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 All right. Welcome to this week in Health It where we discuss the news, information and emerging thought with leading from across the healthcare industry. This is episode number 50. Today we discuss digital transformation and its impact on healthcare, and we reflect on being a healthcare c I O in 2018.

This podcast is brought to you by Health Lyrics. Health Systems are moving to the cloud to gain agility, efficiency, and new capabilities. Work with a trusted partner that has been moving health systems to the cloud since 2010. Visit health lyrics.com to schedule your free consultation. My name is Bill Russell.

We're covering healthcare, c I o, writer and advisor with the previously mentioned health lyrics. Next week is our last live episode, and over the last two weeks of the year, we're going to be airing the best of this week in Health IT episodes. I've gathered some of the most commented on, liked and discussed short videos from our YouTube channel, and I brought them together and given them to our production staff.

And they are going to create a couple of episodes for our end of year. I hope you enjoy them and share them, uh, with your staff. So today's guest, Has such an impressive bio. I'm gonna start there. So, li Lieutenant Colonel Chani Cordero is chief, uh, is c i o for 122 Bed Medical Center located in central Texas.

She leads a team of, uh, 65 IT specialists in support of, uh, 4,500 staff members serving a population of 80,000 enrolled patients. She serves as a principal advisor to the c e O on all matters related to IT services. China Cordero is a fellow in the American College of Healthcare Executives, a certified healthcare C I O, certified professional in healthcare information management systems holds A P M P certification is an agile certified practitioner.

She received a Bachelor of Arts in chemistry from St. Mary's University, holds a master's in education. In instructional technology from Troy University and along with that also has a Master's in Healthcare Administration from Baylor University. Uh, in 2017, the US Army Medical Department named Cordero the Mercury Award for Health Information Technology Professional of the Year in recognition of her contributions and demonstrated outstanding excellence in achievement in.

And, uh, not on the same level, but health data management named, uh, Chani, one of 30 rising stars in healthcare It. Wow. Good morning Chani, and welcome to the show. Good morning. Thank you for having me. Wow. And you know what the amazing thing is? That's actually an abbreviated bio. I noticed that you do a, an awful lot of teaching.

You've been an adjunct professor and some other things. Um, Based on, I I I'm just wondering how you get all that. How do you get so much accomplished? Well, I have to admit, I don't do it on my own. I've been really fortunate in my career that I've had some great mentors that've just kind of given me or just pushing me to, to continue to strive forward and learned as much as I can.

Yeah, it, it is. Um, it is, it is great. I, I've had mentors my entire life. My first boss when I was, gosh, I was as an internship. I was 19 years old, uh, became my first mentor. Um, they do play such a huge role in terms of just the experience that they bring and, and just life experience and pouring in. So is that something you're now doing, uh, in the other direction?

So are you now mentoring some people? Oh, absolutely. And so in one of my roles, I served as the deputy consultant for, um, the mil for the Army officer as far as them being, um, CIOs trained. And so from there I had, you know, the opportunity to meet, you know, every member of our corps. And we're really small.

We're about a hundred, there's about a hundred of us. The United States Army. And so from there I was able to form some really good relationships with folks. And so I have six mentees, um, right now. And my mentee, uh, mentor relationship, I try to make it semi-formal in a sense. And so I wanted to be able to be open so that they can, are willing to discuss with me, you know, both professional and career oriented.

Um, Decisions, I'm sorry, and personal decisions as well, but also enough to say, you know, we, we need to discuss, you know, routinely we need to talk about all avenues and don't call me when you need help. You need to, we need to discuss prior to that. Yeah, I, I find, find the, uh, more gray hair I get the more, uh, satisfaction and, and, and more, um, excitement I get for the people I've mentored and their successes.

It just, um, it, it, it really is. It, it, it's a, it's a great satisfaction for me in my career, and I'm, I'm sure for you as well. Well, one of the things we like to do with our guests is to start with a really open-ended question and just give you the floor, and that is, you know, what are you working on today or what are you excited about that you're working on today?

No, absolutely. So I wanted to, uh, mention, um, I changed shirts and actually happy idea because today, and the Colleen Fort Hood area is red, so it's called, remember everyone deployed. And so I thought that this was actually pretty good time and so we're wearing a red shirt today. So, um, but what I'm working on right now that we're, that I'm quite excited about in our, in our agency is we are, um, expanding virtual health.

So, you know, this virtual health telemedicine is kind of in a buzzy word for the last couple of years. You know, trying to figure out how do we, you know, increase access, increase, uh, quality, you know, for our beneficiaries and, you know, We're actually finding that the term is so general. We're trying to figure out, well, what does that really mean?

You know, is a, is a virtual health appointment an email to your provider? Is it a a voice message left or is it actually, you know, secret or synchronous communication where we're talking like we are, you know, using some type of video platform. And so we are, that is part of our strategic plan for . Um, our, our hospital and we are really trying to peel back that onion in a sense of designating our provider templates of being virtual appointments.

But then how do our beneficiaries actually use those appointments? And so are they using, are they calling, are they texting? Are they, um, you know, logging onto a system? And so, um, our, our commanding general has put out that we will use, um, virtual. Um, medicine and so it is all hands, you know, all use a Navy term.

Um, it's all hands on deck. You know, one of the things I, I forgot to do, and I'm gonna go back here, is, is just, uh, I just wanna note for our audience that, you know, the, the opinions expressed, uh, by you in this show. So the, your opinions are really your own. You're not endorsing anything from the, uh, defense Health agency or the US Army.

So it's just a discussion between, you know, two CIOs really looking at, uh, the things that are impacting CIOs. It interesting to. And, and we've talked about this on the show, that it's, it's not a, it's not so much a technology problem. I mean, receiving texts, uh, text, uh, secure texting in both directions, uh, secure email, uh, even the video platforms.

These are, uh, not in 2018. These are not challenging technology problems. It really is. Orchestrating the technology into the workflow. Uh, it's educating people on new mediums for delivering care. Uh, how, how are, I'm curious in the military setting, is, is it more top down or is it more, uh, collaborative? Are you working a lot with the clinicians to determine what works best for them and getting feedback and, and adjusting it?

Yeah. So, you know, um, definitely working with the clinicians and I mean, and I would agree with you, you know, the technology to deploy telemedicine, it's not very difficult. A camera, a phone, a, you know, a computer system. It's not really difficult technology. But what I'm discovering is, is that, um, A lot of emphasis is placed on the tools and not so much on the actual workflow of the process.

And so, you know, you know, we've had to, and we, we still haven't completed this yet, but how do we, what does this process look like from start to finish? And so, you know, the patient picks up the phone. Well, we haven't even decided, well, . Well, is that telephone actually considered an appointment or does the patient log in?

I mean, what does that mean? And so as we're trying to even define what actually is a virtual health encounter, uh, meanwhile the other clinicians are saying, well, but. But the, but the carts aren't up. The vir, the virtual held carts, you know, needs updates and it's like, you know, lemme focus on the technology.

You tell me what type of encounter you want to use, and I'll tell you the right kind of technology that will go with that type of appointment. Yeah. And that's, that's the place they really want us to, to, to play. It's, you know, is there, is there an easier way to do this? We found it was, it was kind interesting that the pilot we did with telehealth.

We, we, we spend an awful lot of time helping clinicians like, like we're doing right now. How do you look on the video presentation? Where should your eyes be? How do you connect with a patient? We talk about, you know, how important it is to connect with a patient, be present, and be there with them while there's a whole new set of skills people need to, you know, where do you look in terms of the camera to make that connection with, uh, with the patient?

And we spent an awful lot of time talking to them. Uh, and, and actually getting feedback from them on what it was like to, to do those appointments and then just adjusting accordingly as we expanded those programs. It's, it's, it's different. It's, you know, and this is, this is what we're asked to do as CIOs.

Now it's, it's, uh, as, as other people have said, you know, it's, it's maybe 15, 20% technology now and it's. It's an awful lot of instructional leader and, uh, organizational change and communicator, and there's all these people, . It's 80% people and it's only really 20% technology at this point. It's really interesting.

Yeah, and what I, I'm finding is of course is you know, that role of that c I o, right? And so like Sean and other, you know, organizations, talk about the c I O, you know, 1.0 2.0. Point oh. But I think that, um, you know, culturally, you know, people still kind of look at us as a technologist, right? And it's kind of like, well, you know, we don't have a computer problem.

So kind of like, why are you here? You know? And so, um, we're definitely, um, have the skillset in a sense of understanding processes. It's because it's like, if I don't understand your process and I don't understand your requirements, then I'm not, I'm not able to support you. And so now, you know, Because of that, you know, I'm pretty well versed on all of the different clinicians roles and responsibilities because I have to support them.

And so now I can say, well, you know, that workflow may not be the best way because this clinic over here is doing it this way and it, you know, and it's increased their efficiency. So maybe you might wanna consider this for yours and know I'm not a provider, but I work somewhere else. So maybe you might wanna take.

I, and I'm looking forward to our conversation a little later on the soundbite section. 'cause I, I, like, you've been sharing a bunch of stuff on social media, on how you, uh, interact with your staff and how you interact, uh, with the, with the health system. So I'm looking forward to getting into that. But before we do, we do two things on the show we do in the news, then soundbites and there's been so many stories in the news.

What I'd like to do is just focus in on two of 'em that I think really strike at, at the heart of where health IT shops are. And you know, the first being Amazon to sell e h r mining software. And this is from, uh, Becker's Hospital Review, is what I'm gonna talk about there. And the second one is Apple and talks to give veterans access to electronic medical records.

So I'm, I'm just gonna read a couple of excerpts. And then we'll go into 'em. So the Amazon story from Becker's, uh, the, the software is dubbed Amazon Comprehend Medical. Uh, we'll use, uh, N L P processing, uh, redundant natural, natural language processing and machine learning to highlight key data points such as medical condition, medication dosage, and clinical trial reports.

From EHRs and unstructured, unstructured clinical notes that physicians can use to inform a patient's care. Amazon said its insights can help healthcare organizations with clinical decision support, revenue cycle management and population health software may also free employees of clerical work such as manually rifling through notes.

So they're gonna help us to really analyze the information that we have, and Apple's gonna help us transport it. So Apple, Inc. Is in discussions with the VA to provide portal. Portable electronic health records to military veterans, a partnership that would simplify patients' hospital visits and allow the technology giant to tap millions of new customers.

The Wall Street Journal reported under the plans being discussed, apple would create special software tools allowing the VA's estimated 9 million veterans currently enrolled in the system to transfer their eh uh, their electronic records. A journal reported, uh, a journal also reported an update to Apple's mobile electronic, uh, mobile operating system announced earlier this year includes a new feature to handle electronic medical records, the acquisition movement.

Uh, so anyway, I'm not gonna go further into that. So, Essentially in, in a digital economy, acquiring data, moving data and analyzing data is really where value is created. Amazon's telling us they can help us, uh, make meaning of the data. Apple's telling us they can help us with the. Um, and so we're seeing a, as we were talking before that we started the show, there's, there's like, I don't know, there's like three of these announcements a week, which means there's about 150 of 'em a year where, you know, new players are coming in, doing really cool stuff with data, really cool stuff with technology.

And I, I guess from a c I O standpoint, How do you determine the nice to have technologies and the need to have technologies in this world? I I, what do you do with these headlines when you read 'em and go, uh, you know, how do you determine which ones you should be focused on and which ones you shouldn't be?

No, that's a really good question. And you know, if you go to any Helms conference and you see the, the, you know, 50,000 vendors that have really great, neat products, you know, you get overwhelmed and you wanna use it all. Um, but of course, we all know that we're eliminated in our resources. And so, I mean, you know, foremost, I, I have to look at what is our organization's strategic plan.

What does the organization wants to go in? What areas do we need to, um, put our focus on? I mean, there's sometimes when a, when a plan is not written very well, it is so open and broad that you can almost fit any technology into it. But it's really going back to my leadership and say that, you know, or being a part of that discussion is, where do we wanna go with this and what kind of resources are you going to provide so that we can, you know, Make it.

And a lot of times, you know, some of these, these technologies out there are fantastic, but sometimes they're happy to go out in a sense. And so, you know, does it, does it really help our processes or does it really, you know, bring in that decreased cost or increase that access or increase that quality that we're looking for?

Or is it just really a great idea? So to speak, you know, is it the, is it the Mercedes or is it the Honda? Both are gray cars, but it both work really well. But one is one really pretty, and one just really rides well and dependable. Yeah. I, I love that perspective. I was recently talking to a health system and they said, do you think we should go to a single e h r?

And, and invariably, I mean, this is what we learn as, as CIOs, it, it depends, right? So you, you'll just look at 'em and say, What problem are you trying to solve? Mm-hmm. , they said, well, why would that matter? I'm like, well, if you're trying to solve a balance sheet problem, you're not gonna want to make that huge investment.

But if you're trying to solve a, you know, a continuity of care problem, then maybe you might want to go to a single E H R. If you're in a state where you know you, you're still gonna have a medical group that's all over the board. You might need to, you know, solve the problem a little differently. 'cause you still have to solve, even if you go to a single e H R in your acute setting, you still have to communicate with, I don't know, a hundred different hospitals that are out there that are gonna be on different EHRs.

'cause you can't control them. Right? And, and so that question of what problem are we trying to solve really strikes the heart of, um, you know, your business or your, uh, community that you're trying to serve. You know, what's most important to that community becomes, um, And I think that's, you know, I like the Apple announcement with the va and the reason I like it is because right now what we're relying on is this mishmash of technologies to try to, to, you know, people from the VA move in and out of, uh, commercial healthcare, military healthcare and va and we're, we're relying on this mishmash of technologies.

If ash apple can really be that medium. Uh, where a veteran can show up and say, I have my medical record. Here it is. Let me transfer it to you. That would, I, I think that would be a pretty neat solution. I mean, what are, what are your thoughts on that? No, that's what I agreed. Um, in a sense of, Does the per, does that veteran have already have access to that record?

Right. I mean, when I kind of think about both articles and I was, it was really, you know, thinking about kind, what Amazon is looking at doing is, is, you know, getting all of that, that disparate data and being able to, um, put it in a format so that our providers can make a decision. It is going on a con, on a conclusion in my opinion, that the, that documentation is there.

We're waiting for it to be found, so to speak. Right. And so, I mean, you know, I can't speak for private sector and how, how comprehensive documentation is, but I can, I do know that. Sometimes in our settings, um, that documentation is, is very short and, you know, it's based off our, our E H R that gives you, you know, the highlights or whatnot.

Some providers have, you know, are very comprehensive, their documentation, um, and some, you know, do enough that satisfies that encounter. And so when you have that variance of documentation, your data. Your ability to comb through that data is gonna be based on the type of quality of data you get. And so that would be my only hesitation about both of these kind of technologies.

Yeah. Yeah. This, I, I, I agree with you. The, you know, overlaying, uh, N L P machine learning AI on top of the data. Um, really requires the data to be a strong foundation. Uh, the next week's episode is with, um, with Dale Sanders with Health Catalyst, and the whole episode is dedicated to just one topic, and that's data governance and data quality.

And I, it's such a, it seems like such a boring topic that I'm afraid to even pre-announce it 'cause no one's gonna listen, but.

It's like the foundation for everything we want, we want to do. It's the foundation for sharing data. It's the foundation for, um, you know, of analyzing that data and finding new pathways that are gonna provide better access, outcomes, quality. I mean, there's in a digital economy that the foundation of the data is so important.

And it may not be a sexy topic, but it is, uh, it's, it's such an important topic for us as CIOs, I believe. No, and, and I agree with you. You know, when the data quality people stalks me, you know, I'm always like trying to go the other way, uh, because I know that is going to be a very painful conversation.

But, uh, you know, but to your point though, it is definitely important what they do in ensuring the integrity and availability of the data. Um, you know, and kind of what you, what you were asking before about the, just the accessibility of that patient record for our veterans. I mean, you know what we all ultimately want, I think, um, as Americans, that we wanna be able to, people to make, take ownership of their healthcare, right?

And so being able to have. Your records available to you so that you know and understand either your diagnosis and care plan so that you can make better life decisions or you know, better health decisions with that information. And so I think definitely what Apple think is doing is a, is a good thing. I just hope of course, is that the data that's provided in there is factual and accurate data.

Yep. Absolutely. So here's the exit question for this, and if, if this is more for me than, than everybody out there, I'm just curious, do you think an adoption of digital technologies will be faster in the military or slower than commercial and nonprofit? I mean, both have their challenges. I, I'm just, I'm curious if you think you're gonna have the ability to adopt digital technologies faster than commercial.

Yeah. So I'm gonna give you that wiggle answer. We call it the Baylor answer. It depends, right? . And so, you know, one thing that of course, that I take pride in the history of, you know, the government or the public, um, sector, is our adoption of technology was a lot quicker, especially the va, I mean va, you know, e um, program.

And, you know, we, we had our electronic health record, you know, in the late . Uh, late nineties, so to speak. And so, uh, but we have been surpassed in a lot of areas when it comes to those digital technologies. Some of it's because of our acquisitions process. I mean, it's, you know, it's, it's pretty comprehensive to ensure that, you know, the government resources are spread appropriately, but it also can be long.

And so why I say it kind of, it depends is though there's areas that I think that we have resources, um, maybe that private sector may not have because our o. Our, our o i determination is different. And so yes, we wanna make sure that we are, you know, getting the resources or we're getting the, uh, the credit, the R V U credit or, you know, value for our dollar.

But our main focus is readiness. And so we have a piece of technology out there that may cost a lot of money and we may not get that money back in savings or, you know, cost avoidance, but it provides a platform for our. You know, soldiers and sailors and airmen, um, are, are able to perform their job, which is to, you know, fight and, and win wars.

Then we're gonna spend those resources. Yeah. I, I mean, there's so many similarities in terms of, there's multi, I mean, the, the. The bureaucracy within, uh, nonprofit healthcare or commercial healthcare and, you know, uh, the military is, is probably not that dissimilar. The sense of urgency to serve the community is, is probably there in both.

Um, you know, when you decide to do an em, I mean, the VA is a great example of the, you know, they decided to do a e r project and it just gets vetted. It gets vetted publicly, which, which is a huge deal and that really is happening. Also in the commercial nonprofit sector, you know, if a major health system says we're going to move our e h r, that becomes, you know, front page news in the, in, in the, in the paper and, and a discussion of, you know, hey, they're spending a billion dollars heading in this direction.

Is that really where we want them to be spending money? Shouldn't they, you know, stand up a new cancer institute? I mean, So, yeah, there's a lot of similar, uh, there's probably more similarities than I think, and so we're both wiggling on this. I, I dunno, which, I dunno which one will be faster. It's, they're both hard.

Change is hard. Is hard. And culture, the culture is also hard. Yep, absolutely. So, I'll, I'll transition to sound bites 'cause I'm, I'm really looking forward to this section. During this section I typically toss out questions and, you know, we get one to three minute answers. But for this week I'm gonna do something a little different.

'cause I, I was in preparation for this because we, we haven't, in all honesty, this is the first time we're meeting, but I. I really became aware of you based on your LinkedIn post and I, I'm, I love your LinkedIn post. It's fascinating. 'cause it's almost like I, I, every, every week or so, every couple of weeks you're posting something where I go, yeah, that's where a C I O lives.

Yep. That's, you know, and I go, this is, this is good stuff. So what I wanted to do with you is I wanted to highlight some of the posts that you put out there and just talk through 'em a little bit if, if that works for you. Yes, absolutely. All right. So, you know, we're gonna start with the first one, which I, which I like.

And it starts with, um, your transition. So you, you, you start by, I wanna thank the dedicated professionals at the Defense health Agency education and training directorate. Give 'em a warm thank you, fantastic opportunity that they gave you. After several years, we're able to provide impactful results that leads to greater efficiencies, learning solutions.

For many years to come. I'm also excited to start my new position as C I o, which we talked about earlier, and you talk about the facility that you're going to. Um, I look forward to the new adventure as a new c I o I make it a point to vi i I make it a point to visit every single department and clinic.

Here I am about to listen to the needs of the OR staff. And the two things I wanna talk to you about on this one is, one is, you know, the role of gratitude. Um, I think, you know, people who are successful are grateful people, and you see it over and over again. It's just a characteristic of who they are.

They're grateful for their mentors like you were earlier. They're grateful for the opportunities that people have given them. They're grateful for the great teams that they've worked with. So gratitude is one of the things I, I'd love for you to sort of comment on. And then the second is, um, you know, you're starting a new role and you're essentially saying, You're, you're gonna go to every single department and clinic and, and listen.

I want, I want you to talk about your first couple of weeks in a new organization and what you're trying to accomplish. So, yeah, no, absolutely. Um, and so, You know, I have to say that my parents is the starting point anytime about any type of moral, I guess, um, something that you learn morally and so whatnot.

And so my parents, very proud parents, also served. My mom was, uh, the United States. Air Force for 20 years. And then my father was also in the Army. And so, um, so they, you know, you know, they teach you, they taught me of course, about just being humble and, um, recognizing that, you know, we're all one team in a sense of, you know, when we try to do our accomplishments that yes, you know, you may be the one to execute, but you know, it's not necessarily something that you do on your own, your own.

And so my last job, um, I had fantastic bosses that were very supportive, gave me Leeways to be able to execute it, um, in a way that I saw fit more so than be micromanagers because I've had that before. Hey, and it's a different environment to work in and you can't really, you know, be like that peacock and spread your wings, right?

So, um, so I was really grateful of the, of my, of my bosses, al to do so. And, and of course, you know, just my staff alone. I mean, you know, they, you know, they were very supportive. You know, I didn't have to deal with a lot of, uh, a lot of human resources dynamics that sometimes you have to deal with, with staff.

Um, I didn't have, you know, that organization. I never had one staff member, uh, that to the union because they didn't change. Um, you know, this kind of says, well, this is not in my job description, you know, to do, you know, certain initiatives. And so I just really appreciate their willingness to kind of see the, the shared vision of enhanced learning that we did at the organization.

And so, you know, um, lastly, you know, kind of with the gr you know, gratitude, you know, sometimes I feel that I was lucky, but also I think it's just the way, how do you approach a job? And so, you know, I, I, I, I'm a subscriber of that positive thinking. I know sometimes it seems like it's a little hokey. Um, but you know, I.

I sat at a conference, and I can't remember the, the presenter, but he talked about, you know, the science behind positive thinking and was kind of like, well, let's do three positive things, um, today because they said that your brain will actually relive that moment in time, and you start focusing on that more so focusing on a negative.

And so it's, it's a practice that I, that I do, um, At work, but it's also a practice I do at home with my children. So my three children, and they were as young as four years old, they could tell me their three positive thoughts of the day. And so if my four year old, I have twins and my four year olds at the time would say, um, we ate pizza

That was. Your positive thought for the day. So, um, but the government to the other part is that yes, when I go to a new organization, you know, to me it's all about relationships in the end. And so, um, I, you know, I discovered in my 18 year career that you start. If you have credibility, which is, or excuse me, if we have visibility, which is essentially, you know, being visible in your organization, that will lead to credibility because people see you, they see that you are, that you are working your issues.

Um, now of course you gotta have, you have to, uh, execute, right? I mean if you, if you know, when I was going to one of the clinics, and it's funny you asked that question because I was thinking this morning, you know, I did a. I did a rounding in the inpatient side and, and they brought up some core cable management.

And they really needed some, um, assistance because they were, they were afraid that they were gonna, you know, pull the cable cord out or pull the credit cord out. And I was just thinking this morning, you know, did I follow up on that? You know, did I send a technician to there? So I really need to do that.

Um, and so, but, but part of that, you know, again, is those being able to kind of, um, form those relationships so when there is a problem and that they come to me first instead of, you know, going straight to, uh, what we, you know, my leadership channels. Yeah, I, the, um, rounding is so important and in fact, I, we, we instilled it within our entire organization.

But one of the stories I I, I, I, I think is interesting, my wife was actually in, in one of our hospitals and, and so I'm sitting there next to her and, and the, she's, um, either getting ready to go into, I forget if it's just getting ready to go into or coming outta surgery, and we had just done an E M R.

Migration. So I was talking to the nurse, I'm like, so how is it, how's the system to use? And that kind of stuff. And she starts giving me all this information. And so I'm just sitting there texting, you know, Hey, you know, they're, they're struggling with this, they're struggling with this. All of a sudden, within like an hour or so, you know, my staff from that hospital starts showing up and asking her questions and, you know,

Uh, and, and it was, she had no idea who I was, which was great. Uh, at that point. Um, So I, you know, I, I just asked her, you know, what's her experience with the IT staff? And she goes, you know, the, the, and at the hospital level, the IT staff was great because they had been embedded in the rounding. And she goes, so I'm talking, she goes, I get an opportunity to talk to it pretty, pretty often and, and to address my needs.

She goes, so, she goes, it's great that they all showed up. Right after that conversation, she goes, but, uh, I, I, I could just as easily have had a conversation with them next, you know, next week in our, in our rounding session. Yeah, no, absolutely. Um, I think it's just important and, you know, and I've, I've learned even it just is, is sometimes, um, when there's an issue that one of our, uh, clinicians have that, you know, it's like, Like, for example, we had an issue with, uh, voice.

So these are are badges that, you know, you speak into the calls. And so, um, and so one of our providers said that, you know, their voice badge and wasn't working in a certain area. And so, you know, prior to me be getting there, it was kind of like, well, it's a network issue. It was a network issue, right? And we had wireless and you know, it was network issues.

And network engineer was just, you know, hey, we looked at this, we can't replicate it or whatnot. And so then it was like, oh, well it's a, a tech issue, right? It's something like physically wrong with the device. And so finally, you know, I said, you know, I wanna do the trifecta. Let's send a network engineer, a trainer, and a technician, and I'll address the provider.

So they sat down and discovered it was just a training issue, right? But we're so quick to blame, you know, the engineers or blame the technology, um, that we don't sometimes look at. Everyone who might be a part of part of that system. And so anyway, I just thought that was pretty funny, . Yep, absolutely. Um, we're gonna come back to your first couple of days a little later, but, uh, you know, the next, next post I thought was interesting.

So trust but verify. As a leader, we have to trust our staff. But we also have to be involved enough to, to really verify what they're telling us. And you talk about a, a situation where you're trying to deploy something. It turned out there was a, uh, you know, a failure in communication, uh, between the team on the system issue.

And you say, you know, trust, but verify it. The point isn't to place blame anywhere, but to ensure that, that the team has the resources they need. Um, and then you ask the question, what are some of the leadership accountability techniques that you use? So when you, when you say trust, trust, but verify, um, it, it's, it's interesting because.

We, at my house system, we had 110 some odd projects going at any given time. And, um, I, I, I really couldn't be heavily involved. So there, there is a, there's a trust. Uh, I, I could only really be heavily involved in the. The critical projects, not necessarily all 110. So only about once a month we had all those project managers.

We set aside a day and we just listened to those project managers come in and we gave them very specific instructions. Here's what we need to hear from you. Here's, uh, those kinds of things. So, but I really had to trust them, uh, that what they were doing was, was right. How do you, um, How do you go about, you know, first of all, how do you go about staying involved enough in the, the various technologies, uh, the projects that are going on so that you, you have a handle on each one that's going on?

And then, uh, how do you verify? I mean, how do, are you, uh, yeah, how would you go about verifying, I guess, Yeah, so, no, that's a very good question, and what I've kind of learned is, um, is that I do the same. So I have a project meeting, and right now I'm, I'm actually having to do it a little bit more frequently than I like, uh, we're doing it weekly almost because, um, because I, I feel that we should revamp our project meeting and so, I am just like you, you know, you always have just some very little, uh, surplus level understanding, a surface level, you know, idea of what's going on with that particular project.

And because of that, um, sometimes when projects are maybe not on schedule or maybe not priority, um, for that project manager or for that department, um, their, their answers are very generalized. And so I think maybe like, uh, maybe from teaching, uh, my BSS factor is really high and it's really sensitive , and so I'll start rapidly firing questions because it's almost, sometimes you can see it's almost like a, a dying fish in the water.

Right. You know? And I'm the shark coming in, you know, like I can see, um, when someone is, is not being quiet. Honest, but I try to create an atmosphere though that, that I'm not, I don't wanna press blame, I don't wanna say, you know, if you said, Hey, I didn't have time to look into this, or I don't have the resources, but I didn't ask you because it's priority, I can handle that.

Um, what I can handle though is, Um, that you just, you're blowing it off or your, or your, you know, your integrity. Um, you're having integrity issues. And so, you know, when I, so when I'm having these project meetings and I'm answering the questions, you know, usually say, Hey, you know, it, this is a, we, well, we're having an issue with the vendor.

Oh, okay, well then that may be something on my level that you shouldn't be handling that lemme call the vendor. Oh.

Well, actually we haven't scheduled a meeting with a vendor yet. Oh, okay. So that's kind of what I mean is that, you know, sometimes when, when someone's not telling you something right, then your spiny senses up, you kind, you know, go up in the air, you, and you know, it's not right. And so just asking those questions so that they know that, uh, you know, I trust you that you do your job, but I also need you to know, um, that I'm, that, that I'm engaged and I'm an engaged leader.

Yeah, and, and we just, and, and what I think people need to know is we look at so many projects that we know when something's on track, not on track. And we're dealing with so much technology that we know when we're talking to somebody who really knows their craft and somebody who's maybe not as strong and, uh,

Um, you know, it, it just, it just doing it over the years. We just know that when somebody's, you know, spinning a tail that you're sitting there going, uh, okay, just, just answer these handful of questions. What's the status of the project? Right? Uh, you know, what do you need from leadership? You know, you just, you just sort of narrow 'em down.

It's like, I, I appreciate the story you're telling me, but just, you know, tell me the status. Are there any risks? Risks, you know, what do you need from me as a leader to make sure this is gonna continue? And, and those kind of things. And, and sometimes the more people talk, the more you're like, ah, , you know, I think there's a problem behind here, so let's, let's just focus in on what we need to focus in on.

Yeah, no, definitely. Definitely. Alright, so you go into, um, You know, you're, you're within your first 90 days of being c i o in a new hospital. You start to identify some things and you talk about silos. This is, um, I've gone into a lot of organizations as a consultant, as a, as a C I O, uh, and as an interim, c i o and silos is, is deadly to an I e T organization.

And, um, so when you identify silos, You know, what are, what are some of the things you, you need to do, uh, in order to break down those silos? Yeah. So, um, I agree with you. You know, if your network team is not talking to your technicians, they're not talking to the trainers, they're not talking to the system administrators.

It is definitely the, you know, sympathy of death , right? So, um, so right now I'm trying just with the baby steps, so just team building, right? So just, you know, getting folks to actually talk to one another. And so I did a survey, um, my first. Uh, a few weeks in the, in the position and, um, and using Poll Everywhere.

So it was completely anonymous and it, it allowed, you know, the, the employees to actually answer the questions and answer, um, you know, hopefully more honestly than if it was like some type of sensing session or, you know, group therapy type meetings. And so got the baseline data and, you know, surprised, kind of see.

First of all, so we're trying to do some, you know, team building exercises in a sense. And so we did, uh, we did bowling. We went bowling, um, one, one day on a, um, on a, on a day that we had a very low census. Um, because it was a training, uh, it was almost like akin to a federal holiday here on, on the installation.

So very few, uh, patient appointments that day. Um, so we went bowling. Um, we are having a, um, a Christmas party, um, a holiday party coming up and I am toying with the idea right now of, uh, fostering engagement. But I'm trying to, I, um, I have ideas of what that platform's gonna be. And so right now I'm thinking something very low key.

This, I call it, you know, c i o chat, you know, Friday mornings, let's, let's get together, let's drink coffee and just say, Hey, you know, what are the trends? What's trends? What are you seeing? You know, my frontline desk, what are you seeing right now, you know, in the organization and my training, what are even my trainers?

And you know, what, what are the providers telling me right now? But I need to find a way to do it, um, in a way that's collaborative and not. Finger pointing because the environment that I came into there is some, there's some frus frustrations between certain departments and their interactions with another, and so yeah, it's people, right?

Anytime you have people, you're gonna have. Um, you're, you're gonna have challenges. So what you're trying to do is you're trying to, you're trying to get them to interact with each other outside of work so that they can, they can establish, uh, rapport means of communication, see that maybe they share the same common mission and see each other's perspective, I guess.

Yeah, yeah, absolutely. Um, and I mean, 'cause again, I mean this is my relationships matter. At the end of the day, relationships matter. And so, you know, I mean, like I, I tease my staff and I said, if I have to give big T-shirts, they say we get along, I will get them . Yeah. Um, you know, you asked the question, you know, what are some other things people did?

I, one of the more successful things we did is, especially around this season, is we had, uh, departments and groups of, uh, Went out and served in the community. They just, um, you know, they did, uh, served Thanksgiving meal together. They, uh, did, uh, presents, they drove, you know, they got presents for, um, you know, underprivileged, uh, families and those kind of things.

And um, actually it was interesting. We found that those were the probably the most effective, um, I know team building exercises that we did. I wish we had figured out a way to do 'em cross. Because that's where the silos really do, uh, get generated. Um, so I, it's, it, I, I found that interesting. But it, you're in the military, can't you just look at some, this is like the, the, this is gonna show my ignorance here, but it's like, can't you just say drop and give me 20?

Can't you just ? Oh, only we brought those good old days back.

actually, um, of my. Staff, about 65, 70 folks. There's only, uh, two military, so it's just me and my deputy. And so, um, half my staff are federal employees, civil service, and then my other half are d o D contractors. Wow. So you can't, that's, I can't . So what I try to do though is kind of to your point. So we are looking at a community, um, community service event.

Um, and so I have one of my team members, uh, teammates is a, is a avid runner. And so he gave me a list of about 15 like marathons, to run and something that won't kill anybody, . Yeah. Those, yeah, those, those, those, uh, common common experiences is what you're looking for. Um, I, I do wanna talk to you a little bit.

You, you, one of your posts was about, uh, chime, giving you the opportunity to sit on a panel discussing diversity and, um, and, and I saw that it, so panel was, uh, you, uh, one of our. Um, one of our previous guests as well was on, on that as well. Uh, what are some of the things you guys discussed on that chime panel that you think is important in terms of really helping us to understand diversity?

Uh, diversity of thought, diversity of, uh, background of experience and, and, um, what are some of the things you guys discussed? Yeah. So, you know, a lot of times when we think of diversity, you know, sometimes the first thought that comes to my mind is, you know, looking at, you know, race or gender and what we're, you know, really trying to discuss that diversity.

It's just really, people are difference, right? And so, you know, obvious, you know, we all have implicit biases and we all kind of. Naturally are attracted to people that are like us, either like-minded and thinking or, you know, maybe share some physical traits or qualities and we kind of, you know, so we were just kind of talking about that.

You know, I mean the, the studies are out there, the statistics are out there, the researchers out there that demonstrates that. Having that diversity of thought from people of difference. To you, you know, you will have greater productivity and you know, and greater benefits from that. But what that looks like is a challenge in itself.

And so, you know, I shared the example of, um, in my last job working in a, in a tri service organization. So we had Army, air Force and Navy there. And because I'm Army, I didn't think how Army, I thought, I didn't think you know about the. Acronyms that I use or the analog that I use were akin to being in the Army.

And so when one of my Air Force. Peers, peers or subordinates would, would say something I, I'm like, well that doesn't make sense. Like, why would you do it that way, ? So, you know that, and, and so that's why, you know, we, we talk about diversity. It really is just a difference of thinking. And so, you know, from that experience and then when, you know, when we talked about on the panel is, you know, is how do you.

You know, you have to actively seek that difference of opinion. And so, you know, you have to, you know, actively say that, you know, in this tri service organization, you know, this is how we do it in the Army. Well, how do you do it in the Air Force or how do you do in the Navy? I mean, I'm trying to care. I really don't, I'm trying to care.

Kidding.

It sounds like your father would be so proud. I'm not sure your, your mother from the Air Force would be as proud, but your father from, from the Army would be really proud that you, you, you've really adopted the Army ways did. Did you ever have those conversations that you know of, you know, why, why you chose one versus the other?

Oh, absolutely. Absolutely. And so, you know, um, when I joined, when I joined, um, I, I always joke, joke about the difference in styles of recruiting. And so there's a lot of jokes of, you know, between all three services and of course in the Marines and the Coast Guard as well. And, um, I just said, you know, the Army recruiter was just kind of like, Hey, you know, your test scores, you know, are so great.

Whatever job you want, you can have it right. And the Air Force. Like, you know, I'll call you when I, I'll call you when I'm available. , you know, it, it, it really is relationships. It all comes down to connection to relationships. Yeah. , um, I, I'll close on this last post 'cause I love it. So, as a healthcare, as a c I O in healthcare, I'm passionate about healthcare.

I love the potential and impact of technology. Some days when the stars are not aligned and systems are not working. I dream about switching career fields and, and trying to sell cupcakes. Everyone loves cupcakes, right? . And, uh, I think every c I o can, uh, can attest that there are some days where you come home and you're like, what this?

Well, today? Well, you just. You know, hang out with your family. You love your family, you go to bed and you hope that you get up tomorrow and tomorrow's not the same, so new day. That's right. So my three positive thoughts on those days is I think I'll have pink, pink sprinkles, right. . Because pink sprinkles are Emmy.

That's amazing. Uh, Chandni, thank you for coming on the show, show. I really appreciate it. Uh, is is, I, I assume LinkedIn is where I'm finding your post. Is that primarily where you, uh, where you're posting. I am, I am hopefully, um, there's some opportunities that I might start a blog with some various, um, organizations, but, um, right now LinkedIn is where I, I submit all of my material.

Yeah. And I strongly encourage people to follow you. I think that, that your posts are insightful and, and, and you close a lot of 'em with questions and they. You know, they, they really, they caused me to think, you know, you know, there's about emotional intelligence, about leadership, about, uh, e even technology and approach and those kind of things.

So I, I really appreciate that. Um, the, uh, so you can follow me on Twitter at the patient c i o. This show, uh, Twitter account is this week, init. Our website is this week in health it.com, and a shortcut to the YouTube channel is this week in health it com slash video. Uh, so please come back every Friday for more news information and commentary from industry influencers.

That's all for.

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