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We recap an exciting week where not only do Apple and Amazon make big announcements but they bring big successful players along with them with JP Morgan and Berkshire Hathaway. Plus a great discussion on the role of the CIO with Sue Schade former HIMSS/CHIME CIO of the year. 


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

Episode 4: Sue Schade on Amazon and Apple make their Big Move, Plus Role of the CIO

[00:00:00] Bill Russell: [00:00:00] Welcome to This Week in Health IT where we discuss the news information and emerging thought with leaders from across the healthcare industry. It's Friday, February 2nd. Today, Apple and Amazon make their big moves in the healthcare. Plus a discussion on the role of the CIO. This podcast is brought to you by health lyrics, a [00:00:30] leader in digital transformation in healthcare.

[00:00:31] This is episode number four. My name is bill Russell, recovering healthcare CIO writer and consultant with the previously mentioned health lyrics. Today I'm joined by former hymns chime CIO of the year and veterans CIO from Brigham and women's hospital, university of Michigan health system, and an interim interim CIO at university hospitals in Cleveland and Stony Brook in New York.

[00:00:57] And currently a principal at [00:01:00] Starbridge advisors. The amazing Sue Schade. Good morning, Sue. And welcome to the show

[00:01:05] Sue Schade: [00:01:05] Morning, bill. Thanks for having me on.

[00:01:08] Bill Russell: [00:01:08] I appreciate you joining us. It should be should be a fun conversation. A lot. A lot has happened this week. The question we ask all of our co-hosts at the start of the show.

[00:01:18] What, what are you working on right now? What are you excited about?

[00:01:22]Sue Schade: [00:01:23] Any given day lots going on. But one of the things that I'm looking ahead to right now is hymns in [00:01:30] another month. And with my commitment to developing next generation of health, it leaders, I said yes to a number of invitations.

[00:01:39] And I'm also a person, I think probably known in the industry who is willing to speak up on behalf of women and women's issues. So I'm going to be doing the health it chicks meet up panel. I'm preparing for a session. I'll be presenting on advice for the aspiring female executive. And I'll also be facilitating one of the [00:02:00] round tables at the women and health it mentor meetup.

[00:02:02] So starting to get ready for that. As well as just working on a lot of different leads as we hear about transitions within the industry right now for CIO and look to place interim in different organizations. So. That's kinda my day at the moment,

[00:02:23] Bill Russell: [00:02:23] Your, your day is different every day of the week. So

[00:02:25] Sue Schade: [00:02:25] Yes, it is

[00:02:28] Bill Russell: [00:02:28] So Starbridge. [00:02:30]You founded that with with a couple of of luminaries in your you're doing interim CIO placement, and you can give us a little idea of what you're doing at not a full-blown commercial, but just a little idea. And then, and then we'll transition into the, into the news.

[00:02:45] Sue Schade: [00:02:45] Sure sure, sure. Not a full-blown commercial. So I founded the firm StarBridge Advisors a health IT advisory firm with David Muntz and Russ brutish back in the fall of October, excuse me. The fall of 2016. We have [00:03:00] about 20 advisors on our team now with a national reach. They can serve as either CIO, CTO, CSO, CMI, or CNIO.

[00:03:07] So we cover a broad range in terms of interim work and then do consulting and leadership coaching. And we're having a great time doing it.

[00:03:15] Bill Russell: [00:03:15] Yeah. It's fun. Fun group of people. Right. So let's, let's, let's jump into the news real quick. A lot lots happened this week. Here's here's how this goes. I've picked a story.

[00:03:25] Sue's picked a story. I'll kick us off this week. With [00:03:30] the Apple announcement. So Apple to launch health record app with HL seven fire specification at 12 hospitals. Let me recap the story real quick. Apple is going to use the fire spec to move data to the EHR, to your phone, to obviously your iPhone on your Android phone.

[00:03:46] At this point, they will start with allergies, meds, conditions, immunizations and lab results. This is an extension of iOS and we'll support notifications from participating health systems. When data is updated in the EHR, [00:04:00] the data will be encrypted and utilize the normal Apple mechanisms for access. Let me give you an idea.

[00:04:04] I'm going to go ahead and read the 12 systems, Johns Johns Hopkins, Cedar Sinai, Penn medicine, Geisinger health, UC San Diego, UNC healthcare rush university medical center, dignity health Oschner health system. MedStar health, Ohio health and Cerner healthy clinic, I guess that's how Cerner does things.

[00:04:25] It's H E H L T H E healthy like [00:04:30] healthy intent. So let's talk about this a little bit. I did write an article for healthcare. It news this past week, and I highlighted the five reasons. This may be a big deal and five reasons why it may not be a big deal and I'll cover those. And then Sue, I'd love to hear from you how.

[00:04:45] How healthcare CIO might think about this or how they might respond to it. So that the five ways this, this could be a big deal is it's a, it's an ecosystem and platform play. Now while Cerner and Epic are starting to evolve their [00:05:00] platforms for developers and starting to think in terms of an ecosystem, they they're not there yet.

[00:05:05] And obviously Apple has a very mature platform for developers. I think this is going to reduce the burden on internal. It we've been selecting patient portals for years. And if, if Apple's able to take some of that and really deliver an experience, that's going to be a good thing. It could empower the patient, but timing may be right for this.

[00:05:28] There's a lot of pressure [00:05:30] on it organizations and health systems to reduce costs and to improve the consumer experience. So timing is good. And obviously another reason this could be a big deal is it's just it's Apple. You know, the only thing that would've made a bigger splash than this, well, I guess is the Amazon announcement or, or a Tesla announcement getting into healthcare.

[00:05:50] That would be interesting. Here's a couple of reasons why it might not be a big deal from the article. Again, hype oftentimes leads on to met [00:06:00] expectations. It's early, the EHR vendors are, you know, it's challenging to get the data in and out. It may not be ambitious enough. They're just nibbling around the edges with this.

[00:06:11] Apple traditionally has taken a long time between iterations. I would like to see them go a little quicker and obviously there's a whole bunch of things. This doesn't address it. It doesn't address tight integration with the EHR. Therefore you're not going to get into the EHR workflow and there could be some unmet expectations.

[00:06:28] As we talked about earlier system, as soon [00:06:30] as we, as we look at this announcement, one of two big tech announcements this week, how should the CIO think about it and how should they respond?

[00:06:38] Sue Schade: [00:06:38] Oh, great question. And in a great selection on the article. You know, it kind of ties into the other article that we'll talk about in a bit.

[00:06:48] And overall for CIO is I think that they need to be broadly thinking about change and disruption and embracing it and not being threatened by it. And I [00:07:00] think that a lot of CIO is right now are going to look at this. This announcement from Apple and this list of really leading organizations who are known for their innovation.

[00:07:10] And they're going to take notice. So many organizations are still, you know, struggling with some basic interoperability. They may still be, you know, in very early stages of, you know, trying to develop their digital health strategy and how do they reach out to consumers beyond the basic patient portal.

[00:07:28] And they're still [00:07:30] dealing with a lot of. You know, EHR optimization work that the clinicians quite frankly are demanding and, and, you know, rightfully so need. So how can they play in this new space? I'm not sure for many of those organizations, but they absolutely need to be taking notice. I think that your comments about why it's a big deal and why it's not really hit on the Mark.

[00:07:53] If I start with some of the not. It's easy sometimes to look at as like, Oh, hi, here's the latest and [00:08:00] greatest, but is this really going to take off? And when you dig under the covers, what are all the challenges to participating in it? But, you know, it's certainly something worth noting. And I will tell you if I was a sitting CIO in another organization right now, I'd be reaching out to some of my colleagues at the organizations on this list and trying to find out more and how we might, you know, think about participating.

[00:08:24] Bill Russell: [00:08:24] Yeah, I think that's a good, that's a great point. Actually. I was, I was just, I was perusing this list and [00:08:30] thinking these are, these are not small health systems. You know, each one is, is definitely over a billion, maybe even over 3 billion. If I thought about it and you know, each has sort of a different budget scale number of people, number of projects they can take on.

[00:08:46] I played golf at the chime event last year with a small system. CIO. And I got this perspective of, you know, we really do talk to two different audiences. We talked to an audience that has a a hundred million [00:09:00] dollar budget, and we talked to one that has a $5 million budget. And those that have a $5 million budget, they absolutely should reach out to these people.

[00:09:09] And they're not going to partner directly with Apple per se, until Apple figures it out. But these other CEOs could be. A good path for them to have conversations and see if they could piggyback on some of the things that they're doing, but the large systems CIO, they, they may want to figure out [00:09:30] how to get in and start to have conversations directly with Apple.

[00:09:34] That's that that's, that's a different, different play altogether. The it'll, it'll be interesting to see how this plays out. I You know, I'm, I'm, I'm one of those hope, as I said in the article, but when I was hopeful optimists, that Apple will be able to create an experience. And if they're able to create that experience, then we can just piggyback on that and, and do the things that we do [00:10:00] well to really improve outcomes, focusing on chronic conditions and those kinds of things.

[00:10:05] But, you know, th the CIO, I believe, has to put this in context for their health system, whether it's a small system or a large system, they have to have a point of view. That they can talk to the physicians about and a point of view that they can talk to the, to the leadership about where's this going and what does this mean for their health system?

[00:10:26] Sue Schade: [00:10:26] Absolutely because you don't want to be in react [00:10:30] mode. You want to be proactive and you want to be part of it. So any of your, you know, forward-thinking executives and physician leaders are going to be looking at this and going, okay, what about us? How do we get in on this? Right.

[00:10:45] Bill Russell: [00:10:45] And how do we get in on this speaking of point of view and perspective?

[00:10:49] Why don't you go ahead and share the story of the week and we'll, we'll dive into that.

[00:10:54] Sue Schade: [00:10:54] Sure. Sure. So the other one that I don't think we could ignore with a [00:11:00] program that, you know, we can help it. News is the one about Amazon Berkshire Hathaway and JP Morgan chase. So a number of articles there was one in the Washington post by Carolyn Johnson on the 30th.

[00:11:14] Title was Amazon Berkshire had the way in JP Morgan chase joined forces to tackle employee healthcare costs. I'm going to refer to a couple other articles as I talk about this in from a summary perspective, what they're trying to do according to the [00:11:30] article is create an independent non-profits.

[00:11:32] I'd emphasize, non-profits aimed at reducing healthcare costs for their employees together. They employ those three companies employ more than a million employees. The article talks about, I would frame it as being, trying to be above the politics right now, going on around Obamacare and instead focus on what's going to be sustainable and how to better deliver service to employees and to patients.

[00:11:59] It's [00:12:00] not a health insurance company, not a hospital, not a pharma company for, into the article, but a company to bring technology tools. There to make healthcare more transparent, affordable, and simple. So their initial focus, even though they're an early planning is on technology solutions. I thought it was interesting in the article that they say very clearly, they don't pretend to understand all the complexities or have all the answers.

[00:12:26] But they're going to try to tackle this and clearly [00:12:30] it Amazon's focus. The potential is there to create. A more consumer focused model for healthcare. So I think it's going to be interesting to see what evolves and on this one in the next couple of weeks and months, as we learn more about it, I would also point out there was a interview in Becker's hospital review on the 31st with Dr. Stephen Klasko, who's the president and CEO of Jefferson health. He had very positive response overall to this [00:13:00] development and he talked about. What he saw three types of responses from his fellow executive to these kinds of changes and disruptions in the market in general. One is that the executives know they need to change.

[00:13:12] So they're going all in and we'll take some risk. Another is that they're just in denial. You know, this too shall pass all these disruptive announcements. And the third is recognizing that they have to transform, but the board that they are accountable to is [00:13:30] looking for the least. Risky way for them to transform the organization.

[00:13:33] So I thought that was kind of interesting take from a leading CEO in healthcare. And then I would also just suggest if anybody's really interested in how some of this came to be. There was a Decker's article also on the 31st, that was the history of Amazon in this whole space, kind of leading up to this.

[00:13:54] I found that kind of fascinating as I scammed all those He developed [00:14:00] mints and milestones. So, you know, it's about disruption and change. And as I said earlier CIO is certainly need to be part of it and not reacting. You know, they're all kind of heading down on the agenda and what they've got to deliver on to the, for 2018, but at the same time they need to have their heads up on what's coming and how their organization is going to play in that and embrace it.

[00:14:29] Bill Russell: [00:14:29] Yeah. [00:14:30] So I'm looking at the modern healthcare article on the same topic. Here's just a couple of quotes, Dr. Stephen Klasko. Thanks for bringing him up. He's one of my favorite either quote, machine here's here's what he, he had to say. The announcement today is a landmark event because a landmark event, that's a big deal that he's saying that in of itself, because it means that the most innovative employers do not believe that most of us see the burning platform.

[00:14:58] They're not comfortable with the only [00:15:00] thing in their and their employee's lives. That is stuck in the nineties. Being healthcare at a time when Amazon has psychology to enter the house the same day delivery, or have a totally automated grocery store. They're not content with the lame explanations around transparency, inequities, and even spending believable are sending in a believable understandable bill.

[00:15:22] I believe this is Jeff Bezos, Jamie diamond and Warren buffet. Doing there. We're mad as hell, and we're not going to take it any more speech [00:15:30] into their own hands. And he goes on to, and each one of these CEOs took a turn this morning in this article, Dr. Mark Harrison Intermountain. You know, th this is indicative of the rapidly changing healthcare landscape, landscape Warner, Thomas Oschner.

[00:15:46] I believe this announcement say it's just another indication that traditional healthcare organizations need to move faster. Dr. William Conway, CEO of Henry Ford medical group, I think many providers would welcome this. The tape form [00:16:00] is an outrageous administrative costs of healthcare in the us and the expense of all the mental services.

[00:16:05] So this isn't, you know, to, to CIO, CEO's talking and saying, Hey, this, this is something to keep an eye on. This is a big deal. This is CEOs from across the industry saying, yeah, I think we're starting to see. This as the moment that we were going to start talking about consumer-driven healthcare made the transition, it made the transition to [00:16:30] being mainstream.

[00:16:31] Something. We need to have conversations with the administration and with our physicians and even the employers in our markets and the the consumers in our markets. We need to understand what they are looking for and figure out ways. To start to to start to deliver on that promise of consumer-driven healthcare.

[00:16:54] Sue Schade: [00:16:54] Right. Right. I have absolutely agree. And I like the fact that you are posing it [00:17:00] as to what the CEO is, they're driving and it's not just two CIO talking. I've been in a number of words as a CIO in the recent years. And you know, the strategy is really very around digital health and consumer driven technologies.

[00:17:19] And for some, it's still very much baby steps, pilot projects, no clear strategy. But let's try some things. And I think that. [00:17:30] It's really gonna, it's gonna really open up that, that discussion and, and put a lot more pressure on healthcare organizations to deliver.

[00:17:38] Bill Russell: [00:17:38] Yeah. Put a lot more pressure on the CIO to be part of that conversation, which, you know, it takes us into the next segment.

[00:17:44] I'm, I'm glad you're on the show. You've written so many good things about leadership and we've had discussions about leadership. And so let's talk about the role of the CIO. How is it, how is it changing? How has it. How has it changed since you started in the [00:18:00] industry and where do you, where do you think it's going?

[00:18:03] Sue Schade: [00:18:03] So has it changed? And I've been, I've been around a while. I, you know, I think what's so critical is that the CIO has become a strategic partner and the organization is highly dependent on IT. That's good and bad. I mean, you got to keep your systems up and running and performing well and reliable 24 by seven, three 65.

[00:18:25] Right. But you should be there. And if you're not, you got to deal with that. [00:18:30] You as a CIO really needs to be at the table as a strategic partner with everybody else in that C-suite looking ahead at where healthcare is going. So that's, you know, over the years, I think that's the biggest change and that's not exactly, you know, any earth shaking kind of comment.

[00:18:47] Obviously that high dependency has a lot to do with the advanced clinical systems. That we've deployed and are supporting and that our clinicians depend upon now. There's, you know, [00:19:00] obviously, as we've been talking about for the last several minutes with these articles, a lot more focus on digital health strategies and where that needs to go.

[00:19:06] So that's some of the changes that I see. I think that You know, if you want to talk about some of the characteristics in terms of what a good they're great CIO needs to have at this point, I, you know, it would emphasize the strategic thinking, the partnership and relationship skills, and that's what the executives, it's what physicians.

[00:19:29] It's with other [00:19:30] innovators in the company. And that's actually one of the challenging things about what we were just talking about. You might have a chief innovation officer, chief digital officer, you know, all these different roles that the CIO might feel are chipping away at them, but you know, if they exist, Partner with them, work with them.

[00:19:48] You know, on behalf of the organization as I said, you've got to be part of the executive team and view yourself that way, not just the it leader. [00:20:00] And you know, as I also said, the, the, you gotta be. Really good at execution, focusing on costs, taking costs out and making sure that your processes are really tight.

[00:20:12] So that balance between solid operations and strategic thinking, which can be difficult in any given day. But that's the whole package that it takes now.

[00:20:24] Bill Russell: [00:20:24] Yeah. There's certain things that you just have to be able to do, or you don't even get a seat at the table. You have to be [00:20:30] able to. Hit your budget every year, you have to be able to deliver a high and highly efficient it operation.

[00:20:37] You have to be open to deliver uptime to your core clinical systems. You have to be a communicator. You have to be able to, you know, communicate well, what it delivers to the organization and, and, and promote your, your part of the organization. That, that part of it is, is as well known. I'm curious, you know, you're, you're from places interim CIOs and does [00:21:00] retain search I've before I started health lyrics in between the time I left St. Joseph health and started Health Lyrics I entertained going back into the CIO role and I interviewed for a couple of roles and interim roles. And I have found that the questions really end there and it really kind of surprised me that a lot of the questions from health systems were around. How good are you operationally? Can you, can, you, we've had some problems with our data [00:21:30] center. Can you keep it going? And can you keep our EHR running? Can you work with the document, but that's where the questions ended and that kind of surprised me.

[00:21:38] Are you still seeing that are our systems starting to look for a different. Type of CIO or are they starting to fill the role or they're starting to say the CIO does this and the chief digital officer does these other things or that kind of stuff?

[00:21:52] Sue Schade: [00:21:52] No, I think it varies. Let me just ask you a question back.

[00:21:55] Are you saying that you're seeing that overall or with interim placements [00:22:00] in particular?

[00:22:01] Bill Russell: [00:22:01] Well, I interviewed for two full-time and two interim. So it's, you know, it's hard to hard to really say that the interim is you're you're right. If somebody is looking for an interim, they probably are saying, just, just keep it running. We're going to find somebody who's strategic. I get that. But it was both. Yeah.

[00:22:21] Sue Schade: [00:22:21] So, you know, it's a balance. You can't see my hand gesture but it's the balance of the two. The strategic [00:22:30] thinking to take the organization to the next level from a technology perspective, I think most organizations want, they also want to know that you can ensure.

[00:22:40] The operations are smooth execution of any projects goes well on time, under budget, and that the systems are reliable and all that, all of that is solid. So that balance between operations and strategy and some organizations more than the other, if they've had some security [00:23:00] incidents majored, you know, data center.

[00:23:02] Problems downtime, you know trends that they can't figure out. They may, in that interview process, focus on those more than they really should or want to for the long haul. If they are you know, if they've got a lot of the core stuff done and they're moving into a whole next level of systems thinking they're going to be looking for you to be more strategic, but any of [00:23:30] these roles.

[00:23:31] Are not one or the other. They are a particular balance of the network. You know, what we haven't even talked about is mergers and acquisitions. That's brings a whole new dimension to the skill sets needed as well as the work that has to get done. Maybe that can be a topic on one of your future shows, but, you know, I would say about the interims that the interim situations really vary, and it depends on whether someone's.

[00:23:55] Retiring and had been there a long time and going to do a nice handoff. [00:24:00]Or if someone, you know, announces are leaving and, you know, 30 days they take another opportunity and, you know, the organization's looking to fill a gap as they search for the next person. And they want someone to pick up quickly or a situation where it's just not working out and someone's been asked to leave and they're looking for an interim to come in.

[00:24:21] Quickly kind of stabilized deal with staff morale, figure out what's been going on and trying to get things back on track. So the interims [00:24:30] are a whole different kind of ball game. And, you know, we had Starbridge advisors work with all those scenarios and just figure out what are the needs and how best to manage them.

[00:24:39] Bill Russell: [00:24:39] Yup. Well, you know, the other thing it's. from a skill standpoint. I know a lot of CIOs are sort of overwhelmed. They're like, you know, should I be a, an EHR expert, a clinical transformation expert? Should I be a, a cloud expert? Should I be a data analytics, data science expert? Should I, should I know blockchain and IOT and all those things.

[00:25:00] [00:25:00] And you know, I think we, what we have learned, you know, given our, our let's just say, length of tenure in. In, in doing this is that the key thing is leadership. It's not, it's not being an expert on all those things. It's leading people and being able to bring in the right resources at the right time.

[00:25:22] But also being able to identify is now the right time to be talking to somebody about data science is now the right time to be talking to somebody about blockchain [00:25:30] or is now the right time to be doing pilots. So our, our job is really as leader to know when to pull the right levers and didn't know when to elevate certain conversations, right?

[00:25:39] Not necessarily to be the go-to person for everything. The job, the job is too big, too.

[00:25:48] Sue Schade: [00:25:48] Yeah. You, you can't be, he can't be. Yeah, I think you've said it really well in terms of knowing when when to raise it, which of those topics and pull those levers and make sure that you can find and [00:26:00] bring in the, my talent and expertise who do know all of those specialized areas and the emerging ones.

[00:26:08] Bill Russell: [00:26:08] Well, it's that time in the show where we start to wrap it up and we each would like to, well, Every every week with our co-hosts, we, we each select a social media post that we want to highlight that we want to talk about. Sometimes it's funny. Sometimes it's serious. The I'll start this week. My post is from a friend of [00:26:30] mine, Ken veneer.

[00:26:30] Who's the CIO over at space X. This is a great example of creative communication recruiting with vision. So he posted on LinkedIn. The he has a picture of a spacecraft out in outer space with, you know, a cool arm. And he goes on to say no VBA, or CQL want to help colonize Mars, leverage these skills to make a difference at space X.

[00:26:56] And I think when you can, when you can recruit to the vision of the [00:27:00] organization like that, I, I have no doubt that Ken is going to be able to attract some people. So hold on you. So surprise me. What, what have you got?

[00:27:10] Sue Schade: [00:27:10] I know I sent you three and you said surprise me, which one? So I'm taking the one that I it's a video and the person who posted it is Ingrid Owen.

[00:27:21] She's the consultant training manager at St. Luke's university health network. And it is a video of the command center week, [00:27:30] two of their big go live. And it was called, bring your kids night. And what she says here is with parents working long hours in the command center week, two of go live, bring your kids night was a welcome diversion and it's it's sh you know, 12 second video of the command center.

[00:27:50] And they, they pan over to this area where there are kids playing and adults with them. And it just really struck me as that's a [00:28:00] family, family friendly company, and we all know how hard. It folks and our users work, especially during that intense go live period and what people have to give up and family-wise and commit to during those times.

[00:28:18] So, yeah. I thought this was a, a good one. A great idea. It's had over 3,700 views. A lot of the comments are a great idea. I hope my organization can do this. So I'll leave [00:28:30] you with that one.

[00:28:31] Bill Russell: [00:28:31] I love that. I love that one chapters and dine is one of my favorite. CEO's definitely a visionary and definitely has a great culture that he's developed with his employees.

[00:28:41] Well, that's a that's all for now. You can follow sushi at SG shade. On Twitter and me at the patient's CIO. And don't forget to follow the show also on Please come back every Friday [00:29:00] for more news commentary from industry influencers.


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