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Today on This Week Health.

I've got tons of people manually taking data outta the electronic health record to put it into someone else's portal. Just painful. And a robot can do that. We could use those resources for much more interesting clinical things. I wanna start to get into some of the quality reporting that we have to do and some of that can be automated and freeing up our clinical quality people for doing more interesting work.

thanks for joining us on this week, health keynote. Today we have a very special episode, interviews with leaders from the floor of the CHIME 2022 Fall Forum. I'm gonna be talking with Andrea Daugherty, Pete Marks, Sarah Richardson, Mark Weisman. Andrea Daugherty is the CIO at Dell Medical School, University of Texas, Austin. Pete Marks is CIO at WakeMed. Sarah Richardson is Chief Digital and Information Officer at Tivity Health and Mark Weisman is CIO and C M I O at TidalHealth. Wow, both titles Wild. Hope you Enjoy. 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. Special thanks to our keynote show sponsors Sirius Healthcare, a CDW company, VMware, transparent Press, Ganey, Semperis, and Veritas for choosing to invest and in our mission of developing the next generation of health leaders. Now onto 📍 the show.

all right. Here we are at the Chime Fall Forum, another interview in action, and we're here with Andrea Doherty, CIO of the future,

CIO of the future. I mean, that's a lot on my shoulder.

That is a lot on your shoulders, but I look over my shoulder here and there's Teresa Meadows, John Glasser, and you, you're gonna be on a panel discussion.

Yeah. Well, first and foremost, I mean, John is kind of like father healthcare cio. You have to.

He was instrumental in the start of my career, making sure I made it as a cio. Yeah. And everybody has a John Glasser story.

Yes. Right. It's unbelievable. So I've, I've learned that and I've heard a lot. And then there's Theresa who just won the I of the year. Right. She's phenomenal. So I actually feel I'm nervous. I wasn't nervous going into it, but yeah, I'm definitely nervous being up there with such esteemed really influencers and kind of industry leaders.

Well, the good news is, and don't tell 'em I said. But the good news is they both talk . They both like talk, which is why I love having 'em on the podcast cuz they have great stories. They do. And they, they really say so. So if you wanted to just sit there and like pepper them with questions as the CIO of the future, that's really the, the role Yeah. Right. Is to tap into them and say, and learn as much as I can. Yeah. What can I, you, what have I learned and that kinda stuff. What do you plan to talk about on the panel.

Well, you have to come to the panel to find out. I will. No, I mean, I think a lot of it, right, the role of the CIO is changing. It's already changed so much and it's gonna continue to change. And so tomorrow during my panel, I'm gonna talk a little bit about what I see, what I envision the role looking like the next 5, 10, 15 years trending technology. That's I think more and more folks will start adopting. And then I'll sprinkle some nuggets in as well.

So you are the CIO of the future. I was talking with John Glasser we were talking about the changes we've seen. I've got a lot of gray hair, . And we both experienced the PC industry. Like we, we'd go into a department and there was only two PCs for 14 people kinda thing. Right, right. There was a time where these computers weren't connected to the internet. Yeah. And I remember we were both sharing how we talked to people about the internet.

They'd be like, I don't need that. What do I need to be connected to the internet? And could you imagine if we turned off the internet for a day now?

Oh, everybody would lose their mind. Well, we happen, right? Anytime there's an outage. AWS outages, right? We've had some of those. I remember, gosh, March of 2020.

So right as the pandemic's happening AWS went down, websites went down some call centers went down. People are freaking out. So I mean, people, you just can't function. The world can't function without it.

Mobile phone. What technology, CIO of the future, what technology I gave you those three things. Has the most potential to impact healthcare as you're looking at?

it

I would say artificial intelligence. I really think there's a lot to be uncovered there still. And in today's keynote, right, we heard Russ talking to the robot, which that was an interesting session that way.

Few technical glitches Yeah, few technical I was saying to somebody. You couldn't have a more sympathetic audience. Right. But it's sort of apropo where we're at with it right now.

Right? Absolutely. But seeing how we can really use that to augment and automate the person, right? Especially what we're seeing with labor shortages, right? Those are only gonna get worse.

And so really tapping into that artificial intelligence to really automate a lot of those processes. We are looking at, my own institution, right? We're looking at how we can really. use AI more machine learning, more, a lot of it's back office functions. But we're really starting to bring that forward and how we can improve that patient journey as well. So I, I really think that artificial intelligence is gonna play a bigger part.

Split up your split your month. I was gonna say day, but days two up your month for us, in terms of percentages, how much time do you spend on the keeping the trains on the track? Yep. The incremental change that you need to do and then the real future looking stuff that you're looking to do?

Yeah, that's a great question. Right now, I mean, I'd say we're probably 50% operational lights on, right. Keeping things going. I'd say another 30% incremental and then another 20% future. And I suspect that that's going to shift and I'll be working a little bit more strategically and forward looking because we have a.

So she's coming in, she'll be seated on December 1st. And so a lot, she's coming to us from Mayo, which Mayo's a very digital institution. So she has a lot of really great ideas. And so I'm, I'm really looking forward to that because that's what gets me excited, right. That's the fun part of the job is the strategic and the innovative stuff. So

What areas right now are you focusing on at. Interim CIO at Dell. Medical school and the University of Texas. Yeah.

Okay. So cybersecurity is top of mind. I think it's top of the mind for everybody. Obviously, so we're focused on that and doing a lot leveraging so, and a lot of automation in that space.

We are also done a lot of work from a standardization perspective, so it's none of the fun stuff. Governance, also not, not the sexy stuff, but it's fundamental, right? You gotta, you have to do this stuff if you wanna innovate.

If you don't do it right, you can't do the fun stuff.

Exactly right. So it's, it's doing all that stuff. And then like I said, we have some really exciting plans in the future as we continue to grow as an organization and volumes continue to increase, I think we'll be doing some more innovative things.

That's cool. So talk about the user experience. Yes. You guys are primarily ambulatory, correct. In nature. I would think having come from an IDNs, cuz so you have to marry the ambulatory and the acute right? But your ambulatory and acute are actually separate. Separate. How do you orchestrate the experience across essentially multiple systems?

Yeah. I'll be honest, we have a lot of opportunity there. Well, there's a lot of opportunity there.

It's, it's hard enough. Yes. When you're within your four walls Yes. And you

Yes. One of the things, I mean, just experience patient provider. Interesting. I, I probably get at least, I don't know, 10, 15 calls, texts a week from a provider. Right. That's employed by us, but practicing at one of our partner, institu.

Who needs access to something or is trying to get on their network and access something there. Right. And it's trying to figure out how, and, and to be honest, I mean, I don't know that we're ever going to truly solve that. At least not in the next, I'll say the next 18 months to three years. But you know, for our patients, I think the experience is a little bit more seamless to them because they're ambulatory.

Is connected to our inventory ehr, so we're able to send data back and forth. But the acute care setting, I mean, it's, it's tough. And I'm actually a patient of both, right? , right? So navigating it as a patient and then also being an operator there's a lot of opportunity there.

Talk to me about staffing. Yeah, so, so staffing has been one of those things and not a topic I've covered much with people at this conference. Do you think it's going to ease up now? Cause we're hearing things like meta is letting people go. Yeah. Twitter cake it around Microsoft. Microsoft and others. Yeah. So big tech is putting people out in the field.

Mm-hmm. that we've wanted to get for, for years. Yeah. Do you think it's gonna free up a little bit?

I mean, I think we're still gonna run into we're, we're still gonna have shortages, right? I mean, a lot of those folks I think they will kind of transition over in healthcare and it'll, I think it'll alleviate some of the burden.

But I still think we're gonna have challenges. And I say that because healthcare, when we talk about kind of the state of the economy, it's, it's really a recession proof industry for the most part. But I don't know that a lot of those people are really. Jump over and I don't know that they're gonna be willing to learn kind of the healthcare side of things.

I, I'm more worried about the fact that even though they will be outta work there, the salary structures are gonna be very different.

Oh, absolutely. Yeah. Absolutely. I mean, you're cutting in, in some instances like 60, 70%. Yeah. Right.

I could see them more going to towards the healthcare innovation companies,

startups. Absolutely. Yeah.

But yeah, I mean, we'll, we'll have to see.

I mean, I think there'll be an opportunity maybe for some of our developers, right? So DevOps space is definitely taking off and more organizations really want to do more around DevOps and DevSecOps. And so I see an opportunity for that space.

To maybe cool off a little bit, but when we talk about architects and the really solution healthcare solution oriented folks, I, I think we're still gonna experience the same shortages.

The learning curve is pretty significant. Yeah. Did did you come up in healthcare?

I came up actually, yeah, I did. So I actually started, my first healthcare job was a pharmacy technician. Yeah, I did not know that. Yeah, yeah, yeah, yeah. So I was a pharmacy technician throughout college. And then I did my first implementation was an epic implementation at the University of Kansas Medical Center. And so that was like my first taste of ehr and that was 2008.

Oh, and you just fell in love. And I loved it. I loved it. I was like, oh, this is cool. Like I can marry healthcare, which is what I always knew I wanted to be in. And there's this technology component and it's really starting to take off. And I graduated from University of Missouri, Kansas City which is in Kansas City where Cerner is headquartered and they recruit very heavily. And so yeah, that was my first. Professional job out of college was Cerner. And so, yeah.

Yeah. And you're, I sat in a room where you presented to a bunch of CIOs on project management approach and methodology, government, and and you held, held court. It was very impressive. I mean, it was, and that was an intimidating group.

It was to stand up and do that with we're gonna close on this Kansas City. So you're a chief saying die. Do you think they're gonna be able to win it this year? Not just as a fan, but as a critical fan? They're just squeaking 'em out this year.

Yeah. There's, there's been, these last few games have been really close, a little too close for comfort. So playoffs, definitely. I think we'll get there. Oh, absolutely. Yeah. Playoffs, no brainer. To come home with another Super Bowl title. I don't know. Tbd.

And the only reason I bring it up is I didn't know how much of a fan you were. Yes. Until the other day we're, we're walking up to my room and you're there and it's like, I'm like, oh, where you going? I gotta go down to the tv. Chief should play. And I imagine if anyone came up to you at that point, it would've been like, you're dead to me. I'm watching this.

Yeah. There were a few folks that tried to have a conversation. Listen, not right now. Not right now. Not right now. So

unless you're gonna cheer for this key, I don't. I don't really.

Andrea, thank you. Thank you. It's always a pleasure.

Great 📍 seeing you.

All right. Here we are from the Chime Fall Forum, another interview in action. Pete Marks CIO for WakeMed. Yes, sir. have we met in person? Is this the first time we've met in person?

I can never tell anymore cuz I You meet I know. I'm

gonna We definitely done the Zoom thing.

I'm gonna say Yes. Which is weird. , I think it is. The first time we met, first I met somebody the other day and I was like, we absolutely met in person. They said, no, we have never. And I said, well, I've seen you every week. And so, yeah.

Well, I mean that's the great thing about this conference.

I think it's an additive property. If you meet somebody 50 times on a video teleconference call, you met them. Okay. That's my, that's gonna be my new metric.

Well it's interesting, I was talking to a group of people. We're just gonna riff at this point. I mean, I met with a bunch of recently graduated college kids. And we were talking about digital transformation, and I was talking about the metaverse. Yes. And I was saying, all right Oculus, whatever. And if you meet through there, have you actually met the person? Yes. And they all said, no, you haven't met the person. I said, okay. I mean, there's this class of like 30 people said great.

If you met him in Zoom, have you met him? Oh, yeah, yeah, yeah. Of course. I'm like, yeah, why is that different? Yeah. Like, well, they couldn't come up with an answer. Yeah, yeah. And I'm like, right. But I'll tell you what's different is I'm standing here, I'm listening to you talk to somebody, and you have a background here in San Antonio?

I do. I grew up, well, not grew up, we lived about a mile from here for.

for 12 years. Yes. And you've been to the Valero Open that's we're at the place where they host that.

I have, that's, I don't know anything about golf, but I've been to the Valero, open . It's just a beautiful course to walk. Oh, it is, it is beautiful. And hang out and, and they have a lot of disabled veterans and soldier and sailor and airmen events here. And so we would come and volunteer for those. Pick up golf balls, shag balls, whatever they wanted.

I mean, we're standing here. The beautiful thing about this location is there's the canyons right there, and it's beautiful mountains. Yep. it's really nice.

It would've been nice to have property here about 20 years ago.

All right. We'll get back to the interview. Tell us about Wakeman.

We're doing great. I mean, I think we are doing the same thing every healthcare organization is doing. We. Trying to help our nurses find joy. We want them to stay. We need them for our patient care. So anything we can do to be helpful in that area. Mostly it's the nurses doing most of the heavy lifting and we're trying to find opportunities for them to find more joy through using it.

That's interesting. We've had this conversation, well, there's been three things people have brought up over and over again, financial. Clinician burnout and finding joy. I like that better terminology than burnout. Yeah. It's great terminology. And then the third is cybersecurity We're not gonna go into the cyber security one, but I do wanna talk about finding joy. What are some of the things we have identified? What are some of the things that Wakemed has identified that is taking joy away from practicing medicine?

Yeah, I I think the documentation process, when you have plenty of people to do it right, they'll do it. But when you. don't You need to really look at those workflows and say, is this working for them to have a better work experience? To provide better care? Right, to let them practice at the top of their license, right? When your labor costs aren't something that you're really intrinsically focused on, then you're not focused on them. And so those workflows may be very inefficient. And so looking for opportunities to make them more efficient and help people find more joy in use of the system is important.

It's interesting. We're at a. Okay. And whenever somebody asks me, it's like I don't understand what the clinicians are going through. I'm like, right, you're at this conference every meeting you have, everybody you talk to, I want, I want you to stop when you're done. Yeah. And write a short note for, for about 10 to 15 minutes.

Yeah. About exactly what you talked about. Exactly. What next, all that stuff. And by the way, if another conversation starts before you get to write that note. Doesn't mean you don't get to write that note. It just means at seven o'clock tonight when you go back to your room, I expect you to write a note for everybody you talk to today.

Yeah. They just look at me like, that's insane. Who would do that? I'm like, doctors, nurses. This is what they do every day, every day, every day. It's kind of amazing. Are we looking at things beyond the Ambient clinical listening and those kind of things. Is that a part of the solution that we're looking at?

Yeah. That, that's not our first, our first is like, do the templates make sense? Right. Are they efficient? Okay. Can we use maybe a little bit of virtual nursing? Right. And we wanna be thoughtful that it's a partnership, so we don't want to come in there and say, here's some cool technological solutions, cuz that could make it actually worse on them.

And so it really is about the partnership with those stakeholders and saying, here are some things that. Which are the ones that would help what order should we put them in? I mean, they're busy, and so sometimes bringing in technology too quickly can make it worse. And so those are the things that we're really focused on. Templating a little bit of ambient but it's more of a thought than it is a direct action for us at this point.

it really is looking at redesigning the practice and the workflow. The data collection requirements.

Charting. Charting, exactly. And then maybe a little bit of virtual nursing. Cause we do a little bit of that now in my organization. So we have an E ICU where very experienced nurses, nurses sit behind the camera and they are observing those patients in real time and documenting their care as. And they have so much experience that the nurses that are on the unit may call, will call them through the camera, or they'll get called from that nurse.

And then it's a kind of a collegial care environment that we do to make sure that we use some virtual ability to take care of these patients. And that works at Weight Med.

We've had a lot of nurses come and go right in, in a lot of health systems have what are you doing in terms. Making those nurses more effective quicker within the health. I assume that's a, a challenge that's been put in front.

It is. And sometimes it's the small things. So onboarding getting everybody coming in once and having access into every system that you need Yeah. Is bigger than most people think. I think we might jump into, Your clinical workflow and is that right? But just getting them when they come to the first day of work,

yeah, this is your first day and you have access to the work you do.

Right. They, they, they have access to everything they need. The templates are right. They don't have to worry about those things. They don't have to call their manager and say, and we're not doing that as well as we should at this point. But when you. Have the challenges that most healthcare systems do now you say, oh, this has now gone from something that maybe wasn't a huge priority from us. We knew it was going on, and now it's a huge priority for us to get that right.

So the conference, have you been to focus groups?

Yes. My favorite thing to do. How, how's it been? The conference is great. I mean, congratulations to Chime. Yeah. I started in. I think it was 95. My first job was 94. Wow. I can't say that my, it was different back then. It was kind of this really kind of academicy kind of interesting organization.

Now it's a big organization. A lot of great vendor partners. The thing I love about it are really twofold. It's all about the relationships and the partnerships. One is the CIO community is incredibly collegial to each other, right. I'll go to anybody and say, I have this problem, and they'll go, I do two.

This is what we're doing about it. Then I have to play that forward for my other colleagues and friends, and everybody's just super friendly, so there's no competition. I love that. The other thing is I love the focus groups because instead of being in a sales meeting, the vendor community comes out and says, these are things that we're thinking about and we get to talk to them about what we're thinking about, and hopefully we'll get. Products and partnerships out of those. Right. That's the other favorite thing I have the focus groups.

So what focus groups have you been to so far?

I did AGFA Today which is a vendor partner of ours at Wake Med. And what they were talking about was a little bit different than what we're doing at Wake Med, but great to hear about what they're thinking about strategically.

Fantastic. Track sessions

good. Yeah, always good because it's usually colleagues standing up there and got to see the challenges of the CIO yesterday. You know it all, but when you sit there at a group and go through it, the public policy one was awesome.

Who's the challenges of the cio?

It was Aaron MI Oh, Aaron, yeah, yeah, yeah, yeah, yeah. Aaron, me. Yeah. Yeah.

it would be interesting, but we could have put anybody up there at this point.

There were more. Yeah, there was. It was a good panel.

Well that's fantastic. The. Wakeman, do you guys serve predominantly? Are you urban and rural? Yes. We've talked about this. So you're like Raleigh Durham?

Yeah. Raleigh more than Durham started as a hospital that people of color couldn't get care, and so Wakeman started under that. And so it is a urban hospital with now a rural, I wouldn't say rural, but on the outskirts of Wade.

I feel like when I leave Raleigh, I've entered rural. I guess it depends where now I was in southern California. So you don't get to rural until you're like an hour and a half through.

No, I think it's, I think it's a good point, . Yeah. But it's beautiful. So, I mean, one of the great things about Raleigh is you can be at the beach in a couple hours and you can be in the mountains in a couple of hours and it's, the climate is really nice. I mean, I love Texas. My wife loves Texas. She loves the heat in Texas. But I find Raleigh to be really nice.

how do you address access to care in your community?

So we do a number of things. One of the things I think we started about eight months ago in patient engagement is bringing patients in and asking them what they think. And so, not my idea the idea of our patient engagement. And so we have a group that actually meets not only internally with our wake meers, but they bring in some patients and say, you were an inpatient. How did this work for you? Where did you see gaps? Oh, out. That's acceptable. You were an outpatient, right?

How did this work for you? Where do you see gaps? And so that feedback mechanism, because it's easy when you're an insider to say, oh, I'm sure that works But until you bring somebody in and they feel comfortable saying, I like this, this didn't work as well. Could you do something like this? And that feedback has changed the way that we look at business.

Yeah. We were talking to somebody about they put a button in their ehr. It's just a button to, to let the IT organization know that they had a problem or whatever. Yeah. And all of a sudden the number of tickets went through the roof. Yeah.

Because they made it easy for them to communicate, Hey, I've got a problem. Yeah. It's that feedback loop. It's the transparency that you're looking for. Your, your team at WakeMed has created that transparency into how the experie. Is impacting the community. Yeah. They're fun to work with. It's a group at Wake that's fun to work with.

I wanna thank you for your time. I wanna thank you for stopping

by. It's always good seeing you, my friend. Great seeing you. Yeah. Never seen you before. How about that?

Well, now we have at least a 3D picture of each. Yeah. 📍 Amen. Fantastic.

All right, here we are from the Chime Fall Forum, and we are here with Sarah Richardson. And no fall forum would be complete without us getting a chance to talk. And thank you for doing this. Appreciate it. Of course. I love talking to you. Amazing conference though, isn't it? I mean the, what I've heard so far is the focus groups have been good.

The track sessions will be good. Yep. And I got, I don't get to sit in enough of the stuff, but I got to sit in on that talk this morning, which I thought was fantastic. John Glasser, Andrea and Teresa. I thought that was fantastic. What's been your experience so far?

I love what you said about, so Chime very thoughtfully has made sure that they are constantly formatting programming. So you notice focus groups are an hour this year versus an hour and a half in the past, and you can choose up to, I think five it is at this interval and it's really more about dialogue and question based focus conversations in these meetings. I've had a couple already where it was really just the idea of sharing what individuals are doing in health.

And we've all been doing the same things over and over in different scenarios. What's important about the adaptation of that now is the fact that, and you heard it this morning from the past present future panel, which I loved, is that whether it's disruption, whether it's innovation, et cetera, it's taking all of the things you have in your ecosystem and finding ways to make them work better together.

It's not necessarily best of breed, it's not necessarily different platforms. It's probably a combination of all. Yeah. And within those you have utilization you haven't even figured out yet. It's bringing vendors together. We talked about this in our podcast recently. Bring three or four of your vendors together to help you solve a problem that still exists, that doesn't need one more application to fix it. And then everybody's innovating together in a way that's really organic and not forced.

The thing I appreciate about you, so we've interviewed two people from your staff. Yes. And you do a lot of work with Chime andwhatnot You really are committed to the next generation. Yes. And giving back to the, which is part of our mission as well. Give us some ideas of how are you giving back to the next generation? Making sure that when we're gone, which hopefully we'll be soon, I mean, we'll be retired soon.

Retired from this to the next endeavor to the next thing.

Yes. We're gonna hand this off to a very competent group of you. How are you that?

One of the things I love best about having a broad network and going out and actively meeting people all the time and being curious about them. So my coaching background allows me to ask open-ended questions and then listen to what people are telling me. And you amass enough of that. Your own brain's a pretty good database when you let it be, right, that you'll know what people want to do next in their career or what they have a passion for.

Now, what you're. right now may not be what you're passionate about. You may just be good at it, or you may be in a system or a vendor partner that you'd love to apply that somewhere different. And so often we get stuck because people think we're good at the things that they see in front of them. Two of the people that are on my team now that are here that you have spoken with, I've known them for over a decade.

And when we all worked together, once upon a time in another state, we all said, someday we wanna do something cool together. And wouldn't even know what that was gonna be until I got to. Right. And then another thing had to happen, activity had to be a place I wanted to bring people, right? Because we've all worked for organizations where you're like, I'm not gonna bring my network here because we can't do the things you want to be able to do.

It's being passionately curious about other people understanding what they want to do next, and then you fill those gaps thoughtfully. And what's really important, bill, I believe in the evolution or the journey of people's careers and lives, is when I reached out to both of them, I said, you get first right of. refusal If you say no, that's okay. Our relationship doesn't change. It just means not right now.

Right. It's interesting, the, one of the things I always coach my managers on is, is this question of, I want you to be able to answer this question. I shouldn't have to talk to your staff to find this out. What do they want? What do they want to do with their career? What do they want to do next? What's the thing that really gets them going and gets them passionate? And you actually mentioned that right there where you're saying, I have this group of people, I, I know them, I know what they want to do and what they're, and I love, so we talked to g on the G David, g David Jimo my gosh, just he exudes passion.

Yes. Because he's doing like what he was put on this earth to do. He is, it's it's so, it's so important to find the right, the right people and put 'em in the right roles. But you're finding the right team. You started recruiting 10 years ago for this? Yeah. 15 years ago. Yes. For this. I think that's an interesting concept that taking that longer view gives you the ability to build out this team today because you were developing relationships and doing all those things like that.

Well, I also wanna do like four or five things next. I'm not going to go be the person that you call the next, the next health system that wants this or that done. Like in all honesty, I did 20 plus. In hospitals and primary care and academic and for-profit and non-for-profit. I've done all of those things now I'm sure I could do all of them better or differently than I did in that round.

And now I'm in a location that's sort of in between the payer and the health system space, which I love because you can do a lot of really unique and clever I things that will really change the face of, of health and wellness, whatever's next. It's something beyond both of those. It's probably healthcare.

But it may be private, it may be vendor, it may be a hybrid. The diff. The thing is, I know there's something next. It's not specifically defined. When you tell people your intent is, Hey, three to five years, I'm pretty certain I won't be doing this job because A, the people behind me deserve it and I'm ready for the next thing, whatever that one up being.

I love the fact that as you meet different people, you just know, Hey, if I went, if you called me tomorrow and said, we're gonna go invent this company, we would say, who do we. And we would just make a whole bunch of phone calls. We wouldn't even need a recruiting agency in that respect for our, our first group of humans that we would want to change the face of whatever as we choose to do next.

man, I don't want go in that direction cuz I love what you're doing here. Talk to me a little bit about t I was gonna say, what are you gonna do next? But you can't answer that question anyway. But talk to me about t a little bit cuz when you came into t what drew you. I mean, what, what captivated you to it? Because you had, you had options. I did. and, what gets you excited about that work today?

The first thing was I had to go work for somebody I admired, and trusted and would teach me things that I didn't know how to do before. Because honestly, when you get into big organizations, and I've come from several of them, you're not forgotten.

But you don't necessarily get access to the person who makes the decisions. The CEO a big draw to. Was a Richard Ashworth, who is my boss. He has a storied background in healthcare and wellness. He's an amazing and visionary leader, and what I always say to people, what I love about him is that he lets me have the autonomy to run my team, but he does not ignore me.

So I'm involved in all of the decisions that we make as an organization because depending on your definition of digital, which has been in lots of conversations this week, we enable the things that. To do what matters in our industry. Technology's an enabler. That's what I love about it, and it's pretty ubiquitous in the fact that technology's there.

How do you wanna implement it? Cuz your workflows and your processes are the things that get in the way. Sot is dedicated first and foremost to senior wellness through Medicare Advantage, health, wellness, nutrition, social isolation, independent living as long as possible. Like who doesn't wanna live a longer, healthier, happier, independent life.

You only wanna live a really long time. If you're healthy doing that, we create that. For seniors if you have your benefits throughout, 18 million people do. And then we have two other branches of our organization both also dedicated to health and wellness. As you well know, I'm a big fan of health and wellness across the board, so the ability to think about how you dress aging populations and serve your seniors at the same time.

Digital literacy is a, is a thing like our seniors are so much more digitally competent than people ever gave them credit for, and so we engage them there and in person. It's just, you feel good when you know that people are with you because they want to feel good, they want to have longer life. They wanna be able to take the necessary steps.

And it's not after necessarily an event or trigger event. It's before that. And that's what we're all trying to do. You want people to be well and be on that journey with you. And historically healthcare happened to our seniors. Now they realize if they're, he. There's still gonna be a part of that combined decision making and journey. So we enable people to make better decisions about living a long time.

You have an interesting background cuz you didn't necessarily come up through the tech track that a lot of CIOs did. And today we talked about the CIO of the past, John Glasser, who we talked to. Theresa was the CIO of the president and we talked to her as well. We talked to Andrea as well. Yeah. CIO of, of the future. It's a very different role. You don't necessarily need to come through that tech track to be a CIO today. How have you been able to thrive in the role?

I know what I'm good at and I know what I'm not good at. So you bring in G. So I bring in a guy like G, which is sort of fascinating because infrastructure was actually what I used to be. I didn't necessarily come up through technology, but started in theological more leadership space.

I just found the longer I was in leadership as a CIO and I'm going in, I'm doing board meetings and I have to talk to supply chain, I have to talk this and this. Yeah. All of a sudden I'm going back to the, to the architecture meetings going what is that? Yeah. Like, I don't know what that is anymore.

There are components of things that I don't know well enough to ever wanna be the person on stage talking about them, and yet I'm. Know enough about them to have a valid conversation until I get the expert in the room. I'm sure when you've talked to my team, when you've talked to three of them so far, they are the best at what they do.

I know enough about what they do and what we do from them to bring them together, help us do amazing things as a team. I am not gonna be the expert in any of those conversations. I will be the master facilit. And a moderator to a degree. I'm the one who can be the interpreter up through the business channels because I have a passion for the business and how we not only make money so we can thrive and do new capabilities in the organization, but all of it has to work together.

And as the CIO and doing the digital components, every single stakeholder has a voice in how we bring forward our solutions and our new capabil. So it's not just about the technology, it's about the business, it's about the environment, it's about the industry. It's about the trends that are happening out there.

The economy, health economics is one of the things I talk to my team about. So you have to be curious at a broader level. I also make myself uncomfortable every day. I try to always be talking about things I actually don't know enough about so that I can ask the questions to be more knowledgeable about that. So I'd like to be constantly uncomfortable,

I was actually gonna go in that direction and say, what's the most uncomfortable meeting you've been in? In like, I don't know, say the last year, where you're sitting there going, this is, this is well beyond my comfort zone.

Yeah. It's when I got toity and realized that we are predominantly a homegrown multitude of software platforms in languages that are all over the map, and then most of that being on.

And knowing we had to modernize data centers only long enough to move ourselves to the cloud, to then retire our data centers. So our journey over the next three to five years, if, if even takes, it won't take us five years. My CFO would have a meltdown. If I hear me say five years, it won't take five years.

It's modernizing those things fast enough to also be at the same time, planning their demise to a degree and in that whole space of like how you do that, that quickly and changing infrastructure to keys. And changing everything to be cloud and we like singular cloud with multitenant locations versus multi-cloud strategy.

You could argue either of both all day getting comfortable with all of that because in my lifetimes previously for the last 10 plus years, I didn't run those spaces. I worked for huge companies that had those teams that did those things and they handed you what you had to go do from really an implementation perspective.

It's getting in the nuts and bolts that I've been like, I can still do that. I still know how to drive. And you know what, now we're on a race track. We used to joke, we had a Ferrari on a dirt track. We now have a Ferrari on a race track, and we are proving that out every single day.

Yeah, I know. I love that. I remember when I went in at St. Joe's and asked for a modernization project. I said they said, how much do you need? I said, this much. And they said, oh, how much time do you need? I said, five years. And they said, five years to modernize. How about you do that in three years? I'm like, well, how much money am I getting? You have all the money. You just have to do it. Is that a recurring theme for you? We've gotta move faster. Faster,

absolutely. In fact, my call, even before I came to chat with you was with my procurement guy because we know with inflation specifically and just the way we want to think about our contracts, we've got to be renegotiating them and refactoring them in a way that's beneficial to us and still serves the purpose of our partnerships with our vendors.

There's tons of hidden cost in things like your vendor procurement spaces and your contracts, and it doesn't sound very sexy cuz it. Regardless of the size of your company, those get away from you faster than anything you could think of. And every time we go find a dime, as I call it, cuz we're small, we can go spend it on something else that's gonna increase the engagement, which creates revenue streams and allows more members to have better services from us.

So everything's always about the juxtapositioning of what goes from where and to where and how you create people around you that can do all of it, not just one piece of it. That's the joy of being in a smaller.

I love our conversations. Thanks for 📍 stopping by.

All right, here we are at Chime Fall Forum. And we are joined by Dr. Mark Weissman with Title Health fellow podcaster. You actually created this CMIO podcast I did back in the day. Yep. And now you're actually doing some of the town hall shows for this week health.

Yeah. The town hall shows have been great. It just gets us in front of some really interesting people, gets some really interesting conversations. So that's been a. Plus I get to collaborate with some of my fellow CIOs and CMOs around what shows we're gonna do. And that's been fun too.

who have you talked to recently?

Brett Oliver would be one. Linda Yang has been another one who recently spoke to, that's been fun.

Yeah. Absolut. I love doing the podcast because for me it has been a way to really stay in touch with what's going on in the industry and hearing from other people and having conversations. And I used to listen, yours was one of the podcasts I did listen to because you talked to a lot of physicians because back then you were in the CMIO role mm-hmm. and you would unearth a lot of stuff that was going on in the CMIO role. And it was really fascinat. But now you're in the CIO role.

I wear both hats. I didn't, I wasn't able to get rid of this C hat. It just tags along too.

I was playing golf with this CIO today and he said, yeah, we through attrition we lost our had a COO essentially and they split up the role. And so the CIO is actually over imaging and labs now. And it's interesting to me because the CIO. Can step into that role cause they have that business acumen are you seeing the role of CIO shift at all?

at least in my change from CMIO to both roles, cmio, cio, the business piece has been the just forefront I'm running a business now as opposed to when I was doing informatics, I tried to find things that had a positive. Now it's, I'm truly running a 35 million business, 150 employees with an expectation that I'm going to improve the bottom line of the organization, make the organization more efficient, or help with length of stay or readmissions. I need to be using my energies towards the business goals.

What are the kind of things you're working on right now?

efficiency has been one of the bigger things we need to. S done the same amount of work or more with a lot less people cause we can't find them. And robotic process automation, I, I have stood up my own little skunkworks and we're seeing what we can do to automate some really, really boring things that we do in healthcare.

Populate registries. I've got tons of people manually taking data outta the electronic health record to put it into someone else's portal. Just painful. And a robot can do that. Yeah, that's one that, yes, we could use those resources for much more interesting clinical things. So those are the kinds of, that's just an example of one of the areas that I, I know a lot of people are playing in that, but there's a good, I, I wanna start to get into some of the quality reporting that we have to do.

and Some of that can be automated and freeing up our clinical quality people for doing more interesting work, not just the finance people. That's where RPAs tends to be.

So, you know what's interesting to me about RPA Mark is when I talk to people about rpa, I immediately go to what are the use cases that you're doing with it?

And what I'm finding is there's a lot of them. It's like every health system has identified a little different thing they want to do with rpa. Or the CIO has identified some things that they can do, put 'em out there, and then they say, yeah, let's, let's give that one a try. But a lot of it is taking the. Away. That's the recurring theme is we have too much of the mundane work being done by clinicians. Is that part of the goal is to just eliminate the burnout that's happening?

I believe that the nurses that we tend to employ to do a lot of this mundane work, we'd rather do more interesting things. They do it because they know it's important to the organization. There's a regulatory requirement typically that's kind of underneath all this, but they would. Rather help patients feel better and prevent readmissions and stuff. No one wants to come back.

Are you saying that no one, when they were saying, Hey, I'm gonna go to med school, I'm gonna go to nursing school or whatever. They, they said I, because I really want to document my day. Yeah. I want to document every interaction I have today. And I just want to and I wanna move that field from there to the registry. This, that sounds like great work for me. No, none of 'em got into it for that reason.

They didn't, we. A happy experience. Mom gives birth, alright. We take a piece of paper, we write down the baby's name, then that goes to a secretary who then is gonna enter that. A nurse is gonna pick that up and enter it then into the state registry. Just manual process after manual process, after manual process. That's healthcare. It's not unique to us everywhere.

And really once, once it's digitized, once one person types the stuff in, it should be able to move from system to system to. Without any problem. Or, and, and that's registries, but that's also some claims data. And finally that stuff. I've seen

training documents we gotta, we've gotta register people for training classes. And so HR says, okay, here comes a new nurse. We know what they're gonna need. Like we should be able to automate those next processes. Provisioning. We should be able to automate. We get it wrong all the time. New nurse comes in, we'll leave something. Those are things just from a business standpoint, we have to run our business better, more efficient, and that really matters to the experience of that nurse the first day.

What does it feel like? Can't get into Epic. Sorry. What's she gonna do or he gonna do? We're getting better from a business standpoint.

Are you being asked as a CIO to we're bringing a lot of traveling nurses, a lot of travelers and whatnot to. Help them to get up to speed quicker. And what, what things are we doing to help them to get up to speed quicker

for the variety of positions that we're bringing on could be locums doctors. Could be, that's true. Respiratory therapists. What? Yes. We have a lot of people that we need to not only train on the tools, so we're an epic shop and a lot of these people will come with us Epic experience, but they don't know the title Health way of doing the documentation that we require,

but, but you're pretty close to foundation.

We are. Okay. We are. But even. there's gonna be that 20% variability that people will look at you funny if you're not doing it that way. So yes, we have to come up with that, but we gotta be efficient and we've gotta be able to scale it. We, we can't take and just keep growing principle trainers on top of each other to scale as the organization grows or as the training needs the ebb and flow.

Some, some weeks you have 50 people coming in, some weeks you have three. You gotta, you gotta come up with new. And we're doing a lot through videotape. We're using a lot of in collaboration with Epic in terms of building that content and making it interactive. All these ways of improving training are now very important to the organization. Plus they have to onboard quite a bit.

when we look out one of the things a cio, you're saying, we're running a business. So part of it is, Hey, what are the challenges that we have right in front of us? But what's. What's the project you're looking at that you're saying, Hey, it might be a couple years out, but it can have a real impact on the way you deliver care at Tidal Health, or the way you practice it? Operations at Tidal Health,

I wanna be much more proactive in the way we're handling some of our IT things. We the other day, the paging system went down. How did I find out? Well, the end user's, like we've been paging Dr. Joe and he always returns the call. It's been a half hour. We really could have used.

him Well, turns out the paging server is down. We need to be able to ping that device on a regular basis, get that in. That technology exists, we have to deploy it, and it has to be for our systems that are in the cloud, the systems that are OnPrem. It has to be comprehensive, complete, and something that our service desk can understand and be able to start reacting to and without a lot of false alarms.

It really is integrating all aspects. I mean, when a system goes down, it shouldn't be a person. It should be an alert that goes not to you. You don't need to know . It goes, it goes to the desk and the desk knows, hey, cause they have a set of procedures they follow to let the people know that are most impacted by it.

Hey, here's what's going on. We are taking a look at it. That kinda stuff. But all that stuff needs to be tied together. But that takes, takes time. to put that all together.

Gotta be integrated into the ITT SM tool. I don't want people making tickets, let the system make the ticket that this is going on, route it to the right person.

It gets into, I've heard you talk before about okay, when, when the day we get attacked, wouldn't it be great if we could just hit some automation that spins things back up again as quickly as the bad guys taking it down? Yeah. We, we adopt that clinically in terms of how we treat cancer. We just need to beat it down so we can contain it and we can keep the patient going and living their.

For a long time, cybersecurity will move into that event. So we we will move towards, all right. Yeah. They got in. Yeah, they're contained and we're still functioning. Cause we could spin it up and fix it as fast as they can. Tear it down. Yeah. We'll get there.

Yeah, it's interesting. ServiceNow,

we're not on that at the moment, but that's okay.

So you have a different We have a different tool, but yeah. Okay. I was, I was just curious cuz as I'm, as I'm looking. These for lack of a better term, service buses across that something needs to be able to take all that stuff in, organize it and get that information out. And I'm curious, what, what's the platform that you guys are using at the moment?

We're on a very old system that we won't be on for long, so I'll just leave the vendor out. Yeah, we need to modernize, we have legacy stuff

and if they're listening to this, I'm sorry, but you can rewrite your codes today and, and be in the running for the next time around. So, no, I love I love where you're taking the IT operation. Was it hard clinician to CIO role? We, we've seen it a handful of times now.

There are a handful of us who are picking up on this. So there's a lot of things that I was able to bring in Slide easily. I know Epic. I know Epic really well. I've learned a little bit more about some of the back end pieces, but the change management, the interpersonal relationship type stuff, the business side of it, that, all I brought.

Did I need to learn a little bit about cybersecurity? Absolutely. And so yeah, I went for a a master certificate in cybersecurity and I still do a lot of, a lot of work on learning the cloud and okay, what is this Amazon web services thing and going in and playing with it and taking some classes on it just to play.

Yeah. You and I have both spent some time with Lee Milligan and he starts, cuz he went and got certified, he went to the Chime CISO Bootcamp. Mm-hmm. . And I said, why you gonna the CISO bootcamp? He goes, because. As a cio, you have to know security, and he goes, this is where I'm gonna start, and I, I just need that foundation.

He goes, I don't need to know it, as well as the guys who are automating it and writing Python code and that kinda stuff. He goes, but I need to understand it from a base level so that I can, again, getting back to the business, I can be a, a counselor and a consultant to the business and say, this is what this attack means. this is what the common spirit attack means for Title Health. It's, Yeah, so you have to keep going back to school.

and so, yes, I just tack up more certificates on the wall behind me. , it's, part of it has been changing the perception and the mindset of my team of it, of I'm a doctor. Yes, I'm always gonna have that, and it's hard to shake that, and that's, that's okay.

But I really want to be seen is I know how to run a business and then I'm gonna lead them in a good direction. We'll pull the team together where it's fragmented and we'll work with the operations and put governance in place so they don't get whipped around from project to project. And some of this is it basic 1 0 1, but it's so important to get that right.

Yeah. And okay. I may not know as much about the data center as some of the technical guys, but I've got good technical guys who know that data center. I need to be able to say, look, what might the data center look like in five years? Right. Where being current and going to conferences like Chime and learning what others are doing, that's where it's so important to be able to lead the organization.

Absolutely. Mark, always great to catch up with you, man.

Thanks, bill. Appreciate 📍 it man.

I love those discussions. I love doing the interviews from the floor. just fantastic discussions with these leaders. Andrea Doherty, Pete Mark, Sarah Richardson, mark Weisman. I just wanna thank each of them for spending time as well as 20, let's see, that's 4 25. Others, we did 29 interviews from the floor. If you're wondering where the other interviews are, you can check them. At this week, health Community When you search, you'll search for this week, health. You'll see community, you'll see Keynote in the conference channel and you'll see the newsroom. The community channel is where we've been airing a lot of these interviews, and you don't wanna miss any of these. These have been fantastic conversations. We wanna thank our keynote show sponsors who are investing in our mission to develop the next generation of health leaders. They are Sirius Healthcare a CDW Company, VMware, transparent, Presca, Seus, and Veritas. Thanks for listening. That's all for now.