January 30, 2025: Chad Brisendine, VP and CIO of St. Luke's University Health Network, explores the transformative journey of healthcare technology. How does a hospital room evolve into a hub of AI-powered care while ensuring patient-centered innovation? What challenges arise when integrating virtual nursing, telehealth, and ambient technologies at scale? As the conversation traverses from imaging solutions to price transparency, how do leaders like Chad balance rapid technological advancements with long-term strategies?
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[:(Intro) we have people both and outside the area to come to us so that they can see the CPT code, and they can pay for it, and it includes everything from, your procedure to your anesthesia to your lab testing, and it's an all inclusive bundled price, , you don't feel like on a surgical procedure you got nickled and dimed and you weren't sure what the full cost of that was.
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)
It's Keynote. And today we're joined by Chad Brisendine, the CIO at St. Luke's in Bethlehem, Pennsylvania. My old stomping grounds where I grew up Chad, always great to catch up with you.
Always good to see you, Bill.
We were just joking about the morning call. I actually, delivered that newspaper for about seven years.
When [:Fast forward how many ever years later, you're doing the newer version of that. The newer version, the
digital, digital version.
I've never left the industry. Just
in IT for a while.
keep getting updates., my two parents at the same time were both in your hospital over there off of Freemansburg Highway. And my dad had a really good view. And so I said hey, dad, while you're there, look out the window, tell me, how it's progressing and how that campus is progressing.
It sounds, from his perspective, it sounds like that's a really awesome campus.
Yeah, we were talking earlier cardiology reports to me and the company, and we're building a 250 million heart hospital at that campus right now. It's a beautiful campus, 500 acres. We have an organic farm there, a huge walking trail and pond, and it's overlooking the river.
ion for our folks with heart [:And as baby boomers continue to grow, we're going to need more space, and so we're building that new capability for everyone within our region.
Well, St. Luke's used to be landlocked. It was originally built for the steel workers over on side where all the steel work was being done. But over time, that all got built up around it.
You guys had no land. Now you have plenty to dream about and you're going to do. I know you were doing a lot of things around digital hospital room in the future and those kind of things. What does it look like and where are you experimenting with some of those things?
about 1, 700 beds total.
documentation and fall risk [:I would say we're fortunate. Our vacancy rate for nursing is down to 8 percent now, where, it was in the high. to mid twenties during the pandemic. So we've seen that climb way back down, but still there's, I think a lot of opportunity to offload work from the nursing workforce and make that job more satisfactory.
And we're seeing that through the technology implementation.
Do you have any Greenfield stuff going on where you're building new buildings?
en of those we've built since:So we don't have a new one, but we're doing a lot of what I call vertical expansion within those. The Heart Hospital being one our Upper Bucks campus down closer, if you're familiar with Bucks County or Closer to our Philly area, we have a hospital there that, we're continuing to grow.
Poconos outside of New York [:Luke's that continues to grow out and what we call It's an area out past in Carbondale Carbon County. And then we also have a new hospital in Lee Heighton that just opened in the last three years that we're growing vertically at right now as well.
, that whole Southeast even Northeastern Pennsylvania.
you guys are up into the Poconos and going North in that direction as well. Let's talk about the hospital room of the future a little bit. What does it need to enable? We talked about nurse efficiency, talked about ambient a little bit the use of cameras, I think cameras are starting, I'm hearing that more and more that people are like haven't gone to scale yet on that, but we are definitely, playing we're experimenting with it.
We're seeing what the application of it is. How are you guys utilizing. technology to support the nurse, support the doctor, support workflows that normally happen, as well as deliver that experience for the patient.
We spent a [:Do we need it to have some kind of AI voice recognition or voice scraps? It doesn't have to be built in, but we need to have some kind of capability for voice recognition, voice scraps. So we want that capability in our hospital room in the future. And we're looking at it not as a vendor, but as a package.
Set of capabilities that we might have to have one vendor, hopefully, but we might have to have two or three alongside of AppDate working in parallel. We need to have the ability for some kind of computer vision because we want to be able to do fall detection. So if we want to do documentation and get rid of some of the documentation problems, we'll use the voice recognition.
We'll use the computer vision for things like fall detection, things like monitoring within the room as well. And then not a must have, but one of the nice to haves that we have, and we are actually moving forward with this right now, which is language translation.
ntegrated service within the [:And then we've had in the past, if you've seen the dry erase boards in the room in the past we've put in their own dashboards or their own stand alone monitors for that. And on that would be like the nurse's name, the physician's name, maybe the patient satisfaction, high level score, and some of the daily activities that were coming up.
So again, that's not a required feature, but it would be nice to have that integrated because we also have my chart bedside in the room as well that so we want to have patient education in the room. We need the ability for virtual observation and As with some of these patients, some of them being behavioral, some of them being significantly made need restraints and other things, the need for tele sitting has certain requirements that it has, both at the state level that we need to be able to comply with, and some of the video capabilities, although don't seem to be all that sexy, it's things like, oh, can we see it in the middle of the night in the room with no lights on?
How can [:We've seen a lot of physicians consulting into these rooms. We have every specialty consulting now at our campuses that we have that are, reducing windshield time, if you will, helping with transfers. So we've seen a large engagement from our physicians and a lot of that has to do with how easy it is to just click on it, get into the room now versus having to have a separate carton that you will in and, all that.
So having this stuff static in a room is a big piece of making sure that we have, real time video in there. And then it's all the policies and practices around how you do that and how you enable it with the patient and what's that experience feel like. And then we have general clinical engagement, which, you know, if you think of things like just results, where's my orders at today?
g tasks and activity for the [:For example, EICU, that is a huge investment to make, primarily not in the technology. But in the infrastructure for the people related to, how you do call and call coverage for critical care and what that looks like in an EICU model. The technology tends to lean itself a little bit more towards the monitoring capability that you need on that and the video.
And there's obviously a few other major requirements on that, but those are those lean you there. So when you stack all that up, the last thing, and I probably put this as the lower thing, but it's important for the patients, is like we have to have personal entertainment. People in here for a long time.
do with voice and everything.[:As far as newer capabilities, some of the things for three years, maybe three to five years, where it's just more like vision, computer vision is a little bit more stable on some of the use cases that it has. Trying to put all that into a bow so we have a more of an integrated approach, an integrated platform on that.
. And, We implemented this in:We're still in, If you say we're five years or seven years into that, what's it going to look like in another five to seven years with all the AI capabilities that are going to come out and what else can really be done virtually in the room? I think we're beginning to make a lot of traction in the area of nursing, but it's going to expand beyond that.
an be integrated, brought in [:and putting a hospital room of the future together. I imagine if we could just bottle up that meeting and a meeting from last week, they would look very different because the capabilities keep changing and shifting and oh, now we can do this. Now, all of a sudden, ambient is much more of a real possibility and the cameras and how we're looking at that is changing.
Talk to me about how, a technology leader, how you think through, I'm going to use these words you can frown on them, but future proof some of the things that we're trying to do.
Yeah. I wish there was an answer for that. Cause, I would say we're probably in our third. Version of vendor on this and the reason for that, I think it comes down to, and how early do you want to be on the curve?
ss case and the ROI and what [:That tends to decide, determine whether we want to jump out early and unfortunately probably have strategy that's a little bit more agile and realizing that we might. have multi vendor thing that gets consolidated and then regrouped and then gets re refined multiple times. And I think this is an area one that we have decided because of the pain points in the use cases.
Now, again, we didn't put it in every single hospital. It's very expensive to do that. very expensive to then replace it two or three times when you think about it. And so I think on this one, we've been conservative as far as The required functionality that we have to have in the room and then these other things are then things that we'll add in that don't have to be in the platform, would be preferred to be, but don't have to be in the platform.
And that's how we've got around having to constantly, I think, replace it as much as you have. But I struggle with this as a CIO a lot, Bill, because, it's when to get in, when to not get in how much to innovate. A lot of what we learn on these is not the tech, but the operations.
implemented and make it work [:Just because we have momentum, because as a CIO, you know this. You can grind an axe against something that makes a lot of sense. Strategy looks great on paper. Execution doesn't happen because engagement's low. And, no one within the company wants to drive it because they don't see value or it's not top of their problem list.
And I have, to work on things where we got a lot of momentum and people that want to, push and drop things beyond IT.
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one of the things that's unique about you, and we've talked about this a little bit on the show before, is that you've picked up service lines.
So imaging being one of those, you have radiology and cardiology is actually under your management structure. And curious what you've learned since the last time we talked about, leading that, and then you're also doing. an enterprise imaging solution. You're doing a PAC solution that's an enterprise imaging solution.
I'd love for you to walk us through what you've learned and where imaging solution fits in.
at I haven't learned. What I [:But when you look at the business functions, they're obviously much different than there's, different components to each one of them. But I would say probably, less IT issues than I imagined. Came in thinking, okay, this is just going to be a slew of IT dumping, and it actually wasn't that.
It was much more leadership, focused what I would say. And that says everything from operational to strategic to leadership development to helping our The departments be better. I think that's at the end of the day what they've wanted and what I think they enjoy working with a lot on is they want to continue to push These departments and these leaders want to push these departments to be better.
s and career development and [:And so you're able to take a lot of those learnings, and bring them in. to those structures. So I think if anything, I've learned how to adjust those things in each one of those areas. But I've learned a lot about cardiovascular medicine. I cannot go do any of the surgeries and you would not want me near one of the rooms.
But, I've watched a lot of the procedures. I've spent time with our CT surgeons and our EP physicians and our non invasive physicians. And so I have a really good understanding, I think, of what their challenges are within the job role. So when we're looking at technology, not just digital tech, but device tech as well, and I'm not a device tech person, expert.
he experience of the patient [:How are we going to get there? Some of that, things I think the CIOs Swedish Strong Act, which is strategic planning helping them do more of that planning exercise so that we can, put budget and plans and things together to help, get more things in motion for those departments.
So I know that's a little all over the place, Bill, but I think just bringing what the CIO knows through its in the job role to those departments.
Yeah, and I'm going to come back to enterprise imaging. I talked about you, I talked about the other CIOs. I think you and Chero Goswami are in a race to see who can have more things.
nd But the imaging one makes [:You just went through that pretty well. Imaging more than any other area within healthcare feels to me like there's an awful lot of technology being applied to it right now. And so having a technical leader for it makes sense from that perspective. And then there's really expensive, big equipment associated with imaging.
And how do you plan for it? And what's the business case? And how do you position that internally? And, a lot of the stuff has AI on it. And a lot of the stuff that's coming out with AI has a huge opportunity. For us, and helping them really make sure that we are on the front of that., we have one of our imaging projects within radiology right now I love it because it's easy.
From a business case development, a lot of the IT projects can be very tough to put a business case together on. You know this from years of working on these things, right? Is it going to save labor? Is it going to increase revenue? Like how much can we tie to soft versus hard?
thcare IT projects, I think. [:Working with them and I like it because it's very easy to tie it together and we have one of the major equipment vendors that we have, I won't speak to it, but we just did a whole roadmap with them with AI capabilities and we're going to increase 30 percent of our appointments across our board.
on one modality across every single one of them. And we have 32 of these one and a half million dollar machines and that are already have a fixed cost in them, right? A fixed capacity, a fixed everything for staffing and everything. And by now making those appointments faster, more efficient, we're creating more slots, we're opening up slots.
in faster and get them into [:Really opening up access has been one of the key things that I'm working on because, as healthcare access is a huge issue, and it's a capacity and a constraint issue, and so I like working with them on those kinds of things a lot because I think it has a lot of kind of and we have a really great management engineering organization within St.
Luke's that we partner with on data and information on, and help us think through those things, and that work has been very fun.
why I think as a CIO, it makes sense. I remember talking to Jeff Sturman about access, and he was talking about the importance of the placement of those machines in terms of location as well.
He said sometimes we place them too close together, sometimes they're too far apart, and you can't take, appointments that were going to be here and move them over to here. And there's an awful lot of strategy associated with this. want to talk about enterprise imaging. lot of people are talking about this.
he PAC systems. And whatnot. [:And they're going, all right, we can't just bring in another point solution. is there a common set of points? functions and features that it makes sense to have an enterprise solution. You're heading in that direction. Talk to us about that journey and what you're learning in that process.
think for us has been trying to time the space and it comes back to the conversation we had a little bit, I won't spin on it too much, but the hospital room of the future. It's like, how many times are you willing to change before it has all the capabilities that you need out of platform?
And I think this is an area where you need a platform. you need multiple workflows within that platform for different specialties. And I can't take the credit for this, but I'll give the credit to our now chair of radiology and our associate CMIO. She works on all of our specialty areas in the two of them.
support from me and our COO [:So we worked out a strategic plan. And if you look at all these organizations, like how deep they've gotten into each specialty's imaging workflow, they might be really good at PACS for cardiology and radiology, but where it falls down, I think, is in the specialty imaging areas. And so we did a lot of work in each specialty, ORGI, et cetera, and mapped out their needs.
deployed out to every single [:There's a lot of people moving to that. I think the real heart of it is getting it into all the specialties, and there's a lot of work to be done between Biomed and the specialties in IT to get that workflow embedded in there.
You're not afraid to get out ahead. I remember I interviewed your team, and we talked about Epic and Azure, and you guys got out ahead of that.
What's the update on that? Is that performing the way you
It's business as usual, Bill, to be honest. We do our upgrades, things happen. We do switch between data centers as part of our cutover of that. So we'll flip back and forth and we'll run out of one and run out of the other between cycles.
So we'll flip to an A B strategy and we have a lot of our DR and do recovery. That's exactly what you want
the answer to be. Yeah.
You want it to be like, Hey, performance is better and no one remembers anything. only thing that we've done I think and I just say thanks to all the other CIOs out there.
ect on the cloud he was able [:we're getting close to the end of this. I want to revisit the patient experience. I remember early on we talked about price transparency and you guys had implemented a price transparency tool and talk to me about the evolution your patient digital experience and the evolution of that.
I cannot take any credit for price transparency other than helping, but what I would give our CEO a lot of credit for is saying we need to have price transparency. And we created, a, you pay us a cash number less than you would pay. So you could either do that through high deductible or you can do it out of pocket, however you want to do it.
e to your anesthesia to your [:mer applications. We built in:We actually are working to shift that over to Epic. So we're in the process of doing that. I think EPIC's made a lot of progress in the last eight years on MyChart and MyChart capabilities and what all it can do and the level of customization. So I think it played its proof out for a long time.
we built a lot into scheduling and decision trees and all these things that I think that were not in the market at that time, where we could basically, show up A patient that these are, not only is your primary care available at these slots, but here's other people locally that are our physicians that are available at these slots if you wanna book an appointment.
And we were doing [:And what are all the functions of that? And we centralized all that into call center functions. And so we created scheduling and triage groups within that. And we grouped them by multi specialty together. So we have about 20 different pods that we have. We've done all that work and we have Twilio and CRM and whole ton of work around that, but at the same time, and not as sexy we've ripped out about eight different phone platforms and went to Teams.
We're in our last couple of [:And then we use Teams as your lighter version call center. So if you need a small internal call center for internal calls, but you still want to volumes, you can do that. And then just for peer to peer calling and for collaboration and everything, we use that as well. We've removed, I think, About 40, 000 phones over the last four years.
So a huge, access call center and telephony transition for our organization. So anyway, I think that's probably more than you wanted to know, but
awesome. Hey, how long have you been there?
I'm at 16 years as the CIO at St. Luke's.
Wow. So I'm going to close with this question and I'm going to take it in two directions.
ivated around the healthcare [:mean, we're always doing exciting projects. think what I've probably learned in my career is making sure that I'm continue to give them more of the big work.
And continue to push that down so that's allowed me to both grow as a leader, but allow them to grow as a leader. So as I've been able to take on these other functions, how do I have them run an ERP project? And I'm literally just go to the meetings, maybe provide some counseling, which they don't even appreciate, but how do I let those do the transformations?
They have the skills. They have the capabilities. How do I become more of the mentor and the coach and the guider? And less in the weeds on some of those things, but still make sure that project execution delivery is high on those things, but give up more control.
And so I think up more control in the CIO job to people that you trust within your team to do more has rewarded me, I think, and rewarded them well.
cially in the Christmas city [:Really appreciate it.
Happy holidays, Bill. Thank you so much.
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