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The Healthcare CIO Look Back / Look Forward series with Chani Cordero, Chief Information Officer at Carl R. Darnall Army Medical Center

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 Welcome to this Week in Health IT events where we amplify great ideas with interviews from the floor. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcasts and videos dedicated to developing the next generation of health leaders. We wanna thank our founding channel sponsors who make this content possible, health Lyrics and VMware if you wanna be a part of our mission to develop health leaders.

Go to this week, health.com/sponsor for more information. This episode is sponsored by Health Lyrics. When I became ACIO, I was really overwhelmed at first, and one of the first things I did was to sign ACIO coach to walk with me through the journey. This was someone who had wisdom that can only be gained through years of experience.

It was invaluable to my success in the role, and I now coach CIOs through health lyrics. If you wanna learn more, visit health lyrics.com or drop me a note at Bill at this week in health it.com. Over the next three weeks, we have a huge treat for you. I'm really excited about it. Uh, I just got back from the Chime fall forum in Scottsdale, which was a great event, and we caught up with 12 active CIOs from various size health systems and ask them to take a look back at 2019 and a look forward at 2020.

Uh, you're gonna hear, um, what they're excited to have accomplished last year and what they're looking forward to accomplish next year. I asked each of them the same eight questions and I think you're gonna be fascinated to hear the similarities. . And the difference is based on where they're at, geography and other things.

Each of these interviews is about 10 minutes long, so you can listen to 'em really quick and some of you listen at one and a half time speed. So it's gonna go like that. Uh, we're gonna publish one a day, uh, with a few Newsday episodes sprinkled in through the end of November. So check back every day for the next episode, and don't forget to look back to see if you missed any.

Our next guest is Chaney Cordero, who is the, uh, former Chief Information Officer for the Darnell Army Medical Center. Uh, she is now taking on a new role up in, uh, Monterey, uh, is still with the military, and she's gonna talk a little bit more about that. Uh, hope you enjoy. So here we are from the Chime Fall Forum.

I'm here with, uh, Chaney Cordero. Mm-Hmm. . Um, wow. Look at all those ribbons. Oh, Bootcamp alumni and, uh, most wired. Oh, you guys were most wired. We were. That's a huge accomplishment. So I'm really excited because this was the first time our hospital actually received that recognition, and so I'm so honored to come and accept it on their behalf.

That's fantastic. And that is a fair amount of work for that, that team. They really have to step up. It, it was, it was. And so the hospital. Hospital is new. And so we had some, a little bit of help in the sense, because we were able to get our infrastructure in place compared to if, you know, if you have an older hospital that has like old, you know, lines or whatnot.

So we were able to do that and we brought in a lot of new equipment. So, um, I think this year was the perfect time as we started optimizing what we had, we were able to compete for the recognition. So you, uh, you have changed roles since the last time you were on the show? Yes. And uh. I mean, you're prolific on social media, so I, I think a lot of people know, but why, why don't you give us ACIO and then you move to a new role.

Right. So I cut, um, I just got there last week in Monterey, but I am now the, what we call in the military health system, a Deputy command administration, but it's. Really, essentially ACOO role. And so within in that role, I'll be in charge of, um, our logistics, our, our budget, our our managed care, our, the payer side in the sense of working out those network contracts or whatnot.

And then of course, the productivity side. So, you know, are we being, um, productive in our, in our service lines. Wow. And how many hospitals? Um, so it's just, they're really actually kind of like . Super clinics and there are two super clinics and we also have a, a share with the va. Wow. That's exci. Are you excited?

I assume you're excited. I am. So, 'cause you know, even in in private sector, you don't typically see a lot of CIOs go to COO World and Army Medicine. And that's not typical at all for us. And so we, you know, normally as A-C-I-O-I stay in ACIO, so even though I'm not getting paid any more money, it's, it is essentially a promotion that's, that's so, yeah.

As my dad says, we pay you an opportunity. So . The Army pays you an opportunity. The army, Hey, here you go. And they did well, they sweetened the pot though by allowing me to move from central Texas to the coast of California. So yeah. So you're up in, uh, up in Monterey? Yes, yes. Monterey is nice. That's where Pebble Beach is.

Yes. And um, but it can also get pretty cold there too, can't it? So compared to Texas. Absolutely, absolutely. So I think the first night I went there was like 50 degrees and I'm like, . I finally get to pull my Uggs out. . Yeah. We, I, I, I was up there probably about six months ago. I went up there and, and I, my son was up there as well, and he met up with me and he forced me to go play, uh, disc golf, and I guess they have.

they have a DISC golf course where they played the US Open Yes. Disc golf championship. And we, we played that course. Nice. It was a lot harder than, than really I, of course, than I really should have been on. Yes, yes. But it was a lot of fun. Yes. No, I mean, the weather there, I mean, is perfect all year round.

I mean, so I've heard the only disadvantage course is the cost of living. So I'm hoping I get to keep my two kidneys, but it's debatable right now. Yeah. . Um, well, I'll tell you what we're, so, I, I've asked these questions of . 15 CIOs now. Okay. So, um, and my thought was it'll be interesting to hear the different questions, our different answers.

And it has been interesting, uh, 'cause I've just listened to all of 'em 'cause I did the interviews. Mm-Hmm. , um, you know, rurals struggling with different things than, yes. Than, uh, urban, than, uh, different geographies of different challenges and those kind of things. So it'll be interesting to hear, uh, some of these things from your CIO perspective.

Yeah. How do you think the roles changed over the past year? Um. So I think again, the role as CIO is still to be a partner with like the proprietors and the clinicians or whatnot. Um, I think sometimes you still, sometimes are, look, I jokingly say as the plumber, you know, making sure that technology works and not really being, uh, placed as, as a partner.

But I think as the organization continues to rely on technology, they're recognizing that you have . To partner up with it. Yeah. So it's moving from a plumber to maybe an architect. Right. Good analogy. Yes. And so you're, you're sitting there planning the building and what it's gonna look like with them instead of when they're done planning it going, Hey, can you put pipes there?

It's like, no. Right. Put pipes there. Exactly. Exactly. Exactly. Uh, so I, I, I don't know if you'll be able to answer this, but you know what, what are the prior, what were the priorities where you were. And how's health it going to support those priorities? No, I can answer that definitely. And so just like private sector, the military health system is looking at using a virtual health private, I mean a telemedicine.

And so we, you know, my, my population's relatively healthy, right? I mean, essentially we're service members or whatnot. And so I have that demographic. That doesn't require a lot of services, and so our bread and butter is primary care. And so when it comes to the telehealth telemedicine space, it's, it's not as easy to go after primary care in that setting.

We've done quite well in the mental health space, and so if we have challenges there, it is really more about provider availability, more so, and, and access. More so than the technology. So you guys, uh, you guys care for, um, the armed force, uh, the people within the army base? Mm-Hmm. their families. Mm-Hmm.

Any, anything outside of that? The retirees, veterans, us. Not veterans. Okay. Um, only retirees. Retirees and their families. Okay. Mm-Hmm, . That's, that's interesting. So the reason I ask that question is, the next question I've been asking is, you know, what's, uh, you talked about telehealth, but what's one thing that if I were talking to that community, I could say, Hey, you could look forward to this, this, this is how we're gonna move the needle on patient experience.

So patient experience is an area that we're probably struggling more. So then in private sector mainly is because my patient population is pretty well defined, so I don't really have to market as much, if that makes sense, right? I'm not trying to be the bright and shiny object that come to my hospital, but our patients do have choices.

So maybe not the active duty member, you don't have a choice, you gotta come to us. But their families have choices, retirees have choices, and we are essentially a capitated model. So what does that mean is that we get paid to take care of those family members and if they choose to take their . Care to the private sector that we're gonna be, we'll lose resources as well.

And so we are looking at how do we, you know, how do we expand on the patient experience? But I had to admit, it has not necessarily been one of our top priorities. Well, it's interesting 'cause on the other side, on the private sector side, you would look at telehealth and go, well, we can't figure out how to get it funded.

But on your side it's completely capitated. Telehealth would be pretty well received. Hey, and actually drive down, um, . A lot of the overhead of certain, certain ailments. Yes. The challenge that we have, I think in this is just Chinese's opinion, is the security aspect of it. And so we are very guarded with our information and we're very guarded of who has access and ability and what platform is gonna have access to that information.

And so as we change our culture to partner up with some of those outside providers, that allows for hipaa. Compliant, um, applications or whatnot, and allowing, allowing that to work then I think will move the needle. That makes sense. Uh, one initiative that's focused in on the clinician experience, the clinic.

No. So, um, I wish I could say yes, but not at my current hospital. Yeah. Um, so thinking back to your team, what, what a chance to give a shout out to your team. What's, what's the thing you're most proud of that your team. That you're leaving was able to accomplish. So I think, you know, this may not something that's very measurable, but I took a, it's nothing very measurable, but I actually measured it, right?

So when I first arrived, I did a real time survey on, on staff satisfaction, and we did it, you know, using the application web-based, had up on a board for everybody can see. So when I left, I did that. Same survey, and I wanted to, and I compare the answers to see did we move the needle? And there was some areas that we moved the needle increment.

I mean, we moved the needle. I, I had wished that we moved it more, but at least we moved it in all areas and, and, and in the positive direction. In the positive direction. And so, but I, the lesson I learned from that though is you can't change culture that quickly. And I really thought . You know, new leadership, you can change the culture really fast and it takes time.

And I have to remember that it's, and there's also a culture within a culture, right? Mm-Hmm. . So there's the culture of the military, of, and then there's the culture of the army. Then there's the culture that you have within your department. That's no. Yeah, absolutely. And, and that same thing happens in, in the private sector as well.

Mm-Hmm. . There's the culture of the health system. Mm-Hmm. . Um, and I think it's interesting 'cause we just assume, well, we came up with these core values and they're just . Gonna permeate health it. And it's like, well, you put us off on a, a building all by ourselves over here, and it's sort of developing its own culture, so we It does, right?

That's something you really have to work at. You do. You do. So, and one of the areas that I just really wanted to move the needle on, and which is communication and not, you know, trying to break down some of the silos. And so again, you know, it wasn't, you know, we didn't reach the mountaintop like I wanted to , but no one's blocking each other on Facebook.

You know, , so. Move, moving it forward. Um, is, is there any area in healthcare as an industry you'd like to see more innovation? Specifically within, I'm sorry, within healthcare? Yeah, within healthcare that you, you think, wow. I, I really wish there was more innovation in that area that was moving, uh, making things better.

Health, health disparities. So, you know, based on your zip code, your life expectancy is gonna change. Yeah. Right. And so, I mean, numerous studies have shown that health disparities, . Is is real in the United States. And so, you know, our, you know, obviously the social determinants of health plays a huge role.

Genetics plays a huge role. But we need to be not, you know, as we try to keep people or patients healthy, we also have to recognize that not all patients are receiving that same level. Yeah. Dr. Klasko was talking, uh, in Philadelphia. He goes, you know, if you're born in this hospital, that's great. You know, mortality rate, we've done great work here.

We're phenomenal. . Hospital. Yeah. Uh, so you'll be brought in. But if you go home with a family that goes in that direction Mm-Hmm. , your, your average age is gonna be, you know, I forget what it was like 78 point whatever. Mm-Hmm. . If you go in that direction, it's like 62 mm-Hmm. . It's like, so what's different?

Mm-Hmm. . It's just zip code. It's essentially Mm-Hmm. . In that neighborhood. It's harder to get good food. It's hard, you know, there's, there's gang activity, there's Mm-Hmm. , there's a whole bunch of issues that he goes, and the thing I appreciated about him, Mm-Hmm, , is he goes, you know, I went to the, to the board and we're talking about compensation.

Is that what's important to you? Is that improving the health of the people in Philadelphia? He said, okay, my compensation has nothing to do with it. And I said, what do you mean? He said, well, let's look at my comp. They looked at his comp and he goes, you're right. It has nothing to do. With the health of the people in Philadelphia, all it has to do with this, the performance of the hospital.

Right? And so he goes, alright, if you want that to be, what, if that's our goal, then I want 25% of my compensation to be the health of this community. Mm-Hmm. , which I thought was bold, absolute. Absolutely. 'cause you have to partner. You can't do that by yourself. Right, right, right, right. And you have to care about the community that you're serving.

Yeah. Right. Yeah. I, I, I agree with you. I think that would be, I'd like to see more CEOs sign up for that and say, we're gonna, and you know, I, I, I'd be ress you don't really do this. I, you know, I. I surveyed the audience. Mm-Hmm. , uh, the listeners. I said, you know what questions you want me to ask CIOs more in the future?

And they said, ask 'em about what roles they're gonna hire, but you don't really hire roles, do you? Um, you mean far as in the whole CDO and, uh, chief Innovation Officer? Through things of that nature. Yeah, I mean, um, so no, we do, I mean, like I have A-A-C-T-O, a Chief Technical Officer. Do you hire them or do you pull 'em from No.

So, you know, it's a misnomer. I'm really glad you asked that question. Just so, um, as we talk about our health system. Uh, out 78 people on my staff. Only, only two of us is active duty. The rest of 'em are federal contractors and federal employees. And so I have to deal with the same challenges that everyone has.

I have union negotiations. I have, you know, people calling out. I have vacation. I mean, I have the same challenges, um, labor issues I have, you know, if it's a government shutdown. Down my federal employees may not come to work. So I mean, there is a lot of areas that we deal with and so no, we, you know, we do hire, um, and, um, and we have not, other than the chief technical officer, we have not done all the other alphabet soup.

It's going to be because you're in Monterey now. Mm-Hmm. . That's, you know, right down the street from Apple and everybody else. Mm-Hmm. . Um, it'll be interesting to see, I mean, from a health IT standpoint, but you're now . We're a larger group, but it's still, it's a challenge to hire in this. Oh no, it is. Well, it's gonna be well fine.

Especially if you live on the, the coast. Right. So I have a resume for one of our positions and I don't know if that person will be able to, how old they're gonna be here. 'cause I don't know Sure. How we're gonna afford to live. Yeah. Somebody asked. Me about a, a roll up up in that area. And, and, uh, you know, it's interesting 'cause they said, well, what's the compensation?

And you know, we went through the whole thing and I'm doing the math and I'm going, uh, I don't think I can afford to take that job. I mean, just based on the compensation and the area you have to move to and the no, the cost of real estate, no abs. The one thing that I really, uh, appreciate the military do is that when service members are looking to retire or transition out, they have the, they have programs.

And one of the programs is actually teaching members that the compensation pack rates and then why it matters, you know, a salary and. To California is definitely gonna be a different salary in Texas. And would it matter, I'm sorry, salary, but in a sense, the impact of the real lifestyle, it matters. So, well, congratulations on getting to California.

Thank you. Thank you. The, uh, the promised lands, well, we'll find out , right? Well, the. Sunshine has already got me so . Yeah. Well you had sunshine in, uh, in Texas. I had lots of sun . I don't know too much sun. My daughter goes to Baylor. Oh, nice. She, she left Southern California. Went to, yeah, she does. My grad school.

I went to Baylor. Oh, did you? Yes, . It's, it's fun. I'll be on the phone with her and, and she'll, and she'll just walking around the campus. She'll go, sick bears, what are you doing? She's like, that's sort of like saying Hi, . Okay. Uh, but her Southern California to, uh, to Waco, Texas. I mean, her first thing was, I, I'm not sure I was prepared for how hot it is.

Mm-Hmm. . And now she just called me and said, it's freezing . How? I'm not sure I even expected that. . It's been while. So thank you for joining us today. It's always a pleasure. Thank you. I hope you enjoy the conversation. Remember to check back often as we are gonna drop an episode a day for most of November of 2019.

Following that, please come back every Friday for more great interviews with influencers. And don't forget, every Tuesday we take a look at the news, which impacts health it. If you wanna support the fastest growing podcast in the health IT space, here's a few ways that you can do that. The first, . Share it with a peer, share it with a friends, share it with somebody who's working right there next to you.

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This show is a production of this week in health It from more great content. You can check out our website at this week, health.com or our YouTube channel. Special thanks to our sponsors, VMware and health lyrics for choosing to invest in developing the next generation of health leaders. Thanks for listening.

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