This Week Health

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The VA CIO just stepped down. Ed and I embark on a thought experiment of what we might do if we were asked to step into the role. Plus seven rapid-fire questions from precision medicine to the future of work for Health IT. A packed 40 minutes of insight.

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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 15. It's Friday, April 20th. Today we take on one of the hardest roles in the country, A C I O Veteran and I will play a little game on what we would do if we were named the C I O at the va.

This podcast is brought to you by health lyrics. Get ahead of the wave. We believe every health IT organization has it within them to be great. It all starts with clarity. Visit health lyrics.com to schedule your free consult. My name is Bill Russell, recovering Healthcare, c I o, writer and consultant with the previously mentioned health lyrics.

Today I'm joined by Hims Chime, c i o of the year, I believe our third on the show, author of the book, extraordinary Tales from a Rather Ordinary Guy, former C I O at Texas Health Resources University Hospitals in Cleveland.

Of Cleveland.

Thanks, bill. Thanks for having me. I'm so excited to be part of it. Well, I, I appreciate you coming. The uh, uh, uh, normally I'd go through the bio, but you know, as with Halamka, I can't read your whole bio 'cause you've done so many things. Um, I think a better way for people to get a sense of who you are. I, I was hitting your LinkedIn page last night and read, uh, your most recent article about your third brush.

Death, that's, uh, three more than I've had. And, uh, it's really a pretty, pretty compelling story. Um, can you share a little bit about that story to get, to give people a sense of who you are? Yeah. I'm, I'm learning a lot more about healthcare and technology actually as a result. So I'm very, very thankful despite the circumstances.

Yeah. So I'm. You know, when it comes to health, I'm a pretty good picture of health. I, I take care of myself and so all my vitals are stellar. You know, my cholesterol is one 40. My blood pressure is like one 10 over seven. My resting heart rate because of all the exercise I do, and perhaps some genetics is 40.

So, and I get taken care of all the time. I get screened. I, I had, I do have some high risk. Things that I do, whether it's climbing mountains or, or competing internationally in triathlon duathlon. So I get screened extra. In fact, a month ago I had, uh, some extra screening done just to make sure that, you know, I'm continuing to be healthy.

Well, anyways, so you take all that and I'm doing a race in South Carolina. It's the 2018 National Championships for U S A Team, U S A for Duathlon. It's the sprint race. There's a couple different categories, but which one happened to be sprint? And so I was tooling along towards the end of the race and I was laying down probably like six and a half minute miles and it's a run bike run.

So I'm on this last run and then all of a sudden I felt my chest tightened, just like you read about, like it felt like someone sitting on my chest. My chest tighten. I thought, man, that's weird. And, and I thought, well, maybe it's 'cause during the bike, you know, during the bike portion it was raining and it, you know, you're going about 25, 30 miles per hour and you're holding on for dear life on the, on the handlebars because you're literally like inch or two from someone else's tire, right?

So one, it's bad news, so you're really gripping down on the handlebars. And I thought as I was running, maybe it's 'cause I was so like tight in the chest during the fight that it finally caught up with me and my muscles were freezing up a little bit. And, uh, it, and I had no shooting pain down the left arm.

I had no jaw pain, I had no nausea. I had no other classical symptoms with this tight chest. So I started breathing a little bit heavier, trying to get breath in, and it was fine, but it definitely felt like something was wrong. And so I, I thought about, okay, I about two miles left. Do I stop and try to find someone to help me?

There's definitely people along the course that could help. And I thought, well, if something's really wrong, by the time the ambulance gets to me, Cuts through all the traffic. There's high traffic area, there's a race going on, it's gonna be 10, 15 minutes. I thought I'll just outrun this thing. It'll be fast for me to run.

So I just kept running. A good friend of mine on the team passed me and he's like, ed, follow me. 'cause he knew I was going a little slower now. And he is like, follow me. And I tried to follow him, I just couldn't do it. I was like really weird. But I was still put putting about a 7, 7 15 pace, still chugging along.

So anyways, I finished the race, you know, and I was like very excited about that. I made team u s A. For, for the next year's World Championships. And, and, but I still felt this pressure, so I checked myself into the bond, secures had, uh, emergency medicine there and I said, I, this feels really funny. I'm otherwise healthy male and something's wrong.

And so they did an E K G. There was enough to show there that there was a problem. Stuck me in ambulance. They did another E K G. I definitely was having a.

Yeah. So then, yeah, so then by the time, the cool thing of the story, sorry. The cool thing of the story is while I was waiting in the ed ready to get taken to the cath lab, the interventionalist cardiologist came up to me and my, my company, the, the place that I served, the Cleveland Clinic already had been talking to.

So the number one foremost cardiologist in the world already talking to this doc in South Carolina. About what they're gonna do and how to do it and all that kind of stuff. He turned out to be awesome. The cath lab was already prepared, even though it was Saturday, early Saturday morning. 'cause there was another emergency right before me that they just finished.

So I went from, uh, bedside, not, not bedside, but door to balloon in less than an hour, which is very key. And then he allowed me to watch the whole thing. So I'm laying there flat on my back and I'm watching him perform his artwork and, you know, stenting me, um, putting a stent inside of me through my arm.

It was amazing to watch. The heart reignite with the blood and things started flowing and everything got back to normal. And so far and prognosis has been on completely normal. Uh, no damage to the heart, no permanent damage to the heart. And so now I'm just chomping at the bit. I'm allowed to do some exercise already chomping at the bit for more, but the cool thing is I'm starting to utilize, you know, uh, Bluetooth blood pressure, e k g, heart rate, all that kind of stuff.

And I'm getting my cardiologist who's. Hadn't used it before, we're putting it directly into our electronic health record so I don't have to like go report it manually. So that part of it's kind of cool. It's like, ah, I get to experience what, what we talk about digital strategy, digital health, and we're actually doing it on myself.

And you know, I love this, I love the story from that aspect, but I also love the story from the other aspect where you, you really encourage people. You have 13 things in there. Uh, talk to them about, uh, You know, things like reconciliation, identity, uh, personal responsibility, and, uh, you close with exhorting, everybody to really live life to the fullest because this is the, uh, the, you know, this is the only body we get and, you know, make sure you make the most of it.

It, it really is an awesome post. And I, I think one of the things I do appreciate about you the most is you don't shy away from sharing the personal, you don't shy away from, uh, You know, talking about things that other people tend to try to keep it all business and you, you share, uh, well beyond that and I appreciate that.

Yeah. I think it's so important to be authentic. People want authenticity and I'm not embarrassed about it, you know? Uh, I definitely prided myself on being an athlete on a team, u s A and all that kinda stuff, but you have to be authentic. And then the more you share, the more benefit there is for other people.

So I'll give you an example. I had a couple people come up to me and I won't give any more detail than that because I, I don't wanna in any way give away who they, I'll speak with you. But since that time come up to me and confide in me that they had a similar episode in their life where they had stem me, they've never told anyone, and I'm giving to myself, come on guys, we are in healthcare.

Let's share this information because maybe with you sharing. I learned some life lessons through you. I don't have to go through the same ordeal, but I learned to pick up the phone and call someone who I love that I haven't had a relationship for a long time. 'cause of your encouragement. You know what?

What that person could have done that or that person could have told other people about it and said, Hey, even if you have a great health record, do this. Everything looks perfect. Do this test, do this calcium test, do this other thing. Because had I done it, I wouldn't have had to go through that. So that's why I think it's so important to share with others.

It's like there's so much, uh, that we can gain from other people's experience. There's no reason that everyone has to suffer a heart attack to learn these things, right? Yeah. And even the description that you gave of, Hey, this is what it felt like and this is what it, it, how it sort of manifested itself.

I have, um, history of heart, heart issues in my family. That's one of the things I asked my dad. I'm like, how am I gonna know when this happens? What's it gonna feel like? What's, and, and we know that, that from the moment it. So the moment you're, uh, you know, you're, you're getting worked on, I mean, that, that timeframe is, is very critical.

So part of it's identifying it and just hearing these stories helps people, uh, along the path. So one of the things we like to do, uh, before we really jump into the media show is just give our host a, an opportunity to talk about, um, you know, what's, what's one thing that you're, you're working on or something you're, you're excited that you're working on right now.

Yeah. I'm so excited about digital health strategy, not just because it's ironic in the middle of this. , um, all this happened, um, but you know, when, when we started, you know, we have a fairly new team and we had a heavy lift to do and we started seven months ago, and the first thing we did, you know, stop the bleeding and, you know, so we put together a cybersecurity plan, all that side of thing.

We, we set, we got it funded, and we're kicking on it. And so we set up governance and our, our CEOs, the co-chair of our. It steering committee along with myself, and we got, uh, this whole P m O developed and we did a lot of the basic stuff. The next thing was to develop a IT roadmap. So with, with this governance structure, with this IT steering committee, we developed an IT roadmap, four year roadmap, first year mostly funded.

And so with the basics in place, and we already have good analytics and we've got good electronic health record. With all that in place, we were ready for digital. So in, we're also an agile organization, so we, everything we do is agile. So we took the same approach with developing our digital health strategy.

So in six weeks we did three, two week iterations. We developed this, uh, digital health strategy, which on Monday was endorsed for the next phase. So, So exciting. So that's the one thing, you know, I I, I'm so excited about because that's really the nirvana for us, is how do we take advantage of all the technology that's available today and do some things that'll really enable the mission of our organization to save people lives.

Our patient first culture. And, and you know, what we do at the clinic, which is cool, is it's really global. So whatever we do here, we work with our global partners around our enterprise, around the world. And, and we, we amazing things to help our caregivers give the best care in the world. Yeah. I mean, you, you really do have a great opportunity.

Somebody wants to ask me, you know, if you were going to go back to being a c i o, where, where would you go? And I, I said, Cleveland Clinic would be one of those places. 'cause you, you're surrounded by such great team and, and such great innovators and, and uh, and really a global reach. I mean, with the things that you guys are doing now.

Yeah. Sometimes I was at lunch with someone today and I was just sitting there thinking, In fact, I just met with my C M I O and I had the same conversation with her. I said, wow. Yeah, it, it's humbling. It's totally humbling. It's honoring and you, you realize you're in the midst of giants and you just wanna do your very best.

Yeah. And, uh, just keep reminding yourself. And on the bad days, just keep reminding yourself of that. 'cause they're, you know, any healthcare, c i o will tell you there's, there's peaks and valleys, so, Totally. Um, alright, so what we normally do on the show is we, we take a look at the news, we do, uh, leadership or tech.

Then we go into, uh, our favorite social media post. Uh, Uh, I'm, we're just gonna do one news story this week and play a little game with it, not a game, but we're gonna play a little, uh, scenario with it, uh, because I really wanna spend a little bit more time in the second and the, uh, so I'll, I'll tee up the story a little bit and give our listeners some background.

So the, the Va c i o, Scott Blackburn, uh, resigned. Recently, it's in the, there's a federal Times, uh, dot com story about it. And what I'm gonna do is I'm gonna give a little background of what's, what's been going on there. It's, it's very public and, uh, hopefully set up a conversation that we can work off of some of the, some of the, uh, last articles you did for his talk around what you do to prepare to be a c i, what you do in those first, the first day, the first hundred days, and what you're trying accomplish.

Tee this. The VA exists within a larger, uh, ecosystem. You have the d o d, you have the Coast Guard, and you have the va. They all have their E H R stories. Uh, the patients obviously are, are heroes. They're, they're brave men and women who are, uh, fighting for our rights and protecting us, uh, around the world, and we wanna give them the best healthcare possible.

Uh, the situation around the e r is very public, uh, and, and very political, right? One EHRs. As measured by surveys that have been done over the years, and they launched a project to replace their E H R with a, uh, Cerner millennium, uh, product in the project. It's called M h s, uh, Genesis, and they're rolling that out and it's getting, uh, pretty good reviews at this point.

The Coast Guard had a failed E H R implementation for whatever reason. Could be change management, could be whatever, but they had a, failed the HR implementation with Epic and, uh, they hit the reset button and they chose to latch onto the. As they say, the requirements are, are relatively the same, and so they have sort of come together and now you're gonna see, uh, uh, the same E H R product, uh, across the D O D and the Coast Guard.

And then the, uh, the va, which was one of the pioneers for the E E M R, uh, has a uh, uh, product called Vista, built on top of C P R S, uh, source. Really is available to anyone out there. They recently did a no bid contract, which was given to Cerner on their Millennium product as well. Very public, very controversial.

And, uh, just one more piece of information here, so that the va, as I said, was it was a pioneer in 2008. A, B, C did a segment dedicated to the E M R. And they, uh, and, and they, they talked about the va. They highlighted how the, the electronic medi medical record had led to fewer medical errors as we know, more effective treatments, lower costs, and higher patients sat.

So they were a pioneer. They're at the forefront, and they, uh, really laid the groundwork. So there's a, there's a history of success to build on. Okay. That's the background. We just make you c i, you and I, we just became, uh, c i o for the va. In fact, let's do it this way, in 30 days, we're gonna become the C I O for the va, and we'll break this down into what are we gonna do between now and the next 30 days to prepare ourselves to become the c I O for the va?

What, what would you tell people? About the, the next 30 days as you're getting ready. Yeah. Fir first as a veteran, myself and the son of a veteran and brother and sister of veterans, you know, I would feel very honored and humbled also by that very sacred patients that they take care of. And so I would approach it very, um, you know, obviously very seriously and, uh, with purpose.

And so, you know, like what I usually talk about is in your preparation, the first. Pre 30 days is you always have to be true to your current employer and then true to your family because, you know, when you start this new job, it's gonna require a lot of effort, a lot of extra effort, so you may not be available as much.

So I, I'd really take care of those two things first, make sure there's good transition where I am. And make sure that I take time with my family to the extent I can get involved still. I like to do that. I did that before arriving at the Cleveland Clinic, so I learned as much as I could about the organization.

So I had them send me a bunch of information, so I requested a lot of information, and then depending on that lead time, I had opportunity to have. Weekly meeting, so I had about six weeks lead time and if you afford that luxury, it's nice just to get engaged a little bit ahead of time. So that tho those are the sort of things I would do is whatever research I could do ahead of time so that when I arrived on day one, I could sort of hit the ground running.

Yeah, and there's a lot of wisdom in that. And I mean, the two two things I would say is, um, I, I went into my role as a c I O with pretty bad habits. They don't get better when you . Start the role they get, they get worse. So I ended up putting on 30 pounds and lived a pretty unhealthy lifestyle for about six years of my life.

So I, I'd say if all you have is 30 days, make sure you get your habits in line. You know, spending the quality time with your family is important, uh, health wise important. So make sure you get all those things and, and recognize they typically aren't hiring a c I O 'cause everything's going swimmingly.

Very rarely is that the case. So, Your first year is probably gonna be a very busy year. So, uh, yeah. So getting ready. So what are you trying to do that first day? The first, uh, let's just say the first 30 days, uh, you hit the ground running. What, what are you gonna do for the VA in that situation? How are you going to engage?

Yeah, so what I do next is really hit the ground listening. So if no matter where the organization is and where the VA is today, it's, it's not gonna get profoundly worse or better. By you not getting super engaged, you know what I'm saying? There's probably a steady state that's occurred over time, and that steady state is okay to continue.

Now, it's different if you inherit a situation where things are tanking, but in the va, you know, it's, they're, they're dealing with stuff, but they've been dealing with the same stuff for a while, so you need to take the time to listen. And to develop relationships. 'cause ultimately that's what's gonna help you is knowing what the issues are.

And you only can do that by listening and meeting with people and then developing relationships because you, one person's too small a number for greatness. So you're gonna have to be reliant on a broader team, not just it, but also outside of it. So I'd be spending. I would be spending a lot of time with, with, uh, my peer group, with my direct reports, with the senior leadership, the organization, and then the time VA is a big place.

And so it has a lot of sites across, across the United States is, you know, starting to slowly make my way out into de developing these relationships and understanding what the, what the issues are. That would be probably the first thing. Yeah. And, and you know, I think one of the mistakes we make, uh, or, or at least early on in our careers we make, as we get older, we recognize that this is not the case.

But, um, they're not looking for a hero. They're, they're not looking for somebody who's gonna come in with all these great ideas and change everything and that kind of stuff. It really, you're, you're coming into something that's already going on. Uh, as you said, the VA has, you know, a long history. They're doing a lot of great work.

There's a lot of great people there with good ideas and good thoughts. I. They, they, uh, I think Flaka sort of mentioned this as, you know, it's the convener. It's the person who's, who can bring people together. It's the, uh, gen, uh, generative questions that, that make everyone a little better. I mean, that's really the role of the c i o is to inject some of the technology and what's going on in the industry.

But for the most part, the people we're working with are very knowledgeable. They already have a pretty good background on the technology, and we just, we come into a story that's already in progress. And, uh, maybe add color and and direction to it because of, uh, the distinctives that of who we're, yeah, you have to, you have to take a very balanced approach and you have to respect those who are still there, those who have left and not think that you know it all.

So that's, that's a, there's some expectation that people want you to come in and fix things right away, but you have to avoid that temptation. 'cause one, you can't, you'll fail. So I always look at it as a marathon. We're talking about running earlier. You gotta look at it as a marathon. It, it didn't break in a day, it didn't break, you know, in a month or a year.

It probably broke over time. So you take some time to do it right. Yeah. And there, I mean there are some things you have to, I mean, you, you mentioned cybersecurity. There's some things you have to fix immediately. I, when I came in, the data center had gone down eight times in six weeks, and it was , welcome to the show, fix that.

Immediately. So, um, do you set like, Hey, in my first a hundred days I wanna accomplish this? Or is there a, I mean, first a hundred days I, we look at the presidency and we say first a hundred days mark. So pretty important. Is, is the same thing true with the c i o or is it more of a longer term view? I think you have to look at definitely at the long term, but.

I think it's important that you have a plan for the first 90 days. So I literally had a plan, which I shared on his talk. As you mentioned, 120 day plan was the pre 30 and then the next 90, and then towards the next 90, you developed the next 90 day plan. And so that manifested itself in, and I developed that next 90 day plan with my direct reports so that they were involved in, in that planning effort.

But, but I knew the basic things I needed to do. I had a list of everyone I needed to meet. There was over a hundred individuals that I wanted to meet in the first, I think I did in the first 45 days. Just 'cause it took a while to make appointments and things of that, that nature. So it was hit the ground listening, but I had a plan.

I had to down to that detailed level of who I needed to meet with and by what time. And then, you know, what did I need to understand? And then what did I need to publish? So at 30 days, I published, so this was my plan. I published my 30 day analysis, and then I had a 60 day analysis and a 90 day analysis.

And I shared this with my boss. I shared this with my peer group. I said, these are my findings. This is where I. Needs to have attention. And then within the, so if you take that 90 plus, that 90 a deliverable in there was the IT strategy, which we did . So that's the, is that the three-year plan or, or the five-year plan that you talked about?

Yeah, it's a four year, it's a, actually it could, I think it's four or five year IT road, we call it IT roadmap. But yeah, I, in my plan, I said by month six we will deliver a roadmap. And that was based on the listening tour. That was based on my team input, part out, external partner input, some personal experience.

We put together this plan and we delivered it exactly to the IT steering committee on my 180th day. That's, that's fantastic. I, and I like the fact that you've, um, split out delivering the plan from, uh, getting funding. 'cause I know for, uh, you know, I delivered a five year plan and it took us almost six months of going back and forth to, uh, to get that funded.

And that's, that's a completely different process a lot of times. Yes. So, um, alright. I, I'm gonna, I'm gonna, the, the, you know, given what's going on in the E H R project, is there any words of wisdom? I mean, there's gonna be a next c i o at the va. Um, any words of wisdom you would give them to how to build consensus or alignment around either staying with Vista or going to, uh, another uh, platform?

I mean, what, what would, what would you, what words of wisdom would you impart? Well, bill, this, this provides us opportunity to be a little provocative. And, you know, maybe it's time to blow up the current model and try something completely different. So, you know, when I think about how we, we deal with electronic health records today.

We, we have, we have the record and then we had, they didn't have very good analytic capabilities, way to build analytic capabilities. A lot of time externally to. and then, uh, we had to build decision support sometimes separately or wait for catch up. And, and now, and there's several other examples, mobility, now we're dealing with, you know, digital health and sort of the future and, and we're having to wait or catch up.

So I wonder what would happen if you're in that role and there's gotta be a big spend anyways. Maybe it's time to start . From and build something brand new that's interoperable, don't have to worry about interoperability anymore. That incorporates everything in that whole lifecycle of, you know, what we call digital, but all the way down to the more mundane things, the base foundational foundation, and it's this platform to which we can then add on.

Anything that we wanted to in the future, you know, whether it was fire or whatever, sort of APIs, that, that to me is a provocative, uh, concept. And maybe it's the fire that's needed to move legacy vendors into the modern era. Yeah. It's, uh, you know, it's interesting that you say that. 'cause the, um, the discuss, so they did a.

They did a survey of all the, they did a survey just in general, should they move, should they not move? And generally people are saying, Hey, stick with Vista. And, um, I think I would take, here's my approach. Um, first of all, the va um, doesn't have to worry about billing for the most part. I mean, there, they're, you know, the, the federal government is paying for those services.

So a lot of the, the E H R. Innards of the E H R if they go with Epic or Cerner or whatever, is around that whole billing mechanism and, and funding mechanism. And so a significant portion of that is almost irrelevant within the VA environment. So I, I tend to agree with you at the, uh, rethinking how they do it.

I don't, I don't like the idea of rebuilding the e h R from, from scratch only because it's already there. And really what we're looking for is, uh, better transitions of care. Interoperability and, um, uh, integration with, with digital, uh, digital tools and digital strategies. So I would, I would clearly define the problem set that we're trying to solve, and then I would take your approach and say, alright, I.

These are the, these are the problem sets. Do we build on top? Do we allow this to run the, the hospitals and the clinics? And then we build on top of that? In which case, you can be very prescriptive when you go to the e H R providers and say, uh, look, you don't own our data. We own our data. We need our data to be able to move in this way.

And, and, and really be prescriptive to that. I mean, if you're gonna write a, you know, $15 billion contract to Cerner, you should be able to have some. Sway into what they're gonna be doing, don't you think? Absolutely. And that's what I'm saying with that, with that sort of scale and spend, you know, it, there's, there needs to be a catalyst to help modernize.

Current state of things, and, and, and that might be one of the catalysts, you know, to, to sort like that. It would be, it would be, uh, it's very provocative, very fun to, to think about. Uh, maybe they'll, uh, maybe they'll call you up after this episode and, and offer you the role. And, uh, I know you're very happy where you're at.

So, uh, nobody should get too concerned at this point. Um, leadership or tech talk, we're gonna. We're gonna do something a little different here. I'm just gonna rapid fire some questions. I'm not gonna respond to 'em. I'm just gonna give you the questions. I'd love to hear your thoughts on it. So I have seven questions.

First one, how is Precision Medicine going to change healthcare in the next three to five years? Yeah, three to five years. I don't think it's going to have a massive change, but I think after that period it will. We're starting to see the benefit already. Taking a lot genomics data, putting it together with our electronic health record data and being able to do predictive analytics on likelihood of a certain type of, uh, ma.

And then as a result of knowing that, again, the genetics and the overall health, being able to, with precision target a, uh, uh, a remedy for that. Um, so we're seeing that already, but it's early stages. I'm hopeful that, you know, towards the end of that timeframe that it'll be a major difference. You know, I could see us doing three d printing for specific drugs right now.

Everyone gets the same drug, right? You have certain dg you get this drug, but the efficacy is 50%. So I can see in the future, hopefully closer to three years about thinking the backside of five year part. Uh, we'll see a, a big difference. And in prep for that, I can't keep my mouth shut, but in prep for that, Geisinger is actually moving towards collecting genomic data on as many of their patients as they possibly can.

'cause they know it can have an impact. Alright. Question number two. What do you think the, uh, what do you think innovation and patient engagement is going to look like from, let, let's just stay at the provider from a provider standpoint, what's patient engagement gonna look like? So I think it's gonna be, you know, wrapped around customer relationship management and really knowing the patient at in-depth level, not only the, the genomics that we talked about, but also from a social perspective.

And like the example I was giving for myself now is, you know, I'm very connected with my provider, unlike in the past, right? So they automatically get the speed of my E K G and my other vitals. And they'll have this real time data and hopefully, we'll, we'll layer in the analytics, you know, whether it's chat bots or machine learning.

We call it augmented intelligence that will alert them. Not that they have to look at all that information because they don't have time to do that, but there'll be algorithms and bots that look at all that information and alert them there's issue. Yeah, I agree. And that was one of the biggest challenges.

Doctors, uh, we were trying to bring that data in. The doctors were saying, no more data there. The, they're, it's two, uh, too crowded, too busy right now. And, and I think that machine learning and AI and the bots are gonna help to sort of sift through it. Question. So, Um, this actually impacted me, so I, I really wanted to share it with others.

So we had a conversation early on in my healthcare c i o tenure, and you said that you bring in, uh, you take your team out and you bring in people from outside of the, uh, healthcare industry to have discussions around strategy, trends and technology. Can you give us an idea of what you did, why you did it, and what, uh, benefit was derived by your team and the health system by interacting with organizations outside of healthcare?

Of course. So I think I first learned this technique when I started to be on a couple of boards for organizations. And instead of being a bunch of healthcare CIOs, there was a C I O from Kellogg's. There was a C I O from Colgate and Wrigley's and, and I remember just learning a lot from them and different perspectives.

I thought, wow, I wanna hang out with that person and not just myself. I want my team to hang out with that person. So then we started doing that. So once a year I'd pick a different company. Meet with those companies. I'll give you, uh, one example, P one. So P one was really good at data analytics. They, they had this amazing, uh, performance in revenue and when I asked about how they went from a penny stock to, you know, a very successful company, it was all around analytics.

And so we met with them and talked to analytics. We were about to launch a big bit bi analytics endeavor at my organization then, and we learned so much from them. And one thing was they watermarked all their reports, whether they were online or hard copy, they were watermarks, so c e o, and everyone knew that you could trust that data that came with that watermark because it was part of their bi.

As opposed to someone else creating a spreadsheet, giving out data, you know, if it.

That it had our watermark on it, you knew you could trust that source of information. So that helped with our credibility and, and the standardization and, uh, you know, going from many different data sources to one. So that's one example. So I, we do it all the time and we've got it some planned here as well.

Yeah, that was, uh, I, thanks for sharing that with me. That was very powerful. So question number four, um, are, are there any technologies right now that you're keeping an eye on, maybe that you're not? You're not implementing or doing a deep dive on, but that you're, uh, you know, uh, piloting or, or playing with?

Yeah. Well, we, we have an amazing development team. They, they do all the, I call it g whiz, my, my term of that. They do all sorts of g whizz technology. And one is, um, you know, taking some, some P ps capabilities. So we have patients that we, we don't admit them to our facility, but we allow them to heal at home.

Right. It's a, the patient satisfaction is higher. Quality of care is the same or better and the cost is half. So we developed this application for our, our, so we have ambulance drivers who go to make house calls, essentially. So when they're not, when they're not providing an ambulance service, they're making some house calls.

So we have a G P S that's embedded now in electronic health record that they follow. It's a smart G P S, so it tells 'em where to go in order to see these different patients and the stories you get from.

It's amazing. So some of that technology of using, uh, G P S and inputting it into the electronic health record, that's something different. You don't normally hear about that one, so I give that one. I could talk about blockchain. So, but you know, we, we, we, we embrace blockchain. Certainly I think there's a lot of, uh, great future for it.

So we watch carefully. We work with, uh, select vendors and. You know, in terms of blockchain, but I just think the real one that we're actually doing is like this, this gz stuff that our amazing development team does. But you are, you are keeping an eye on blockchain and that's, yeah. It's, it's that, that will be an interesting one over the next, uh, couple of years.

We'll, we'll have to. We'll have to circle back with you on that. So, um, alright, so I, I wanna talk a little bit about, so, uh, the fifth question's really around the, the IT workers. So healthcare, it used to be pretty intensive from a labor standpoint that's really changed with cloud and automation. And, um, what's the message you're giving to your frontline IT workers around, uh, the future of work and how they can maybe adapt or adapt their careers to, to stay relevant?

Yeah, I'm, I'm like, wow. I'm just like a little kid, you know? So sometimes I, I, you watch little kids who come on an airplane for the first time, you know, these two, two year olds or three year olds, and they come around and they come around the corner and as they get on the plane, they look down the aisle and they're like, wow.

And that's why I tell our, our team, it's like, it's like, do you realize that we're at the tip of the spear? We are doing digital health. We are imagining things and then actually doing things. What a great opportunity and whatever training you need, we are there to give you that training. So I, I talk about it as a very positive thing.

And so it's like, whether it's basic stuff like idle, so everyone has to be idle trained because I'm a big believer in process. Or Agile. So I mentioned earlier we're, we're becoming a completely agile company or it first, and, and so everyone's getting this agile training. We're being certified and whether you need to be certified in electronic health record or these other digital capabilities, we're sending people to training and leadership training and investing in people because people make things happen.

So even though our our positions are changing and morphing with the times, it doesn't mean that we're still not needed. And so we continue to invest in. What an amazing opportunity, you know, that we all have. I'm so, I'm, so I'm jumping here because I'm just so excited about everything that we're doing.

Yep. And so I, I guess the message is, um, I mean, we live in a great time. Keep investing. Look for a company that's going to invest in you and keep investing in yourself. Keep reading and, and diving in and, and, uh, learning new things. 'cause there's plenty of opportunities. Yeah. Just keep growing. I always tell people it's like riding a bike.

You can, you can coast every once in a while, but if you don't keep pedalling. So, uh, sixth question is the obligatory question that every healthcare c i o gets asked. How has the role of the c I o changed in the last five years? Or, or do you think it's gonna change in the next five years? I think it's gonna continuously change.

And so we're seeing, I call it the postmodern c i O, and I know you've covered that topic pretty well, some of your pasts, but it really is more about the business acumen. It's about leadership. It's like digital health, you know, I got opportunity

of the team. They're not it. So that's a beautiful thing. It's, it wasn't it thing, it was across enterprise. Initiative that we took on, and the leaders of all these different journeys, I think I may have alluded to them earlier, they're all non-IT people. They're they're leaders or clinicians elsewhere in the organization.

You know, whether it's hr, revenue cycle, supply chain, clinicians, it was across the board, we gotta help, we gotta lead it. And, and so, wow, what opportunity, but I wouldn't have been able to been afforded that opportunity if I wouldn't have learned and grown and morphed and learned about the business side, about the clinical side.

There's all sort of things that you know, we can do, even if we're clinicians. I do have a slight clinician. Background, but even so, I, I, I routinely, uh, walk in the shoes of our clinicians. I continuously try to hang out with our clinicians to learn about what they do, what their pain points are. I volunteer in clinical areas so I can learn more about nursing and what they're doing, and, and so there's things that we could do to immerse ourselves to better understand the business and the clinical side.

Yep, absolutely. The role's gonna continue to change. Just like we're talking to the frontline IT worker. Keep investing, keep reading, keep engaging. We're saying the same thing to ourselves really as, as CIOs. And then the last question's, a selfish, selfish question for me is how do you do it? So, your work life balance, you're in shape, uh, you have a wonderful family life, you have a high profile career.

Give us an idea of how, uh, how you make it all work. And, and maybe I can apply some of it. I, it is probably different for, for everyone, and I'll tell you what my grounding is, my faith. I won't get religious on you or anything, but my grounding is my faith. So my faith keeps me grounded, it keeps me humble.

I know, you know, why I'm created, I know why I'm here, so I have a sense of purpose. Um, so that's, that's one thing. But I, I, I, I have given up sleep, so I will admit that . Um, so I, I only sleep about five hours to try to. Five hours a night to fit it all in. I try for six. My goal is six. I know it's important for health to have good sleep and good rest for your mind and your body.

Uh, so I always, my goal is six, but I was around five right now. I'm now eight because I'm, I'm not, not allowed to work out as much as I used to, uh, for now. But, uh, so I think getting good rest, but, but you try to fit in in when you can. So I'm an early bird. I get up early to work out, so it doesn't impact my family time.

Uh, and so when I come home, I'm home. So that, so that's one way and it's, and it also learning to delegate and building a great team. So if you build a great team, you don't have to do it all, you, you should never be in a position where you're doing it all. So building a great team and then of course, you know, you're having an awesome family helps as well.

I'm fortunate. Yep, absolutely. And I assume there's a bed right there in that office, somewhere off camera that you take naps during the day. I wish that were the case. I feel like it sometimes . Yeah, that's hardly ever the case. All right. Hey, uh, so let, let's close it out. Uh, I'm gonna share my social media post and, and this falls into the category of, uh, pride comes before the fall.

The Toronto Blue Jays, as you, as everyone knows, there's been a lot of baseball, uh, cancellations. I'm a huge baseball fan. And, um, the, uh, Toronto Blue Jays tweeted this out weather update due to our stadium having a roof. Today's game will be played as expected. And later on that afternoon they tweeted Rogers Center, which is where the Blue Jays play their game with the dome, confirms that ice from the CN Tower has hit our roof and the building crews are unable to assess the damage and more ice could fall and they canceled the game even though they had a roof.

So pride does come before the fall. Um, uh, I, uh, to you, uh, do you have, do you have something you wanna share? Yeah, I, I love the clinic actually very progressive. I puts out a lot of, uh, social media is awesome with Cleveland Clinic and they put out some edgy stuff, you know, uh, on Twitter, but not, so I won't do the edgy with you.

But the not so edgy, but very comforting is that coffee is healthy. So they, they, they tweeted something yesterday from one of our docs talking about the health benefits of copy. As long as you don't add in all the other bad stuff, though. Wow. You, you just made, you just made my daughter very happy. Yeah.

Yeah. I thought that was good news. I'm like, yeah. . Uh, well, again, thanks for coming on the show. Uh, ed, can you tell people how, how they could follow you? Yeah, I'm on Twitter. It's not all that exciting, but, uh, Mark's tango at, you know, on Twitter and. Uh, probably LinkedIn is the best place. I I, I'm starting to blog now on off of LinkedIn, and so if you attach with me on LinkedIn, there's definitely a way to, to keep in touch, but that's probably my primary, uh, areas.

Fantastic. So, uh, you, you can follow me at the, at the patient c i o on Twitter, uh, my writing on health lyrics, website, health system, c i o. Um, you know, don't forget to follow the show on Twitter this week. In h i t and check out our, our website at this week in health it.com. If you like the show, please take a few seconds to give us a review on iTunes and Google Play.

Catch all the videos on the YouTube channel this week in health it.com/videos. The easiest way to get there and, uh, please come back every Friday for more news information and commentary from industry influencers. That's all for now.

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