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The Healthcare CIO Look Back / Look Forward series with Joel Vengco, CIO at Baystate Health


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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, 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 or drop me a note at Bill at this week in health 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 a returning guest, Joel Vanko. I caught up with Joel last year at the, uh, chime, well, actually this year chime spring Forum at the, uh, HIMMS conference. And I got a chance to sit down with him again at the, uh, chime fall forum. And we have a, a really fun conversation. Uh, we actually ended up talking for about a half hour.

You're only gonna hear about 15 minutes of it. But, uh, really appreciate his perspective. Joel is the CIO for Baystate Health. Hope you enjoy. So Joel Vanko, uh, Baystate Health in Massachusetts as you have educated me on the last time you were on the show. , good to see you again, bill. It's good to, yeah. I appreciate you sitting down with me.

This is great. Sure. And, uh, you know what I'm excited about is we, we now have, uh, 10 CIOs on the record, including you, uh, answering the same eight questions so people will get an idea of, um, how different size health systems and different markets are thinking about that. The challenges. I, I mean there's a, a core set of challenges that are same across healthcare.

Yeah. And then there's, uh, geographic challenges. Some, uh, we just had somebody on all rural hospitals and I said, you know, what's, what's the most challenging thing? It was like, our network. And you think about that, you're like, oh, yeah, that would make sense to me. I mean, you're in this town and this town, you're not in Dallas and Houston, you're in, who's calling me?

Oh, as, uh, um, you have more important things to do. My interview. Uh, no, this is . Most important thing I have going on. So I really appreciate you being here. So, um, uh, the first question is not necessarily how's the role of the CIO changed in the last five years, but how has it changed over the last year?

How, how have you felt sort of a, a change in the expectations of the role of CIO in 2019? Well, you know, I think it's, it's continuously be becoming more of a strategic, uh, role. You know, there were, there was a point . In the last five to seven years where folks were even questioning whether the CIO role was gonna exist, right?

Is it gonna be the CDO, is it gonna be the Chief Transformation officer? Now those roles absolutely exist, but, um, I think the CIO role is really transforming and to be, uh, become a, uh, a senior leadership role focused on strategy, really focused on the business with. Uh, expertise in technology. And, you know, that's, that's really where I've, I've seen my role evolve over time as I've even elevated to the president's cabinet, which is what we call our, uh, you know, sort of senior leadership, um, uh, team, uh, under the CEO.

And, uh, a lot of the discussions there about, you know, what's, what's the strategy for Baystate Health look like? Uh, how do we support that? And, and by the way, what's the technology, uh, that has to. To support that, that business objective or those strategies. So that's what they're looking, they're looking for you to say, um, to look at the strategy and then look at the technology landscape and things that are going on in your market and understand that and sort of apply technology to those.

Absolutely. Yeah. So, so they, there's an expectation, at least in my team, and I appreciate that expectation that, um, that I should know the business Now, you know, I, I don't have any clinical background. I did go to medical school for a couple years before I dropped out and um, but that's a different story,

Can do a different interview for that one. But, um, and my parents did forgive me after I, I dropped out now that they know what I actually do . Um, but, uh, but you know, I, I think as ACIO in today's, um, environment, if you don't understand the business, you don't understand the folks that utilize the technology, um, you know, you're gonna be in a, a really deep, dark hole and you're gonna be isolated and they're just gonna treat you.

Uh, like what I think they treated, uh, CIOs and technologists in the past, which is sort of the basement. It, you know, lights on, keeping the lights on kind of team's. Make sure my iPhone works, make sure my laptop works. I mean, there's still some of that, right? Well, that's, but you gotta get yourself out of that.

That's the core, core of the job. Yeah. Um, I, I'm glad you're talking about business and business strategies. So what are some of the business strategies, maybe three, uh, have here three priorities for your health system next year? That health, it is ex expected or is going to support, you know, the, the, the elevation of the consumer, um, into, into, really every strategic plan is a big, a big

Thing. So there's a focus on the consumer, uh, or our community really. I mean, it's always been about the patient, but now there's this notion about how do you really engage with them, um, using various vehicles and channels, including digital. So consumer is a big deal and that, and really just rebuilding our health system, uh, with the consumer in mind rather than with the provider in mind.

That's sort of the first, um, big strategy that we have for the next three years, really. Uh, population healthcare. Continues to be, um, you know, a big deal for us. Uh, value-based care and population health are kind of bundled for us. Um, and, and you know, we've been in that game as I spoke to you about last time for quite some time.

And we continue to increase our, our risk, um, pool. Uh, we're close to 50% of our population now, um, and we're gonna continue to grow that. Um, and I think the third is really our, our workforce. Um, you know, our CEO's really, uh, focused on, on making sure that our workforce is . Is not only engaged, uh, but they understand with clarity where we're going.

Um, and they feel, uh, like they're part of the mission and, and, uh, and we're giving them the tools that they need and the training they need to really, uh, effectuate, uh, transformation in the health system. So let's drill down on this a little bit. Um. So if, if I were a patient in your community, what's, um, you know, what's one thing that you're doing that's gonna materially impact how I experience care within your community?

Well, you know, access for us is a big issue. Um, one that we've been attempting to tackle for quite some time. And, uh, and really now it's, it's really, uh, the, the core . Probably the, the, the first core pillar of, uh, or the first core step of, of our consumerism journey is really figure out how to, how to address this access issue.

Um, and so for the consumer, uh, we're really trying to figure out how to put them, you know, give them the right care, put them in the right environment, give them the, the right access to our health system. Um, and again, that . That comes in a, a variety of different channels and different means. Uh, but we have to know our patients first to be able to say, Hey, bill, uh, you know, we know you're fairly healthy and we know you're, you're just sort of posts surge and, and probably afraid of, of that, um, that that big wound that you have on your chest.

But you know, you really don't have to go. See your cardiologists, you could go, uh, you know, to x, y, z um, channel to, to engage with us. So we're trying to figure out out how so's a lot more than telehealth. There's, there's some tele telehealth there, there's some, um, are you looking at chatbots and those kind of things or?

We, we have started to look at chat. Bots. We, we haven't really done much in terms of piloting yet, but we're, we're considering, you know, how that can, um, help our contact center triage some of those calls appropriately. Um, we've been using some apps also that we, uh, discharge patients with, um, that help them with their care plans, managing their pain, um, you know, giving them the access to care managers and even, um, you know, uh, physician extenders as they need them, uh, post.

So there are, uh, we're starting to use a lot of these different, um, tools, um, to really sort of manage care, post surge outside of the house, uh, hospital, et cetera. So, so how about one initiative that's going go, same kind of question materially impact the clinician experience? It's really, well, you know, we're, we're.

Optimizing, uh, continuously optimizing our EHR. And, um, and so I'd say that that's probably our, our biggest and perpetual, um, you know, piece of work is to continue to optimize the EHR. And, um, and some of that is, uh, in the native EHR. And, and, and then other initiatives that we've taken on are actually, um, sitting on top of the EHR, like an app, uh, that we, uh, actually helped

Develop in TechSpring, uh, it's, uh, it's called Praxify, and actually it's now owned by Athena Health, but, um, where a Cerner shop and, and Athena has this app that actually sits on top of Cerner. Yeah. That enables, um, you know, hospitalists, for example, to round on patients, uh, very seamlessly using their, their iPhone.

And they can, uh, see the documentation, they can actually document, um, we're about to execute on, um, on a function where they can actually do, uh, orders through that app. But. You know, things of that nature where we're giving folks the ability to choose. Um, and I think that's an important part of, of our optimization work is we're hoping to get to the place where we're giving clinicians choice on how they interact with our EHR.

So that's one of your wins from your, uh, your, uh, innovation. Yes. Absolutely. Uh, you know what, when, when you have clinicians saying to you, uh, you know, bill had, uh, this app, how come I didn't get it? That's, that's a win, especially when it's a technology, um, that you, you, you deploy. Uh, adoption is a big issue with technologies, you know, and if, if clinicians are asking for it, that's a good thing.

When it goes viral, it's a good thing. What's the name of your innovation arm again? It's called TechSpring. TechSpring. Thank you. 'cause you mentioned it there again, and we talked about it. I think you're assuming that the audience is gonna know this, but we have a lot more listeners now than we had back when Oh, okay.

Yeah. When, when we talked to him. So, um, yeah, tech Springs, our innovation, um, it's basically our, our, uh, innovation center, uh, at Baystate Health. But, um, I'd say it's a very unique model in that, uh, really the focus of it is to identify what we call passionate problems in the healthcare system and match them up with, uh, folks who can actually deliver transformative solutions to those problems.

And a lot of them . You know, either come by way of, you know, a vendor partner that we have, um, somebody that's outside of the industry who thinks they have a great, um, you know, idea startups, et cetera. So they, they come and meet us at TechSpring and, and they connect with these, these business leaders across the enterprise to solve some of the biggest problems.

So what's, um, as you look at 2019, what's one of the things that you're most proud of your health IT team for having accomplished? You know, I. I think that our, our focus on, um, continuously, uh, improving our clinician experience is something that is, again, it's a journey, but, uh, this, this past year has been, I think, a profound, um, move forward.

Uh, not just with the technology itself, but getting clinicians more involved and deeply involved in the technology so that they can make change. Um, it's not enough . To, to just complain about the, the, uh, you know, unusable, um, components of the EHR. But to be a part of that is, is a, is a big deal. And I think my team has done a great job, uh, really involving them, but also being out there, you know, they round, uh, weekly, um, on every unit.

Um, we have . Business relationship, uh, partners or business relationship managers, as most call them, um, for every, uh, division in the, in the health system. And that's created a, a really deep connection, um, with our, uh, yeah. That's a, that's a neat model. Uh, yeah. There's part of me that wants to go deep into that and ask your questions around, you know, how you finance that and what other roles those people are doing.

And, you know, I think, I think that's a great, um, conversation to have. 'cause we, we, we we're challenged by that. Um, uh, that very question, how do you finance that? But, you know, I can share with you guys, um, how we, we sort of did it and, and it was really sort of a, a very innovative approach. Well, we will, we will definitely do a full, full episode with you, not the, uh, not the abbreviated, this is the second abbreviated one we've done.

We've, we've got a, we've got a schedule, the other one, . Um, you know, I've been phrasing this question as, you know, what's your biggest missed opportunity for 2019? And, uh, I've gotten some feedback now that it's not the best way of asking that question. Oh. So not PC enough. Yeah. Well, no, I think how I want to ask the question to get to an answer is, uh, you know, we're also, we're, we're busy.

CIO job is a busy job. A lot of priorities, a lot of things people want you to, to tackle. What's one thing you wish you had, uh, had given more time to in 2019 that you just couldn't get around to because of all the competing priorities? Oh, that's a, oh boy, that's a, that's a great question, a loaded one, but it's a great question.

You know, I, I think that, um, I'd say probably the, the, the, the one area that, um, that I think really needs a lot of focus, uh, at least our, um, organization, uh, is our, uh, consumer platform. So back to the consumerism piece, um, you know, we're really, uh, just, I'd say, uh, op. Our patient portal. Um, and so we really focused on, on, on really creating a, an experience of what I'll call a traditional portal, um, to, you know, to the level that I think it needs to be at this point.

But we really didn't create a, a broader strategy or, you know, we didn't really execute on a broader strategy of, of really beginning to engage patients, um, the way that I would've liked to. But it also starts with, um, what I'd say is, uh. Um, as a larger coalition of, uh, you know, partners across the, the enterprise.

And so I guess maybe that's the, that's the big sort of regret for the year is, is that because of all the things that we were doing, bringing on a new health, um, or new hospital, uh, you know, going live with work. Day, all this stuff that you, you know, that we do. Um, so you were just sitting around on your hands all year, all all year.

I was just sitting like this, you know, gosh. Um, but, you know, not being, not bringing folks to the table and say, Hey, let's, let's talk about the consumer strategy and therefore let's talk about the digital strategy. So we're gonna do that this year. Um, we're really gonna focus on bringing folks, um, from a, a, a variety of disciplines, uh, to talk about that strategy.

Workday. New hospital. Yeah. Workday, new hospital. TeleTracking, I mean, you name it, it's, you know, uh, it's the everyday CIO. Right. What, what, what's an area you'd like to see more innovation that within healthcare, that you'd like to see the industry really move the needle? Um, you know, at some level it's not.

And innovation. It's really, it's sort of back to the sort of blocking and tackling, um, or actually plumbing. I'd really like the, the, the, the industry to really focus on, on data, um, you know, data management, um, making sure that the data is, is, is liquid. And liberated. You know, it's, it's, I think we're getting there with, uh, you know, with things like fire and, and all the API work that folks are doing.

Um, but there's also that, that, that one sort of area that's still kind of not sexy, which is, you know, you gotta manage your data so that it can be usable. When we talk about ai, we talk about, you know, um, ml, all these great buzzwords. You can't do any of that stuff if your data is not, is not good, right?

So, uh. Maybe it's not innovation, but maybe there's an innovation that can help us really manage that, that data better, um, and get us to a place where, you know, we can really leverage that information. Because at the end of the day, when we look at all the things that are on the horizon that we want to achieve in healthcare, which is they transform it so we know who you are and give you the proper.

For care. It comes down to, it boils down to, do we have information about you enough so that we can do what Amazon is gonna be doing? Which is, you know, not only are they gonna start to, you know, sell you stuff, but they're gonna say, you know what? 'cause you bought that stuff and because you're . Um, you know, in this region, and because you're X, y, z, uh, this is what you need in your healthcare today.

And we're not quite there yet. I was, I was talking to a healthcare CEO and, um, they were saying, you know, and actually we were talking about an article and they, they were saying how, you know, what you need, um, dictates an awful lot of your health, right? And there was this study, and if I remember the study it was in, it was in, uh, London, and they could by zip code.

Based on grocery data, uh, almost predict the po the health of the population in that community. When you think about Amazon and their push now, same day delivery, uh, Amazon Fresh, uh, free for prime members. This is not an advertisement for Amazon, right? Um, but. It's, it's a great example of that. Yeah. But it's interesting to see now that, okay.

And, uh, Cerner is an AWS platform. So you have your Cerner da, you have your patient data in there. Yes. You could potentially have a significant amount of grocery data in there. You could. I mean, there's some interesting, uh, interesting things that start to evolve in terms of. Really getting a, a clear picture of the whole patient.

Absolutely. We're, we're eeking into a, a full episode here. So let me, let me finish . Um, so, uh, we did a, a survey of our, uh, listeners and one of the things they want me to start asking CIOs is, uh, what roles do you intend to hire in 2020? Do you think there's gonna be growth and need? So . You know, one of the areas that I'm really focusing on right now is, um, in this, uh, area of design, uh, you know, design thinking, uh, human-centered design.

Um, you know, it's, it's really an area that I think technology INT it really needs because it's no longer just about. You know, plugging things in or deploying things, right. Um, there is, you know, there are considerations of workflow, um, and considerations of of use. Um, I don't wanna use the word delight, but you know, folks use delight oftentimes in terms of, you know, uh, how does this, uh, really impact.

A provider or a user, um, you know, folks who understand how to create journey maps of both the patient and, and, and users of our technology. But ultimately it's, it's designing, uh, either a workflow or even an app, uh, that requires a different type of, uh, sentiment and different kind of skillset that, um, that I think it organizations just don't have.

And there are some organizations out there that . That have some really great, uh, examples of, uh, design studios, design teams, and I think that's, uh, you know, one of the areas that, um, you know, I think it would help us, you know, not with just with the consumerism strategy, but also with the, the, the workforce piece and making sure that we're, uh, doing right by our.

Partners. It's interesting. So the big winner in these, by the way, this, these questions has been, uh, the arts because now it's, I mean, people have said data science and those kind of things. 'cause we have a lot of data. We need to do stuff with it. That was gonna be my second one actually. But, but an awful lot about creativity.

It's like, okay, how, how are people using this technology? How can we make it more usable for these people? How can we, uh, for our users and, and, uh. You know, it's really the coming together of your, your left brain and your right brain. Yeah. Well, I think that's gonna be really, I think those are gonna be the careers of the future.

When you think about where, um, you know, technology is going. Ai, I mean, you know, the stuff that we're coding right now, which is mostly now drag and drop and, you know, fairly, um, rudimentary, not rudimentary, but you know, they're, they're very nice, um, uh, coding segments. Not like when we were, you know, starting to code, but, um,

You know, that's gonna become a commodity kind of an activity. And really the, the winners of, uh, I think industries are gonna be folks who can create stuff out of nothing. You know, it's design, it's, it's the, you know, let's build this and, and make it look. Like this and then sort of just, you know, give it to the machines to, to really sort of build I, you know, and I tell that to my kids all the time when, I mean, they love, they love math, they love, um, technology.

And, and I say, you know, what's even better is the, the stuff that you guys do, um, you know, in writing and, um, and drawing and, and you know, the, um, the creative side is, is really what is gonna . I think gonna be the, uh, the profession of the future in many ways. Liberal arts, if you will. Yeah, it's interesting, Joel.

Always a pleasure. My pleasure. And we will have to schedule a full episode, , uh, after, let, let's do that after hims probably. Great. So we'll see. I look forward to that. Thank you, sir. Okay. 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 friend,

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Bill it this week in health 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, 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.

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