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The Healthcare CIO Look Back / Look Forward series with Nassar Nizami CIO for Jefferson 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, health.com/sponsor for more information. 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 asked 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 differences 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. 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 quickly becoming one of my favorite CIOs, Nasser Nazami. Uh, he has been on the show, uh, let's see, this will be the third time he's on the show and I had him on with a special episode with him and his CEO Dr. Klasko, and uh, that was a fantastic conversation. I, I got a chance to sit down with him again and talk through the eight questions that we're asking all the CIOs.

And I love his, uh, I, I love his pragmatic approach to it, and, uh, I think you'll like it as well. I. Hope you enjoy. Alright, so another, uh, session from the, uh, chime fall forum. And, uh, what we're doing is we're sitting down with CIOs like Naer Ami, former guest of the show. I appreciate you coming on. Thanks.

Sure. Always a pleasure. We're, we're gonna, what we're gonna do is take a look back and take a look forward and, uh, I'm gonna air these in December, so it's gonna be sort of a retrospective in 2019 and, and looking forward. Okay. Um, the first question we've been asking people is, you know, how has the role of the CI changed just this year?

Question. I think I see two trends. Uh, one is, uh, we are in organizations where CIO role is to certain degree diminished. And uh, and you see roles like chief digital officer, um, chief Information security officer, chief Analytics officer that are peers for CIO. And second trend, which is very interesting, is, uh, the role of CIO has.

Been elevated in organizations, uh, where they're seen now or they become business leader. And mainly I at attribute it to the digital transformation and the leaders who are able to really, uh, you know, demonstrate that they can transform, transform organization from a digital point of view or really at the table now.

Yeah, absolutely. Yeah. We're, we're seeing that across the board and a lot of the sessions are addressing that. Um, you know, one of the things you talked about, . Strategic. Mm-Hmm. , the CIO's still at the center of strategy. The data, it still falls under the CIO. Um, and even though some innovation does, there's an awful lot of innovation that happens everywhere Sure.

In the health system. Mm-Hmm. , uh, what are, what are like three priorities that Jefferson Health is looking to do next year? That health it is being asked to support? Great question. So. Jefferson is growing by way of acquisitions, you know, in organic growth. Um, and uh, one of our top priorities, uh, is to integrate the organizations that, uh, are part of Jefferson now, Jefferson family now.

That's one. And, uh, second initiative that I would say is associated with integration is the implementation of our core clinical systems. Alright, which is set of EMRs and systems that we are deploying. And the third initiative where I think Jefferson differentiates is . Self, a number of other organizations in the area of innovation.

Yeah. Um, that, uh, is going to be a top priority. This has been a priority for us and it's just, uh, more of a priority going into 2020 for us. Yeah. I really appreciate you and Dr. Klasko giving me the tour of the vault. Mm-Hmm. , uh, was really interesting, but also just the discussion around the number of health systems you have to bring together is significant.

So do you envision a common clinical platform across all those hospitals? Slowly. Yes. Yeah. I, I can see that. And then you have Tom, your, your new CTO Yep. Working on, uh, a cloud strategy to enhance the infrastructure. 'cause when you bring that many organizations together, you, uh, it, it changes things overnight, actually.

You think about it this way, right? I mean, so even though strategy is to put one standard EMR, but, uh, we are contin, we, we are continuing to acquire organizations. So we will never be in a situation where we'll all be on one platform. Right. We just understand that. Right. So there is a degree of . Uh, expertise that we need to develop and we have developed, uh, to, uh, work in a multi-vendor environment.

Right? But the goal that we set two or three years ago was very standard organization set up, standard set of back office applications, e hr, clinical applications, and we are executing on it. But again, look, I mean, things change. We acquire more organizations and every time we acquire a send these set of systems, yeah, I, I think since the last time I've, I.

Interviewed you guys this, this past summer that you've acquired more? Yep. Yes. Yes. It's uh, it's amazing. Uh, so the, the next two questions really are around focusing the question, maybe, uh, getting a little more narrow. And so what's one initiative that you're doing at Jefferson Health that you think is gonna significantly impact the patient experience?

So, uh, so I'll answer both your questions. Is that all right? Sure. And then the clinical experience? Sure. Yeah. Clinical experience question, because I think they're related. So I think for us at Jefferson, we have been operating, um, with multiple set of patient portals, communication equipments, uh, apps, patient facing apps, uh, EMRs, both inpatient and outpatient.

We start with nine set of EMRs, just EMRs and forget about revenue cycle, et cetera. Right. And I just believe that by having, and we are already seeing this, by having a standard patient portal where physicians can respond to patient . Or we can send them labs in a timely fashion, so allow them to book an appointment and so forth.

It is already translating into a much better patient experience. We are seeing a much better adoption. We, we had portals for the last several years, right? But with the new standard, uh, portal and along with it, uh, set off. Apps way finding, et cetera. Right? Uh, the standardization I think is paying dividends both for clinicians and um, our patients.

And for clinicians it's a win-win situation. 'cause as a system, we were never able to, uh, se exchange data in a seamless way. We always exchange data, you know, CCDs here, some interfaces there, but it was very, you know, patchy at best. Right? One patient record, one patient, one patient record. That's our model, right?

That's how we are. Breath system, uh, the . Patient experience have increased quite a bit, right? I mean, look, EMRs are not perfect. There's no single EMR that is perfect, right? We have all the challenges of our, uh, typically EMR, but just going from multiple systems to one standard build. So it's critical to, to, to, I think, differentiate that we have one, build, one product, right?

I think, uh, is, is is the key for both patient experience for us and clinical experience. That's fantastic. We'll get right back to the interview in just a minute. I believe the healthcare CIO role is one of the hardest but most rewarding jobs out there, but I'm aware that many CIOs live in a state of feeling overwhelmed.

It's just not good for anyone to live in that state for too long, and the mission is too important to continue to have this high of a turnover in the CIO role. I've been in your shoes the month I took over as interim CIO for a 16 hospital health system. The data center had just had eight outages in six weeks.

We experienced a data breach and I was informed that everyone in it had their resume on the street. How's that for month number one, ? That year we launched a major cloud initiative. Set clear it. Career Paths, launched it university and started a two year project to consolidate nine dispar EMRs. In addition, we participated in the launch of two successful health IT startups.

The internal satisfaction with it jumped over 15% and IT staff satisfaction itself jumped over 20%. I had a coach every step of the way and it was invaluable to me. A coach is someone who helps you to organize your thinking. Keeps an eye on the industry for you, encourages you at times, and challenges you at other times.

But above all, a coach is someone who's committed to your success, someone who's in your corner. I coach new leaders and, and longtime leaders alike to be more effective because your role is too important. I would like for you to schedule a free discussion with me to see if coaching makes sense for your situation.

It's, it's really easy. Just go over to health layers.com and click on this schedule a free consultation button. I wish I could coach every healthcare leader in the country, but I only have two openings for coaching clients left for 2020. So if you think this might be something that would help you to thrive in the new year, head over to health lyrics.com today and schedule some time for a discussion.

I. So, you know, as, as you look at 2019, what's, what's the one thing you're probably most proud of your team in, in having accomplished? Okay. It's, I mean, there are many examples that I can give, but I can tell you, you know, from a, from a budget and from just impact point of view, uh, we implemented EMR. Okay.

Uh, it is a, uh, very expensive undertaking for us. A lot of, uh, hours. Good. Uh, and what we are very proud of is that it was on time, it was under budget, okay? And we hit, uh, top quartile metrics in number of areas. It was, you know, uh, uh, we were very proud of the, the execution that went, um, and, uh, the goals that we have set.

We surpassed all the goals, uh, our internal metrics and so forth. And frankly, in a very short period, we were able to study the environment and our, uh, colleagues in clinical areas are actually . Is seeing the results, they're able to, you know, our, uh, compliance with, uh, bedside medication, you know, and uh, things, things of that sort have really shot up.

So that team that did that just moved to the next hospital and now they're gonna move to the next, is that how it's working or? Yeah, so, so look, I mean, like many other organizations a journey for us, right? Yeah. So, uh, you do once, you do twice, and now we are come, we are now in a mode where, yeah, we know that we are gonna be doing these implementations for quite some time to come, right?

And we have an organization to run. Yes. And we have implementations to do so, uh, we, I think we are improving and we are getting better and just doing that. We'll continue to bring hospitals on, uh, by the same time have these . And that's critical because we, our first implementation was all of our implementation.

There was no optimization. There was no studies. And so we're all focused on implementation. This was, I think, a mixed bag, a little bit. We did implementation. Optimization. I think our next one is going to be more steady state optimization, and our focus implementation actually is getting less and less just because we have learned a lot.

We have leaders who understand and uh, it's just, you know, you keep doing it, you learn from it. Yeah. And, and you guys, yeah. Very successful implementations. And now you just get to replicate that, which is on, I mean, that's fantastic. The thing I'm looking forward to is the point at which Philadelphia was a very fragmented market.

Yeah. It would be great to have a single patient record across all of Philadelphia. I mean, before there's how many academic medical centers, how many different hospitals? So it's probably one of the markets that I look at and say, consolidation's welcome, I think, in that market to the patients. I think. So, um, let's, let's talk about, um, now I have this phrased, people have told me they don't like the way this one's phrased, so I'm gonna ask it a little different, which is, um, what's one thing you wish you had more time to spend on in 2019?

Yeah. That you just didn't get? Around 'cause there's so many other priorities. So I'll tell you, you know, so we, we talk, and I do, I generally believe that AI, machine learning and robot, RPA, these are, these are, this is our future and this is where we continue differentiate ourselves. I, we knew going into 19, right?

Uh, like if you back up to December of last year, right? Uh, that. We should be looking into RPA because there's some real savings side to it. Right? Right. And with all that's going on, we just, were not able to give it the right time and attention. We just, just, it was became a pure bandwidth issue. Right.

Yeah. And in hindsight, I wish, uh, we would have . Uh, done more work to at least get it started. We've started, but we are not, um, at a point where I wish we were. Yeah. And we talked about Daniel's session Yeah. Yesterday. And, uh, Daniel's been on talking about New York Presbyterian's RPA journey, and, and it's, it's really interesting.

I mean, they're really sort of out there setting the bar. Absolutely. I mean, absolutely. Like I was at Presbyterian once a great organization and Dan was doing great things there. Um. Certainly another thing or two we can learn from them. Absolutely. So pick up your phone call and you can Yep. You can compare notes, which is which.

Great. Absolutely. Um, what, what's one area that you wish the industry, you, you would like to see the industry innovate more? Mm-Hmm. . So, look, uh, we, uh, Jefferson is known, has made it a name for itself. Uh, I mean, mostly because of our, uh, CEO Dr. Klasko, who has such a great emphasis on innovation. Uh, I, I talk.

To vendors all the time who basically talk about patient engagement, patient experience, et cetera. I'm not really seeing any, um, real innovation in this space. I mean there are nice and nice tools, right? Yeah. But basically, in my opinion, there are redo of same portal. We are gonna do an app and its same concepts for the last two or three years that people are sort of, you know, incrementally improving, which is really good.

So incre, I'm all for incrementally improvement. I mean, there is a lot of value . In, but I have not seen innovation right. In patient engagement. And as a matter of fact, the rest of these now that show things like MyChart have not really contributed to patient engagement or improvement to the degree that everyone thought it would.

There are certainly, you know, people who use tools like MyChart or Patient Portal, I should say, and apps, uh, are, are, are doing better as patients, but . We really have not seen the innovation, the true innovation in, in the area of patient experience such. No, that's, that's fantastic. So the last question, we did a poll of our, uh, user community.

Yeah. And, uh, one of the things they wanted me to ask CIOs more was, uh, what, 'cause I think there's some college students out there wondering, you know, where are you gonna be hiring? And the, the question is just, uh, what health IT roles do you anticipate hiring in 2020? So for us. Uh, Jefferson, uh, we are hiring across the boat, first of all, I would say.

But the two areas where I think we are, uh, I think that there is growth and if you have students listening to your podcast, I would say cybersecurity. Yeah, right. Uh, continues to be, uh, hot area. And I think, uh, will continue to be an area where high demand for probably a few years to come and second for us at least, is, uh, within the space of EMR.

So folks who, with some clinical background that understand clinical workforce and so. Forth and can translate that into it. Those are the two areas I would say. Uh, we are gonna be hiring in 2020. Cybersecurity. Yeah. Yep. I, I definitely can see that. , thanks for taking the time. I appreciate it. Always a pleasure.

Thank you. Thank you very much. Take care. I hope you enjoyed 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. Number two. Sign up for Insights and Staff meeting. These are services designed to help you in your career.

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.

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