Today and I'll have it. We're going to talk about management malpractice, especially with regard to hiring and firing of it. Staff. My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health. A set of channels and events dedicated to transform healthcare.

One connection at a time. We want to thank our show sponsors who are investing in developing the next generation of health leaders. Short test artist site, enterprise health parlance, certified health notable ad service. Now check them out at this week. Dot com slash today. One last thing, share this podcast with a friend or colleague, you said it's a foundation for daily or weekly discussions on the topics that are relevant to you and the industry. Agree disagree.

You use it as a foundation for a discussion. Great way to mentor the next generation. They can subscribe wherever you listen to podcasts. All right, I'm going to play an excerpt from our new stay show. Here's what happened? Our new state show went out and one of our listeners, a will leader was listening to it and he took exception to the term. Uh, commoditization.

I think it was commoditization of staff of it staff. And I want to put it into contacts and then I want to talk about it because, and I want to go into a little bit more detail. I find that, uh, You know that social media back and forth don't really capture. The, uh, the entire essence of a discussion.

And I want to, I want to be real clear on this one. So let me give you an excerpt from yesterday. Here you go.

📍 All right, news. Health systems, there's an article on Becker's why health systems are laying off IT workers. And this is common. I've been on phone calls this week with CIOs and one of the CIOs, a pretty significant health system, was talking about the cost reductions that he's being asked for at previous 229 events.

Some health system leaders, CIOs specifically, were talking about some of the cuts they've being asked to make. This is a direct result of the economic pressures that exist within healthcare. So anytime I read a story like this, I think two things. One is, are we telling the story correctly? Are we framing it up correctly? The things that IT does for the organization. If we're not framing it up correctly, people don't know.

Therefore, them making these cuts without considering the strategic nature of health IT is perfectly acceptable and perfectly understood. On the flip side, the other thing I would say is, Sometimes, think if I walked into a significant number of health IT organizations today, I would not see the strategic nature of IT.

I would see the operational and tactical nature of IT, not really a strong participation with the things that lead to a stronger organization. That is very strong connection with the clinical staff, very strong connection with the with the business model and understanding where revenue comes from and supporting those things.

That's all part of the strategic nature of the role of the CIO is telling the story and making sure that you are very connected to the things that drive a successful organization, both from an outcomes and a profit standpoint. When you read this article, what are some of the things that pop out at you?

One of the first things I think of is, if you think of something as a commodity, then your first instinct, you want to drive the price down.

Okay. So there's a majority of the clip. The article talks a lot about the different ways that people are cutting staff. A bunch of them are just complete outsources, right? So they are. Taking a desk side support call centers. Whatever it happens to be, and they are going to a third party. They are. Uh, contracting with those third parties

and rebadging those staff over to those entities. Uh, we can argue whether that's a good move or not, but I think we need more context to determine whether that's a good move or not. , here's what I'd like to do as I think about this, to try to lay this out. This is a, this is a challenging topic.

Clearly we don't think. That it staff are commodities. But I also don't want to communicate that there isn't pressure to commoditize some of the it roles. And , I want to go into that a little bit. And the different roles. So I want to talk about the administration. I want to talk about the CIO, then I want to talk about the staff real quick.

So from an administration standpoint, Actually let's start with the CIO. The CIO, his role is to tell the story. It is the best supporting actor in healthcare period. They, they show up. If you were to take a movie of care being delivered, there would always be technology involved, even if it's the patient at home. , there's that technology is at the center of the delivery of care. Period.

End of discussion. The patient experience is dictated by how well the it team has handled. The data has handled. The integration has created. The, , interfaces for them to interact with the medical record and what their doctor in a seamless way. These are all the things. This is the story that the CIO has to tell. , we actually had, there was a couple of times I've told this before we, we actually hired a video crew and we created videos that we could share with the organization because. The natural feeling over time is it spends too much money and we don't get enough return. You have to tell the story.

If you don't tell the story. That is going to be the natural gravitational pool of the organization towards, you know, what is our money going towards? And they will compare you to other health systems. They will compare you to things that don't even exist. Oh, look, I read this. This thing about generative AI in this article, and it can do this.

And the reality is it can't like we're not there yet. But they read that article. They're comparing you against a ghost. And, , it's important for you as a CIO to get in front of that. So is that management malpractice a little bit? , I think the CIO, one of the key roles of the CIO is to tell that story. And I can always tell if the CIO is doing a good job, telling that story based on how they do in the budget discussions. Do they get enough money to run it? And the good ones.

Tell the story well and get funded. Get the organization funded at a level that allows them not only to sustain operations, but also to move them forward. Um, so from that perspective, You know, Management malpractice is too strong of a term for me, but I think there's a skillset that CIO's need to have in order to be successful. Let's talk about the administration. I find the administration too often is taking short-term thinking. Now, again with these outsource arrangements, there are cases where a selective outsourcing makes sense.

And we talk about security all the time and say, if you can't get the security staff, then you have to go somewhere else to get it. And a lot of people outsource to a knock. Or SOC I'm sorry. And they outsourced to, different entities, CrowdStrike and others. That will, uh, well, keep an eye on their environment for them and keep them updated and those kinds of things.

So a selective outsourcing around, uh, constraint skills makes perfect sense to me. But when you are taking things and this, I went through this in the show yesterday. When you're taking things like your desktop support and you're outsourcing it. I think that's a recipe for disaster. Like at the point where you touch the client. And in that case, it's the clinicians and whatnot.

You are giving that to somebody else. , that's a dangerous. , place to be and yes, it feels good. It may feel good, upfront because you're like, oh, that's something off my plate and whatever. It's never off your plate. Like you still have to manage that third party. And I would, I would put out there that managing that third party to deliver at the level that you need them to deliver is in most cases harder. Then managing your own staff, it's better to get your own house in order and not outsource it in that way. Then it is , , to outsource it. And by the way, I think it's a short-term financial gain and a longterm. , not a financial game.

So I think if you're looking at it in the five-year horizon, you, , you essentially, in those kinds of outsourcing arrangements, you do well in year one and two, you do poorly in three, four and five, and then you reinforce in here six. , my gosh, we go through this cycle, , way, way too much. , let me talk about the staff's responsibility.

I don't think the staff gets out of this unscathed. Right. Much the way I talk to CIO's is that they have to have one foot firmly planted in the present. And one foot firmly planted a couple of years down the road to look at what's coming next. I believe that the staff has to do the same thing. Right. And so when you look at your role, And you think of automation and the automation that is coming down the pike. And you start to look at it and go. Wow.

My job just got a lot easier. You know, this is now being done by automation. This is now be done by automation. This is now being done by automation. The response to that is not to get comfortable. Their response to that is to say, What new skills am I going to pick up that AI machine learning? , large language models, automation can't do. And I talk a lot of times about the, the value that a person can add is in that interpersonal dynamic. Right.

It's launching a project. It is, , gathering. The momentum around communication. It is empathy. It there's a whole bunch of things that a human can do. That a computer cannot. And I think , there's an opportunity for those who see their job slowly, but surely being , automated to get ahead of the curve.

Now I will say this. Though there are a group of people that choose to say. You know what? I'm not going to get retrained. I'm not going to learn new technology. I'm not going to learn new skills. And good for them. I mean, quite frankly, I had a guy on staff, did some cobalt programming. We had very little cobalt stuff around, but we needed one.

Right. We needed a person. Well, we finally got rid of all that stuff. And that person is. You know, we sat down with them and said, Hey, we don't have any more COBOL. Do you want to learn something else? And his response was. Nah, not really. I'll just go find another company that has a couple of COBOL applications sitting around. And I'll work with them.

And then I will do that for a couple of years until I retire. And I believe he did do that. And , that's a path and people could choose that path. But as the CIO and the staff, I think it's incumbent upon us to have one foot here, one foot, three years down the road and looking at what roles aren't going to change dramatically.

And as a leader, , it is coaching , their supervisors. It's potentially having those conversations directly. To say, Hey, this is what I see happening with your role. What do you see happening with your role? What do you see happening with the technology in your space? And I don't know, maybe I'm, , I I'm pushing the, the staff a little hard, but I expect, , the person who knows VMware to know more about VMware than I know. And I expect the person to understand virtualization.

I expect the person to understands architecture, expect the person to understand security, to understand it at a deeper level than I do in most cases. And so I want to ask them, Hey, where do you see this going? And what does that mean for you in your career and how can I help you? To ensure that you have relevance three years from now. And it's, it's not meant to be a conversation.

That's communicating a lack of value. They have value. They have value today. They had value five years from now. They had value two years from now, and they will have value three years from now, but it may not be doing what they are doing today. And from that perspective, I think, , the thing that we'll was, , concerned about is when we talked about the commoditization of it, staff, Which I think some of the roles that's going to happen. And I think it's incumbent upon the leaders to help people to navigate that as they move forward. Thanks for putting up with this voice.

I've been sick all day. Just trying to get one done. Today for a Tuesday morning. So you guys can listen to it. Hey, if you have feedback, just shoot me now, bill it this week, health.com. I am open to a discussion. , you can also. , hit us up on social media as well, and we can keep the discussion going there.

I just find sometimes when you have a longer thing to say, it's better to just. Record it. So there you go. That's all for today. Don't forget. Share this podcast with a friend or colleague. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders.

Short test artist, site, enterprise health parlance, certified health, notable and 📍 service. Now check them out at this week. Health. Dot com slash today. Thanks for listening. That's all for now.