Today we caught up with Nassar Nizami with Jefferson Health at HIMSS 2022. Great discussion on virtual go-lives, cloud, and addressing the clinical staffing shortage. I hope you enjoy.
ll right. Here we are at HIMS:
Doing great is it's great to be here in person. Yeah. Yeah. It is
for it to appear in person the, , mean we haven't talked to him in a little while. I think it has it been almost a year
now. More we over a year now. Yeah. It's been a
lot. Wow. That's a, that's amazing. So what's top of mind, what's going on, , for you in Philadelphia?
lot happening. I V acquired, , Einstein health, which is a three hospital health system. Four months ago, three months ago, we acquired health partners. And of course we have been going, , is COVID ways finally feels after almost two years that we may be out of COVID now. So the real projects, bold implementation consolidation are heading us more.
Now last week has been just remarkable, focused on COVID vaccination testing, that sort of stuff. So now more integration, digital. , AI automation, some topics that I care a lot about are bubbling up, which I'm really excited about this. Well,
with the, with the, , acquisition strategy, a lot of M and a, and you guys were right in the middle of a significant amount of EHR work that's right in that consolidation in the middle of the pandemic, did all that stuff go off as
planned, better than Ashley Fran shovey went live with, , , our EMR in the March off duty.Five hospitals,:
The teams did a phenomenal job. We had some great. But overall, it went really, really well, no revenue cycle hiccup clinically. We are just back onto all the basics less than a year. So, so we've been really built on foundation,
I assume. Yes. So, um, interesting. Are there things you learned in that, that you're going to take forward and do for,
So like virtual training, I mentioned. So we are now basically a virtual training first organization. , we are just redoing some of them. , training that we provided to nursing in regular orientation and taking them virtually. So just reducing the time that nurses spent actually physically in a classroom, right.
That's worse for support has gone up and just, , we, we had these things before go in, but it's just, adoption was not great. And we'll go, it changed for us is a larger nursing realized and probably largest area, but even physicians, we are training them online more and more virtual training virtual. , I think digital adoption in general, I think about, you know, both on the patient side and physician check skyrocketed during COVID while of is this that is sticking.
Now we found is it's only dropped from the peak of COVID. , but it is still 20 times more than pregabalin, which is still event I'll take it. Yeah. Yeah. It's
amazing. , Jefferson very innovative organization does a lot with, , , I mean, w it's it's Jefferson. Innovation group or is that right? Okay.
Ventures, innovation, ventures, innovation ventures, and visited their location in the vault, federal reserve all, um, what a contrast you're in that old federal reserve vault, and there they're working with 3d printers and doing all, are you seeing a lot of that stuff start to bubble up and end up in the clinical workflow?
right, too. So that is one of the exciting things that's sort of, you know, during COVID, in some ways innovation X-rated and other ways it did not accelerate, you know, cause we're priorities. , but now in the last few months, a lot of that work is not only bubbling up. As you said, making their way to clinical workforce.
We just critical for any success of any of the digital or it, it plan. And the big, I think differentiator for us is, again, going back to the adoption adoption by physicians, a lot more openness to things like online scheduling or telehealth, or you just name it. Right? I mean, people are responding more to the.
That are coming through digitally. Right? So a lot more, I guess, acceptance and adoption and focus on. Yes. We need to change the workforce of people that we always discuss, discuss virtual described things like Porsche described a lot more openness to that and seeing things on the patient's end. Right? , the, the, some of the just, I guess, , biases we had about eight patient ages and who's going to adopt just not true.
We are seeing some. Older population actually adapt more. So during COVID have rabid technologies more, which was remarkable. I mean, I think so. So across different demographics of just adoption of solutions that are presented, there is a generally, actually more silo called a hunger. Give
me more. Yeah. , how big is Jefferson now?
You guys went through such a gross word. I, I, I'm not sure. I know where your well,
we are eating hospitals. We are a health system with a university and a health care plan. We're about $9 billion in revenue. Now, , we cover both, , Philadelphia and greater Philadelphia, including Southern Jersey to the Sr , general area, about 40,000 employees, 8,000.
So any challenges with that kind of growth that quickly in terms of, in terms of staffing
and infrastructure? , so, so you hit it like a staffing probably is our number one challenge today has been for the last 12 months or so, both in it and outside it, nursing is our number one issue will be just, it's very difficult to recruit and retain talent, or you just be the nurses of leaving in droves of, we are looking at things like virtual nursing, which is again, not something I'm excited about.
It is not a replacement of nurse leaving. Just be, be clear if it was going to augment. And it's a good thing. It has been a big time in his staffing. I was just talking with another CIO who was looking for cybersecurity and that's one of the areas where we just are so understaffed right now. , the turnover, especially at the junior to mid-level is just such high
People are thrown by
their exactly like it's it's it's like every time I turn around, there's like 20% more than someone else is willing to. And it's both healthcare and outside healthcare. And it, we have this unique problem that you know, that you can go and work in any industry. It does not have to be healthcare.
Many of the jobs, finance, retail, et cetera. It's, it's, it's a challenge that I don't think that we are going to be, , getting out of any time soon.
You know, we, we talked a while back about cloud and I'm curious, how, how has that cloud journey gone? Everybody's sorta at different points.
, we are, , we have been, so, , well, what I would say is we've been using inflection points to move to cloud, right?
And eliminate the you and the last spoke about three years ago, since then a number of systems have already moved latest one being our data. , we moved to Microsoft Azure data platform. So that's now a data warehouse solution data lake solution. , we just put an RFP out and the final processes are.
How much can we go? One of the lessons learned in COVID was this is something we knew and you and I discussed joystick, look, you know, we are so much more Asia when we are in the cloud, we can be our Jefferson being, as you said, an innovative organization, speed matters a lot for our delivery times right now.
, our goal is to reduce like simple things, like standing up a summer for, from three months to less than in two weeks that, and there are multiple goals that we are trying to achieve with cloud. And so I would say. I think we are going to go from 70, 30, 70% today. On-prem to 30% in the cloud to 70 30 in the next three years.
goal. So I assume your office 365 yesterday, you are so teams during the pandemic probably
went zoom teams, , our learning platform, , the university we were using canvas, which is a hosted system. Anything that was. It was not an issue. Right. And I give a lot of credit to our partners who just scale up, whether it's Amazon or a Microsoft, someone else, everyone did a phenomenal job,
but scaling up within your own data center, even today with the chip shortages and whatnot, not easy.
Yeah. I'm talking to people and they're like, well, yeah, we've got, we've got six months, wait times on certain
switches. And oh, the supply chain is a big issue. We are not, we have orders that are not fulfilled that we play six, eight months ago.
, ???? masseur. We can always talk for another half hour, but it's always great to catch up with a Creek catching up