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Today on This Week Health.

(Intro)   At some point it's become about making it work for the business of healthcare, and I think it's not so much what can technology do, but how can technology be positioned so that it can help what healthcare is

trying to do

  Thanks for joining us on this keynote episode, a this week health conference show. 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. For five years, we've been making podcasts that amplify great thinking to propel healthcare forward. Special thanks to our keynote show. CDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders. Now onto our show.

(Main)   All right. Here we are for another keynote episode. And I'm excited to be joined by Dr. Hal Baker, CIO for Wellspan out of York, Pennsylvania. Hal, welcome to the show.

Thank you. It's great

to be here. By the way, we are recording. This was January 3rd. Yesterday was your birthday. We're celebrating a new year Happy New Year and happy birthday thank you very much for that.

Was it a big birthday?

Starting that seventh decade of life.

Wow. Yeah, so you're gonna be dropping a lot of wisdom Today is that what's gonna happen?

I, that, that line between what I think and what I say is getting thinner and thinner. .

that's an interesting point about getting older.

I remember when I was young, I thought everybody needed to hear everything that went through my head. I have such important thoughts. The older I get, the more I realized some of my thoughts are not that important. it's just that filter just becomes so much better.

It's should I say that to my wife? No, I don't think I should.

think we get better at determining those ideas we have that are useful versus those that are not.

And those that are going to require way too much explanation for the time that we have. I'm looking forward to this conversation.

And if I'm not mistaken, this is the first time you've been on the show. Is that? It is, yes. you've come to a 2 29 event, but I can't believe this the first time we're gonna be talking about the work of Wellspan.

Let's start there. Give us an idea of Wellspan the mission. What geography you guys cover and what kind of services do you deliver?

Yeah, Wellspan Health is located on the south central border of Pennsylvania. We are primarily six counties, though we do extend into parts of Maryland and have some services there.

We are a locally managed, locally governed, community based health system. About 3. 5 billion. Eight hospitals, but more importantly, 20, 000 plus employees. We're running about 3. 5 billion in revenues. And the interesting thing for me is I used to have to explain who we are, where we are from and what we do, but I think in the last 10 years more people know about Wellspan than don't.

And that's been an interesting journey because we've tended to be very humble but I think we do have some things worth talking about. Yeah,

I'm looking forward to getting into that and cause you guys have done some really cool stuff. I've seen some of the YouTube videos and whatnot that are out there, plus you talked about some of them.

Talk a little bit about the culture. Wellspan unique? makes Wellspan special?

I think what makes Wellspan special and why I've spent my whole career here, I'm 28 and a half years here. I've had a lot of different jobs have done many different things, had great challenges, a varied career but never had to change houses.

And the thing that makes Wellspan special is, I think, the culture and the people the integrity of the organization. The ability to call on somebody and know that if you're aligning what you're asking with the mission, they're going to help you. And just having that absolute trust of each other that we will work as one.

That's part of our mission statement, that we work together as one for our community. And I think that line is our tagline and center of our culture. So

Physician CIO, I love having Physician CIOs. on the show to talk a little bit about your journey. So I assume you went there. You started

your career there? I finished a general medicine fellowship at Johns Hopkins. And came up to York as they were starting a faculty practice in ambulatory medicine. I to say I have a homozygous deletion of my research gene. And I knew that A publish or perish world would not be great for me, but I really loved teaching.

I'd gotten involved with the American College of Physicians in their American College of Physicians online while I was at Hopkins, a role I worked in for about 10 years. But when I came up here, I was working at the residency program, but yeah, that was really early, and just even knowing the internet made me somewhat of an expert by comparison only to what was going on.

And I always stayed interested in what technology could do to help health care and at some point that became an opportunity for me. I went from teaching and education and training residents, medical students to become the first chief medical information officer, later CIO, chief digital officer, been involved in quality safety infection control, a lot of different roles here.

But the IT one has been Part of my career for the last 19 years, and boy, it's been a fascinating time. Yeah,

let's stroll down memory lane. The technology in healthcare has been a little bit fits and starts and it's, the emergence of the electronic medical record and the use of technology.

You're talking 20 some odd years. What EHR were you on 20

years ago? 20 years ago we were on Cerner we were, and just starting to roll out all scripts, TouchWorks. And we rolled that out in 2016 and had that system wide and, had a working as one philosophy on two different electronic health records.

And then through Mergers and acquisitions. I like to say that we got to the point where we had everything but epic. And in 2017 we converted to Epic. It was actually, 2006 we went on to touchworks. But in 2017 we went to Epic and have enjoyed the benefits of moving to a consolidated record.

I was at a system that had two different systems. We had all scripts in the inventory side and MetaTek on the acute side. And that has its own set of challenges. And we had some similar kind of phrase, it's one operating whatever, but it really doesn't function that way, does it?

did as best we could. And we did build one patient portal to bridge between the two, because neither company had one that would work with the other. And that was a very successful enterprise for us. We had over 150, 000 people on that by the time we flipped over to Epic. But it was more disjointed than I would like and I think our whole principle is, that we know you and when you show up at our place we don't start from scratch.

We start from where you're left

off. that's really interesting. talk a little bit about your physician perspective as you're, you come up through the ranks, teaching, then CMIO, then CIO. How has that influenced the selection of technology, the use of technology, the integration of technology into the practice of medicine?

I think that the part I played was I came in at a time following Buddy Gillespie had helped us get everything electronic, and now I was trying to make it work for clinicians so that we could work for ourselves and the record would help us versus us being slaves to the record.

The EHR has been a fantastic tool, but it often does have extremely strong accountability. You can't move forward unless you click certain boxes. And, Those tasks are great for the administrative purposes of the business of medicine, but they can sometimes distract from the focus. So we've really tried to work to make the systems help clinicians and try to fight that tension between supporting the completeness of documentation and the necessary care of the patient.

I like to say that a hand holding a mouse can't be holding a hand. And I do think that the recent years and some of the AI stuff allowing us to move the attention back to the patients has been very cool. Yeah, you

guys have led the way. Maybe that's being a little bold in saying that, but you've definitely advanced.

The use of the Scribe technology. I don't know what to call it.

Ambient's the term I think we're using. Yeah. Just a listening computer that writes a note for you.

Yeah. You guys have really have pushed that forward, have been written up a lot about that. Talk about your journey into that and what that has really meant to to the organization, to the physician patient relationship.

We started out with Allscripts and there we were getting a lot of pushback from our doctors and I recognize that a lot of the pushback about the technology being dangerous and people are going to die and all the hyperbole that we physicians are often able to create at times around these changes was often people who are really competent.

fearing they're going to look stupid because they don't know how to type. They don't feel confident in computers. And we found that Dragon was very quickly able to help us neutralize some of those fears and allow people to just speak into the dictaphone instead of to the tape recorder and record their notes.

And so we developed a relationship with Nuance and always had this idea that Nuance has been a listening company and If they could get the computers to listen and essentially take over some of these tasks that are lots of clicks, it would be a wonderful offloading of cognitive attention that could be refocused back to the patient.

I will call out Peter Durlach and Joe Petro, people who I was able to develop a really trusting relationship with over decades and talk about these ideas, and when they said they thought that this new product was finally ready for us to take a test drive with I jumped at the chance and got going with that three plus years ago in the summer, and was amazed when I went into the exam room, I still practice, by the way when I went into the exam room, how different it felt being able to not worry about the note and let it be written by someone else.

Yeah, pretty amazing, and I feel like when we were first using Dragon, we rolled it out a while ago, just as, not in the ambient form, but in the dictation form, and it was almost like the Model T, right? You spoke into it put things in, and it put it in the right boxes, and people would look at it and go, that's amazing, that was helpful.

And we've gone from that to ambient. which feels we're moving from a Model T to, some of the more modern cars in the 1950s. But it feels like we're also on the cusp of another renaissance with generative AI and the things it can do. And also just automation, like we're starting to link things.

even beyond this, where we're doing natural language in these things. What do you envision, from where you're at today, what do you envision the next thing might be in this space

There are so many different possibilities coming forward to us. some of them will be really cool, and there'll be neat experiments.

But what I really like is when something becomes useful to the technically agnostic clinician, the person who just wants to get through their day and doesn't really care how they do it they just want help. want to be doing what they went into healthcare for and have as few distractions and administrative overhead.

We all know it's necessary for regulations, for billing for compliance, all those things are out there. But we're really coming into work each day to take care of other people help them with what they're experiencing and trying to return them to their lives. Nobody really wants to be a patient.

We all want to be people, and we want to slide out of that patient role as quickly as we can and participate in it as easily as we can. So when technology can start to help us do that that's really cool, and it's been nice to see smiles return to people's faces with some of these things.

think the other thing that was always interesting, and I'm saying this so the nuanced people can't beat up on you.

Everyone wanted to expand its use throughout their system, but they just struggled because there was a cost aspect to it. And I think this whole idea of these large language models and being incorporated. I think it's going to drive the cost down and allow us to have more physicians now it's going to take some time, we have to get the languages right and those kind of things, but at the end of the day, I think there is going to be a uniform use of this you share that perspective that we're going to Do you see a more widespread use of this across the system?

I absolutely do, and were very deliberate in our analysis of DAX and Ambient and looked for things that would justify the expense because expense was, at that point, with the human reviewer, wasn't insignificant.

So we met with our finance team and we said, what does it do for us if we can squeeze one more patient in a week? Two more patients a week. We got down to a number and we figured with the direct revenue and downstream revenue if we could just squeeze one more patient in without any change of variable cost what would that do for us?

And with that, we were able to track, not that we asked people to do this, because doctors are very risk averse people. We're all, we all think about the worst things. We worry about risk the time. You want us to. We just observed what happened and we found that our clinicians were seeing on average 12 more patients a month than they were before we had it, and that was enough to cover the cost.

Now we were working on access, so our people not using DAX were only adding three or four, but that difference was enough to justify the expense. And it wasn't So much that people were being asked for it. But, we all have a triage we do every day of priorities. We get asked for things and depending on how stressed out we are, how exhausted we are, how much we think we're going to have to do before we can get home to our families.

We answer yes or no. On the moment, but I found myself just much more likely to add in another patient. Somebody was 10 minutes late, just put them in a room. And I think that was what I was seeing in all my other partners that was allowing us to be a little more open to the needs of our community and a little more flexible, a little more resilient.

What was the impact on pajama

time? That was tremendous. One of the fun things that we did afterwards is we started to survey spouses. And we got some really interesting comments back from spouses about what a difference the person coming into the house was. And that has been repeated.

Lance Owens, a friend of mine up at the University of Michigan has had the same experience. And that's where you know it matters, when the family can tell that mom or dad's just a little bit less stressed out. That's an

interesting metric. I never thought of that. I do want to delve into this a little bit, because you're a physician by training.

You had to And still

by practice.

And you still practice. Yeah. do any study in technology

and IT? I took one FORTRAN course in college in my freshman year, and that was it.

I don't think most airlines are led by pilots or most trucking companies led by former drivers.

At some point it's become about making it work for the business of healthcare, and I think it's not so much what can technology do, but how can technology be positioned so that it can help what healthcare is

trying to do.

Yeah, coached some physician CIOs as they make that transition, and that's one of the points I make all the time.

they need you to be a leader. They don't need you to the smartest technologist in the room.

Yeah, I think one of the reasons why many of us come from generalist backgrounds, emergency room, ICU, primary care, is that We are used to working around people who know more than we do on every topic.

There's always a cardiologist and a nephrologist that knows more than me, so I'm used to asking questions, bringing different opinions, and trying to find a path holistically through things. And whether it's a technical thing or a biological thing it's still some of the same diagnostic thinking.

If you can recognize that what you're trying to do is just trying to figure out how to apply therapies to help, it's a system or a patient experience or, sometimes a disease.

Yeah, there's a humility factor to it that I like in that. And it would be interesting one day list all the specialties and whatnot and the humility factor that we ascribe to those things.

imagine we wouldn't see many don't want to go there. I'll get in trouble for saying whatever I'm going to say next. Going back to what we talked about earlier of learning how to filter. One of the areas I did want to go down is not necessarily the technology, but the finance. One of the biggest transitions for people moving into the CIO role is to understand the money and the flow and the business and how to get budget and how to be a good corporate citizen in that whole aspect.

How did you come up to speed on the financial aspect of being a CIO?

Admitting I didn't know very much, asking a lot of questions going to some courses on learning, how to calculate a net present value and understanding the difference between accrual based accounting and cash flow and just recognizing, once again, I needed to pull on the people with the MBAs and the CPAs to help educate me.

But early in my training, I'd actually developed a curriculum. I called it Introduction to Real Life because medical school teaches a lot of things, but it doesn't teach financial planning. And so I had a lot of residents with, hundreds of thousands of dollars of debt. And to this day, some of them thank me more for helping them set up an IRA than for teaching them anything useful clinically.   📍  welcome to This Week Health, where every morning is an opportunity to transform your day with the power of health IT knowledge. Dive into our diverse podcasts on Spotify or Apple Music. Featuring shows like Today and Keynote, bringing you insights from the forefront of healthcare technology. But there's more.

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that's interesting in and of itself. talk about the patients. for a little bit. Patients in your community. York is urban. Are you mostly urban centers? do you go into Philadelphia? Do

no. Our biggest city is York. We're adjacent to Lancaster.

But, our counties are in the hundreds of thousands none in a million. we right now have touched about 850, 000 noses in the last 18 months. And that's what we keep count of. But we're, we have cities small cities. Pennsylvania is a Commonwealth state and often those cities have socioeconomic challenges.

Philadelphia and Pittsburgh are big, large cities, but Harrisburg's just up north. And we have Gettysburg, which is a very, unique community. Yeah, actually,

we talked about the ICD 10. You're the one I talked about with that. The ICD 10 codes of,

For bayonet injuries, yes. Because during reenactments in July, sometimes you have

bayonet injuries.

And the ICD 10 code is?

don't remember it right

now, but I could find it pretty quickly. Oh my gosh. Yeah, or, heat exhaustion for being in a wool coat doing a reenactment in the middle of the summer. Yes. I can only imagine let's talk about the patient experience and, the balance of technology and personal and how do you engage the patient, keep them informed, get them connected to the system access how does Wellspan think about that?

How does your team put together a suite of solutions that, moves the objectives

forward? I think very early in our process, we were just starting to do the patient portal. I remember meeting with our CEO team and asking a question about whether we were going to put lab results into the computer or wait until the doctor was ready for the patient to see them.

And it really was a fork in the road of, did we want to build a system that we were comfortable with as providers or the one we wanted when we were patients? When it was our daughter who was waiting for a result, when it was our spouse when it was us and we chose to build a system we wanted for ourselves as patients over the one we were always comfortable with, and that guiding principle, that fork in the road what I now call the golden rule I think served us well because we were open notes before there was open notes and a lot of the fears and the what ifs turned out to not happen, and the positive stories were there.

We, we had those ideas of the devastating finding, the person who clicks on their CT scan result and finds out that they have inoperable cancer. But that they were clicking refresh every 10 minutes. They really wanted to know. They wanted reassurance, but at least they're going to go into that meeting the next day with answers.

And we did. We put in things like a 24 hour hold when that was able to be done to give a chance to communicate that. We just constantly came back, would we want if it was us? And that principle has helped a great deal. So

the portal is is your foundation for communicating, creating that connection between the patient community and

the system?

a very big

Marker

part of our system. Approximately three quarters of our patients have an active account. And we're one of Epic's leading users of MyChart, but we've built out a number of features around it. We've taken advantage with them. We've talked to them about new features, many of which they brought from our old portal into their portal for things like proxy function.

But it is a big part of our brand, and interestingly, as we've done research on our brand, we've heard back that It's unusual for surveyors to see this, but they hear from our patients that our portal experience is a brand differentiator for us that they believe is unique and special. And we want to continue to accelerate that.

if You're using MyChart, how have you been able to do that? Because I think I've Five different MyChart systems that I'm a part of, and each one's a little different. It's not just cookie cutter anymore hey, here's your MyChart.

How have you guys been able to make that differentiation?

It's not holding yourself back. It's making appointments available online. You can book an appointment with one of our orthopedic surgeons online today without even having an account. It's making all your appointments available.

It's sending out scheduling tickets when I order a CAT scan, giving the patient the ability to self schedule that ability to make their spouse a proxy without restriction. It's just trying to walk through that. And then we've built out functionality around it, like I did a refill of one of my medicines.

I just took my phone and did a barcode scan. That's our technology. It's not in Epic, but it feels like it's part of the whole. Experience.

The last part was technology. The rest of it you talked about was operations. It's Oh yeah. I've said this a couple times on the show.

It feels to me like all these projects now are like 10 percent technology and 90 percent operations

Absolutely. And I think that's why those of us in clinical roles coming into it have to recognize that we bring a different set of skills to it. But me being able to go to one of my colleagues and have a conversation about how to think about using the technology and why we would want to do it and what's in it for them is really what I can contribute.

Is

there a change in the business model? Are you guys going more at risk with the population and taking? moRe value based care, more in that direction?

we are certainly looking at that and looking to that shift. In our region, we don't have a lot of full capitation, but we've partnered with Capital Blue Cross on a product in the Medicare Advantage space.

We do self administration of our own employee base for our benefits. And we're also working with our Underserved communities where the compensation often effectively makes it almost like capitation where you want to do the right thing and keep expenses as low as possible. So we, yeah, we are looking at those type of things.

What about virtual or at home? Is there a push in those directions?

Absolutely, yes. We do a lot of work with devices for heart failure patients at home. We have been working with Keek Care, we were one of their earliest clients, to use their integrated approach with Epic for virtual on demand care.

Some people call it urgent care, we run it more as a family practice online. But that's been really interesting for us and we're talking about a number of different opportunities with them from behavioral health to wellness visits for our patients insured through our shared savings plan.

All

I'm going to shift the conversation. This is going to be you and I just talking about the future here. a little bit. And I appreciate, I love the stuff that you've done, you and the team and the entire organization has done at Wellspan. But it feels to me like we're at An interesting point, especially with generative AI.

And it's, comes back to that thing you said earlier, which is, it's a technology, like I introduce it to my parents and they're like, Oh, this is pretty interesting. And they just sit down and they start asking you questions and whatnot. My parents are 86 years old. It's very accessible. a CIO, that there's something that's really fun about that, because, a lot of times we have to think of and worry about adoption and how we're going to do these things.

And there's things that are really scary about that, because all of a sudden people are like, Doing, letters back to insurance carriers that are written from chat GPT and whatnot. It's like, how are you looking at that? how are we going to navigate this really cool and accessible tool and this really cool and accessible tool?

Yeah I think carefully but without Lurking in the shadows, we've got to dive in and embrace it. One of the most exciting things we've been working on is with nursing, some of the work we're doing with tele sitting, but AI assisted tele sitting, because that can be god awful boring. So you try to marry what the humans do with what the computers do.

you're doing some like computer vision kind of trials

or? Yeah, we have increasing number of our patient rooms in the hospital have a camera that an AI algorithm is watching, not a recording, but watching concurrently and can tell when a movement is a patient trying to get out of bed versus a patient trying to roll over and highlight that screen for a virtual nurse.

who is watching 15 patients and alert them to look at this patient in particular. And it could even trigger a voice command to say, Hal, lay back down, somebody will be with you, if I was confused at the moment. It's trying to figure out how to marry the two together so that the things humans do and the things computers do are complementing each other.

How's the room going to change? We're getting to some Star Trek moments. We've talked about ambient. So you walk in as the doctor and you're not pulling up the keyboard and the mouse. You're speaking naturally to the system. you have a camera there. Are we going to have like remote vitals?

And what's next in that room?

I think it is going. to be that more of what is happening will be passively observed by the technology and less of it will need to be entered by the human. So right now I have to say that I'm emptying a Foley bag if I'm a nurse but you can imagine a camera could recognize that action and possibly even estimate the volumes that have been taken out.

All this stuff could be tracked passively. We're talking about repositioning people in a bed, which you need to do to prevent ulcers and breakdown when people are critically ill. If somebody's turning over, the camera can see that. Why does a human being need to go type that in the computer? They just did that.

So thinking about the ways that the environment can become a listening Observing situation passively and tell what's going on versus having people constantly feed the beast.

Yeah that's interesting. It's beyond interesting because the, we've talked about burnout and those kind of things.

curious the more of those mundane tasks, the more of those things that, you know, feeding the beast, sitting in front of the computer, typing things in, pajama time. These are things that have been cited as Really driving discontent and there's been this push towards returning the physician and the clinician back to practicing medicine, the thing that they originally got in there for.

as we put cameras into the rooms, you could really go in both directions. People could be like, Hey, are you looking over my shoulder? Or they could say, Hey, this is really nice. You're taking some of this. mundane stuff off of my plate. This is helpful.

Are they, are there those kinds of conversations that still need to be had?

Absolutely. One of our core principles, our values, is to presume positive intent because, when somebody raises bias in the highway, we usually think they're a crazy bad driver versus their child's in the emergency room and they're trying to get there.

That negative attribution bias is inherent in many of us, but if we can view these things as trying to be helpful and create credibility and trust, and those are won slowly and lost quickly then we can, I think we can be helpful to that. And I mentioned the cameras in the room. Those cameras do not record.

There's no playback. And that's been part of our trust promise is that we're not watching to catch you. We're having an AI watching to help you. And that's a dialogue.

that, that's a key moment. I know that some health systems have put covers on them. They go down and whatever, but.

That really takes away a lot of the utility of having that camera in the room. Where you know, you shut it off, you turn it on and that kind of stuff. I like this whole concept of it's not recorded and I asked somebody about this and they said, look, legal came to us once and said, hey, we need the recording from that room.

We just looked at them and said, it doesn't exist. And they're like, I don't, there's a camera there. It has to go to a computer. Where's, it's you don't understand. It feeds through the algorithm. It produces its output and then it just drops on the floor. It's gone. And they said, that was it.

And legal just could not believe that we have cameras in rooms that aren't, but , it has a function and its function is not to record. Now it can, clearly like in an operating room for those kinds of things, I guess you could. Use those functions a little differently?

You could, or you could use them just like that.

We're using a company called Artis site. We're bullish on it because it's a platform more than a specific solution. I can use it to watch for patients turning over or patients at fall risk, but I can also use it in the parking garage to find an empty parking spot. I could also use it for inventory replacement in the store room.

So using a technology and multipurposes versus. Trying to have 15 different solutions that orchestrate together. That's one of the dangers for all of us, is we can find a cool solution, and then we can get a second and a third. But once you start to have a mosaic, it doesn't come together.

And I do think that, maybe Judy was brilliant in choosing never to try to acquire other technology and integrate it because there's been something that arose out of that that I watched others struggle with the technology that.

know, you're entering your seventh decade. I assume you're not going to be doing this for another 20 years.

Talk to me about the next generation. What does it look like for you to prepare the next generation? You like to teach, you like to pass it along. your organization for what comes next after you are out doing your I'm sure you're going to retire and start doing reenactments.

That's probably what you're going to do living in that area.

it's a great. career to have been in. I feel incredibly privileged. love the people I work with and we have brilliant people on who work in our department who are really helping us move forward. So I'm very comfortable with who is going to be taking care of me.

My kids are all in healthcare. I've got a son who works at WakeMed in Raleigh in an ICU. I've got a son co graduating from med school. my daughter works in programming at Epic. I'm very bullish on healthcare because it's the one place where you get to come in every day and just try to do the right thing, and just try to help people and you're working with people who are aligned with you.

For all the struggle, that's the good thing. I think one of the reasons why 229 works so well is because we're all mission aligned. We're all trying to do the same things to our communities. And so we share and we're more collaborative than competitive. So I'm very bullish on the future.

I think the other thing we've done at Willow Allspan is leaned in and developed relationships with our vendors, so to speak. Those relationships with people at Nuance, people at Artisite, KeyCare, even Epic, Sumit, Rana, Shanbina. Putting in the time to develop a credible relationship with those people makes all the difference in the world.

Yeah,

it's interesting. When you talk about the next generation and making sure that Wellspan is well taken care of past your tenure. You're probably the first person I've heard talk about those partnerships. Those partnerships are the continuity, are part of the continuity plan.

If you have very strong partnerships with those key players. Their teams have some of the institutional knowledge and are able to carry things forward.

really Absolutely and, none of us are indispensable. The sun will come up tomorrow, whether I'm here or not.

You've got to foster a culture with your team that honors The relationship that you may have been part of starting but needs to continue past you and the person on the other side. And that's having an integrity that allows you to speak honestly, allows them to speak honestly, recognize when things are.

Setting confidence but also gives you the ability to have really crucial conversations when you need to and know that there's a trusted relationship behind that, just as there is with your co workers or your family members.

this going to be the last question here, but you're doing some investments there.

So Wellspan is one of the organizations that, that does some investing in startups and filling some gaps that exist and those kinds of things. Give me just one, one area where you're like, hey, here's a gap. Here's an interesting solution. Something that we're keeping an eye on that we think might have a future in healthcare.

Oh boy, there are a lot of them. I mentioned Artisite before. I walked into a booth at Epic and ran into Lyle Berkowitz, and he explained what he was trying to do with KiCare. And we were using another vendor for remote virtual visits that was White labeled as us, but disconnected, and I just saw the possibilities, and within 15 minutes, I was like, this is something that we should get into and help figure out what to do and you've got to invest your money, but more importantly, you've got to invest your time and your energy, because anytime you go live with something, half of it's wrong, and you don't know which half, and so you've got to iterate, And be resilient and have people who can lead with you and persevere with a vision of what could be versus what is.

So we've been both an investor but also a sweat equity investor with that team. And I'm really bullish around what it can do by integrating what is good about Epic. to allow, essentially, different health systems to work really collaboratively together because their platform allows essentially contracted vendors to feel like they're part of Wellspan in delivering care to our patients.

it's interesting you mentioned Artisite and KiCare. My experience after talking to Andrew, CEO of Artisite, and Lyle CEO of KiCare literally, after the first time they explained to me what they're doing and, Whatnot. I was like, I want to reach in my pocket and go, how much can I invest?

I wish I had this. When I was CIO, and both of them are doing quite well, I think, right now,

They're both very good at explaining the why, in a way that a layperson can understand. And essentially, that's one of the origins of being a doctor. It's being a teacher, it's being able to translate not just what you should do to treat your COPD, but why you would want to do it, and how it's going to make your life better.

And I, those two are very talented people. That I've really enjoyed working with.

Yeah, both physician CEOs and doing a great job. Dr. Hal Baker, CIO, Wellspan. Hal thanks for coming on the show. And I look forward to catching up with you again at a gosh, there's so much coming up.

Who knows where we'll catch each other, but we'll definitely see each other at a 229 event coming up here shortly.

Yeah, thank you for setting up that program. That's been a great one. Appreciate it.

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