After climbing the corporate ladder at electronic medical-records company Cerner, Button took a detour into the Vermont woods to fulfill a childhood dream of becoming an innkeeper. She continued to keep track of the nursing industry and when an old colleague who was now CEO/founder of Zynx, Scott Weingarten, called with a business vision, she was ready.
As a provider of evidence-based and experience-based clinical decision-support solutions, Zynx’s first focus was on doctors and hospitals. Its customer base now encompasses 1,900 hospitals that represent more than half of hospitalized patients across the country. Currently, more than 215,000 of Zynx’s order sets and plans of care have been deployed nationwide. Weingarten wanted to extend this service to nurses.
Following this new direction meant getting in at the ground floor to create the first clinical decision-support solution for nurses. To develop the more than 190 plans of care, a team of nurses and allied health professionals did rigorous reviews of clinical research and literature. The resulting templates can be customized for patients thanks to Zynx’s collaboration with electronic health-record vendors. Giving nurses access to current, proven best practices and medical research while they are taking care of patients reduces care disparities, minimizes errors, and saves staff time and money.
Over the past five years, Button has grown ZynxCare into a multi-million dollar product line which directly empowers nurses to make more efficient clinical decisions by putting proven medical research at their fingertips. Here’s what she told Fast Company about her journey and how she sees the future of health care.
The Big Idea, And Its Challenges
Evidence-based medicine might be the most intuitive, yet least widely-adapted practice in the health care industry. Though touted as being both money-saving and a quality-improving, both scientific (from double-blind randomized clinical trials or literature-research reviews) and experiential (practices that physicians have judged effective through their treatment), evidence hasn’t been traditionally easy to access.
Now that Zynx is providing solutions, Button says there are still hurdles for the health care industry to get over, beyond cost, access, and research and development. "In terms of the practice, we need to move away from traditional roles and power relationships and adopt the concept of being a team of clinicians whose purpose is to provide care," Button says. "I think we tend to talk about more of those issues [cost, insurance, etc.] instead of how we behave. It is going to take some time to change."
"It speaks to the difficulty that individuals have to not make the leap to recognize that the way I do something is not the way research shows. In nursing we have a concept called novice-to-expert practitioner. One thing evidence-based medicine requires is to keep going through that cycle and be open to new information and research which sort of negates expertise."
Taking A Break
When Button left health care and bought the inn in Vermont, she thought she’d hung up her stethoscope and patient charts for good. Along the way, Button had to have an "insignificant" surgery. She declared the experience "horrible." Button says at one point in her care, she had to tell the practitioner on duty that something was clearly wrong and they needed to call the doctor right away.
"When the opportunity to come back and be involved in health care again it made me realize I was not done. But if I were to go back in and do something it would be doing something very focused, impacting care at the bedside and really changing care at patient level. Zynx is really focused on making a difference like that. Being a nurse and working with other clinical [professionals] who are there with patients 24/7, to bring the evidence-based approach [to them], I couldn’t say no."
Leading By Example
Button admits she’s very self-motivated but she also enjoys working as part of a team and she tends to hire people who also have an expertise she might not. "Having a team that is bright, energetic, and confident but with deep skill sets provides a great opportunity [for all members] to perform at a much higher level."
That said, Button admits, "I have very high standards from how the content is developed to how the muffins are baked. What people have said about me very consistently is that I have high expectations, but they are reasonable and they are clear. For me, it is important for people to know where they stand but to do that in a thoughtful way."
As such, Button works to cultivate individuals as well as the whole team. The payoff is a more effective and productive group. "Being part of a successful team is a wonderful experience. My team is particularly exciting right now because it is growing each way."
From scooping ice cream and waiting tables to working as a nurse’s aide, Button has been involved in caring for people in some way since her early teens. But when she set her sights on a career in health care, her father put his foot down. As a business person, "he was horrified," she says when she told him she wanted to transfer to a nursing program in college.
Button wasn’t discouraged and went on to earn a BSN from Columbia University, an MS from Syracuse University, and an EdD from the University of Vermont. She currently holds adjunct faculty positions at Loyola University Chicago and the University of Vermont.
Button confesses that she uses knitting therapeutically to get perspective on her work. "It is a way to stop and say, okay, I’m not responding to this email right now," she says, which is particularly good "when you need to get out of the moment and think through a situation analytically and rationally."
Button recalls that she sadly had to bear witness to her mother’s death from a critical illness, an event that also shaped her ideas about health care. During that difficult time, she also became familiar with Carol Gilligan’s work. The former Harvard professor who authored In a Different Voice, a 1982 text on gender studies, inspired Button in multiple ways. "I was in my late teens and early 20s and [Gilligan’s work] helped me frame how I experience things."
The Next Big Thing
Though she loved running a B&B, Button admits it was also grueling and she’s not sure she’d want to do it again. When she does reach the end of her tenure at Zynx, Button is confident she'll be doing something care-related.
Until then, the challenge is to keep cultivating the evidence-based approach to health care.
If we could fast forward through the medical evolution, Button says, we can take advantage of having access to research and using it as a basis for coordinated care. Button’s vision may not be far from fruition. The Institute of Medicine's Roundtable on Value & Science-Driven Health Care predicts that by the year 2020, 90 percent of clinical decisions will be supported by accurate, timely, and up-to-date clinical information and will reflect the best available evidence.