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Today on This Week Health.

  (Intro) 📍 Using fire if Bill Russell comes in, I no longer have to fax your information over to Premier to say, Hey, are you eligible for, this scope or for this shoulder procedure?

It's immediate.  📍

Thanks for joining us on this keynote episode, a this week health conference show. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health, A set of channels dedicated to keeping health IT staff current and engaged. For five years, we've been making podcasts that amplify great thinking to propel healthcare forward. Special thanks to our keynote show. CDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders. Now onto our show.

  (Main)

 All right. Today we're joined by Bradd Busick, MultiCare Health System, cio. Brad, welcome to the. Hey, good

to be with you. Thanks for the invite.

I didn't ask, do you have more than one title? Are you one of those CIOs?

No I ideally I have less titles.

There's an extra d in my name, and so that typically is plenty. I am the senior vice president and cio, but I just. Prefer to be just one of the team in it. Yeah.

And actually that's a plus when you have two Ds in Brad. It keeps vendors from finding you in email, I

would imagine.

Yeah. My team, as a joke, decided to set up Brad with one D as an alias and active directory. So I managed to get all of them still . So it didn't fully work.

You're not trying to hide. Well, I'm looking forward to this conversation. I always start the conversation. Giving you an opportunity to tell me about your health system.

So tell us about MultiCare.

Yeah, you bet. So MultiCare is located here in the Pacific Northwest. So for those that aren't familiar with that we're headquartered in Tacoma, Washington and have been around since 1882. We're not a huge system. . About 24,000 employees. And serve Washington, Oregon, Idaho, Montana, and Alaska.

And are really Bullish on providing incredible outcomes to this community. And in that the evolution has been through pretty significant growth and acquisition. And so with that growth and acquisition, as you can imagine from an IT perspective, bill comes incredible opportunity for change management, cultural in some cases revolution.

and we're not done.

Yeah. No, I would imagine. Well, tell us about you. What's your journey? How did you get into the CIO chair?

Yeah. My son asked me the same exact question and and it was a wandering answer. I I actually have a different philosophy around the C IO role.

I never started out in healthcare. I was a political science major and heading to law school at Pepperdine. And met this incredible brunette, who's been my wife now for 23 years and decided to stay here in Washington. And in that, journey Bill. It took me from, finance and supporting technology initiatives for organizations like Russell Investments all the way to consulting for seven plus years doing e r P implementations.

And that took me around the globe, which I caught this idea that technology, I think done well can be an incredible amplifier and technology done poorly is the reason that everybody hates it. . Right? And so how do you finesse that line of both the people and the process from the technology And that caught my attention.

And so, as I was just fortunate to have an incredible group of mentors who said, I actually really think you should be heading down this path of IT leadership, even though I always fashioned myself as more of a business wonk and. Really cut my teeth on this in a profound way at the bill of Melinda Gates foundation.

And really helped drive strategy, planning and architecture there. At a place like the Gates Foundation Bill, where you have a problem of giving away $4 billion a year responsibly, it's a very good problem to have. Yeah. Except it's a very different value prop, but the problems.

Are still the same underneath, like how do you scale, how do you, how do

scale? You need visibility, you need accountability of the funding. And bingo, correct.

Yeah. Bingo. And so that, that's what really caught my eye at this time. Seattle was still growing and then this little company named Amazon decided to put their headquarters about three blocks away from the foundation.

So my commute went from an hour to three and a half and. Really just wasn't the quality of life that I was looking for at that time. And so, a colleague of mine who's a physician here, reached out and said, Hey, there's a CTO opening at MultiCare. Why don't you throw your name in the hat?

And I love to compete. . And so, I did and was fortunate enough to get that role and then have since moved into the cio role.

Wow. So you come up through the technology bit. Is your approach. That's my approach as well. I don't know about you, but I tell the story now, especially at the 2 29 events.

I say, it cannot be underestimated how much of a learning curve there is in healthcare. That's unbelievable. The first month I had to memorize like what all the specialties and practices were. Cause I'm sitting across from this person and they'd say, I am a phlebotomist, and I'd go.

I have no idea what you do now. It's very basic to me. Now. I know, and I don't want people to laugh, but I literally had just a chart of, this is what the, these people do because it's a different language.

And I'm glad learned it after a short time. I'm on, year three and really in most cases still drowning.

And as the needs maybe have a different definition. The opportunity to optimize once we actually understand what we're trying to solve for. I mean, it's literally in some cases, pitching softballs. Cause I'm like, look, healthcare may not have solved for something like patient access through an access center, but Alaska Airlines did.

So why wouldn't we just go and use that playbook? Right. And and so this is some of the really hard thinking and I'd say dialogue that's happening not only in our shop, but as I partner with other CIOs across the nation. It's fun to see that healthcare lens actually look more towards, in some cases retail capabilities to help drive a cool patient, experie.

I remember when I started talking to the leadership team and the board about moving to the cloud and service oriented architecture, and they're just like, I don't know if we can be this, and this was 20, 20 12. Sure. I don't know if we can be this cutting edge, and I just looked at 'em like, It's not like, I mean yeah, it's not, I'm giving you presentations from a decade ago that I was doing as a consultant.

Totally. I mean, this is like, we've done this. This is like tried and true. Totally. We can do this.

Totally. And I would say, every shop differs, right? I mean, there's some colleagues that I have that when they have that conversation, the board , it's, you're speaking a different language.

I am incredibly fortunate here to report into the president of MultiCare who used to be the cio. And so as we have conversations about opportunities to, remove waste and cut cost even at the board level bill it's not so much what are we reporting into the board, it's what can we actually leverage in partnership with the board to help drive strategy?

And they get it. They absolutely get it. We have a tabletop exercise with them this afternoon around a cyber event and. Really awesome to plan. Some shops wouldn't even be able to have a conversation about that with their board because their board wouldn't maybe understand the benefit of it or why you would invest in it.

Well, I'll tell you what, you should have all those board members listen to and not promoting my own stuff, but we did the interview with Sky Lakes Medical Center after. They're, oh yeah. Where they were. Ransom. Yeah. And that's like a picture Perfect table talk exercise. You could just go through all the things.

That's actually a great call. Yeah, it was really interesting. I'm sorry, this is you and I could really just riff on this stuff for a while, but what what are some of the priorities at MultiCare today?

Yeah. So at the top line we are a hundred percent focused on three distinct .

Strategies. One of those is performance excellence. So how do we actually increase our quality? How do we actually increase our margin? But as we also think about expanding access to care and services, we're growing at an outrageous. Pace despite the financial challenges,

are you growing geographically like a larger region or is your region growing itself?

Like people are moving there?

No, actually it's both. But we have a really intentional strategy around population-based care that is taking us into some geographies in support of covered lives. And so these are regions that are in our geography, right? Yakima, for example, we closed on that hospital last month.

And now the real work starts, right? Where we're integrating in some cases, five plus. EMRs because they've also grown over time in a m and a fashion. And so if I go acquire Russell Link and you guys are running UltiPro, Okay, well what, rather than Russell Link, just keep that alive and we're gonna continue to go and roll on Workday.

And so over time you have a Frankenstein and we're aggressive. I mean, our leadership and our board is on a really aggressive trajectory and it obviously plays a huge role in that.

Do you have an it m and a playbook?

We do. Yeah. We very much do. And it's living because every one of these.

Different. I've done three since I joined. And there's always these lessons learned of things that you're like, man, I literally, last night at six, we were on a call. I said, look the next time we do one of these, I need to have a structure in place like day one when the attorney general signs, because I can't wait 30 days to go, we probably need to go start, like you need to see that integration between it.

And in this case, facilities for permitting, for data center builds on site and redoing network closets. And a lot of times people get surprised about that work too late. And so you miss your deadlines and go-lives and.

Yeah, we went through a major merger when I was at St. Joe's. We merged with Providence.

Yeah. also we did minor ones, but that was a major one. And I remember we had to educate the leadership on no. You don't understand. We're not gonna be able to. Tie our active directories together on day one. There's too many security things. We have to do this. And they're like, well, we trust each other.

I'm like no. You trust each other. We don't

trust each other. Totally. Totally. And that's the timing of this is so funny. So, we go live at the critical access hospital that is part of our community Connect offering that we call Myriad. And we were having a conversation with them last night actually up at dinner.

And it was about this exact conversation that, things like identity and access management. I'm not just gonna allow you to hook to my domain. It's not that I don't trust you personally, it's, I just don't trust your business. So how do you architect this in a way that they can hook into a domain that isn't the MultiCare domain, but it's a proxy and it provides a really awesome experience for onboarding and, access to our epic systems and et cetera.

So, I think this becomes incredibly prevalent for us moving forward, particularly given our security situation.

Well, my biggest security reportable event happened as a result of a merger and it's like, there, there are so many variables you have to take into account when you're connecting these things up and just one misstep and just once

somebody's in.

Just once, and I think this will be a really interesting dialogue today with the board to start to shine light on, the increase of attacks for impersonation and fishing that we all see. But, to your point, I don't want to have a system, which I kind of look at as the, free safety Block that executable that a doctor's trying to download because it comes from his, colleague at work.

I'd rather train that person to know, like, we never download executables, . And so, this is the journey that we're on. So those are our three strategies that we think about at the kind of top line. And then underneath that we support this. So,

so run through those

three again real quick.

Yeah. So performance excellence. Got it. Uh, population-based care and expanding access to care and services.

Fantastic.

We'll get back to our show in just a minute. We have a great webinar coming up for you in April. We just finished our March. On April 6th at 1:00 PM Easter time, the first Thursday of every month, we're gonna have our leadership series. This one is on CSO priorities for 2023. Chief Information Security Officers, we have a great panel.

We have Eric Decker within our mountain, Shauna Hofer with St. Luke's Health System out of Boise, Idaho, and Vic Aurora with Hospital four Special Surgery. And we are gonna delve into what are the priorities for security? What are we seeing? What are the new threat? What is top of mind for this group? If you wanna be a part of these webinars and we would love to have you be a part of them, go ahead and sign up.

You can go to our website this week, health.com, top right hand corner, you'll see our webinar. And when you get to that page, go ahead and fill out your information. Don't forget to put a question in there. one of the things that we do, I think that is pretty distinct is we. like for today's webinar, we had 50 some odd questions that we utilized, in order to make sure that the conversation is the conversation that you want us to have with these executives.

So really appreciate you guys being a part of it and look forward to seeing you on that webinar. Now, back to the show. 📍

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So, a lot of health systems are making this move into more covered lives, managed care and those kinds of things.

Is that a foundation for how you want to deliver care? It is, give us an idea of the percentage of fee for service versus managed care that you guys are looking at.

Yeah, so our overarching goal right now, bill, is to get to 5 million. Covered lives. And you can imagine that the ecosystem that's required to light that up thoughtfully is really substantial.

I mean, this ranges from, the sources of data that you pull from, right? So if I need to actually go and identify, so who is part of that? Covered live strategy. I've gotta look at data sources that range from, your EMR data sources all the way to, member eligibility and claim types, right?

But then you actually have to aggregate that. And you and I both know most of the times that data's a disaster and trying to aggregate that thoughtfully and in a way that is easy on the back end for our patients to. Enter our system, but more importantly, our providers to be able to say, oh no bill Russell's part of this, covered Lives program.

He's probably a candidate for, this trial without that provider actually. Having to ask somebody, right? I want that nudge to be so seamless inside of the system. It says, yep. Hey Bill, have you thought about this trial? And then you get a text message that lets you go sign up. Part of that workflow in the operation is where we're at right now.

And right now we've invested a ton in partnering with Primera, for example to literal. become the first healthcare system in the nation, to your point, to leverage cloud services for auto approval. So, using fire if Bill Russell comes in, I no longer have to fax your information over to Premier to say, Hey, are you eligible for, this scope or for this shoulder procedure?

It's immediate. And doing this in with some of our partners has been incredible and I actually think this is where it's gonna go as we start leveraging more advanced analytics. But, Leveraging cloud services to help you buy all these crazy systems together. So,

well, when you talk about m and a and you talk about analytics and population health, I mean, cuz when we're talking about managed care, we're talking about taking on risk Yeah.

For that population. So it's increasing the amount of communication points with them, but it's also really knowing them and understanding them. That's right. But you touched on this a little bit, the number of data sources and bringing those together. You're doing m and a, you end up with more data sources that you're bringing together.

Have you set up sort of a platform and a process to. To aggregate that data and make it available and create the profile that you're looking to Yeah.

Around the patient. Nope. You nailed it. Yeah we absolutely have. So, dating back to even, last year we really focused on creating this master member experience through enrollment management and trying to make sure that we actually had a way on the cloud to actually be able to do this.

And we landed on fire. Vehicle, if you will, that was going to go and do it. Once we figured that piece out, to your point, we had to find some partners to help us build, right? I mean, In healthcare, , you don't have typically the type of depth and asset just sitting on the bench going, Hey, so can I go write an interface with Prime to go, bring over all this claims data so we can match that up and then figure out who's part of our Covered Life solution automatically.

And so we went to the board and basically articulated the view for how are we gonna migrate enrollment systems to the cloud, and what does a claims management product look like and what does a. Look like. And again, back to the, credit of our board. Not only did they get it, but our leadership team specifically was, was all in.

And we needed to find a partner with Premier where we had shared risk for both quality and cost. And when you bring those teams together, Really powerful stuff starts to happen. So there's energy around it for me right now. As we, we literally just launched that fire integration that I had mentioned right at the end of the year, and it grabbed headlines and was a, is a big win for both

systems.

All right, so help me with the geography a little bit cuz I, I want talk to you about access and I'm trying to figure out if I'm asking questions more from a rural standpoint or from an urban standpoint. When you say 5 million covered lives, that's a lot of lives. Yes, I know. That's not all in Tacoma.

It's, no, it's not. Yeah, it's not. Yeah. So, again, when we think about our geographies, we actually think about 'em as spheres of influence as opposed to states. So we're talking, going across all of Washington state. That means western Washington, all the way to, my hometown of the tri-cities in eastern Washington and up through Spokane.

Across all of Oregon, across all of Idaho, across Western Montana and across Alaska. And in those geographies, to your point, it actually isn't just. Hey, are you in a suburban setting? I mean, we're talking some really rural areas. Yeah. Yakima for example, that I just mentioned it's in the middle of central Washington and that region struggles both of the demographic of the patient.

It's highly Medicaid but it's also rural. And so access to care it's not like someone can just hop on their phone. Pop on with their doctor because there's no cell phone service. So it's a really fascinating problem to get after and solve, but that's how we're gonna get after those lives.

Yeah. During the college visit phase of my life, my daughter and I went to Pullman, Washington to Wazoo and I think they had, yeah, they had two gates. There was one, one gate on one side of the building, one on the other. And when you went through either door, they came to the same waiting area. . I thought so funny.

That's, that was so funny. I wanted to give people an idea for rural and the challenge of access. From a technology standpoint, how are you addressing. access. I mean, you want to give people touchpoints, access to their doctor. What kind of technologies, what kind of approach are you looking at?

Yeah,

This is this is a really wild opportunity to go put some technology toward. And I'll say that most recently, even starting, Q1 of last year we invested heavily in a new access center platform that brought some of those retail experiences to market.

The day that Covid happened, bill we had 60,000 people bomb our access center and it shut down our entire pbx. And it was at that point I thought, okay one, this is on my roadmap, but we now need to move this up. And we started looking at cloud-based solutions for easy access, which means in some cases to schedule an appointment.

I don't want you to. , call I literally want you to come and engage with me on our website, on our chatbot via sms, via social media. And if you post something on your Instagram, like, man, I can't get an appointment at MultiCare. I have a capability that then says, Hey Bill, I saw you on your, TikTok. Here's a link to go, set an appointment.

With direct scheduling. It's those capabilities that we're very used to with a. Solution for access. But we for some reason have changed our priorities and our expectation for healthcare. And so we've changed that. But on the patient side of it, particularly in rural areas, how do we meet.

Patients where they are, like, how do we actually go to the patient? And so we have an awesome partnership with dispatch health, where in some cases we're heading to the patient's house. And I actually think as you look, further into the future this is where things are going. How do I enable you at home, particularly if you're, in a certain demographic or you're part of a Covered Lives program to engage with MultiCare from where you.

So those things happen and manifest through things like, well, if we have an SED out in the middle of nowhere how do you leverage starlink? And so we're doing that today for some of those areas. And we were one of the first healthcare systems in the country to, to partner with Starling during Covid because we couldn't get internet out in our parking lots because of the overflow.

When the National Guard was. And I think it's that type of thinking that, okay, I'm not just gonna hope and let patients, code in our parking lot. I, we have a moral obligation to think differently. And so those are some of the things that we're technically putting in place to help ease some burden.

So feel free to talk about the specific technologies, but integration is so key, right? Yeah. When you talk about the call center and you talk about the pbx, you talk about the crm, you talk about the EHR and even the E R P solution and whatnot, I mean the magic of it is getting all of that stuff to work together.

You talked about chatbots and scheduling and all that stuff. How have you been able to create that A cohesive experience for the patient?

Yeah. I think this actually starts, not necessarily with a product, but with a capability internally. So we have a dedicated team that we call data orchestration and That's all they do. The head of this the gentleman named Nick Shepherd.

And he is the conductor. And it's, 40 plus people that in some cases as we, upgrade to the latest version of Epic, we've gotta go light those integrations up so that it talks with our pop health platforms or to your point, We just launched our new access center platform that has to integrate with Epic on the backend.

Or, we launched a robot to go help our nurses just given the wild shortage. Well, where does that data go and how do we actually make use of that data? So I'm really honestly fortunate to have a team of rock stars there. We've invested heavily in that orchestration capability so that the patient doesn't have to worry about it.

How do you determine the priorities? Is it more of a strategic initiatives for the health system sort of drive the priorities for it, I would assume?

Yeah. It's actually a top down and a bottom up. So one of the things that again we're fortunate to have is very clear objectives.

One of them in 2022 was called infrastructure. But underneath that it consisted of three things. One, we're gonna go implement a new e r P platform which as you would imagine, a system of our size that is not an overnight deal. We go live with Workday in July and are really excited about replacing our old or platform and again, providing our own staff and our candidates that we're gonna recruit with a really elegant solution.

The second was upgrading Epic. So, I inherited in a significant amount of technical. and trying to cut out of that to get to a place where our clinicians can save in some cases, three, four minutes. A patient that's real meaningful time, particularly in today's economic situation.

And the third was our access center platform. Now most systems will do one of those in a given year. MultiCare is bullish, and so we're doing all three. We'll wrap up the Epic upgrade at the end of this year. As I said, Workday launches in July and we already launched the Access Center platform.

Those are the top line. Priorities that come down the bottom up. We have two governance groups that we call Bolt and Colt. Bolt. The B stands for Business Operations and colt. The C stands for clinical operations leadership Team. So these priorities come up through the user groups. , and it could be something as simple as, Hey, I'd like to change this workflow for E eras, well, Brad Busick doesn't make that decision.

Our clinical operations leadership team does and we, put it through intake and size it. But it's based on capacity and I only have a certain amount of capacity. And then you can go and choose to outsource and we can bring resources in to help. But I love this idea that we don't have it project.

Everything that we're doing is in support of the business. And that's been a cultural transformation that's happened since I joined the system. Wow.

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  📍 We'll get back to our show in just a minute. Having a child with cancer is one of the most painful and difficult situations a family can face in 2023 to celebrate five years at this week, health we're going to give back. We'll be partnering with Alex's Lemonade stand all year long. We have gold to raise $50,000 from our community, and we are already up over 11,000.

And we are asking you to join us. There are two ways you can do that. One is that you can just hit our website. There's a banner at the top and it says, Alex's lemonade. Stand there. You can click on that. Go to our lemonade stand and give money directly to the Lemonade stand itself to make it a little easier.

We also have drives that we've been doing and we've done a bunch of drives, in January and February. Our drive in March is something that the team came up with and I'm really excited. we're, We're going to be at Vibe with the team, and we're bringing Captain. Captain is my producer, service dog and Captain will be with us for the entire event.

You're gonna see us around that event doing interviews, and here's the drive. The drive is, get your picture taken with Captain. You and a bunch of your friends with Captain get the picture taken. Go ahead and post it to social media, Twitter, LinkedIn, and go ahead and tag this week. Health. When you do that, if we're gonna count the number of people who are facing the camera in that picture, and for each person in that picture with Captain facing the camera, we are gonna give.

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And order O R D R order is, going to be a part of it as. And we hope that you'll participate with us and, we really look forward to seeing you at the Vibe event. Now, back to the show.

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Is there a technology right now that you're keeping an eye on that could potentially impact one of your priorities?

Or one of the biggest challenges right now is the clinical staffing shortage. Yeah. Are there technologies you're looking at that you mentioned, like, save four minutes, save five minutes, but even beyond that, really supporting the additional workload that clinicians are feeling.

Yeah, there's two. And we're actually investing heavily in both. I had mentioned the use of autonomous robots and that sounds novel and

wild.

Are these the robots that are like just taking their path around the hospital and carrying things around, or is it different?

Yeah,

It's actually a bit of, so it's not the tug system, right, which is like delivering linens and all that, although that's, I mean, I would consider that an autonomous robot. This is actually a solution that we launched about a month and a half ago. And in its first month of delivery it's about four or five.

It can get on the elevators, it can. Swipe into patient rooms and it's tasked and controlled by our clinicians. So when you think about from an IT perspective, like, look, this isn't gonna be done to you. This is gonna be done with you. It's called Moxi and it's through a company called Diligent Robotics.

And in our first month even, Typically get impressed with technology. You probably don't either. This thing blew away my expectations. So in our first 30 days Moxie delivered 3,500 things, whether that's, Hey, bill, forgot is EarPods up in the room, task it, go get it. And this is what it looks like all the way to, can you go down to the lab and pick up this specimen and bring it to.

This location or can you go to the pharmacy? It traveled 605 miles . So, you go, wow. Like, I had no idea that our nurses were actually doing that. What we think gave our nurses back over 2000 hours. And if you think about that, it's like, okay, well what were those nurses doing?

Well, those nurses were with my kid. Your kid at the bed. Not walking down to the farmer's house. So someone jokingly said like, well, can I go get my GrubHub from the lobby? I'm like, absolutely, I want it to because I'd rather have you with my kid at the bedside. So if you quantify all of this, all right, well, annualized, we actually think this is doing the work of taking like the manual tasks off of our nurses to the tune of 12 to 13 FTEs.

Wow. That adds up. quick Particularly in our nursing shortage. So that's one thing I'm really bullish on and we're investing in, and that will go across our system in 2023. The second thing that I'm keeping an eye on, and I think it's gonna be controversial for a number of reasons.

Half the people will think that Star Trek, and it's never gonna happen. The other half are probably gonna be more concerned that it's gonna clutter up our skyline. And this is the use of drone delivery for interdepartmental lab specimens and then delivering meds to patients at.

We signed a strategic agreement with Zipline in 2021. And I'll never forget the conversation I had with someone who said, wait a second, so you're telling me I'm gonna look up in the sky and I'm gonna see a MultiCare drone take off from our children's hospital and go deliver medications to a patient on Vashon Island?

And I said, absolutely, because again, zooming out on this bill. Amazon's gonna go figure this out. And they already have, by the way. So is CVS and so is Walmart. Why not healthcare? Right? Like why patients deserve that. And so we did and we are. And so we launched that in Q4 of this year. And it's really fun to do something that has not been done.

Before, I mean, think about the logistics of how do you design a takeoff and landing station. No,

I know, I'm, that's what I was just saying. It's one thing to have the takeoff and landing from your hospital or your health system. The landing though, at the patient location, those could be tricky.

It

not only would be tricky, I mean, there's some beautiful technology that goes into the telemetry and literally being able to drop it within, a quarter inch precision and you almost have to see it to believe it. I think this is gonna become a commodity. I really do.

And 10 years ago when you and I are like, wait a. I can order something and have it delivered to my house in two hours and pay $2. Like, I'm open to that. And now if I went to your garage, there's Amazon boxes all over the place just like mine. Why not healthcare?

Why not healthcare? I feel like you're calling me out, like I'm ordering too much stuff from Amazon, but no comment.

Yeah it's every house. I mean, is the Amazon. It's amazing trucks, two or three times a day around this neighborhood. I'm telling you the first company that offers drone delivery, I don't care what they're selling, they can sell. I just wanna see it. Something I don't want.

I'm gonna order it and I just wanna see it, deliver it to my house. I'm so totally, that's one of those early adopter kind of things. Not the closing question, but you know, we're getting close to the end here. I do want to ask you about home care and the push to home care. I talk to a lot of CMOs and cio.

and this seems to be a focus for a lot of health systems of changing the care venue based on need and desire of the patient. What is MultiCare what's your approach to that?

We're incredibly bullish on it and have an incredible hospital at home team today that's supporting this work.

I will say that maybe in the last two years, And this space evolves quickly we finally got to a product set that I actually would be willing to roll out to my parents that they could use and not have to call their son who understands it. , like, how do I turn on this stethoscope? Where do I put this thing in my ear?

Like, that's all been solved for, and it's easy to use. I'd also say, sadly but in a really cool way the market has actually changed our utilization due to retail application, meaning with the emergence of things like 23 and Me or Covid tests at home. bill before any of this, none of us were doing those procedures at home.

No one would swipe their own nose or mouth or send their d n a off. And now this is almost becoming common. And so again, why not healthcare? Why not retail? We are actually really bullish on that, particularly back to our previous conversation about rural areas who may not be able to make it in Washington State, as you know it, there's islands all over the place.

Well, if it takes. Brad Busick, who lives on Vain Island, 45 minutes one way on a ferry, 45 minutes, another and 30 minutes to get to that ferry. Why wouldn't I just drone delivery this stuff to his house, let him do a telehealth visit, put on the box and the drone picks it up and brings it back home. Or even better, he just goes to a locker and hits the MultiCare locker, opens it up and pulls the hospital at home kit out.

And so we're incredibly bullish on that and coming up with support models to help support that. It.

Yeah, we're coming up on ViVE and HIMSS and this is the space I expect to see continue to evolve and get better and better. Best Buy just did the big announcement Yeah.

With Atrium and I think more and more we're gonna see those kinds of partnerships of Yeah. Organizations that aren't I mean, although Best Buy calls themselves a healthcare company, Yeah, but our traditional healthcare, but the skills they do have is setting up that home for multiple levels of acuity.

That's right. And so that's the area. But I'm trying to figure out what closing question do I want to ask you? I ask generally, sometimes I ask questions about your staff and where they're working and that kind of stuff. You're pretty remote. My guess is your team is probably mostly work from home at this point based.

Your geo, your geography. Is that accurate?

Yeah. And their work from home, and they're all over the world. We've intentionally, stood up our knock and our soc overseas because we need that capability 24 7. But it wasn't. But three years ago, MultiCare was located in, those geographies we talked about earlier.

We've now got staff across the country, which has been a really interesting because if I've got folks in New York and Florida and they start their day a couple hours ahead of time, and I call a staff meeting at three o'clock my time, well that's six for them. And so it's been a really interesting evolution for us culturally I would say, , aside from all the cool capabilities that we just talked about there isn't anything that's more important to me than that culture of trying to create a place where my staff feels challenged.

They can connect themselves to the work that's happening on that front line. And I remember someone said to me before I came to MultiCare she literally leaned down the row and looked at me and she goes, wait a second. You want to go let people work remote? This is pre Covid. And I said, I absolutely do.

And she said, well, how am I gonna know what they're doing? And I looked at the president and I said, the real question we should be asking is why are we hiring those people to begin with if we have to actually look at them to know what they're doing? So do we trust our staff? And this has been a really awesome way to increase our productivity as well.

Folks don't have to commute every day, and so I don't think you'll see MultiCare go back to coming in the office five days a week. We're past that point.

All right, so here's the closing question. I'm a new hire to MultiCare and you just hired me to be your whatever within MultiCare phlebotomy the technology side.

How do you bring me into that culture? There was whole groups of people that we hired during the pandemic. These companies just massively went remote. We hired a whole bunch of people and then we heard of those people either leaving abruptly because they just weren't connected or they just didn't know the staff or they're not connected with the clinicians cuz they're not in. What are you gonna do to bring me up to speed? How are you gonna connect me into the MultiCare vision, mission and objectives?

Yeah, you bet. So, we'll look at this use case just through the lens of it, so philosophically I believe that every single person deserves a right to have an incredible manager.

And if you zoom out, bill, and you think about all of the healthcare systems that you engage with on a daily basis, there are people in management that have no business being in management. They might be incredible with a Java stack or a Citrix stack, but it doesn't actually mean that they have a genuine gift for managing people.

We redesigned is and t three years ago to build on that premise. So our leadership stack in it is legitimately stacked. Meaning I have the LeBron James' of the world in every one of those leadership positions my c O will literally hold a new employee orientation for IT members that come in.

walking them through their mission, vision values, but then more importantly, like how do we actually get into the work that's happening in it? And so we have that playbook that's dialed. And then outside of that we have recurring touchpoints, obviously monthly from a larger staff meeting where 500 plus people hop on a teams and Bon Jovi's blaring in the background.

And it is a all in high energy. This is what we're doing and it's really the gift of letting our staff story. To articulate the value of it to the business. So it's really awesome when, not Brad, but someone on our pharmacy team is sharing the story about how we automated pharmacy refill and 10,000 patients didn't have to call.

they just used the IVR that we just rolled out to go refill their own stuff. And I find so much joy in watching our own staff flourish on that because we immediately take that and then put it in our own newsletter that goes out to all of MultiCare just to continue to keep it top of mind and show her how we're supporting our growth.

Fantastic. Brad I just wanna thank you for coming on the show. It's Great to learn about MultiCare the things that you're doing and it's great to develop a relationship with you as well. Thank you for sharing with our community. Really appreciate it.

Oh, good to be with you.

Thanks for the opportunity.

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