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Lowest unemployment in a century, good news or bad news for Healthcare IT? We explore strategies for addressing the growing talent shortage. Also, my guest puts me on the spot with regard to recent Cyber changes in the Whitehouse. All this and more on This Week in Health IT.


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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 number 18. It's we're. Uh, tackling the growing talent shortage within it. This podcast is brought to you by health lyrics changes everywhere in health healthcare.

It. Get a plan for agile, efficient, and cost effective it from people who've been in your shoes. Get ahead of the way. Visit health to schedule your free consultation. I. My name is Bill Russell, recovering Healthcare, c i o, writer and consultant with the previously mentioned health lyrics. Um, you know, healthcare is loaded with, with really good people, people who are on your side, who are ready to be in it with you at a, at, you know, at, at a moment's notice.

Um, and no one epi epitomizes this more than our guest today. Today, today I'm joined by, uh, David Mun, principal at Starbridge Advisors. David, welcome to the show. Thank you. Appreciate it. The opportunity is really nice. . You know, I think sometimes, you know, you're, you're such a luminary, you've been around for so long that people would think that maybe you're unapproachable, but you are clearly one of the most approach.

If people see you at a conference or whatever, they should just walk up and introduce themselves, and you're one of the most approachable people and, and willing to, willing to help. And that's what I've, I've really appreciated about you. Good. Well, I tell people the strongest ability I have. Is availability.

So if you've been around long enough, you get to have a lot of great experiences and I love sharing it. So thank you. Well, I'm looking forward to this, you know, with the, with the combination of our gray hair, we should have something something to say. Uh, let me, for people who aren't familiar with you, let me give you a little, a little bit of, uh, of the bio here.

So, you began your career as a, a biostatistician, but what is, what exactly is a biostatistician. It's, uh, somebody who takes, uh, statistics and in my case, worked in a cancer and leukemia research hospital. And, uh, so I made, uh, the data speak and tell the story to the physicians who are taking care of the patients There.

Wow. And so that somehow led you on a path to become a C I O. So then you became, uh, uh, eventually became c i o at, uh, Texas Health Resources for, uh, 15 years and then five years at, uh, Baylor Healthcare System, I guess before the Baylor Scott and White, uh, merger. Yes, actually I was part of that activity.

So it was, uh, A really interesting, uh, you know, it's always interesting to go through the merger and acquisition discussion. Yeah. So this latest round of m and a is not, you know, this has happened before and, and there's a lot of experience out there around it. So in, uh, and so it gets really interesting here.

So in 2012, you accepted a, uh, white House appointment, uh, to serve as the first. Chief of staff and c i o at the O N C. What, so for all of us who are wondering what's it like to work in the federal government around healthcare? Well, actually, um, financially it's terrible , um, every other aspect, it's just fabulous.

Um, the fact is that it's really like getting a crash course, uh, in an area where you really have no, uh, exposure experience before. And I've done a little work in the state. But nothing to compare with the federal activities and working inside Health and human services was really an honor because of the diversity of the activities associated with healthcare.

And we talk about the healthcare continuum and there is nobody who has a broader view of the continuum than h h s and 'cause I was a political appointee. I got to sit in the meetings where we discussed policy and it. Fabulous. Uh, to actually watch the formulation of policy, even though they say there are two things you should never watch as.

Sausage making and policy making. Yeah. And I, I, I, and I think some people, because of their maybe cynical view of the government or legislature or whatnot, might think that, um, you know, these aren't the smartest people in healthcare, but they are some of the, I mean, some of the things that people are doing at the government level in terms of biodefense and cybersecurity and, and policy, these are some of the smartest people in healthcare.

Uh, and we, they just don't operate in the limelight. So we just don't see 'em all that often. It's, it's very true. And the fact is that these people feel a passion for what they do. They're public servants in the kindest, uh, way that you can take that word. Yeah. Um, servanthood is, uh, is how they live. And, you know, I had a secretary who was a, a, a lawyer, an assistant who was, uh, worked for me who was also, uh, had a M B A and was a C P A.

So people doing just normal jobs have these extraordinary credentials. Uh, but every one of them shared a big heart and dedication, and it's the permanent staff there that makes, uh, the government work well. So now when people say it's good enough for government work, I always correct them saying that government work with some of the most effective, odd sitting.

Now, whether or not you agree with what the decisions are is another issue. The one thing I would like to say to people is, and the reason I went to the government is if you don't like what's doing what? What's happening, you need to express yourself or you need to join and help try to make the changes from inside.

Yeah. And there aren't enough people there who have experience in health it. And I think that was the advantage I brought to the position. Yeah, I, I hear that a lot. People go, well, I don't want those people making decisions. And you know what? There's, you know, MU's a great example, you know, that stuff's out there for comment right now.

So comment. Yeah. Um, well that's, that's how I got there. I used to raise my fist and go, what are you thinking? And I got a, and, and I was on the board at Chime in charge of policy at the time, assisted by, by the way, a lot of very brilliant CIOs. But I was always the one that would do the final editing. And so I communicated frequently.

My displeasure with the programs and what I wanted to bring to the government was a practical and pragmatic approach. Right. And when you raise your fist, they, they assume that you're raising your hand. So when they say, Hey, we need appointee, that's like, Hey, that guy has his hand up. Uh, yeah. And by the way, when I got there, I continued raising my fist in the meeting

So, uh, c i O of Getwell network, uh, member of the board of directors, uh, there, uh, uh, still. And, uh, also, uh, board of, uh, Ahima, um, tell us about that work a little bit. So, oh, sure. You were there for, uh, three years or you're currently there for three years? No, I not finished just the last, uh, or in the middle of the year.

Yeah, because you know, chime, they get up there and they talk about Ahima, ah, and I forget the other one. And a lot of us are sitting back going, that's way too many acronyms. So, so tell us a little bit about that. Oh yeah. Well if you, if you don't like acronyms, watch the government. Um, the fact is that AHIMA really is one of the largest organizations for healthcare, and we think of them as the own medical records group, and they are far more capable than that.

Uh, it's some of the most dedicated people I've ever worked with and, um, they are frequently unsung heroes when it comes to moving data around. So there's nobody who really has a more end-to-end view of. In healthcare than the people who work in health information management. So it was a pleasure to be on the board there.

And what I kept pushing them to do was to be ill behaved, uh, and to try to get a chair at the table with the c i o. And I would love to see a greater partnership between the people in h I m. But knowing you, it's, it's be ill behaved, so get noticed, but, but do, do it in a respectful way. Absolutely. Um, there are ways that you can, uh, say things with candor and kindness at the same time.

Right. So, so you, so you've, you've led, uh, You know, tons of great teams. Uh, you know, it says, it says here in your bio that you know, at any given time, and people don't recognize this as a C I O, you oversee a lot of projects and, and you, you note here, you know, more than 180 project golis annually. And most people outside of our industry would say, that's crazy.

I, I can't believe there's that many. But those of us who have sat in the chair go, yeah, that's about, that's about the right number for the size organizations you were doing. Oh yeah, we, uh, can, just to give you some context, we used to say that a project was anything that involved more than 40 hours. Um, so that'll give you a sense of it.

So it could be something as large as a E H R implementation or as small as a implementation of a a departmental system. Yeah, so you were, uh, two times, two different organizations, chimes Innovator of the Year, and, uh, in 2014, Chi Chime presented you with your, uh, c I O Legacy awards. So I mean, that's, that's a great bio and probably the most.

Uh, time I've spent on anyone's bio, just so you know. I mean, there's, there's just , there's so much. I mean, it's like multiple careers here. I mean, it's, it's, it's very fascinating. Um, you know, one of the things we like to do with our, our co-host is give 'em an opportunity to talk about what they're currently working on or what they're excited about.

So, um, you know, this is, this is your couple minutes to sort of share what's going on. Sure. Well, after serving as a uh, c I O for a very long time, I decided it was time to come back to Texas to spend with the family and wanted to have a little more freedom. And so consulting is how I started. And, uh, after starting my own company, I decided at the invitation of SS Shade and Russ Brutish to join them and start STARBRIDGE Advisors and you know, only too well, um, and I'm sure every c i o in the country.

Knows only too well that there is far more demand than supply. Uh, and so the focus of our company is really to give additional bandwidth to CIOs. And one of the things that's fascinating, again, is what it takes to start up your own company, as you know, only too well. Uh, and so I've been engaged in activities that are designed to provide interim support, uh, to provide consulting services.

Also to do some coaching and mentoring. And the idea is not that the c I O isn't capable of doing that or either CMIOs, C I C M O or c t o, but um, they don't have the time to pay attention to all the things they want it to. And as you noted from my resume, when we're doing that many projects, you can't pay attention to more than a handful.

Um, and so by the way, I was blessed in every organization by having wonderful employees around me and take care of me. So , that's the key to my success. And by the way, a very patient family, but I enjoy offering assistance to those people who just don't have the time to do the work themselves. Yeah, and it's, I, I was in two rooms this week with, uh, different groups of CIOs and uh, it's interesting and we've highlighted it on the show.

Some people come from a clinical background, some people come from a technology background, some people come from neither, just come from a business background and just know how to get the most out of people. Um, The good CIOs recognize when there's areas where they're, you know, they could use some help, uh, be it on the technical, clinical or, or the business side.

And I know that people have brought you in on the business side a lot to say, you know, how do we handle this transaction? How do we handle this, uh, interaction with the federal government? Uh, given your background, I mean, you, you.

That's where they, they pick up the phone and call Starbridge and, and, uh, get you guys engaged. Alright. So, as you know, um, uh, you know, we, the, so the format of the show is we talk about the news, uh, then we do a little bit of soundbite section where we put you on the hot seat and, uh, then we, we do a social media close, which is just, uh, a little kick.

May not have been in healthcare, but it, it really does impact healthcare. And that is, uh, the US unemployment rate is now the lowest it's been in, uh, this century. Right. And mm-hmm. , um, it's, uh, and it, it becomes a challenge for healthcare to find great talent and, you know, how bad is labor shortage? Wall Street Journal had an article, uh, two weeks ago that talks about cities will now pay people to move there, cities.

We'll pay people to move there. And I've had, I've had conversations with CIOs where they said, you know, Uh, and we talk about all this really cool stuff and what you could do with Lambda architecture, that kinda stuff. And I say there are no people in my city that understand the technology that you are talking about.

We are going the Microsoft route. And that is a very valid and actually pretty wise I. Uh, you know, way to look at it is to say, what can I do with the talent? I have not, what is the really cool and, and and exciting thing that's, you know, right around the corner? So, you know, these two stories provide us with a snapshot of what's happening now and.

Probably what's gonna happen over the next two to three years that, you know, whenever you have this kind of tax cut, we saw a major boom in, uh, after Reagan did that massive tax cut and we'll probably see just, I'm an economics major just based on pure economics. We've just poured a ton of money into the economy and it's like, it's like a log on the fire.

So, Um, for the foreseeable future, there's gonna be this talent shortage. And so let, let's go back and forth on, on a couple things, uh, of how CIOs might think about this or just how people might, let's start with, uh, kids gonna college. I remember when I was going college in 19. Whatever, um, 1980 something, uh, they were saying, Hey, get your computer science degree, and everybody did.

And then when we came out, everybody had a computer science degree and so there was, you know, an abundance, but what, what's the, what's that major you're telling college kids as they're going in there, they say, I want to be in healthcare it, I wanna be in it technology summit way, and I wanna be in healthcare.

What's, what are those degrees that they should be pursuing right now? Well, it really is a tough question to answer and everybody's situation is different. But generally speaking, I say that there's one thing that they have to concentrate on. Um, that's a skill that you need no matter where you're gonna be in whatever profession.

And that is the ability to communicate verbally, and that's either orally, uh, or in writing. Um, and that's really number one on your list. So if you don't come out with good communication skills, You won't be able to sell yourself, you won't be able to explain things and you're just not gonna be able to succeed.

Um, but the fact is that there are many different pathways, uh, into healthcare. And so I happen to be a pre-med major in college and in English with a minor. And of course nobody can see those straight pathway. But I love that, that, uh, country western song that says, God bless the crooked path.

The real key is if you know that you love healthcare, the idea is to pursue something that compliments the activities that are going on in your area of interest. Now, my, I, I happen to be married to a nurse, the father of a nurse, and a married a nurse, and a have a niece and a, so I'm very nurse friendly.

So if I had to say something, it's. Follow a clinical, uh, pathway. Uh, there's never gonna be a lack of need for, uh, healthcare professionals. And if you don't mind me switching to a tactic that I used to use to fill positions when I was, uh, strapped for people who had clinical experience, I used to call the presidents of the organization together, both at T H R and Baylor Healthcare System.

We've got this big, we're gonna kick off. And I don't have enough people with clinical skills. I've got plenty of people with technical skills, but what I'm gonna do is I'm gonna find who are the best people in each one of the areas where we're implementing the software, and I'm gonna pull them onto the project team.

And if you don't say, ouch, I haven't found the right person yet. And so we would populate our projects with the best of the people in the clinical areas. Generally speaking, once they got into healthcare, it, it wasn't touching one person at a time. It was touching hundreds or thousands at a time, and it was easy to draw 'em over.

So, um, I would say you don't need as much technical skill as you need, uh, human skills. Wow. And, you know, John Wooden is quoted as saying the team with the best players usually wins. And so if you.

That is, uh, always extremely helpful. Um, you know, the clinical side, we are seeing more and more on the clinical side, people getting that clinical background and then making a, a, a move either towards analytics or towards data science or um, you know, just all all areas within within it. 'cause it's, it's fascinating to them how much so they got into healthcare 'cause they want to help people.

And they're generally high, very caring people, high empathy, and we need more of that in it. Oh, have always needed more of that in it. Um, absolutely. But their, their understanding of clinical also helps 'em to be empathetic towards the other clinicians. As you know, we've rolled out some bad technology that has been designed by, By technologists over the years.

And so we get, we get a bad rap from time to time from the clinicians of, do you know how many clicks it takes to get this data? Why can't we visualize the data in this way? And, you know, having those clinicians there to, to, to ground us in terms of process as well as very attuned to. The patient's very attuned to the, uh, the consumers of healthcare and what they're asking for as well.

So that's a, that's a great, you know, I, I, typical technologist, I'm gonna say analytics. If I'm talking to a college student, analytics will, will, will not steer you wrong. Uh, data science is not gonna steer you wrong anytime in the next decade. I don't believe. Uh, AI programming is one of those things. Um, I believe we're gonna need more of, we're gonna be teaching the machines how to think, how to process information.

Um, you know, we, we now have, uh, digital vision, digital, uh, you know, obviously, uh, machines are, are hearing us now and we're gonna need people that can sort of build those new constructs for us. And then security, I mean, we'll get into security. In your article that you shared, there's you. We're at war right now.

I mean, there's a cyber war going on and, uh, you know, need people to sign up for that. So, uh, you know, you gave us one of the strategies, uh, you know, give us some of the other strategies that CIOs can employ to find the best talent. Really, it's, uh, The best approach that I've used that worked well was the summer intern, uh, activity.

Uh, we used to beg, borrow and steal to get into the budget enough money to do things, but, um, you can take students from anywhere and everywhere. And to let you know, the only time that we brought on a student who stayed with us was one who wanted to move back to be close to her parents, but we used to get five to eight people.

Every summer and grow our own. And the fact is the enthusiasm is really a great quality to find in any employee. And these people would start at the lowest level to get a good understanding. We put 'em at the help desk and that would give them an exposure and a good test. Patients. Um, they would also allow them to see the diversity of needs, put 'em on the floors and have them do the, so what are the, what are the steps to set up a good internship program?

Because I, I, here's when, when I went to St. Joe's, I, I was kind of surprised we didn't have one within it. Mm-hmm. , we were bringing, actually we were bringing in high school students for one week over the summer. And that was, that was fascinating. That was great for my team. My team loved that week of working with those high school.

How do you together a good. Uh, program that's gonna appeal to undergraduates as well as graduate students to bring them in and, and expose them to healthcare. Well, truthfully, I have to tell you that my administrative assistant, uh, was the one who made this a success. We'll have to have, we'll have to have, uh, your administrative assistant on Oh yeah.

Chief Fabulous. One employee of the year in the healthcare industry. In, I mean, in Dallas. So I'm really telling you that she deserved the credit, but there are enthusiasm of those kids to get experiences is huge. And so the pool is very large, larger than you can possibly imagine. So I would call together my direct reports and their direct reports and we would scour through the, the resumes and um, you know, we, we made guesses at would be what would be good fits.

Based on what they had as experience and what they put down at mission and goal in life. Uh, and we really didn't focus as much on the technology things as we did on, again, on the soft skills. Um, because if you hire the right person, they can pick up the technical skills. And, um, again, having, being very deliberate about the time, making sure that you have somebody administratively taking care of the program is a real key to that.

Yeah. One of the things I love that our, uh, data team did was they started tapping into the grad, uh, the various graduates and even PhD programs, and we set up a way for them to, uh, access anonymized data within our system that they could, they, they could, I. Uh, they were doing really neat things, and part of that was almost a retraining of our, of our data team internally, because they were, they were coming face-to-face with the, the most, and we were not an academic medical center, so we didn't have the access that most, that, at least an academic medical center would have to that, that level, uh, uh, academic rigor and whatnot.

And so by partnering on that level, man, we were seeing all sorts of new ways of, uh, visualizing data of, uh, really uh, Breaking it. So don't just look at the, the college interns, you know, the, the, the kids with no money. Um, also, you know, try to figure out ways to tap into those PhD firms. 'cause you know what?

They, they want access to healthcare. They want access to the data. Uh, it so benefits them, uh, to partner with a, with a health system that has. Uh, at least their act together in terms of, uh, providing access to that, that level of, uh, depth within a healthcare organization. Yeah. And just one more little trick or tip.

Uh, we also would look at projects that were three to five months in length and we would go to, uh, graduate schools just like you suggested, which I think is great. And we would say, we have a fixed program that we want you to complete. Can you make this one of their senior projects? And because of the remote nature now of work, it was easy to get that done and they actually had a real world deliverable, uh, that we would actually put into production at the end of the process.

Now, we only did that a few times, but we were successful in each case. Well, great. I've been going long on this show the last couple of weeks. Oh, yes. So I'm gonna, so I'm gonna kick it to you for the next story, and we'll probably only spend maybe five minutes on the next story. Okay. I'll try to speak a little faster.

The draw slows me down. Um, one of the things that happened this week, uh, that I thought was very interesting was that Rob Joyce left the White House as the cybersecurity, uh, chief. John Bolton, uh, is pushing to eliminate that post, and that caused me a little heartburn. And so I'm curious about what your reaction is to the White House taking its eye, if you will, off or changing its, uh, focus.

Great. So you're gonna ask me a political question on, on Exactly. So I can't hide, uh, I'm gonna quickly steer this back towards, uh, cybersecurity in, in healthcare. But you know, is it the right move? I don't know. I, you know, I, I, but, uh, here's my gut. Cybersecurity should be handled by the military and Homeland Security.

The reason I believe that is because it's, it literally is a war. If you go in and look at your log files of who's. It, it, it used to be that we would say, you know, it, it's still true that a majority of cybersecurity incidents happened internally. So it's, it's your people that are exfiltrating data, um, for whatever reason.

And then, um, and in Nation States was this little subsection of people that were trying to get into your data that has, uh, not completely flip flopped, but that nation state attack has grown exponentially. Over the last, um, I would say two to three years. And, you know, most of the malware and stuff that we're looking at today was develop, was developed by governments, if not our government and, you know, has fallen into the wrong hands.

So I think it's a military and homeland security thing. So, you know, only in the federal government do we create a job and think it can never go away. Um, I, I don't think we lose any focus. Every branch of the military now has a cyber command and a cybersecurity group. Yes. Homeland Security does the F B I investigates.

Um, so it's not for lack of a cybersecurity focus. The question is how does that information and stuff get to the president? And, you know, there's a Secretary of Defense, there's a Secretary of Homeland Security. It could filter up through that. So, uh, if we were gonna reorg it like a business, we would look at it and go, That's a redundant position.

That's, that's my gut. I, I don't want emails on, you know, politics or whatever, . So let's, let's, let's flip this to health it . Um, so we're, you know, we're talking about how to reorg the government. How do you reorg it? So what's the best way for it? 'cause that's really the question. Uh, what roles need to be in place in healthcare it in order to have a very good focus.

On cybersecurity and be able to inform and educate the board and, and the various things that need to happen. I mean, what's, what's the best, I'm turning this right back on you. What's the, what's the best organization and, and, and way to, to get ready for that. Yeah. They, you know, this is an interesting time and people say that they want the cybersecurity people reporting up to compliance or to the board itself.

Um, and to take it away from the c i o and um, I'm not so sure that I agree with that. Uh, and the reason is that there're the people who are wonderful at cybersecurity have to be a little bit paranoid. And that paranoid is not based on, uh, false concerns, it's based on a reality. Um, but there're always just this balance that you need to make.

And so the question is, who's the best risk manager in your organization? Uh, and if the C I O can play that role, then cyber security should probably report to them. Um, the reason I suggest the c i o is because early they speak some form of cybersecurity, probably more effectively than many of the other, uh, groups that have been typically assigned as we're making reassignments of cybersecurity.

So I still think the CISO should have a reporting relationship to the c i o and I. If that's not the case, there should always be a c I O and CISO in discussions where you're trying to make decisions about how to take care of the cybersecurity, uh, or, or actually all of the it, uh, assets that you have responsibility for.

And it's the trade between access and security that always is the most difficult thing to.

I'll, I'll give a little different spin on that in that. Sure. When I came into St. Joe's, uh, all the security reported up through me, and one of the first things we did is we hired a chief security officer, not a chief information security officer, chief security officer. Oh. Had a digital background and that reported into co compliance.

So oversaw physical security, I mean, you name it. Uh, building security as well as, uh, really compliance around, uh, information security, which was interesting. So I now had a peer. Who, uh, you know, the two of us would always go together to the board and present because he would present, Hey, here's the, here's where we're at.

And I would talk about the very specific minutia of, okay, you know, here's, here's the investments that it's going to take, here's what we're trying to defend against. And those kind of things I would be very focused on, um, on cybersecurity and, and so we sort of tag team there. The thing I liked about it was he was very focused on education, and quite frankly, the, the biggest risk we have is 23,000 employees clicking on an email, giving away their credentials, reusing passwords externally and that kind of stuff.

And so, uh, you know, that. That element of the, the training and education he was focused on, uh, every day. So I, I think, you know, cybersecurity, most CISOs I've met are really strong technically. Uh, but when you talk about influencing an organization, they almost need to be at the C level in terms of how do you drive education programs and how, and those kind of things.

So, so we had a little . I don't know if it's different, but we had a, a, a little different bent on it. Uh, you know, we, we stole a guy from, uh, MD Anderson and uh, and he became our chief security officer, and he was phenomenal. Um, and, and a great partner for me and a pain in the ass. But anyway, , but, but that's, that was his role.

His role was to get in my face and say, uh, we're not making enough progress in these areas. How are we gonna move the needle? He never said, This is how I want you to move the needle. He would say, how are we gonna move the needle in? You know, he had, uh, 10 different areas that he was measuring across for us.

So, no, I think, by the way, I think I love that idea. Uh, I think, you know, security at that level makes perfect sense. So Good model. Yeah, it was, it was. I I, there's a lot of different ways to do it and uh, you know, I'm sure people have different models, so, um, alright, we're gonna, we're gonna jump to the soundbite section and I have one, I have five questions for you.

I'm just gonna ask the question. You get about two minutes to answer and, and we'll, we'll just move on. I'll try not to comment on your, your answers. So , given your government background, assuming there's no changes, that it goes through the comment period and no changes, what do you think the impact of the new MU program promoting interoperability is going to be on healthcare?

Uh, not enough. Um, and the reason is that we keep pushing interoperability, uh, that's based on patient managing. And, um, I think except for patient, except for actually positive person identification, all the pieces that we need are already in place in the private sector. So I had pushed for a private sector approach to this.

Um, but I think having the O N C push interoperability is really important. Uh, I would like to see them look for a bio combination of biometrics and a user selected identifier like we use with every other product that we have. For example, email, Facebook, whatever, uh, to be able to help identify those naked and unconscious people who show up in our eds.

Uh, not to mention the people who come through the front door, but have very common. Shared names. Great. I'm gonna hold myself to not commenting on that. So , uh, because there's a lot of ways we can, we can approach inter interoperability. So that's, that's, that's fascinating. Okay. So, uh, you're a part of a group that's looking to hire a new c i So you guys do interim c i placements.

Yes. I was starbridge. So you're looking to hire a new c i o I'm now putting you on a board for a health system. What are the three most important attributes you're, you're looking for in your next c I o? Well, we happen to be comprised of people who have a lot of experience, and so I'm always interested in people who have experience in depth.

So that's one. But diplomacy, uh, is probably the other. And under diplomacy, I'm cheating because under diplomacy I'd make a list of characteristics including communications, empathy, et cetera, uh, that, uh, I would, uh, think are associated with diplomacy. The other really is optimism, which underneath it would've energy, uh, as well.

So, uh, those are probably the three things that are most important to me. And ultimately, by the way, as you, as you know, do well, every relationship is based on good chemistry. Uh, so what you have to be able to do is look at that combination of characteristics. Make sure that the profile of the organization is consistent with the profile of the individual who you might be putting forth as a candidate.

Yep. And I had a, I had an article I wrote on health system c I o about hiring the best C T O candidate. I had the five C's. In order to drive hitch to that article, you'll have to go to health System c i o and see what the five Cs that I. I will do that. So you have a unique perspective here. I'm gonna a little twist on a question I asked you earlier.

So you've worked with the health systems, uh, private sector, you've worked in the public sector. At O N C, you're talking to a college student who wants to have an impact on healthcare. Which direction do you point them in? Do you point them into the private sector or do you point them into the public sector or, you know, or what attributes of the person would point you help, help you to guide them in either direction?

Yeah, I, you know, it depends on whether you wanna work on a micro or a macro level, really. Uh, and ultimately, if you're interested in the macro, I think the government is a great place to work. Um, I would suggest that you have experience before you come to the government. So I'd push you toward the micro.

Um, the fact is that policy made without experience and pragmatism is not necessarily gonna work. It would be surprising if it does. And so you know that p pragmatism of practicality is critical. So head toward the private sector first. Then when you've gotten to the point where you can make a contribution, policy is a great place to join.

And by the way, you can make policy on the local level, the regional level, the state level. And the national level, which is actually exactly what I did in my career, right? And so working in either doesn't break you for the other. If you've spent too much time in the private sector, you can still go into the public.

You spend a bunch of time in the public, you can still go into the. And the important thing is to maintain that optimism regardless of which direction you choose . Yeah. You seem to have the right temperament for b for both. So, um, , what, what is something that the O N C does for healthcare that may surprise healthcare leaders?

Yeah. You know, the, the thing that I, people don't really associate with the O N C is their laser-like focus on making sure the data is available to patients and providers. What they see is, oh, they're just in here to regulate features, functions and to provide some money. And that is not why O N C exists.

O N C wants to make data accessible and the products that are out there don't always make that so easy, hence the reason. Um, so that's part of the reason that you've seen that. And you need somebody who's still passionate about interoperability lead that effort. No, that's, that's great. So, uh, 180 project go lives.

I'd be remiss if I didn't ask you this question, you've had some level of success. 'cause if you're, if your first 10 fail, they don't let you do 180. Um, give us, you know, give us a handful of things that, uh, that health, it can learn from your success. So we wanna replicate your success over 180 Project GoLive.

You know, what would you tell us? Sure. I, I would say, you know, it really gets down to demand management no matter what else you're doing. You have to have a very strong governance process. So you're controlling the funnel. Exactly. And one of the, and you have to, part of the reason for governance is not just to control the funnel, but to get the people engaged.

And so I'm never led a governance committee. Uh, I always would set it up, do the, all the work that had to be done, take care of all the administration, but I. The people who populated those committees were all from the operations side, and we would always have a president who had some sway at one of the hospitals chair, the committee.

And interestingly enough, it had no vote on any of the prioritization or project approvals. And the idea was the operations is earning the money, the operations is doing the clinical work. Operations should make the decision about what the priorities should be and the order in which things should be done.

Uh, our job was to talk about what made sense and there are some dependencies there, um, but having brilliant people working for you, as I have enjoyed my entire career as the key. Um, but I can't tell you how powerful it is to ask people what they want and then let them make the decisions. The challenge we all have is it people.

Is that when I did surveys of people who had the same kind of discipline that we did and were tracking numbers, the lowest, uh, demand to supply ratio was five to one, and people were, sometimes it's 16 to one. So the idea is you cannot, and there's an no, and I attribute this to coach. No coach ever said this, but it sounds like something the coach would say.

And I used to tell my staff all the time, you need to focus on this. We can do anything. We can't do everything. Yeah. Uh, and you have to be able to have to say no, and you don't create a backlog in that process. You say, what I'm gonna do this year, and I'm gonna ask you again in another year what you wanna do for the next 18 months after that, um, so that you don't have this heavy weight.

On the staff of it or the organization. And because things change, as you know, every day in healthcare and priorities will shift from here to year. Yeah, no, that's, that's, that's great. Uh, wisdom and advice in that area. Um, can I do one bit of advertising? Sure. Yeah. The Gartner article that was published about what we did at Baylor, if you wanna see in a lot more detail what it is that I was talking about.

Is there a, is there a title for that article? Baylor Healthcare System offers strong example of a PMOs ability to help healthcare systems manage high it demand. Wow is the answer. Great. Well, we'll definitely have to pull that article up and, uh, reference it in the, uh, post. So we're at the close of the show.

We close with our favorite social media post of the week. Uh, I'll go first. So this past week, I got to attend the inaugural health conference at the AR aria in, uh, Vegas. It was interesting. There was about 4,000 people there. It was highly tech, uh, centric in terms of just the, you know, it was all around innovation and those kind of things.

Uh, pretty well attended, very well run conference. So I, I don't know, I, I don't know. I don't know if I'm recommending it, but I'm saying it was, it was fascinating. Good speakers, uh, David Feinberg, c e o of Geisinger, uh, did the, uh, keynote and he had this quote, and he's a quote machine. I, I love. People like this.

So at Geisinger Health we have 13 hospitals. I think my job is to close all of them. I know that if we use proven and behavioral techniques to get us healthy again, half of the 2000 beds I'm responsible for would not be there. Um, just an interesting approach. This is the same guy who said, uh, you know, we want to get rid of the waiting room and all that it represents, you know, think about those quotes, they're.

I, I, I don't think that's a, a, an announcement that we're gonna get rid of every hospital in Geisinger, but it's saying we can do better at keeping people out of the hospital, and that should be our focus. So it's very interesting. Sure. So do you have one? No. The, the one I would suggest that you look for is something that Jonathan Perlin, who is the C M O at H C a, um, talked about was the virtual virtuous cycle.

How that was related to analytics and what they had done to work on, uh, bloodstream infection. So just fascinating. And he's one of the most brilliant, eloquent speakers I know. So that's well worth looking. Well, thank you. You, thanks for confirming that you are a nerd. We, we appreciate, we appreciate this stuff here.

I've got the, I've got my pocket protector to prove, uh, biostatistician to c i o. What's the commonality? Yeah. You love, you love getting down into the minutiae of, uh, of how, how things work. So, uh, thanks, thank you again for coming on the show. Um, so give us an idea of how people could, can people follow you on social media at all?

Sure. Um, I do have at David m Tweet hand, Twitter handle, and then, uh, as part of Starbridge Advisors, there's an at Starbridge Health IT or h i t, uh, that we use. And I try to push people, uh, to. Uh, starbridge where we highlighted this week that Che was one of the top 50 women in healthcare. It.

Not place for her to be and very proud of what she's accomplished. Absolutely. Uh, former, uh, formerly on the show and, uh, I'm sure will be, again, I'm looking forward to having her back on the show. So, uh, so awesome. You, you can follow me on Twitter. The patient's at the patient cio. My writing on health on the health lyrics website, I noted health system, c i o picks up an article every other week.

Uh, don't forget to follow the show at this week in h i t and check out the website this If you like the show, please take a couple seconds, leave a review on iTunes or Google Play and uh, we are now up over a hundred videos on this week video. That will take you to our YouTube channel.

Uh, we every show we cut into 1, 2, 3 minute segments, about five or six a week, and we put those out on social media and we put them up on the show. So, uh, we're gonna start organizing those by topics. Uh, the role of the C I o, uh, AI data analytics, those kind of things. So, so we can, uh, so people can get more out.

So, uh, last thing I wanna say is if, if you know of someone you'd like to have us, uh, have on the show, uh, please, you know, let us know. Just hit us on one of the social media platforms and, uh, you know, just direct message me. And, uh, you know, I'm always open to that and I'm always curious as to who people recommend.

It's, it's fascinating to me. Um, and please come back every Friday for more news, uh, information and commentary from industry influencers. And can I have one last word? Sure. Uh, make sure that all of us who appreciate your thought leadership, uh, get a chance to say thank you for what you've done for the industry.

Thanks. I appreciate that. And I will give you the last word. That's all for now.


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