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Welcome to this week, health my name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health. A set of channels dedicated to keeping health IT staff current and engaged. Today we have an interview in action from the 2023 Spring conferences, vibe in Nashville and hymns in Chicago.

Special thanks to our cDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders.

You can check them out on our website this week, health.com, now onto this interview.

 All right. Here we are from the Vibe Conference, and we're joined by chuck Christian with Franciscan Health Systems. I don't know why, I forget the health system you're with. Have you been with them for a really long time? No,

No, about four years. Give me a few days.

April 7th will be four years.

Four years. what do you think of the conference so far? I mean,

oh it's, it's great. I was, I had breakfast with Russ this morning and you know, when you look at the hosted buyer thing, you go, you know, that's like speed dating, but actually I did 14 yesterday.

Wow. So, and I gave myself a break for lunch and it was actually really good. I learned a lot about some companies. That I didn't even know they existed. And the reason I did, it's because, we're always looking for, what's next and trying to figure out what's out there. You know, I had some really good discussions.

I had some that I'm wondering why they chose me to sit down with 'em. Yeah. but I, you know, and the, the really interesting thing is that when you're having a really good conversation, 15 minutes goes by in a flash. But then you have those not so real good conversations and it just, when is it gonna be over?

I, I

think the, The hosted buyer is one of the best things about this conference. Yeah. Is what I've heard from both sides. And I heard, somebody said to me, they're like, Hey, we're really laid back in this thing when we sit down with the CIO or whoever we're sitting down with, will say, Hey, here's what we do.

Yeah. Any interest. And then if they say no, it's like, Well, let's talk about, I don't know. Yeah, let's talk about whatever

else you want to talk about. Well, I'll sit down with David Ting I'm on their Davis town size advisory board. And I know everything they're doing, but David still wanted to talk and pick my brain a little bit, and I wanted to pick his, and then we, he's a woodworker just like me.

So we talked about table saws and a whole. You know, Making sure we counted all of our fingers and we still have all those. So

you, you know, I wa I'm glad we captured that cuz David Tang could be one of the most broadly. Oh I know. He's just unbelievable to the amount of things.

One of the smartest guys I've ever run into.

And David used to call me cuz I knew him from him Bravada days. And David when he would call me about an idea. And, we'd start talking about it and I told him, I said, David, you've had 45 minutes of conversation in your head about this. You need to back up and let me catch up a little bit.

Yeah. So it was great cuz I got to, I've had the pleasure of seeing inside of his head a little bit more.

Well, this afternoon I have Drex and David on. We're gonna do uh, sort of a recap of the conference. Oh, that'd be great. Yeah. Yeah, it'll be fun. So 14 hosted buyer meetings. Yep. I keep pointing back here cuz it's right behind here.

Right. What's next? I mean, you said you, you're looking at what's next? What's next?

Well, I mean, we're looking at everything virtual. I mean, and I've listened to the pitches of quite a few virtual companies, and what we found out in our research is when you look at virtual, particularly in the acute care setting, there's a couple of different kinds.

It's the one to many. We could be tele sitter. And it could be virtual nursing and that kind of stuff, but also virtual nursing is one-to-one, one that virtual nurse to the patient. And up until recently I,, we haven't found any technologies that has that same form factor that you can do both and will do the handoff.

Because typically the group that's doing Teles sitter. There's a different group of people, they're more like the cardiac monitor techs and that kind of stuff. They're watching people making sure they're not getting out of bed. And there's actually a couple of those technologies that have AI that watches for motion and that kind of stuff.

I don't think you can ever , take a human eyeball off of them and let the machine understand that the patient's about to get up out of bed. But if you need to have that one-on-one with a patient with virtual nursing, then , it's a different form factor. So, the other thing that we're doing, sorry to interrupt.

Hold on, please. We've got a request from our nursing department about and we call it virtual mentoring cuz we have a lot of young nurses coming in. Right. And so, they have to have a mature nurse to, stay with 'em and that kind of stuff when they get on the floor and there's just not enough to go around.

And now you have a young nurse and a uh, more mature nurse, a seasoned nurse. I'm not gonna say old but what we do is that if they're about to do a procedure or something that they've only seen or done once, then they can get that other nurse on the phone wherever she is and they can, you know, follow up on a couple of things and, be right there with 'em while they're doing this.

Procedure for the patient. We've got a lot of great feedback from the young nurses and the older nurses who can take a moment and not have to go to that young nurse that they're working with

you. You gave me A bunch of scenarios. Yep. There to go off of virtual in the acute setting is really interesting to me because we have this, nurse shortage, we have a clinician shortage.

Oh yeah. And we have a tech shortage. We have, We have a shortage. Right. And so we, one of the things that people have come to us and said is, Hey, as are there technology solutions that are gonna help us to. Spread the knowledge of this group. Yep. Increase the number of product productive hours of this group.

And so you talked about nurse sitter. When you talked about AI and some of those things I've interviewed some of those companies. And they're not looking to replace the nurse, but their case is the nurse can't be in that room right at all times. And so we have an eye on 'em. Yep. 7 24 365, and the models are saying, Hey, something's about to happen.

So it gives them that warning that something's about to happen. Well,

I mean, I would agree with you. Another thing too is that you have nurses who've been nursing for 40 years. They're not ready to retire, but physically they cannot do the, you know, they can't be on their feet all day long. So move patients around and Right.

And they, they've been there, done that. They're trusted by the rest of the staff. They're trusted by their medical staff. And so, there are things that you can remove the cognitive workload from the nurse, because I don't know if you've ever been through an admission assessment re recently.

They're mind numbing. Because you have to capture all this information about the patient. Even if you already have an emr, you still have to validate it with the patient to make sure that everything, something hasn't changed. And then when the, if the patient has a question, wants to talk to the nurse, pop up on the screen, why do you have to wait for the nurse to come to the room?

That was my question. So do we have to do things in the rooms to prepare them for this? This virtual world, isn't it?

Yeah. For the patients. Yeah, absolutely. They have to be, they have to be educated. Most of the people I've talked to have already done this Deb Gas out St. Luke's in Kansas City.

I talked to her. They've been doing it now for a couple years, and they're about to roll it out and they may already be rolling out through the entire system.

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So do you have cameras in all the

rooms? Do you have

Not yet. you know, the thing about it's, we've been, I stood up a tech innovation center so we could actually.

Test the technology because there's all kinds of stuff and the requirements are so different from depending upon what it is you're wanting to do. And some of them are a little more aesthetically pleasing. They're little more hidden, and some of 'em are, you know, you know, they look like you're about to be executing.

Cutie because of the size of the camera.

And, And we've been doing this long enough to know you buy that camera and within,

It's 10 minutes. It's ex, it's extinct,

right? Yeah. And so we have to be thinking about, what are the use cases we have for today? But, how long can we get these things to last?

And if we can't get 'em to last for a long time's, no reason to put a thousand dollars camera in every right. Room. We saw this with video conferencing stuff a long time ago. So sometimes it's better to go with the least expensive camera you can find. Yep. That can adequately do the job

Well, the thing No, you're gonna replace it.

Well, the thing about it is I think everybody goes to that, that ultimate that's gonna zoom run into the patient so you can do a diagnostic quality image. And for the grand majority, you know, for me it's a, kind of an 80 20 thing. You know, You may have 20% of the time that you need, the physicians on the.

Could be a hospitalist or it could be a neurosurgeon or somebody on the other end that needs to see the patient very up close, very detailed. But I don't think that's the, the usual use case for it. It's about a 20% solution. There's no reason for you to spend 80% of your money on that 20% solution.

Yeah. I'm curious and, and. It seems like a really big exit question, but Yeah. I've been talking to a lot of, of technologists and CIOs about platforms. Yep. We don't seem to be bringing a lot of new, really big platforms in. We want to use the technology that we have. How are you guys approaching this in terms of rationalizing the number of applications?

How, are you viewing it? What's your approach or your mindset to simplifying the environment and reducing and driving. Cost out.

Well, you know, be surprised. We just have gone through an app rationalization process and I've also done a workload placement strategy about what things do I need to move to the cloud, what can move to the cloud easy, which ones are more expensive and harder?

And what we found is in a organization our size, there was a, a lot of duplication, I shouldn't say a lot, but we found applications that maybe one or two people use, that the same functionality can be handled by these other applications. And so we're shrinking that portfolio. Uh, and the also too, we have with 12 hospitals that used to be allowed to, roll their own, do whatever they wanted to do, is we're finding that there are enterprise-wide solutions that we need to put in place to take care of this functionality.

Then we'll support them from the enterprise rather than that application being orphaned. Because there's nobody at those facilities to support 'em. There's nobody on my team that understands them because they were put in so long ago. So, I think there is a lot of appetite to do that because we'll find some that you basically, you have to do a scream test on, not a screen test, but a scream test.

Unplug the server cuz you can't find anybody using it, so you unplug it. Nobody screams. If it's got PHI on it, you hand it over to the archivist and make a determination.

That was actually a documented process for us. Yeah, exactly. We, when we did our inventory of 930 applications we had, could you identify the owner?

Could you identify users? Could you, and if you couldn't, it was like, all right, the next step is unplug it. Yep. Wait for the, Wait for the phone call to the help desk or, Or email to,

we had we were looking at one SQL data server. It had 130 applications on it. Most of 'em were built internally long ago, and I still, one of my architects was, is one of the developers that built most of 'em and he knew exactly who was using 'em.

Well, those people were long gone. And so we were trying to make a determination. So we just started turning the databases off and nobody ever called, but we were running those, we were backing 'em up. Yeah. We were, and then we were actually modifying code because when you go to the next level of SQL server right, it won't run.

So you have to modify it to run or re at least recompile it. So we quit doing it. So we got a about half of 'em.

Yeah. That's amazing. Chuck, I wanna thank you for your time.

Hey, you very welcome Bill. It's good to see you guys. Appreciate it. Thank you very much.

    📍 Another great interview. I wanna thank everybody who spent time with us at the conference. I love hearing from people on the front lines and it's phenomenal that they've taken the time to share their wisdom and experience with the community. It is greatly appreciated.

We wanna thank our partners, CDW, Rubrik, Sectra and Trellix, who invest in 📍 our mission to develop the next generation of health leaders. Thanks for listening. That's all for now. 📍