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(Intro) You have to make sure that you're not saying yes to everything. That you're really trying to make sure that you're doing the right thing for St. Jude. Not just today, but, a year from now, five years from now, ten years from now.

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.

Now, let's jump right into the episode.

(Main) All right. Here we are for a keynote episode. And today we're joined by Keith Perry, St. Jude Children's Research Hospital CIO.

Yeah, the vast majority of us have grown up with those commercials and hearing the story of St. Jude and not, not having to pay for their care and treatment. And like you, I remember as a child. what we say is our focus is more than just our commercials.

So our commercials, because of our funding is, on the generosity of the American public. Our aim is to eradicate catastrophic pediatric disease. And, that's primarily cancer and other blood disorders. And that's with, not only the care of the patient in front of us, but also how do we discover new knowledge that can help in that fight?

So we've got both the clinical side, but also a very large research and scientific discovery endeavor as well. So It's a blessing and an honor to serve the mission here.

pretty amazing. I see the cranes behind your window there. People might be listening to this, they don't see what I'm seeing, but it looks like you guys have a lot of work going on down there.

are really interesting for CIOs. it's exciting because it's just an exciting thing to do is to be able to do something in Greenfield and whatnot, but it's really challenging too, because you're like, all right, how are we going to do this? We want to future proof it, but you have to build with the technology you have today, but plan for what you, it's a

really interesting challenge for CI, exciting challenge, but challenge nonetheless. Talk a little bit about what it's like to be a part of those construction projects.

that concept that you just had. That's a microcosm of what a CIO's role is or what an IT function is, right?

And how do we design that in such a way that it's already day one, but also is ready to introduce some of that future that we see happening with pediatric care.

Let's talk a little bit about that future. we're looking at changing care venues and how we deliver care.

What are some things that are maybe different as you're looking forward than what we have today exam room?

we're all talking about having that ambient listening ability. So somebody is, having technology that's able to help improve the care coordination and the delivery and just the operational aspects of listening and interpreting and deciphering and developing work list as a result of a conversation that you're having.

And , we've done models on how does that flow today so that we've optimized, but we also know that's going to be evolving too as we introduce different types of tests and what that test mean. And so been a really fun endeavor, thinking through that what tomorrow looks like,

pediatrics is interesting to me because realize a lot of care is family based, but pediatrics is absolutely family based.

And so there's a connection, keeping them connected. with the care providers, just in the entire process of that. Talk about what you're doing in terms of, connecting the care team to the family and how that communications evolving over time.

We'll put them up in our housing. You see some of the housing facilities in the background. Their care is paid for their food and lodging education, and we try to meet those needs as well. All of that is provided. And so you think about that and the family unit too, and housing is not just a single bedroom. These are two and three bedroom units where the family is together. We want to keep them together. And so one of the challenges that we had to work through is, look, okay, if we're, with that why are we making our families come across campus just for a blood draw in the morning?

before round of tests and round of appointments in the afternoon. And so we're trying to push that challenge to housing. So they really just come down in their pajamas and they're able to get that blood draw. And so there's technical challenges that are associated with doing that that we've had to work through.

How much of the care is, now clearly you have some care that's delivered right there on the campus and that's fascinating in of itself, but then how much of the communication and the connection is done remotely where they're back at home and

your physicians are interacting with them there.

Yeah we've got I don't know the breakdown, so we've got affiliates throughout the country that are really connected to us and delivering the type of care that you would receive here on the St. Jude campus. So that's one aspect.

That treatment had so that we can constantly improve that for the children that we're treating today. Once a St. Jude child, they're always a St. Jude. So they're always going to be part of the family.

Always connected. You talked about the affiliates. Do you rely mostly on EPIC's interoperability to. Now we

do, now we do. But before that was a big challenge. And it's a challenge for the industry, but it was a big challenge for us.

I remember, the doctors would say to me, Hey, these patients are showing up with these.

Binders and they're especially the really complex cases like here's these binders and then we'd have to get them into the medical record. I assume that's from days gone by. We're not looking at that kind of situation much anymore.

Yeah, our transition to Epic, it just works, right? So it's it's been great. I was just looking at the data the other day and we share patient data with all 50 states. and it's not a huge burden for the IT team, which has been fantastic.

There's so many things you do with data, especially at a research hospital.

Yeah, I would say that, part of the transition and evolution of an IT organization too, right? So it's, once you're able to put in place something that reduces the complexity of the technical stack and the technical debt that you have.

It allows your team to think differently. So our integration team is, how do we optimize the integrations that we have? How do we bring on instruments? The evolution of instruments continues to grow, especially in the research and science space. And how do we think about that in sharing data across those paradigms and domains?

And so it allows us to think differently about the problem when you reduce the complexity. Of the technical debt that you've been saddled with.

Or is it getting less complex with the platforms that we're heading towards?

That's a great question. I'm shaking my head, yes. But at the same time When I think back to, again been in this for a while, it's pretty simple to set up an application. You just go get a server so it's very simple from a technical infrastructure perspective.

Isn't

it easier now I just drop my credit card and I have another application?

You can, yes there is, but there's all this downstream complexity that you have with managing cloud environments and the, in which cloud environment. And then the whole information security umbrella how do you protect that data and those digital assets and then how do you make sure that's up and operational, so that you're supporting a, clinical and clinical research in a pure scientific environment.

Yeah the platforms. It's interesting. The cloud platforms are interesting to me. It creates a complexity because they're almost doing updates without you approving them in some cases.

It's there's some systems, it's hey, just every quarter they just do an update on the system and then you log in that morning and it's updated. And to a certain extent that's easier for us because we have refresh cycles we used to have to do on every system. That was very challenging.

But on the flip side, we have a lot of workflows that are highly dependent and highly, it could be sensitive to those changes.

You're correct. On one hand, that's fantastic that they're patching and keeping updated and introducing new functionality, but yeah, it sometimes has a potential to break, but you have to go through those accelerated validation cycles to just ensure that everything's working.

Yeah, testing becomes more important. How are you thinking about AI? How's that for an open ended question?

Especially in our scientific side and, neural networks on imaging analytics and some of the stuff at the cellular level, it's really fascinating to watch. The generative stuff is really exploded and exciting. So it's exploded in terms of allowing us like everybody else to rethink, how can we use this new tool that's been given to us in a thoughtful manner that, that really helps advance our mission and how can we put it to use, and so it's been really fun to watch and so we've got it.

use cases stood up all over the institution from administrative to, clinical, to our scientific and research side.

do you keep it from taking a life of its own and creating its own complexity out there? I'm literally, I'm using three or four different generative AI tools.

you know, I think that's part of what my role as the chief information officer is helping the organization to be able to look through the window of technology and see the possibilities, but also understand there's other windows on risk mediation and just understanding what's possible, but also what's the risk associated with it.

And so with The generative ai, we recognize early on, hey, this is something that has a a lot of potential and a lot of risk associated with it. And so we got a group together. We've been meeting monthly for the last year and a half, almost two years now. To work through that.

And so like you, I use. Some of these tools too, I also recognize that, if I'm advancing something I'm passing that off as my voice and that I'm taking responsibility for it, as opposed to saying somebody else a technical tool did this so yeah.

Working through that and then, helping the organization see that the possibility is. opportunity that's in front of us.

Yeah, it was interesting earlier this year we had a lot of this discussion and I think UCSD, Stanford, and some others decided that when they implemented the generative tools around creating the note, potentially creating a note back that they identified it, they literally said that this note was generated.

So what was your path to get to this, to the CIO at St. Jude's?

I didn't start off thinking I wanted to be a CIO, right? So, I got into technology because I didn't like talking to people, right? And so I was an introvert that really loved computers. And so went to school, got my undergrad degree in computer science and then got my first job, programming job out of college in oil and gas, decided.

, I needed to go continue my education and went back and got my MBA at night, really focused on not technical stuff, so more accounting and finance, just because that was fascinating to me. I don't know why. And and then found an opportunity in Nashville with HCA.

And I just found out I had an affinity to really make it my life's work to serve that segment of catastrophic disease, primarily because I never met my father's mother. She passed away, when my dad was young from cancer. And I lost my other grandmother when I was nine years old.

So I really, grew up with very little, I only had a grandmother for a short period of time, both passed away from cancer, and it's so I hate this disease, and then, working at MD Anderson I've always been in healthcare IT, or always been healthcare IT, most of that time.

And somebody took the attention to detail to clean those red wagons and align them up perfectly. I was like if there's a place that has that much attention to detail for these families. That's where I want to be. And luckily we connected on where I was going and what they were looking for.

And I've been, again, like I said, I've been blessed to serve this organization for nine and a half years now.

I appreciate the fact that it's driven by life experiences, and it's a passion to really address cancer as a disease.

You should know some stuff about technology. I like the fact that you got your MBA. One of the things I would tell people who are real strong technologists is branch out into the business. Like understand, make yourself valuable in that room when they're talking about the business. Expand your clinical knowledge.

You're not going to go back to become a doctor or clinician per se, expand that side of it because when you do, you just increase your value in those rooms more and more until people go, yeah we want you in that room because you add value to the conversation.

Obviously you bring your expertise of technology, but you also have those other things that you're bringing to the table.

Yeah, I tell people I talk to that asked me that question, and I said, first of all, they would not have even talked to me without an MBA or a master's degree.

And so I, I went back and took coding classes and medical terminology classes at night. Just so that I could understand what they were saying. And you try to find a way to immerse yourself. The other thing I tell people is don't be afraid to move around. I've been honored with mentors that have pushed me into managing, so before I got here, I'd managed an electronic medical records team.

I managed a networking, the data center, the networking teams, the telecom, the client service, I've done basically every job in IT and healthcare. In an academic medical center before, but that prepares you for conversations with your peers and leaders because you know what systems they need and you know what the challenges are that they're trying to work through and that just further prepares you for, growth and your career journey.

Your day can start normal. Hey, you're just, looking at email, you're preparing a presentation. Then , there could be an outage. There could be. Some strategic project, but even if it's a normal day, you could start talking about research, and then the next meeting you're talking about food service, the next meeting you're talking about connecting with a community or connecting with Minnesota to, the conversations are so vast for a healthcare CIO I'm not sure what a normal day looks like.

A lot of context switching. It's yeah. And some of the meetings you walk in and you go, what was this meeting about again? Okay. Yes. And and you're going through the file in your mind and you're going, all right. Yeah. Yeah. All right. No, I talked to my team about this.

It's really interesting. Let me switch gears a little bit on you. And that is. We're launching a sales certification for the 229 project. And one of the things we're hoping is that we can elevate the relationship between the sales professionals and the health care professionals by educating them a little bit on what you go through, how you make decisions, how health care works, the difference between a pediatric hospital and A pediatric research hospital and an academic medical center and whatnot.

I'll give you a roundabout answer. What I tell people is that especially the new partners or new vendors that are coming in and want to want a relationship is okay, first thing we're going to do is we're going to tour. You're going to come here and you're going to tour, and then we're going to talk and we'll negotiate second because I want them to understand what we're trying to do and what we're trying to accomplish and I want them to see it firsthand.

I want them to walk the hallways and see the kids and see the families. And then I want to talk to them about, look, the families that are here, we're a closed campus. are here because their child has a catastrophic disease. Put yourself in their shoes. Now let's talk about technology and now let's talk about what problem we're trying to solve.

So like for example I've can't tell you how many times I've had people reach out from the vendor community and they want to talk about revenue cycle optimization, which I understand that's a huge issue within the healthcare industry. Not for you. First of all, let me go back to do you know, we're here, and yeah, we have a revenue cycle team, and they're fantastic.

That's not our driver is, catastrophic disease. And how do we end this? And so it starts with. understanding the mission it, it ends with them kind of coming back and forming a partnership that really , help them bring the technology to us that we need to solve the problem.

Yeah. That's really interesting. Probably going to get in trouble with some of my revenue cycle friends by no,

you're distinct. It's that's like going to the VA and saying, let's talk revenue cycle. It's different for the VA than it would be for. Another health system, and it's a little different for you you're not.

But then I had IT. And, IT, obviously we wanted to be a part of that culture, but there was distinctives within IT. It wasn't just, this is what we are. We wanted to have a culture of innovation and those kind of things. , that's how I would describe our culture.

I'm curious how you would describe the culture of St. Jude and the culture of the IT organization and how, are there distinctions in the IT culture or is it just one culture that's just one culture? is very focused.

for example, we have food trucks that used to come on campus. They starting to now again, but, long lines would be formed at lunchtime at these food trucks. But if a patient. I've been standing in those lines and you see a patient and their family and come up and they'd start to walk to the back of the line and everybody's Nope, Nope, you're going to the front of the line.

Your time is more valuable than my time. That just permeates the culture here. And so taking that to the IT organization, I would say that, That culture is there as well in terms of how do we make sure that our technology is serving the mission of St.

Jude. Not just today, but, a year from now, five years from now, ten years from now. But that's just part of the culture here is how can we help? And it goes to our core values, is how can we work collaboratively to make others successful?

And I love, that's such a great story to end on, because that culture of, hey, go to the front of the line for the food truck is, you want that to permeate IT, right?

We're here to serve. How can we, Make it work. Appreciate that culture. Keith, I want to thank you for taking the time to share with the community and share your experience and your wisdom. I really appreciate it.

Awesome. Hey Bill, it's been a pleasure. I really appreciate talk.