I Gave You Dollars. You Gave Me Capacity. | Newsday with 229Project

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I Gave You Dollars. You Gave Me Capacity. | Newsday with 229Project

[00:00:26] Alright, it's Newsday, and today I am joined by Eric Utzinger, the, chief… what are you? Chief Growth Chief?
[00:00:35] I'm just… I'm just chief, Bill. I'm just chief, chief, chief.
[00:00:38] Chief of Revuud, and revuud, for those of you who don't know, is a really interesting platform for… that really transforms the way we think about staffing, and creates a model where it's a cost-plus type model, and
[00:00:53] really puts the, the client in the driver's seat, around that. We're not gonna talk about that as much today. We're going to do a Newsday episode. Sarah and Drex are off doing things. Sarah's doing a webinar as we speak, and then,
[00:01:08] Who knows what Drex is doing, you know? He's so cool. He could be at a rave or some such thing. It's kind of crazy. But Eric, it's great to be with you.
[00:01:19] Good to be with you. Thanks, Bill.
[00:01:20] We're gonna talk about… so we did a signal index survey for the first half of 2026,
[00:01:27] And there was a couple of findings that were really interesting. One is that 54%, over half.
[00:01:34] Cited competing priorities, too many initiatives, not enough capacity as their number one tension.
[00:01:40] So, you know, and 43% cited flat or declining budgets.
[00:01:48] And so I think this is an area where you guys live. It's… it's the whole idea of every health system right now is being asked to do more.
[00:01:55] And the priorities aren't necessarily being filtered correctly through governance, and they're ending up with too many things on their plate, and the IT organization is believed to be able to do magic.
[00:02:09] And do amazing things with almost no resources. And that is putting a significant stress
[00:02:18] on the health IT organization these days. I… you know, and we're going to talk about two use cases here, but I'm wondering, does that resonate with you as you're out and about talking to clients?
[00:02:30] I mean, 100%, and it has for a while. I mean, you think about… I mean, we've talked about this, and I think, Bill, in your former seat, you would agree with this 100%, days are gone of IT being a cost center. It doesn't make it easy to prove ROI on everything that we do, and we don't really talk about ROI a whole lot. What we really just try to do is understand
[00:02:53] the organization's initiatives.
[00:02:55] and really try to, and I think I said this before we started, Bill, was just think a little bit differently about how you can grow and flex your teams.
[00:03:04] And again, not talking about review per se, but it's just really about the idea of getting more done with less, which is what they're challenged with. I even talk to vendors a lot that are trying to implement their solutions.
[00:03:17] At these hospitals, and they could be a cardiac solution, it could be, you know, a diabetes platform, anything like that, but it needs integration work.
[00:03:26] And it's… and it's a challenge. They know there's a reason to do that, it's good for the patient, it's good for the health system, yet it's taking way too long to get there. 9 months, 12 months, and obviously the company wants to get that done.
[00:03:38] But at that… for their revenue standpoint, but at the same time, it's also what the hospital agreed is good for their organization and good for the patient.
[00:03:47] And I just think when… and we've had this, we've seen this time and time again, when people start to embrace these newer models.
[00:03:54] They can truly build these flexible teams where you're not kinda,
[00:04:00] set up to have to go to a certain place and get someone new every time, someone that knows your organization and can come in and out and flex accordingly. Part-time project management, anywhere from technology resource needs all the way through, you know, full, full implementation. But we love… it's actually harder for organizations to.
[00:04:23] predict revenue when you don't know how many hours people are gonna work. I think a lot of consulting, traditional consulting companies would tell you that.
[00:04:31] But, but we just find such value in delivering that flexibility, and scalability to our clients, and I think clients are embracing that, whether it's from us or other organizations as well.
[00:05:16] So, I mean, you talked about the ROI story, and…
[00:05:20] In the survey, it's… CIOs cited, because we broke it down by title, CIOs describe struggling to prove hard ROI
[00:05:29] Before committing to more spend, especially in the area of AI. CMIOs name the absence of agreed ROI standards across ambient vendors as their number one vendor gap.
[00:05:42] So, it's, it's, it's inter… these, these, these, the, the requirements for ROI, is extremely high.
[00:05:51] you know, it's hard to even get the conversation started without having an agreed-to ROI. But even internally, people are struggling.
[00:06:02] To have the appropriate conversations, and to be talking apples and oranges.
[00:06:09] One of the things I noted in an article this week was that, we're talking in dollars.
[00:06:16] And AI is returning, not dollars per se, it's returning.
[00:06:21] hours. It's returning capacity back into the system. The problem is, you have to turn… you have to do an exchange of some kind, and turn that capacity back into dollars, otherwise the CFO's sitting there going.
[00:06:34] Wait, I gave you dollars, you gave me capacity.
[00:06:37] But the capacity's sort of sinking into the background. I need the capacity to be used
[00:06:44] to bring more patients into our ED, or I need more capacity to be used to bring, you know, more patients through, more dollars through, more…
[00:06:53] More patients being seen, or some aspect.
[00:06:57] That's right then.
[00:06:57] That helps them not to… to…
[00:07:01] lose the money in the process. And so that ROI story
[00:07:05] Is… is a little muddy right now, at a time where it really can't be.
[00:07:10] And that's what… it's been a hard thing for all vendors, I think in any industry, but healthcare specifically, with lower margins, and Medicare, and all the reimbursements going down, and just all the different challenges, but also having to stay progressive and ahead of the curve, and having to trust
[00:07:29] that that ROI will come, it just may be hard to recognize on paper. You can try as much as you want, like, what is that physician's time?
[00:07:39] What does it mean to the organization that he or she gets to go have supper?
[00:07:42] With their family. And, and what does that mean? The CFO probably doesn't see anything on that. Again, you've given me time, but you haven't given me… me dollars. So it, it remains a huge challenge. I think in one of the articles, that we were talking about that was, you guys did an interview with.
[00:08:01] It's, it's, I think it's, Tanya Towson was basically suggesting it is time to.
[00:08:07] Now, once we implement these solutions, we have to go back and start documenting all that to kind of… it's almost like proving it after you've purchased it. This was worth it. This did give us not only time, but it gave us dollars back as well. That will help the next time that, organizations want to purchase something based on ROI, to show that, you know, we are going to prove that this makes sense to our organization.
[00:08:32] But these guys are at a critical point. There's things they just can't not do. Ambient listening, for example, it seems like everyone's talking about it. Are you not gonna do it because you don't see an ROI? It's almost impossible not to. So it's a balance.
[00:08:48] Yeah, so you're, you're citing the interview that, Sarah Richardson and Tanya Townsend did. Let me just throw out the, the bullet points on that, and also, Joey Sudemeyer, Texas Health Resources. So, Tanya Townsend, Stanford Children's. The thing she talked about the most was operational transformation.
[00:09:06] And it's the real work behind the hype of AI. She talks about treating AI as just another tool in the toolbox that needs governance. It's not a magic bullet. Some of the proof points she gave were digital engagement standardization, 36% increase in online scheduling.
[00:09:23] There's, you know, turning capacity into real dollars. 20% lift.
[00:09:28] in waitlist acceptance, that's huge. Ambient listening, clinicians leaving earlier, less scribe dependency, faster chart closure, revenue upside. So, it's interesting. With each one of these, the comments she made on ambient listening, it gets less nebulous and more…
[00:09:46] More hard dollar. Two more things from her, big move, kill the IT cost center label, transparent budget analysis, document the ROI, and tell that story. And then the discipline she closes with, every initiative gets a goal and gets measured before moving to the next one.
[00:10:03] Before I talk about Joey's stuff, I mean, it's interesting.
[00:10:07] Operational transformation. I think that…
[00:10:10] We talk about AI in these broad, grandiose terms.
[00:10:14] But the thing it's delivering is a new way
[00:10:18] of processing the work, of getting the work done. When these agents are brought online, the idea is that they will take some repetitive work that we have been doing and turn it into something that just
[00:10:34] potentially gets done. We have an appointment this morning.
[00:10:37] the AI agent recognized my appointment schedule, went through, and analyzed the entire chart, including all these PDFs that I would never have time to read, and it surfaces that information and puts it in front of me and says, boom, here. You're seeing Eric today as a patient, here's his longitudinal patient record, here's what we found.
[00:10:59] And it just… it… it makes it that much easier. So we're… we're looking for agents
[00:11:06] to do things, but really, the foundation for what we're trying to do, and we don't want to talk about it because it's not as sexy as just saying the word AI, is operational transformation. It's changing the way we process everything within healthcare, from claims to…
[00:11:23] To incidents and everything else that goes on.
[00:11:27] Well, and I think it's gotta change. What's interesting about
[00:11:30] kind of just from myself, and I think we see this from the consumer perspective, is trusting that the information you're basically getting from a computer, as much as these guys are getting good at the agents sounding and being realistic and natural language processing.
[00:11:46] It's, it's trusting what this… Agent is telling me.
[00:11:50] for some reason, I mean, there's a lot of people that are still stuck, like, I gotta talk to a human being. There's probably people that get on these phones and just say agent right away, or… or I want to talk to a human.
[00:12:01] I'm guilty of that as well at times, just because I don't think the agent, at these organizations can actually answer my question in a meaningful way.
[00:12:11] Well, let's stop there for a second. So, the quality of the agent.
[00:12:16] matters. And I would say the quality of the person building the agent matters. And the quality of the data that has been given, and the context that has been given to that agent matters. And the thing that I'm concerned about right now is I have seen really good agents in healthcare.
[00:12:35] I would trust, and I've seen…
[00:12:37] less than good. Less than good agents that I wouldn't trust. And you know what? Trust is the foundation for
[00:12:44] the AI strategy expanding in your organization, or just coming to a dead stop? Because trust… healthcare, more than anything else, moves at that… as the cliche, or the book title, at the speed of trust.
[00:12:59] Yeah.
[00:13:00] Yep.
[00:13:01] And that's what… that's where I think bringing in… and when we talk about operational transformation and getting…
[00:13:08] There's probably folks in every organization, I don't have any studies on this or anything, but some are ready to embrace AI and move with the next step, and, you know, there might be Epic analysts, they can be, you know, on the development team, which, as Joey mentions, like, we're not a development shop at THR, there's some organizations that are, but most are not.
[00:13:27] But there are people that are going to embrace those models and be able to…
[00:13:32] get that clinically… get that clinical aspect and that analyst aspect of Epic, and what goes in there, and how to make that… the people creating, as you say, the agents.
[00:13:43] make them trusted out of the gate, because it is extremely challenging to do so.
[00:13:49] But if they… and I think, you know, you tell me, Bill, more than anything, is that these organizations are embracing their clinical leadership, making these decisions not in a bubble with the proper governance and whatnot.
[00:14:03] And then slowly, I think everyone wanted to just AI, AI, AI, to the point I was sick of seeing AI and didn't even want to read your, Saturday coffee post, because all it had to do was AI. But I caught myself reading it anyway.
[00:14:18] So it really is interesting, and there are some companies, and I won't mention them, but literally are on the…
[00:14:25] On the edge with serious funding behind them.
[00:14:28] to make the agent experience just exponentially fantastic in healthcare, because it really is about that patient experience. Where I live in Charlotte, North Carolina, there's multiple organizations all triangulated right here, and they're all fighting
[00:14:45] For your patient record, but to also keep you out of the hospital and keep you happy.
[00:14:50] I've had great experience with some of them, and not great experiences with other. And that changes my perception of where I want to go as a consumer, but how do you get that ROI? I mean, how does that equate to that ROI, like we were talking about, and that's almost impossible to do?
[00:15:07] Yeah, well, let me… let me go through Joey's… so Joey's, conversation with Sarah, here's some of the key points. He had a thesis, which is growth without growing. Add capacity and services without adding headcount. That is a… a…
[00:15:22] very much a reality for health systems today. You have top-line pressure, you have costs going up, and so this whole idea of growth without growing.
[00:15:32] grow capacity and services without adding headcount is very real. Planning shift, kill the multi-year strategic plan, shorter sprints, rolling 3-year roadmaps.
[00:15:43] I'm hearing that more and more. I'm even hearing that on the budgeting side. Practical AI first, Gen AI chart summaries, ambient listening, immediate pain, not moonshots, and I'm hearing people more and more try to scope
[00:15:57] their AI… their first couple of AI projects in an area where they have,
[00:16:05] as much impact as they can, but the likelihood for success is a lot higher. Finally goes governance first, system AI level governance program, hardwired leadership messaging, that automation augments roles, doesn't cut them.
[00:16:18] And buy, don't Build leans on epic and established platforms, the realistic path for most systems, and calls AI the second technology revolution.
[00:16:29] after meaningful use. Just to be clear, meaningful use is not a technology revolution, but it doesn't… doesn't matter. It was a technology entrance for technology into healthcare. So, AI is the second technology revolution. CIO moves from infrastructure manager to strategic business partner.
[00:16:49] I want to touch on that last one. CIO moves from infrastructure manager to strategic business partner.
[00:16:56] I think most health systems would love To have a… very seasoned.
[00:17:04] Person who understands technology.
[00:17:07] and has a defined point of view of where technology is going to go with healthcare, and a deep enough understanding of that technology at the table, at the business strategy table. We are thinking of growing in this way, we're thinking of expanding this way, we're thinking of doing these things.
[00:17:24] And the question is, you know, what skills
[00:17:30] What does the person need to demonstrate in order to be at that table? You've interacted with a lot of CIOs.
[00:17:36] And, whether we do it publicly or not, we all sort of have this ladder in our head, and we go, hmm, this person is distinctly better than most.
[00:17:47] When you say someone who is distinctly better than most. What are some of the characteristics that you think
[00:17:53] Puts them at those strategic business… Partner table.
[00:17:57] Extremely interesting question,
[00:18:01] I do, like, when I think about what you… what we said and what Joey said about a seat at the table versus just the kind of the…
[00:18:08] holding on and watching the infrastructure. I… I was, you know, I've been in healthcare since 2002. I would have thought meaningful use changed that. I remember having those discussions, like, the CIO now has that broader seat at the table, so I do find it interesting that we seem to still continue that.
[00:18:26] And so, I think that's…
[00:18:28] I think it's personality-specific, by the way, but keep going.
[00:18:31] Yeah, that's fair, that's fair. And I think to answer your question, it's not always about what makes that person the right person to be able to lead that organization through that transform… transformational changes that they're looking to do.
[00:18:49] But it's an organization that, at the C-suite level, embraces that need, and embraces them as someone to go do that. Because there's many that probably can, but the C-suite necessarily doesn't see that
[00:19:01] as a necessary part of healthcare, because we're looking at numbers, and we're looking at Medicare reimbursement, and things are going down, and I don't have time to think about this other stuff. Where really what the CIOs, CDIOs, and whatnot are bringing to organizations are truly transformational, and will change the way healthcare is delivered.
[00:19:20] So, and I would… I don't know what your perception is. We've seen people dabble in CIOs that are outside of healthcare, you know, as maybe a mantra of, okay, let's… let's… it's more about the nuts and bolts and just the patient experience versus understanding healthcare.
[00:19:40] I kind of think healthcare is a completely different animal, and it's really important to have that knowledge, that you've been around through the organization for a long time, but not too heavily on the technology side that you don't understand the transformation that's needed.
[00:19:56] You know, I think people from outside of healthcare do not put enough emphasis on really understanding healthcare. They're like, well, it's a technology job, and I can do it, and it's not that big a deal. I was one of those CIOs, by the way, and I would say
[00:20:11] it was likely a mistake to hire me as CIO back then. It's… I mean, I'm not pointing the finger at anybody, I'm just saying that I did really solid things on the technology side, but it was a huge.
[00:20:27] hindrance, not really understanding healthcare. And I have seen some people who really understand healthcare. On the flip side, people in healthcare do not value the technology side enough, and they think you can just phone it in. And that is insanity, and it's the reason most health systems
[00:20:45] Have this legacy environment that is
[00:20:49] Horrific. Not bad. Horrific. Like, everybody from outside the industry would come in and go, what are you people
[00:20:57] doing? What are you thinking? It's like, well, but our CIO's a physician, and he blah blah blah. Like, well, that's great, he's a physician, I'm glad he knows healthcare. He doesn't know technology to save his life, but…
[00:21:09] You know, and so we've made really poor decisions on the technology side. So we underestimate, in healthcare, the need for a technologist who really understands it. We're like, oh, I have a team, they understand it, I'm good.
[00:21:21] Yeah.
[00:21:22] I think that's a mistake. On the flip side, going out and getting a CIO from
[00:21:26] You know, fill in the blank.
[00:21:29] Can they do some things and be effective? Yes. But the lack of really understanding healthcare and digging into it, which I've now had a decade to do, and I still think I know about this much.
[00:21:42] of what I need to. It is just massive. It is… it's not… it does take… it's a field of study into its… onto its own.
[00:21:53] And I think it's too much of a deficit to bring somebody in from outside of healthcare. Not that we don't need additional lenses, but it's too hard. Hey, by the way, the people who I've seen who have been really successful here, they talk in the right terms. If you want a strategic seat at the business table, you know what language you needed to talk?
[00:22:12] Business.
[00:22:14] A lot different.
[00:22:16] it's a lot different, right? You're talking about, you know, how can we, you know, how can we serve this population better? And you gotta be able to talk in dollars and cents, and you gotta be able to talk in terms of, you know, revenue and cash flow and net days.
[00:22:31] cash on hand, and I mean, you… you have to be able to speak P&L. You have to be able to speak clinical quality. You have to be able to speak
[00:22:39] strategically on the things that matter to a health system, and I've seen a lot of CIOs that can do that very effectively. When I talk to Chero, one of the things that impresses me about talking to Chiro Goswami over at Providence.
[00:22:53] is, he is not a clinician.
[00:22:56] But if you listen to him talk, you would not know that he is not a clinician. He recognized the deficiency, and has really spent a lot of time being proficient. And on the flip side, if you look at someone like Alistair Erskine, who is a doctor.
[00:23:14] He's… he programs. He's a… he's a complete nerd.
[00:23:17] Hold on.
[00:23:18] He, like, spends a ton of time really understanding the technology, because he already understands, and so those people at a… at a business table are incredibly valuable, because they can… they can understand… they've… they've,
[00:23:31] They've really worked on the area that they are weakest.
[00:23:35] And their strength really comes through when they're at that table.
[00:23:39] And those business leaders are probably about… I'm thinking about our mix of… we've got about 50 clients from Bermuda to Hawaii, and and I'm trying to think of each one, and kind of… and everyone's unique. I mean, like the old adage, you've seen one hospital, you've seen one hospital.
[00:23:57] And we always kind of get started in different ways with different… it just kind of depends on their project meetings, and the ones that are really taking advantage of the ROI found in… in our platform can talk those business cases and understand that… that, you know, looking at these new flexible models will mean a lot to us, and there's,
[00:24:17] And with Bermuda, for example, I mean, they have truly embraced this model of fractional use. 10 hours a week, 15 hours a week, as needed. Don't get invoiced unless work is done.
[00:24:30] you know, truly flex my workforce, which is what we're… which is our aim to be able to do in the way we've created our platform with trusted resources. So… and that's a business case.
[00:24:41] that I think the forward-thinking CIOs are seeing a new and better way to build their workforce, and allow them to create more transformation within their organization.
[00:24:54] Because you can't ignore the day-to-day operations, while you're going out and playing with new toys.
[00:25:02] Eric, I… you are a professional. You're a true professional. You run that line really close to promoting your stuff, but you don't really hit it, and if people don't have a chance, take a look at Revuud.com. That's that whole model that Eric was just talking about. And it makes sense.
[00:25:18] You know, if you don't need 40 hours, 15 hours is great, get that expertise.
[00:25:23] For the hours that you actually need it, and start to get a variable workforce, because that is what's going to be required to get past the 54% of people who are saying, we have too many projects, we can't get it done, we're going to have to be creative and look at different models.
[00:25:39] And I would argue the other 46% aren't being truthful to themselves.
[00:25:44] Some, some. I… you know what's interesting is there are some organizations… I agree with you that a portion of that group is absolutely.
[00:25:52] Maybe not 46.
[00:25:54] But the, but I am, gonna do some interviews with some organizations that
[00:26:00] have talked to me about their governance in the, in the larger, summits that we do, and their governance is well thought out and well done, and so because of that, the organization understands that there are limitations on the capacity that IT has.
[00:26:18] And that… there's a transparency associated with that, and then…
[00:26:22] They, only push the right amount of projects to IT, and they make the tough business decisions where they should be made.
[00:26:31] Which is… Which is not as prevalent a skill as it should be, Eric, as we all know.
[00:26:38] Eric, it's always great to catch up with you, I appreciate you, and
[00:26:44] And, hey everybody, thanks for listening. That's all for now.
[00:26:48] Thank you, Bill.