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August 13, 2023: Laura O’Toole, CEO at SureTest joins Bill for the news. They delve deep into the challenges of modern management and leadership, focusing on the rapid pace of change in our current business climate and how the adoption of technology, particularly in a post-COVID era, impacts the workforce. How can organizations balance rapid technological advancements with ensuring the well-being of their workforce? With remote work becoming the norm, how do leaders ensure constructive feedback without affecting morale adversely? If managers are indeed becoming more critical in a remote setup, what training and resources are essential to equip them for success? In the context of "human sustainability," what should leaders prioritize: rapid progress or workforce well-being? How transformative will generative AI be for administrative tasks, and how can it be harnessed to benefit both the organization and its employees?

Key Points:

  • Modern Management Challenges
  • Workforce Well-being
  • Remote Feedback Difficulties
  • Generative AI Impact
  • Balancing Rapid Advancements

News articles:

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

Today on This Week Health.

When you get on a town hall call or you go and you talk to your associates, you can't just say, tell me what's going well, tell me how things are going. I think you have to turn and flip the question and say, what are two things that I can do to really make your day better and to make your work experience better?

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. Clearsense, CrowdStrike,. Digital scientists, Optimum Healthcare IT, Pure Storage, SureTest, Tausight,, Lumeon 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 we are excited, I'm excited to have Laura O'Toole back on the show from SureTest, CEO of SureTest. Laura, welcome back.

Thanks, Bill. Always fabulous to be with you and see you. Although, I'm shocked. You're in Florida, I'm in Florida. You got a long sleeve shirt on and I'm sitting here in my, you know,

This is one of those things.

I'm in my house and my wife keeps the temperature down so low that I can wear a long sleeve shirt. But if I were to step outside, I would begin sweating almost immediately. So, It's crazy. And so oh, you're on the, you're on the eastern side of Florida.

Yep. Palm Beach County.

It's it's crazy because we have not gotten much rain this year. And I know a ton of rain in Vermont, ton of rain up north and those kinds of things. And people are worried about rain down here. And I sort of, I look at them like. Seriously, you're worried about, I mean, like, one of the things we don't have to worry about in Florida is eventually we will have more water than we know what to do with.

Exactly right. And I gotta tell you, it's sitting at like 69 degrees in my place, so Beth is a woman after my own heart.

Alright, We've got a bunch of stories. Very interesting. We're going to talk a lot about, I think, the culture of healthcare and whatnot. And since we're going to start there, I'd like to start with Sachin Jain's post. And just so people know how this works, we, at This Week Health, we're following so many stories.

And it's not your full time job to follow these stories, although I'm sure you're staying current. What we do is we send like 20 stories over to the people who are going to be a part. Either select from that list or they can go out and say, Hey, I've read this article. I read this post and send it over.

And so essentially I go with whatever you guys select and you selected these stories. And I wanted to give people that, that background because from time to time, I say to people, you selected the story. Why? And somebody said, well, do you not select the stories? I'm like, well, generally we do.

We were following a lot of stories, but these are the ones that you picked and you picked a lot of culture stories. Why did you? We'll go into Satya and James in a minute. What are you seeing in culture? What interests you about the culture of healthcare right now?

Well, you know, it's so interesting to me.

And I was out with a client, Erlanger, last week and it really became apparent on how important it's become as we've come out of COVID to connect with people and be able to look across a table to people. I think we've gotten so used to the Zoom cameras and so used to phone calls. And my fear is there's a disconnect between, and you see this across all these articles that we read and what the C suite thinks.

Their employees need and what they need and there seems to be a lack of engagement and I have a hypothesis and this was a common theme in a lot of the stuff we read this week that because of that kind of lack of engagement and people feeling like they're not getting what they need the can is getting kicked down the road and I think it's having an impact in terms of how fast we can move in getting things done.

So I'm feeling it. I feel that it's taking a long time to get things done in general with our clients because they've got so much on their plate. And I think it's because we're just not connecting with people. We're making assumptions about how they're feeling and what they need versus Really getting in there and peeling back the onion.


I think we're growing a new muscle. It's interesting, we did two 229 CIO roundtables in the last week. And this topic comes up of remote work in place and that kind of stuff. And there was this really robust conversation going. And I said, all right, time out. I want to ask this question. How many of you are remote work or some variation of hybrid and it was a hundred percent.

So I said, okay, fine. Let me ask you this. How many think that the hybrid work will be the, we will still be in hybrid work three years from now. And they all agree that it was going to be hybrid work. I'm like, all right, so stop the conversation about people coming back in. You're not bringing them back in.

You don't believe they're coming back in. So the question becomes, how do we engage them? In this new environment. And I think it is a new muscle for us. We're trying to figure it out and there's a lot of really interesting strategies, but I think a lot of it starts with hiring and it was interesting because that's where I brought the conversation back to because some people have really broad.

Definitions where they essentially say we can hire in any state. And then other people have regional strategies. Other people have policies that essentially say you have to be able to get on campus within three hours if we call you. Yeah, which really limits it. Some people have policies that essentially say, look, We're only paying for one flight a year to the location.

So if there's a need to come more than that, I'm, so there's a lot of different policy things. But again, it almost demonstrates this is a new muscle for us. this isn't wired yet. We haven't figured it out. There's not a lot of good. Case studies and articles written on this just yet.

And I agree with you, I think it's leading to some disconnect. Sachin Jain points out some of this stuff in his post. He said we need to accelerate change in US healthcare, and a new management culture is a starting point. Building a new management culture is acknowledging limitations with our current culture, regardless of the sector, having worked across all sectors of healthcare, I reflect on some of them.

And he says, slow pace of execution. And he said, we have convinced ourselves that Uh, The second is avoiding hard decisions. Many leaders and leadership teams know the right thing to do, but fail to do so out of fear. Number three is passive aggression, which is interesting. So many cultures perpetuate silence in decision making meetings. And then four is committee led disempowerment, which we know what that is.

And then leadership. The days of player, coach, and healthcare have given way to excessive hierarchy. Where many leaders are unwilling to roll up their sleeves and see what the real work of their teams is like. This is, I mean, this is from an insider. This is from a CEO. Now, granted, ScanHealth is a payer, not a provider, but he's been on the provider side.

And I've seen all of these. I mean, this is What were your thoughts reading this article?

Well, I think, you know, I think he's right. I think that as we came out of COVID and the full focus on, digital health and, you even see CIO titles changing to chief digital officer.

And I think there's been some layers that have been created. Which I think is necessary. But at the same time, you got to keep bringing up that workforce and you've got to have some leadership layer that will roll up their sleeves and really empower these folks to just get things done and not do death by committee.

And, make a decision, got to be innovative. There's a big push from the boards for them to be innovative and to digitize. And I think the only way that's going to get done is by empowering people to make decisions and have them be straight up in these meetings. And I think it goes back to basic leadership and not tolerating, the passive aggressive behaviors that I think sometimes

we see.

The hard thing about this is, again, understanding the culture. Who makes the decision? It's interesting, we want to say, oh, this consumer driven healthcare. And my comment always is, the consumers aren't in the boardroom. The consumers aren't in those decision makings. And so when people wonder why we continue to make clinician...

or administrative led decisions, more administrative led decisions than clinician led decisions, is because whoever's in those rooms, that tends to be the focus of the decision. And so a majority of the decisions we make are administrative led, and then a secondary group is clinician led, and then tertiary is consumer led, because that's who's in the room, that's who's making the decisions.

And so I mean, that's my first point on this, and then the second is when you look at these things, passive aggression, it's who's in charge. I know it's leadership. It was interesting. For me, the best example is imaging just in general, enterprise imaging.

And I thought, well, just like everything else, we're going to consolidate applications. We're going to get to a single set of applications. And, it's going to enable sharing of data and new workflows and all this other stuff. What I didn't realize is, How many people had decision making ability around that decision?

And it required a new skill for me in leadership, which was consensus building and and building the case. And even the best people that I've talked to in the industry. We haven't been able to do this across here because, cardiologists make a lot of money for health systems and wield a lot of power and they say, well, I like this one.

This is the one we're going to use. It's like, well, would you like to discuss it? It's like, no, I wouldn't really like to discuss it. This discussion's over. And you're like, and the discussion is over.

Yeah, I think part of it, I think since COVID a lot of executives aren't doing as much rounding, really being out and out with their constituents, out with the physicians, out talking to even some of the lower level clinical people in the organization to again, peel back that onion to make sure that

we really have our pulse on that we're solving the right problem, and I think there's been a disconnect, and this gets to my point of, I don't think we're ever going to see, I completely agree with you, where people are coming back into a brick and mortar building. But I think as leaders, we need to find creative ways to engage and connect and to make sure that we are hearing people.

And hearing the right people. And I think that's hard to do in an entirely virtual world. So it's about making a choice to extend yourself. And really listen, and I just think we need to do more of that.

Yeah, I heard one leader talk about they stream rounding. So, all these people are remote, they're not going to fly them all in and that kind of stuff, and they've started to actually stream with permission, and just actually there's a whole bunch of hoops they had to run through, so I'm not...

I'm not saying to be like, you have to talk to legal. You have to talk to compliance. You have to talk to a lot, and you have to get sign offs from the people you're going to be talking to as you're rounding, do they want to be videoed and that kind of stuff? And you don't do it with like a hidden camera.

Everybody in the room should know that it's being videoed. But what was interesting about that was how powerful it was. So that CIO is doing the rounding for a large portion of the team that needs to be doing the rounding. And he was hearing the insights, he was hearing the feedback, but it was going to the team.

And by the way, it was a limited, it wasn't like an open stream, it was... Hey, these 15 people I've been invited to round with me today, kind of thing Really, again, talk about creative solutions. I thought that was a really creative solution.

Yeah, that is cool. I think there's all kinds of ways that you can connect.

It's about... Making the time to do it and with everybody's schedules as busy as they are, it's, it becomes a challenge. So it's about pushing it down in the organization. Managers have to be empowered and they have to be held accountable to timelines. And, I think that leaders are feeling this real balance that, they're hearing about all the pressure and the stress that everybody is under.

They don't want to put more pressure. But I think it's about focus and working on those innovative solutions that are going to really make a difference at the end of the day for their consumers.

Yeah, I did ask the past couple of weeks in those meetings if the clinicians felt a little put out by the fact that, these analysts and whatnot used to be like right there at the elbow and now they're at home and they're, they're dressed like, like me, they're, they pull over on and that kind of stuff, are the clinicians put out and it turns out there, there are cases, it's not the norm, but there are cases of it throughout the system that you have to get in front of.

Because the clinicians are like, look, they don't even come to work anymore. And that perception... Can balloon on you pretty quickly. Workforce well being. This is a Deloitte article and I like this one and I definitely want to talk to you about this. I'm going to skip to the chase here. The path to progress, three keys to unlocking workforce well being.

Little chart here. Empower managers to support workforce well being. Hold executives and organizations accountable and embrace the broader movement towards human sustainability. I don't know about you, but that's the first time I heard that phrase, human sustainability, was in this article. I'm curious, workforce well being, as a CEO, you probably think about this a lot.

How do we, it's funny, it's like, how do we almost force people to take their time off? How do we force people to take care of themselves? Becomes somewhat of a manager's responsibility, doesn't it?

It is, and it's got to be ingrained in your culture. It is a manager's responsibility. And I think...

When you get on a town hall call or you go and you talk to your associates, you can't just say, tell me what's going well, tell me how things are going. I think you have to turn and flip the question and say, what are two things that I can do to really make your day better and to make your work experience better?

Give me specifics, not what am I doing well, what am I not doing well? I think we need to really flip the question and make sure that we understand What people need. And I think that's what creates sustainability.

It's interesting, we knew that managers were important before because, I remember doing the Pulse surveys and HR would just come to me and say, you have two manager problems.

I mean, from the Pulse surveys, they could look at me and say, you need to sit down with those two managers. They're not effective managers. And that was really helpful. I was able to sit down with those people and help them to develop the skills they needed. My gosh, how much more important is the direct line manager today in a remote environment?

that it was before. I mean, I would assume it's like 5 to 10x more important.

It's immensely important and I think we need to give managers more training. I mean, it's one thing to manage a project, it's another thing to manage people and to help managers be successful. I mean, I'm a firm believer we should never get to the end of the year and have anyone be surprised about an annual review.

And, I had a manager recently come to me. And say they were struggling to give somebody feedback because they do such a great job in so many other areas and, just conflict avoidant, really embracing conflict. And I said to him, I said, but if you think about it, this isn't about you, it's about that person.

And if you give them the feedback, is it going to make them better? So if you don't make it about you. And you make it about them, really make it about them

but you know, and I said to him, I said you're doing a disservice by not embracing the conflict and telling them the things they need to know. And, I think when you help people think about it from a different point of view, it's easier to manage.

You're hitting one of my hot buttons, and my hot buttons was, used to do twice a year reviews, June and, was it June the end of the year?

No, it was off because we didn't do them around Christmas. But anyway, there was twice a year we did reviews. And it was mandated by the organization, so we had to do it. And it was the form, the process, we were educated on it and whatnot. And I would get them back and everybody's doing a phenomenal job.

And I'd sit there and go, well, that's really interesting. Cause this group keeps missing their deadlines. They're way over budget. They're whatever. But we're the managers for whatever reason, we they're people and we don't like to have difficult conversations. So let's just be honest.

I don't care how good of a leader you are. You don't like, no one likes difficult conversations and it's difficult to look at somebody and say, Hey. Look you're falling short here, and here. Even if it's I would like to help you. Right. I had a conversation with one of my employees, and I said, Hey you're falling short in this area.

But I really appreciate how you've approached it. And I a Monday, I said,

Hey, I'm just curious. What did you hear in our conversation? And the person said, I heard I'm doing a horrible job. Right, right. Because that's what people hear. And so it is so, so hard. And that's why that follow up phone call was so important to say, What did you hear? So I could say, Okay, that's not what I was communicating.

What I was communicating was, In this area, you are falling short. Like we have to, as an organization, we have to do better. And I'm going to help you to do better. We're going to strategize. We're going to plan. We're going to do all these things. But my gosh if I were to go into an organization today and just pull the HR files and look at, and you asked.

like a disinterested third party to read them and then rank your employees. I guarantee you the rank would be different if you put the leadership in a room and said, rank your best employees. They would not match what the reviews say. Oh, no,

they don't. And it's a, I think you have to create a culture where, like, we go through that process to make sure that there's alignment and, really try to hit things along the way.

I, I think it's really important. I think it's the right thing to do for people. And I think COVID taught healthcare for the first time that we can do things really fast. And so I think part of what's happened is that. in terms of sustainability is that pace has just stayed since COVID.

And I don't think we as a market are focusing enough on what are the most innovative things we need to do. We're just trying to move faster with everything. And Making sure that everything gets a piece of the pie versus, focusing maybe on the chunk of the pie that needs to be focused on right now.

And I just think this pace needs to be measured, but with focus and almost a different level of intelligence in how we approach it. I don't know what you think about that, but I think that's impacting the sustainability that people are feeling

We'll get back to our show in just a minute. To celebrate our fifth year as a podcast, we set out to raise 50, 000. for childhood cancer in a partnership with Alex's Lemonade Stand. Thanks to the generosity of the Health IT community, we hit that goal already. It's August 2nd or 3rd, and we've already hit that goal.

It's pretty amazing. In July, two of our 229 Project events brought together Health IT leaders with the help of the chairs. want to recognize the chairs, Sarah Richardson, Tressa Springman, Michael Pfeffer, and Donna Roach. The group of leaders they brought together. And the sponsors that were a part of that helped to donate over 10, 000 to Childhood Cancer and Research and Alex's Lemonade Stand.

And we want to thank them and we want to thank you for participating all year long. It's still going. we're still raising money and we hope to really break through this goal. Alex's lemonade stand is doing wonderful things in cancer research and family support. join us by going to this week, health.

com, clicking on the Alex's lemonade stand logo. It's right there on that front page in the top right hand column. we would love to have you do that and give today and be a part of helping us to fight childhood cancer. Now back to our show. 📍   

The last article why the pandemic era acceleration of health tech isn't going away Talks about that pace a little bit and has quotes in there from Zafar Chaudhry, BJ Moore All these people who have been on the show and essentially they're saying look the answer to what ails us in a lot of cases Is technology we've got to continue on this pace.

I will tell you I do not believe the pace Is fast enough. But there's this crazy balance that you have to strike between the pace being fast enough and the organization being able to accept the change from two perspectives. One is the clinicians have just gone through the pandemic, which has really been a massive burden.

And so, you can't keep moving their cheese while they're in a bad place. And then you have this. Sensitivity to a workforce that you're afraid is going to leave because now essentially they're working remote. They get a phone call and all they do is change their login tomorrow and they're working for another company doing the same thing.

for a little bit more money. And so you don't want to push your team too hard and you don't want to push the organization too hard. And there's this balance we're struggling and you have a lot more because of that, you can see it visibly it's union activity. It's high turnover rates.

It's those things. And so we're seeing it. We know we need to move faster. I don't think we are moving faster or fast enough. I

agree we're not moving fast enough. What I'm suggesting is that we need to move faster, but in focused swim lanes. And I think right now people are so all over the place that, and that's where leadership has to come in and has to agree on the set of initiatives that we're going to focus on over the next six months, 12 months, 18 months, whatever it's going to be and get everybody aligned.

And then that engagement has to push down. and make sure that everybody clearly understands what the directive is. And I think that there's a little bit of running amok and kicking the can down the road, and we've got to pull all the cans together and decide which ones we're going to kick and then really kick them


Yeah, I agree with you a thousand percent. I think focus is the answer to this. I think identifying a few things that you can move forward. and really move the needle on, it makes a ton of sense. I think the important thing in the executive suite right now is the narrative. It is answering the question for people, why are we doing this, why is it important, and it needs to resonate.

It's not going to resonate 100%, because no message resonates 100% across the board, but it needs to resonate where people go, yep, I get it, we need to move faster. This is great. Again, CIO roundtable generative AI. First group I asked, how much of an impact will generative AI have? One to 10. And the average answer was five.

But two people in the room were like, look, the average would be higher if you let me go above 10. Because I think it's like 15. So fast forward to the next week. And I have a round table, it's academic medical centers. And I say how impactful will generative AI be? The average in the room was nine.

They're like, this is going to change the game from an administrative standpoint. Absolutely.

Yeah, at least. I mean, there was an article that we read, I think it said an average, primary care doc, whatever, spends 18 minutes with a patient and 49% of that is based on administrative tasks where they could, at some level be leveraging AI.

So, absolutely, that's something we have to embrace and we need to make sure we put the right controls in place and and use it for where we can get the biggest bang for our buck. I think right now, aligned with those initiatives that we want to wrap around kicking a can fast down the road.

But that's why I think the focus becomes so important. And I think from a workforce perspective, we need to say, and one of those things that could also be a talent attractor or a talent. Retainer and try to wrap that together so that we can get impact across the board.

So think about the things that are weighing down your workforce and what can we be doing better, either from an AI perspective, an innovative perspective to make them happier in their jobs, to make them feel more sustained in their jobs.

Well, Laura as always, I've gone over. We're like six minutes past.

What my team has told me is my limit for these shows. It's only because I love talking about these topics with you. Thank you very much for being on the show. I really appreciate it.

So great to be with you again.

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,, 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 Clearsense, CrowdStrike, digital Scientists, optimum, Pure Storage, Suretest, tausight, Lumeon, and VMware who have 📍 invested in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.


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