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September 1, 2023: Edward McCallister, Senior VP & CIO for UPMC, joins Bill for a discussion exploring the pace at which technological advancements, such as AI, have impacted healthcare. Reflecting on the landmark shift of 2011's "meaningful use", we ponder how AI will shape the future trajectory of healthcare. How does the "carrot and stick" approach of the past relate to current advancements, especially when AI promises so much yet requires caution? What role does data management play in safeguarding sensitive information amid third-party breaches? Join us as they also discuss UPMC's innovative strategies, the role of AI and machine learning in patient care, and the challenges and promises they bring. Moreover, can the marriage of speed and accuracy between humans and computers create the ultimate healthcare synergy? Finally, as the hybrid work model reshapes the professional landscape post-pandemic, how are companies adapting to deliver value while ensuring employee well-being?

Key Points:

  • AI in Healthcare
  • Data Management Concerns
  • UPMC's Strategies
  • Machine Learning Advances
  • Hybrid Work Model

As healthcare technology professionals, we're in a seismic shift. Artificial Intelligence is not just a buzzword—it's transforming our field and altering how we deliver healthcare. But with these technological advancements come complex challenges and unique opportunities. Are you ready to navigate this new landscape? Join us, September 7th, 1pm ET for an unmissable journey into the future of healthcare. Register Here

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Transcript

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.

(Intro)  People aren't work, you manage a workload, you don't manage a person, you lead a person. 

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.

 All right, here we are for another conference episode. I'm looking forward to this. I'm going to get to talk to Ed McAllister, CIO for UPMC. And Ed, I've been doing this show for five and a half years. We've known each other for that long. And this is the first time you've been on the show, and I am so excited to have you on the show.

And I'm excited to be here, Bill. Again, you're right. In passing, we've known each other, so to to formalize it and finally sit down with you I'm extremely excited and look forward to great conversation.

Well, my excuse is just, I think you've been pretty busy over the last five and a half years, but, there's been a lot going on, and we're going to talk about that.

I have had Rob Dimash on the show several times, actually, he's a phenomenal guest. His insights into the economics of healthcare are just fascinating. I know you got to work with him for many years. So Ed, first question for you is a lot has changed in healthcare. We had the pandemic, we have financial challenges and those kind of things.

Talk a little bit about the environment that we are operating in today. And how you are approaching that as a leader in health care.

So, post pandemic is, it's a different world. And I think that it's, what generically we call the new norm. How we're approaching it is we're... Adapting to the new norm.

And we're recognizing that our clinicians and our senior leaders are defining what that new world is. And from a technology vantage point, we're applying and meeting that patient and meeting that person where they need to be. And when I say that person, the patient is always at the center of what we do, but our employees are extremely important as well.

Our clinicians, our clinical operations folks, our nurses. We're adapting to the new world, what it means post COVID. Again, I think it's still evolving, it's still changing. Thinking it's going to go back to where it was is being a bit naive for a number of reasons.

And I just feel as though you have to meet the person where the person is met. Technology continues to evolve and get better, and we have to recognize that, and as the IT leader, I have to recognize that I have to paint that picture of what it could be, and create the reality of what it could be, and deal with the reality of what it needs to be.

And balance it somewhere in between.

Let's talk about UPMC a little bit. Tell us about UPMC. Tell us a little bit about your tenure there because , you've been there a long time.

Sure. So for those of you that don't know, UPMC, our headquarter, we're located in Pittsburgh, Pennsylvania. 40 hospitals, 800 outpatient offices, 5, 000 employed physicians, and our health plan has 4. 5 million members. We also have hospitals in Italy and Ireland. So, by the numbers, that's who UPMC is, but who we really are, if you think about it, we're a three legged stool, right?

We have the academic side, we have the health system side, and we have the payer side. And I think that's unique. That's unique in a way that we have a holistic view. Of who we're caring for, right? So myself personally, I started with UPMC back in 99, 1999, when the health plan was just getting off the ground.

So I, I always joke that I, I have a mug behind me someplace that says 200 K and Y2K. So we had. We were targeting 200, 000 members in the year 2000, and we made it. We got the mugs. But if you think about it now, fast forward, the health plan is actually more than 50% of the revenue. We're probably about 14 billion on the payer side.

And up to 4. 5 million members. So me personally, it's satisfying to see. I will tell you Bill, as a former CIO and CEO, you'll appreciate this. My best job was probably my early days at the health plan because we had no technology, right? It was a whiteboard. It was wide open and we could create what we needed to create.

So we did things a bit different and we continue to do things a bit differently. For instance I think that. on the payer side, it was always the game was to hold the money for a period of time and then, then make payment, hold it 30 days, whatever the the legal ability you had as a payer.

Our goal is an integrated delivery system was to get our providers the money and not spend as much time on the administrative side. So we started paying providers within 5 days and lo and behold, other payers came on board and did the same thing. So that was. That was an early indicator of what UPMC is all about, not necessarily focus on the traditional, here's what we've done, but what can we do differently so that we could actually get our attention to where it needs to be, which is on our patient and on our member?

So I spent the first 14 years of my career at the health plan and within the insurance service division. A lot of great things happened, a lot of growth, and one of the more successful startups, if you think about it , in this region. In the last nine years, I've been CIO for the entire system, which is great because it provides me with a lens.

that I didn't have necessarily when I was only within the insurance division. So, it's more encompassing as far as like what we can do differently, what we can do to improve the patient experience and how technology can enable the very brilliant people that we have here at at UPMC.

I'd like to tap into both of those. I'd like to go as far back as we can, but I'd also like to really focus in on because you have that lens and because you've been in this industry a long time, the pandemic hits we react and some people have said we've never been as nimble and as effective in IT as we were during the pandemic. And I'm hearing people saying, and we're going back to where we were prior to that. which is not as focused and maybe not as nimble as we once were.

And then we have these financial challenges that are going on. Talk about the, the mindset. How are you approaching that and what experiences are you bringing to bear on the conversations that are happening now?

No I would agree with those comments. We get nimble and also I throw in creative.

I think we had to be very creative during the pandemic because it was a world that we weren't living in. I remember it was March 13th, Friday the 13th. And we sent everybody home. And they were no longer coming in the office. So from a technologist point of view and from a CIO point of view, we had to figure out who needed access immediately.

I mean, this, we're talking about patient care. My early days were within the insurance division and you can make somebody upset because payments didn't happen at a certain time or, in certain things when you're talking about care of our most vulnerable population, it's a different model.

So we sent everyone home. We had to be nimble. We had to say. Group of people need access immediately, starting Monday morning, and we were able to get them access, right, and so it was a different world, and I think that kind of describes the nimbleness as well as the creativity, because what we also had to do was to transition from, I won't get the numbers right, but our telemedicine visits, for instance, were very low.

Pre pandemic, like everyone's wear, right? I mean, I think many people can tell this story and all of a sudden they spike. So, to your point, I've seen them drop recently, but we're still higher than we were pre pandemic. I think it lends itself to the fact that and this is where UPMC's vision, I know that our CEO, Leslie Davis said put the patient at the center of what we do.

You talk to people and , we had to be in a different place. Post pandemic, everything changed. It wasn't a matter of just a few things changing. We had to overhaul everything we thought about.

Are we looking at a new norm? Have we emerged into a new norm? Or Are we going to go back to what healthcare was five years ago? Or are we coming out and it's not going to return? I mean, telehealth is now... An acceptable modality for patients.

Some clinicians have adopted it. We have new technologies. We have new entrants. We have new competitors. We have new just all sorts of things that are emerging right now. Are we in a new norm? Or do we anticipate that healthcare is going to return to what it was prior to the pandemic?

I would say the latter. Healthcare will not return to where it was pre pandemic. And I'll tell you my opinion, a couple reasons why. First our most vulnerable population and many of our patients. By the way, we lost them during the pandemic, right? I mean, it was so unfortunate.

It was an awful time and we lost a lot of people. So that's one category of why the numbers are different, I think, post pandemic. Secondly, people recognize that they don't necessarily have to come into an office, right, for care. And you have a certain population that said, wow, I couldn't do an in person visit, so I did a virtual visit, and it wasn't bad.

It was actually a good experience. So we have a certain population that they've adopted that. So what UPMC has done is we've recognized that and we've actually created a new division post pandemic for community and ambulatory services.

So services that were rendered as inpatient services are now this new division is focused on because now they're going to be either via a clinic. Virtual, or in some cases, home care. So, we've actually revamped our organization to adapt to the post pandemic world and address the fact that those numbers aren't coming back as inpatient numbers any longer.

So, where is that person? And how do we meet that person where they want to be met? So, I think this new division is an example of the changes that happened post pandemic.

One of the things I like about UPMC is when I talk about the model that I think works the best, it is UPMC, it's Sharp Healthcare it's a couple across the country, it's Intermountain it's organizations that have all the legs of the stool.

And it's because when you look at it you're driving better care for the community, you're driving more efficiencies, but if you're in a fee for service model, you're actually cannibalizing or hurting that business. But because you have all the legs of the stool. You can actually, it feels to me like you can focus more on that outcome for the patient and on that experience for the patient.

Much more so than if you were relying on just one leg of that

stool. You're absolutely right. , I'll give you an example at UPMC. So we've opened a neighborhood clinic in an underserved community. And through that neighborhood clinic, there are many services that come through this neighborhood center.

We also have two rooms for virtual care. So as the person comes in, they don't know they need care necessarily, or they don't know what next step to take for their care. So we have rooms set up, virtual rooms, and they have the ability to do a virtual visit at the point of when they enter the neighborhood center.

They may have entered the neighborhood center for, some other needs that an underserved population would have. We've actually said, hey, as well as needing, the The assistance with, the food assistance and other areas within a neighborhood center. We also have the opportunity to serve you from a care perspective as well.

So we've created two care rooms and we do the virtual visit right on site. Person didn't have an appointment. They didn't know they needed care necessarily, but because we have that visual Take on them, we're able to do that. That's what happens when, to your point, when you have all the legs of the stool, because this is our insurance services, our health plan, which leads the neighborhood centered effort, and it ties them into care within the health system.

So, if you didn't have all the legs of stool, you wouldn't know the person. it's more of a, we invest heavily into the patient experience. And that's okay when you're a patient, right? And we're able to enhance the patient experience. But how about when you're not a patient?

You're a member of the health plan, and member of the community, and you need care. So, tying it all together, I think, is extremely important. And I think we've done that through the Neighborhood Center.

The last time I was in Pittsburgh, I think the last time I was in Pittsburgh might have been five or six years ago.

And I did end up seeing you while I was there. And the thing that struck me was, we're in Pittsburgh and I'm seeing these Ubers with self driving, I'm seeing a Google office, and obviously Carnegie Mellon's there and whatnot. And I was actually there talking to UPMC about some of the things you guys were doing and really pushing the envelope.

The it really is an innovation center. It really is a place that... That pushes the envelope. What areas do you feel like UPMC is pushing the envelope with regard to technology today?

I would say our analytics area. And that sounds like somewhat of a generic answer, but I'll tell you why.

I think the data, number one, we have an abundance of data. We're because we have As we mentioned, we have the holistic view of the member and the patient and as well as the research arm. We're doing a lot with data. What's unique, I think, is we're taking that data and through the work of Dr.

Oscar Marroquin, who heads up our clinical analytics team, we're using that data for care. And care at bedside and determine, hey, this person, what's the odds of readmission for this person based on what we know about them, not only what we know about them here in the doc, in the office, but, their experiences through the health plan and what experiences they had through our insurance division, because they're also a health plan member.

And if they're not a health plan member, what experiences that they had within UPMC or other areas using clinical connect our health information exchange. So, I think. I think what we're, where we're pushing the envelope, and I think where the world is going, and we've been leading for a while, is to actually take that data and be more precise in how we're using it directly for clinical care.

Because I think what that positions us to do, and we're doing some things with AI, and I'm sure we'll, I'm sure we'll mention that at some point in our conversation. It's impossible not to right now. You can't. I mean, I call it the The cloud of 2023. I mean, 10 years ago, we were talking about the cloud and everybody was pointing up saying, Hey, this thing called the clouds coming, right?

And it's here, right? But AI is similar. I think we all say it. And it's, it's evolving. But I think what we do when we put the Put care at the center of use of data in our analytics team. Our clinical analytics team is we position ourselves for the future, which is AI and which is, the whole machine learning and make it smarter and the experience that they have.

So I don't know if I call it pushing the envelope, but I can tell you we're being very. Very precise in what we're doing and how we're using the data and how we're applying that knowledge to care.

The amount of data given, again, the three legs of the stool, the amount of data that you would have would be pretty significant.

I would imagine even the social determinants data would be brought into that. But one of the challenges we've always had is making making use of that data, making insights from that data and those kind of things. And this is where we're going into AI and generative AI. We have so many different models.

And I assume, just like a lot of other health systems, you're already using AI in, and I don't think people are aware of this. We're, we have been using AI. And a lot of different models around the health system for a while. This whole generative push that we're hearing now just opens up a new way of bringing that data together and gaining insights.

Talk a little bit about is approaching the AI journey and how you're setting yourself up for success in that

area. Yeah, I would say that We're cautiously optimistic about what we'll be able to do through AI and through generative AI. What we, where we're focused initially, like most people, we're focused on the administrative side, right?

And how we do it, like, I think our vision is that you come into an office and we, been leaders in the biometric space where you come in and we use the biometric fingerprint reader and you sit down and it recognizes who you are and ask a couple questions and then you sit and you're taken back to the to the office.

I think the future looks like a chat bot greeting you, at the door and knowing that Bill Russell normally when he comes in, it just pulls all of Bill Russell's information and we know that Bill always. He wants a water. He'll ask for a water. When he comes in he'll actually, he may step out and make a few phone calls, knows everything about you.

And at that point, because those are just like the administrative things, but also on the clinical side, it knows what questions to ask you for your physician when you do have the face to face meeting with your physician, if that's what it is. So I think that our vision is that we're positioning in a way that we're not leading with the technology.

Thank you. We're leading with the patient experience and how do you enable that patient experience? How do you apply ai? How do you apply the automation versus the in-person? What's the blend? How does the, how do you transition from only the administrative type things to the care piece of it?

And how comfortable are we? So, so I think we're moving at a pace that's the right pace. But I think we're leading. We're leading with some of the activities that we have going on there. Many of them are in beta and they're in test and we're working through details. But I think the biggest challenge we have as a healthcare organization and as an industry is that transition from the trust of.

Having a bot answer your phone call walk through that process to actual care and what does it mean. So the whole twinning world and things that are happening around I could actually have see what would happen if I did this with Bill because of the AI and recognize the outcome prior to the actual experience that Bill has.

So I think we're, I think we're, we're extremely interested. I think we're extremely involved. I think that we're committed to understanding where this can enhance patient care, but we're also very cautious in making sure that we're not moving for the sake of technology, but rather having our clinicians lead us in and provide the insight that we need to move forward.

Yeah, so let's focus in on the patient experience. By the way, I love that narrative. I love it because that's such a great example of what a CIO does. A CIO paints this picture of, hey, here's what the experience is today. Here's what the experience could be in the future. And it's a lot of those conversations throughout the week, throughout the day that people are going, oh, that's interesting.

Yeah, that would, and drives people to start generating new ideas and thoughts. The patient experience is a practice that you've brought up several times. And I'm curious, how do you get the priorities from that? How do you surface the priorities of the patient to know, what would make their experience better?

What would make their care journey more effective?

Yeah, I mentioned earlier, we're very invested in the patient experience. We've been on this, I'll call it, journey for... Five to seven years where we actually huddle on a regular basis every other month but there's also the patient experience and starting meetings in certain ways and recognizing what the patient experience is.

So this isn't, has nothing to do with technology. It's truly the patient because the people that care for the patient, the nurses the docs the folks in the office, they know that patient experience. So bringing that group together and recognizing that we don't do everything right every time.

Let's only do it wrong one time is the starting point for the discussion around patient experience. It truly is putting the patient at the center of what we do. How technology comes into play is, if you think about it, we have technologists in hospitals every day. And they're, many of them are bedside.

Many of them are relied upon for patient care. Like during the pandemic we talked a lot about the nurses who are heroes. Not a doubt, and folks that didn't go home for so many hours. Well, I had technologists. That were shoulder to shoulder with these folks that, were in the hospital and doing what they did so that the patient experience journey is we do it through the obviously the traditional ways and understanding our patient experience scores and what we're doing but we also score the IT team, we have our clinicians, our nurses, our staff, they actually tell us what we're doing wrong.

They tell us where we're falling short. They tell us what we could do better, like what can happen to create a better patient experience through the use of technology. And that's the starting point. Again, we're not a technology company, but we're a company that is very interested in enabling.

Great experience in using these great minds at UPMC on the clinical side to better enhance a patient experience. So it's a long winded answer, but I think it's important to note that it's really driven by the patient when we talk about what we want and from the patient, it tears down into the people that are there at the point, some technologists, some clinicians, and then at that point we create a better patient experience.

Thank you.

Yeah, and I think the thing I hear there and it's exciting is it sounds like it's a culture. It's not just an IT culture. It's a system culture that says, hey, what can we do for the patient? How do we change the patient experience? And that makes, the conversations become more grounded and more focused around that objective.

And you don't have to, as the CIO, you're operating within that culture. You don't have to You know, try to elevate something that isn't the the core of the culture.

Absolutely right. I mean, I don't have to, I don't have to sell it. As a matter of fact we had Sandy Radar, who's our patient experience executive sponsor.

I had her speak at my IT leadership meeting last month, and I think it may have stuck I jokingly called her the godmother of patient experience because she lives it, right? She explains to us exactly what the patient experience journey means.

Again, we've been on it five to seven years. We've invested in IT. Sweat equity as well as financing to, to make it happen but again, we have the executive sponsor, the executive champion and again, Leslie Davis, our CEO is 100% behind it and she speaks at the conference on a regular basis to explain how important it is.

Along with giving kudos to the folks that are working so hard on this patient experience journey.

  📍

 We'll get back to our show in just a moment. I'm gonna read this just as it is. My team is doing more and more to help me be more efficient and effective. And they wrote this ad for me, and I'm just gonna go ahead and read it the way it is. If you're keen on the intersection of healthcare and technology, you won't want to miss our upcoming webinar, our AI journey in healthcare.

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We're going to take a look at , the things you have learned and maybe some things that have impacted your experience that changed the way You do things today.

I know I know for myself, I look back and some of the decisions I made ended up being legacy gear that we had to push out and that kind of stuff. And it changes the way I think about architecture and technology. Today, when you look at your career and the decisions and your experience, how is that impacting the kind of work you're doing today or have done over the last three

years?

Yeah, that's a great question because I think it starts all the way to my first job in IT, right? And it was with EDS. Back in Plano, Texas, way back in the Ross Perot days, right? But a thing that happened you go through, and I'm sure you're familiar with the with the organization, but they really train you in a way that's somewhat of a boot camp.

You go through the train program, but one thing they did. And it didn't really resonate with me until a bit later in my career, but all of the leadership courses and all the management courses, it talked about managing people and people did it after the fact, but it was one of the first experiences I had where they changed manage to lead.

So you don't manage people, you lead people. And I think that's been the compass of my career. To say like, hey, I think you're better off in a leadership role, leading people rather than in a leadership role trying to manage. People aren't work, you manage a workload, you don't manage a person, you lead a person.

And I think that's helped me throughout my career. And what it's done is decision points where when you talk about legacy systems and other decisions that we make I make sure that. It's not me. It's not a singular vision as to how it should be, but rather, ask around, work with the folks that are actually doing the work.

Let them provide insight, the boots on the ground. Make a difference. From managing from 50, 000 feet, , and it's easy to miss something from 50, 000 feet. But when you're on the ground, you don't miss much. So I think it's just engaging, the team.

And by the way, I have an amazing Group of IT professionals. There's 2,500 IT professionals that I tell 'em often, and I probably have the best job in the world, man, we have a program that we bring in college students and train them. They go through three rotations. I actually stole it from Rob and he did it in the finance area years ago.

And I think he stole it from GE actually. But the I T R program, which you bring in the young guns and they go through a rotation program and they come in with a Different insight and a different focus on what they want to do. While at the same time at UPMC, we're privileged to have employees that have been here from the beginning of UPMC, when UPMC started.

So 40 years, and everything in between. So to be able to manage such a diverse population of people in a diverse knowledge base is unique and I'm extremely. fortunate to have that. I think that as I step through, I go back to the leadership piece and I say, hey, why would I think that I have all the answers when I have this resource at my fingertips that are from, early on learning things , that I don't even know they're learning because I've been out of college for a few years to the folks that have worked through this journey.

And they'll allow us to avoid the landmines that are out there because they've lived it. So, I guess that's probably again, that's the compass of my career and my thought process is to leading a group of IT professionals.

Yeah, and I think GE stole it from Bethlehem Steel stole it from u. S. Steel stole it from Because I grew up in Bethlehem, Pennsylvania, and having grown up there, I've talked to some executives that they would bring in these college students, usually MBA students, and they would move them through like or seven different parts of the organization so that they could see all the different aspects of it before they moved them up in management.

It's a fascinating model really works well. So, we are in very interesting times. curious as you look out over the landscape today what do you see as really driving change in healthcare? And, how do you think technology is going to play a role in keeping UPMC ahead of the changes that are coming in healthcare?

It's interesting because I think that healthcare has been an industry that we haven't been known to move rapidly. And we haven't been known to adapt to changes. I know that in your career, I'm sure you always hear the analogy. They always compared us to banking, right?

And banking does this and healthcare. So neither is lightning fast in, what we're trying to do, right? So I think what's going to drive healthcare in the future. I don't think we'll have the same luxury that we've had to move at the same pace that we've moved over the, longevity of my career.

And if you think about the last time that We really saw technology impact healthcare, not the last time, but probably a big bang was meaningful use, right? In 2011. But we were rewarded for digitizing healthcare. So we were taking paper out of the drawer and saying, here, we now have an electronic medical record, if you will.

I'm not sure how to use it, but it's it's still it's electronic now. It's not in the filing cabinet anymore. So, and that was a big deal. And by the way, we were rewarded for doing that. And then we were going to be penalized if we didn't. So it was the

carrot and stick thing at the same time. I think the current version of that is going to be AI. I do. I think that AI is going to take healthcare by the back of the neck and move it forward. I'm using it some, and I'm using AI in general terms, but just basically the intelligence gained.

Through AI is going to not allow us necessarily not to keep up and it's going to push. Healthcare in a direction. What UPMC is doing. Knowing that, I think, is when I mentioned the structure of the organization and how we use data, how we're using data, how we're managing data, because data management's a big piece that's not necessarily talked about.

Our clinical analytics officers are clinical data and analytics officers. So, in other words, we're not allowing data to run rampant and be, Places it shouldn't be. We're trying to rein in some of the third party concerns that are out there today in the security world. I mean, every breach here, it seems to be a third party breach.

So, I think that we're creating a structure within UPMC that's going to allow us to be positioned for when what I see as an accelerator called AI. Comes into play, and we're doing certain things in certain ways, and we're staying at the forefront. Again, Dr. Marroquin is very much aware of what's happening, in that space, and stays at the forefront.

If you talk to folks at UPMC, we've been doing machine learning for a long time. Right. I mean, we absolutely been doing machine learning for a long time. This is what we've been doing on steroids. When you think about the capabilities and chat GPT and things that are happening out there.

So, again we're trying to balance that with the fear created, the creators of chat GPT, and they're the ones saying like, Oh, pump the brakes. So, if knowing that they know more than we know, you heed the advice in that way and say like, okay let's do what we can do.

Let's advance patient care using these tools and these technologies. But at the same time, let's be aware that that all of the answers aren't necessarily there yet.

Yeah. It's fast. A physician sent me a string of things that he pumped just through chat GPT and, generate the node, generate this, generate that.

And I'm reading it and I'm going, wow, this is really fascinating. And then he goes, and he goes, and it's only 5% wrong. And I'm like yeah, that's,

that's enough.

But the point he was making to me is he goes, chat GPT wasn't specifically trained. To be a medical doctor, he goes, I believe we can train these models in a much more narrow way.

to give us the outcomes that we're looking to get. So the promise is there, but the caution is there as well. That's what I'm hearing.

No, I agree. People are inaccurate. Computers are accurate, and I think that we're at the current day version of the beginning of the computer error.

So, I do think it's true. You need, I don't think one without the other right now, where we are in this point in time, when you talk about patient care, works.

I want to close this out. I mean, you've talked about your team several times. I want to close this out. So has your team come back into the office or

have you settled on some sort of hybrid work environment at this point?

Yeah, we have a hybrid work environment. And I'm always careful, I'm always cautious as we have town hall meetings. And I'll talk about the hybrid model or the virtual work model. But as I mentioned, we have people in hospitals that have never gone out, right?

Right. From the beginning of the pandemic. And they've been in the office. And I appreciate their effort so much because it was necessary. If we were going to get through the pandemic. They played critical roles and we recognize that they played critical roles as in general, as a whole, we've landed on the on the hybrid model and, because I'm of the age that I am in and, the experience I've heard all the.

The initial comments were, well, you don't get that same experience being in the office. You don't have that camaraderie. You don't have that face time. And I thought about it and I'm like, yeah, in the early days, it might've made sense. But as I think about it here's how I approach it.

And here's why I've landed where I've landed. Life, if you think about it, pre pandemic was you work, You sleep and everything else, right? And it was a very, it was a very vertical experience and, being, in the roles that you've been, I'm going to get these numbers are just like, for the sake of easy math, but eight hours of work, eight hours of sleep.

And then eight hours of everything else. So you did that every day of the week, and then the weekends came you tried to scramble and do what you needed to do and then you started Monday again, with this vertical approach to life. I think when you flip it on its side and you create a horizontal approach to life and you allow.

The person there 24 hours and let them manage those 24 hours in a way that best fits their needs and if they're home and they may work four hours and they may have a two hour thing that they need to take care on the personal side and then they have another, they work their calendar in a way they may work till eight o'clock in the evening because that's their preference of being able to get things done.

That's why I think the hybrid model works. You given the life back. That said, the Overriding rule of thumb with this model is that the customer comes first. So, it's not your schedule, it's not your calendar necessarily. If somebody needs something, you have to meet the customer needs. And we've done that.

And we have surveys that have been taken through the patient experience piece and the MyVoice surveys. And we've scored very high, and I thought, why would I try to change it? Post pandemic. It's worked very well. Customer satisfaction is higher than it's ever been.

Employee satisfaction has been higher than it's ever been, and the metrics around delivering what we need to deliver are there. So, we've created the hybrid model, but we've allowed for three. Workspaces. So if you want to come into the office, you're always welcome to come into the office.

We were able to reduce our footprint. We had 22 locations where we had IT professionals. We were able to reduce that down to three. Efficient workspaces and they're geographically spread out in a way that it works. So it's just been I've probably done a 180.

From the beginning of time, I probably thought, yeah, we need to really be in the office and shoulder to shoulder doing what we do just because I grew up that way, I had to take a step back and say, it's not about me, it's about what's best for the team, what's best for the company, what's best for the customer.

And I think this model is is working quite well.

That's fantastic. And I really want to thank you for your time and sharing your experience with the community. It's greatly appreciated. Always a

pleasure, Bill. And I look forward to catching up next time. Thank you.

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