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Today in health, it keep on keeping you on. You are appreciated. 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 dedicated to keeping health it staff current. And engaged. We want to thank our show sponsors who are investing in developing the next generation of health leaders.

Short test and artist's site two great companies. Check them out. Today at this week, health.com/today. Having a child with cancer, one of the most painful and difficult situations family can face in 2023 to celebrate five years at this week health we are working to give back. We are partnering with Alex's lemonade stand all year long. We have a goal to raise $50,000. We're already up over $34,000 a Testament to the generosity of our community.

We asked you to join us at our website and in the top banner, you're going to see a logo. For the lemonade stand. Click on that, , to give today, we want to thank you in advance for your generosity. All right. As you know, Fridays, I sort of riff a little bit. , I've been doing this more often lately. I will get back to the news.

, but before I even get to that, , I'm taking next week off. So there will be a new state show on Tuesday. Well, we're all off on Monday. There's a new state show on Tuesday. There's a new state show on Wednesday, so you're not going to miss me much. , but Thursday, Friday, I'm going to be. Out with family hanging out. So, , I will not be prerecording shows. I'm going to actually take a week off and, and, , listen to myself when I tell people that they need a break from their job. So.

With all that being said, , I riff on Fridays and today. After the week I've had just talking to. I think. A better part of about eight or nine. CIO is this week. I'm getting the impression it's hard out there. And I know it's hard out there. I'm. I'm on record as saying that being a CIO in healthcare was one of the hardest jobs.

I've ever had. I started three businesses, helped navigate a fortune 500 company through chapter 11. , I managed 2000 engineers in 50 states for national delivery organization. You get the picture, I've done some seriously hard things. But the CIO role holds a special place. Let me, let me tell you what I experienced and just say, I hear here just a handful of the challenges. If I think about it, there's, there's four main ones I'll I'll touch on. One is, , bureaucracy and momentum.

The healthcare system is loaded with bureaucracy. It just, it just is. It's a big organization with people. A lot of them have been around for a hundred plus years. , there's a lot of money flowing around and there's a lot of. , power struggle cycle won. So the bureaucracy is real and there's momentum.

, In some cases, you can turn that momentum into positive momentum, but in a lot of cases, there's a momentum towards. , the Stacy's towards keeping things to say. Right. And there's, there's always a contingent in every organization. That's like, don't change anything, stop changing things. And, , we know as technologists that, that, that.

His death that you know, to not change the water in the pond will eventually become corroded. You gotta keep, , keep the flow of new things in and the flow of bad things out. So bureaucracy of momentum, I think, was the first challenge. And I didn't anticipate how, how difficult that was going to be.

I think that the next thing is a well-meaning opposition. There's a lot of people right now that are pushing back on you. That have the best interest of the patient have the best interest of the clinician has the best interest of the system. At heart. And so there's, well-meaning opposition. I didn't realize how much of that there would be. Now we want to embrace that as much as possible and adjust our plans and the plans of technology in healthcare.

To make sure that we're meeting the needs of the clinician, make sure we're meeting the needs of the patient. But there was just so much of it. It felt like every day somebody was wanting to grab me and take me aside and say, Hey, let's do lunch. And then lunch would be, let me tell you the 55 things that are wrong with the EHR.

It's like, oh, okay. I, I know you want to want to make it better, but you realize 55. This is an overwhelming conversation, even for a CIO. So let's narrow this down. What are some areas we can have an immediate impact, maybe not 55 things, maybe 10 things. And then we'll come back and do the other 45.

Later. Anyway, there's a lot of well-meaning opposition and you can't just brush that aside. Cause it's well-meaning. It is. It is designed to make the system and the experience better for everybody. , the third challenge is not something that's going to go away and it's the vastness and complexity of healthcare.

Right. Healthcare is huge. I tell people, you know, when they say healthcare I'm like, what are you talking about? You're talking about an academic medical center. You're talking about a critical access facility. Healthcare is vast. It's vast and it's, it's different. And each system, depending on what category an IDN is different

then a, , academic medical center and, and, you know, you have. , you have individual hospitals or regional hospitals, which are different than IBNs and you have, , you know, the rural health care, critical access hospitals. They're all very, very different. And so sometimes we just lump them all together.

Talk about them. Like they're the same. It's, it's vast, it's complex. The number of tools, most organizations, most CEOs I talked to will talk. In the, , thousands of applications. , some have done. An excellent job in getting that down. And when they say we've done an excellent job, we've reduced our number of applications by almost 20%.

They say the following sentence will be we're down to 900 applications and like 900 applications for any it organization. That's a fair number of applications. There's complexity in healthcare. There's complexity in healthcare technology. There's just complexity in healthcare. The billing is very different.

, generating a bill is very different. , just the number of things that can be prescribed, the number of workflows that have to be brought together. , we operate a hotel. We operate a commissary. We operate. A hospital, you know, with care and those kinds of things going on. , massive supply chains and whatnot.

Fastness and complexity of healthcare is amazing. And as the CIO. I couldn't believe the number of meetings I was brought into and they were looking at me like, what is the technology for fill in the blank? And you're like, wow. You know, what's the, what's the technology for custodial. What's the technology for, , running a cafeteria. What's the technology for, and.

You know, you realize there's very few jobs that I can think of where you have to have that breadth. Of knowledge around the technology. That's going to be applied to all these different types of businesses. And I think that's one of the reasons we're seeing more and more CEOs. Take on C O O type. Functions.

They're becoming more operators and they are, , because they understand the business in a significant way. So if you're actually momentum, well-meaning opposition, vastness, and complexity of healthcare. And I think one of the hardest ones is we live in an imperfect system. We still are in a sick care system. We want to make people healthy. We want to help our communities be healthier.

But we still operate in a sick care system and that's hard. I think it's hard for the clinicians and it's also hard for us. We want to make that transition and we're struggling to make that transition. So I think those are the four big challenges. That I see. And really I could go on and on. But my goal isn't to stack up the challenges, but to encourage you in the battle.

We are making a difference. For all of its missteps over the years, technology is starting to have an impact on the patient experience. The clinician effectiveness. And outcomes. We're experiencing a Renaissance of sorts in the advancement of care delivery enabled by your work. Over the past 15 years,

digitizing healthcare has been hard and mired in missteps, but the promise is being realized. We now know the patient more than at any other point in history, we have multi-channel communication enabled by digital tools. We've increased the number of touch points between visits and expanded our understanding.

Of the world that the patients live in, we process thousands. And in some cases, millions of data points on patients, even when they aren't on our campuses.

We've extended the reach of the physician's care to the patient's home. Without the physician having to go to their home. We can know the patient better now than at any point in history. By knowing the patient we can now. Personalize the care experience. The journey is different today. Customized care plans, digital therapeutics and the appropriate nudges and messages along the way to guide the patients in their health.

With each interaction, we get smarter, collecting more information and putting more information to work for the patient and the clinician.

The pandemic put a strain on clinicians and technology professionals are being called on to ease their struggle. Just this week, I explored multiple ambient clinical listening tools that create notes supported by AI and automation based on integration into the EHR that delivers a more completely documented patient encounter.

This improvement in the note builds our ability to provide more complete and better care for the patients while decreasing the cognitive load on the clinician. Artificial intelligence. AI is assisting clinicians at Stanford and handling their inbox while decreasing pajama time at Mayo clinic, a set of AI generated data points are brought directly into the care providers workflow to eliminate clicks and assist the clinician in identifying potential health anomalies.

AI has been assisting radiologists and cardiologists for years. To provide secondary read on images to support better outcomes. Technology has enabled us to take bedridden patients and let them go outside with the power of virtual reality. Clinicians are getting more reps. In on virtual reality, allowing nurses to experiencing, , you know, placing an Ivy well, before they have to do it at the bedside.

While there's no replacement for the real experience, the tools provide avenues for clinicians to face variations on challenges. They will face many times before they actually face those challenges in the real world. That's a lot of faces. Cameras are being used in evermore creative ways, not in an Orwellian big brother kind of way, but in an assistive kind of way, capturing our time to review performance and improve.

Much like professional athletes do and have done for many years, looking at the time and the, oh, are, are we efficient? Are we productive? Are we providing the best care that we can? That review. Allows us to become better with each time we enter the Orr computer vision is being inserted into the workflow and increasing the efficiency of clinicians, staff, and resource utilization. I could really go on for awhile.

If this were a movie, technology would win the best supporting actor or actress category every year. I want to close this out by saying you are critical. Your role is critical.

The battle is worth fighting and your efforts are starting to yield fruit. Some might say these winds are longtime coming and they would be right.

I would say that when done right technology advances begin to layer on each other and we see an acceleration in advancements. Consider all the things we're talking about today. Today right now.

Would any of these have been possible? If we hadn't digitized the medical record? The effort is good. Your effort is good. The promise of technology is real and your work is appreciated. That's all for today. If you know someone that might benefit from our channel, please forward them a note. Really helps us get the word out. And we want as many people to be encouraged and talking about these subjects as possible. So send them a note, let them know that you're listening to the podcast. They can subscribe wherever they listen to podcasts.

We want to thank our channel sponsors who are invested in our mission to develop the next generation of health leaders, short tests and 📍 artists. I checked them out this week. health.com/today. Thanks for listening. That's all for now

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