This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Welcome to this week in Health It, where we discuss the news, information and emerging thought with leaders from across the healthcare industry. This is episode number 34. Today we discuss Epic U G M in Verona, Wisconsin, uh, diversity and c R m. This podcast is brought to you by health lyrics. Health systems are moving to the cloud to gain agility, efficiency work with trusted partner.

Visit Health lys do com to schedule your free consultation. My name is Bill Russell. We're covering healthcare, c i o, writer and advisor with the previously mentioned health lyrics. Before I get to our guests, I want to, uh, make everyone aware of a great resource for your IT teams This week in health, it has a YouTube channel with great insights from industry insiders.

Our guest today, short segments, complete episodes, all curated for easy access. We're now up around 275, 280 videos. Uh, I have a team of millennials working to make it very easy to, uh, uh, to identify, uh, videos just on analytics or videos, just on AI and those kinds of things. So check it out today at this week in health it.com/video.

Easiest way to get there or you. This week in health It, uh, today's guest joins us from beautiful New York City, um, Kristen, s v p.

Good morning. Thanks for having me. Well, I'm, I'm looking forward to our conversation 'cause you are, uh, freshly back from, uh, the Epic U G M conference. Couldn't have found a better person to have this discussion with, and I'm looking forward to your insights later on the, uh, uh, on the, uh, soundbite section.

But first, before we get going, tell us a little bit about, uh, Mount Sinai Health System. Sure. So Mount Sinai Health System, it's an academic medical center that has seven hospitals, over 6,500 physicians, over 300 locations, 38,000 employees. So we're one of the largest New York City employers. And, you know, very much focused on an integrated health system and, you know, really ensuring that we're able to provide care, you know, from birth to, you know, the end of your life.

Wow. 30, 30,000 employees. Um, I have a friend who always says that, you know, every business is a people business. Every problem is a people problem. And when you have 30,000 people, I would imagine coordinating projects, rolling projects out, communication. That's, that's probably one of the biggest, uh, biggest, uh, challenges for someone in your role.

Um, well actually it's. Give, give us a little idea of, of your role. I didn't really cover it. So give us a little idea of your role at Mount Sinai and then I'll go through some of your bio. Sure. So I oversee the application strategy and application portfolio here in the technology department, and we have over 700 applications.

And that was due to the merger that took place with Continuum Health Partners around four years ago. And there wasn't a lot of synergies between the applications. So what we're doing now is looking at. All of the roadmaps for the applications and working out, how do we actually rationalize, come to enterprise platforms and be able to decommission some of the legacy systems.

Yeah. So I have, so you said 700 apps. Yeah, we have around 700 apps at this point. And you know, I think that, you know, our approach is really around enterprise platforms. So you know, epic for our clinical and revenue cycle, Oracle for our E R P, and we're also looking at A C R M A customer relationship management.

Platform. So I have direct responsibility for the Epic, uh, team. Also the IT program management office and change management office. They oversee around a hundred million dollars in capital projects per year. Uh, interoperability and also clinical ancillary. I mean, we could do a whole show just talking about application rationalization and, yes.

And, and platforms. I mean, platforms is the, um, is, is what every IT organization is looking, uh, to get. Uh, to get to platforms being open, the ability to programmatically access the information, create workflows on it. So yeah, those are some interesting, and I'll look forward to, we're gonna talk a little bit about c r m a little bit later.

So Mount Sinai for about 14 years pm at Capgemini, but you started your career in Australia. Uh, uh, clearly that is not a New York accent that you're sporting there.

Cer. Um, I think we're gonna find out here that, you know, while we already found out that you're a, an epic shop at, uh, at Mount Sinai, so, um, that's correct. So, one of the things we like to do with our guests and, uh, just to just open it up and say, you know, what are, what's one thing that you're excited about or that you're working on today that you just wanna share?

So I'm working on the customer relationship management strategy, uh, here at Mount Sinai. And you know, that's really exciting to me because being able to understand, you know, our patient population and have a 360 viewpoint on all of our patients, I think important. And, you know, how do we personalize how we are able to communicate with.

Text or, you know, email or phone. I mean, knowing that and being able to actually engage them in a better way. I think it's important for health systems to be able to, you know, have that knowledge of the consumer. So that's what I'm working on today. Uh, we're going to be releasing a cm R F P in the very near, um, have CM already implemented.

Such market and our population health group and business development. But we're looking for one platform, uh, across the enterprise and, you know, case around center and you know, how do we provide our call center agents? With one platform so that they're able to see, you know, whether it's a patient's birthday, how they want to communicate, um, what was their experience at, you know, one of the physician's offices, did they make a complaint?

Did they have a great experience? You know, what are the Press Ganey scores? You know, all of that. I think it's so important. Yeah, absolutely. And you know, c r m is, is interesting when we, uh, took a look at it at the health system where I was c I o, um, you know, you, you did have multiple, we had multiple c r M systems in place.

We had some clinical systems that were trying to do c r M type features, and then we had call center systems that were trying to do some c r M type features. Um, but when you try to, uh, orchestrate a patient experience across , I don't know, 15, 20 different systems, uh, you know, that it was hard to move every patient touchpoint across there so that everyone sounded like they at least worked for the same company.

Um, and I assume that's one of the challenges that you guys are facing. Yeah, and I was reading actually, uh, some of the Gartner reports around c r m and, you know, only about 20% of health systems that actually are implementing C R M are able to get an enterprise solution. And I think the challenge is who is the operational owner?

It touches nearly everyone in the health system. So I think getting that sponsorship around, you know, who actually is going to be, you know, driving these decisions, uh, is problematic at many health systems. So, you know, we've been very lucky that, you know, our executive team clearly understand, uh, this is a priority and you know, Really supported the ability for us to, you know, go to RFP and have an enterprise strategy.

Yeah. Well that's great. Um, so on our show we do two segments. We do in the news where we each pick a story to discuss. Today we're just gonna. We're just gonna focus in on the, uh, on the conference and talk about different aspects of that. And then we do a soundbite section where I more of an interview type thing.

Just ask you a couple of questions, um, which we've discussed ahead of time. So if people don't think, I'm just gonna try to stump you here. Um, so in the news, uh, I'm gonna have you kick us off since you were there. Give us some idea of, you know, what, what was I, I assume it was a festive kind of mood. You know, what was, what was the atmosphere and then what were some of the key themes and topics from, uh, from the conference?

You know, I've been there, uh, at U G M for the last 13 years, and this year, uh, was a great experience, as usual. It was a great outdoors theme. And, you know, I think one of the focus areas for, uh, epic is around patient experience and access. So I was really pleased, uh, to see at some of the usability sessions, you know, the focus on, um, their MyChart, which is the patient portal, and how they are ensuring that the mobile version of MyChart is exactly the same as the web-based version.

I mean, we've had some issues here where . You know, you, we have initiatives such as open notes where, you know, we're being very transparent about, you know, the progress notes that the physicians are writing on MyChart. But that's, that can only be seen on the MyChart desktop, not on mobile. And, you know, many of our patients, uh, do not have access to, uh, either the internet and they're not able to see, uh, that version of MyChart.

So they only have the mobile version. I think the ability to have all of the functions, uh, consistently is going to improve patient experience dramatically. Uh, they've changed the look and feel. I mean, clearly there is a lot more focus on user experience and how to engage the patient. Uh, so that was a pleasant surprise that they're really moving in that direction.

I was pleased with that. Yeah, that's, uh, that's awesome. The, uh, mobility, the, the numbers continue to stagger me. I mean, just, uh, you know, case in point, this, this podcast, uh, you know, 90, I think it's like 95 to 97% of all listens will come on a mobile platform. Uh, hits, hits to the website is, is almost, uh, 95% from mobile phone as well, which, uh, actually.

I'm not surprised that it, it leans in that direction, but it's, uh, a little high for me considering that a majority of our listeners are healthcare users. And healthcare users generally, uh, are, are web uh, type users, but if that's just the, the transformation that's going on, people are mobile. And so everything we do now in it has to have a mobile component for how are you gonna show notes?

How are you gonna show the medical record? How are you gonna do scheduling online? So that's really fascinating. So let me, I'm gonna tee you up with some of the articles have been written, some of. Uh, we're gonna look at four main things. So, uh, some of Judy's comments early on this, this is really around innovation and startups.

Uh, Faulkner acknowledged that there's a lot of buzz around digital health today. Many leaders in hospital IT departments have words like innovation, uh, have titles like innovation, analytics, digital, uh, data in their job titles. She said most of the titles barely existed 10 years ago. Uh, I assume you're seeing these kind titles.

Are you seeing that people with these titles of Chief Innovation Officer and chief, uh, data officer, analytics officer, are these reporting into it? Are you seeing them outside of it? And, and what kind of models do you see sort of emerging around these new titles? No, I think that, you know, healthcare, uh, as you know, I mean, sometimes lags behind, you know, the.

The industries such as retail, et cetera, and, you know, this has been going on in those industries for quite a while. And you know, so we, we seeing chief digital offices and chief data offices, you know, in the business at other health systems, We recently, uh, actually, um, were able to, you know, hire a vice president overseeing, uh, consumer digital and, you know, that person is in the business.

And I think that, you know, that is a model that you're going to see more and more of, not necessarily in the IT department. Yep. Yeah, I, I, I think we are seeing them while we're seeing a lot of different models. That's why I've, I've put the question out there. I mean, we are seeing it really tied to the business.

We're seeing some in it, and then we're seeing some departments that are purposefully being kept separate, uh, so that the. Uh, I think, I think how Rad Hoffman described it is so that the organization, the culture of the organization doesn't crush innovation, uh, is, is how he described it. Yeah. Uh, so yeah, I mean, we're very lucky.

I mean, we're an academic medical center and so, you know, we have a lot of innovation occurring, uh, not just within the IT department, but you know, also in operations and also in our research and genomics division. So, uh, you know, There's a innovation occurring here and you know, that's, that's what makes it exciting and you're able to partner with these teams and actually, you know, work to.

Yeah. And so, which is why I find these, so innovation in startups. So, uh, uh, Judy went on to say, there's so much money in Silicon Valley, uh, for startups. When I go to an innovation conference, I feel like a piece of meat walking around dogs, and I like dogs. Uh, she goes on these, these are, I, I just found these.

It's kind of comical. Uh, I assume people laughed at that. Startups sit at one end of the spectrum of the technology business. At the other end are, uh, giant gadgets, uh, gadget and software makers like Amazon, alphabet, apple. Uh, in, in addition, uh, Faulkner mentioned I B M, Microsoft, Netflix, Walmart, uh, among others.

We've talked about others on this show. Uh, it's too early to say how they'll fare, but some big companies from outside the industry have struggled to impact healthcare in the past. Uh, see Google Health and Microsoft, uh, Uh, uh, that it's hard to make meaningful advances in the area of comp as complex as health.

It. And then she went on to say, um, that the E H R is the most complex area in the world, which is health, uh, operates in the area that's the most complex in the world, which is healthcare. She said, I think it's more complex than rocket science. Um, You know, is Epic saying, uh, look, we're in your corner as they're saying to this crowd, which is, you know, health systems, we're in your corner.

Our intentions are good. We've made good progress together. Don't look somewhere else for a shiny object to solve your problem. Uh, their intentions. The Silicon Valley people, uh, may not be good. They failed in the past as, as, as been noted. Um, you know, this stuff is really hard. Uh, do you think these comments are a form of you?

Fud of, of fear, uncertainty, and doubt around startups and tech companies because they are starting to capture some attention within this space and, and, and do hold some promise. I mean, what, what do you think her, her, her thinking was behind? Uh, really those feisty comments about, uh, tech startups and, and the established players?

I think she's concerned around, uh, some of these applications not being HIPAA compliant. I think that, you know, we we're all aware of what's on with Facebook.

I think that her concern is around patient data and you know, making sure that, you know, patients aren't being directed to inappropriate services, or that their data is being shared in a way that you know clearly that the patient doesn't understand and you know that they're being subjected to advertising, et cetera.

So, you know, I think that that was probably one motivation. I think the second would be around fragmentation of workflow. And I think that that is one of the challenges as it relates to digital health is how do you incorporate, you know, these applications in such a way that it actually makes the workflows more efficient for our physicians, um, and our other providers and nurses and within a.

But also from a patient access system, um, and the consumer experience, you know, just having, putting apps out there, uh, is very confusing for some of our patients. I think that, you know, there needs to be an intentional, comprehensive strategy around how do consumers and our patients actually access care.

Health systems. Health systems, and it needs to be a very seamless experience. And, you know, not a lot of healthcare systems are actually doing that, from my opinion. Yeah. So, um, this wasn't one of the topics I was gonna take you down, but I assume there was a lot of conversation around physician burnout and making the systems easier to use.

I mean, what, what, what were some of the things that you heard around that topic? I think, you know, physician wellness is a huge issue, and in fact, uh, we have a Chief Wellness Officer, uh, at Mount Sinai and we've really aligned, uh, some of our optimization efforts, uh, with, uh, his efforts also. You know, I think that.

Know the way the systems are implemented at times, um, there's a lot of ways to be able to achieve, you know, the same workflow and there needs to be an emphasis on simplicity and efficiency and making sure that you know the physicians and, you know, their support staff, you know, really understand, you know, the tips and tricks and the shortcuts.

To be able to get through, uh, their office visit in the shortest amount of time. And, you know, I think that's been an emphasis from Epic. They've been, you know, very much focused on this and, you know, been great partners working with us on our own optimization efforts. Yeah. And a lot of the challenge, you know, 30,000 employees, uh, not all of them use the E H R, but.

Um, uh, what we found in, uh, having physician champions around the different hospitals was there was just, there were some physicians that were using the system so poorly, they hated the system, but when you sat there next to their elbow and said, Hey, did you know this was available? Uh, because they didn't have time to go to the full training or they didn't have time that.

Which is training and, and, uh, communication of how to use the system better. That just takes time to, to propagate that. Well, and that's a challenge for us is, you know, we have over 6,500 physicians in our health system. And so, you know, we're taking a two-prong approach. One is to have optimization teams go out to the practices and actually, you know, shadow the physicians, which we find is pretty much the most effective way, uh, to teach them at the one-on-one at the elbow, you know,

Push content out in an enterprise way and, you know, deliver these 10 minute videos that are very quick that they can watch, um, around these shortcuts and, you know, going to their departmental meetings. But, you know, it's, it's a huge amount of work and I think that. It's labor, intensive labor and trying to find different ways of being able to, you know, do this at scale has been challenging.

So we're looking at, you know, developing the power users in the departments, uh, getting more physician builders out there who can really work with the departments, you know, not independently completely, but you know, have a lot more autonomy. Um, you know, we'll.

Uh, more of this configuration work out there in the department. Yeah, absolutely. So getting onto the next topic, so, uh, interoperability. Uh, Judy said, enabling seamless data visibility across Epic customers via one virtual system, uh, worldwide would improve patient care and allow for idea sharing that could lead to medical breakthroughs.

Uh, epic is working to take interoperability globally. Uh, Judy told the attendees. Um, uh, you've, uh, let's see. She goes on to say, you've eliminated the silos from within your organization. Said Faulkner speaking at, uh, at the conference. Uh, now it's time to eliminate the silos from outside. Faulkner was referring to Epic's one virtual system Worldwide Initiative, which it launched early this year.

The initiative enables clinicians across all organizations using Epic. To more easily gather, share, and interact with health data, no matter the location, and presents it in a unified view. Uh, so I'm gonna, I'm gonna spin this a little bit. Let's take this from a different lens. Um, interoperability, uh, as we've talked about, is really good for patients.

We believe it's good for patients. How do you think, uh, you and I as patients will benefit from one virtual system worldwide? And are there any risks or drawbacks to us? The patient. Well, I go back to not every organization has a, uh, has consent, uh, implemented and in a way that, you know, allows a pro prospective consent, meaning the ability to share that data.

And I would also say that, you know, many EHRs, especially in the ambulatory setting, Don't necessarily have the capability of being able to share that data in a real way. Um, you know, there's a cost associated, especially for voluntary physicians that, you know, they may be solo practitioners or, you know, very small practice.

And having the ability to actually share that data with large hospital systems can be very, very challenging. So, While I, you know, share the vision, uh, from an epic standpoint, I think that, you know, on the ground, uh, there are a lot of challenges, uh, surrounding this. When you're, I was going to say, if you are, you know, working at an Epic to Epic site, it's amazing.

Um, you know, I have been, uh, a patient at, uh, different epic sites and the ability for, you know, the physicians to be able to see, uh, you know, the data from the other sites, um, in a prospective way, uh, has been fantastic. Uh, the challenge is, you know, when you're going to these small, voluntary offices, uh, that, you know, don't have that ability, uh, to share the data.

I was with a a, a Kaiser, a physician last night, uh, Kaiser Permanente, and I was just asking him, you know, what's the, what's been the biggest challenge and benefit to the E H R? And obviously he was just talking about within Kaiser, but he said, um, He goes, you know, we, once we, we got it implemented across the board, he said, it's amazing how much time it saved, how much it, uh, organized the care protocols.

But he said, but for the patient, uh, within, within this Southern California market for Kaiser, he goes, you know, we just, uh, the communication is so good and the, uh, the patient experience has gotten so much better because they. You know, I, he goes, I am aware of all the tests that they've had. I am aware of their history, I'm aware of whatever.

And so if we can create that across health systems, that's, that's great. And I, as you said, you know, for an epic to epic shop, uh, I don't have to worry about, you know, does my health system have a good h i e strategy? Do they have a good, uh, mechanism in place? And, uh, at least from, from that standpoint, and even, you know, Cerner has their, uh, their, uh, ability to do that across their partnerships.

Um, But it would be nice to see that across all the EHRs. And I think that's what we're, and, and, and Judy actually noted that they do share across, uh, multiple EHRs with that platform. Uh, utilizing FHIR, uh, standards, I believe is what. Yeah, I think, you know, there are organizations, um, other vendors like athenahealth that are, you know, really progressive.

Um, I think that, you know, they actually Epic and Athenahealth have, you know, the ability to exchange, uh, health records very easily. And I know EPIC is exchange records with many, many other EMRs. But there, it, it's unbelievable, but there's still EMRs out there that it, it is problematic, uh, to share, uh, And we're not gonna mention any names here on those difficult, no , there's no, there's no wall of shame.

So, uh, research and discovery. I thought this was one of the more interesting and, and, uh, I think hopeful things that was talked about at the conference. And that's, uh, what Epic is calling Cosmos. And that's the, uh, world's largest, uh, uh, clinical database of information, uh, de-identified information that can be used for.

Um, uh, be used for research and research purposes, which I assume as an academic medical center, uh, you know, this is, this is a, a, a huge, uh, benefit to organizations such as yours and the Biden Cancer Initiative and other things like that. Um, you know, I, I didn't get much from the stories that are out there.

I assume this is more. Uh, like aspirational at this point. Not there, were, there actually, were there a lot of details shared? I guess I should just ask the question on, on what Cosmos is gonna do when you can have access to it and, and who's gonna, uh, who's. You know, I did not see a lot of information shared.

Um, we had our chief, uh, research informatics officer, uh, also attend the session. And, you know, from from that we decided that we're going to bring Epic on site, uh, for a deep dive, uh, with our research community because, you know, the information, um, that we received, um, you know, was, it was light on detail at this point.

Yeah, but it, but it is exciting. I mean, to, to have the, the more information that's available to, uh, researchers such as the, the ones at Mount Sinai, uh, it's, you know, it's, it really is gonna be, I think it's gonna benefit humanity that we, um, Just have, have, you know, better research being done based on the data.

Um, yeah, I mean, the ability to share, uh, de, de-identified data, uh, amongst other institutions and being able to collaborate that way is going to improve research, uh, exponentially, I think. And there, there's a lot of arguments over how and who benefits and where does money go. And we're gonna avoid those in this because you have a hard stop.

And I wanna get to another question. So safety and privacy. Uh, the last things, you know, she mentioned, uh, Zuckerberg, uh, going to the hill, Cambridge Analytica, you mentioned it earlier. Um, so Epic plans to develop tools that when third party software applications, um, healthcare providers and HR vendors, uh, being the other parties ask patients for permission to access their medical records.

Epic can tell the patient what the application is likely to do with their information. So Epic's gonna act as this sort of gatekeeper to say, Hey, what? What are your intentions? And then they pass that information along. Uh, critics of Epic have, uh, previously called the company's software closed platform and argue that software was limited and its ability to easily exchange data.

Um, echo has muffled some of those critiques by configuring and keeping. Tools to be able to share information. They're participant, obviously with Apple's, uh, health kit. Uh, they're, they participate with fire, they have open api I, while they have APIs through App Orchard. Um, and, uh, let's see, social norms have changed and if patients wanna share their data, they should be able to sit, uh, submit.

Rana. However, Ranana said that a typical meth, uh, medical record not only contains identifying information about patients, but also genomic data and information about their family and family history. For example. Above all, people should keep in mind that long-term consequences of clicking. I agree on a computer or smartphone apps, terms and conditions screen, and she closes out by, say, consider, consider.

Uh, the implications of uploading the protected health information of a minor, um, as an adult, they could very be, uh, could be very upset to find that mom opted to share their personal data with an app 20 years ago in exchange for bonus points on their favorite game. Um, so how was this received at the conference?

I, I'll, I'll give you, uh, you know, just some. Some things that I've heard from, uh, the development community. Uh, but how is this received and and what are your thought, uh, just, you know, how is it received at the conference, I guess. Yeah, I mean, for the people I spoke to, I think everyone thought that, um, you know, Epic's intentions were really good.

I think the, uh, challenge is going to be around, you know, the vendor reaction, um, around this and, you know, are they going to be collaborating with Epic? Uh,

Epic is gonna be working with the third party. So, you know, I think more to come on that. Um, but I'm interested to hear, uh, what you heard from the development community. Well, it's, it's interesting. The development community is scared of Epic. So it's, you know, so I get these comments and I'm like, so do you want to come on the show and talk about this?

And they're like, no, I don't, I don't. If I come on the show and talk about this, it could decimate my company. So I, I'll just, I'll. And really no commentary on it. Just, just, you know, the foundation for this thinking is that, um, the patient needs to be protected from themselves or better yet, that the patient no longer holds sway over the record because, uh, it really holds information about the family.

If you get my d n A information, if you get my genomics, you're really getting information about my daughters and my son. Uh, and, and I'm, I'm sharing that information or I might share their information, uh, when they're a kid. So it's an interesting, uh, new tech take, but it's the foundation is we need to protect you from yourselves.

Uh, the fear factor. Um, being, you don't want to be, I mean, the fear factor that she sort of laid out there was, you don't want to be the next one on the Senate floor, uh, like Mark Zuckerberg, you know, sweating while, you know you're getting grilled. Uh, and it really is, uh, a fear, uh, fear factor and it's, it's brilliant marketing also sort of pushing people in the, uh, in the epic direction.

But here, you know what I'm. You know, it, it, it really places the attendees in a position of, uh, first of all, they, they feel like they're doing the right thing. They're protecting the patient by limiting their ops options to access the data. Um, and Epic now access the ultimate gatekeeper in the role. You want to innovate on our data.

Uh, you have to ask permission, pay the toll, and we'll determine if your attentions are nefarious. Oh, and by the way, if you read Epic's agreement, nefarious can be defined as bad for the patient or just. Bad for Epic. If it's competitive to Epic, it can be bad. Uh, and so these are the things I'm, I'm hearing from the development community, which is, okay, so now Epic controls that data, um, and it's not really Epic's data, it's the patient's data.

And if it's not the patient's data, we can argue that it's this health systems data. Um, At the end of the day, uh, you know, there's, there's, this is a very nuanced argument. I get both sides. I get, I get Judy saying, Hey, look, uh, we've gotta protect, we've gotta create a mechanism where people know what they're agreeing to.

Um, we don't want them giving away information. To bad parties. I get that. I get Epic's intentions, but I also hear that the developing development and innovators saying, Hey, wait a minute, do you realize how much I have to pay Epic to get access to this data? And, and when I do, I, I have to follow their rules and I can't compete with them and I can't.

And they could easily come out with something that crushes our company in two years. So I, I hear both sides of it. I, I don't have an answer, I'm just sort of teeing it up, I guess. Yeah. And I also think, you know, for the academic medical centers that, you know, are, you know, doing their own innovation and, you know, working on their own, uh, products that they ultimately commercialize, you know, such as Mount Sinai.

As an innovative health system and you know, as well as other third parties, uh, because sometimes Epic does differentiate between, you know, the health system innovation and the third party vendor, uh, innovation. So that will be a nuance we'll have to work through with them. And, you know, the devil's always in the detail.

With Epic and you know, they do listen to customer feedback. So, uh, it'll be a topic that, uh, we engage them on pretty quickly. Well, we're gonna get into the questions, but just so people don't think I'm wishy-washy, I've been very clear on this. I believe that the patient owns the record. I believe what, regardless of if we can trust the patient, uh, it's not really epic's, uh, place to protect me from myself.

It's my data, it's my health, it's my children. I don't want the government that tightly. Overseeing what I do. I definitely don't want epic tightly overseeing what I do. Uh, I've been on the record as saying that. I just don't wanna come off as wishy-washy yet. But with that being said, I under, I, I completely understand Judy's intentions of protecting my parents who don't know technology and can click on things.

I, I get it. I understand where they're coming from. I, I don't like it, but I get it. It's a very difficult problem to. Um, there's a quick section, you know, shorter, shorter answers are great 'cause we're gonna cut these up into videos and put them out there on the YouTube channel and out on social media.

Um, so five questions. Let's just, uh, we'll rifle through 'em. First question, uh, what are some of the new business models you, uh, you're seeing within healthcare and, uh, that are really changing healthcare at this point? No, I think that health systems are moving in a direction of being, you know, integrated outcomes based and, you know, being able to, you know, really support empowered consumers.

And it goes back to some of the topics we were talking about earlier around, you know, mobility and customer relationship management, and how do you engage you. I think that health systems are going to be exploiting digital platforms, uh, ultimately, uh, to support, uh, these business models. Yeah, absolutely.

Um, so second question. Um, you know, what are, what are some of the digital trends that you're seeing within healthcare? So we talked about mobility, we talked about c r m, um, you know, definitely telemedicine. Um, you know, there's a lot of trends in machine learning, predictive analytics. We actually had, um, The head of our data science team do a great presentation at the Epic gm, uh, Robbie Freeman on some of the predictive models that Mount Sinai has developed, uh, independently of Epic and then ingested it into Epic, uh, around sepsis.

Um, so I think that that's definitely going to continue to be a trend, uh, wearables, uh, blockchain. Um, you know, I think that they're probably, you know, the major trends. Yeah, I was at a, I was also at a conference this week. I was actually just at a one day of a conference this week where I got to hear the, uh, uh, uh, head of Nvidia talk about, uh, ai.

And, um, it, it was fascinating to me to hear, uh, one of the, one of the, I think, more fascinating things that he said was, um, You know that the, the next generation of data pro of programmers are gonna be the, the data scientists, not necessarily programmers that write code. 'cause the AI itself is gonna write the code.

But what you're gonna do is you're gonna present the data to the, uh, to the AI in a way that the, the, that is the person that's really gonna dictate how, uh, new algorithms and new code gets, gets written. And so I think, you know, the, the combination of all these trends, digital trends that you're talking about is, is gonna be really exciting and impactful for healthcare.

Um, I agree. Third, third question here is we, uh, we see some health systems investing, uh, in c r m. So let's go into the c r m conversation a little bit, uh, more. Um, where do you guys seeing it? Where do you see it fit within your health system? And, uh, and, and actually I'd love to hear you answer the question of, Who does own it within a health system.

I mean, it, that has been one of the more interesting challenges. Is it a marketing initiative? Is it a pop health initiative? Is it a medical group, uh, initiative? Is it, uh, the call center initiative? Um, you know, where, where does it fit in healthcare and, and, and who owns it? Yeah, I don't think that it fits into one particular group and that that really is the challenge.

Um, I think that, you know, it all comes back to governance and so you've gotta be able to, you know, work with, uh, you know, a number of sponsors. So in our case it is the Chief Strategy Officer, um, and also, uh, the head of population health. Amatory care who are, uh, driving this initiative. But again, we've got governance that brings in every group, uh, across the health system to engage them.

So we have, uh, you know, marketing there, uh, network development, um, our access center. Hospital operations, you know, all represented, uh, in this governance model. So, you know, I think that we've got the right engagement. Um, but again, this is why enterprise c r m, uh, sometimes fails in health systems because there isn't one owner, um, as you correctly identify.

Yeah. And, uh, so you know, you're gonna have your E H R, you're gonna have your E R P, and now you're gonna have c R M. And these are gonna form a, a pretty strong, uh, platform, foundation, uh, across the board. And as we've become, become more, uh, customer centric, uh, yeah, I, I see a lot of health systems looking at C R m.

I don't see a lot of them implementing c R m, uh, on a, on an enterprise scale. So we, we, we will definitely check back with you. After you get done with the, uh, uh, the R F P and, and see how the implementation goes. 'cause I think a lot of people want to hear, uh, success stories around how it gets, how it gets done.

Absolutely. So, uh, fourth question. What, what challenges do you, uh, are you seeing IT departments face and, and, uh, and how do IT departments really need to adapt or change? Uh, do you think? Yeah, I think a few, few areas. One is, you know, many IT organizations are built in a functional model and, you know, I, I think that, you know, they're organized in that way and not necessarily aligned, uh, with a service type model, um, which is aligned with the business.

I think that, you know, sometimes organizationally it needs to, uh, change to be more aligned, uh, with the business. And I also think that the competencies and skillset of, you know, people in the IT department is changing rapidly and we talked about all of those digital health. Technologies and, you know, trying to get, uh, the technology teams up to date on what's going on in the marketplace and educated in these technologies, and again, giving them other skills.

Um, I think that the soft skills around emotional intelligence, communication, understanding strategy is going to be more and more important, uh, as time goes. Many organizations are going through this where, you know, infrastructure and legacy applications become commodities and become managed services or even offshore.

So, you know, we need to focus on where the value is and the values with the business. Yeah, it's interesting and, and this is becoming a recurring theme, so Ed Marsh from, uh, from Cleveland Clinic. Talked about embedding it in the standup huddles, and I know that, uh, Dr. Anthony Chang, when he was talking about ai, talked about how his analytics teams is in those, uh, those lean huddles and those, uh, and does rounding with the physicians as well.

Um, yeah, and we have the same, we, uh, we have business relationship managers that are rounding with hospital operations every single morning at every site. Yeah, it should become harder and harder to, to identify, you know, who the IT people are and who the, uh, business people are. And we're seeing a lot of clinicians, um, you know, uh, head in this direction of, uh, an analytics, um, career path or, uh, or, you know, making, making sense of the E H R or even programming the h r We're seeing a lot of, uh, you know, people take that, that degree and, and head in those directions.

It's, it's fascinating to watch. Um, and, and you know, this is a topic I wanna give you some time on, 'cause I, I know, I know that you're, you're an advocate for Women in Leadership and diversity. We talked about this, uh, the last time we were on the phone. Uh, why do you think diversity is so important to promote?

And, uh, I think the following question for me on this is gonna be, you know, what, what's some advice that you would give women in healthcare it at this point? So why, why do you think diversity is important and advice for women in health? It. So I think, you know, diversity is important. You know, we need to have different opinions at the table in order to solve really complex problems.

And as you know, in healthcare and specifically in it, we've got a lot of complex, um, problems to solve. I also think that, uh, you know, at the leadership level, we need to have representation of our patient population. And when you think about it, 60% and above of healthcare decisions are made by women. And so that's why I feel, you know, pretty passionately that, you know, the uh, leadership has to reflect.

Our patient population and where the decisions are being made, um, in order to engage our patients also. And, you know, I'm very lucky to be working at an organization where, you know, we have great examples of strong executive women. Uh, we had a number of them, uh, recognize. Recently in Cranes and you know, we also, the number one, uh, health system, uh, according to Diversity Inc.

Um, for diversity and inclusion. And we've got a great diversity and inclusion program here. So again, an honor to work at Mount Sinai. Yeah. And well, that would have to be the case in New York City. It is literally the . The epicenter of a melting pot. Um, you, the, the, your patient community is very diverse and, and your care community is, is there anything you, would, you, any advice you would give to women?

I, I mean, I saw, I saw a. Post, I think it was LinkedIn post where, uh, you know, a health system team said, just finished our strategy session, our setting, our strategy, whatever. Great meeting. And the picture had a picture of all the people that were attending. And I, I kid you not, I think it was like 14 men and two women.

And I thought, uh, that's a, that's problematic. Um, but what would you tell, what would you tell, what's your advice to women to get more women in that, uh, in that, you know, executive level? Um, You know, a seat at the table talking about strategy. How, how, how are we going to do that? Well, I think, you know, ultimately it starts with, uh, the recruiting and the pipeline.

And, you know, if you are, uh, an executive, it doesn't matter, uh, what gender you are and you're receiving the same resumes over and over, uh, the ans the question is why. . And so you've gotta go back to HR and you've gotta look at, you know, the pool of resources that you're trying to pull from. And that's not just the gender, it is also for underrepresented minorities.

And, you know, so I think that that's where it starts. Um, I would also encourage, um, you know, female leaders to engage, um, the men in their department, um, as allies. Because just having a discussion with other female leaders, Great. And I think that, you know, it helps other women in the department, but ultimately we have to engage the men, um, in this endeavor.

So if there is, you know, a room full of men, um, I think that, you know, the question would be, you know, where are the women? I think that, you know, women leaders and, and men leaders need to bring in, um, other women into the meetings. Um, even if they're, you know, directors or senior directors, just to give them that exposure.

Give them the seat at the table and hear what their opinions are. I think if more and more happens like that, um, we'll get some progress. And I also think mentoring is huge. Yeah. I know that, uh, you know, sometimes it's a challenge, uh, for, uh, women. I've heard many, many women say there's not being mentored by a female leader.

So I really encourage mentoring, um, at our health system and, you know, we've got a great program here. Um, but I would encourage, you know, other health systems and hospitals have a mentoring program and have, uh, women to women, uh, mentoring. It helps. Yeah, be a mentor. Seek a mentor. Um, and, and I think that's, that's a great way to, uh, to end the show.

Uh, Christian, thank you very much for coming on the show. I know you're very busy coming back from the conference and then your first day back in the office. Uh, are, are you active on social media, uh, at this point? Uh, mainly LinkedIn. Mainly LinkedIn so people could follow you on LinkedIn. Uh, excellent, uh, not, not too hard.

Uh, Christian Meyers, uh, m y e r s at Mount Sinai Health System. Find her on LinkedIn. Uh, click follow and, and you can see, uh, what, what things she's talking about. Uh, you could follow me at the patient cio, uh, on Twitter. You can follow the, uh, show at this week in h i t. Uh, you can check out the website this week in health it.com.

Catch all the videos on the YouTube channel that we talked about earlier. This week in health it.com/video. And don't forget to come back every Friday for more news information and commentary from industry influencers. That's all for now.

​