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Chuck Christian: (INTRO) we're taking a measured approach and some of the pilots and stuff we've done, we've worked really hard and we've just decided, we're gonna fail fast.

That's not gonna work. Move it out of the side and let's go do something different.

Bill Russell: 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.

Nayan Patel: Well, hello, I'm Nayan Patel, senior VP of FinThrive and one of the moderators at Town Hall Show at this week Health. Today my guest is Chuck Christian, vice President and Chief Technology Officer at Franciscan Health in Indiana, and he is been there over six years.

Chuck Christian: Great. Well thanks Nayan. How are you this morning?

Nayan Patel: I'm doing great. We've known each other for many years and I appreciate you taking the time and being a mentor for me.

Originally when I went to the bootcamp back in China.

Chuck Christian: You're too kind. It's very nice to have you in my sphere. because I firmly believe that we take the good parts of everybody we meet. So thanks very much for being part of my makeup.

Nayan Patel: Well, you're right on that. I think as long as we focus on the good you're able to move forward. So let's get started. Tell me a little bit about yourself and Franciscan Health.

Chuck Christian: Sure. How far you want to go back? I've been around a long time. So, I am the Vice President of technology and CTO for Franciscan Health, and I've been here a little over six years.

We've probably got 350 locations, physician practices, imaging centers, urgent cares oncology centers you name it. We have hospitals from Mooresville, Indiana, which is really between Indianapolis and Bloomington. Kind of sorta of all the way to south suburban Chicago.

So it's it kind of follows the 65 corridor, which I found really interesting. Franciscan was founded 150 years ago this year by the Sisters of St. Francis, a perpetual adoration, which is an order that came over from Europe.

And so it's a really, a great organization. We are a, as you can tell, a big C Catholic healthcare system in our mission is to provide high quality care for our patient populations that we serve, and we really, truly take that mission seriously.

it is one of the biggest challenges we've had as, hospital CIOs is, trying to keep the lights on activity. Right? Yeah. But, at the same time you're trying to innovate. So tell me a little bit, I know we talked in the past and you've actually had some articles published, I believe, regarding, some of the things that you were leading the way on in terms of Epic on Azure.

And other things of that nature. So maybe you can tell me a little bit about, your experience in terms of what challenges you had with trying to lead something innovative like that?

Chuck Christian: Well, I very much appreciate the opportunity. The thing about it is Franciscan decided to move to the cloud.

And as they decided to get out it made our decisions a little bit. More rapid for us , we knew we were gonna get to the cloud and we thought maybe it'll be five years from now. becuase we wanted to kinda watch everybody else and see what they did and, not be that pioneer.

You know what pioneers get, don't you? They get the arrows and so, but we decided to go ahead and do it. We had some encouragement for Microsoft. We had some people that used to work for Franciscan, that were working for Microsoft at that time. And so, we had looked at what others had done.

They had moved partially to the cloud. Most of them had gone with Dr and some of the really non-production systems that you had to have with Epic, but we decided that we were gonna move everything and we moved all of our production environments, all the non-production environments.

And they found that really quick, I think, well, I shouldn't say really quick. We learned together that they're just not a platform. They have to become a partner. They have a dog in this race as well. And so I think that they've learned how to support it a little bit differently , than they would a regular

in site, because we are life safety there's a higher level of infrastructure integrity that we have to have and also resiliency. And so I think we have built that into our cloud journey. So, it's been interesting. And the fact is that We had hosted our Epic solution and had a managed partner, managing all that backend infrastructure for us.

Nayan Patel: That's awesome. So, one of the things you just said was very interesting. You said that there were a lot of people from Franciscan Health that actually had moved to Microsoft.

And I

think that is, so important because in this society, obviously we're certainly all interconnected, but it gives the partners the value and insight into what matters to hospitals.

Chuck Christian: Yeah.

Nayan Patel: I think, that is something that. All partners need to be more cognizant of or reach out. Same reason why I'm in a different role these days, but I think in terms of, what a hospital cares about, that's something so critical and tying it back to patient care, ultimately, it's always about patient care.

Chuck Christian: Yeah.

Nayan Patel: But maybe you already have selected something and moving forward with that and

Chuck Christian: Well, we're doing some pilots. Yeah. The one thing about Franciscan, we're pretty risk averse. We're going to jump out there and do some things, but we're also going to not, try to eat the whole elephant at one time because been in the business long enough that you know the people are gonna come sell you solutions.

And they're gonna tell you that it'll leap tall buildings at a single bound stop bullets in its mouth. And they don't. And so we're taking a measured approach, I guess We have a couple of pilots on ambient listening in our physician practices because we think that's where the biggest bang for the buck.

We did a lot of really creative, innovative stuff during COVID because we had to and a lot of it was, piece together technology using iPads and teams and a whole bunch of other stuff. But it worked. And I think we learned a lot about what works and what doesn't work. And the fact is you don't have to have a fancy platform that's extremely complex in order to get the job done, however.

Do have to have something that is put together well enough that it's going to be solid from a performance standpoint, because, when we're trying to cobble something together and people are trying to just do their job because of certain limitations that have been set because of COVID.

Just works well. They want the same thing in everything that they touch, because if it doesn't work and just like they think it should, then it becomes a hindrance. It gets in their way of providing the care to the patients. and we don't want to do that. So we're taking a measured approach and some of the pilots and stuff we've done, we've worked really hard and we've just decided, we're gonna fail fast.

That's not gonna work. Move it out of the side and let's go do something different. And so in that, we've stood up a, what I call a tech innovation lab. One of my enterprise architects who's running that Chris has been a developer. He's got that developer brain and he likes digging into and finding solutions.

And so we're putting it in the lab first so we can understand how it all fits together, making sure that it works. And then we know how to. You know, Kind of rinse and repeat when we roll it out. When we've got 12 hospitals that we're and a whole bunch of physician practices, you just have to do them one over and over again, and it has to be a repeatable process.

Nayan Patel: Yeah, I think and we talked about it that in the past of your tech innovation lab, I think Yep. Not all organizations take that investment because that is a way that you can test things out. You also mentioned that, during COVID, we all had to change so many different things and we

Chuck Christian: Well we have a pretty sophisticated what we call a demand process. where people bring things to the, we have a leadership group of our senior leaders for the entire organization. Our Chief operating officer for the entire corporation chairs this group and it's basically managed by our PMO our enterprise, PMO.

And they have to write business cases for these things. Now, the one thing I wish that we would get more disciplined about is when people say, we're gonna save, millions of dollars uh, go back and say, okay, did you. Right. Yeah. Oh, by the way, we're taking it out of your budget.

And we review the technologies as they come in because we wanna make sure that all the enterprise architects report up to me. And I've got a group of extremely smart individuals. And so I can truly declare that I'm the dumbest person in the room when we all get together.

All that we had to buy, some rack and networking and stuff, but most of everything was donated. It was given to us to start the lab and so therefore, our cost of that investment has been very small in comparison to what it could have been. So, those are out there

that are wanting to stand something like that up. I encourage you to have conversations with your partners about, what they're willing to help you fund.

Nayan Patel: and that's just the difference today. We have to look at every vendor as a partner.

If they're truly, in it to win it type of thing. They're helping you as the organization and, doing post ROI, that's been a challenge for the past 20 years that I've been in the business. Oh, yeah. And I've been part of a PMO and I love the fact that you're saying that. Franciscan uses an enterprise PMO because that really puts it back to the business.

Have y'all done much to look at data handoffs and integrations between claims and reimbursements to, figure out how to improve those processes? Have y'all looked into that at all?

Chuck Christian: Well, actually they're doing that right now. I think it's one of those things that you have to constantly do because the rules of the road, as you well know, continues to change.

I think our large payers are government payers. Our case mix is leaning that way because of the mission of the organization. We are designed to support those communities that can least afford care. That's the mission of Franciscan. And so, we're gonna get to those government payers pretty quickly.

Yep. So if you're not staying on top of it. You're gonna wind up with your denials and stuff, you're gonna see them skyrocket. So you have to do it. And the other thing too is that, you mentioned ai we're implementing some RPA as many organizations are to take care of those, repeatable tasks over and over again.

And we're also looking at ai, we're an epic shop, so we're trying to take advantage of, what. Epic is, creating and putting out there for us we haven't embraced all of it, but, our AI is divided into two different communities.

And then they'll have to clinically make the decision whether or not they're gonna accept that. And then you have the, what I call The production side of the house, which would be, your co-pilots your RPA, your other AI related to revenue cycle or anything else. It could be, as much as, or as little as.

Having AI help you manage inventory levels and par levels? We're a big organization and so we have a lot of supplies that are rolling in all over the place. And so how to manage that inventory and, the turns on the shelves and stuff. because that's big money sitting in the warehouses. And in healthcare, everything has an expiration date If you're not watching it.

Nayan Patel: And that's interesting because as someone who's recently moved into the revenue cycle world it's about getting those claims processed sooner than later because they devalue with time.

We just have to, keep focusing on why are we in healthcare. Healthcare is for taking care of people and making sure that business stays intact. I think a couple years ago. You also did another interview, I believe, and you were talking a lot about, reducing redundant or unused software.

Yep. I think that is a big piece of what I love to champion, application rationalization and in finding different things. And revenue cycle is one of those too. You can, find these end-to-end solutions. That's the world I'm living in today. But specific to Apprat, from two years ago to today.

Do you think you've made a little dent into, reducing some of those redundant apps?

Chuck Christian: Part of that app rationalization we were doing was related to our journey to the cloud. And when I first joined Franciscan, everybody was kept telling, well, we have a cloud first strategy and I'm going, really?

It's not gonna cost me if I have capacity, but if I put them in the cloud, then I'm gonna start paying a monthly fee on that. And so if my job is to balance the cost of operation with performance, then I'm gonna, I'm gonna do it in the data center as long as that host is viable and I don't have to replace it.

Close range. How much is that gonna cost me on a monthly basis? We know that well, and Microsoft's got tools too, but, I think, Microsoft's job is to enhance their revenue stream as much as possible. My job is to make sure I don't give them as much of my money as they want.

And so there's a balance. And so what we're doing is looking at how do we effectively move stuff in? So we, I think the last count we've decreased probably about 150 to a 175 applications. Just got rid of them in Zo. The other thing that we're doing is I've got a great partner in clinical engineering now.

She reports to a different part of the organization. She reports up to quality. She's a great partner and so we provide the hardware that all of the, the clinical engineering medical device software runs on, the cardiac monitors and that kind of stuff.

That footprint of hardware significantly. We're doing the same thing for the physiological monitors that sit in our cath labs and we're doing it for nurse call as well. And so it's not just the apps, but you also , have to consider the hardware that all the stuff runs on.

Then the other thing we did. One of the first things I ran into when I joined Franciscan is I had a bunch of anesthesiologists that were absolutely unhappy. I was gonna say pissed, but you know, that's not an appropriate term. They were unhappy. We had a solution in place to capture data off of their anesthesia carts and put it into Epic.

. But I have to say I've had absolutely zero complaint. Then we turned around and did the same thing with our ventilators. And then working with Karen's team, we were able to go direct to Phillips to pull all the

cardiac monitor strips and that kinda stuff directly into Epic without a piece of middleware. And so there was savings for that. So you have to look a little bit deeper than just the applications if you're really going to, find those nuggets out there. And, I have not gone back and so, okay, how much money have we saved?

And that's what I wanted to get to was, they don't have to worry about it it's just going to work and it has to be maintained.

Nayan Patel: the way you just outline many of those activities right now is, our roles as tech leaders is actually less about technology in some ways.

It's more about the process of Yeah. The business and the business itself. And so I see, your role as well as all of our. Hospital leader roles now are part of the business, or the technology leader roles, whether you're a CTO, CIO or whatever you might be. Yep. It really is about, being engaged at the business level and making sure you're, tying it back to the business, and the fact that you have an enterprise PMO, that's kind of how it all fits together.

So this is great. This has been great. I got one final question for you. Okay. if you could be one cartoon character, which one would you be and why?

Nayan Patel: There you go.

Chuck Christian: Yeah, and the reason why is because he's a smart dude, number one. And he gets into trouble all the time, but he also gets out of trouble.

And Elmer Fud has never been able to kill him.

Nayan Patel: That is true. Yeah. So that's awesome. Yeah. E either that or the

Chuck Christian: Roadrunner. Yeah, because he's always outsmarted the coyote, so

Nayan Patel: You grew up with what I did, the Looney Tunes, those are the best cartoons ever. I don't know, you know how.

The next generation would answer questions like that, but, oh, no, that's definitely

Chuck Christian: Well, and the thing about it, those cartoons taught so many life lessons because, they're not reality. And that means that, the cartoons can be anything you want them to be. They can be absolutely stupid and unbelievable.

But they could still be funny as crap too.

Nayan Patel: Yeah. That's awesome. Well, there's nothing better than, talking to leaders like yourself and for me, a mentor of mine for the last 10 plus years. So really appreciate you taking the time and sharing your insights today. So, well,

I very much appreciate it. And I think folks like you you lift up your own boat. And so, if we don't. Have an opportunity to learn from each other because I can promise you, the years I taught the CHIME bootcamp I told everybody that I learned more from the cohort and the students than I probably taught.

And so it was a truly a two way street.

Nayan Patel: Yeah. No, and I think that's. The best part about even doing these type of interviews that when you teach and give back, you learn a lot.

Chuck Christian: Oh yeah. Absolutely.

Nayan Patel: Yeah. Well, thank you very much again, and we'll see you at the next event.

Chuck Christian: Okay. I appreciate you. Have a good one.

Take care.

Bill Russell: Thanks for listening to this week's Town Hall. A big thanks to our hosts and content creators. We really couldn't do it without them. We hope that you're going to share this podcast with a peer or a friend. It's a great chance to discuss and even establish a mentoring relationship along the way.

Thanks for listening. That's all for now..