Today in health, it why health systems. Are laying off it workers. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health. Instead of channels and events dedicated to transform health care, one connection at a time. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

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They can subscribe wherever you listen to podcasts. All right, this is one of those articles you have to read. You don't want to read, but you have to read. And this is one of those realities that we have to talk about. Don't want to talk about, but we have to talk about. Why health systems are laying off it workers. CIO's sold.

Becker's had a recent rash of it. Layoffs at health systems. Isn't surprising given the financial challenges in healthcare, but that cutting on the tech side can be shortsighted. I'd like to know why it's shortsighted. Is it short-sighted is it really short-sighted? I don't know. I'm being a little facetious here.

I believe it is shortsighted, but I'm not at every health system. Is it shortsighted? Because I'm not sure that every health system is utilizing technology. To drive innovation in the health system. To drive efficiencies in the health system. And so when we get into this conversation about cost centers and people are like, oh, they view it as a cost center.

I'm like, most of it is a cost center. I remember when I started. And my team came to me and said, look, we need to spend $4 million on a crack units and a. Oh, gosh. PD use and crack units. Can you imagine going to the board and saying, Hey, we need to spend $4 million on PDFs and crack units.

And they're like, what the heck is a PDU in a crack unit. Now, if you don't know computer room, air conditioner. And PDU is power distribution unit in the data centers. And if nothing screams cost center more than PTUs and and crack units. And so there's a significant portion of every it organization that is a cost center. So let's not fault the organization for looking at it and portions of it as a cost center.

Now it should be an enabler. I'm sorry. I will read some of the article. Give more context. Some of these people are friends and I appreciate their. Their comments, even if I am I'm are armchair quarterback right now on this stuff. So I understand how hard it is to be in the chair and do this stuff. All right.

Each health system has a different set of circumstances that may be hard to see from the outside priority shifts and financial distress can happen quickly. With limited options. These things happen said Scott Arnold, chief digital and innovation officer at Tampa general hospital. With that said technology is an enabler for lowering expenses through automation. So it should not necessarily be the first place to cut in a financial pinch.

If value can be identified and delivered. And he nails it right. If it is being used to lower expenses through automation, if it is delivering. And identifying value that it's delivering, then I think people will shy away from it. And so that identifies a handful of things. One is strategically, are you prioritizing automation, clinically automation in billing automation on the call center automation in it. Are, you should be the champion for automation across the entire health system.

Are you doing that? And then the second thing, and I talked to my coaching clients about this all the time. Are you measuring? Are you measuring and then are you telling the story back to the organization? We saved this many hours we saved. Now, this should not just be an it function. This should be ingrained in the project management approach of every healthcare organization that they understand how to set an objective and then measure that objective as they go forward. There's no other way to know if the projects or the investments are really making sense.

And I find a lot of organizations make the investments based on a set of criteria and never go back to validate that criteria that they said, oh, it's going to save us this much money, but they never validate. It's so important to validate so that you can tell the story so that you can continue to do the projects that are delivering. The most value. Let's see. In December.

Oh, there's a whole bunch of they, they cite a bunch of them. Kaiser Permanente slash 115 jobs. Let's see mass general Brigham laid off 20 digital employees. Bon Secours mercy health system laid off employees. Nevat. Out of Winston Salem, shed it staff as well. Let's get some other quotes here.

Firstly, I believe these moves are a result of continued pressure placed on health systems today. To manage costs and do more with less true. Secondly, they also demonstrate that it is still largely considered a cost center. It is because most of it is cost center said, Joyce, oh, CIO. Tampa Florida based Moffitt cancer center. There is a paradigm shift that still needs to be fully manifest in healthcare. Where technology is viewed as a business driver. And I agree. Thousand percent with what your way is saying here that it needs to be viewed as a business driver.

If it is a business driver. And if we are. Utilizing the investments that they are giving us to be a business driver. Match it to rev. If you match it to revenue, they're going to give you more and more money. If you match it to profitability, if you match it to efficiency. They're going to just throw money at you.

It's like you are a business driver. Absolutely. If technology is viewed as business driver and enabler of new capabilities, a new channel for patient acquisition. And a toolbox that can bring about increased efficiencies and economies of scale. It has the ability to do all those things, but in it shops that aren't delivering those things.

It is a cost center. They should cut staff. Because it's the only way to get the efficiencies is to cut staff. And so that's why it's incumbent on the leadership at every level within it to always be focused on the things that are delivering value for the organization. Not necessarily only for it, but for the organization. And I think the other thing that's happened to us is we are so EHR focused.

Every time I have a conversation, people are like, they always come back to the EHR. And it's an important piece of the puzzle and it's running about a hundred things in the health system. I get it. But if all your innovation is coming from epic, they don't need you. They can hire the next person who can wait for epic to come out with their thing.

And then. By that and implement that. Quite frankly, The question is what can you do? What can you do that is creative and above that is matching the different technologies that is eliminating the waste. That's what they need you to do. Let's see Navon health for one said it's moving. Some of it's digital products and services to an external partner. Other smaller health systems have also sent it staffers to work for outside companies in recent months, including Providence, Rhode Island based care, new England. Can't say that word. Oh, Indiana based Franciscan Alliance and west Redding. Pennsylvania based tower health at this point, when you send it to the outside. Let's see care.

New England sent 160 employees to IBM spinoff, Kendra. As they move to epic at Amazon web services. At when you die, you've done that you are no longer strategic. Those players are not going to be strategic for you. They're not going to think strategically. And by the way, when you outsource to these external partners, you have to ask yourself if they are a publicly traded company the margins that they have to hit in order to hit the the objectives for wall street.

Now, some of these are, there are smaller players, that kind of stuff, but still there's. There's investors and those kinds of things, they have to hit numbers. I'm not sure how much money it's actually saving. And I think you've just lost a significant amount. Of the strategic nature of it.

Now they may not have been able to run it. It could be strategic outsourcing, which we've talked about before, which is important and a. Good use. Of outsourcing dollars. That is. Identifying those things that you don't deliver. Giving people career paths and that kind of stuff, there's a whole bunch of reasons to do. To do those kinds of strategic outsourcing things.

That security is a great example. I say it all the time. Security is is one of those areas. Strategic outsourcing makes sense to me because it's so hard to get enough qualified people. Let's get one more last quote. Oh, Michael Second time I'm talking about him this month. Let's see ID departments also have an opportunity to ease financial pressures on their health systems. Yes, they do such as deploying artificial intelligence for automation. Yes, I'm not sure we're there yet, but yes.

He said Michael or sushi, a CIO. Philadelphia based Penn medicine. But he said healthcare is still waiting for the next revolutionary technology. The likes of speech recognition and the introduction of which drastically saved time and reduced costs on the clinical side. By the way, I think that is the area that we should be looking at right now.

There was a time where we struggled with certain technologies because of the cost and. I'll just say it nuance at one point was expensive because they actually essentially had a scribe. Technology front end to a scribe in the backend. And it was costly. It was people intensive. It was very cost.

It was not cost-effective so you couldn't roll it out. Crush your heart entire health system. I think that has changed. And I think we should be looking at that. We might be able to drive this further into our organization. And drive more efficiencies because speak speech recognition at the point of care is one of those areas that I think we should all be looking at expanding within our health system today.

And I also read an article today that Nuance's now a hundred percent integrated. Into epic. I also know that a bridge is integrated into epic, and I also know that. There are other players. That that worked really well in that environment. Michael goes on, although promising and many are evaluating multiple AI opportunities as yet to generate the results. Matching the height. I might talk about this tomorrow, actually that the hype around AI and what we can expect this year versus what we should be looking at.

Long-term. And what we should be doing today. Time will tell if AI will mature fast enough to generate the promise benefits until then many health systems. Are already on borrowed time. And as a result, we'll need to resort to further expense intervention. I thousand percent agree with that. We should be looking at AI.

We shouldn't be thinking it's a savior, especially for 2020 for your health system is struggling right now, financially. You're probably going to have to take some cuts. And then the question becomes, how do you balance that? As the CIO at this point, how do you balance that? And I think it is. A situation where you have to look at this is operational it.

And you're going to try to make that as efficient as possible. You cannot automate enough within your it organization. It should be to the point where you, as the CIO could provision new servers, it should be that simple. And if it's not, you haven't been paying attention for the last seven years. Because the automation around dev ops is there. And you absolutely could be provisioning servers. Cloud or not cloud it.

Even your architecture that's inside your data center should be cloud-based should be a cloud architecture and should have the ability to provision. And de-provision servers very rapidly. You should have a minimal number of images in that data center. It should be highly efficient. Backups every automated. Th the things should be automated to the nth degree.

That's one side, the other side is. You ha you have to maintain no matter how many cuts you do, you have to maintain a group of people that is focused on the future. If you don't you absolutely have you cut off your nose to spite your face. I don't know. My mom used to say that it makes sense to me.

But you have to. Keep an eye on the future. If you don't keep an eye on the future, you will have started this endless cycle of reduction cost center reduction cost center. You have to break out of it. How do you break out of it is you identify those opportunities with the most potential, for delivering value to the to the clinical side, delivering value to the business side of healthcare. And potentially changing the dynamic and the interaction between the patient and the house system and automating all those things, the workflow and the care journey and all those things. That's where I would maintain.

Even if that team gets down to two people. And you as the CIO have to be the one person that's doing that as well. Then do it. And by the way, if you're still standing on what you did last year of, oh, isn't this amazing look at this. Stop it. You gotta be looking forward. You gotta be looking over the next year, three years, five years. What is the story?

What is the vision? What are you going to be doing? Yes. You're still telling that story from a year ago, but you're not standing on it and saying, look, what I did, what you're doing is you're essentially constantly coming up with what's next. What's next? What's next. I read the Elon Musk biography.

Don't like them. I don't really care. The thing I really like about them is. Tesla's not a car company, Tesla's an energy company. And now Tesla's a robot company and Tesla is an automated driving company. At every turn, what he does is he changes the game because he's always introducing.

If we put these new capabilities in, it will change the game. If we get the fully self-driving cars, it will change the game. And if you look at the valuation of Tesla and why it's more than the next 10 competitors, it's because essentially. They derive value from what they could be. Not what they are. Today. And he's telling the story while he's making progress on all of those things.

Maybe not as fast that's. That's the one knock on Elon Musk. He always says, this is right around the corner. And it generally takes a little longer than that. But the things he's trying to do will completely transform. Automotive completely transformed space. Completely transformed. Just fill in the blank. We can do a little bit of that in healthcare.

How can we transform the way our system interacts with the patient? Make it more efficient, make it better. Make our clinicians more efficient, make our clinicians experience better. Make it just. Better, all around, more efficient, all around. That's what the forward-leaning people need to be looking at, not redefining what healthcare is going to look like.

Like we've talked about yesterday, the day before, that's for the business side to say, Hey, we're going to go more at value based care or more in that direction. If they do make that shift, then your future looking people have to look at how they're going to recraft the technologies to serve whatever the objectives are.

And once again, I've gone too long. I'm going to get better at this. I apologize. Third day in a row, I went over 15 minutes. All right. That's all for today. Don't forget. Share this podcast with a friend or colleague. Keep the conversation going. 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 par Lance certified health, notable and service 📍 now. Check them out at this week. health.com/today. Thanks for listening. That's all for now.