Visit this week health.com/google-chrome O S to learn more. All right. Hey, it's been a little while since I've done this show, we are putting together some really fun stuff. For you for 20, 25. And so in the fall I've been spending a lot of time doing that. And Sarah and the team have been doing a great job around this.

Oh. And Kate, Sarah and Kate have been doing this together. It's been fantastic. Appreciate them doing it. And they are going to continue to do it. I am just stepping in for the start of the year. Because that's what I like doing. I like to get a little get a little time to talk about some of the things I did to prepare for the coming year and some of the things that I'm seeing. And so I wanted to start with seeing into the future. So one of the things that I find is that there are what people call visionary leaders. Visionary leaders are interesting because the word vision is literally to see and to see into the future is not some sort of mystical skill. It is people that are able to look at trends over time.

They are. Able to look at current events and things that are happening and they're able to extrapolate things. As they look out at the future. And so one of the things I used to do as a leader, Is I would segment my week segment my month and my year. And in these terms, I would spend about 40% of my time on the present.

You have to be present, you have to be present in meetings. You have to be present with people. You have to be present in your life in order for people to realize that you are listening to them and whatnot. So that's a very important skill to be present. I find that's almost overemphasized these days.

So you have to be present absolutely critical skill, but sometimes it's overemphasized. I find that I would spend a significant portion of my time thinking about the next 90 days, 90. To let's say 120 days. And what I would be looking at is things that were coming up in the near future deadlines that are coming up in the near future. That I would have to stay in front of.

And as a CIO, there are countless of these projects. That are going to be coming due in the next 90 to 120 days. That if you're thinking about them today, if you're looking at them today, you can actually do something. To transform those things. You can actually do something today that will have an impact on them, either getting done on time and within budget, or maybe not getting on time within budget.

And it depends on how long those projects are, but. You don't want to find out on the day that you're expecting that project to be done or that thing to be done, that you could have done something 90 to 120 days. I guess I spend a lot of my time thinking about what do we need to make sure happens in the next 90 to 120 days.

And then I spent about 20% of my time thinking about the future. Now, when I think about the future, it's not a. I'm trying to look into a crystal ball, come up with my 10 predictions for 20, 25. And that kind of stuff. What I'm trying to do is to think about what things people have brought up to me. What kind of discussions that they, that I've had in the past year, what kind of things seem to be recurring?

And I remember. Last year around this time, Chacha CPT was everywhere. So everybody was talking about it. My parents were talking about it. At that point, it doesn't take a rocket science scientist to realize, Hey, this has entered the consciousness of the world and we're going to see a lot of conversations around this. And so as a CIO, I might've had that conversation and said, okay, I need to be in front of this.

I need to have a canned response to how is chat GPT going to be utilized in healthcare? How are large language models? Depends who you're talking to, whether they're just going to say how's chats or PTE going to be utilized, or how are large language models going to be utilized? Or somebody with even a deeper understanding, you might say, how are AI models going to be utilized?

How has a Gentek AI going to be utilized? How is a vision, computer vision going to be utilized? So they might be talking about very specific models and depending on how the question's asked, that's how I would respond to that person at that level. But I can't respond to that person in the moment. It would be a mistake to respond to the moment.

I would want to have seen this trend coming and be thinking out a year, two years, three years out. On these things. So I would have a good response. To those things. This is how you are prepared at all times. And I've come across leaders who are phenomenal at this, by the way. There's so many of them.

I remember rod Hochman once he and I were having a conversation. He's the CEO. Of Providence. And I said you have a story prepared for every question. It feels like I've been in like three meetings and you answer that question exactly the same. And he said bill there's. There's now 90,000 people who work at Providence. And I have to make sure that I have those answers prepared and I answered the same way because I need to make sure that I've communicated at the same in Washington state, as I do in Southern California, as I do an in Alaska and Texas. Yeah.

So it's the importance of consistency of communication around those things? I think Aaron MIRI actually also is one of the, one of the masters at this. Whenever you asked it. Give it a try. If you see Aaron at the next meeting, ask him a question about some technology aspect. He'll say that really brings up three points.

1, 2, 3. He didn't come up that off the top of his head. He has those answers. He has prepared those answers. He's probably one of the better. CEO's at that skill. But I digress go back to spending spending time in the future, thinking about things. Just I, what I like to do is get in front of a post-it pad.

It's just an empty post-it pad or a whiteboard. And start to think about, write down the things that the trends that I hear, people talking about, the things I see happening, and just write those down. What are the concerns, those kinds of things, and then start to. I think about other trends that are going on, how those things are going to converge and what's going to happen. It's interesting to me. When I talked to CEO's and they say, oh my gosh, a I was just asked to do a cost reduction and it's this significant cost reduction.

And I've no idea how we're going to be able to do that cost reduction. I don't understand that response, to be honest with you. And I'm kind to them in that moment, but good CIO spend time thinking about the future. They spend time in the future so that when that question gets asked in the future, They are ready for it. And last year after the election, people are like, oh, this is, this means bad things for health care, or it means good things for healthcare, whatever you happen to believe from a political standpoint. And they said what do you think this means bill?

And I said here's what I think this means. And let me rephrase it back to you as a question. Do you believe? Regardless of which candidate. I was elected that the reimbursements for healthcare were going to go up or down. And I said probably down. I said, I agree with you.

I believe they were going to go down, regardless of who was going to get elected, you could say that dos was going to make cuts in this way, and it's going to impact Medicare and whatnot. Regardless, the cost of healthcare keeps rising. They're going to, they're going to try to address that cost. It was going to go down. All right.

I can manage things through attrition and I can. Identify projects that are going to create efficiencies across the board, that I'm potentially not going to have to do those physical reductions of staff. So that's the advantage of spending time in the future. When you spend time in the future, when you finally get there, you've already been there.

It's almost like a time travel device to be able to have that kind of thinking to, to get out there ahead. So let me give you a couple of things I'm thinking about, and I'll close this out real quick. Again, these are short shows, so you just get a taste of this.

Let's start with large language models. Been talking to a fair number of people who are using large language models in their systems. And as I look at this. It's we are starting to see the term, a agentic AI pop-up. Agentic. AI is essentially. Large language models that can do inference.

They can make deductions and then they can act on those deductions. They can actually do things. They can schedule an appointment. They can change an appointment. They can do those kinds of things. Agentic. AI is a real thing and it is going to be a real thing. That AI is going to be able to too. Again, make an inference. And then it's going to be able to act on those things. Now we can all sit back and say, oh my gosh, that's scary.

What about human in the loop, human in the middle and all that other, all those other kinds of things. And I do believe those things are very important. And I think there's ways to keep humans in the loop in this process. But with that being said, agentic, AI creates a significant opportunity for. Just about any process you can think of within healthcare. That you can have it make an inference and actually act on that.

Again, this is not rocket science. You could have done the same thing. The question is, will you act on it? Now that you've spent time in the future, thinking about what this might look like. How do you act on that today? I tell you one of the ways that I buy the same things happening in my business. And so I'm looking at it going okay. These tools are there.

They're available. What am I going to do next? And I've been thinking about hiring a technology person for our organization for quite some time. Now, this sort of informs the type of person I'm looking for. I want somebody now who is comfortable with and understands the large language models. I want somebody who's. Comfortable with it. With automation at a very deep level, comfortable with automating business processes, comfortable with potentially training models. Okay.

So I'm looking for different skills because of what I'm looking for in the future. I'm not hiring for what I need today, hiring for what you need today is a recipe for disaster. It's you're hiring for what you need today, and you're not going to need that tomorrow. And then you're going to have to do a reduction or you're going to have to re-skill minus wall higher for what you need in the future.

But in order to do that, You have to spend time in the future. And I find that the people that set aside mine time, Literal time to think about the future. And to start to extrapolate, what's going to happen in the future. Think about computer vision. Think about ambient intelligence. Think about the future of the EHR, one of the things we're seeing more and more. With AI is it's just coming into our health system. Through all of our major platform systems. And it used to be that we were going to have to figure out AI and. And it's not feeling like we're going to need to figure out AI, it's going to just show up in our EHR.

It's going to show it doesn't matter which EHR you have. They're all talking about it. Epic stock and manage a Cerner. Oracle's talking about it. Meditech's doing it. They're all doing it. They're all building that into the model. So if that's being built into the model, it's more of a configuration thing that is that is starting to happen within those systems.

And so we're seeing pervasive AI. Now the good news on that is we don't necessarily have to find people that know how to. Train these models. However, I will say there will be a significant advantage for people who have some organizations that have people on their staff who really understand these. These models at a deeper level. And there used to be a time where our real technical person, new Cisco switches, and they were CCIE certified in CCNP and they understand how routing tables worked and all that other stuff.

And all those things are important, but more and more, I think that stuff is going to go the way of AI. You're going to have software defined software, configurable systems. I think those are going to be the future. And I think what's going to happen around those systems is they're going to be self configuring.

They're going to be adaptable. When they see a cyber attack happened, they're going to be able to essentially on the fly, be able to to resegment your network and to segment off the parts that are. Causing a problem, there'll be able to see that through the traffic resegment, stop that attack from happening.

I think that's the future. And I think we're going to have to move at that speed and think at that speed. And the reason I can talk with such clarity around that is I've been reading a lot of articles and I've been spending time in the future in front of a white pad and then validating those things with conversations with people.

So I find that really strong leaders see into the future and they do that by spending about 20% of their time in front of a white pad, say. What does the future look like? And that's not only with the technology aspect, it's the people aspect. What I just spent a bunch of time writing. What the future roles are for everyone in our company.

Now, our company is only 15 people, a large, so it wasn't a huge process for me. But just thinking about what the future holds, given the technology advancements, given the the community that we're building and the things that we're doing, what does the future look like for that person? When we were able to put that in front of them?

Anyway, That's that's me not talking about the news, just talking about what my experience was as a CIO, how I spent my time, how I was able to really prepare for the coming year. And hopefully that helps in some way. Don't worry, Sarah and Kate will be back talking about the news and no time, but I think you have me for the first week and a half of January.

Because I haven't gotten a chance to talk in a while. I over-talked by about six minutes. So I look forward to catching up with you this year. Hey, we want to thank chromo S who's investing in our mission to develop the next generation of health. It leaders. 📍 And you can check them out this week.

health.com/today. Thanks for listening. That's all for now.