Today in health, it solving the right problems. My name is bill Russell. I'm a former CIO for a 16 hospitals system and creator of this week health instead of channels, dedicated to keeping health it staff current. And engaged. We want to thank our show sponsor shore investing in developing the next generation of health leaders, short test and artists. I check them out at this week. health.com/today.

I have a child with cancer, one of the most painful and difficult situations a family can face in 2023 to celebrate five years of this week health, we are giving back. We are partnering with Alex's lemonade stand all year long. We have a call to raise $50,000 from our community. And right now we are up.

Really close to $40,000 for the year. We are so excited. , we would ask you to join us at our website top banner. You're going to see a logo for the lemonade. Stand, click on that to give today. We believe in the generosity of our community and we thank you in advance. All right, I'm going to talk a little lower today. Don't hear that as lack of enthusiasm.

I, , Did not record this on Thursday night and I'm recording it Friday morning and there's people sleeping in the house. So I'm going to use a little softer voice. To get this out here. You know, I'm amazed at how many times I hear people solving the wrong problem, identifying and solving the right problem is one of the key distinctions of a great leader.

Maybe not a great leader. I'll say it in a way that may sound like it's softer, but it is actually more direct identifying and solving the right problem. Is one of the key distinctions of a leader, any leader? Okay. And , you know, I have conversations all the time. I have conversations at my 2 29 projects events.

Conversations , with, , leaders throughout the week, CEOs and others. I do interviews. I have conversations with startup founders and I have several of those every week as well. And I find myself going back to . This, , I don't know. Th this formula, this recipe over and over again. So I'm going to tell you a couple of stories.

, You know, the, the, the number of times I've been. Asked. For more staff to solve a problem is amazing. Think about the request. I'd like the most expensive resource a health system can commit to, to solve a problem. Almost always my research is what's the problem you're trying to solve. There's too much work for the team, you know?

We can't get it all done. Okay. How about we solve that problem. And invariably what I'll get back from them is. What do you mean? What do you mean solve that? I am trying to solve that problem. Give me more staff. How about we dissect that problem and identify the source of the amount of work and see if perhaps we have some issue that has crept into our process that requires more hours of work than we have available. Is there a governance problem? Is there a training issue? Are we not using the right tools? Are there new tools that will help the entire team be more efficient?

See what? I mean? , lazy leaderships stops without identifying the right problem and dissecting the right problem.

I remember one such case where I asked. A VP that report into me, why we couldn't accelerate the number of physician practices that we were connecting to. As you know, from time to time you bring on new physician practices and there's an integration. , challenge that goes along with that and whatnot.

The backlog that we had divided by the pace at which we were bringing the practices online was going to take over three years. And hopefully as a leader, you're hearing that and you're. You were as surprised as I was like, wow, three years to bring these position practices on. So from the point a physician.

Practice might say, Hey, we want to join St. Joseph health. We were saying, okay, we'll get to you in three years. Imagine that response. I, I heard that and I thought , that that's not tenable. We cannot do that. , he said we needed more teams to complete the work. I thought he was probably right at this point, since the backlog had gotten so long, but I still wanted to understand.

How the backlog had gotten so long. And I asked him to take me through the processes as if I knew nothing of healthcare. And I was just going to ask a bunch of questions and I warned him that I might sound like an eight year old. And, , you know, the eight year old, the one who just keeps asking why. Right.

, and he keeps asking why over and over again. And, , in management terms, this is the McKinsey five why's. Ask why five times and you get to root of a problem. I started with, , when did the backlog start? It was a few years ago. He answered the acid. Why. Why did the backlog start a few years ago? Was there an influx of new practices wanting to align with our health system? Was there another reason that all of a sudden we couldn't keep up with.

Demand. He had no idea. Okay. Tell me about the process of bringing a new physician practice online. First we meet with the physician practice.

I thought about that for a second. I said, Hey, wait. How do they get on the list? He then explained that process.

I asked, why are they interested in aligning? He said he wasn't really sure. I assume because we are the largest health system in the market. But he wasn't really sure.

I said, okay. We meet with the practice. Why do we meet with the practice first? What do you mean?

Why is this our first step? Because we have to collect a bunch of information. Okay. Well, why didn't that information get collected when they signed up? I don't know. You get the picture, suffice it to say, by the time we were done, we had completely revamped the process and technology stack and dropped the backlog to one year without adding staff, but adding a few tools.

Tools we paid for once and not every two weeks with benefits. You got the picture of sometimes when you identify the right problem. And you continue to ask why it forces people to coalesce around really solving the right problem. I remember another case. We moved patched to the cloud, private cloud, all images sent centralized, and, , we utilize caching.

At the edge. I remember when I asked him about doing this and what efficiencies might be gained. , the answer. It really doesn't matter if there's any efficiencies, it can't be done. Of course, my eighth grader came out and I said, why. Not enough bandwidth, bandwidth. What are you talking about? You know,

We can get a massive amounts of bandwidth. We, all we have to do is write a check. Oh, I meant latency. Oh, latency. Oh, okay. Well that's different. , Well, , what are the latency metrics that are required to make our PAC system work? I'm not sure, but I know it can't be done across our wind.

Why. The answer latency. Okay, , let me step back a second here. What is the latency across our, when. I'm not sure, but it's higher than packs will allow for this conversation was so interesting to me. It's like we didn't have any of the details, any. And it also reminds me of the other principle, which is don't accept anecdotal information.

Whenever possible. Get to real data. And so I said, I'll tell you what, give me the numbers and let's see how far off we are. And if we can come up with a solution, we did this in conjunction with the benefits analysis on the return. It turns out that the latency numbers weren't that far off. With some technology that we were implementing a decade ago, we could get pretty close.

, not to an acceptable level for real-time access, but we could get pretty close to, , designing a solution that could work.

Well, the next question we had to ask is, you know, how many of our images were required in real time. If we couldn't get a real time solution, how many were required in real time without prior notice? And of course the team didn't really know, wow, let's find out. It turns out. , very few. Most are precipitated by an appointment of some kind.

Or in the case of emergencies are retaken, , whenever a patient presents. And so we looked at what, if we centralize and cash, the images for appointments each day down to the local market. And it turns out that it worked. I mean, the algorithm is a little more complex than what I'm stating here, but, , but it did work and I, what I'm really trying to demonstrate is a lot of times your team comes to you and doesn't really know why they're saying no.

, maybe it's always been done that way. Maybe they don't use . Those words anymore, because they've learned not to use those words. But in a lot of cases, , they won't know it'll be driven by, oh, you know, the person who used to be here said this, or our architects said this, or our vendors said this, and I'm not really sure that kind of stuff. A lot of these things, if you have the data, you can do a math problem. . All right, I'll give, give you one last one. And this is one of my favorite. We, we can't afford a solution is something that I hear all the time. And my question always is why. And they'll say, what do you mean? The budget is only this much. I'm like, well, you know, There's two directions you can go from here. One is we could get more money. And the second is we could ask them to sell us the solution with a little different.

, program or a little different way, or maybe we can bite it off over multiple years or those kinds of things. Invariably, what I ask them is, is it the best solution? The solution we should use this? The answer is yes. Then I say, solve that problem. Get a better price. Find the money to do it extended out over a period of time.

My team got used to this process of me helping them identify the core problem, and then saying, why don't we solve that problem? They then started to do it themselves. I find a lot of lazy problem-solvers in my travels. I also find overzealous problem solvers in the other direction. And we all are aware of those.

These are the people that believe, you know, we can build an EHR. How hard can it be? We can do it better. How systems used to try to build the HRS. And I used that as an example, because it's a crazy example. Today. We look back on it. We realize how silly it is. , but I find ID departments in health care, still trying to build things that already exist and are much better than anything they will ever develop internally.

They will say we can build something better or it costs too much money. And I wonder, will they build something better? And I doubt it. Will it cost more than us building it and maintaining it. And I also doubted. Perhaps it is expensive, but perhaps. That is the problem we should try to solve before we go out and embark on a build that will usher in a new set of problems that we've already demonstrated. We are ill-equipped to address.

That's just a thought as you know, Friday mornings are for me just to ramble. Look back over my week or two weeks and think about the discussions and the conversations I had and Just sort of riff on what I'm hearing and what I'm wondering. And this is really about problem solving and it's, it's about not being lazy with problem solving.

Identifying the right problem to solve. And then continuing to ask why until we get to the root cause of why we cannot solve that problem. And then addressing that root cause. All right. That's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week, health.com or wherever you listen to podcasts.

And you know where that is. We want to thank our channel sponsors or investing in our mission to develop the next generation of health leaders, short test and 📍 artist site. Check them out at this week. health.com/today. Thanks for listening. That's all for now.