This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 episode is brought to you by Quantum Health. Quantum Health celebrates its 25th year as industry leading consumer healthcare navigation and care coordination company for over 500 employer clients that delivers an unparalleled consumer experience to its over 3. 1 million members, as well as validated claim savings and high satisfaction rates for its self insured employer clients.

Quantum Health's proprietary real time intercept capability and Gen AI helps identify opportunities for early intervention in a member's healthcare journey, resulting in better engagement, outcomes, and cost efficiencies. Visit thisweekhealth. com slash quantumhealth for more information. \

Today on Keynote

(Intro)  Those capabilities need to build into the expectations of every single role in the organization, because we know at the end of the day, we're knowledge workers and people working on knowledge through digital and these new tools is changing.

So it can't sit on an island.

  📍 📍

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

Now, let's jump right into the episode.

  (Main) right. Hey, it's Keynote. And today we're joined by Tressa Springmann, Chief Information and Digital Officer for LifeBridge Health. Tressa, it's been too long.

It has been too long and you're too tanned and I'm too pale, but it's lovely to be with you again, Bill.

Yes. One of us is working extremely hard and one of us has been doing a lot of traveling. Actually, right now, as I'm recording this, my air conditioning is out and I live in southwest Florida. So I have beads of sweat on my forehead as I sit in my office. It's I know these are the hard problems of the world.

Tressa, I'm looking forward to this. There's a lot of things to talk about. The changing role of the CIO. We're going to talk about digital, a significant part of your job. We're going to talk about some of the things we talked about in the past and just get some updates. But before we get there, love it if you could talk a little bit about your journey and how you ended up as the Chief Information and Digital Officer at LifeBridge Health.

It's pretty boring, but I'll put it out there. I started out in healthcare. My undergraduate was in biology, biochemistry. I did protein chemistry research at Hopkins. I thought I was going to go to medical school. I didn't see enjoyment in what I was observing in a lab. And I have to admit, I didn't have any.

physicians in my family. And so what I thought I saw in that ecosystem was probably not really representative. But anyway, it informed me to take a different path. I got my master's at Hopkins in managing technical professionals and decided rather than wasting a whole nother degree on something I wasn't sure I'd want to do for the rest of my life, I joined And I spent time doing systems engineering work and Rossboro was running the company at that time. found that scientific method in a biology biochemistry lab was actually pretty analogous to deductive reasoning and IT and troubleshooting back in the day. And yeah probably I was.

Only a little bit deep in that systems engineering program when the organization had need for product in the healthcare space. And they were like here's someone who's worked in healthcare. Little did they know I wasn't a nurse, a doctor, et cetera. So they plucked me out. They, I got a lot of great professional development training early in my career.

And since then I have been in this shared world in this industry I have a passion for. But whether it's been post acute sub acute care, ambulatory those have really been the two common threads for the last number of years, with my last couple of jobs in the very enviable role of CIO of a couple health systems.

When you think back to, the people who invested in you, when you made this transition and you're going into technology, you know, who are like just one or two people that, you feel like invested in you and helped you to get to where you are today.

Oh boy,

or 10. I wouldn't do, an Academy Awards speech where it's I would like to thank, but it's.

Yeah, no, honestly this is going to sound so cliche, but my parents were both, are both they're still around educators. And although my undergraduate degree was in the sciences, they're like no, you need a Bachelor of Arts. You need to be well rounded. You need to understand these other things.

We know you have that scientific bent. And frankly, back then it was, and by the way, that's not a good thing because Most women aren't great at that stuff and you're going to be really alone and lonely. And so you need these other skills. So that was a big part of it. I think another part of it was honestly, Bill.

I'd like to say there were specific individuals, but a lot of it was just this theory of doors opening and closing. And so many of the doors I thought I was going to step through closed that I had to creatively. So many people along the way that just encouraged me to put my hand up, to put myself out there.

And from an Academy Awards perspective,

aside from my parents, there are very few people that I would call out because there were so many people at these critical junctures when, where I thought I'd be heading. just reached an impasse. And they, in fact, that encouraged me to really pivot and do something different.

Yeah. The CIO role talk to me a little bit about that.

We were talking a little bit earlier of, what's going on today and those kinds of things., when you're looking at a certain day, what gets you really excited about being in that role? And when you look at that day and you go, man, I'm going to get to do some things that are really exciting.

Right in my wheelhouse, I really love doing this. I really like working with these people. What kind of things do you do as a CIO that you're like this is a privilege to be able to do this?

I thrive on variety.

you're definitely in the right role.

I'm in the right role.

I, but on the other hand it's a little bit of a lot. In other words, I love it when I've got time with my people. I love it when I can actually contribute to a problem they're trying to advance or solve. I equally enjoy it when we're like this morning, going over an approach to getting funding for a pretty bold strategy.

So I think that variety keeps me going, Bill. And you and I both know that there's no shortage of that in this industry. Like this job has not been the same Three, three years running than it was three years prior or what it will be in three years. We had a little leadership exercise and I think it was at LifeBridge and I've been here almost 10 years now, but we went through this process of coming up with a personal mission statement.

And I think it really speaks to the things that I believe I'm good at. And then I really enjoy and gets to my flow. And if you look at my LinkedIn I'm an ideas to outcome architect. I love seeing an unsolved problem, sitting in that, the whole messy space of how to solve for it, how to measure for it, how to programmatically develop it, how to implement it.

And how to make sure it has the elements of sustainability. And then honestly, I just want to wipe my hands off it. So alternatively, what doesn't excite me is when I've got too much maintenance of too many things going on. That's not my flow.

A real skill to be able to wade into the messiness.

And I could see where your scientific method comes into play. You're you look at it and go. All right, there's a lot of ways we could go here. Let's do a couple of experiments and see, what works.

Thank you. We've failed more than we've succeeded, but ultimately It's been so enjoyable.

And I think it's, I've been very fortunate because look, today it's AI, but every year or two, whether it's cyber, whether it's pop health, whether it's analytics, whether it's digital. There's always something. It comes at you and you've got to learn just enough to understand how to take that idea and lead to some outcomes and get something implemented and then move on to the next something.

let's talk a little bit about the digital transformation, because as you said, cyber, cloud, AI, it just seems to, it's just washing over us at this point. And you've been a champion for digital transformation in healthcare. What are some of the standout projects, as you look back over the last couple of years that your part of the organization has been a part of bringing to LifeBridge?

As well as I, that form follows function. And yes, we have hospitals in our inventory, but as we look at a new strategy for the organization, I think we all intellectually understand, especially post COVID. People want choice. Digital needs to be an option, and if it's clinically appropriate choice, wins the day.

And consumerism, using digital to smooth transition of episodes of care, and a focus really on, Our future outside the hospital are all key elements of our go forward strategy. Accessibility and convenience are so important. The last couple of years, our digital front door strategy has been really important.

We've made a lot of the right investments. But the things that I thought would be the earth shattering successes, they were okay. Telehealth visits went up, people are doing more online scheduling, yada. I think the dark horse to your point about what was a big success, this is something that was a big success that we didn't anticipate.

We, in order to make this strategy change recognized a couple years ago, we needed to get about 120 million out of our operating model. And so we partnered with a third party and although they didn't really spend much time specific to technology. Because believe me, they wouldn't have found much. They did help our patient financial services team understand that if we put in a touchless check in process and allowed our patients across our five hospitals and, our 200 or so ambulatory locations, to either by kiosk or digital make a co pay and give their insurance information that alone would pay for the investment in these tools.

So what started out being a very revenue cycle centric capability led to a place where all of our hospitals and ERs and all of our practices are digitally front ended by a tool where someone can check in, whether they have an appointment or just walk in, share all their demographics, if they're going to a practice, for those of you that know eCQM speak, The patients complete their own clinical screeners, so our MAs aren't having to take that on to fulfill the eCQM process and really get them well positioned for a good clinical gap in care conversation.

Co pays are being paid for but we're also grabbing all kinds of cell phone and email information for our digital marketing and our gap in care CRM strategies. This digital check in that was really meant to pay for itself through quicker copay collection and better insurance information was really a dark horse that across our system even if it's attended by a registrar, which is only needing to happen in about 20 percent of the cases.

We have this unexpected digital on ramp to everything now. Anyway, we've made all the other investments. We've got some good work to do to pull them together in a journey. That conveniently and in an anticipatory fashion guides our patient but this specific investment and that situation that reminds me that what we went to solve, we did, but it became so much more.

Yeah, there's a lot of things you could do with digital. is LifeBridge would you consider it a value based care model for a significant portion of your population or a portion of your population? Because it's interesting with that model you describe getting some additional information that allows you to care for them post the visit or post the event.

I would think that would lend itself to a really solid model moving forward.

Yeah. Yeah. For those not in Maryland, all of our hospitals are on a fixed reimbursement model.

More volume is not good for us. We don't get paid for more volume. It's just more expense. We are highly incented to keep people well to make sure they don't bounce back.

To make sure that they are being seen in the most cost effective care setting that has it's good and it's bad, but back to that screener capability for our practices. And for those who have ambulatory sites, and I just, I have some of the statistics about this. Digital check in, there's, since we started, no, five months running last year, 78, 000 clinical screeners were completed. Now we see about 100, 000 ambulatory visits a year, so not insignificant, but before we implemented this and our patients chose to answer those questions digitally before an appointment, this was something an MA or someone in the practice did ahead of the physician.

Just think about the efficiency and effectiveness of that.

78, 000 is a significant amount of hours that somebody is spending doing that. Talk to me about the process for rolling this out and what are the hurdles as you're, as you're doing this, we're hearing this with AI now.

AI is nowhere near ready to do what you just described, but We're hearing these difficult conversations of, hey, this is going to save, 78, 000. It's going to save a lot of man hours. And then people are recoiling on that and saying, hey, wait a minute, what am I going to do? I'm curious how you were able to lead that conversation within the organization.

Let me first be really clear, Bill. The automation has allowed us to collect this. So we're doing a better job caring for those patients. We did not have sufficient staff to actually execute on this. So this was not A cost savings from a labor perspective, and I think that's what a lot of us are finding in health care already, when you talk about tele sitting heck, people are struggling to even find close ops sitters that are sufficient.

We've got enough of workforce shortage that, sadly where the CIO sits, there's so many enabling technologies that we didn't dip into because there wasn't enough burning platform to force us to actually change, like the typical nursing. It wasn't until we also had a huge workforce challenge that tech's been there for quite some time.

But back to how do we do it? Look, you know this, there are three basic steps here that I think you got to press hard into, and you got to learn along the way, and this is where this didn't turn out where I thought it would turn out. It became so much more, first is you got to implement something, and we've gotten pretty good about implementing but that next step, which is adoption is key.

If we'd implemented this technology and we hadn't set an expectation for ourselves that everyone was going to use it, even if a registrar helped them use it, and even if they didn't choose to do it on their cell phone, we had a tablet there and a staff member that could help them we wouldn't have gotten the adoption.

Our adoption is well over the industry norm and the averages even for this organization. There were some. Appropriate key tenants that got us from a successful implementation of technology to actually really high adoption, and that then translates into the outcomes. That's where we can actually see cash coming in more quickly.

These screeners being done more quickly and comprehensively, which is just better care that honestly, in some cases, we were not doing. They are helping us with our quality based measures, which otherwise fall on the back of staff in our already understaffed clinics trying to gather this to meet those eCQM capabilities.

And then there's just so many other things along the way that we're picking up and better understanding and gathering information about the community that we serve because it was effectively implemented. It has really high adoption percentages. So we are actually not only getting the outcome. That drove the investment, we're getting so much more.

I'm not sure that's the angle you wanted me to take. No, that's exceptional. But that's where I went.

It's interesting, I was talking to a bunch of CIOs recently, and said, alright, how much of your job is organizational change management? And they all looked at me and they're like, oh, significant portion.

I said, alright, how much of your job is budget management? They're like, oh, significant. I'm like, alright, if you had to add those two together, How much of that is your job? And somebody said, if you add managing the team, that's 90 some odd percent of the job. It's, you're just constantly working with the various parts of the organization to bring new technology in, but also, start all these projects now with adoption in mind, because if you don't get adoption, it ends up being a waste of an investment.

I love how you talked about that. Talk to me a little bit about governance. How you choose which projects you move forward with and, and specifically, one of the things I'm asking a lot of CIOs right now is AI governance. There's just an onslaught of stuff. It's showing up in products that we use every day.

Yeah. And then, just everybody and their brother wants to call you up and say, Hey! We have this new AI thing that's going to create the kind of efficiencies you just described and we have to somehow vet that. Does that make sense and whatnot? So what does governance look like?

What does it look like?

I'm actually not allowed to use that word here anymore because I don't know if you know the Loeminger or Korn Ferry competencies. But for Tressa, governance is deemed by the executive team an overused strength. Got

it.

Quit calling the governance card. But as you and I know, we live in a world where there's an insatiable appetite, and there's never enough to go around.

So I don't care what we call it, but Yeah, I actually love it. Specific to AI, I'm really excited about it. I am involving myself personally as much as I can. I am partnered with our chief legal counsel on our enterprise AI governance process. And, I hope the CIO is out there who remembers talking to me because I love talking to everybody in this industry, so lots of times, I don't remember who gave me an idea.

But this discussion resulted in what I thought was such a practical reflection and something I think we need to get really good at. Just like I mentioned, being an ideas to outcome architect, sustainability is key. AI, there's going to be something after AI, Bill. You and I both know it. So how do we get the organization appropriately informed?

appropriately putting into place a structure that doesn't slow you down but sufficiently mitigates risk. And then most importantly, just like digital, starts back informing the change management exercise. And what do I mean by that? Do not create a whole siloed structure. This is going to be a new way of being.

This concept needs to back inform the committees you already have. If you've got clinicians, Working on clinical standardization, the AI capability and enablement over time needs to be part of that discussion, not its own committee, not its own discussion. The same is true with security. AI is going to bring upon us some new implications around IT security.

Don't stand up another function. Figure out how, as an executive leader, and the journey I'm on regarding this today, here at LifeBridge is less about AI. That is a future for us because we're going to be a taker, not as much a maker. But for digital and certainly for analytics, part of my role is to be that change catalyst for us to go from doing digital to being digital.

And that means coming alongside other senior executives. and help them understand how they need to create that competency with their own divisional structures. can't have these bloated, here's a new AI function, here's a new innovation function, here's a new IT function, here's a bloated analytics function.

In this day and age, those capabilities need to be something, over time, it's going to take time, that we need to build into the expectations of every single role in the organization, because we know at the end of the day, we're knowledge workers and people working on knowledge through digital and these new tools is changing.

So it can't sit on an island.

I saw an article today that we saw Apple's announcement and how they're going to do AI on the phone and that kind of stuff. And I think the title for the article was, Apple shows us that AI is going to be a feature, not a product. And as you just described it's going to show up in everything.

everyone's been doing RPA for quite some time. That's early stage AI. What's really freaky and weird and scary is generative AI and How do you control the large language models and any unintended bias and what data sources it's sitting on and on, right? Very complex very important stuff.

I'll give a really precise example. One of the outcomes of our governance structure was after doing an inventory of what we had and understanding what was going on and everything coming into the market, we made sure from a legal construct that we had very intentional language being put in our contracts that as the legislative structures.

and the regulatory environment around this evolves the business partner reflected in that contract would thereto evolve. And either party could pull the other back to the table to have conversations that recognize those changes in legislation and regulation around particularly, in this case, AI.

What became really clear as we are putting this in new contracts for new AI tools that we're using is that everyone we've got contracts with is starting to embed AI capability and function feature. So very similar to when HIPAA encouraged us to start contemplating putting a BAA in place for everybody because of the sharing of ePHI, the same is true where I'm now saying to Chief Legal Counsel, Hey, Do we need to put this back in every one of our pre existing contracts?

I know we can't staff that, but to your point, This is going to become an accelerant for so many things that are already in place, as opposed to standing on their own.

Let me take you down path, and then I want to get your comments for the next generation leaders and we'll close out with that.

But the first path I want to take you down is patient and in the hospital for the clinician and the physician. Talk about how technology is empowering patients. and giving them I don't know, more control over their health or more participation in their health. How are you viewing that at LifeBridge?

I actually don't know how to answer that. Let me think for a minute about that. And here's where the disconnect is occurring for me, Bill. I mentioned we're on a very aggressive strategy. I think we all realize that we're very close to a circumstance in healthcare in America where if you can walk and talk, you probably don't need to be in an acute care facility.

And frankly, most of us don't want to be in an acute care facility. It's the lag between our reimbursement structure. And, what has been the organized delivery of healthcare that puts us in this place where we've got walkie talkie people who expect the amenities of a hotel sitting in our hospitals.

And from a patient experience perspective, that's what we need to provide. That's why I'm struggling a little bit in the participation of care. I think if there were primary care physicians in the room, what so many of them would tell you is that the patients they struggle with to, to lose weight, to quit smoking, to exercise more, to do things that help their family history on their heart conditions, etc.

They are worn out trying to figure out how to motivate people to take that step on changing themself. Because those changes are only going to occur from the inside out. The doctor's already been told, has already told them, quit drinking, quit eating chocolate, you need to walk a little bit more.

And, visit after visit, that's just not happening. I really think, and we nibble around the edges of it, but we all understand. That 80 percent of what's really influencing us on the steps we take to change our lives and be more compliant are all those barriers that have nothing to do with our healthcare and they have everything to do with our lifestyles.

Who we live with, where we live with, how easy things are to access or not the company we keep, those have so many influencing factors on our choices to change and then lean into our own healthcare. That was a huge preamble to the fact that once we have this infrastructure in place that's allowing a more modernized health system to capably make trustworthy decisions based on the accuracy of its data, we will then be on this journey to better take advantage of people's social situations so that We actually can personalize what we recommend based on a very real conversation about the reasons.

why they feel they can't change what's going on in their world.

Yeah, that makes a lot of sense. So let's change this conversation to in the acute care setting or in the clinic. How are we helping the clinicians to be more effective with technology?

Yeah. So again technology is certainly not the barrier, but one of the things we're doing by way of example, and others have gone before us.

But a lot of it has to be about ROI is, we're contemplating this idea that technology exists at every single med surg bed today, because today they are walkie talkie patients ought to have two way audio and video. And even implementing that's not tough. But when you go into a room, like a conference room, you have it for a meeting.

When you go into a patient room, they should be able to say hi to their child. They should get a virtual visit from a social worker. They shouldn't have to wait three days to see that specialist across the health system because they can, do a virtual check in. Tele sitting, virtual nursing facilitated discharge planning.

Meds to beds, I could go on and on about all the appropriate use cases, if we could effectively implement enterprise virtual strategies across an organization, an inpatient, an acute enterprise, and it's hard because in each one of those use cases, You're really asking those social workers, those counselors, those nurses those physicians to change the way they have done things and the manner in which they've been successful for years.

So back to your comment, it's not about the technology, it's entirely a change management exercise. But now's the time to lean in because these very real hurdles in having sufficient workforce. Are finally to me that burning platform that's going to get us there.

So you are the board chair elect for the CHIME board.

Congratulations on that. But in that role, one of the things is you're serving that community of healthcare leaders. What advice would you give the next generation of healthcare technology leaders looking. to make an impact in health care?

This is an increasingly complex industry, and what I try to share with folks coming up, And, it's no longer really about what you know, it's about how you know to get to that information, and the value of relationships and network, and the humility to know that other people may have solved something, and that you're not the smartest person in the room.

are really the way to magnify the talent that you do have. And there are a number of organizations out there, CHIME certainly is one of them, that I believe has helped magnify my own capabilities through the invaluable relationships, successes, and learnings of others. Yeah, It is really hard to fight for time on your calendar, to network, to remain connected, to hear about other people's successes.

But believe me when I tell you that in this ever complex environment, it is the most important way to find fellowship when you're struggling, and to find answers when you need to provide them to your own organization.

I definitely appreciate that. Tressa, it has been too long. We will have to make sure that it's not this long between now and the next time we get together.

You were actually one of the one of the first interviews that I did on the show, and I appreciate all these years being able to stop back and hear how things are progressing at LifeBridge. I appreciate you sharing your wisdom with the community. Thank you very much.

it's invaluable that you've sat in this chair, and so your questions are really informed by your own experience, and always appreciate it.

Thank you.  

Thanks for listening to this week's keynote. If you found value, share it with a peer. It's a great chance to discuss and in some cases start a mentoring relationship. One way you can support the show is to subscribe and leave us a rating. it if you could do that. Thanks for listening. That's all for now..