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November 4, 2022: How can IT leaders ensure that employees have all the technology tools, information and support they need to help their organizations navigate uncertainty and disruption? Chero Goswami, CIO describes his efforts at the University of Wisconsin Health System. Employee health has become a strategic imperative. It doesn't matter if you're a provider or a non-provider, every employee and every health system is stressed. And so the behavioral health of our very own has become an important factor.

Key Points:

  • How do we care for our employees? 
  • People come to work for a leader, not a boss
  • When we think of priorities, it's smart growth. Coming out of the pandemic, where do we focus our energy and resources?
  • When we say workforce shortage, we are misleading ourselves because it makes us believe that staff are coming back
  • University of Wisconsin Health System

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

Today on This Week Health.

Employee health has become a strategic imperative. We always talked about provider health, which is important, but today it doesn't matter if you're a provider or a non-provider, every employee in the health system, every health system is stressed to a point. And the behavioral health of our very own has become an important factor.

Thanks for joining us on This Week Health Keynote. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, a channel dedicated to keeping health IT staff current and engaged. Special thanks to our Keynote show sponsors Sirius Healthcare, VMware, Transcarent, Press Ganey, Semperis and Veritas for choosing to invest in our mission to develop the next generation of health leaders.

All right. Today we're joined by Chero Goswami, University of Wisconsin Health. Chero, welcome back to the show.

Thank you very much, Bill. Glad to connect again on a Friday afternoon.

Friday afternoon, four o'clock in the afternoon. You're still at your desk. Still working hard. I'm actually at a hotel, so I'm, technically still working as well. So thanks for your commitment. I appreciate you doing this so late in the week.

Well, you've been in our shoes for a long time. Bill Healthcare is 44 7 Friday afternoon, as we used to say. It's two days to Monday, so great time to catch up and prepare for the next week,

That's funny. People are like, Well, what time you get up on Saturday? I'm like, Well, I get up the same time every day. I mean, it's not like my body clock is my body clock. And so I would send out a ton of emails on Saturday morning from like five 30 to seven 30. And at some point HR came to me and said, Could you stop doing that?

Like, it's, it's creating a problem. And so I had to get a mail scheduler where I, I dropped it into a bucket and it, but it didn't go out until Monday morning.

So technology is an enabler in everything in life. There you go. See

everything. Yes. Sorry, I, I didn't mean to confess so much on a Friday afternoon.

All right. Today, actually, it's kind of appropriate we're gonna be talking about the CIO's role in caring for their staff. Right? So, you and I had a interesting conversation about a month ago. I asked you to come on the show cause I said that's a great topic. Love the stuff that's going on there.

But before we get there, I'm gonna have to go back and say, Tell us about UW Health. So give us some stats and where you guys are at and who you serve. Right.

So we are University of Wisconsin Health System based in Madison, primarily and affiliated with the University of Wisconsin Madison what we call the School of Medicine and Public Health.

As much as we call ourselves University of Wisconsin Health, we actually operate across two states. It's Wisconsin and Northern Illinois. In terms of numbers, we are roughly about 4 billion in revenue, about 21,000 employees. 1900 providers serve about, say about 700,000 patients. And when it comes to it, we have an IT team of about 750 as part of that 21,000 employee base.

750. And you're right there. So people come to a conference every year at UW Health because do you feel like the, the home organization for Epic, because you're, you're so close. I,

I do, They come for the Epic U GM conference, which is now end of August, I think. That's where it's been the last few years. And it's interesting because I was one of those people that would visit Madison once a year. And pay my pilgrimage over there at that time. Now I play get to play the host cio, and I joke with many of my CIO counterparts who've been on your show. I'm sure that I become the local Uber driver by evening and night people around because they're not in Uber and Lyft drivers around town.

So it's, it's interesting because it lightens up the city. It's good for the economy and what has started happening is it allows us in Madison to actually get together with a lot of peers by adding a day on the front or the back instead of flying to yet another conference halfway across the country.

Right. All right, So there's a lot going on in healthcare. What are some of the priorities for you right now at uw?

So like almost every other health system our priorities probably are, are the same. So when we think of priorities, it's smart growth. And by smart growth coming out of the Covid piece, we are saying where do we focus our energy resources, human and clinical and technical.

So in terms of smart growth, we are building out some distinctive programs in terms of oncology, women's complex health, pediatrics. Tho that doesn't mean the rest are not important, but those are distinctive programs. I would say also starting to use technology as an enabler and an investment versus seeing it as an expense.

And there is a big difference because the investment in technology in the last three years has grown at UW Health in a similar way. And I would say the fiscal stewardship is being challenged at every quarter, every quarter, the last two years. If you look at the balance sheets, We all lost money.

Last two years, we lost money, then we made money, then we, again, losing money. And most of that is also coming down to, as a result of workforce shortage. So while we have always talked about margin and mission, I think today it's become a leader's imperative to find that balance between that margin and mission, And most importantly, I would say at the first time, I feel employee health has become a strategic imperative. We always talked about provider health, which is important, but today it doesn't matter if you're a provider or a non-provider, every employee in the health system, every health system is stressed to a point. And the behavioral health of our very own has become an important Factor

It's interesting I was on a call with Craig Richfield just this afternoon. I, I was talking about the clinical staff shortage. And he said, Bill, I'm gonna have to stop you there. He said, You need to stop talking about the clinical staff shortages.

Just talk about the workforce shortage. He goes, Cause when we have these technicians and whatnot not available anymore and we can't find them. Cause you know, he's like, literally McDonald's is hiring in this area at $25 an hour and these people are choosing to go there instead of work at the hospital.

He goes, but then someone has to do that and that's falling on the nurses to do that work. Because we don't even have the technicians to do this. And he goes and, and he goes, and that goes over into it. It goes into, he goes, A lot of the areas are really stressed right now with a, a challenge of finding. Workers that can do the job and, and really want to do the job well.

It's interesting you brought up Craig's name because Craig and I talked on this at another panel maybe two weeks ago, and I would go even further to say, when we say workforce shortage, we are misleading ourselves because it makes us believe that it's coming back.

Short means you're gonna make it. Part of me wants to believe this is the new workforce. And it's not just nursing to, to the point we talked about earlier. It's environmental services. It's culinary services, it's valet services. It's, it's all those places where people are going, I can go somewhere else and work.

And so how do we have to get to a point where, We have to manage those services because you can't eliminate those but find a different way to make it work. And in in our world, we did a, I at least I choose to think a phenomenal program where we said, let's make it a win-win where we had shortages in certain areas like culinary services.

So volunteers from my team went, actually worked in the culinary services because you gotta serve food to your patients. That's not an optional task, but the win-win came out of it that many people in it don't get to visit frontlines. Or embed themselves in front lines. So we did that program and we all came out smarter for the cause to know what happens when a dietary order does not go through or fail. It's not just as simple as cleaning of the queue. You understand the frontline impact of that.

How do we care for our employees? Again, yesterday I had a great conversation with the cio. As I go to these cities, I stop in and talk to some of the CIOs and, he was talking about, before the pandemic, 50% of my job was my staff's wellbeing.

Like I met with them, I focused on that. And he said, And through the pandemic, he goes, That investment, prior to that really paid dividends. As we transition to new work models and, new management styles and all those kinds of things, but that investment in those people, and he goes, and that's cause that's a significant portion of the CIO's job, the wellbeing of your staff. And because these people are leaving and it really does increase the, burden on the people who stick around,

right? And. You and I have done enough of these my three resources, your human resources, your fiscal resources, and your technical resources. And as CIOs, we have to ensure that the technical resources, you have good managers, vice presidents, directors, taking care of it.

So it comes back to that fiscal resources and human resources. and I feel that we have lost or had lost the people aspect of it. It became a number, it became a user ID or something. And it starts with relationship building. I mean, I came to Madison two weeks before Covid arrived, so I didn't even have the runway to build the relationship.

But you take the time and meet people where they are. Money goes a certain distance. Respect, empathy, and care goes a lot. further And so certain folks wanna meet me on a Saturday morning. That's great. We'll make the time certain people wanna meet on a Friday evening, make the time. Every one on one should have a human aspect of a conversation, not just a project status update. People come to work for a leader, not a boss.

📍 📍 Everybody's talking about hospital at home, health at home. Market Watch article states that in-home hospitalizations saves five to $7,000 per episode and with the economy where it's at, and the pressures that are on health systems, this is an important topic. On December 1st, join us for a webinar with a panel. They're gonna be able to share how they stood up a successful program and work through the complex requirements for helping patients recover in a comfortable and familiar setting. You can register on a website this week, Go to the upper right hand corner. We have current webinars and upcoming webinars. You can register right there and you could also, in that registration, put any questions you. And we will try to address those questions during the webinar. We love doing that and love having you be a part of the conversation. So I look forward to seeing you there.

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So talk about mental health. I mean, do you guys have benefits around mental health as a, as a system?

We do have benefits around mental health as a system. We have our own mental health or behavioral health system, but like any other system, even our behavioral health resources are taxed at this point.

Like many other places you want to get an appointment. It takes a long time to get an appointment. There's a shortage of staff over there too, but there are different ways you can even address that mental health with each of us being there for each other. I mean, the resiliency word is very strong and we, yesterday I was at work in one of our office buildings and a team was doing a scavenger hound and actually doing that as part of a project and leading to how do we work together in a virtual environment yet come together once in a while to have fun.

I remember having this conversation with Stephanie Lar and she was talking about they had a person who was, or actually a team, I think it was a multiple people. Not that it was their full-time job, but it was part of their job was to was to coordinate the, the social interaction.

That was the new dynamic of social interaction. In a remote work environment. And so they did, they did a lot of really creative things and even to the point of investing in the community. So they were doing like fun runs and that kind of stuff. Mm-hmm. people would meet up. Is that, is that the kind of stuff that's the norm?

We used to do that physically when we were physically in a building. Are we we're. Doing that stuff promote.

It's coming through organically. It's interesting you bring this up because having watched two separate teams different days of the week trying to do different things and actually enjoying when you sit in your office and you hear laughter in the corridor.

That's not something we have heard in the last three years. So it's a good sign that's coming back. So when I go back and I listen to folks what they're doing, when I hear every idea is unique to a point, they're creative, they're funny, and they're educational. So next month at all staff, I told two of my teams, I said, Come and present because.

There are 10 other teams when I do what I call coffee, coffee with shero on couple days every week. And they go, What do we do? And I say, Talk to your peers. Don't wait for leadership to solve this. But as leaders, we have to give them the forum where they can exchange such ideas. So,

it's interest. I'm it's Friday afternoon, there's people actually playing golf and doing stuff in the, in the background here. So it's kind of, kind of nice to be outside and hear that noise. I was in an office yesterday. I walked in, there was, I mean, the office probably held about a hundred people, and I think there was two people in it. That's kind of an eerie setting. , I mean, are you starting to see people come back? I assume you're giving them the option of coming.

We are given, You're talking about how do you take care of your people. Empower them, let them make the option, reduce the number of policies and empower them. And so earlier this week I went into work and for the first time in a long time, I didn't have a parking spot in the front row that were that many people.

And I'm like, Should I complain or should I feel good about it? Part of it turns out that there was a, there was a go live. People decided to have a virtual center and many showed up in person and I actually asked the person to say, Give me a write of when all this is done, how did it work? What were the benefits of going back to a semi in person?

But at the end of the day, we are humans. We need the social interac. Each of us in a different way. So there's a group I see that's normally there on a Friday. There's a group I see that's normally there on a Monday, and summers are beautiful in Madison. So people come here during summer and then go out for a hike, a walk, or a golf course, which is also down the hallway.

So you've mentioned earlier, I'm gonna transition a little here. So you mentioned earlier this whole idea of investment in it as opposed to a call center and investment in it. But when I hear the word investment, Generally, I don't make a an investment without a return in mind. Right. So is there more scrutiny being put to the return on those investments?

I would say we are going through an educational approach on that one. We did this in my previous life in St. Louis and. The return on investment needs to be more than dollars. It needs to be a value proposition, and so what we call a business value scorecard, you take the a hundred percent of the budget that we have in technology and we transfer it to what is the outcome, whether it's in pharmacy, to reduce medication errors, whether it's in supply chain, to reduce inventory on hand or expired inventory, whether it's in nurse staffing to ensure you reduce.

Over time hours because now you're doing real time documentation. When you start doing that, you at least the first step is awareness. Where am I putting my dollars? Am I buying systems or am I creating solutions? Then when you go back and I use the run, grow, transform model quite a bit in, in whatever I do in life to say, take percentage of your savings from efficiency and put it back into the transformation model to invest in new technologies and new workflows and things like that.

So it's with my colleagues at the senior leadership level, we, it took me two years to establish the foundation and now you get the buy-in to say, Let's do this differently. So, because $200 million can disappear very quickly and you have nothing to show, So,

yeah, some people are gonna hear that and say, I, I don't even understand that, but I, I had roughly a $250 million budget.

It can disappear, especially in at a time where there's inflationary pressure, so all the contracts coming for renewal. You look at 'em and you're like, Where did that 15% increase come from, or that 10% or 20%? It, it does become I mean there's, there's, definitely some, some pressures around this right now.

couple of questions I've been asking CIOs about lately. One of 'em is around adoption. in order to really impact the. patient experience, you have to impact the clinician experience as well, Right? So it's all tied together. So, so well but that requires adoption both on the clinician side and on the, the patient side. So what are you doing in the area of adoption?

I would always say when this question comes up, less is I don't use number of applications or petabytes of data or servers or number of data, data centers as currency. Less is more, and your metric for that is simplicity. How simple are you making it?

Simple things. You can't, You talked about the provider and the patient. In a very similar way, you can change physician workflow or provider workflow without impacting nursing work. They go hand in hand, and one is you get your boots on the ground. As a programmer, back in the day, my company at a rule, you can't write your first line of code unless you see where it's used.

And so when you go and you see it, you understand the complexities of a large ac, actually any hospital, not just academic medical center. So you don't deploy things, make it simple. The second piece I would say is make it sustain. As IT project managers, we are used to going leading to a go life. Go live is the easy part.

Make it sustainable so that 90 days post go live. When the project team dism submits the user group has the assurance that technology and IT support group is available to support it. And at the, one of the simple things, actually, I've given an example, it's not even a system as a security measure, we spend a lot of dollars in cyber.

We have passwords that are eight characters long. Everything from special characters, uppercase, lowercase numbers, can't use vows from your mother's maiden name. You know all the rules. We moved to 16 characters. We moved to 16 characters and we made it simple. It's a passphrase, do whatever you want. 16 characters, you change once a year.

But the change management we did was we give folks fingerprint readers, batch tab or batch. Readers, fingerprint readers. And by 16 characters, we said, You have to avoid remembering all these funny characters. The answer came back. This is actually much simpler. I don't have to remember. I don't have to mistype.

It was a one time getting used to it. It reduced the number of, it, reduced the number of calls we were getting to the help desk. It reduced the frustration. Of the employee changing passwords every 60 days or 90 days. So what could have been a disastrous technology experiment turned out to be an excellent change management experience. I use a very simple one to illustrate the point. If you make it simple, people will adapt it.

Yeah, yeah. No, I, I agree with that. A thousand percent. It's, interesting. How do you make sure you're solving the right problems? This is more of a governance question than anything. So it's, interesting I was talking to somebody I used to work with and we just talked about the daily onslaught of ideas.

And it's great, right? The number of ideas, the great ideas that are constantly coming at you, it's like, Hey, why don't we do this? Why don't we do this? Why don't we do this? It's phenomenal. But how do you prioritize? how do you prioritize 'em? How do you make sure you're solving the right problems? How do you make sure that you are investing in the areas that are gonna bring the greatest. return

I'm yet to see a very successful governance model anywhere. I mean, every governance model

come on. There's got, there's gotta be one.

No, there isn't. That's why, that's why, even not to get into the political aspect of it, that's why you choose a government every four years because you get to vote again. Because every governance model needs to be visited over time. And I mean that in all seriousness, Bill. So we are, we are launching, literally last month, September we launched our new governance model. For technology and, and the way we are doing this is the word like demand management or ticket management needs to be almost abolished because then you are reacting, you're just reacting to every ticket It's death by a thousand paper cards.

Versus if you take the time to invest and build your roadmaps, maybe 18 to 24 months, just build your roadmaps and now you start when the requests come in to say, where does this fit on the roadmap? Does it complement, does it compete or does. it Replicate stuff that you already have. You ask the value proposition.

Now, you also have to be careful that there is not so much analysis paralysis that nothing gets done. So you keep the train running to say, Okay, keep the fires off. But how do we prevent the fires? Simple example. I'm not gonna call it vendor names here, but if you think of capabilities, think of communication within our clinical.

staff I think every health system has probably 10 vendors and 20 products in that area, and our poor clinicians are going to war with like everything from pagers to 15 other devices. Technology has come a long way, but without a roadmap. We refresh contracts with a roadmap. We say, What does a nurse of the future communicate and work backwards into it

📍 📍 All right. Conference season is upon us and our team this week, health team and I will be at the Chime Fall forum celebrating their 30th year in San Antonio. And we're also gonna be at the health conference, HLTH in Las Vegas the following week. While at these events, we're gonna be recording our favorite show on the road, which is interviews in action. And as you know, what we do is we grab leaders from health systems, healthcare leaders from across the country. And we capture 10 to 15 minute conversations with them to hear what's going on, what they're excited about, what are their priorities, and those kinds of things. It's a great way for you to catch up very, very quickly on what other health systems are thinking and doing across the industry, so don't miss the chance to hear what's happening from these great leaders. We actually air this on the community channel this week, Health Community. It's the green one. So if you go out onto your podcast listener of choice and do a search for this week Health, you're gonna see three channels. The community channel is where we're gonna air the interviews in action going forward. This channel is also where community members like your. Have been invited to do interviews of their peers, and so that is moving forward as well. So check those out as well. You can subscribe wherever you listen to podcasts. Just go ahead and do that in your podcast listener, or head over to this week and scroll down to the community channel and you can subscribe there as well. So look forward to catching you on our interviews and action. 📍

📍 How do we get the voice of the patient at that table, at the governance table to say, Hey, this would be important to us. We would like these kinds of changes. Cause I'm sure you're doing a lot on the patient engagement and. Patient experience side. Right. So,

fascinating, fascinating. You just opened the door for me. I'll here. So nothing, nothing is, there's no such thing as a technology project. I always say this, it has to start with the patient in the center. And one of the initiatives we launched over here with a colleague of mine is sort of the patient's electricity, but with human-centered design or design.

As a cio, as a codigital leader, I will tell you sometimes we are abusing technology by putting it so much technology that we are confusing the patient. So we started with oncology. We are doing tons and tons of personas and actual, actual patient interviews and things like that to what does it mean to be an oncology patient?

Tell us what happens when you hear the news that I have cancer. How do we change our flow? To treat you. What about the two weeks that you have to wait for your second appointment? How do you feel? What can we do to do that? Because technology should always improvee efficiency. Technology should always enhance experience.

Technology should never replace empathy, which is called to our business. So through our human centered design, through our patient centricity, we are saying, Come tell us whatever way we worked for the last 5,000 years. How do we change it? Not everything needs to be a text message.

Yeah, it's interesting cuz there's that philosophy, which I believe in a thousand percent. But there's also that, that Steve Jobs quote and the thing I always remind people when I hear it is very few people in the world are Steve Jobs. Like Steve's comment was people don't know what they want until I build it for them. Something to that effect. That was the

never ask a customer what they want. That was a score.

I mean to a certain extent, if you ask a an oncology patient, a patient with cancer, what technology or what outreach or how would you like for me to respond? This is the first time they're going through it. It's not like the 10th time they're going through it.

This is for a lot of 'em. It's the first time they may not know they may. Have the wherewithal to go, Hey, you know what would really be helpful right now? A video. A video from my physician talking to me, right? Cause you know what's gonna happen to me over the next month. I'm gonna get asked 25 times. What does that mean?

And what I'd rather do is just send the video out to my family and say, Hey, I've got cancer. Here's what the doctor told me. That would be, That would be wonder.

It's, it's simple things, and again, it's just thinking from that perspective. It's just thinking from that perspective, having grown up in a pediatric hospital, what, what does the parent of a patient go through when the baby is birthed in one hospital, airlifted to a NICU in another hospital, doesn't get to see the baby for 40 days or maybe four days and then comes over.

There's enough technology out there, but you have to get from that side of the lens to understand what you are going. I think that's the empathy aspect of it that we have. Technology is sometimes accidentally replaced.

Why? I think people, So I ask these governance questions a fair amount and I think it listeners might listen to it and go, Why do you keep asking about governance?

And I'm like, cuz we're doing a lot of projects. But it's like the difference between cleaning up a room in your house. Or trying to clean up your entire house, but not really having the resources or time to do it all. And so you half sweep and you half whatever, and it feels like there's so many half done workflows and experiences throughout healthcare.

It would be nice to clean up oncology or clean up labor and delivery or clean up orthopedic clean up like just one area at a time so that people look at it. and go Yeah, this is really, this is excellent. I mean, this, I Was able to schedule my follow up via, because via my phone I was able to text my my primary care doctor.

I was able to all the things that they're asking for, if we could clean it up in one area. And then just keep moving around cuz I, I, I don't know about you, but it. At, at my health system where I was the cio, I never felt like there was enough time to do, to really clean up one area.

So I think this is where healthcare is at. The cost where we can catch up to other industries. We always say in different ways, right? Technology is 20 years behind in healthcare. Maybe it's down to 10 years behind now, but I think that's the, that's the difference. And I'll use my words here, Bill. We are very focused on projects. Projects are an output.

It's a go live. We say the project is successful. If you change the phrase from an output to an outcome, what was the outcome I was trying to get through this investment? You talked about labor and delivery. What was the experience for the mother? What was the transition point? How well was the baby taken care of post-delivery?

How was the discharge process? How was the first visit post discharge? If we look at that holistically and start having what I would call an experience measure, And I'm not talking about our, our press Gainey scholars or anything like that. I'm just talking about a, a holistic experience measure and then start saying, Here are the five things we need to change, improve, or eliminate in the process, and then fund your projects back.

Governance is also not just about approving new projects, it is also going and looking at those outcomes measures and saying, How am I moving these things out?

yeah, I mean, it would be phenomenal if we one of the things I worry about, I know I, I'm like starting and stopping here cause I'm trying to figure out where I want to go.

But one of the things I worry about is a lot of these exterior organizations have greenfield scenarios, right? So they're, they're, they don't have to pull all this legacy along. In terms of workflow and all this other stuff. And so they're may be able to create an imaging experience that's a lot better than going to the hospital.

And as imaging is a, is is a fairly good source of revenue. There's a lot of places people are recognized. There's a lot of places in that hospital that lose money. Yeah. And, and we know they lose money and we accept they lose money. And there's a handful of places. We do make money. So if, if they're able to Greenfield, sort of come in here and you, you do your appointment online and you get your results in this way and that kind of stuff that's the stuff we have to compete with long term and get in front of this is, this is why I think I keep coming back to governance of staying in front of those things that are so important. Because it, it's, right, it's healthcare, it's all critically important.

Well, and, and we are not the only ones though. We have a very strong imaging in the specifically radiology department over here. So that's a great example that you bring up, right? Because time is money. Time is money. Yeah. So if you start reducing your waste and weights and what you have to go for an MRI scan encounter, you're creating more throughput, which means you can take more cases when you have more throughput, you can provide your imaging services to some of those and become a competi.

And not just do your own reads, but other folks out there. But it comes down to starting to think of every asset in the supply chain of that experience as a commodity. And if you're not deriving the highest value of that, then you're leaving money on the table.

Sure. I love I love our conversations. I'm gonna ask you a question. I didn't really prep you for this one, so but you're a professional. You, you've been doing this for a while. Talk to me about vendor partners. So we're remote now and. I was talking to to a CIO about this, or no, I was talking to a partner about this and it's like it's hard to find these people now.

They're, they're remote. It's like, we used to be able to go to their office and have lunch with them and that kind of stuff. It's like, how do you interact with your vendor partners? Is it more you going to them now or have you resettled sort of the way you interact?

So, so first of all, you and I both know tho those two words are not the same, a vendor or a partner and Covid has made us aware of who's one and who's not the or who's the other.

To my partners out there, they know very well. I don't do lunch. That's an easy answer, but the most important thing is I always tell my, my, I will use the word vendor partner. Here is what works. Most places may not work in he. Come and take the time to understand my business, come and take the time.

I've said this again and again in most interviews I do. We're the only industry where our cust customer does not get up in the morning and go, I have nothing better to do. Let's go to a hospital. You choose to fly to Philly, you choose to go to a restaurant, you choose to go to a ballgame. You choose to go to a store, you choose to do whatever.

You don't choose to go to a hospital. You go because you have to. So our vendor partners need to understand. Our experience trusts three below zero. How can I make it better? The next thing I'll tell this to our partners is where did design go? You talked about Steve Jobs. It was about design. If you give me a product with five pages of manuals, you've lost me.

Right. You think a trauma surgeon or you think an urgent care physician, or you think somebody has the time to understand that you gotta put this over here and type over here and drag over here and do all this. Make it simple. Yep. Three, be my partner. Be there for the long run. I call it inventory on shelf.

We buy a lot of things, but we sometimes don't know the thousand features it comes with. Right. Spend time with me and tell me what I'm not using because I don't know everyth. Because what we tend to do is we go and buy three more of the same thing, not knowing we have that in our inventory. And finally, I'll say every human being, every vendor, every partner is a patient of some health system.

Ask yourself, would you want this to be tried on you or your mother or your sister? Do the user test yourself before you come and sell it to me. Yeah, because otherwise it's vaporware. So simple real life examples. I.

Alright, so shero to close this out this week was my birthday. I had my birthday on Tuesday and my daughter bought me a meta quests two. Have you been in virtual reality? Have you like, put one of those headsets on and, and done that whole thing?

I got two teenage boys that do that for me, so they're my user testers at home. So, no, I have not, but I know what you're talking about.

This is the first time I put one of those things on and I, I mean, Facebook thinks enough of this that they've renamed the company meta. Okay. I mean, so it's not a, it's not, they're not making a small play. And I think it's now already like a billion and a half of their revenue. They bought Oculus and it's a billion and half of their revenue. They've renamed the company. And so I'm like, All right, there has to be something here. And I spent a little time in there and I'm.

This is really interesting and I mean there are definitely some, some applications to care that I had I'd heard about cuz there's some stuff going on at Cedars and whatnot that I think is really mm-hmm. interesting in this space. But I'm gonna be exploring and I'm gonna challenge you if you ever get, if you get a chance, we get your boys to say, Hey, put this thing on me and show me around.

I, I'd love to get your thoughts on this cuz it's sort of got me, got me think. What does the, the next round look like? What is augmented reality and what is virtual reality and what's the practical application? Cause I'm giving a talk tomorrow to a bunch of, of millennials on, on, on living in a digital world, and I'm gonna talk about the 50 years I've been doing.

Actually 40 years I've been doing this and the transition from the first pc, the Commodore 64, all the way through to the things we're using today. And then I'm gonna just pose the question, what's next? And I'm curious what's next? And I think it'll, I think there's gonna be some applications for healthcare and I think it's gonna be, it's gonna be interesting. Do you have any answer to what's next? What's the, the next big thing?

So I think this is a great time to be in healthcare It because of what you just. Because the art of possibilities, we always start with a problem statement, right? I always start with the art of possibilities. What can we use out there?

I mean, we have abused the word digital. All my friends know this. We've abused the word digital. We, there's vendors that call portals as digitals. They've been around since 1970s or nineties at least, but when I start thinking of artificial intelligence, and we talked about imaging modalities and stuff like that, think of where it's going.

We talk about digital. Digital pathology is coming. It has got me intrigued, but not for the technology aspect of it, but the adoption aspect of it. As, as more and more health systems are looking to centralize their lab facilities and things like that, especially those across big areas. Imagine the risk we have in carrying specimens back and forth, and that, and digital pathology is still an incubator, if you may.

It's coming up in the, in the simple world of, as I'm thinking of virtual reality and stuff like that, I'm thinking of recovery for multiple different types of patients like orthopedics and stuff like that. Start giving them hope of what good looks. Yeah. When all this is solve, when they're at the lowest from the career, ambient digital service scribes are coming up.

I mean, those are things that will help our providers, but this is where I do look at other industries. And say, Let's not wait for a problem to occur before we go looking for a solution versus start looking for things that work in other industries. Bring us up. Precision Medicine's, another one that's got my personal interest here, so,

yeah. Yeah, like going digital pathology. We talked to Jamie Nelson about that, and they've done great stuff at hospital for special surgery. Definitely worth a conversation with her. If you're anyone who's, who's looking at. And precision medicine, my guy, the academic medical centers are doing some really fun, i, I don't know if fun's the right word, but impactful things around precision medicine. And I I think we're still just scratching the surface there.

Exactly. I mean, this is, this is, this is at the cusp, I would say and I don't think we, there is a common definition of that either. But I think this is where that's the you. You are right. It's the fun part of our job, cybersecurity and everything else is the tax we pay on our jobs, as we say.

But this is the fun part of our job. And Bill, I mean, I know you well enough to say this. We owe this to the next generation. Yeah. Data is showing that our next generation, for the first time in the history of the United States, will have a lower lifespan shut off a disease or a water or a disaster. We owe it to our next generat.

Yep. Absolutely Cheryl. Always great to get together with you. Thank you for your time on this Friday afternoon.

Always fun catching up with you, sir. 📍 Stay wild.

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