Conversations from the 2022 SAFe® Summit: The demand for digital healthcare at CVS

In today’s episode, we discuss the demand for digital healthcare with two experts at CVS Health: Zach Wanerus, Director of Scaled Agile Execution, and Matt Bergenholtz, Solution Train Engineer. Find out how leaders can stay connected to teams through big transformations, and learn why empathy is the hidden key to success.

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Welcome to this special edition of the SAFe Business Agility podcast featuring in-person conversations captured at the 2022 SAFe Summit. In today’s episode, we discuss the demand for digital healthcare with two experts at CVS Health: Zach Wanerus, Director of Scaled Agile Execution, and Matt Bergenholtz, Solution Train Engineer. Find out how leaders can stay connected to teams through big transformations, and learn why empathy is the hidden key to success.

Hosted by: Tim Shisler

Tim Shisler is the director of media production at Scaled Agile and an experienced documentary filmmaker, journalist, coach, and speaker. Tim’s deep understanding of story elements and structure, and his strong business acumen, make him a rare breed of storyteller. One who knows how to motivate audiences while staying within the confines of strategic business initiatives.

Transcript

Announcer:

Welcome back to the SAFe® Business Agility Podcast. We took a short break to brainstorm new ideas to improve the show, but now we’re back and excited to bring you new stories, perspectives, and updates about SAFe. Thanks for tuning in and be sure to subscribe to the show wherever you get your podcasts. Welcome to the special edition of the SAFe Business Agility Podcast, featuring in-person conversations captured at the 2022 SAFe® Summit.

Zach Wanerus:

“I think the best place to start is to talk about agility and the power of agility. We need to put some tools in place that allow us to scale that, and Scaled Agile is the best tool to really deliver those sorts of promises of Agile at scale.”

Announcer:

In today’s episode, we’re discussing the demand for digital healthcare with two experts at CVS Health, Zach Wanerus, director of scaled agile execution, and Matt Bergenholtz, solution train engineer. Find out how leaders can stay connected to teams through big transformations and learn why empathy is the hidden key to success. We hope you enjoy the show.

Tim Shisler:

I’m here today at our SAFe Summit in Denver, Colorado, talking to Zach and Matt from CVS Health. Zach Wanerus is a director of Agile transformation. Matt Bergenholtz is a solution train engineer. Gentlemen, thank you for taking a few minutes to sit down and chat with me.

Zach Wanerus:

Yeah, thanks for having us.

Matt Bergenholtz:

Great to be here.

Tim Shisler:

Zach, why don’t you give us a brief overview of SAFe at CVS and how that looks.

Zach Wanerus:

So, we help lead our, SAFe transformation inside the CVS Enterprise Digital Space. That group has thousands of employees. We have over 30 trains and we’re organized into seven solutions.

Tim Shisler:

You’ve been working in SAFe for multiple years at previous companies. You understand the way SAFe works. You’ve been through multiple transformations. Where are you right now? What are you working on?

Zach Wanerus:

I would say the exciting opportunity right now is we’ve got some new leaders in place, and I think that can be scary in a transformation, but I think the opportunity that we’ve got in front of us is we’ve got the chance to go from a situation where we sort of had a mandate and we were doing SAFe because someone who was very important said, we’re going to do SAFe. And now we’ve got the chance to say, we can actually come together and figure out what we want this to look like. We can agree on some of the things that we’re going to do, the ways of working that we’ve got, and I think that’s going to be a much stronger implementation of SAFe than doing it simply because someone said this is where we’re going.

Tim Shisler:

What solutions are you building currently?

Matt Bergenholtz:

Well, you’ve probably got better context on like the global solution landscape than I do. My particular solution context is around our developer platform. So, we’re actually at a place where we’re trying to scale out our capabilities for cloud development, for automated pipelines, really giving the developers and our teams compelling experiences that will accelerate them and reduce their wait time for things like releases and procuring hardware and all that kind of stuff. So, we’re really investing in the technology components of how we build a modern infrastructure for our developers.

Tim Shisler:

Are you finding that your customers are expecting more from CVS every day? They want a different digital experience, they want something faster. Do you feel that internally?

Zach Wanerus:

Yeah, I think that’s absolutely true. And so I think especially after the pandemic or during the pandemic, we saw people thinking a lot more about healthcare and a lot more about the details of their healthcare. And so with that, there’s a whole digital component that needs to be considered as well. All of a sudden, people are less eager to go into a physical store. They’d much rather engage, you know, on their app, on a website. And so when that happened, we had to think about, hey, we’ve got to be able to do a lot, you know, obvious things for COVID, like vaccine scheduling and testing, but also just making it easier to shop, making it easier to get your prescriptions filled. Those things all become really important from a digital perspective when folks are stuck at home.

Matt Bergenholtz:

We also get to solve the receipt problem, which has like been a really fun thing for us in digital.

Zach Wanerus:

<laughs> Yeah, everybody loves the CVS receipt or at least likes to make fun of the CVS receipt.

Tim Shisler:

It’s like the Best Buy receipt or something three feet long.

Matt Bergenholtz:

Yeah, yeah. With digital we get to try and work on that problem, which is great.

Tim Shisler:

We talk a lot to RTEs and Scrum Masters. But as a solution train engineer, what does your day-to-day look like? What are you responsible for and what are some of your challenges?

Matt Bergenholtz:

I was an STE in our healthcare business prior, and I made a transition over to help us launch our digital platform. And I’ll say, in the healthcare business, we had a lot of trains that had to work together to try to move things out to the customer and they had to be coordinated, they had to be seamless, and they had to work together. So, not only with the end user but also with our operations teams, we had to make sure that things that we were launching and releasing to customers, were going to be well supported. Customer service reps knew how to answer those questions. So, it really is a lot of building a network, understanding who’s doing what in the organization, and building empathy with your partners. Because in a large organization, no matter what, our own trains that we build, our own solutions that we built, we don’t understand our context. We rely heavily on other parts of the organization that aren’t operating in SAFe or have older ways of working still. So, understanding where the people are coming from, what’s driving them, and really helping to build out working agreements that we can all understand the collective value that we’re delivering.

Zach Wanerus:

What’s interesting about Matt is he became a solution train engineer a few years ago, and at the time there weren’t that many solution train engineers in the world. And so as you go up through the layers of SAFe, things get more, sort of experimental or newer, right? Everybody knows what Scrum Masters do. Most people know, at least if they’re familiar with SAFe, what release train engineers do. But as you start to get up to solution train engineer, it’s a little fuzzier. So, I think the cool thing that I’ve gotten to see is Matt actually helping to define what it means to be a solution train engineer, not just for us, but you know, industry-wide.

Tim Shisler:

So then Zach, as someone who is helping lead this group, what are you doing then to help support Matt and his job?

Zach Wanerus:

The main thing I try and do is be a person who can truly embody that idea of servant leadership. Meaning, what can I do to support these guys in this really tough job? So, for our solution train engineers, they’re running large solutions. They’re also managing release train engineers. So, they’ve got a lot going on, and I try and figure out what are some of the things I can do to keep them unblocked or to solve tough problems that they just can’t solve from where they sit. Sometimes that means engaging with Scaled Agile and saying, hey, it would be really great if we have more information about what it means to be a solution train engineer. Or sometimes that means going back and working on things inside of our Agile transformation: hey, let’s figure out better ways to run PI planning or prep for PI planning. Let’s find better tooling to support some of the things that we’re trying to do around here.

Matt Bergenholtz:

And I’ll say from my perspective, having Zach as a manager and somebody who’s looking out for all of the solution train engineers, gives us a space, a safe place to voice, say, we’re running the real problems here. He’s a coach as much as a manager for us. So, that’s been a huge benefit as we delve into really ambiguous areas of, hey, how do you even do that? And I’m thinking about doing this, what do you think? Let’s run through some scenarios there.

Tim Shisler:

So from an elevation perspective, you guys are definitely off the ground. You’re up there in that 10-, 20-, 30,000-foot view. How do you stay connected then to the teams and the people doing the work?

Matt Bergenholtz:

For me, it’s part of an environment of trying to flatten that solution as much as possible, so that people have access to everybody else’s when they need it. We try to limit the effective hierarchies in the organization. Really leading on the network for myself, I’ve got a team of release train engineers, but I work almost every other day with the scrum masters on the teams just to stay connected to what’s going on with them. I coach them, I coach the RTEs, we do that back and forth and we learn from each other.

Zach Wanerus:

Concretely there are two things I think have helped us. One is, we have an Agile team, you know, super synced. So, for every solution, getting together the solution train engineer, the release train engineers, the scrum masters, any coaches or scrum master managers, people who are associated agilists to the solution, get them together on a regular basis and make sure that they’re working together as a team. I think that’s really helpful. We’ve also seen great results in surveying our folks. So, as you get to a certain size, hey we’re running a small to medium size business of agilists, even. So, surveying that group, understanding what they’re thinking about, how they’re feeling about the changes that we’re making can be really helpful.

Tim Shisler:

If you had to stack rank the impact that you want to make as an individual—because there are a lot of ways that your attention can go—how do you prioritize, let’s say, your top two kinds of things that you want to do for the biggest impact to continue the implementation forward?

Zach Wanerus:

For me personally, I want to help leaders, especially leaders who don’t have a background in SAFe and Agile. I want to help them understand what we’re trying to do and why it’s important and how we can help them solve the problems that they have in front of them.

Tim Shisler:

How do you do that now?

Zach Wanerus:

It’s a lot of empathy work. So, one-on-one conversations, listening to what they have to say, trying to understand, hey, what are the problems that are in front of you? And then seeing what we’ve got in our toolkit that can help with that.

Tim Shisler:

So, you’re really talking to them about the potential that they have and how they can use SAFe to unlock that potential, essentially.

Zach Wanerus:

Yeah. Often it comes in the form of, hey, I’ve got this really tough problem. It feels like the teams aren’t fully aligned with the strategy that we set down. And they may not immediately think of me or Matt or one of the STEs or RTEs as someone who can solve that problem. But sometimes we’ve got some solutions that we can present. Hey, yeah, that does sound like a tough problem. Also, it’s a problem we’d love to help you solve. We’ve got some ideas. Let’s sit down, let’s think of some things we could do together that would make that better, and then we can have a real impact. Because, not only are we furthering our SAFe implementation, we’re solving problems for leaders.

Tim Shisler:

So, you’ve been doing SAFe for about eight years. When did you feel comfortable having that conversation with leadership? How long did that take?

Zach Wanerus:

It took me a while, personally, to understand SAFe as a concept, deeply understand it to the point where you don’t have to look at the Framework; you just sort of know, hey, based on the idea that we’re scaling Lean-Agile principles, this is what the Framework would tell us. So, I would say it probably took a couple of years before I felt comfortable getting in front of a senior leader and giving them advice or perspective.

Matt Bergenholtz:

I think the thing that hung me up when I was first learning, there was just so much to take in. There was so much to learn that I didn’t know exactly how that technique worked. I didn’t know exactly how to deploy that in the best way. And the thing that actually unlocked for me was like, oh, well the principles are the things that matter. So, that’s what I grounded myself in and I’ve put every decision, every conversation, and every coaching moment I’ve had with leaders or my teams through those principles. And that really helped me let go of a lot of the nitty-gritty because there are a million ways. If something feels stale, you can try a different method and get the same result.

Tim Shisler:

What’s the reception from leadership like?

Zach Wanerus:

So, we don’t have a hundred percent hit rate on these suggestions, right? So sometimes we’ll bring something up and we’ll hear, you know, not now. That sounds like a great idea, but that also sounds like a lot of work. Or, I’m not sure the team is ready for it. But you know, when something hits, then you know. When you’re talking to senior leaders, people who are established, they got there because they’re good at getting stuff done. So, usually, the next thing that happens is, yeah, let’s put it into action. What’s the next step? And so that’s another important part of it, right? Come with your ideas and also, come with a plan. If we’re going to do this, where will we start?

Matt Bergenholtz:

Yeah, I think that’s where meeting people where they are, especially with understanding. Empathy is going to come up again and again here. Because I think a lot of what we do is understand the pressures that senior leaders are under; what kind of problems can we solve for them? And I think just, you know, deploying the techniques we have to be really useful for them in prioritizing the things where we can get the most benefit. And then you build trust with them that you have their best interests at heart and that’s what opens up a lot of doors to do really cool things.

Tim Shisler:

You’ve mentioned empathy a few times now. How do you personally define empathy?

Zach Wanerus:

So for me, it’s about being able to connect with another person, understand the concerns that they have, and incorporate that into what I’m thinking about. So not just sort of changing perspective, but being able to incorporate that perspective into how you are going to think and operate.

Tim Shisler:

Do you think that, you know, sometimes there are times when the Framework might feel prescriptive to somebody? Or, you know, I have to do it like this and so you are immediately up against this aversion, possibly. If that’s the case, then how do you help change that and help folks understand, look, we’re trying to see eye to eye here; we’re trying to meet in a place where we can have a conversation as opposed to this is what must be done.

Matt Bergenholtz:

Yeah, I think that’s where Lean-Agile leadership and the mindset shift are what we focus on. So, it’s not so much that particular technique; it’s more around hey, this is the way I’m thinking. And I think the nice thing about what Zach and I do is that we’re in positions with these people where we can be in the room, we can have these conversations, and we can alleviate some of those fears around being over-prescriptive.

Zach Wanerus:

I just want to jump on that and give a shout-out to one of the masters, Rebecca Davis, who helped me at least learn that SAFe is not as prescriptive as you might think. Very little is set in stone there. If you can take the idea, if you can take the general concept and apply it to your context, chances are you can find something that’s going to work for everybody.

Tim Shisler:

So, she gave you permission through leadership to say, hey, this is OK.

Zach Wanerus:

She was great about that. And she would say in front of leaders, Hey, I’ve talked to the people at SAFe that wrote this article or gave this piece of guidance. And they would be the first to tell you this isn’t set in stone. This isn’t a prescription, this is a suggestion.

Matt Bergenholtz:

Learning is a major part of how we operate. Where we were going to try something. We have ideas, we don’t know if it’s exactly the right thing, but it’s going to get us in the right direction. And then we’ll iterate and learn from there.

Tim Shisler:

It’s kind of a cliche question, but I think it’s something that we can’t ask enough, which is, what advice would you give someone who’s starting as an STE who’s trying to understand what is the role and what should I be working on?

Matt Bergenholtz:

The best thing I’ve done as an STE is really to treat my peers and colleagues, especially across the different organizations like engineering, architecture, design, product, and anybody that you’re working with as your first team. Being able to be Agile in that environment where you have senior leaders who are trying to make hard decisions, very complex environments, and being the person that can help them gain focus is absolutely the place I would start. I mean all of the other things are kind of window dressing. If you have that, if you’ve got that core team that’s operating together and can be on the same page, then you’re winning.

Tim Shisler:

And then as a leader of STEs and RTEs and communicating upward and downright all across the organization, what would be some of the advice for someone stepping into that role? Maybe they have leadership experience, maybe they don’t, but they’re coming into that spot.

Zach Wanerus:

So, if you are lucky enough to get to lead RTEs and STEs, you’ve got a great challenge in front of you because you’re leading extremely capable, extremely smart, motivated people. I think the biggest thing I would say is to hire people who you want to work with every day. Hire people who are able to demonstrate empathy and work with empathy and then just find ways to help them be successful.

Tim Shisler:

What is one thing that you’re most proud of, either individually or as a team, during your time at CVS?

Zach Wanerus:

I think for me, the thing I’m most proud of is what happened for us in 2020 when the COVID pandemic hit for us. We had already launched our SAFe transformation. We had teams organized into trains and solutions. And so in March when everybody had to go home, this wasn’t a disaster for us. We were able to say, hey, we’re still organized; we can still pull together. We’ve got to change a few different ways of working, but we can keep going. And that was critically important because we had important work to do. So for me, that’s something I was most proud of. We were able to pivot, you know, all of our meetings to be virtual meetings. We were able to take our PI planning and turn that into a virtual PI planning and not miss a beat. So that was pretty great.

Tim Shisler:

And then Matt, how about you?

Matt Bergenholtz:

I think the thing that I’m most proud of during my time at CVS is the really positive culture we’ve been able to build there. And the environment that we’ve created, it’s an environment of sharing, people having their best interests of each other and the company and the users and our customers at heart. And really I think that’s kind of a tall order when you think about CVS acquiring Aetna just a couple of years ago and it feels like that process has been healthy; it’s been constructive there. You know, obviously, with any kind of acquisition or transformation like that, there are friction points, but we’ve come through it stronger and I think that has a lot to do with the culture and the mindset and the agility that we’ve been able to bring to that.

Tim Shisler:

Wonderful. Well, I’m going to leave it at that. Thank you very much, gentlemen. I hope you have a great rest of your time here. We look forward to talking with you in the future.

Zach Wanerus:

Yeah. Thank you very much for having us.

Matt Bergenholtz:

Yeah. Appreciate being here.

Announcer:

Thanks for listening to our show today. Be sure to check out the show notes and revisit past episodes at scaledagile.com/podcast. Relentless improvement is in our DNA and we welcome your suggestions for the show. If you have something to share, send us an email at podcast@scaledagile.com.