This Week Health

TownHall: Being Brilliant at the Basics with William Walders

January 23: Today on TownHall Sue Schade, Principal at StarBridge Advisors speaks with William Walders, SVP and CIO at BayCare Health System. William shares his journey transitioning into his new role and the challenges he faced. He reflects on how his military background shaped his leadership approach, emphasizing on how 'being brilliant at the basics' has been an influential mantra. He touches on the technological strides at BayCare, highlighting the exploration into AI and voice technologies as initiatives towards cost reduction and efficiency improvements. William also spotlights the need for better adoption of technology within the healthcare industry. How can healthcare systems better manage across major transitions? What does it mean for a health system to be "brilliant at the basics"?

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 This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Today on This Week Health.

imagine this your nurse walks into a room he or she does a verbal assessment.

Through this bone conducting headset that documents everything into the chart. But more than that, which seems to be table stakes these days with some of the technology, it then does decision support saying you missed a step or based off what I just heard, this is a sepsis risk et cetera. So we're really excited about that technology, that co development effort with a partner and where that will go.

Welcome to Town Hall, a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels and events dedicated to keeping health IT staff current and engaged.

We've been making podcasts that amplify great thinking to propel healthcare forward for over five years, and we want to thank our show sponsors. who help to make this happen. Armis First Health Advisors, Meditech, Transcarent, and UPerform. We thank them for investing in our mission to develop the next generation of health leaders.

Now, on to our show.

Hello, I'm Sue Shade, Principal at Starbridge Advisors and one of the hosts for the Town Hall Show at This Week Health. Today, my guest is William Walders, Senior Vice President and Chief Information Officer at BayCare """Health System in Florida. William has been there since April after serving as SVP and CIO for IDN Operations at Health First the previous four years.

I'm really looking forward to hearing about William's challenges and lessons transitioning to a new health system and what he and his team are currently focusing on. So welcome, William.

Thanks, Sue. I'm super excited to be

here. Great. This will be good. Let's start by having you briefly introduce yourself and tell us about

Baycare Health.

Yeah, absolutely. So you did a good job of it. So William Walters, Chief Information Officer at BayCare. BayCare is a 16 hospital health system, about 6, a little over 6 billion in revenue. All aspects of healthcare, ambulatory, hundreds of provider practices, hundreds of physicians, as well as our 16 hospitals.

Growing actually, adding a standalone children's hospital, we just announced. I'm really excited about that and what that means to the community, as well as expanding into a new county North Manatee County. Most people know Manatee is probably Sarasota, kind of the county just south of Tampa. So, really excited about the growth at BayCare.

We've been an entity or a health system now for, since the late 90s disparate hospitals came together, like I think many, many health systems do, and I'm really proud of that tradition, that contribution to the community and really being the largest health system in the region. So, because of that, we get to do some amazing things.

I'm sure we'll talk about some of those today.

Great. Great. How about telling us about some of your current priorities that you're working on? And I know you've only been there, what, now six months? Yeah. I imagine you've got your next year laid out pretty

well. I do. So, it's always a priority for me to be what I've always called being brilliant at the basics.

I spent 22 years in the Navy. And it was a mantra we adopted in the Navy sometime in the early 2000s, and it just made sense. made sense in all aspects of my life. I've got a 17 year old son now. I would tell him 10 years ago to be brilliant at the basics, right? Show up on time, be courteous, be kind.

And it's surprising, like, when you think about it in that perspective. How important that really is, right? So, from an IT perspective, we call it IS here, so I'll probably use those terms interchangeably. It's great customer service, keeping the systems up, patched, operational, secure, right? Those are the basic elements that really are the foundation of what good IT is.

Work is so that is certainly priority. The best part, you know, inheriting this IS shop from Tim Thompson, who's a well established leader and CIO in our world. It was probably the easiest transition I've ever made. I've always had to inherit something broken when I was took over Walter Reed. It was no secret.

In fact, it was on the front page of the Washington Post at the time when I took over around some of the issues that had my prior employer as well. Came in there to fix the culture, fix sustainability operations. They had a significant issue prior to my arrival of downtimes that lasted multiple weeks, et cetera.

So coming here start being brilliant at the basics. We were there. So some of the other priorities we're looking at, we're looking to grow and grow smartly. Baycare has. 560 days cash on hand. Last report I saw, which we get daily. And if you think about what that means, it gives us quite a war chest, right?

Second most viable health system according to JP Morgan and all the Fitch, Moody's, S& P. With our new leadership, our new CEO coming in exactly a year ago, she wants to grow. She wants to spend some of that war chest smartly, smart growth, smart things around innovation. So, that's why I'm here.

And really doing assessment of what we had, where we're growing has been part of this first 6 months. So, you're going to see a lot of things from BayCare around the innovation front. Focusing largely on A couple of key themes. Reducing the total cost of care, right? It's no secret that healthcare is getting more and more expensive.

So we're looking at technologies to do exactly that, bend that cost curve. In particular around labor, a lot of people have been doing this. Nursing labor, other labor, but getting folks to operate at the top of their license, reducing low value work so a lot of themes there. A lot around data. We have a lot of data, we do it well, really enabling that, and I can use all the buzzwords here, self service BI, citizen data scientist, but meaning it, right?

Putting data in the hands of our 30, 000 team members to help with their job. Not only does it do great things for those team members, but it. Freeze up my staff from building simple dashboards 90 percent of their time and doing pivoting data. I joke, if I could get every director and above to know how to use a pivot table, I'd probably free up a significant portion of our IS team's time and building dashboards and manipulating some of those simple things.

We'll get there working on some data literacy, working on tools to now and enable that. And then the last thing, is informatics. You'll have seen we just appointed for the first time a formal chief nursing information officer really taking the informatics discipline to what it should be, growing that smartly.

That'll be a common theme about smart growth. And then really leveraging the power of those informatics relationships with workflows, with productivity, with, Trust, faith, and transparency to our clinical partners, of which we have a great relationship today, but just further building on that.

Excellent. I love your brilliant at the basics mantra. You said that came from the Navy days.

It did, yeah. If you Google it, you'll find a couple of navy white papers. Like, someone should have wrote a book on this. Like, anyone listening I'm good at talking. Horrible at, like, putting all that thought to paper sometimes.

Like, I'd love to ghostwrite it with you.

Okay. And instilling it in your kids. That's a good one, too. Yeah, it's a good

parenting mantra. It's very simple.

Yeah, I wanted to ask you about innovation and some of the areas that you're, where you think you're pushing the envelope. So can you expand, you talked about one of the themes being reducing the total cost of care and you talked some about the importance of technology.

Any particular things in that area that you want to comment

on? Yeah, I think a lot of the augmenting the nursing talent within is table stakes these days. I'll, talk about tele nursing, virtual ICU. We've been doing that for decades having command center construct to monitor that. We've never called it that.

We've never celebrated it like, like a lot of folks do. So that helped during the labor crisis that occurred a couple of years ago, in particular the premium labor. It's no different now. So we're looking some simple things. Environmental services, we're putting technology in place to automate those processes where you would, go into our cafeterias, it would now be open 22 hours a day, vice versa.

14, and just grab your food and leave, right? Using technology to do that, to charge your either employee account, your badge, or your credit card. And in some of our communities, this cafeteria is the only, I shouldn't say the only place, but a common place folks come for meals, regardless of if they're a patient or a guest of a patient, other things around reducing low value work and everywhere, you know, automating simple processes and technologies we made a press release on it, so I can talk about it.

Voice, AI, and I struggle with the term AI at times because my vacuum now says it's AI. Five years ago it said it had floor sensing technology, today it's AI because it has floor sensing technology. But true AI. You branded AI, right? Yeah, exactly. But true AI, where through Generative, implemented to the EHR with voice, a bone conducting headset.

piloting it now, but in building it and co developing with a partner, putting the sweat equity in their IP, co developing , with an investment on our side from a grant perspective when this thing is successful. But imagine this your nurse walks into a room or a nurse walks into a room, he or she does a verbal assessment.

Through this bone conducting headset that documents everything into the chart. But more than that, which seems to be table stakes these days with some of the technology, it then does decision support saying you missed a step or based off what I just heard, this is a sepsis risk or et cetera. So we're really excited about that technology, that co development effort with a partner and where that will go.

A lot of health systems do this with co development, with kind of taking some chances with things that aren't quite baked yet. That's where this one lies, but we're seeing some early indication and early partnership that this could be a game changer for us. So that's, that's a good example. We have many others.

We've got a whole innovation arm, a brilliant gentleman by the name of Craig Anderson, who has a great team that gets to go hunt these things. We joke he's got the best job at BayCare and then he, he and I collaborate and it actually implemented.

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📍  Excellent. Okay. We first spoke a couple of years ago when I was the CIO, interim CIO at Boston Children's Hospital, and I remember reaching out to you because there was a startup company we were talking to, and you were working with them, and I wanted to kind of pick your brain.

And we both know that learning from our colleagues and in the health IT community is one of the things that we do and is very valuable. Are there any things that you've reached out to colleagues about in your first six months in BayCare as a new organization for you?

We help each other. I think that network's essential. I remember the conversation you and I had with that great company who's still doing great things. So, yeah, I would have talked about My only Cerner experience, I shouldn't say only, was with the DoD. I spent 10 years kind of evaluating Cerner and Epic then implementing it in the Pacific Northwest for the first 3 hospitals, but didn't have a ton of optimization or operationalizing it experience.

Thankfully, I have an amazing team of 700 people who know it well, but in the early days, I reached out to folks like Craig, Joel Van Gogh. Others who had, been at Cerner shops, and just to kind of build back some of those relationships, understand kind of where the directions were going in particular with, where Cerner, now Oracle Health was at the time.

So that was one. Another one around data, kind of understanding the healthy intent aspect of similar around Cerner, but how our data ontology was. And then we all reach out around new technologies. We're looking, we ultimately made a selection with RPM so kind of vetting a couple of the remote patient monitoring partners, but I'm not kidding when I say every day, there is not a day that goes by, except maybe some weekends.

And then we're talking about soccer or football. We're about chatting with, I think it's about 28 CIOs, so.

Great. Well, I know in those roles you don't have to feel alone because of that network you can reach out to. So tell me about your move from Health First to BayCare. Some of the differences in the roles and what were you looking for in making this move?

Because I think you probably had broader operational responsibilities outside of IT in your previous role?

I did, yeah, it was a blessing and a curse. About a year into my CIO tenure, COO retired, and we kind of chunked off parts of the operations. I got supply chain, the PMO, clinical engineering, retained IS.

I think I'm missing something across the entire IDN. And I was like, wow, you brought me here a year ago to kind of fix IT as the CIO. Like, gosh, yes, I'll take it. And it was great. I got to do a lot of great things, but learned a lot, certainly around supply chain things here, I think, as. As CIOs, we tend to shake our fists at supply chain sometimes around procurement.

We could do it better if you don't have that ability to influence, directly influence supply chain. There, I didn't. Here, I do. So anyway, it was unique. I'll be candid. I wasn't looking until about a year ago. There were some big jobs out there about a year ago. I got a couple of those calls, and I was very transparent with my leadership who hated the idea of me looking.

And they said, why are you looking? And someone told me this, it might have been Bill actually, because I might have been in Naples around the same time. And he's like, hey, when you play baseball and the Yankees call, you try out. And, the Yankees had called. The Yankees thing didn't work out for a couple of reasons.

But at some point, BigCare did shortly after that. Born and raised in Tampa. I'd always joked I was trying to get back to Tampa. I got close. On the other coast of Florida. And but Baycare had this amazing brand. Tim is well respected. Everyone knew how well that IT shop was governed and structured and resourced.

All my family's in Tampa. So I'm like, you know what? I'll take the call. And and did. And then the best thing, and I joke with Tim and Stephanie, our CEO about this, I think the best thing that happened is uh, I was 30 minutes early, blame the military for that. And they parked me in the lobby and I'm staring at the wall for 30 minutes.

Beautiful lobby, lit up in this beautiful white tile with blue light, were the five key tenets of BayCare, and it said trust, respect, dignity, excellence, responsibility, right? And I was in a culture for 22 years that every morning you woke up and you said these words, this requirement, right? Honor, courage, commitment, you went through the Navy.

Sailors Creed, you really represented that. So I was like, let's see, as part of, we interviewed them as much as they interview us and boy, do they exhibit those five core values and oh my gosh, the culture. If I had to pick one word as to why. I left an amazing team at a prior organization.

If you saw my LinkedIn when I left, it brought tears to my eyes and still does when I read some of those comments. Exceptional team, but it was culture. I could impact the culture I had at the IT team. In fact, that's why I was brought there. But the culture here is And I'm reticent to say that for any of my Navy alum who are watching, but it surpasses my 22 years of naval culture where, you know, you took a bullet for the guy or gal to your left and to your right, so I could talk for hours on it.

I should write a white paper about it. And it's, you won't meet any of the 30, 000 people at Baker who don't say the exact same thing.

Inspiring. Very inspiring. And you referenced the Navy a couple of times those comments. Thank you for your service. I know you served, what, 22 years in the Navy?

I did. It was an honor to serve.

Two very different careers as a nuclear engineer for eight years, doing electronics and fire control weapons kind of stuff on a submarine. And then I crossed over at the remaining 14, doing the exact same job I do today, just at hospitals across the Got

it. So you've talked a little bit about that.

The mantra brilliant at the basics. Anything else you want to comment on in terms of what you have brought forward from your military career into the private sector?

Yeah, I think a lot of folks have a hard time transitioning. In fact, I brought more private sector into the military career, I think, that I took.

Vice versa. And I never forget interviewing, gosh, six years ago and everybody said, you know, how hard is it going to be to walk into an organization and not be able to bark orders at people and they just do it. And I joked, I was like, have you ever worked in the government? Like postal workers or government employees and not to disparage postal workers or the IRS, right?

Like there's a certain moniker around government employees. I had 300 government employees who were collective bargaining union. If I barked orders at them, I'd have been in trouble. And so,

I have a lot of veterans, but I don't, besides being brilliant at the basics, and I'll continue to say that, but the courtesy, showing up on time, being on time for meetings, valuing other people's time, those are some of the foundational elements I think you learn in corporate culture and that's mirrored.

The best thing that happened to me shortly into my transitioning to military health was meeting a bunch of military veterans, like the Drex, the Fords of the world, the Rusty Jaegers, who told me that, hey, it's no different. Come with us, we will help you be better at your military job by taking traditional commercial or civilian, we'd call it, methodologies into your hospitals.

And those hospitals were run no different. And that was the hardest culture shock. I was on a submarine, deployed 90 percent of the time. And when I was home, a third of that time you always spent on the submarine, was not taking that level of 📍 commitment to the hospital. I was now I was like, hey, we go home at 4 o'clock, right?

Like, and I'd be there till 9. And everybody's like, are you crazy? So anyway, it's, I think I answered your question in a garrulous way in regards to just, similar but different and all good, right? The diversity, the variety. just before this, I spoke to our, we had 12 new folks and about every two weeks I speak to, we have an IS orientation meeting.

It was so amazing to see the diversity, about a third were veterans, a third were from other countries. And it's just so great to see that. So I think that's the other thing, now that I think about it is diversity. I was a Florida boy. In a big town in Florida, but, for 22 years, I had no control for the most part of who was, who are my peers, who my boss was

and I went all over the world. I lived in three continents, Japan, Spain, other places. You really get exposed to a lot in a short period of time, a lot from a work career perspective, but a lot from a people and culture perspective, which I think allows you to be a better team member with your staff and really empathize and understand different perspectives.

Great.

And it sounds like you hire a lot of veterans and I would encourage our peers to do the same.

Yeah, we hire a lot of them. I don't see a lot of veterans. We hire a lot of diversity. Yeah. Just I think it came up. I think more people are like reluctant veterans. I don't start with that by any means.

And I mentioned it this morning as part of my bio and others did. I don't know that others would have. But yeah, I appreciate the perspective and gratitude.

Great. Last question for you. And you might say AI, you might say something else, but what technology are you keeping an eye on that you think will have more of an impact on health care in five years than it's having today?

Man, five years, gosh.

No one can predict five years, right?

Yeah, there's a quote, and I love that, you know, we underestimate what happens in the next Five years, but overestimate what's going to happen in two. That's a good one. I love answering this question with the following, like, it's not a technology.

It's adoption of technology. Right? So, I asked this question, and I did a panel a couple nights ago. And I don't know that I was asked this question with something similar. And I've asked a room a couple hundred people. I said, who uses IRIS. Telehealth, this device to see their doctor and, I think folks lie to me because about half the room raised their hand but if you look at the statistics, it's around 25 percent use it for primary care and anywhere between 10 and 16 percent for secondary.

And I'm like, this is a problem. Like, we've got all this technology. No one is using it. Right. We complain about access to care, but I can get you a doctor right now on big care anywhere, or you can call and I'll get you one in three weeks, and for whatever reason, we've got this. Desire to want to drive for 20 minutes, park, sit in a waiting room for 30 minutes, reading three year old magazines for the doctor to see us.

So I think adoption of technology, is what I'd love to answer there. It is no secret and surprise that AI generated AI is a spectrum assistive AI, or what I, augmented intelligence is what I love, what I'd love for AI to stand for, right? The ability for, and I hate AI, hate and love AI, as I mentioned earlier, but the ability for some tool, we'll call it AI, to augment our intelligence and our day to day interaction.

If that's, me with email and spreadsheets and PowerPoints, Building those for me, augmenting them, getting them close, and then I tune them. If it's for a physician to make better clinical decision support in healthcare, if it's for a nurse to do some of the things I told you about around documentation, around improving workflows, that will, it's a no brainer that is going to be the thing.

There's a lot of, again, there's really the basics things that have to occur. How about we adopt it? How about we are literate in it, right? Advocacy, literacy how about we have the foundational elements to do it? Infrastructure, data, right? All these things are fed by data. If you don't have the data fabric in place if you're not grounding these tools in something that is known, good, reliable, that you believe in Those are the things we need to do in the next 5 years to make sure that prediction comes true.

Great. Great answer. I'd love to follow up on some of the things you just said, but I think we're at time. Is there anything else that you want to highlight before we close?

I think I covered it. I mean, super excited to, to be here. It's the best job I've ever had. And that's hard to say, knowing my history, knowing a lot of the people I've had an opportunity to serve with and work with, BayCare is not the quietest, largest health system it once was.

Under new leadership with some changes, you're going to hear a lot more exciting things from us. I encourage all of you to follow us on LinkedIn. to engage with us and our other leaders in the organization. You're going to see a lot of great things come from BayCare. Excellent. It

sounds like more than just the honeymoon period, William.

Yeah, no, I'm I somehow fell in love, got engaged, honeymoon is over. We're now at kind of 20, 30 year anniversary, I feel like, but now it's good.

Okay great. Well, thanks so much for talking to me today. It's been a

pleasure. Absolutely. Sue, always a pleasure.

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