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January 15, 2021: What does a hybrid CIO-CDO role entail? Digital definitions can sometimes elude us. Tom Barnett of Baptist Memorial defines it as meeting the patient where they're at and allowing them to digitally engage for their care in the easiest fashion possible. From the CIO perspective, it’s keeping the core systems, roadmap and strategic direction of the healthcare system in place. How can a leader effectively engage with their remote workforce? How can we further reduce the amount of burden on medical staff? How do we reduce touch points during the pandemic whilst still maintaining a high level of care? And are healthcare system’s just responding to COVID? Or are they able to field other projects?

Key Points:

  • What kinds of digital projects have come to the forefront during a pandemic? [00:07:30
  • The rise of inpatient telehealth [00:12:13
  • As we recategorize rooms, in order to adjust to the changing patient volumes, the Epic team needs to be able to jump in and reconfigure them to make sure operations are in real-time. [00:16:00
  • Learn how to manage a drive-through COVID testing site using tricks from the fast food industry [00:13:25
  • It’s important to focus on optimization areas for physicians [00:16:50

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 Thanks for joining us on this week in Health IT Influence. My name is Bill Russell, former Healthcare CIO for 16 hospital system and creator of this week in Health. IT a channel dedicated to keeping health IT staff current and engaged. Today we have Tom Barnett, the CIO and CDO for Baptist Memorial Healthcare.

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A quick note. We launched a new podcast today in Health it. You're not gonna find it on this week in health IT podcast feed. It's a new channel. It's its own show. We look at one story every weekday morning, check it out. We, you know, it's roughly about six to eight minutes long. It's a easy way to, you know, stay current on what's going on in the health IT space.

Subscribe wherever you listen to podcast, or you can hit our website this week, Hit the subscribe button and it'll show you how to find the podcast. If you're new to this show or returning after a while, we now do three shows on this channel. On this week in health it on Monday, we cover the news, and I do that now with a round robin group of about six to eight people.

So it's a back and forth on the news and what's going on. On Wednesday, we have an influence or a solution showcased episode, and every Friday we're gonna do an Influence episode just like this one. Be sure to check back for more great content and now onto today's show. Today we have Tom Barnett, the CIO and CDO for Baptist Memorial Healthcare out of Memphis with us.

Good morning, Tom, and welcome to the show. Morning Bill. Glad to be here. Yeah, I'm looking forward to this conversation. So before we get started, this is the second time you've been on the show, but you're now with a, with a new organization. So talk to us a little bit about the move. How, how do you like Memphis so far?

Oh, I love Memphis. I love the weather, especially. Especially this time of year, so yeah. And you came from upstate New York, right? Absolutely. Great area, great folks. But it also has 104 inches, roughly average snowfall for years. . Oh man. So when did you make the move? How I long have you been down there? I've been down here since the last week of May.

Uh, do, do you have a favorite restaurant yet? This, one of the things Memphis is known for is restaurants. Oh, it's for me, it's barbecue. I've been working my way through the, uh, through the barbecue restaurants here, . I love it. No, that's fantastic. So, so we're gonna talk a lot about the digital side. We'll, we'll talk a little bit about Covid and what's going on because, because you, as we were talking earlier, you experienced Covid in New York, having made the transition in May, and then you experienced a couple peaks in Memphis when you got down there.

So you, you seem to be. Hitting the peaks in these various locations. So we'll touch on that a little bit, but before we get there, tell us a little bit about Baptist Memorial. Sure. Well, Baptist Memorial is a, uh, Baptist Memorial Healthcare Corporation is a 22 hospital health system based out of Memphis, Tennessee.

So, but their markets are pretty much Western Tennessee. Northern. Yeah, basically mid to northern Mississippi as well as northeast Arkansas. I've got about a 4,000 member physician network and associated ambulatory clinic network as well. Wow, so, so you are so MI Mississippi, you are hitting some places that have some escalated levels of covid even right now, I would assume.

Uh, yes. We're seeing our second spike that we're kind of going through right now, which has actually eclipsed the Covid spike that the first one that they had, which really peaked kind of in the late June timeframe. Wow. All right. Well, here's what I'd like to do with you. You have one of those interesting roles and I wanna sort of talk about that.

So the C-I-O-C-D-O role, what does that entail? What is the combination of those two things at your health system? They're actually very related. So from the CIO perspective, obviously keeping the core systems and roadmap for the health system and their strategic direction for the future in place, but digital in order to now begin that and, and digital means.

You could probably ask five different health systems, you might get six different descriptions. , from our perspective, it's primarily from the patient engagement perspective, so making sure that encompasses everything, such as, I know a lot of terms different organizations use include, um, digital front door, but it, it, it all of those patient engagement technologies and how health systems interact with their patients as well as providing that care.

Digitally, but it also has a, a secondary focus as well, which I think has come to the fore as part of the, uh, the pandemic this year. And that's digitally engaging our workforce as well for new ways that they're working. So I think it encompasses both hats of them. Yeah, it is interesting you talk about that digital definition is something that, that alludes us, but it is at that intersection of how people interact with our health system, either the, the care, the caregivers, the care providers.

Or the patients and enabling that with all sorts of technologies where they can do visits, they can send, they can pay bills, they can uh, do inquiries. All the things that they used to do, you know, face-to-face in person, send a mail, send an email, now are becoming tools that, that are tightly integrated into the operation.

And it's interesting to watch. 'cause you, you're right, it is very. It, it's very different. The reason I, I point that out is that the C-I-O-C-D-O role is, is still interesting in the, in the IT world. There's some organizations that are going with both. There's some organizations that are going with combined and there's some organizations that just call it ACIO, but they also have taken on the, really the digital.

Digital roles, so that's why I highlight that. Did, does your digital group have sort of a, an OB objective statement or a mission statement around the digital initiatives? In a sense, we have an informal one. We're working through what those digital roadmaps look like. As I'm getting into this role, it kind of defining what this space means for us.

Overall, I would say it's meeting the patient where they're at and allowing them to digitally engage with us for their care in the easiest manner fashion, the easiest fashion possible. So do you have a, do you have a team, do you have a, like a, I mean, clearly you have a, CIO has a lot of teams around, around the operations and informatics and, and those kinds of things.

But do you have a, a team that's dedicated to, to digital, uh, by itself? We're in the process of building that team out. So a lot of those skills and those, um, disciplines are, are within the existing IT team that we have today. So we're very much around assembling teams around initiatives to be able to move forward on different aspects that we need to work with as we need to build out additional.

Skillsets internally, we'll look to figure out how we come up with a more dedicated team, uh, for the areas that need it. So, so let's just talk, uh, generically and maybe even across your previous health system in this one. What kind of projects have come to the fore during a pandemic? What kind of, uh, things are we doing to reduce the touch points and those kinds of things?

I think it's, uh, reducing the touch points and it's a lot to your earlier statement about things that, that patients did with us in person previously that did not wanna do, uh, digitally. And the pandemic really became a catalyst for that. So from our perspective, it's definitely working through, and I think this.

As the pandemic began its onset earlier this spring, video visits, which may have been a curious technology before or, or telehealth suddenly took a spike and uh, it suddenly became a very fast growing, uh, area. So you were either ready for it or you weren't. And I think that's consistent with both health systems that I've done with this year.

They were both poised to be able to take advantage of that, to be able to help those patients who necessarily maybe did not wanna come into a, a healthcare setting for risk, uh, aversion reasons. But now we're able to engage with that physician digitally, uh, through video visits. What, what areas? So we saw the spike in, in terms of telehealth.

I mean, the numbers were just staggering and, and, and amazing, but we also saw it, it come back down. Are there areas where telehealth is really taking hold? And you, you see that it, it's it, the future is really clear and other areas where you're like, okay, we may have some work to do here. We still have to figure some things out.

I think it's gonna depend on, on the individual use cases, so obviously that themselves to a.

Certain sub medical specialties possibly, but that becomes a big convenience factor, not only for the the provider, but for the patients specifically in order to be able to quickly get that, that, uh, diagnosis or, or that follow-up that they're looking for in terms of ongoing patient monitoring and and, and so forth as well.

I think as you look toward keeping those touch points lighter in this post pandemic world that we're in. Any of those types of transactions that can be made frictionless or a quick speed, if you will, from that interaction definitely lends itself to digital. And we're looking at those as we look at our use cases to figure out which ones are the best candidates to become, uh, digitized.

So has Baptist Memorial gotten rid of all clipboards and pens? Are, are we, are we at, at that point yet? Well, I think we have 15 that are there, are left here, but we share them. , the, uh, no, the reason I ask that question, so CVS just announced they're taking PayPal, they're taking Venmo, they're taking all those things and part of that is the retail nature of their business.

They're trying to reduce touchpoints, right? So even, you know, touching that pen or using the card, uh, the credit card. They're finding that people are more amenable to solutions that they're educated now. Right? So they know how germs move, not at the level that a doctor would understand the difference between a virus and other types and how things move.

But, but they, they're more educated on hygiene and cleanliness, and they're more willing to touch their phone than they are. The things that people are handed to them are, are, have you seen like a higher demand for those types of projects or is that one of those, if you didn't have it before covid, you, there's hasn't really been enough time to put anything in place.

I think that level of distancing and, uh, and doing a lot of those forums online prior to getting to the office visit, in your example, uh, anywhere that we can minimize those types of physical touch points. We're already in place, and I think they've been refined since Covid has, has, uh, taken root. So we're looking at where can we optimize those?

Where can we reduce those, uh, touch points wherever possible? And, and even, but it's always a, a combination, right? Of not only digital technologies, but it's, it's people, process and, and tools. So making sure that. That the social distancing is in place, how we're scheduling those clinics to make sure that we avoid a lot of folks being in the same waiting room at the same time.

Anytime you can push that, and that can be a couple of different things. That can be alerts, going to a phone to let patients, uh, who are waiting in their car and know when that they can come in, uh, for their, for that appointment. I think we're looking at all of those different strategies as things to, to make life easier.

Doing a with. Uh, for lack of a better term, inpatient telehealth between the clinician and the, and the patient, but also the physician to physician communication. Are you using telehealth, uh, in your inpatient settings? Absolutely. So I think with, with consults happening across, uh, state lines and so forth, again, particularly within this post covid world that we're those through video.


Even small things like, uh, in order to help reduce the level of, uh, PPE equipment that we're going through as a health system in some cases, particularly in higher touch, uh, ICU settings, uh, we're putting, you know, uh, tablets out there so that patients can engage with nurses directly through these kind of digital communication channels.

All that allows, uh, constant monitoring, real-time interaction with the patient, but it can also be, uh, sensitive to some of the environments and, and circumstances that we're, uh, in as well. Another area that, that we're looking at that was actually optimized and it was processed, but some technology as well.

We have a drive-through covid testing lane, uh, in our main Baptist, uh, Memphis Hospital. And, uh, it, it gets a fair amount of activities you can imagine. So figuring out ways that we can almost emulate, if you will, certain fast food restaurants, uh, in, in terms of how they manage lines. So working with our inhouse process improvement team.

Allowed us to extend wifi coverage across a larger parking lot area and then deploy tablets to allow staff to be able to register and check in patients who are waiting on their cars and in these testing lanes, but all focused on increasing throughput and increasing the uh, or decreasing the amount of time it takes for folks.

Those are aspects of where we're utilizing. Process improvements combined with technology too, to really drive some results. Yeah. So you've been there since May. I don't think there's been a normal day since you've been there, but I'm, I'm gonna press in some of these questions might be unfair, but I'm gonna press in anyway.

Uh, what's, so from a data perspective, from a real-time analytics dashboard, those kind of things, what kind of projects have you been fielding since you've been there? Mostly they've been around responding to our covid situation that, that we have not, again, not unlike a lot of health systems right now, but real time dashboards in terms of bed utilization, levels of care, acuity levels that we used.

Are, are, are these things you already had or were there things you had to develop? I think these were things that were already in place. So again, from Baptist perspective, there's a lot of fantastic tools that come out from the Epic platform. And Baptist was the first site. So I'm, if you're familiar with the Stars rating in terms of implementing Epic functionality, Baptist Memorial was the first health system in the world that had 10 stars in 2017, and we were just recertified again this year of 2020, uh, as a 10 star site.

And as such, we have access to a lot of tools, a lot of dashboards, and a lot of enabling technologies, if you will. That can definitely be, uh, just some refinements in some cases, in terms sometimes speaking specifically to bed utilization and, and throughputs and, and acuity levels, that can definitely allow our team to make adjustments.

We're also responding, um, from a, um, surge. Level as we do readiness around us, we're all watching infection cases rise. What that means for our team, yes, we're on Epic. Yes, we have been doing that for a while here. But what it also means is that as we, uh, recategorize rooms in order to adjust to changing patient volumes, that requires the Epic team as well to be able to, uh, be able to jump in and reconfigure some of those rooms and make sure that we're working real time with operations.

Reflected both in those daily dashboards.

Uh, what the overall activity level of the health system is. Do you guys participate in the arch collaborative at all? Just outta curiosity? Yes, we do. Yes we do. So are you doing a lot of things around the physician experience and the the EHR interaction and. Absolutely. And it, um, working very close partnership with our CMIO, Dr.

Jake Lancaster, who I know is, was on the program earlier this year. We are definitely focusing on, on optimization areas within physicians. So some of the things we're looking at is kind of getting. In refining some of the standardized templates around physician documentation. We're also taking a look at other metrics that are available such as the time spent in the EMR outside of normal working hours and, and how we can set those as benchmarks to work with our in-house training team, as well as our process improvement team to focus on how we reduce the amount of burden's.

Flowing that work through for a provider in, in a, a realtime fashion, and with as many optimization points as we can input for them and keep them outta that record during, uh, downtime. Yeah, it, I'm looking at this video and you, they really haven't given you much time to like, unpack boxes or put anything up on the wall or, so you, you've been fairly busy since you got there.

Absolutely. So it's. Learning a new organization, learning a tremendous amount of talented people that I'm working with, as well as doing a lot of it, quite frankly, through this camera. So a lot of what we're doing are video visits right now. So a lot of our management staff and leaders are still on site.

While our staff is working in various modes of working remotely, depending on the team. But a lot of our meetings are all done through, actually almost exclusively through video right now. While it is very beneficial, you can get from one meeting to the next through a click very quickly. It doesn't.

I was talking to somebody, they're like, which kind of doctor makes the best CIO? And I'm like, uh, that's easy. It's an ed doc. I said, because you can't possibly do everything they put on your plate, so you're constantly prioritizing, triaging, triaging. Yeah. I mean, you're just, uh, there's some things you look at and go, that's important.

I'm gonna put that in a holding pattern because this is critical. And you just, you're making those.

It's, I've been asking s this question different. What do you thinking impact on health it is going to be as a result of the pandemic,

the lasting impacts. So I think a couple of the comments that I've heard in, in a few of the different systems.

Operations has been very impressed with how quickly it has been able to turn around solutions very quickly. Whether it's suddenly within a few days, let's move a thousand or 2000 people to work remotely and and clear out offices as a result of what we've all been dealing with or drive through covid lanes or dealing with video solutions to be able to engage with patients means it.

We've been able to focus on things because there's been a priority and an urgency put on it. I think a lot of the other work has kind of gone to the side, so the lasting impact. I think we're gonna all gonna be looking at new ways to work, embracing digital tools on a level that probably haven't been done in health IT before, just in general, because healthcare in general is always a step or two behind, maybe other industries, for example.

But I think as we all look at how well. The remote or the WebEx or the video world has worked for everybody. I think there's gonna be an opening up of how do we do this type of focused teaming and being able to rally teams around kinda what these new strategies are and being able to implement them in a lot shorter timeframes.

So whether you call that DevOps or any of the other trendy words that are out there, I think there will be a. Digitization, learning how to work remotely and focusing on all of the work and only the necessary work needed to drive a result, to bring a solution, uh, in, into fruition. I think that clarification as well as the catalyst that, that, uh, the pandemic has done is really going to leave.

Its, its imprints, uh, on our industry going forward. Yeah, I love that. And actually I lied 'cause I have another question, which, how big is your staff at this point? The IT staff? So the corporate staff we're about between 3 50, 3 75. So is that spread out or is that mostly in Memphis? Group is mostly within Memphis of, uh, supporting a lot of our enterprise IT systems.

We also have, uh, desktop support and a number of it, uh, personnel, uh, embedded in each one of our hospitals. So collectively, we're probably up in the 800 ft range. It just, the reason I wanted to go down this path, it just dawned on me, I mean, you're new in the, into the role. There's probably people that you've literally only met this way is my guess.

Absolutely. Uh, might see them in the parking lot after work and not recognize them when they're not on video. . Yes, it's literally been like that. And what, what's the most number of squares you've had on a screen as you're trying to have a meeting? Probably, I think 20. Yeah, it's,

I've heard the same thing that it's been, uh, really interesting to be able to connect people in. Very freeing for some people. Some people have long commutes, maybe not as much in Memphis, but in in other markets people have long commutes and those kind of things. They've now been given part of their life back.

A lot of 'em are are wondering like, what the future, and I'm not gonna put you on the spot, you haven't been there long enough to put you on the spot here, but. A lot of health systems are trying to figure out what the future of work is and it it'll be interesting. We've really had to adapt. So I'm gonna assume you're gonna, the next time we talk, you'll have a few more books on that show.

I think I will. And, and one of them I'm reading through right now is, is Ed Mark's new book on digital. Alright. Yeah. Well you'll have to listen to the interview as well. I, he sent me the book on a, like a Tuesday and I interviewing him Wednesday.

Yeah. I love those, those two guys, guys are doing, uh, great work and I, I love the book, so I look forward to hearing your, uh, thoughts on it when you get done. Absolutely, Tom, thanks. Thanks again for coming on the show. I appreciate it. My pleasure. What a great discussion. If you know of someone that might benefit from our channel from these kinds of discussions, please forward them a note.

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