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The Healthcare CIO Look Back / Look Forward series with Darren Dworkin, Chief Information Officer at Cedars-Sinai

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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 in the series is Darren Doin the CIO for Cedar-Sinai in la. Great conversation. Hope you enjoy. So Darren, thanks for joining us. Chime another, uh, one of the interviews so we have, uh, eight prepared questions. Excellent. 'cause what we're gonna do is we're gonna ask a bunch of CIOs the same questions, really a look back and a look forward.

And, uh, we're gonna start with the, uh, almost obligatory question, which is, how has the role changed this year? Not how has it changed over five years, but how has it changed this year, do you think? I think this year more than most, or maybe a continuing of most, it's getting harder and harder to pick what not to do.

There's a lot, there's a lot of new technologies, new . A lot of new technologies, a lot of new operational imperatives. You know, the blessing of technology is that, um, all of the operational clinical areas want to embrace technology in some way, shape or form, and get us involved. The curse of this, of course, is that every business unit in clinical areas, priorities in some way involve it.

And the reality is we can't do everything well. And so this constant battle of sort of where we're gonna allocate time and resources is just getting harder and harder. Do you try to focus on those things that you can really do well as opposed to doing five things Mediocre. Is that a, is that a. Uh, a conscious process.

You know, I'll say that, um, uh, we've evolved a little bit. So I think that, uh, there's no doubt that myself and many on my team have these, like big views of what we can do well and where we should spend our time and what are, you know, a priority over another priority. But the truth is that's a never ending battle that I'm not sure you ever hit the right equilibrium.

And so we've really embraced something that early in my career, I was very opposed to. And that is turning over almost as much decision making as is possible over to governing groups. And when I say turnover, I don't mean just sort of the dog and pony show of a meeting or two. I mean truly turning over and letting those groups decide and transparently see where all the conflicts are, uh, or competing priorities, and ultimately help sort of pick where they want to go.

You're like the third large system, CIO, who has said something to that effect of, um. I, I've removed myself from the decision making process, not completely right. I'm, I'm still an advisor. I'm still an I, I informed the decisions, but the business makes the decision on what they want to do. Now, the tricky part of that comes in two areas.

The first is nobody's gonna come to you and say, you know what? Yesterday. Dial tone was spectacular. And I've been really thinking about this new upgrade plan I have for dial tone to make it even better. So, you know, we have to advocate for those projects. And then the other is that I think that one of the advantages that CIOs have is that because we get to work across the organization, we can view and see the emerging platforms coming.

Better than some of our colleagues, right? And so we often have to weave them together. So I'll give you a great example. Our, uh, my counterpart in hr, my counterpart in finance, my counterpart in supply chain, all are very excited about a new series of initiatives. They don't naturally think of that as an ERP project.

I think it's our job to sort of tie those together into a platform. Looking into next year, what are, what are maybe two or three things that you are going to do, you think are gonna focus in on ? From a health IT perspective, dial tone. Uh, yes, dial tone. I have this new idea for dial tone. It's gonna be spectacular.

Um. You know, I think probably the biggest challenge is gonna be figuring out what the three of them are. Um, if I had to guess ahead though, I think one of them is we continue to grow and supporting that growth and really remembering that, um, you know, when, when we brought one area of the organization up to a certain level, that becomes the expectation for the next level of the organization.

And so we've been growing quite a bit, uh, on the ambulatory side. And so there'll be a lot of that expansion. Um, there will be the constant pressures and I would be remiss if I didn't sort of highlight efficiency and trying to figure out how to do more with less and working smarter. I think automation has a big role to play there.

I think, uh, what I'll call operation or a practical ai Yeah. Will have sort of a real thread that can sort of weave in. And then, you know, I think that, uh, there's gonna be sort of the, everything else, all these other sort of new exciting areas. It would probably would be cliche to say it'll be digital or digital transformation.

Uh, but I think that we are gonna continue that march towards thinking about it as not just its traditional B two B, but also now bringing in sort of our patients as consumers and the technology they're gonna want. . But that what, that's, that is what it is. Digital transformation. When you're talking about RPA going in and replacing Yes.

Processes and those kind of things. Yeah. Um, I wanna give you a great example. Um, 'cause it just happened. Uh, so on Sunday, my amazing team, while I was gallivanting here at Chime, uh, upgraded our EMR. They did a fabulous job. Not only did we upgrade DMR, but we did four infrastructure upgrades. It went flawless.

Wow. Fabulous, fabulous, fabulous. But here's the thing that we didn't naturally think of. We notified everybody in the health system about the downtime really, really well. And I'd like to think that we got a eight, a nine, maybe even a 9.5 outta communication. You know, who, we didn't notify our patients that the portal would be down and that some of their patient facing functions would be down.

And we don't think of that and we just don't think of that way. We thought of it the moment patients called our help desk to say, Hey, what's wrong? But up until then, uh, we hadn't really a lot thought about and I think we just need to start doing that. I appreciate you sharing that. And which gets to the next question, which is, um.

One initiative that you think will materially, uh, impact the patient or patient experience next year as we continue to offer digital tools to reduce the friction in access to healthcare. Unfortunately, um, we are closer to the DMV than we are to Amazon. One click and, uh, there's not gonna be an Amazon one click for healthcare.

Uh, but there's a lot that we can do to bring that closer. But you're bringing a lot of companies in through your accelerator. Uhhuh. , you're bringing a lot of companies in. Mm-Hmm. . And there's a lot of companies going after this patient experience space. Are, are we just not finding it or is it just too difficult to plug it all together?

Um, I think we're finding it. I think though, um, you know, as the expression goes, healthcare's complicated , and so it's taking a little bit of time and like anything and, you know, people, process and technology, the reality is that technology is the easiest part. And so, you know, we've discovered with online scheduling is the actual digital tool of online scheduling is easy as can be normalizing schedules across ambulatory practices from the 1000 plus visit types to five that are schedulable.

Yeah, absolutely. It turns out that takes a long time. Yeah. It took us almost a year. Um. One initiative focused in on the clinician experience for next year, do you think? Data, um, we, um, are, um, amazed, um, or, um, continue to be amazed at, uh, the power of giving information back to physicians in their hands so they can see what's happening.

And so we have a couple of, uh, broad initiatives, but they all sort of boil down to the same thing. Of putting detailed information, report cards or other dashboard like things in the hands of physicians so they can see their own use of the system and so that they can be better at articulating where they want their improvements and where we can help support them.

Uh, greatest success for it in 2019. Quarterly updates, greatest success, uh, was probably in rounding out our team, um, unemployment of technology in it, in LA is, uh, pretty low. Yeah. And we've made some really great strides of expanding and bringing in some really great people. And, you know, it might be, uh, ironic to say, but, um, the technology business runs on people and so without great people, we're not gonna get great things done.

You know, it's, uh, it's interesting 'cause I don't think people recognize Southern California is really a hotbed for a lot of these companies are moving down from Northern California. That it's, it's, it's the unemployment rate for technologists is really low and you still have to get cybersecurity expertise.

You still have to get, uh, data, all sorts of data stewards and, and, uh, data scientists and whatnot. That's competition's hard. It is. Um, any missed opportunities for 2019? Lots of them. , lots of them. Any one come to mind? I don't think we spent enough of a focus of really, um, being able to launch our digital solutions, those sort of customer facing solutions and them in a way that engaged operations enough.

Uh, I think that we initially came outta the gate, starting with them being very tech-centric, . I think we had a little bit too much of the Disrupt first figure out what happened sort of next, and I think we sort of failed to understand the amount of process redesign that had to occur. And I think that, you know, honestly for ACIO and for many, there's a lot of pressure that if you come out and say no to a digital solution, you're quick to be cast as a Luddite or somebody that doesn't quite get it.

And I think, um, you know, one of my bigger regrets in 2019 was not finding the right balance between still saying yes to the very important initiatives that we wanted to move forward, but, uh, intertwined enough with operational engagement. Yeah. Area you'd like to see more innovation at this point. I think there's a lot more we can do in, uh, everybody talks about ai.

Um, I will say just reporting, uh, getting the right information to the right person at the right time. Um, we have spent the last 10, 12 years painstakingly, digitizing, enabling so much of the organization. You know, in our case it was really deploying the EMR. Um, yes, it's true. We don't have everything in structured data, but there's so much more information we can figure out how to put in front of people at the right time.

We have an unbelievably great leader over our data science and, uh, business intelligence team, and I think he's really helping me understand that the old worlds of self-service thinking it would be this magic button of you just sort of turn it over, doesn't really work because again, the data's complicated.

But creating a service desk for people to go down the path of self-service, I think is really a big, big untapped opportunity. So we're not gonna see the Google search button where I go, tell me how many patients have, whatever. That's, that's not anytime soon we're, we might. Um, and you know, I guess the folks at Google will have to answer whether they'll be anytime soon or not.

But I. I think that, uh, my point I would make is that with all of the talk of AI and predictive analytics and fancy Google search buttons, that I'm sure will be great. Um, there's a lot of, you know, basic level stuff that we can do to make lives for our users a lot easier. Uh, last question. Health IT roles you expect to hire more in, in 2020?

Cybersecurity data visualization. Um, you know, I, uh, tho those, those are two of the . To mind. Um, you know, again, though, not to be all over the place, but not to also forget, um, you know, the, the folks that can do clinic, uh, clinical translation and help us continue to, to deploy and optimize and roll out our EMRs, but those first two in cybersecurity, I think that there continue to be a big, big sort of, uh, uh, amount of openings and opportunity there.

And back to this data thing, um, you know, I often meet folks and I tell them, you should think about data visualization or a data role in healthcare. Oh, I'm not a math person. I'm not a data person. Um, and especially to creatives. I say to them that we need new ways to be able to view and consume the information, and so there's just this amazing intersection going on right now and I hope the best people decide to hop into healthcare.

Fantastic. Darren, thanks for stopping by. Thank you. Appreciate it. 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.

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Number three, interact with our social media content on Twitter and LinkedIn. Number four, post or repost our content. And number five, always send me feedback. Bill it this week in health it.com. Your insights continue to shape the channel. This show is a production of this week in health It from work, 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. That's all for now.

Our next guest in the series is Darren Doin the CIO for Cedar-Sinai in la. Great conversation. Hope you enjoy.

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