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Today on Town Hall

coming into this position, I have responsibility for both the health plan on the I. T. side. And on the delivery side and it is it's almost like you have to take off your hat and put a different hat on When you are in those discussions because you are looking at it from a different lens

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. .

Alright, let's jump right into today's episode.

Hello, I'm Sue Shade, Principal at Starbridge Advisors and one of the moderators for the Town Hall Show at This Week Health. Today, my guest is Sonny Sopra, Senior Vice President and Chief Information Officer at Samaritan Health Services and Samaritan Health Plan in Oregon. Sonny's been in this role for close to four years now.

I'm really looking forward to catching up with Sonny today to hear what he and his team at Samaritan have been focusing on. So, welcome Sonny. Thank you. Thank you, Sue. And thank you for having me and the time and look forward to chatting more. Yeah, it's great. We have not caught up for a couple years. So let's start by having you briefly introduce yourself and tell us about Samaritan Health.

Sure. As mentioned, I'm Sunny Sapra. I'm the, Senior Vice President and Chief Information Officer at Samaritan Health. Hard to believe I've been here almost four years now. It feels like yesterday actually made the trek from San Louisville, Kentucky out to Corvallis, Oregon. And Samaritan Health is a five hospital system in the Willamette Valley area of Oregon.

A beautiful area. We've got vineyards, we've got mountains, and we've got the coast. And we cover our hospitals in a lot of those areas, actually. So, very lucky to have the hospitals in those regions because it's always a pleasure to drive. To those locations as well.

we have about a, and 120 clinics as well. But, the, I think more of the differentiator for us is that we have our own health plan as well. we service 130, 000 members in the three county area. Where we are the sole provider for Medicaid, the Medicaid population in that three county area and we're designated through the state to take care of that population so, the beautiful thing about Samaritan is that my neighbors, my community all goes to Samaritan.

They're either members, patients, or both. And I get to see them on a day to day basis and really impact their lives as well. And so, our mission is building how their communities together. And I truly feel like we, we live on that mission.

That's great. And I wrote down here in my notes the concept of secret shopper, something that I used to do when I would uh, be a patient at hospital where I was serving as CIO and try to get feedback.

But there's other ways to get feedback about how the system's doing just within your community and from your neighbors and friends. It sounds like

it is I run into, patients and members that are part of our system and keep coming to our system and I run into them at the grocery store, at the coffee shop and, having healthcare being such an important part of their lives.

The topic of healthcare always comes up and so it's always interesting to hear and honestly, we get very candid feedback, like it took me six weeks to get into this clinic to see somebody can you help with that or is there something, or is there a reason why, and you get into those discussions and sometimes, our patients and members walk away with more of an informed discussion and sometimes they just, need that extra help, honestly.

So, you know. yeah,

you know,

I'm going to make one more observation because I see you're in your office.

Yes,

you're not working remote. You're not working across the country and going there, so many, days or weeks a month. I think it is so important for healthcare leaders to be in their communities and doing just what you said, which is, being able to connect to people who use the services.

So, kudos on that. Let's hear about some of your current priorities for you and your team at this point.

In that space in the healthcare industry today, right? There are a lot of financial pressures. And so we are really looking at our margins and making sure that we are putting all efforts to have positive margins and we're trying to see where technology can help with that. Right? So. There's definitely a focus on the margins.

We've got a partnership in place that we're in the middle of right now with a hospital which Is soon to be the sixth hospital that we're adding in into our samaritan system and so there's a lot of focus being put on onto that we also are looking at population health Very carefully and also with an acute lens.

We feel like the future Cannot be without value based care and truly pop health. And we are as being an organization that is on the delivery side and on the, health plan side where we are the payer as well, in some ways are looking at how we can align those pieces a little bit more to really get into really serving those communities that we do serve with better health, right?

Our CEO, is very adamant that we should be able to provide the best service and the best health care because we can see and have a lens in both sides of the fence. And so lot of attention being put in that. And that, you know, we are, we've gone on a journey of being an, a highly reliable organization.

And our HRO journey has been. Pretty much at the forefront off as our operating system for our organization for the last now four years. And so with that in place we do a lot of rounding. We really listen to the voice of our employees and our patients and our members. And have really built that into the culture and so we're really elevating that to the next step to saying how do we make that better for the organization as well.

And all of those priorities when we really look at them, Sue, have IT touch points, right? When we talk about, HRO, we're looking at Press Ganey and how do we bring Press Ganey more into our day to day lives. So, we're not being reactive to the patient, we're being proactive when the patient is actually In the facility, right?

We're getting constant feedback from them. When we look at just our population health, how can we do better with aligning the data that comes from the health plan and the delivery system and bring those together? So we're looking at it cohesively. When we look at, our partnerships, we're looking at growth.

How can we bring more of, another hospital into the system and bring. That pop health to that space as well. So, our IT initiatives really do honestly center on those while also really looking at how do we advance ourselves with the technology that is coming forward with AI and also cloud cloud based technology, right?

We're probably one of the few, I'd say, hospitals in the nation where by this, April, We are going to be done with our data center. We will not have a data center presence anymore at all. You're going all cloud on prem? We have given up our on prem. We've been on this journey for the last two years.

We took Epic to Azure and we're one of the few hospitals that had done that in that early, in those early stages. We're already more and more going in that direction. And we've taken all of our applications now out either into a SAS platform or into our Azure environment.

And so we rent space today from a data center perspective. We are giving those keys away in, in August of this year, we are going to be done with our data center presence.

Wow. So you are a leader in that respect. Sounds like

yes, I'd say we are probably the forefront of that journey. Yes.

That's great. Are there any particular challenges having the health plan for your it group? That's not something that I have direct experience with as a CIO in the past more on the delivery side, but anything unique there you want to comment on.

Yeah, it is a unique and it's probably something that attracted me to come here as well was to have that experience because, having gone through my career, I primarily have gone through organizations where I was primarily on the delivery side.

Now, coming into this position, I have responsibility for both the health plan on the I. T. side. And on the delivery side and it is it's almost like you have to take off your hat and put a different hat on When you are in those discussions because you are looking at it from a different lens, right?

And I think that In today's world, it is really important, whether you have a health plan or not, to really look at the lens of what are those members going through and how do you make delivery better for those members, while also keeping the health plans interest in mind, right? Now, from an I.

T. perspective, I'll say our tools are different. They different than than what we use on the delivery side, because they are very claims focused and really do get into, I'd say more of what those members need and the journey is a little different, but the data at the end of the day is, I think, critical to leading us into understanding what happens to that patient slash member.

And that's where I think we are starting to see more and more of those benefits. And also putting more of that focus. There are a lot of challenges in today's health plan world, especially with medicare advantage I'd say the ma plans are struggling in today's world to keep up and I think those regulations are going to really build whether the future for health plans and where it lies, especially for smaller plans like ours I mean, we are not multi million Member plan.

We are a smaller plan and we service a very niche population, right within this three county area and primarily focused on Medicaid. Right? And so, learning through those journeys and, going through on what it takes it's definitely a huge learning environment.

Got it. Great. Are there any particular technologies where you and your team are pushing the envelope right now in support of those efforts?

Yeah, I mean, I mentioned the cloud journey already. I think we are pushing the envelope with that. Right. We are also in the journey of, ambient listening and really making sure that's working well for our providers. And really looking at how we can make their lives easier. We've piloted with DAX.

We're piloting with a bridge as well to see which one works better for our organization. , the results coming back from that have been positive so far. Where we don't, we didn't really see time maybe saved as much as we thought we would from, from ambient listing. But we definitely saw a higher level of coding.

And that's real dollars. So when you really start thinking about the roi piece of it our studies show that if we have a provider that spends 60 percent or more of their visits on ambient listening, their coding is higher. So they are, users that are really using the system and putting the time and effort into that system we are seeing a higher level of coding from there.

That's great. And what's the the clinicians on that?

Oh it's been great. I mean, a lot of our providers say they can actually go home and have dinner with their kids now and, are not spending, evening hours actually documenting. I think it's always, you're not never going to get 100 percent of satisfaction, but I'd say the majority there are extremely satisfied.

That's good. So you have high adoption then as well.

Are

there any technologies that you're keeping your eye on for, in the next five years?

Yeah, I think there's a lot that's going to come out with. AI and helping us in that space. I mean, there's a lot that's happening around virtual nursing.

There's a lot happening around truly AI technology and being able to look at a patient from a visual perspective. So if you think about quality metrics and what that patient needs from a patient monitoring perspective. I think AI is going to help us a lot. And so we are looking at technologies that will be able to help us in those spaces and really again, push the envelope to make sure we're giving better care and safer care for our patients.

And we are already looking at it from, again. The journey that we've taken on from a higher height, being a highly reliable organization. We want our patients to feel and members to feel like when they do come into the organization that they are not at a higher risk by coming into the organization.

There are actually a lower risk. And so looking at technologies that can actually help in our day to day work to keep that going without having to add a whole bunch of workforce, I think is the constant. search, honestly for us to move forward.

Right? Right. Let's talk about the workforce.

Okay. A lot of challenges and organizations. Now, this new age of hybrid remote. Maybe you can tell us what your arrangement is with the staff, but what innovative approaches are you taking to develop the workforce focusing on your team at this point?

Yeah, our I. T. team just from our makeup is we are primarily I'd say remote.

We've got about 80 percent of our staff that is remote remote. Now, a good percentage of it out of state as well. So we actually made the conscious decision 3 years ago to go and hire from out of state because it was becoming very tough to either convince people to move to Oregon or move to Corvallis specifically.

Right. And I'm trying to find that talent is can be challenging.

So, repeat that for me. I'm sorry. Did you say number of percent out of state?

out of our close to 300 employees in it, I'd say we've got about 50 of them that are out of state.

I know people don't want to just pick up and relocate, but Oregon would be attractive to me.

Yeah, beautiful. It is a beautiful state and we try to. Make that appeal for sure. And then the area is beautiful, but the cost of living is higher, right? And so when you have somebody coming from a different state, they have to look at the whole package. And sometimes that becomes a challenge.

And honestly, I think, hiring people from out of state is helpful to find. The talent that you need.

Yeah, absolutely.

And it makes sense. Now we do have, my leadership team, myself and my leadership team. We come on site. We are all on site as far as just spending time.

At least I'd say at least 3 days a week. We are site. I'm pretty much here 4 to 5 days a week. Yeah, but by my leaders coming about 3 to 4 days a week. And. Yeah, absolutely. I think just having that presence here is important. And I think it keeps you in pulse with what's happening in the organization and in the community as well.

totally agree. I totally agree. You know that, for the leadership team to be there on site. Yeah, that's critical. That's

good. The pieces that we're working on Sue is that I feel like, we have a lot of our teams that work very well within their groups. It's more the cross collaboration.

And I think that's the constant struggle honestly, is having that collaboration. Take place because we all know that, the inpatient team versus the outpatient team versus the teams that, work on certain applications that water cooler talk is so important because they kind of can check in with each other.

What's truly happening and scheduling a team is meeting to do that. Sometimes it's a challenge, right? Because you're having to build that time into your calendar. we are encouraging it more and try to, have people when I say, bring yourself to work days, you know, take a day, bring yourself to work once a month and spend time with your teams and try to cross collaborating.

But, it's not as easy as it sounds at times. It is challenging to do that. Do

you have any requirements for staff to come on site? The 80 percent that are remote, do they come on site on any scheduled basis?

Not completely. I mean, that, the 20 percent of course, out of state.

No, but 80%. Yeah, I think once a quarter, they get together and they'll come on site and they'll have a meeting together, put a strategy session in place. I do it. manager summit three times a year where all of our managers come in and we get together and have an agenda to, to work through.

But I do encourage our teams to also do the same thing, right? And come on site and do that. And there is some of that happening and I'm seeing it more and more actually. Because I feel like some of the employees also feel like they're missing out on that human connection and really. Spending time together and so I'm seeing a little bit of that coming back naturally as well.

So, what are some of the differences here? I talked about, you have the health plan and you wanted that opportunity there, but what are some of the differences in your roles and, what caused you to move? Make the move. Yeah.

Yeah. I loved Louisville. Honestly. I thought it was a great place.

I, I love the organization, great leaders, really, thought provoking leaders honestly. And my time there was. Absolutely incredible, even though it was a time of turmoil. Just to put it in perspective, we went from 7, 000 employees to 15, 000 employees overnight. There we went through an acquisition of five hospitals at that time and, little did we know that once we signed the papers that four months later, there'd be a pandemic and then went through the pandemic. And actually, as we were transitioning those organizations into the University of Louisville system, we had a timeline of 18 months to bring them all onto our systems and transition fully.

We brought that down to 14 months with the pandemic in place as well. And so it, was a time of just. Yeah, absolutely. Honestly, a lot of work, a lot of hard work by put through by all, but absolutely incredible. I think it came down to really, Sue was my family at that time, my son who had, we had moved to Louisville missed the Northwest and my daughter did too.

And so we, went and spent our time there and then made the decision of coming back to what felt like home to them. Now they're. They're finding their own path, honestly by going to college and doing their own things. So, we're past that transition probably. But it was just they felt like they wanted to come home.

And the attractive thing was, when we sat down and talked as a family. I told him that, if the right, right opportunity came then I'd be open to it. And this one, I went from a community based health system to an academic health system. And now I've come back to more of an IDN with a health plan in there.

I've kind of gone through the different phases of different systems and gotten different experiences and it just felt like it was the right time to jump with this, especially with the health plan in place there. I've learned so much about health plans and value based care in this last three, four years that I don't think I would have ever learned being just on the delivery side.

And so it's opened my eyes a lot and I'm very grateful for both organizations. And having the opportunities that I've had,

that's great. It sounds like a good balance of career trajectory decisions in terms of what are the right opportunities at the same time, what works for the family and as someone who's lived in a number of places around the country.

I understand how you have to try to work that balance. So that's great. Last question I have for you is about. Okay. Vendors and you know what you've learned from working with vendor partners over the years in your different organizations and roles and any advice you would give to vendors who work with health care organizations, technology vendors in particular, of course.

Yeah I think we can do anything we have to do in our organization without our partners. And I truly call them partners because I feel like, they go through the ebbs and flows with you as an organization as well. And they are valleys and they are peaks, right? When you talk about a journey, especially in healthcare I think we all, know that well.

And we wouldn't be able to do it without our partners. And we take our partnerships very seriously. I mean, we've put a lot of effort into our epic first mentality out here and really. Look at how we can take advantage off the investment that we put into epic and have really looked at that.

We've also put a lot of effort into our first philosophy there because we are now walking away from our data center and really, have put all bets on our cloud for strategy. And so we couldn't do it with our partnerships there. As far as advice goes to our vendors, I would say that learn the organization before you come to the door.

Learn about what they may have and what uniqueness they may have coming in with a blanket thought process never helps. It's good to be open to start thinking about what that organization is going through because, I get. ping probably, hundreds of times like other CIOs do in a week from different vendors.

And it's the ones that really put the thought process of getting to know us a little bit better and bring that partnership philosophy forward really does help. And it, the rubber hits the road when you really need that vendor by your side. And how they respond makes a huge difference.

And so be really open to the discussion of we may have to do things a little differently because of our circumstance at this time. And how will you help us get there? And that discussion always goes a long ways.

That's great. That's great advice. Anything else you want to highlight before we close today?

No, I appreciate the time. I, really enjoyed the discussion. And it's nice to hear from others that are doing these, you know, podcasts as well. And just these, blogs. I learned so much from our community, honestly the CIO community. It's so nice to be able to lean on them to get advice.

And I feel like I feel like I'm seeing that more and more now where it's more about helping each other than anything else. Right. And I feel it. I feel that when I go to conferences, when I talk to people, when I pick up the phone. It's so easy to get, Oh, this is what I went through and here's the pain.

And, you may want to check into this and avoid yourself getting stuck in this place. And I think that makes all the difference. And so I'm very encouraged by this community and really grateful for it.

Yeah, good. Yeah, there's so much to learn from each other. I've always felt that way.

So

absolutely, I look forward to it. I think there's nothing better than connecting and talking and it makes it easy when you can just have a casual conversation.

That's right. Well, good luck with that. And thank you so much for all your insights today. Thank

you. I appreciate it. Bye. Bye.

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