanswerable, but very difficult to answer with disparate systems, and depending on the system, there are some that track all that information, but they're not very good at actually surfacing and visualizing it. So, that was a key for us. 

Derek: What would a podcast in the year 2023 be without a conversation about artificial intelligence? So, I have to ask, what are your thoughts on AI in medical education? We've all seen the articles about the chatbots trying to take the medical exams to varying degrees of success. What's your take on all this? How does it impact your business, and maybe take a step back and think about the sector as a whole? 

Andrew:  It's a great question, and definitely it's going to change the landscape. I do recall a conversation back in my role as competency-based medical education technical lead sitting at the assessment subcommittee that we had formed with a number of program directors from the GME programs and our director of assessment evaluation. I remember I had the concept of natural language processing -- obviously not necessarily AI -- but just a type of tech that could help potentially with some of the decision-making processes. For instance, based on the feedback we’re seeing that's always positive about a student, plus the assessment data that's in there that's been done or the experts that have been watching them complete whatever it was they were performing that day, is there some way of us creating a mechanism to help make that decision of “Yes, they're competent” or “No, they're not”? And if they are, well, they're ready to move on to the next level or stage. 

I remember one of the faculty members and program directors saying that basically they didn't want to leave it up to the computer to determine that and that they had computers in their heads, if I remember her wording correctly. That they should be the ones making that decision, not the machine. So, I think you're going to get different ends of the spectrum there. I'm sure there's people that would think that it makes total sense to let the AI make that decision, but I feel like there's probably a sweet spot where you can introduce it and it can be something to support and help with the decision making, but I don't think you ever want to let it drive the bus completely on its own. 

The educators know the nuances, I think, better than at least AI can now. Maybe later it can understand it better. But there's just certain things...that gut feeling about a learner that someone might have or that's shared across a number of people that AI just wouldn't be able to get. 

I know we are looking at it for different possible functionality, but I think it's always going to come back to our educators as experts and leaning on them to be the ones to make those important decisions about how our learners are performing and where they need to get help. 

I think it's important to surface that, and if AI can help do that, obviously, then we'll do that. But end of the day, always putting the educator in the driver's seat, I think, is sort of my take on it. 

Derek: Yeah, that's helpful. And at least right now, it seems like the error rate with a lot of medical topics is still high enough to give everyone a bit of pause on AI. But that'll probably change, as the months go by. Maybe you can talk a little bit about the team behind you. You covered a lot of ground on this podcast -- twenty years of experience -- but I'm sure you're not doing it all yourself. 

Andrew:  No. 

Derek:  So, maybe talk a little bit about the team that you put together for this new venture.

Andrew:  Sure, absolutely. So, there's a number of us involved, and I could take a couple of hours just talking about how great each one of them are. But, first and foremost, Candace Miller is my Chief Customer Success Officer. She's got experience in a wide range of topics and at different levels. She was on the administrative side of running or helping run the curriculum committee and has gone through curriculum reform in UME at the institution we used to work at and she's then transitioned to actually come and work with me in the EdTech unit. So, she got more of the tech side of things, then transitioned into becoming more of that user-facing and customer-facing role of supporting their needs. She's extremely organized, but the point I'm trying to drive across is the expertise is there from her perspective as it relates to pedagogy and the curriculum and how important it is to understand how that's structured. So, she's got a ton of advice that she's able to provide institutions that may want it in regards to curriculum reform and those different aspects. 

I should have mentioned our motto is, we know what it takes. That sounds very bold and I was worried about it sounding arrogant because that is not at all me, at least I like to think that, but it is truthful in the sense that, you know, Devin Monroe, for instance -- our team lead and software engineer -- he's got over ten plus years of experience developing as an embedded software developer within a health sciences unit. So, again, boots on the ground, day-to-day experience working closely with the faculty, staff, and learners. I think that's what differentiates our team from many others out there. That experience is what has made us understand that this space truly needs a team to function that way as a vendor, or more as I like to look at it as a partner, with the institutions they bring on board. 

Because if you just go in with, “here's our solution, this is how it works, and this is what it does and send a ticket to our support system when you need help,” I don't think you're going to succeed. I think that's why, at least from what I've seen over the last number of years, people are bouncing from one vendor to another, trying to find the balance of that product and that team that really can truly deliver for them. That's 100% what we're going to be and what I'm striving to be with Fenix. I just mentioned a few of our team members. There's a number of other people -- Joe, Corinne, Ivan and some great other team members we have -- but I know we’re nearing the end of the podcast so I won't speak to all of them. But at the end of the day, it's our expertise, I think that really is what differentiates us. 

Derek: That's helpful, and it's often challenging for medical schools to build up that kind of diverse and expert team on the technology front, so I'm sure you're adding a lot of value. 

As a teaching and content company, we're always looking for feedback on what we could be doing better or what we may be missing. So, given your perch in this ecosystem, what advice would you have for teaching and content companies right now in the era of AI and disruption in medical education? 

Andrew:  Yeah, that's a great question. So, for software companies and content providers -- and I'm sure this sounds like, ‘well, of course we do that,’ -- but it's to really truly listen and I think that's hard. That's a lot. That's very difficult for some as they scale, for sure. That's something that is at the heart of what we plan on doing and what we are doing with our institutions and I refuse to let go of that. We are going to make sure we have the right people in place to truly listen to what's being asked and to be flexible, too. I know you can't necessarily create a custom solution just because a school says they need it or, you know, or a bespoke piece of content that's not going to help anybody else. But oftentimes there's an underlying theme there that does connect the dots with other asks that have come from other people. But you can only do that if you're truly listening to the conversations and questions and topics that are being posed.

So, I guess that's the advice I would give. I feel like that's the only way, honestly, to be successful in this space. We work with a lot of type A personalities and you can often dismiss perhaps what's being asked because they just want it that way, so to speak. But that's not the case. They want it that way because they need it and the question you have to ask is ‘why do they need it?’ Ask them that and then really dig down because maybe there's another way to do what they're trying to do or solve the problem they have with something that's already in place. Or you just need to understand it better to be able to then provide them with the solution that will work not only for them but other users of your platform or content or whatever it might be you're trying to deliver. I don't know if that answers the question very well, but that's, I guess, the advice I would give. 

Derek: I appreciate that. That's very helpful. As we wrap up here, we have a lot of students who listen to the podcast, a lot of early health care professionals. What advice would you have for them, again, in this age of disruption -- dislocation in some ways -- as they embark on a career in healthcare or technology? What would you tell your younger self based on what you know now? 

Andrew:  I would say definitely leverage the technology tools that are at your disposal. Don't be afraid to demand user-centered design. I sort of talked about that earlier, our iterative collaborative approach to everything we do in addition to the development side of things. But for the learners, voice your opinion when a solution doesn't meet your needs and provide feedback to support further development. If a company or a vendor or a homegrown shop doesn't respond to your feedback, call them out on it. I mean, this is your education and as an end user, your experience really matters. That's what should be driving the product or the solution or whatever is being offered. 

That is exactly why we believe so strongly in our customer first approach as a differentiator and we're fortunate enough to have Candace driving that home for us. If you have the chance, provide feedback directly to IT at your institution because it's critical that they truly understand the problems you face on a daily basis that you can try to help them solve. I find that having the chance to have those direct conversations really helps in identifying solutions. Something that was on my mind coming into this podcast was learners should be advocating for their own education and have a strategy for reflection in order to identify gaps or weaknesses in their learning as early as possible to help overcome them. 

So, whether that's leveraging tech tools at your disposal or something else, make sure that there is something there that allows you to understand where you're succeeding, where perhaps you're maybe a little weaker and be able to overcome those weaknesses through additional content providers outside of your institution if the curriculum there is not maybe giving you enough of what you need in that space to be able to at least identify the curriculum in your institution and the resources to have in place as well. 

Derek: Thanks. Does the platform you're creating give learners that ability to be proactive about giving feedback to faculty members so they can kind of raise their hand and say, “I need more help in this area?” 

Andrew:  Yeah, absolutely. We've got built-in chat so they can reach out to their mentors or instructors or faculty if they so choose and the faculty want that, of course. We want to make sure that it's configurable and we're able to turn that on because maybe some institutions might not like that, but absolutely. What we're striving for is the ability to tag potential resources within VidaNova. So, when you create a session, you're able to upload resources to that session for the learner. It's not just at the course level -- which is what a typical LMS would do -- it's at a more granular level. On this given date and time, we're learning about X and there's been Y and Z uploaded as resources. We're able to tag Y and Z with different curricular objectives they may cover so that the learners are then able to go and search for those components later when they realize, “I see in the learner performance visualization engine that we're putting forward that we're struggling in this area, but I need to go and review that in more detail and maybe I need to reach out to Osmosis and get the content that covers this.” 

So, yeah, there's tools definitely within VidaNova to support those feedback loops, if you will, and then ultimately the ability to reinforce perhaps areas of weakness and get better. 

Derek: Fantastic. Of course, we're always open to referrals. 

Andrew:  There you go. Perfect. 

Derek: Andrew, we appreciate that. Well, I think we're at time. Andrew, this was incredibly informative. You're very generous with your insights and I think our audience is going to learn a lot listening to this podcast today. Any final words from you? 

Andrew:  No, I think I just want to say thank you. I appreciate the opportunity. I've been watching Osmosis. You guys have done a great job and continue to grow and I'm just really

happy to be part of the podcast today and hopefully share some of the insight I've picked up over the last couple of decades in this space and just to share a little bit about what we're doing with VidaNova VLE and our company at Fenix Alma Solutions. So, thank you very much, Derek. I appreciate your time. 

Derek: Thanks. It's certainly our pleasure. Best of luck to you and your team. We're definitely rooting for you. 

Andrew: Awesome. Thank you. 

Derek: I'm Derek Apanovitch. Thanks for checking out today's show. Remember to do your

part to raise the line and strengthen the health care system. We're all in this together.