David Baker on The Wisdom of Epic and Google Gets Another Healthcare Star

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 Welcome to this week in Health It where we discuss news, information and emerging thought with leaders from across the healthcare industry. This is episode, I don't even know what episode this is 47, I believe. 47. Can you believe it? Big 50. Do you remember what episode you were on? I was on, was I like number four, five?

It, it was a single digit number. It was, it was pretty early. So you were on for the, uh, The HIMSS week. Yeah, it was a big week. Fun week actually. That was crazy. Well, I'll introduce you in a minute, but this week we're gonna talk about, uh, epic's move into, into dental, which is interesting. Uh, David Feinberg from Geisinger goes to Google, which, uh, is big news.

C m Ss is now reimbursing remote patient monitoring. Wouldn't that have been nice when we were at St. Joe's, if they had done that and we were trying to do so many things there and it was just hard to get the funding. Well now . Now the reimbursement's coming from Medicare. So, um, I think that's gonna spur a lot of things happening outta the home.

So it'll be interesting to talk about that. Uh, uh, this podcast is brought to you by health lyrics if you're moving to the cloud. Uh, check out health lyrics.com and, uh, take advantage of our, let's see, about eight years of experience of moving healthcare to the cloud. So my name's Bill Russell, recovering healthcare, C I o, uh, consultant and writer.

And, uh, uh, Who else am I? Who are you? I don't know who I am. Big time. You know, I, I laugh now 'cause everyone always introduces like, I went to the chime event on Tuesday. Didn't see you there. Sorry. Um, it the chime event and as I go around, people go, oh, this is Bill Russell. You remember him? This is who he, this is the former.

The, the, the recovery. The recovery. The former, that's like people always . They always talk about who I used to be. What are you now? Are you a journalist now? Uh, . Thanks for doing that. Uh, no, you're gonna find I still have some thoughts on being a C I O, so I, I'll, I'll share some of those today. Uh, today obviously returning guest David Baker.

Uh, now a C I O, but I knew you when you were just, actually, I knew you when you were a consultant, right? Yes. So you went consultant, director, vp, and then when you left St. Joe's, you became a c i o, c i o s v P and c i o. That's like living the dream. It's, I mean, what do you attribute that to? Uh, great solid mentors, , who scrutinized every, uh, every molecule of my work.

I was, uh, I was a little, I was a little tough on you, but I'll tell you, I, we actually, I've, I've told this story a couple times. The thing that impressed me, you're a consultant. I get named c i o, you're a consultant and you're like trying to get on my calendar. I mean, you're like, . Feisty to get on my calendar.

You come into my office and you're like, what's the biggest problem you have? I, I, I, I guess the fact that the , I think the actual problem was the clinicians hated it. Right. And, you know, at a, at a certain point, That's unsustainable. Yeah. You can't do that. I'm like, well, the clinicians hate it. You're like, I can solve that problem.

Cool. And you started on that path and it started with EZPass, then it went to um, 20 back or 60 back. Yeah. 60 back. 60 back. I mean, you just did all sorts of things around the experience around the internal users experience with it and took us from a very low ranking to a very high ranking with makes it personal.

Yeah. And, and when people ask me, you know, why, how did David get from here to there? , I say, anybody who walks into your office and says, give me your hardest problem, I'll figure out a way to solve it. That person's gonna get your attention, especially if they start solving the problem . Uh, and so I, I always, you know, I use that story to tell people, take a risk, figure out what the hardest problem is and see if you can see if you can solve it.

No, I appreciate that. I, it is funny 'cause I'm having some. Really cool conversations right now around a, a syllabus for some, uh, women in tech, uh, work. I'm just trying to help contribute to, obviously I'm not a woman in tech yet. Um, and, uh, I just wanna see how, how can, I, I think what I can probably help folks with just through my own experience as you know, is, is some of that, um, the personal branding in your career.

And then, and then when, when's the correct time to, to, you know, step up, put your head above the parapet and, and, and, and go and find those hard problems that folks are scared to address. Do, do you appreciate those people? I mean, so it's now role reversal, right? So I was the c I O and you were in that, the chair driving me nuts with Bill, you gotta get me more money.

We could do more things, look at what we could do. Um, does that happen to you now? Are you getting that kind of thing? Like your, your staff is as eager as you are all the time. It's actually, you know, it's annoying. When I find myself sympathizing with you back in the day, , because I'm like, damnit, I did used to, yeah.

I guess give you some grief, but no, I, I like it. It's about channeling that energy, right? You want that? I'd rather have someone in the office passionately fighting for, uh, you know, something they believe in for the, for the great good of the company, right? Um, and, and talking through that and what it looks like to someone who's just, you know, sat back, just, just going through the motions every day.

Yep. You want, uh, you want a group of people that are waking up every morning thinking about how do you make, you know, in our case it was healthcare. In your case, it's healthcare, right? We've talked about this before. I mean, tech, oral technology, but it's, I mean, I find myself, I, I like to look at myself as retail healthcare, to be honest with you, but I mean technology in general, but whatever industry you apply it to, how do you make

Um, how do you make lives of, of, of folks better within the business in terms of giving them back, I always say minutes in their day. That's always been my big thing and it still is. And that's, that's applicable across mobile verticals? Yeah. We, I, I, we used to always talk about, you know, the four areas where you need to.

Really think about e experience and the people's experience. One is the clinician, the second is the consumer patient, and we sort of loop those together. Um, because every patient is really a consumer at some point. Then there's consumers that aren't even your patients yet, but you're, you need to think about them.

Then there's the system slash payer side. I mean, there's a whole bunch of people that are your, your clients in that space. And then the other space, obviously it's just the population at large. How do you get people to think . About, I mean, from a healthcare perspective, we were like, Okay. 80% of the PE we're not gonna see 80% of the people in the markets that we serve this year.

They're healthy, they're whatever. How do we keep 'em in that sphere of health? And, you know, and, and we were always thinking about those, those experiences. There were, but I mean, um, in fairness to you, and I think something that I, you know, I try and model and would and, and would try and pass on as well.

Is, is making sure, um, and you did this and, and, and I made sure I, I did this, but you have a seat at the business table and it sounds cliche now 'cause you know, a lot of people repeat that. But what does it mean? It means you're not an order taker, you're not there just, um, sending out technology upon request and then supporting something you're given.

It means what are the business objectives, right? For the next, I mean great for those five years, 10 years, right? Fortunate there. But what are the business objectives in next year? Whatcha trying to do? Right. And, and how can it help you on, on that journey in, in liberating, uh, some of those wishes and, and, and meeting some of those milestones?

It's really important that you, you, that you are discussing first and foremost at the business level and then translating at the technology level. Well, thanks, uh, thanks a lot for, for being on the, on the show. I clearly, I'm not dressed for the show. They won't pick this up on the podcast, but you were actually the most watched full episode of the podcast so far.

Really? Yeah. How I was, was the, the volume was a little bit, uh, uh, scared. Maybe people just, uh, the, the volume on you. I think they, I it's . I, I don't wanna go down the normal jokes that I would tell about you and, and whatnot, but, but essentially, um, you know, I guess your, uh, your parents, your, uh, all the people in Europe who saw you, you know, they all, you know, you have a huge Europe following, European following.

Really? Man, that's what it is, right? The massive island of London. , I have no idea. The United Kingdom. No. I really can't answer the question of why I can't. Anyway, I, I, but it, it's, uh, almost double Any other . Full episode of the podcast. I think it's, people think if this stupid dude can get a job, anyone can.

How did this ? Let's, let's figure, let's figure out how he got into the role. Exactly. How did this part in a roll up and get a job? You know what I, I, I do know how you got the role and I have talked to your, uh, the people you reported to since then. I saw, I've seen him at conferences and they thank me for, for, for hiring you.

And I'm like, and, and you know, we, we joke when we do a lot of self-effacing humor, but, uh, they, they really love the work that you're doing. So the work that you're doing, It made the news this week. Yes, it did. So this is a pretty big deal. So, so, um, so Pacific Dental is, you know, one of the top two or three dental practices or dental Come on.

Dental. D S O D S O. Dental Services. Organization. Organization. There you go. So you provide back office for all these dental practices across the country? We, we support, uh, dental owners. Yeah. In, in, in doing better dentistry. I like to say there's a whole support network, um, uh, behind the partnerships where, where we will help, uh, the office with absolutely everything.

Uh, you know, accounting, recruitment, finance, IT services, business coaching, essentially. And it's thousands, hundreds. Uh, we're at 700 offices now, 700 offices and yeah, with some really impressive plans for growth next year. It's no secret, but you know, uh, Barreling along towards the next a hundred. Well, anyone who's followed the, the growth of Pacific Dental knows that every year's an aggressive growth.

That's actually true. They made the fortune, uh, 500 or 5,000 now, uh, a record number of times that 14, 16, I saw a badge on the, on the magazine the other day. Yeah, it's, it's just super impressive. And the fun thing for me is working with a, a true privately held company. Um, with just this, uh, breakneck growth that's organic.

Yeah. So it's off. Awesome. So you make the news because the big epic announcement, you actually alluded to this when we talked way back in February. No . So it's been a long time coming. You've been thinking about this for a long time. Yeah. A really, a really long time. It's obviously not the sort of deal that you embark upon overnight.

And, uh, and, and there there were lots and lots of conversations around making sure that, uh, It was a good fill on both sides because they don't, they didn't have anything off the shelf. It's not like you could, you could demo the software. So, um, you can, as you know, there's just a handful of, of customers, essentially, I think less than 400 that, um, you know, epic work with.

Uh, so you have to be of, of a substantial size. And, uh, the, the module that sits within Epic is essentially called wisdom. That's the dental, uh, module and it is actually, it, it's live at multiple, um, uh, okay. So you're not developing this from scratch. This is No, not, not total scratch. I mean, we are, we're obviously, um, we're a vanguard partner, uh, with, we're their pick true partnership.

Um, and we are. Uh, building out the, the A D S O ready, uh, version of wisdom, let's say, like some improvements that will help a, a organization of our size be able to, um, operate hopefully with, with real efficiencies and, and a, and a great experience. Uh, but they are live, uh, in the country of Finland and National Health Service, I believe have both medical and dental.

And then there's a handful of other organizations using that foundational, uh, product currently. So where I, um, What's gonna be the biggest benefit? So paint us the picture of whatever it is a year from now, two years from now, when this is implemented in all 700 offices. Actually, if you want me to set the timeline, you know how I set timelines,

So I'll let you go ahead and set your own timeline. Always. But, but what is it? What is, yeah. I'd be like, well, you know, can we have it done in six months? And the answer is no. But, um, because it's organizational change, there's an awful lot of things that have to go into place. Yeah. More about the organizational change actually, uh, than the

Than the product, as you know, and with the consolidation when we did back in the day of, uh, Of Meditech going down from the nine instances to the three was, uh, looking back naively at the time when I was, you know, fresh into healthcare, oh, that looks relatively easy. It's the same piece of software. How difficult could it be?

And boy, it, it's painful. So I, I got good grounding, I think, in understanding the, the pain that you inflict upon the poorer . Clinicians, um, major workflow, uh, upheavals and uh, and, and huge reeducation, right? And it's, and it's a time suck, let's face it. So I think we've come a long way practice management wise in general.

Um, and I don't think there's a lot of options in, in dental outside of a, a handful of key, um, enterprise players. But still, the, the software's not. Uh, it's far from, uh, I would say, uh, an amazing integrated user experience. But you're not going from paper to electronic. You're already electronic. I, I like to think that we're, uh, we have a huge set of obviously, dental data.

I mean our, uh, our founding owner really, I joke that he's the original c i o 'cause that, that's how he started out. He, uh, he put a, uh, practice management system, uh, in his, in his father's, uh, . Dental office back in 19, I think it was 92 or four. So yeah, we've been on, we've been digital since, uh, you know, office one.

That's, that's, I think that's what we've done extremely well. And the existing practice management system has, has seen us through, you know, really well. Um, but it's, uh, you know, it's an operational tool that was built, uh, a long time ago with . Probably the purpose of just getting off of paper. There's not good workflow announcements, so it's probably, it's client server probably creates all, all sorts of a hundred percent, yeah.

Challenges and you know, and there's loads of questions obviously. Uh, Around, you know, there's multiple views as we know on their pick for sure. Uh, but the, I think it's a really, um, solid decision for us, um, because we're able to build something out that is, uh, really meets d ss o uh, of our size, our needs.

And at the same time, I mean forward, you know, . Forward thinking, like you say, in terms of, uh, the, the integration opportunities. So if I'm a C I O in a market, let's assume I'm a C I O in a market. , I don't wanna say. So, uh, would I, would I contact Pacific Dental and say, Hey, you're on Epic. We're on Epic, or even if I'm on something else, but we would, we start trading data in, in terms of through an h i e or even directly.

And so it's a great question, right? We're not at the moment, so this is kind of where our mindset is. We're a, we're a platform company. Okay, so folks, um, plug in, we help support through, through multiple channels and, and ultimately, you know, multiple technology channels. So, um, yeah, the, the option at some point for, I, I refer to it all the time as imagine the dental health information exchange, um, that also.

Plugs in and plays with the health information exchange, right? Imagine the correlation of, of data that can, that we can draw from, um, with regards to oral systemic health and, and those, those, those conditions that affect the whole body that are driven through the, the, the window of the body, which is the mouth.

Right. That's interesting 'cause um, so epic's also part of sharing data with Apple and their iPhone. Oh gosh, that's, yeah. Their, uh, uh, uh, health record Yeah. Application. Which name is just neither. I'm gonna pull my phone up in a minute, but, uh, But essentially so we could see in the not too distant future, essentially information from wisdom in there as well.

So I could as a, as a patient be looking at potentially messages from you, uh, from my dental, dental practice and information on, uh, prescriptions and those kind of things. Yeah. For us, um, I mean, it's truly exciting and I, you know, I don't think I've ever been more excited about liberating some of that, that data safely

Um, but in terms of you as the patient. Can now see if you want to, I mean, let's think about Epic right now, approaching 70% of, um, of the US population, knowingly or unknowingly are, um, operating within some component of Epic. Yeah. On their medical journey, right? That's pretty outstanding in terms of that volume.

So imagine now, you as that, uh, epic based patient can begin to bring the full continuum in right, of your healthcare information, the traditional P c P, um, and then you know, your acute visit information as well, and, and a multitude of, uh, of data around that. If you wanted to, like the imaging, the billing, possibly, I mean, more than, more than a lot of folks are utilizing, right?

Leveraging. Now you add in . That full dental journey as well. And you have the pharmaceutical, I mean, it's just you, you're never gonna have the, the, the, the bigger, uh, view of, of your health information. So last question, you're starting on the cloud or are you starting, are you gonna . Build it out internally and host it.

What? You, wouldn't you be disappointed with me if I said I was gonna build out and host it internally? I, there are, there are. Yes. I would the answer to that is yes, but the, the, there are, there are valid reasons and, and a lot of 'em are financial, it's. It's, um, the, some people have said that the cloud model is still a little pricey from, from Epic.

I, I know this, this will probably get back to Judy and I apologize. I don't even know the pricing model. I've just heard this from some clients. Um, pricing's relative, I guess, huh? Well, if you're just starting out, you know, you're not, you're not replacing, you're not moving. Some people already have it on site.

They already have the equipment. It's already in a data center. They don't have to build anything new out. . And they're, and then they look at the cloud pricing and they're like, well, why would I do that? I already have all this stuff. Yeah, well you would do it when that equipment becomes end of life and you have to do something.

Uh, yes. But plus, as you know, forearmed with a ton of information around what it costs to build out the um, Practice management, uh, infrastructure, architecture that sits on top of a huge V d I usually, you know, infrastructure. So forearm with that where it's really gonna cost to build out, to see us into the next five years of growth.

Um, these things start to normalize, I would say. Plus, I'm, I'm also, you won't see this on camera, but. I'm looking over your shoulder, seeing a map of all the locations you guys are in. Alright. And you almost have to be in the cloud if you're going to be Yeah. Servicing that kind of geography. Yeah. We're so distributed right there.

It's, that's important. Um, especially from a, you know, even a latency standpoint if you like, that we are, uh, that, that we're set up in a, in a good distributed way across the country. Well, let's hit, uh, let's get to the two other stories. So . Um, you know, we're seeing a, we're seeing a little bit of a brain drain here.

So, David Feinberg, who I consider one of the really, uh, good thinkers within healthcare, one of those people that was out there, he's one of the, he's the c e o, who said, we wanna eliminate the waiting room and all that it represents. And, you know, for a C E O to say that, that was a pretty big deal. Um, Because what it represents is that the physician's time is the most important thing, and we're gonna queue people up and make it inconvenient for them because we want to queue up physician's time.

So this is a C E O saying, Hey, you know what? We're gonna eliminate that waiting room. Not necessarily because we don't value the physician's time, but we're, we value our patients' time as well. He was bringing, uh, genomics into the, uh, primary care area. So, uh, really forward thinking. Toby Cosgrove, former c e o from, uh, From Cleveland Clinic is at Google as well.

So if David Feinberg's at Google now, Toby Cosgrove is at Google a tool. Aul Gawande we know, went to Amazon, Berkshire, j p m. It, it, it feels to me a little bit like this is signaling that they're looking at it going, Hey, you know what, there's only so much I can do within a health system, potentially is what

I don't know. I don't know what's going on in their heads. I would love to interview any, any of those three. Um, but potentially what they're looking at it going, I think I could have a bigger impact there. Either the, the, the reach is broader. I mean, if you look at a Google, you're talking about potentially world health, right?

You're talking about, which is huge, the global reach. You're also talking about reaching people, you know, when they're on the internet. And we all, it clearly we're in, we're in front of the internet a lot more times than we're in front of a physician or a, that telehealth thing. Is that real now, or? I, I, it's actually, it's very real.

and c m s is gonna, uh, start reimbursing it. So that's also very real. So, Um, so to a certain extent, I think these people, I think they're looking at it going, look, I think, and we also know this, that most visits start with not telehealth. It starts with a Google search. Hey, I've got a sore on my foot. I've got, you know, I mean, that's where most health starts.

So if you're, if you're Feinberg in Cosgrove and they come to you and say, look, let, let us give you a, a little picture into what we have access to. I think anyone who's creative and whatnot is gonna look at that and go, oh gosh, we could really impact global health as opposed to say, Cleveland Clinic, even though they're pretty broad, they're within a certain set of markets and Geisinger's only really

Pennsylvania and I think a little bit of Jersey, maybe some New York, but essentially that's the market they're in. And so they see this greater opportunity. Do you think we're gonna see a lot of the. The innovation. I mean, now that you have these people going over there, do you think we're gonna see these companies finally get really focused and really understand healthcare and how to apply these technologies?

So I think there's been an exodus of a lot of the leadership and just the, the, the traditional, especially acute model in general, right? I mean, it's been changing and morphing substantially o o over the years into, um, into those smaller specialties. To build around those acute centers, essentially. And then, you know, the, the, the joke around telehealth is, it is real, right?

I mean, it's, it's been there. We've been, I've used it. I'm sure you've used it and we've deployed systems that we know, you know, the numbers are there now. So I guess the question, I, I, I feel it that it could go one or two ways. 'cause this is a hard industry to change in terms of just big healthcare population, health management, right?

Big numbers. Um, It's very standard, its ways, even the thinking, which is why sometimes, you know, in all honesty, I stay away from some of the, some of the events, um, and, and particular tracks, right? Right. I mean, Dreamforce for example, right? You go to some of the really cool executive tracks and stuff. Um, I go hit the retail tracks a lot of the time, and if I'm really worried about, let's just say security at a certain point in time and want to go deeper into a certain area, I'll go hit the finance tracks.

Why? Because I'm going to areas retail. They're given an amazing, uh, customer journey. It's about the experience, right? Um, finance, well, there's no one that cares more about, uh, the security of, of the information than some of those finance houses, right? So I guess my concern is, does, does healthcare just talk about, um, thinking outside the box and doing things differently?

Have we really moved far enough in the last ? What, eight years I've been at it, I would probably say no. In all honesty, certain pockets have certain companies you've seen move the Mark A. Little bit, but it's only when, um, I think these, these big changes in leadership happen that you'll, you'll see some, some, some changes for the better.

With that said, Google, Amazon I, I mean, I love some of the stuff I'm up to with them. It's great, and there are these little innovative pockets. But on the flip side, are they also too big to be as monopoly focused in that area that they need to be, right? Yeah. They're . there, there's still billion dollar companies whose major source of revenue is advertising and, and those kinds of things.

Uh, Google search and advertising is still their, I think it's like 90% of their revenue. I mean, it's, it's, it's a significant number. It's huge. So this is play. They want to be disruptive, right. Um, I, where I think it's going is, I guess to finish that point is I'm pointing over there 'cause there's an Orange County Business Journal somewhere.

There's a, uh, damn, I can't remember the name of the clinic that opened up, but it's, it's technology based membership. Um, primary care physician office, essentially, um, no insurance. You go in, you pay your membership fee. It's funded by, uh, Ben Hoff. Oh, right, is one of the financiers. There's one that was up in San Fran, um, and one that just popped open down Fashion Island here.

They're, the folks I think are pushing the boundaries 'cause they're saying, and you know, unfortunately there's a barrier to entry, right? There really is. But in terms of are you interested in your care? Can you afford, you know, true private care. Common payer's monthly fee. See us as much as you want. Do all of these amazing tests that you, that you want to do stuff that you're never gonna get in the traditional healthcare system.

That's the stuff that I really see pushing the boundaries, is folks who want to take, uh, you know, health into their own hands and, and wanna throw the cash at it. Yeah. I, the, uh, Jonathan Manis, former c i o for Sutter. Um, I, I, I love listening to him talk and he and I had a conversation re recently and it, you know, one of the things he talked about at the CHIME event, gosh, I think it was a year and a half ago, was that, uh, you know, digital transformation is happening to healthcare.

The good news is it's a 10 year journey. The bad news is we're eight years in , and he said, and now all of a sudden he said, you're gonna see the disruption start to pick up. And, and he has just, he just, he just rattles 'em off. He's like, look, this has happened, this happened. And, and as he goes through the lists, he goes, what you'll notice is these people have come around the outside of the business and said, what's the high margin, low risk business?

And they said, we're gonna take radiology. We're gonna take surgery centers. We're gonna take, and they just boom, boom, take them off. They just knock 'em off. And until what's left at the provider side? Is high risk, low margin. Well, that's no way to run a business. It's all high risk, low margin. Um, as the sisters used to say, no money, no mission.

So you, um, you know, if, if you don't have the money to invest and you've lost all your high margin business to subsidize the rest of the business, then you're, you're facing, uh, a world of hurt. I don't, I'm trying to think what . You know, Google's doing. So I think one of the things these guys will do is help them to focus.

They're everywhere. I mean, they're like, Hey, we're going to, you know, we're gonna store your medical record was a long time ago. Then it's, Hey, we're gonna do . Um, contact lenses that can tell whether you have these diseases. And then obviously they're doing the, uh, they're collecting all this, uh, medical information with this project they're doing.

Uh, now with, with artificial intelligence and whatnot. I think that's their space. Yes, I was gonna say it is the artificial intelligence. They're gonna be able to, Make meaning of all this? Yeah. Because they've got, I mean, if you think about applying, what are you really good at? So here's the thing, both Amazon and Google, I'm really fortunate to work with some, um, some really great minds in both those places.

A couple weeks back I was up doing, uh, . Uh, a session of their briefing center up in the mothership, which is cool. Silicon Valley. It's really pretty amazing up there. Are, are you allowed to talk about that or do I have to cut this out of the show? Yeah, you might have to cut it out. The lawyers will hit me.

No, I'm not gonna give away any, uh, an anything I shouldn't other than the fact that. I think there's a huge angle because, um, of, of what they're good at, right. With regards to those volumes of data and the world's information is in applying that machine learning and ai and they've opened up their, their, um, their healthcare stack is open now, right?

Their a p I library. Is there, it's just, it's, it's ready to be tapped into. So utilizing that against your own data sets is, I think, I think it's gonna be a, an amazing, uh, leap forward for lots of folks that tap into that ne next year. It's there right now. You know, and I guess it's the, the last story here is just c m s is gonna start.

Um, some C P T codes around remote patient monitoring. They're gonna start reimbursing. . Um, is, is your, so dental, I'm not familiar with dental. So, um, you know how comp complicated healthcare is. You know, we have Medicare payments, we have, you know, payers, providers, all, you know, just a whole litany of things to figure out how we're going to get compensated.

Do you guys have a lot less of that? I mean, is it a pretty closed . System. Yeah, it's, uh, it's complicated for sure. Um, it's a lot less, uh, complicated than, than big medical for sure. So you're not sitting around waiting for c m s to say, Hey, we're gonna start reimbursing remote patient monitoring. You guys, you guys might have an opportunity to be more innovative or move a little faster.

We are, but it's, I mean, for us it's, there's, you know, a slightly different set of, um, of, uh, insurers sometimes. Right. And, and, and we're still waiting for, uh, . Certain treatments to be paid on, for example, right? So telehealth teledentistry is the perfect example. There's still a little way to go. There are, believe it or not, some really core use cases for Teledentistry that we're, that we're working on right now.

But obviously the model has to work. Uh, do you have any, anything you would do remote patient monitoring with remote patient monitoring? Um, Yeah, we have maybe from a, from a specialist standpoint, possibly. That's an interesting question. I mean, yeah. Ours, there's no, uh, there's no in, you know, inpatient services, right?

They're all folks. Folks come in and go. It just, it's just fascinating when we talk about dental, it just fascinates me. It's, it's, uh, it's right alongside, but it grew up differently. So it has different, it's a redheaded stepchild, unfortunately. Right? Yeah. It's, uh, so it's, it's really interesting. So, um, yeah, so that's, that's all the news.

I didn't really prepare any questions. I, I could ask you a couple questions. I mean, you have a, you have a big e h R implementation coming up and, uh, you know, how do you, how do you prepare for that? I mean, what's, what's mean? Do you have, I mean, this is pretty new, but I mean, do you have like a. Uh, you know, a, a team of, because you didn't have a team of people before that knows Epic.

So you have to build all that from scratch. We have, they've been, they've been really good in their partnership and helping facilitate that, that build out. So if there's, oh, so Epic will help you to, they'll definitely help us and we have a few select vendors that will also help us, but they've been very methodical in, uh, how we build those teams.

'cause it's not just a deployment initiative, it's a, it's a, there's a big build out. Right. So, um, they've been a great partner and, and quite frankly, I've been fortunate. Um, in, in having some amazing resource internally as well. And we've gone, we really, I, I see that my number one job is, is recruitment right now, bill.

So I'm out there, I'm pounding the streets as well 'cause I, I can't do this alone. And, and I really work hard at bringing in world class resource. So are you saying right now that you want as many vendors to call you as possible to help you? I don't. No more vendor help. No. I love my vendors. Right now, there is a, there are a lot of, uh, of staffing shops out there, let's say, right?

So there's, in Orange County, I, there's, there's lots of realtors I've noticed, and there seems to be lots of agencies that specialize in, uh, in finding the right staff member. I believe that at this point in time. . Especially in places like Orange County, um, there's an amazing network. I'm part of like the Orange County Techno Technology Professionals Group, um, part of several other organizations.

Even through like LinkedIn where there's, there's good dialogue. I'm, I'm always looking around. We're always looking for people and I think that if we post a job here, I'll start internally with our, our recruitment side of the house. I'll pick that up and, and I'll ping it out and, and I want known entities, people that are referenceable by great people I work with.

There's no, there's no better candidate than, you know, than a referenced candidate, right? Yeah. As my, as I brought him in, as my friend Eric used to say, there you go. Past, uh, past performance is the best I Case indicator of future results. It's true. Play results. Good book. I have to have him back. How's he doing?

He's doing well. He, uh, yep. So he wrote that book, how to Hire A Players, and, and I love that that phrase, past performance is the best indicator of future results. And it really is true. I mean, when you say, well, I've never done that before, but I could figure it out. I, I appreciate that. And I like people who say that, but I'd much rather have somebody who come in and who goes, uh, yeah, I've migrated three or four health systems to epic revenue cycle or whatever.

And yeah, I, I know, I know the process and . The good news for you is you're not on the edge. I mean, I mean there's, well, as you said, how many couple hundred, uh, epic clients? Yeah. I think we're on the edge in some of the, um, aspirational build out we're doing, uh, in terms of the integrations, we're doing some really, uh, great integrations.

Uh, but like you said, it's tried and tested. And, and, and the attractiveness of, of the, of that product as well is just the amazing, uh, you know, rev cycle and, and, uh, back office functionality that we'll be able to leverage out the gate to an extent. That's awesome. Well, anything else you wanna talk about?

I mean, I, I don't have any other questions, so, well, so was this, did you ever pull out today and you're like, can I plug Baker in ? He'll come on the spot. Be honest now, bill. Uh, I am booked through the end of the year and you know what happened? I kept looking at my calendar thinking I was booked through the end of the year, and I looked down and I was like, I didn't book this week.

I didn't have anyone I even have next. I have good, I have, uh, black Friday. I have that actually booked and I'm You missed today. I missed today. That's fine. It's always a privilege again to catch up with you. And, uh, and to be honest, people don't think I'm busy 'cause I, I show up in sweatshirts a lot, but, uh, there, there's an awful lot going on in my life right now, so I'm glad to have the podcast booked through the end of the year and I'm, I'm starting to book, uh, Book some really fun people in January, February, and you've got some ballers on there.

Like I said, I mean, it's impressive. Some great, some great content on there. So I was early doors when you were scratching around for people, and now, now I'm, now I've come further up the list. I'm like, wow, I'm privileged. This is great. Yeah, I mean, people don't know how this, how this sort of transpired was it just conversations with people and they're like, oh, you know, and I said, I would like to really record these conversations.

People like you would be like, . Yeah, you should do that. Absolutely. And then I just turn around and go, if you're on the show, I will do the show. And, uh, enough of you said yes. And, um, yeah, and I'm looking forward to it. I finally got, uh, Darren doin from Cedars. He's gonna come on. Awesome. And, uh, it, it took a little while to get him.

And then, uh, just, just a whole host of people have, have said yes. I just need to, . Follow up. So I'm, I'm looking forward to some really fun conversations, uh, e even through the next couple weeks, and then into next year. But, we'll, we'll definitely have to keep doing this 'cause next time we'll do it at, at a, at a bar where you are sort of dressed like this.

There you go. And I'm much more comfortable in a bar. You'll get a wave more fun interview out of me anyway. Right. As you know. So as, as I, as I do know, I appreciate it. I congrats on the folks you've had on there. There's definitely some, uh, some, uh, giants of the industry. So, and if anyone's, you know, listening

And watching haven't been on there that, uh, are upstanding their community. Get on there. And this is about paying it forward, right? Upstate it, it is about paying it forward. That's what, uh, you know, the, the shows, um, tagline is for the next generation of healthcare leaders. And, uh, I thought. , you know, it's, if I had had this resource when I was a c I o, it would've, I, I would've just listened to it, looked for the videos, and I would've just sent 'em to my staff all the time.

I mean, to have John Halamka talk about blockchain and, and Chad Stein's, one of the smart, uh, He's in that young category with you? I think he's, I think he just turned 40. Oh. Or you're, I did a couple of months ago. Yeah. Oh, okay. Yeah. So you guys are both in that exact same age. Is that consider young still, uh, for getting to the c i o role?

Forty's? Yeah. I think that's, that's, uh, you've accomplished something to get to a c I O role by 40. I just skated by my accent, but it's good. Yeah. People just assume that finished accent makes me smart. So, uh, . Yeah. And, uh, yeah, I, I would've just been picking up that material, sending it out. I would have if I listened to, you know, there's just so many, so much

Great content and people are like, you know, they just appreciate me bringing, oh, it's, it's like an, it's like a quick education in certain areas. If, if feel, I, I was saying, I referenced some of the material, some of my favorite material, and it's a short blog post, but so relevant. I did actually, I should really say this was mine and you stole it.

But no, it was, I, I by all means take whatever. That's what I do say. Yeah. But, um, It's, uh, planes, trains and automobiles. Planes, trains and automobiles, right? So it's keep the trains running, build new track and then build airplanes. And it's so true. And if you haven't, I don't know what that was early on, blog post, but I would say there's nuggets in there 'cause it's so true.

Check that out. I think in three weeks we're having arch collaborative on, and, and that's something you're, you'll want. It's 'cause they went through and interviewed all the, uh, implement not all, um, like 180 implementations of EHRs. To good, bad, or indifferent and then identified the seven or eight things that were common across the successful implementations.

And probably something to love that stuff. Yeah. Get, get ahead of, and I'm really looking forward to that conversation. Some people had come on, um, Lee Milligan had come on, Amy Maner had come on and, uh, alluded to it and the gentleman from class agreed to come on and just talk about the research and that's great stuff.

So, uh, I think that'll be, that'll be a good, it's nuggets, right? It's like life hacking. Like my, my man Tim Ferris, who I love very much. I see. And I make, I make the three minute videos just for people like you. In fact, the thank you gift for people who've been on the show is, is a, a book. I just sent you a book.

I, I don't know why I sent you a book. You hate, you hate these really thick What books? What book is it? Uh, it's, it's Have pictures in it. Pictures in it? No, it's the, uh, uh, leader's Myth and Reality. It's, um, general, uh, Stanley McChrystal's. Oh, I love, I mean, no, that's good. I got plenty. I've always got book.

I like the tactile fill of paper, but it's annoying carrying it around so there's nothing better than the Kindle. Yeah, when you, when you're just flipping out. It's convenient, but I'm always book a month is my target. How many books do you read? Uh, I, I don't finish many books. I, uh, I talked to a publisher once.

This, this is really just us real. This is, yeah, actually this is what the show You're up, but this is, this is what the show was meant to be actually like. Oddly enough. But, uh, I, I met with a publisher once and he said what they try to do, because they know most people don't finish books, especially business books, they will take the meat of the content and try to shove it into the first three or four chapters.

And so I have found that to be really true, that like I get to like the fifth, sixth chapter and I start to get bored of the material, right. And I, so I just, I suck as much out of the first couple of chapters as I can. Plus I, I listen to a bunch of books while I'm exercising. So clearly I'm not, not listening to that many bucks.

Exercisable, uh, order Boy is awesome for that. I like to listen in the car, right? The education machine, otherwise known as the car. I'm always on calls or listening to podcasts and Audible. Okay, so number one podcast outside of your own. Wow. Um,

a Andy Stand Lee's podcast on leadership is exceptional. Really? Yeah. All right. It really is exceptional. There's another one I started listening to, which is, uh, StoryBrand. I can't remember the guy's name, but he wrote a book. Um, it's by the same title, StoryBrand. And what he talks about is that, uh, when you're building out a vision or those kind of things, it's just like writing a story.

There's a, uh, you know, there's a, an event or something. There's a. There's a villain, there's a guide, there's a, and he talks about that whole aspect of it. In fact, that's part of the chapter I wrote for Ed Marx's new book, which the editors have not cut out yet. So Really? Yeah. What said, got a book coming out on, uh, that book should be out.

Uh, I think it's coming out for hymns, so it'll go. It'll go to print in early January. It'll be published at hims. Ed's a champ man. He's got good, I I, he was a speaker at the, um, what did I do? C i o bootcamp over in Chicago booth. Oh, yeah, he does, he does bootcamps. Actually, the, the, the lineup for the bootcamps now is just exceptional.

I mean, it is. Um, Tim has done a great job bringing in, uh, well, Jonathan Manis was there. . Ed Marks was there this past week. Sarah Richardson was there. I mean, it just, if you haven't done the bootcamps, it's worth doing. I tried, I sent you there, Jim. Uh, yeah, I did. Did a couple, both of those. Yeah. Really good.

They are, yeah. If you haven't sent your staff to those, those are. , those are worth doing. Yeah. Good tools as well. Right? In terms of what, in terms of that progression is thinking about managing up, what, what does an executive team really need to see? 'cause as technologists, we get a little detailed, but, but all of my guys said the same thing.

The test was a little wonky. The test at the end. Yeah. There's a, uh, certified c i o whatever was a little wonky, had spider diagram. Oh yeah. I think I fouled go goofy , stuff like that. I don't Well, good content. People ask me, it's like, Well, are you a certified C I O? I'm like, no. I was, I was an actual C I O, but I wasn't.

You're certified as well, . I'm certified. I'm certified on goofy things that don't matter anymore. Certified insane. Like, like Citrix and VMware people. Alright, bill, as now this is the David Baker show. One more, one more question for you. Um. , you should do more. I should have you as a guest. Lemme co-host one.

Lemme take a couple in it. 'cause I don't have the discipline to keep putting these on. I got like a profile bio thing. I stuck up and it's got a blog coming soon. 'cause you know, I'm just not good at following through on, on how can you possibly do this job An epic implementation. I know there's a lot going on, but hey, if, if you happen to like be in a bar with somebody and want to do a show, let me know.

Okay? I will. You'll find someone interested. I know a few good people. Okay, so let's just say I did see a picture of you and Benny off together. If you can get Benny off on the show then by all means. You want me to He is on speed dial . I'm sure he is. Me and Mark, what, what was your question? Now you're just bragging.

No, I'm, no, I'm joking. I wish, uh, What's my question? Oh, yeah. Okay. Five. The five's a busy freeway, right? Yes. Okay. If you, um, could put anything you wanted to on a billboard on the five, just for the hoot, what would you put on that billboard? Just for what? Just for the hoots. Just for giggles. What would you put up there?

What message would you like to send to the millions of commuters driving past the busiest point of the five every day? Gosh, you bet not cut this. Okay. Yeah. You know, that's, um, that's tough. I love you have to really think through that because. Uh, Aaron Levy, who's the c e o of box at one point, put this really funny thing, he used to really poke fun at Microsoft and so he used to put this really funny stuff up about Microsoft making fun of Microsoft on like highways in San Francisco.

Really? Yeah. And, uh, you know, so you fast forward about three or four years later and he's trying to partner with Microsoft , and it's like, you just never know what your future's gonna look like. So you just, you, you gotta, you have to really burn your bridges, right? Uh, yeah. He's like, Hey, about that SkyDrive thing, which is now OneDrive, right?

OneDrive, yeah. We've got an idea with this box being integrated. Can you help us? It worked out. They're integrated. Yeah. I, you know, I, I, I, I would take just one of those quotes from . You know, we, we see 'em every now and then pop up on, uh, on LinkedIn. That just reminds people to, um, You know, invest their life, give back, serve, uh, you know, it's, it is crazy.

The, the wealthiest people that have the best disposition are those that give a lot, that do philanthropy. Right. And we don't think that way. We think, oh, they're happy because they have the money. Yeah. I think they're happy 'cause they're giving the money and it's people that give back. It's people that give back to the community.

It's people who give back. And so I. I don't know whose quote I would use. It wouldn't be one of mine. I I, it should be, I don't know if there is a, a original quote from me, but it would be something to the. Um, to the extent of, you know, see the need around you and meet it, just see the needs of the people and, and start meeting it.

So that's, I mean, that's, I don't, I don't know what it would be. I don't know what the quote would be. When's the last time you gave back Ha, question mark? I don't know Bill. I don't bill Russell. You know what I have learned because. One of the things I brought into our IT organization when I came in was the fact that we are not graphic designers,

So I actually put a graphic design budget together. Yeah. And we hired graphic designers to really, it's good, good stuff to really help us really good. And all of a sudden people were like, yeah, I really understand now what it is trying, we are just bad communicators. Terrible. And we hired, I, I actually had a professor, uh, head of a department for one of the universities on speed dial, and he would read our

Uh, our text and stuff, and he would help us to communicate better. And we had, uh, graphic designers, we had videographers. We had an engagement team for projects. You created a couple videos. That's my secret source. Yeah. No, the eng the engagement team was the, uh, was really cool because it was like this buffer right between if you stick sometimes a really technical person in front of your, you know, your average, your, your user.

And it is just like they're speaking a different language and then people get annoyed with the it not understanding. So put a human in between that actually is I, I'll tell you the other thing I love with about this. This is, you get those sound bites and the per, the person who is most impressive to me on sound bites is, um, is Rod Hockman, c e o for Providence.

And, and we sort of joked, uh, at one point when, after Providence came in and we merged with St. Joe's, we sort of joked because I asked this team, I'm like, . What do I need them to know about Rod? And they said, um, rod speaks in sound bites. So I asked Rod about it and Rod essentially said, yeah. He goes, you know why he goes, because you have to be clear about communication.

He said, so I, if I'm gonna talk about, you know, what we're doing in this area, yeah. It's these three points. 'cause you know what, I'm gonna have to say it like a thousand times to a thousand different groups. Right? And I wanna make sure I'm communicating the same thing. 'cause if, if he waivers and it gets.

Goofy. You know, by the time you get to the fifth, sixth, seventh group, they're like, they're not thinking the same thing that the first group's thinking. Right? And so he sits back at some point during the year, he'll sit back and he'll . He'll go through his, his things to say, what's the most important thing to say about, you know, our mission?

What's the most important thing to say about, and, and he will just get those down. Because as a leader, especially a leader of a 20, oh, I'm sorry, yeah. 20 something billion dollars organization. 20 billion I think, right? Yeah. A hundred thousand some odd people. I mean, you're communicating to a lot of people.

It's almost like a presidential election. You are. Do you have to drive home your, your talking points so people can act on, so was Rob was on the, was he on there? Was there Rod was on the podcast? Yeah. Okay. So thank you again for being on the show. Appreciate it. And, uh, look forward to hearing about your implementation.

I guess we'll talk to you after you're done, your implementation. So what's we'll know before that? What, what's that like three years from now or? No? No, you don't have to. Three months? No, we'll be quick. Uh, then I get general. Um, but no, we'll circle back. Let's circle back in a year at a ball. Absolutely.

And if you wanna host somebody, just let me know. I will do. And that's all for, uh, that's all for this week. And, uh, please follow the show at this week in health it.com. Uh, follow me at the patient CIO on Twitter and follow, um, the show at this week in h i t. Thanks. Thanks a lot for being on.

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