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Today on This Week Health.

I have no issue with my providers using every tool they can get in their toolbox, because I think they need it.

I mean, the pressure that's on our clinicians today is exorbitant. So any tool that they can leverage, I'm all for.   (Intro) 📍

Welcome to Newsday A this week Health Newsroom Show. My name is Bill Russell. I'm a former C I O 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 Newsday show partners and we have a lot of 'em this year, which I am really excited about. Cedar Sinai Accelerator. Clear sense crowd strike. Digital scientists, optimum Healthcare it, pure Storage Shore Test, Tao Site, Lumion and VMware. We appreciate them investing in our mission to develop the next generation of health leaders.

Now onto the show.

  (Main) 📍 all right. It's Newsday and today we are joined by Laura O'Toole, CEO of Shortest. Laura, welcome back to the.

Bill, it's always fabulous

to see you. This is your second episode, so you're now a seasoned veteran of Newsday.

All right. I like it. All right. It's always fun talking to you and your team.

Great people.

Well, I appreciate that. I think it was Gosh, the coach for ucla, John Wooden, who once said the team with the best players usually wins. So hiring is so important. And we have a great team and I love it and I enjoy interacting with your team as well. We're gonna have an interesting discussion today.

So we're gonna go from legacy to ai, and then we're gonna go back a little bit and talk about what some of the things that are going on Press Ganey as an announcement integrating with Epic. We'll touch on that a little bit and then we're gonna talk about healthcare workers.

Are still thinking about quitting. And I think that's a very relevant story for sure. First story, how to best manage or dump legacy healthcare IT systems. This was an interview on healthcare IT news and instead of going into the article itself you've been in the industry for, gosh, 30 years.

Is that right?

Oh, thanks. Yeah, that's right. You had to, you couldn't say 25, right? had to say 30, but that's alright. I'm, yes, sorry. I'm sorry. It's all good. The truth is truth bill. Truth is truth.

Well, some of that equipment that was in healthcare 30 years ago when you started still resides somewhere in the health system.

It's amazing how we seem to be unable to get rid of legacy equipment in healthcare. I mean, why do you think that is?

Well, I have a hypothesis that, and I've actually seen it transform at some of my clients where when you think about some of the infrastructure teams that started and created to use the tools that they had and some of the, even the manual processes and technologies that they had back then, they're the only ones that know where the ghosts are in the closet.

So I think. That's part of the cornerstone of the challenge is as new staff comes in and staff retires and people evolve, I think there's a little bit of fear for people to say, what risk am I exposing by getting rid of something because I wasn't here when it started.

Yeah. There, there is a fear of touching it, like it's not broke.

Don't touch it. I will say this. When we started our application rationalization project, our move to the. Was our impetus for application rationalization. . when we started it we found applications like if there was applications in our environment we didn't even know existed. It didn't even know existed.

And it was funny cuz the first report I saw, I thought the application rationalization would actually reduce the number of applications and it increased the number of applications.

I can believe it.

What just happened here? You guys are killing me. And yeah. They explained, Hey, we went out there and sure enough these things are still running.

That represents a huge risk though, doesn't it?

I think it's a huge risk, and it's a huge opportunity to reduce cost, especially at a time where our health systems are bleeding, the way that they're bleeding and the challenges that they have with their operational spend. I think it's critically important.

To really work to eliminate those tools and technologies that just aren't adding the value that maybe they once did.

Yeah, it's it is interesting, some of it's architecture related in that it's only recently I would say in the last three to four years that we started thinking about platforms.

We're gonna put in a platform for. Our medical record, then we're gonna put in a platform for our E R P. We're gonna, I mean Sure. Test. We're gonna put a platform for our testing instead of going off and getting all these one-off solutions. . But I think now that we're starting to utilize Platform thinking, hopefully we're gonna be able to pull that data in, archive that data, integrate, keep that data integr.

With new systems and new processes, but this does require I believe the word I'm looking for is intentionality. Yeah. Like, you have to identify this and focus in on it. Yeah,

absolutely. Purpose driven. And I also think that most things are about process. Right. I mean, you can have all the great technology in the world, but if you don't have a good process around your outcomes I think that's why people find things in closets that they didn't know that they had.

Yeah, we're gonna touch on AI now. I put a poll out there as I do every Monday. . So I'm gonna check in on the poll. The Monday poll this week was The age of AI is upon us. How will it improve the practice of medicine? And the question was, in your opinion, what's the most significant benefit of using AI in medicine?

And I had three options and tell me if there's another. Improved diagnostic accuracy. Received 33% of the vote, personalized treatment plans, 19% of the vote. Efficiency in cost savings, 41% of the vote and others 7%. And the others really fell into one category, which is. , all of the above, and then some.

. . So I know that AI is at the peak of its hypecycle, or at least Chat G PT is at the peak of its hypecycle, but we are starting to see AI get integrated into healthcare in a lot of different ways. And the Wall Street Journal touched on this, how doctors use AI to help diagnose patients.

And it says, AI tools use algorithms to better identify patients that might be at risk for certain conditions, which is a great use case, right? It mines all that data and it takes all the telemetry data and it says, oh, , look this is a potential risk. Doctors aren't relying on the technology alone to diagnose patients.

And their use of generative ai such as Chat GPT is largely limited to paperwork and reports. Though some are testing to see if it could play a larger role. And they go on to talk about how Mayo clinic is using it, how Duke is using it and some other health systems are using it to let's call it physician augmentation or clinician augmentation.

Right? It's coming alongside of them saying, Hey, I see something. Do you see the same thing? Do you want to confirm this? . And so, I guess the question isn't if it's going to be adopted, it is being adopted. The question is, how rapidly do you think we're gonna see an expansion of ai? In healthcare?

Well, I think it's gonna move more rapidly than I originally thought that it was. And healthcare moves at a slower pace, it seems to me. But this seems to really be getting, adoption. And I experienced it, firsthand. I think I've mentioned to you, I'm a twice breast cancer survivor and it was interesting to me.

I went to my doctor the other day and Sure. He was using several algorithms based on my physical, based on my blood work, based on my weight, based on the density of my last exam. A host of things that really were tools that were at his fingertips. And that was the first time I had ever had that level of conversation.

With my oncologist before, so I experienced it firsthand, and that had not happened to me in any of my previous appointments. So that's kind of an n of one, but it tells me that, it's moving more rapidly than I thought that it would. I will tell you one of the things that concerns me a little bit when you alluded to just making sure that it augments the physician. As with anything, you think about process and really that three legged stool of, people, process and technology and making sure that there's a component of all three of those things when you're caring for somebody and making a decision about their care or their future care is critically important.

I believe.

Yeah. How do you feel as a patient? By the way, I don't remember us having the conversation about being a cancer survivor. . But I'm curious from a patient perspective, how do you feel about, if the doctor were to say to you, Hey, the AI. Is telling me you might have something here.

How do you feel about the computer? Are you worried about, hey, how did the computer come up with that? Or is there a certain trust level because the clinician's the one telling it to you? I mean, what are your thoughts?

I mean, I think that it should be a data point. I don't think I would be comfortable at this point with only.

A computer deciding what my, diagnostic approach should be for my care. But certainly the data with the images and with someone laying eyes on those images and interpreting them, a absolutely, I think I have no issue with. My providers using every tool they can get in their toolbox, because I think they need it.

I mean, the pressure that's on our clinicians today is exorbitant. So any tool that they can leverage, I'm all for.

Yeah, One of the posts here is somebody who works in reality saying, I'm using AI right now in imaging, and we have already improved our turnaround times materially.

. And imaging is one of those area. The image doesn't lie per se. I mean, the image is the image. There's so many variables when you're talking about caring for a patient and social determinants, all this other stuff. But an image is an image. , and you can compare it to the last image and you can compare it to a million other images that have been taken.

And so that's the area that we've seen it have the most impact. Like, there's been a lot of studies where the technology can actually see things that the radiologist or cardiologists or any of them are looking at and doing the read, they may not see, but the computer might pick it up because they have.

Looked at a literally a million images and they've been trained on a million images and they go, now this looks like something maybe take a look at it. So imaging has been moving fast. I am really surprised as I'm reading about Duke and I'm reading about Mayo, how extensive they're starting to integrate it into.

The ehr, like they just pull up the EHR and there are dashboards that are using AI to give them some additional data points and insights.

Yep. Absolutely. I mean, screen scraping and image capture, has been around for a long time. I think what's interesting with this evolution of what we're seeing with AI is that the data.

Is now really integrating into the message different than just a comparative picture and taking research and taking information and making a determinant of what you wanna do with that data and what's the next outcome.

  📍 📍

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

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

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

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

$1 to Alex's lemonade stand. So with your help, we hope to raise a bunch of money for Alex's Lemonade Stand at the Vibe event, and we hope that you'll be a part of it. It's going to be exciting. We have some partners that have, agreed to be a part of it and help us out with this and they are Sure. Test and we really appreciate shortest being a part of it.

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

📍   📍

I want to hit this Press Ganey story for a couple reasons, but I want to hit on it because you're a CEO of a company that's relatively new, about two two years as Sure. Test, but previously as part of another organization. So , but fairly early on. So, Press Ganey been around for a long time. Epic obviously is the 800 pound Gorilla, elephant, whatever in the industry. So, Press Ganey takes their data and their user experience.

and their analytics collection applications and intellectual property. And then announces this integration with Epic. So now essentially from within Epic, you can send out the Press Ganey study. , you could have the data come back and be integr. Into cheer, which is Epics crm.

And so it's a highly integrated approach to care and understanding the patient and understanding their experience. I found this to be a very interesting announcement for a couple reasons. One is Presganey is known for kind of being a little behind the times.

I mean, press gain surveys right in the mail all the time. Exactly. . And this sort of catapults them forward and then it catapult them ahead of some of the competitors with the integration into Epic because it just makes it that much easier to deliver that digital experience to the consumer.

I think it's really great announcement in terms. How they have repositioned themselves as a digital leader and also how they're positioning themselves to be really a go-to choice for Epic partners. First of all, I'm curious of your thoughts on this, and then what I'd like to ask you about is, , how do you get Mindshare as a new company?

How do you gain people's attention? .

Well, I was a little surprised to read that announcement. I think it's cool. I think it was brilliant on. I don't know who the driver of it was, but you know, I do think it's brilliant because, to get in that healthcare niche especially and to be able to change perception of the way that Press Ganey is perceived, cuz I like you think of them as the surveys that come in the mail and now if you're gonna be able to transition that and really.

Look at outcomes and how you engage with your population based on how they're feeling and how they view the service. I mean, I think it's a brilliant move. I'm, I was a little surprised. I think it'll be cool to see how the integration works and how they isolate that information as appropriate for.

The specific community that's being served within the E H R, because the data will need to be specific for the communities that are being served. Right. So, it'll be interesting. I think it's a bold move and I certainly don't think it can hurt their position at

all.

Yeah.

Well, I'm curious, so, a fairly new company that you're CEO of. You guys have a fairly good client list. I mean, I'm looking at your client list here on your website. It's extensive. How do you market, how do you get in front of people in healthcare?

How do you get that message out?

So two things. I think primarily for us, it's all about, m meaning what you say and say what you mean, and the best way to prove that is through referenceable clients. So it's very important to us. We were very purpose built in terms of developing our library to be able to deliver speed to value quickly.

So the best way for us to get our message out to the market is by having satisfied clients

so

the product matters. The product and the service

matters

and the quality matters, and you know who wants to do anything if you're really not gonna provide value and make a difference for a client, particularly with what our clients are dealing with today.

It almost, to me feels like an obligation to figure out. Ways, meaningful ways to make a difference, to either give them back time or money, and it's gotta be both from my perspective and delivering a solution that really delivers an roi. But the best way to get your company to a market is proof.

And the only way you can prove it is by doing good work. And. having referenceable clients and I'm really proud of the referenceable clients that we have, we have a lot of 'em coming to VIVe this year and I'm excited to have them talk to some of our prospects and their willingness to do that, I think is where the proof is in the

pudding.

Yeah. Speaks volumes. Yeah. I used to as cio, it's kind. Corny, but I spent 20 years of my life in Missouri and Missouri's known as the show me State. . And so invariably somebody would be showing me all these great slides and, oh, we can do this, we can do this, we do this.

And I'd look at 'em and I'd be like, I just moved here from Missouri. You gotta show me. I have to see it. I have to talk to somebody who's using it. I have to see the return. I mean, all these slides are great, but at the end of the day it is gonna be the references. It is gonna be the product in motion, actually doing something, actually delivering value that is gonna get it over the finish line, I think.

Yeah,

and I think you have to ask your clients the hard questions, and you have to listen to your clients, and you have to hear what they want, especially as you're thinking about how you wanna evolve a solution or take it to the next level. Don't do those things in a vacuum. Ask the hard questions.

Listen to what your clients say. And I think the rest follows. I mean, we started with three pilot clients and you can see from our client list where we've come. And that's because we're very committed to delivering a quality product.

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

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

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

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

That's fantastic. All right, we're gonna close out on this story.

Healthcare workers still think about quitting often, even on well-staffed teams. And this is Dr. Adrian Boissy, C M O, for Qualtric. Gosh, we're talking about Qualtrics and Press Ganey in the same show, two Competitors. So they went out and they talked to healthcare workers actually in a bunch of countries.

Australia, France, Germany, Japan, Singapore, uk, and the US 200 or more in each country. And what they found is beyond staffing levels, the report found some other factors contributing to workplace dissatisfaction, not being asked to provide feedback and thinking of quitting multiple times per month.

43% of healthcare employees versus 37% of customer facing. Employees across sectors indicating that they have not received a raise and find it hard to keep up with living expenses. 74%. Yeah. I would imagine. Yeah. Reporting workloads have increased 53%. So workload pay and not feeling like they're a part of their own destiny.

Right. Contributing to the culture Contributing To the environment. Aren't those like management 1 0 1 kind of things?

I was just gonna say leadership 1 0 1, but you know, it's amazing to me. I don't know if you see it, and it feels more prevalent now. There's such a void of leadership. At times, and it just blows my mind because, I was just out in Kansas City on Friday.

I flew out for the day. We have a bunch of our development team is out there and our entire solution is delivered remotely, so everybody works remotely. We tried to it very cost effectively, but we had several new employees and I hadn't met them. And I flew out there to take them to lunch and just to hear what they had to say.

And it was almost, this shock on their face that I would fly out there to sit down with them just to listen to what their ideas were and what use cases they're seeing that our clients are really getting benefit from. And as importantly, I wanna hear from them which clients are being the most innovative with their testing.

And I walked away from that meeting Bill and I said, Wow. I was just shocked and it was so gratifying to feel like just by wanting to understand what they were thinking, they felt special.

It's such a basic concept and, it really does blow my mind. The opportunity that we as leaders have every day. to keep our clients and our employees at the center and listen to what they have to say and make them be a part of the solution. Don't just dictate this is what you're gonna do.

Have them be a part of the solution. To me it doesn't seem that complicated, but I think people struggle with it.

Yeah. I'll take it one step farther cuz I can and not get in as much trouble as. . There's too much fear. Now. We all have to grapple with fear. Leaders have to grapple with fear.

We all have a certain level of fear, but I find that when fear is too much front and center in your decision making, in your process that's when you get self-serving. That's when you get cautious. That's when you don't make the moves that you need to make. And I find that to be.

Too prevalent in healthcare today. And I'm not calling anybody out. It's like, look, this makes too much sense. We should be doing this. And my example of the day, Is the public health emergencies coming out and incomes this Medicaid, I forget what the name terminology is, but they're reevaluating all these Medicaid because during the pandemic, during the public health emergency, no one could be kicked off of Medicaid.

Now people would normally have flowed in and flowed out of Medicaid based on how much they made and that kinda stuff. But for the PhD, no stats could change. This is all gonna change. And I'm talking to some health system leaders who are like, oh my gosh, this is huge.

We need more money from the government and all this other stuff. And I'm like, time out. Did we not know this was gonna happen? , did we not plan for this? And how is this an emergency now? Like we knew this was gonna happen. So there's a fear aspect and there's also the obvious things that are gonna happen.

We don't plan for, we don't like, You

know, avoidance. Stick your head in the sand, right? Yeah. I read this great book a long time ago and it really helped shape my career. I read it like in my late twenties and it was called The Color Code. And what that book did was kind of assess different personalities and how you could deal with those personalities.

But one of the main premises of the book is that every single thing you do in your life, whether. Work-based or personal base, you either do it from a place of love or a place of fear, period. Those are the two spectrums. And fear is typically aligned with a dirty motive and the things that you do coming from a good place of love and what's best for people is from a clean motive and.

When people operate from a place of fear, it might not be because they intend to do something wrong, but because they are so fearful, the motive becomes dirty. And then their behaviors that are associated with how they act out of fear get reflected in many things that they do, and it rubs off on people in very negative ways.

So I think you're gonna constantly check yourself as a leader and ask, why am I doing this? What's the right thing to do? Yeah. I can be bold. We have to move forward. We've gotta make difficult decisions.

Yep. I agree a hundred percent. If I were hiring a CIO today, I would definitely look for humility.

and I would look for fear. And if they didn't have any humility, I'd be afraid that they would just do stupid things. . And if they operate outta fear, I'm afraid they're not gonna do enough. They're just going to just get by.

Perfectly said.

Well, I appreciate that and as always, I appreciate you coming on the show and look forward to seeing you guys at Vibe.

It's gonna be in person again. And I don't think we will ever take being in person for granted again. So looking forward to it. No,

and I'm excited to see Captain too and do a bunch of cool stuff with Alex's Lemonade stand. Be a fun, it'll be a fun time.

Yeah, absolutely. Well, and we will continue to share more about that as we get closer to the event, but we have some really fun things going on and I appreciate SureTest being a part of that.

Laura, thanks for your.

Thanks, bill. Have a great day.

  📍 And that is the news. If I were a CIO today, I think what I would do is I'd have every team member listening to a show just like this one, and trying to have conversations with them after the show about what they've learned.

and what we can apply to our health system. If you wanna support this week Health, one of the ways you can do that is you can recommend our channels to a peer or to one of your staff members. We have two channels this week, health Newsroom, and this week Health Conference. You can check them out anywhere you listen to podcasts, which is a lot of places apple, Google, , overcast, Spotify, you name it, you could find it there. You could also find us on. And of course you could go to our website this week, health.com, and we want to thank our new state partners again, a lot of 'em, and we appreciate their participation in this show.

Cedar Sinai Accelerator Clear Sense CrowdStrike, digital Scientists, optimum Pure Storage. Sure. Test Tao, site Lumion and VMware who have 📍 invested in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.