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  Today on Town Hall

(INTRO)  It is my absolute passion and it is the one thing that I know for sure I'm going to continue working on after I retire from this role someday

it just is a way to give back and if people don't believe their voice can make a difference, it can.

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.

Today's episode is sponsored by Meditech and Doctor First .

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

 I'm Sue Schade, Principal at Starbridge Advisors and one of the hosts for the Town Hall Show at This Week Health. Today my guest is Pam McNutt. She's the SVP and Chief Information Officer at Methodist Health System in Dallas. Pam has been in this role for 31 years, so I'm just going to pause and go, wow, but we'll talk more about that.

So welcome, Pam. Thank you, Sue. Good to see you. So let's start by having you briefly introduce yourself and tell us about Methodist Health.

I've been in healthcare my entire career, right out of college. I was recruited into, a startup of healthcare IT. That was 45 years ago. But who's

counting?

Yeah, who's counting? We then progressed to where I came here to Methodist. And I have been here In, at Methodist for 31 years in the CIO role. I was the first actual CIO role here at Methodist. We were small at the time. We were two hospitals, no physician, practices. Since then we have grown to six wholly owned hospitals, some JVs, and we're opening our seventh hospital in March.

We now have 60 medical group clinics and five teaching clinics. It really has been journey here of being. in multiple organizations, even though I never change seats.

always told people being in technology and healthcare, constant change and evolution. So even if you're someplace for quite some time, It's not stale.

It's not stagnant. It's constantly changing. But let's talk about your longevity at Methodist. I think you might be the longest serving CIO at the same healthcare organization. Maybe not. I don't know anybody longer. What are some of the keys to your success there in terms of the longevity?

The biggest thing I'd have to say is having a great team.

My direct reports have been here nearly as long as I have. Thank you.

Wow.

And then underneath them and their manager and director roles, we have people with equally impressive tenure. And you see that actually throughout Methodist at the hospitals, at in here in corporate we consider our culture to be that of a family, of a caring family.

And I think that's the secret sauce that we have here. And that also is what makes it very hard for people to leave Methodist is because of that. Great sense of family, but if you look at a different angle of this is if you look at what would my board say about me or previous CEOs that have been there?

What would they say when they talk about why they were pleased to have me here in this role? And I think the main things there is, first of all is financial prowess. I had a business major so I do very well with doing pro formas and cash flow projections and also with all the planning we have to do for very big projects and I'm proud to say that to this point we have never had a big project that didn't come in under or at budget and on time.

Congratulations on that.

Yeah, and so the board obviously appreciates that. The other thing that I hear is that they really appreciate that I am not just pushing technology for technology's sake, but rather when I come talk to them about things or a part of a big project, we are talking about the business cases.

For technology, first and foremost, and not about the technology itself and so they believe that we have a very calculated and measured approach to when we spend money on technology at Methodist. And I think that has helped a lot. Also, my knowledge of healthcare regulations and healthcare operations in general is really what has brought me to the executive table.

That's great. So if I could just recap for someone who's, in their career thinking about, some keys to success, I heard the financial acumen and prowess. I heard the really execution in terms of on time, on budget, on major projects, the business savvy and relationships, not, it's not just about technology, it's the business.

And then your broader knowledge within the industry and around regulations. Did I get it right?

Yes, you did.

Okay and congratulations on your long tenure there. It's really impressive. Tell me about some of the current priorities that you and your team have at Methodist right now.

The biggest thing going on Methodist, at Methodist right now is a growth. We are continuing to grow aggressively. The Dallas market has a lot of players in it, and you'd think there'd be no room left for growth, but because of the growth the Dallas Fort Worth market is experiencing, and people moving to this market, and companies moving to this market there's plenty of room for growth for healthcare organizations.

We are bringing on physician practices at the rate of one every couple weeks. so it's huge focus on that. But also we want to look at some digital solutions and we have a digital. Front door initiative that, that I am chairing, where we're looking at every possible way we can engage with our patients.

in the fashion that they would like to be engaged with. And that's moving along like it is everywhere. I think everyone has similar initiatives. You've got to get the online scheduling up and running. It's just an expectation from our consumers right now and that things will be able to be done on mobile phones, check ins to appointments, communicating with your physicians, all that is extremely important.

The other thing that we're looking at and that I am spearheading is looking at position productivity tools. And that does dip us into, the world of AI a bit. So we are very focused on that. And like everyone around the country, we are also focused on operational efficiencies. I do have to brag a little on us.

We have one of the highest Moody Bond ratings. For health care and one of the highest margins for health care at this point in time, but a large part of it is our really, we focus for years on running very lean and very efficiently and that really shows in that achievement.

That's impressive. So in terms of technology and some of the areas where you may be pushing the envelope, you mentioned digital front door like most organizations, physician productivity tools, AI any particular technologies there that you want to comment on that you're working with?

In the realm of ai. Like I said, we don't really we're not an early adopter on a lot of things. We're maybe a second adopter. . We don't like to be late, but we don't, we're not usually first. And we're doing, we're really following epic's lead a lot for how AI can enhance the EMR and we're.

following along with their playbook there. But artificial intelligence has another really big role. I also am over biomedical and clinical engineering it corporate wide. Yep. And there is so much AI potential. In that area, in particular for post processing type of overreads and AI on CT scans, MRIs that can identify diseases, conditions, and cancers really far better than the human eye can.

Radiologists may not like that but they do like it. They do like what these technologies are finding. So we are doing a lot in that realm. And I think that's probably where the biggest impact for AI is going to be in healthcare.

Is augmenting the clinical component. Correct. Yes. Great. Great. And is there anything in terms of physician productivity tools to comment on?

Probably like everyone else in the country, it's all the rage to talk about the ambient listening enablement of your physician documentation. And that is right now I think it's becoming pretty standard in PCP and specialist office, but I predict it's going to move very quickly into the emergency department and other areas where you have those same kind of encapsulated visits like you do in a doctor's office.

Any particular technologies you're keeping an eye on over the next few years?

AI advancements. The other thing that we're looking forward to, I think the whole industry is a little behind in, in being able to share images. With each other in a real slick and easy fashion I'm surprised that our industry is still a little lagging on that front, so we're looking to hopefully get in, move the envelope on that here at Methodist, and I know there's third party providers you can do that, but with, but I'm a little disappointed that kind of your core PAX vendors don't have better solutions for that technology.

I think that's a gap. One thing that is a little bit of a disappointment to me, and I think other CIOs would say this is the way telehealth took off and now it's retracting.

Yeah.

That's a disappointment, and I'm hoping we can move forward with regulatory changes, and working with our insurance carriers to ramp that back up again.

I think it was very effective during COVID and I hate to see it ramping back down.

Do you have any numbers at Methodist in terms of telehealth use? during pandemic versus now to comment on? I agree, it's disappointing.

It was probably, 60 percent of the visits happening and we had a whole program stood up to do that and then it started just and, now we're lucky to get a doctor or two who's willing to participate in our telehealth program and patient visits are declining.

They'd rather come in and be seen in person for things. And I also think that there's a lot of other telehealth offerings for like almost an urgent care like setting that, that are out there. There's so many out there that right now that perhaps patients are not looking to their primary care doctors to provide that kind of service.

Yeah.

Yeah. why there's such, A drop off. I'm with you that it was extremely beneficial and it's disappointing to hear that you can't get doctors to use it at this point. And from the patient side, if I can do a telehealth visit instead of drive somewhere.

Oh, yeah. I think reimbursement is a

huge driver to that. Think about it. If they started paying as much as a regular visit it would be promoted very heavily.

  📍 📍 📍 📍 📍 Hi everyone, I'm Sarah Richardson, president of the 229 Executive Development Community at This Week Health. I'm thrilled to share some exciting news with you. I'm launching a new show on our conference channel called Flourish. In Flourish, we dive into captivating career origin stories, offering insights and inspiration to help you thrive in your own career journey.

Whether you're a health system employee in IT or a partner looking to understand the healthcare landscape better, Flourish has something valuable for you. It's all about gaining perspectives and finding motivation to flourish in your career. .

You can tune in on ThisWeekHealth. com or wherever you listen to podcasts. Stay curious, stay inspired, and keep flourishing. I can't wait for you to join us on this journey.  

Let's talk about vendor relationships and the challenges that CIOs face with so many large scale vendor acquisitions on one end and so many startup companies on the other end.

You've dealt with a lot of vendor partners in your 45 years, but in your 31 years there what have you learned about dealing with vendor partners? What advice would you give to vendors working with CIOs like yourself?

The first thing I would say is they all come and say they want to be a partner.

Candidly, and Sue, you know this, there's probably only a handful of them in the long run that as a CIO you would consider as a true partner to your organization. But to be a partner, expect certain behaviors, you expect that they do understand that you're the customer. They expect that they will respect the value of the investments that you have put into their company, and that they would be looking out for you.

for your well being. Now, of course, they have to make money and as a good CIO, you understand that you're not going to push vendors to the brink. has to be a win. But what I'm seeing right now, especially with all these acquisitions, and it's really a big buzz right now with my peer CIOs, is some of these some people call it predatory practices.

Others would call it price gouging that's going on. with some of the big vendors right now who have been acquired by another company and then they end of life products that you might be using very quickly, like with six months notice, or they are flipping and or I should say the new product is always a subscription based model.

And very frequently, they're not giving you any consideration for the vast investment you already have, capital wise, in their product. You probably have a bunch of depreciation still on the books for your capital investment in their products. And this is very frustrating, and CIOs are about at a boiling point.

And I Almost once a week, another vendor calls me with great news. If you can sign this new contract and document within six weeks, then you're not going to get stung as bad as you're going to get stung in October with us flipping you to subscription and end of lifing your current product. This is like a weekly occurrence.

And this is when vendors, is this a result of the acquisitions that are happening, or is this just a pricing model that vendors are moving to now?

It's both, and I would have to say that the price gouging aspect is probably coming on more from the acquisitions, but the flipping to subscription model is really happening across the board.

And how are you dealing with that, from a budgetary perspective?

It's extremely difficult. I'm having a whole meeting tomorrow with our COO and CFO to show them in a cash flow kind of format the impact of the numerous, capital to subscription flips that we're having to deal with this year and the increase that, millions of dollars increase in my budget.

Is there a room for pushback and negotiation on these?

With some vendors there are, and with your experience in the market, you can imagine in your mind some vendors who don't take pushback, but then there's others that do.

And let's wind back to what a true partner is. I was completely braced for a meeting about a month ago, completely braced for the worst possible news. coming from a vendor who we would have considered a partner.

Okay.

Guess what? They are a partner. They came to the table and showed me that they respected the value of my previous transactions, gave me flexibility in how I could move to their mandatory new subscription model, and despite what I had heard from other colleagues the price lift that I was told was less than I expected.

And the whole meeting was we really value as a customer. And yes, we are switching our business models, but we're trying to make it as painless as possible for you to get there. So that's a partner.

Yep.

Someone coming in and saying take it and take it or leave it. Here's your offer, here's your deal, you have six weeks to decide.

That's not a partner.

Yeah, so circling back to where you started in defining a partner before you started talking about the practices that partner demonstrated what it takes. And I'm assuming you walked away from that interaction negotiation satisfied? Yes. Okay good. Can I move on to another question?

Did you have more about that? Okay, so I want to talk about workforce challenges and given what you said about the, your own longevity, direct reports have been there a long time, the family culture of Methodist I wonder what you're dealing with in terms of, Challenges with hiring when you do need to replace people, but there's, we're in a new period here in terms of hybrid and remote work.

So what approaches are you taking to make sure that you're developing the workforce in the future, retaining good people, able to hire, good talent?

We have remained with a hybrid remote work model for roles, which, where that was appropriate. We did struggle, candidly, when we had remote workers that were all over the country, and we were trying to still have that family feel, because we do like to have some in person celebrations.

And I think the first time after COVID, when we all got together, I think we were celebrating someone's retirement, and everybody came into the office. People were literally in tears to see each other again. And that's very powerful. So we have pulled back a from saying you can work remotely anywhere in the country to trying to get people that are with at least within a certain range where they can come in for some of these in person huddles.

But that's helpful. We know we can't retract back to total. in office only

for

a lot of our workforce here in IT. But we're trying to balance that. And I think we've found the sweet spot, for the moment. The other thing is that keeps the loyalty with our staff and also gives us great opportunity is that we really like to grow our own from within our own family.

And I could tell you so many stories about people that started on the help desk or as a PC technician that are now in even lead roles on our EPIC teams, or on our security team, or on our network team, moved into management. That's where we always look first. When we have an opening, our first question is, do we have anybody?

that might be ready for this challenge. And we groom people along the way by giving them training, giving them opportunity to become EPIC certified in something to see if that's the right thing for them to do or to have them get the various technical certifications. But I think that has served us extremely well and that is what produces, I think, the loyalty and the family culture that we have in our department.

Great, great. And are you still hiring, I'll say, national from other states or just in the region? Texas is a big state if you're somewhere in Texas to travel into Dallas even.

We try and look at about a 250, 300 mile range, which for us opens up Oklahoma and Louisiana.

Okay.

Of somebody that could come here, for one of the in person meetings or celebrations. Or in case we have a really big project going on where we need hands on deck. So that's what we're trying to focus on right now. it's working at, we're very lucky here in Dallas Fort Worth, as I said earlier, just so many companies are moving here.

And with that brings spouses and people that work in healthcare. And also it's a desirable area to move to in general. So we're blessed here in Dallas, Fort Worth.

Is there anything else you want to highlight before we close? Mindful of the time here we've got.

Yes, thing that I always say, and Sue, this isn't going to surprise me, because my drum that I beat is about policy and helping shape the industry.

We can help shape policy. As CIOs, you need to get involved. You need to get involved with your professional groups. You need to get involved wherever you can, volunteer, get nominated for local. state, even national committees that help influence healthcare IT policy. It is my absolute passion and it is the one thing that I know for sure I'm going to continue working on after I retire from this role someday at Methodist.

It just is a way to give back and if people don't believe their voice can make a difference, it can.

Pam, that is such a strong closing and I so appreciate that you mentioned your passion and policy and having an impact on the industry because you certainly have done that. You've led the way doing that and to encourage other people maybe earlier in their careers to start thinking about how they can also be involved.

That is a powerful message. So thank you and thank you for your time and all your insights today.

Okay. Thank you, Sue.

All right. Take care. (MAIN)  ​ 

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