One last look at 2018. The year is behind us but there are some great insights and wisdom that we may want to bring with us into 2019. What a great year of discussion on the show thanks to all my great guests. Thank you for lending your voice.
Bill Russell: 00:08 Happy New Year. Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is episode number 55 and the first of 2019. So, uh, this is our final year in review episode. The top 10 episode I know it's the one you've all been waiting for. If you miss the first three, you might want to check those out. There's the, uh, the innovators episode, there's the clinicians episode, and then there's the CIO's episode. You can check those out on itunes. You can check them out on the thisweekinhealthit.com website. You can check them out on Google play as well. This podcast is brought to you by health lyrics. Be a market leader. Uh, we help you to clarify your health it plan, eliminate confusion, align your work experience breakthroughs. Visit healthlyrics.com to schedule your free consultation. My name is Bill Russell, recovering healthier cio, writer and advisor with the previously mentioned health lyrics. Well, here we are, uh, the, uh, the last episode of this series, which is the top 10 episode. And, uh, you know, this is a fun and a dangerous episode. It's fun because I get to go back and listen to all the great content and just remember the great conversations that we had this year and just soak it in one more time. It's dangerous because there can only be 10, right? So we've had between 35 and 40 guests this year, we've done over 2000 minutes of recording and you're gonna hear 21 minutes of that. So I went through and just listened to it and just pulled out my favorite episodes. Uh, and so that's a little dangerous because some people might feel slighted. I, I'm guessing that no one is sitting around there, they're a podcast listening device right now and going to be hurt that I did not select their, uh, there two or three minute video to be on here.
Speaker 1: 01:57 But on the off chance that I did, I just want to make sure that all of my guests a recognized that, uh, I really appreciate everybody coming on the show. It really has been an honor to have them on the show and we've had a great time, uh, recording this year. Um, you know, for those of you who have been on the show, you know this, but for our listeners, I, you know, for a lot of these people, I just send them emails and say, you know, will you lend your voice to this community, this community, which is about, uh, helping to train the next generation of health it leaders. And so many of them just jumped at the chance. And, uh, and I'm, I'm thrilled to be able to bring this show every week and I'm thrilled that you're listening to it. The numbers just keep going up every week, uh, since we've started. So a while, there is a little bit of risk of, of selecting the top 10. I don't think anyone's gonna be offended. So we're just gonna. We're just gonna get to it. So coming in at number 10 is Jason Joseph, Cio for spectrum health. Jason was gracious enough to sit down with us following his panel discussion at the Becker's conference in Chicago this past fall. And I was really impressed with his perspective. He's a newly minted cio and I asked him the question of what opportunities exists for health it and uh, this was his answer. Check it out. So what's the biggest opportunities for health IT right now. You're talking to a whole bunch of CIO's potentially, what's the biggest opportunity that you see out there?
Jason Joseph: 03:34 Yeah, I think you could answer that question into two fronts. Um, one, I think that we, uh, have a huge opportunity to leverage our core in it infrastructure and simplify it so that we are more digital ready. Um, I mean I'm a big believer in having a few core systems that you really invest heavily in, but the pace of change is such in our business that you're still going to need to adapt and you're going to need to flex into those strategic opportunities. And it's incredibly hard to do that if you've got a complexity under the hood. And so I would say, do not underestimate how much that complexity will hurt you in the long run if you're not ruthless and rooting it out, not only for the cost but also for the agility that is going to provide you. And so that's kind of philosophically I would say our opportunity is to get more simple so that we can be more agile so that we can innovate and I think the innovation is going to come in two main areas you've already touched on digital and how we transform our healthcare systems digitally, some of which will be know very common types of capabilities that we're all going to have in our, in our toolbox. And then there's going to be those things are true, truly differentiating. And the second is how well we used the data that we actually have in our systems to come up with new answers and new outcomes. And that's where our business and our clinical competitive advantage it's going to come in with advanced analytics and some of these tools, if we can apply those well, we will actually see significant changes in the core of business of healthcare. There's other things that we do everyday that just helps us kind of make the core a little better. The things that I look for, the things that actually changed the core, the things that say you no longer need that diagnostic process. Um, you know, I'm looking forward to a point in time and this may be way out there where you could actually go in and have some medical imaging done and when you walk out you're going to get a report because it's so protocolized in the AI engine has become so strong that you're going to get a 99 point six percent accurate report out. Same thing with low acuity. A primary care is that these, um, the, the engines, the intelligence and machine learning is going to quickly make it so that these are, these are realities in the near future and we have to be ready to capitalize it.
Bill Russell: 05:47 You gotta love that answer. Route out complexity, uh, use the data to really change the core business of healthcare. I love how pragmatic his answer is, but I also love the visionary aspect of it.
Bill Russell: 06:14 So at number nine, we have a two time guest to the show. Uh, Sarah Richardson, who is the CIO for the California Nevada markets for healthcare partners, a Davita medical group. Sara is an amazing leader and a great voice for women in leadership within healthcare. I was able to catch up with Sarah at the Chime fall forum down to San Diego and this is what she had to say about soft skills It's changed has been so dramatic in it itself, how do you prepare your it staff. But one of the things we've been talking about is the role within health its, the roles are really changing from technology roles to people roles, people and understanding culture and communication. And these are all areas where if we have a, as they were talking about, you know, a 75 slash 25 or 80 slash 20 male to female ratio. This is areas where we can really make that transition and start adding a lot of. Because you know, stem is under represented today. That's not what we're hiring. We're hiring. So what does it look like? I mean, what are we looking? What are we looking to do with that staff to help them make the most transitions?
Sarah Richardso: 07:20 What I feel like people forget about or what they say is that people are focusing on the soft skills. It's the soft skills that women are better as a soft skills that are important. These aren't soft skills. This stuff is hard when you need to have a thoughtful conversation, you need to be articulate and you need to know what you're talking about. You need to have the education. You need to have the background. Those are not soft skills, so leadership and communication and the ability to affect and drive change within an organization to be a role model and beacon for others to have a crucial conversation, but do so with respect. Those are tough skills. Those are the things that everybody needs to bring to the table and so whether you're in stem or operations or wherever you come from, from an educational perspective, it's having the ability to embed those capabilities into your organization, into your teammates and create an environment where they can practice those types of skills and it's not always going to be at the bar at 10:00 at night. I'm always fascinated when it come to conferences, everyone's, you know at the bar and people excited to go out and party. I'm like, you are never going to see me having too many drinks or staying out past 10:00 because that's not where you're going to create that momentum and create an example for others to follow.
Bill Russell: 08:24 Absolutely. Guess what you're saying is we should start calling hard skills. Soft skills should be the things where we just sit behind a computer and create spreadsheets.
Sarah Richardso: 08:32 Yeah. When you do not have to interact with other people. That is a soft skill.
Bill Russell: 08:38 You just have to love that answer and the wisdom that Sarah brings to the show when you. When you have to interact with people, those are the hard skills when you have to actually lead people to rally them, to get them excited and to point them in that direction, to get them motivated to do things. Those are the hard skills sitting behind the computer, not interacting with people. Those are soft skills. Uh, I really appreciate Sarah's insights and her willingness to take time out to come on the show. Thank you very much Sarah and I look forward to coming on your Socal Himms podcast, uh, early this early, this spring. And I also look forward to seeing your new apple watch
Bill Russell: 09:29 at number eight. We have Daniel Barchi, cio for New York Presbyterian. In my research for the show, I was struck by the number of times that a Daniel referred to history. He referred to history in his talks in his interviews. And, uh, I thought that was interesting. So I thought I'd just ask him why, why that was. So, give this a listen. I read a bunch of stuff, stuff on the Internet in preparation. Um, and you, you appear to be a big fan of history. You made, you made reference to a Lincoln grant, the Wright brothers, Alexander Fleming, uh, and you even studied the history of the Chrysler building as you know, that you referred to in a story which I found interesting. First of all were, you know, where does that come from? It just the love of history. And I think the second thing is, um, you know, what lessons are you drawing on right now in terms of inspiration for being a cio in healthcare? in 2018
Daniel Barchi: 10:23 I'm interested in history because I look at what we do at New York Presbyterian as a small part of the continuation of work that men and women have done for more than 200 years now. And in any great institution like this, we are standing on the shoulders of giants who went before us. And so the foundations that they put into place are important to recognize. And whether you look at your local history in your town or village or you look at a national or global history, we can look back to fantastic people who are inspirational. What they did and learn a lot of lessons from them, so I think when I look at history, I try to see what challenges people faced and what lessons I might draw from them. Now thinking about going forward, I think that we want to invest our time and our energy and our resources in a way that create a foundation more and more as we've run into a problem, I've thought not, what do we need to do this week, but if we could really change things, how would we want this to look five years from now? How would we want it to look 20 years from now? If that's where we want to end up five or 20 years from now, what changes do we need to put in place right now that will get us on that right kaleidoscope there. Even if it's hard, it's worth doing, but there's no point in putting in a quick fix and then two years going in and do the hard work.
Bill Russell: 11:44 What great wisdom from a great leader and I'm just think of some of the things. I mean we're standing on the shoulders of the giants that went before us. We lead today with an eye on the future. We're setting the foundation for what is to come. I love the wisdom of Daniel's answer. Appreciate those who've come before you and create things with an eye on those who will come after you.
Bill Russell: 12:23 So throughout the year people come up to me and they say, hey, there's someone you should meet or there's someone you should have on your show. And I really appreciate those conversations. And this next guest is someone who I didn't know starting this year and sue shade. One of our other guests on the show introduced me to amy Maneker and amy is a former cio, cmio for a children's hospital and now with starbridge advisors. And Amy and I started talking about the arch collaborative. She introduced me to what the arch collaborative does around EHR effectiveness. And, uh, it was a really fascinating conversation. So here's amy at number seven, sharing some of those insights.
Amy Maneker: 12:59 So I think one of the hottest topics, both for me personally and across the industry and I suspect is how do we address the Emr, whatever brand you're on, roll in provider efficiency and satisfaction. So people say physicians are burned out. I was at a social event the other night and the neurosurgeon next to me kind of heard what I did and immediately started complaining about clicks to me. No joke. It doesn't even work anywhere where I've worked, but I hear about the clicks and so I think we're really trying to. We're beginning to address that and one of the most helpful tools. So I did a project on that at my last organization, but his class is doing this arch collaborative and I think we're getting some really good fascinating data. And so what class is doing is they're asking, I think they're probably close to 120 organizations and they basically say hey to all the users. Does your, do you agree? How do you feel about me? Does your EHR enable you to deliver high quality care? And then kind of like when we do population health, you look for the bright spots. So what are the characteristics of places that where everyone says, yeah, it's pretty good here, the Emr, so it's not what you think. So you ready for the big surprises?
Bill Russell: 14:11 Sure. Love it. So you're going to share some of the things that arch collaborative, uh, found.
Amy Maneker: 14:17 Yep. With their initial findings and that I've had. And I've also had personal, some similar experience. I think it's more powerful to talk about national data. And so they found, I'm going to give the big surprises first, that it spend doesn't correlate. Voice recognition doesn't correlate and scribes doesn't correlate with improved user satisfaction.
Bill Russell: 14:42 Wow. That's hard to believe because you hear that a lot. If, you know, if I didn't have to do the data entry this, this whole thing would be fine. That's an interesting finding.
Amy Maneker: 14:51 So, and in fact, this week I'm Jama had an article about scribes and satisfaction and 18 PCP practices which shows the opposite. So then now that I've kind of rained up, you know, everyone's assumptions, what are successful organizations and what they found. And I personally found is it's really about how do you help support the users to use the Emr and it's robust, high quality, the or at least the perception of really good training at first it's ongoing support and the ability to personalize which I tied ongoing support and one of the things that I really think, and it hasn't been born out yet in the them gotten his granula it's ongoing ownership and engagement of the physicians. They need to have some ownership and engagement. Not each and everyone, but like someone in each specialty needs to own the content and understand the software and that's what really makes a difference. So the organizations that haven't had good data have keep trying to. It looks like they throw money in technology at it. Well the organizations with high user satisfaction seem to have a more of a culture of support and relationship with it. And the other thing is that everyone complains about entering the data. And, and this is my concern about the gem articles. No one talks about getting the data out, which is as important as entering the data.
Bill Russell: 16:24 I think amy captures the spirit of so many of our guests on the show that we know we can do better and we want to do better for our clinicians and for our patients, and we continue to work diligently to find ways to ease the burden and, uh, and really to move technology into the background so it's not at the forefront, but really is in the background just serving the needs of the people who need it most and really restoring that human interaction back into healthcare.
Bill Russell: 17:06 So Ken Lawonn is cio for sharp healthcare in San Diego. Ken and I became friends when he moved to southern California to replace longtime cio for sharp, a bill spooner, who was also on the show this fall during the, the Chime series that we did. Um, so ken and I decided to discuss an article that talked about these disruptive forces that are impacting healthcare and they identified eight disruptive forces. And Ken and I decided to go in depth on those. So coming in at number six, here's a short sound bite from Ken Lowonn Cio for sharp healthcare, the three more millennials as consumers, internet of things and non traditional entrance into the market such as Amazon, Berkshire Jpm talked about that last one a bit, but yeah. So, uh, what would you tell your peers about those last three things? You know, consumers, Iot and non traditional entrance?
Ken Lawonn: 18:02 Well, I'd say, you know, consumers kind of goes along with what we talked about on the retail side. They talked really about the millennials and, and you know, they don't want to go through the traditional process. So I think you'd have to start thinking about, you know, how do I serve a different kind of population? It's really about transforming what we've grown up as kind of a, an operational automation of points of care and removing the complexity internally. And we've shifted the complexity to our customers and we really have to switch that model around and think about how do we take the complexity out of the interactions that we have with patients and consumers and if we have to move a little complexity back inside, then how do we work on, you know, on automating and streamlining that. But you really have to shift your thinking as an organization from a, what I call a process and operational driven company to a consumer or retail type company. And, and, uh, and as part of that, you know, the Internet of things is all this information that can be collected in the patients are looking at, on, on their own. This is what's the plan for incorporating that, um, you know, how are you working with apple or whoever to bring that data in and make it relevant to providers. So I think it just, it causes us as, for me, it's really shifting and everything has to be thought of as more of a patient, consumer focused thinking, not about how can I make this part of my operation more efficient and how can I make that interaction because as you said, you know, you don't want to lose the, you don't want to lose the relationship.
Bill Russell: 19:33 Yeah. So the consumerization of healthcare came up an awful lot this year. It seems to be a trend that is not going away and you have all these disruptive forces and companies coming in from the outside, uh, to try to impact healthcare I think Ken really captured it well when he said shift your thinking from a process and automation company to a consumer based company,
Bill Russell: 20:10 our next guest is so gracious. I've mispronounced her name so many times. I half expect her family to start picketing right back here behind me. Uh, Anne Weiler is the CEO and cofounder of wellpepper. She is so smart and so excited about what technology can do a within healthcare and to change healthcare and the healthcare experience. In this clip we discussed the move from point solutions to the platform at number five. Here's anne weiler. What area would you focus on right now? You're on patient engagement and enablement. What is there an area that you're looking at going, that's a great area.
Anne Weiler: 20:42 You know what's really interesting is just in the time that we've been doing this, which I'm the one hand seems like a long time and in healthcare is really not long time at all. We've gone from point solutions to platform solution, so the, you know, a point solution for each type of patient or each type of intervention, whether that's like, here's a cardiac rehab solution, here's the total joint solution to, but basically what we do and what we've always done, which is we can support any type of patient experience. So interestingly we went from people saying tests you're trying to do too much and now they're telling us we're trying to do too little because of this, the ones who see this overall digital patient experience. So they're asking us, how do I attract more patients? How do I, you know, you do a great job of retaining them and recalling them, but how do I find them to begin with? How do I do some basic triage of them when they're just starting to think that they might need care? And so I think what, what we would do if we were doing today is we actually do something even bigger because our customers are asking us for, for that something bigger and the market is ready. I think if I'd come out with like, we're doing a, you know, all of these things that a patient needs to do outside the clinic, we're going to do them. If I'd done that like four years ago, people were just like, you're crazy. I don't understand what this is. So I think we would do similar, a similar thing, but even bigger
Bill Russell: 22:10 Plateforms really have changed every other industry, our EHR is really haven't taken that next step. They haven't filled that void. And I think that's partially not for lack of trying. I think it's partially because it's really hard to get from here to there on top of 1980s technology. Um, but you know, who knows, maybe we'll see some re, re architecting of these platforms. Are these solutions to become platforms and let's see what 2019 brings.
Bill Russell: 22:49 Yeah. Who owns the medical record is a, a pretty simple question that you would think would have a very simple answer. But, uh, sometimes we get wrapped around the axle with this one. Uh, Dr Rod Hochman is the CEO for Providence Saint Joseph Health, uh, one of the, I think, believed the third largest health system in the country. Um, and he is one of the leaders that I appreciate that has the courage to state, the answer to that question very simply. At number four, we have rod hochman answering the question of who owns the medical record. I apologize in advance. The audio was a little rough on this video. I wanted to cover one last topic and that's data with you and there's, there's a handful of ways I want to talk about this. You've talked about the power of data in healthcare and how it can have a meaningful impact on, on outcomes and many other things. We really have a ton of data within healthcare already. Uh, so let's talk about of that data scope of that data privacy. So let's start with the first question, which is, um, uh, who do you, who do you think owns the medical record or who should own the medical record and how will that change the way we view data and use data moving forward?
Rod Hochman: 24:02 So, I think ultimately, individuals need to be in control of their own data I mean I think that that's almost a given, the question is who do they give proxy to and who do they trust and uh, unfortunately we've had some bad examples out in the social media venue. You know, I think in healthcare we've always considered, you know, the sanctity of data we're regularly teaching that so we protect that incredibly well. So what I hope is that I want individuals to have control over their data, but I hope they will trust their health organization to be that trusted partner with them and then figure out how that data gets used and where it gets used. And I would not say our patients . I just think that one of the advantages that we have in the sector where we are is that I think are our patients and our clients still trust us and we have a relationship with them. So thats what I would see that work and then the question is how do we use that data for our patients benefit and also try to advance how we do care and Our interest is the health of our patients and communities but we see ourselves being able to use that data to advance that not nessesarily you know shareholder value.
Bill Russell: 25:43 simple answer data is there to serve the patient, not necessarily to build shareholder value. Really appreciate Rod hochman coming on the show.
Bill Russell: 26:06 And here we are now down to our top three. Most weeks we discussed the news, but some weeks there are topics that I really want to know more about. And artificial intelligence is one of those topics. And I decided to do a deep dive episode where I would find an expert and just really talk about artificial intelligence in depth. Dr Anthony Chang is chief intelligence and innovation officer for, for Choc Children's Hospital of Orange County, as well as the Sharon Disney lund medical institute. He leaves the Ai Med conference around the world, uh, the most recent one in December down here in Laguna beach. And, uh, we had a fascinating conversation around artificial intelligence in medicine. Here's a short story that he shared with me about human machine interaction.
Anthony Chang: 26:54 So that's a great story about the Alphago software program from Google being and that human contestant and go, uh, so handily actually, um, and everyone publicize the second game 31st move because it seemed like the computer made a move that it had not learned from any human based on hundreds of thousands or millions of games before. It was like a move out of nowhere. And then yet that move was instrumental in winning the second game. What's not publicized is in the fourth game, a one of the moves the human champion made was sort of in the category of that really creative mood. So some area moments there, right? Because maybe the computer thought or was created for the first time and now the man the human champion is learning from the computer. But I think that's a wonderful, uh, example how man and machine can learn from each other. Right?
Bill Russell: 27:54 I love Dr Chang's a vision for the future where machines and intelligence working in the background, providing that information to the care providers and even to the patients. Uh, he made the point in our interview that, you know, we really don't think twice about taking directions from computers anymore. It's really becoming more and more commonplace. You don't think twice about following your gps when it tells you to make a right turn and you don't really think twice about the information that comes back from Alexa. When you ask Alexa or Siri a question, you get that information back. We do check it, we do filter it, but we're doing it every day. And, uh, I'm, I'm also thrilled that Dr Chang, uh, agreed to come on the show and I really appreciate his time.
Bill Russll: 28:53 As you guys know, we share a lot of videos on social media platforms and this video got far and away the most attention of any of the videos that we shared this year. Dr John Halamka is the cio for Beth Israel deaconess medical center in Boston, Massachusetts. And John and I got into a discussion on the role of the CIO and I think John Really captured this massive change that's going on in the role of the CIO. And uh, you know, only John could really address it because, you know, he is a practice practicing physician. He's an mit trained engineer and he's been a cio for a, for a very long time. So take a listen to John Halamka talking about the role of the CIO
John Halamka: 29:36 that the role of the CIO has changed. Totally right. So back again, since you and I are of similar age, you know, we were software developers and architects and we could tell you what ram to use based on its transactional speed. Do you think any of that matters anymore? The answer is NO! What you need as a cio in 2018 to be is a convener. You understand business requirements and strategy and then you take that and procure services from multiple cloud providers and plummet together and so it's just so funny. I have an mit engineering degree. You know, I had to be a doctor, engineer, politician, economists to survive the 1990s, but today unbelievably. You'd probably best be a sociologist, right? It's all about people. Yeah.
Bill Russell: 30:30 The role has changed to how can you help the organization to navigate change and that is helping people to understand the vision for hey, here's what's possible and then bringing them together to have a conversation of, okay, if these are all the things that are possible, what should we be doing? Should we be doing something different in the Boston market then than they are doing in southern California? Probably. I mean our, our environments are very different and our communities are different and there are things that are probably a priority here that aren't there, but we're, we're people that lead those conversations. It's really fascinating to me. The other thing that's fascinating is I had a fair number of conversations at the Chime Forum and a whole bunch of the cios, the, the have been pushed into this operational role and then you've seen these other roles sort of elevate chief digital officer, chief innovation officer and uh, and, and I'm not sure the cio, the chief information officer knows what to do now other than, okay, well my job now is to keep the emr running to make sure the data center runs to have dr capabilities and even security somewhat. I mean not the implementation, but the oversight of, of security has been taken away from them as well. And they're, they're saying, okay, my job, they really have become more of a director of infrastructure and technology than, than a traditional cio. I mean, what do you say to someone who's saying, I want to get out of that trap, how do I get out of that trap and how do I differentiate myself in, in that space?
John Halamka: 32:03 Right. So I became a cio in 1996 and as a cio I was the chief digital officer, chief innovation officer, chief medical information officer and the CSO. Right. And so what have I done over the last 22 years? I've actually, I'm the air traffic controller, right? But I have carved up the office of the cio into five different components. I mean the ones that you just enumerated because that's the nature of how the work has to be done these days. So fine. Tell us cio, you're a sociologist, it's a change management activity and you're a convener and you have these experts working for you at these individual domains. You can't do it all yourself. It takes a village.
Bill Russell: 32:46 I love having John on the show agree with John, disagree with John. That's not really the point. The point is, John puts ideas out there that we have to think about ideas that we have to discuss a agree with, disagree with, a really come to grips with. And I think that's what, that's what I really like about him. Uh, the other thing is he really has a passion for training the next generation of health it leaders, and that's what the show is about. So, um, thank you John for coming on the show.
Bill Russell: 33:29 So here we are down to the number one video from this week in health it for 2018. I'm todd Johnson is the CEO of health loop and someone that I've gotten to know pretty well over the last seven, eight years. I really enjoyed our conversation this year. He gave us a, you know, a couple of great soundbites. Actually, I'm, one of the ones I didn't use was your technology has no soul. It's a great story of todd presenting to a Silicon Valley investor and it was some funding round. He was showing him his technology and uh, the, the gentleman looked at him and said, do you know what todd, the problem with your technology is it has no soul. Uh, and it was, it was a transformative event for him. It caused him to change how we thought about, uh, developing the technology around the user experience. And he now talks very significantly about a building empathy into the applications that he's putting out there into the marketplace. You'll want to look that one up because that's not the number one a video, even though I'm excited about it. Um, the, uh, the minute I heard this clip, I asked him a question and the minute I heard this clip, I thought that is one of the top things I've heard in a long time. It just resonated very deeply within me and I believe it will resonate with you as well. So without further ado, here's the number one soundbite from this year. Todd Johnson, CEO of health loop. All right, so this is a selfish question. Let's talk about implementation from, from a digital entrepreneur standpoint, what are the characteristics or activities that organizations that have successful implementations? What, what did they have in common?
Todd Johnson: 35:03 Yeah, I mean, it's conviction, right? System, have conviction around a thesis and really work to identify the right partner and treat them like a partner and make the, make real investments to achieve those outcomes. Right? Find ways to really, really go strong. I think it's almost that simple and clearly when there's the right economic incentives and organizational objectives that we can align those incentives together. It works. We've seen, you've seen this, um, you know, the emergence of a pilot, right? There's so many damn pilots and now we have innovation centers that just, you know, their pilot, I'm a wood chipper factories and on the one hand it's great that, you know, health systems get to take a test run for digital innovations in digital innovators, get some tests runs with the hospitals, but more often than not, results in failure and it results in failure because it gives everybody an opt out a chance to take the exit ramp as opposed to just saying, look, we're committed to this one way or the other, we will make this succeed, this is where we're going and we're going to go big. And I think that's really the critical, like when a, when a health system has a conviction and is committed to achieving real outcomes and is willing to expend the energy to get the change management inside, the sky's the limit. Right? You can do amazing things without that conviction. You can sputter
Bill Russell: 36:40 yeah. And I actually, I think the conviction, I think that's a great answer by the way. I think the conviction starts with what problems are we trying to solve. I think too many health systems are trying to solve 100 problems and you can't solve 100 or, or more problems every year. You almost have to say these are the 15 to 20 problems we're going to solve this year and we're going to focus our energy, our resources, our investments on these 15 to 20 problems. It depends on the size of the organization, but I just find that the, uh, the focus of the organization is spread so wide, so there's a sort of a conviction that these 20 problems are the most relevant to our community that we serve right now.
Bill Russell: 37:21 I feel like it's a little bit of a Jerry Maguire at the end. Uh, you know, you had me at conviction and if all you had said was conviction and this would be a great clip, but then he gave us this visual picture of the pilot wood chipper. And I just think that's a so indicative of what's going on. We just, we just keep trying things and trying things instead of really sitting down and figuring out what are we trying to build, what are we trying to establish a, are we trying to do experience for the clinicians, are we trying to do experience for the patients and really setting the direction for our partners, for our system, for our staff. And uh, I just think it's a phenomenal answer. It's going, it, it resonates with me and I hope it does with you as well. Well, that's a wrap for 2018. I want to thank all of our guests this year on a thank you for your time and your commitment to developing the next generation of health it leaders, your voice has had an impact this year and it will for many generations. And, uh, that's what I believe and I really appreciate you being a part of the show. If you enjoyed the show, please share it with a friend or colleague. If not, please drop us a line. Let us know what we can do better. Bill@thisweekinhealthit.com. Uh, as I said earlier, we recorded it over 2000 minutes of audio and video this year. Uh, this episode just covers 21 minutes of that. If you're interested in more of this great content, you can find it @thisweekinhealthIt.com. You can also hit the youtube channel. Easiest way to get there is thisweekinhealthit.com/video. And that will pop you over to our youtube channel with over 400 some odd videos. Our sponsor also host the, uh, the content on that website healthlyrics.come. So, uh, so that's all for 2018. Please come back every Friday starting in 2019 for more news, information and commentary from industry influencers. That's all for now.