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September 26: Today on TownHall, it's another look back to an episode from last year. In this episode, Sue Schade, Principal at StarBridge Advisors spoke with the Boston Children’s Hospital duo of Heather Nelson, SVP & Chief Information Officer and John Brownstein, Chief Innovation Officer about effective collaboration between their two teams. What projects are they working together on currently? How do they go from a pilot to a successful house-wide implementation? What advice would Heather give to fellow Chief Information Officers on working more effectively with their Chief Innovation Officers?

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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.

 The innovation groups gets excited by a new shiny object, and then we go off do something and then come back and find out that it was a terrible idea.

And we didn't have the buy-in. The, flip side is sometimes trying. to Come to it with thousands of different ideas and hopefully get input on that . So you sort of find a sweet spot

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.

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Now, on to our show.

 Hello, I'm Sue shade, principal at Starbridge advisors. And one of the hosts for the town hall show on the community channel. Today, I have two guests. I know. Well from Boston children's hospital, Heather Nelson, chief information officer and John Brownstein, chief innovation officer. I'm super excited to be talking with both of them today.

We're gonna talk about their work together, how they and their teams partner to serve Boston children's hospital. So welcome Heather and.

Thank you.

Good to be here.

Good to see you guys too. So let's start by some introductions. So Heather, you wanna start by introducing yourself and your role and your work at Boston children.

Sure. Thank you so much. So I am the senior vice president and chief information officer here at Boston. Children's. I've been here about nine months now. And it's been a busy nine months at that, including us getting to a selection for our enterprise EHR. Boston children's has two EHRs and a whole host of custom and third party applications.

So, Sue did such a great job of teeing us up for this huge milestone and huge decision for the organization. So really shifting my focus now on starting the planning for this big project prior to coming to Boston children's I was at U Chicago medicine where I was the senior vice president, chief information officer there.

So really super excited to be at Boston. Super excited that I get to work with John Brownstein and his teams every day and the work that we're doing just to improve the lives and the health of our patients and the communities around us. So

that's who I am.

Great. Great. Thanks, John.

Yeah, let's talk about you.

Yeah. So I'm the chief innovation, another CIO. And my role is really around trying to drive the organization forward, thinking about emerging technologies and how we need to evolve to consider how to improve the, the experience for our patients experience for our providers, decision support tools to.

bring better decision making and better outcomes. Obviously our view has been that the role of digital is gonna play a transformational role and still has on the delivery of healthcare and healthcare. Compared to other industries is lagging in many regards and in adopting digital, that is one of them.

So our team has been resourced for many years. I've been in this role for close to nine years running the innovation efforts and many of the digital health efforts of the hospital. Also professor at the medical school, Harvard medical school where I also run a lab that is focused on new emerging digital technologies.

Mostly. To understand and impact population health and public health. So, take a lot of different experiences from both the research side and from the healthcare delivery side and the sort of the digital health ecosystem to try to bring that to bear, to improve how we think about new tools and in Boston, children's.

Right. So thank you both. And Heather thanks for the kind words for the listeners. Her reference was to the fact that I served as the interim CIO chief information officer and partnered with John last year before Boston children's hired Heather and brought her in and we did the handoff.

So, I was happy to work with both of you in those ways and to be able to serve Boston children's. So I know the importance of the partner. There between these two roles. So why don't you describe that how you do partner together?

Yeah, I'll start. I think, having the synergies that we do have between our teams, but more importantly, our missions and our roadmaps and our planning is so critical for me to be able to help.

Pull the technical pieces together, but more importantly as we implement or as we decide, you know what, this is the right thing to do, this is gonna make a difference, making sure that we put together an operating model so that we can sustain it, enhance it. Or there may be times when we're like, you know what?

That was a good idea, but it's just not the right thing. But the fact that we have regular conversations. Our teams are, pretty intertwined. I see my role in this, in supporting the innovation, but more importantly, making sure that the innovation is synergistic within the current environment.

And, but more importantly, making sure we have a good support model, we don't wanna implement something that doesn't get care and feeding and in it, we need to be able to do that work for the innovation team and with the innovation team.

Yeah. I mean, listen, I think that

it's interesting because innovation groups sit in different parts of different organizations and they're structured very differently in every group. Sometimes they're directly inside of it. And some of the challenges there of course, are in terms of allocating appropriate resources to really.

Push the envelope and by putting sometimes innovation inside IT it's problematic because it just doesn't get the sort of juice it needs to really make something happen. On the other hand, I see many innovation departments that are out on their own island and. A don't get enough resources to do anything, but B do not have the sort of connection to, for instance it and other parts of the organization as well.

And so. Our view is that the optimized way to get innovation to actually function in an organization is to have a very separate, yet very close partnership with it. And that's been something that, we've cultivated and I think is working incredibly well with Heather in her role. Right now we have people that are cross functional across both teams.

We have dedicated resources. And very tight collaborations. And I think part of the. Way to optimize that is to make sure that we're constantly in close touch on projects. Some of the challenges that we've experienced in the past are, the innovation groups gets excited by a new shiny object, and then we go off do something and then come back and find out that it was a terrible idea.

And we didn't have the buy-in. I mean, the, flip side is sometimes trying. to Come to it with thousands of different ideas and hopefully get input on that that's impossible So you sort of find a sweet spot where we know that we want to execute on something, but we need the sort of a close partnership of it to be able to really make something happen.

And so that's something that we've figured out over time, but I think as of now works incredibly well mm-hmm

and it was real important for me in that vein. When I came on board was to build out the it strategic plan. There wasn't one like a formal strategic plan. And I knew that I needed that innovation swim lane in my roadmap because I needed to know what I needed to do with my teams, how I needed to restructure things, what we needed to do for funding or skill set assessments.

And so I did. With John and his teams the innovation strategies that, we had in front of us in my fiscal year 22, it strategic plan. So again, continuing to make sure that we're always on the same page and John's right. There's some things that pop, there are those bright and shiny objects that, Hey, they're worth a looksie.

And I feel like we are becoming more nimble. Because we have the teams aligned that if we need to shift a little bit and pause something so we can focus on that, that we're able to do so. And that to me, we're gonna continue to refine that and enhance that and continue to build that type of a culture where we can be more nimble.

Versus having to go to 15 different committees to get approval and all that good stuff, we're trying to knock out some of the red tape and be more nimble for the organization and our clinical care team members who are a big part of it. I mean, they're the end users of these innovations and technologies, and we need them to be excited about it too, and use it and give us the feedback.


It's great. You guys hit on a lot of key points. Talk about the culture being nimble, not just responding to the bright, shiny objects. You talked John about finding that sweet spot. And I truly believe that the two of you are doing that together. So what about the synergies between your teams?

Is that working that way? How do you get them working together?

Well, I've brought on some new leaders, since I've started and, done some restructuring within my teams. And fortunately. One of the individuals that I brought on. Is very excited about innovation and making sure that we have those strong handoffs.

So, we're still tweaking, we're determining which of those team members need to maybe sit more on the it side to continue to just support and optimize and, you know, from a, support model perspective. And then we're also working together on. What are some of the skill sets we don't have so we're advocating for each other to make sure we've got the right number the right skill sets between both sides, John.

Yeah, no, I think the teams work incredibly well. There is a funny dynamic in the sense that sometimes we're finding some Flipping of people from group to group, because there are some people that, as Heather said will look at the innovation side, will get excited by the fact that we're on the cutting edge and we're getting to try many different things.

And that can feel, sometimes disheartening to people that are just sort of dealing with core. It systems and they don't get to be part of that sort of excitement. The flip side is there are number of people that are on our end that feel like they live in an ecosystem of pilots and they're constantly either seeing projects fail or if they do well, then they have to hand them off because they've done so well.

And now it's time to grow it. And it can't necessarily grow in innovation. And then, so for some people. They'd like to be on the real growth stage. And it's just like any startup. There's some people that are more mind towards the early stage of a startup where they're excited about the idea, trying it out, failing, trying the next thing.

And there's some people that are really more growth minded and, just like. There's employees that fit every stage of an idea. Like, I think that works well for our group, but sometimes people are maybe fit into the wrong group and need a switch. But overall, if there's some equilibrium that eventually resolves itself and we have really high functioning teams that work closely together.


We'll get back to our show in just a minute. Our monthly Leader Series webinars has been a huge success. We had close to 300 people sign up for our September webinar, and we are at it again in October. are going to talk about interoperability from a possibility standpoint. We talk a lot about what you need to do and that kind of stuff.

This time we're going to talk about, hey, what's the future look like in a world where... Interoperability, where data, where information flows freely. And we're going to do that on October 5th at 1 o'clock Eastern Time, 10 o'clock Pacific Time. We're going to talk about solutions, we're going to share experiences, we're going to talk about patient centric care.

And see what we can find out. We have three great leaders on this webinar. Mickey Tripathi with the ONC. Mary Ann Yeager, Sequoia Project. And Anish Chopra, who I'm just going to call an interoperability. evangelist, which is what he has been to me ever since I met him about 10 years ago. Don't miss this one.

Register today at ThisWeekHealth. com. Now back to our show. 📍

 Yeah. That's great. That's great. So are there joint efforts you're working on now that you wanna describe? And I'm, also curious and I think listeners would be too as to how you go from that pilot, what you tried successful and then scale. We all wanna see if it's successful, house wide, not just in one malaria.

I think when a good example is, we are looking to figure out how to improve the experience of our patients and providers in the hospital setting with new technologies. And so. We're trying to optimize data, but we're also trying to use new modalities to collect data in reduce the amount of time it takes for instance, to document a patient.

So we have a big effort that's ongoing with nuance now owned by Microsoft in their They're basically ambient listening device, which basically captures information as part of a conversation that a provider has with the patient and structures that turns that to text and then is used to essentially feed into the electronic medical record and the amount of work it took to put a device that can listen to a patient and a physician and the consenting that it took, but also the sort.

The it infrastructure that is required to bring those devices into the patient room and be able to capture that information and populate the HR that requires deep collaboration. We're already seeing incredible amounts of enthusiasm, both on the. Patients side, especially the provider side where the amount of time around documentation is being cut dramatically because so much of that initial, upfront work is being taken out of the equation.

And so right now we're in a major pilot of that, but again, that required an innovation, it collaboration. And then from there, we'll be growing that pilot, but we think that that is like, A part of, one of the pillars that we are going for, which is trying to improve clinical efficiency, decision making, documentation, burnout, and, that's a very classic example of a real sort of fundamental.

Operational goal where innovation can identify the opportunities and then working closely with it to actually implement these things, capture some initial data, understand the value and then operationalize it. So that's one example. There are many like that.

Yeah. That's great. Heather, you wanna say anything about that example?

No, I mean, it was great. I mean, there was a lot of collaboration on it and a lot of it was getting our care team members. Like okay with it, helping them to understand the benefits of this versus there's this thing in the room that's listening, you know, how do you get them to.

Leverage that as just another tool in their toolkit versus you know, that it's, barrier or that it's gonna impact their ability to care for the patients. And what's great is when you see the patients and their families excited about it and they're seeing a difference I think that's what always makes it worthwhile.

And, we just opened up a new Building on our main campus. And we were able to get all of those devices deployed in the units. And so, as we're continuing to stabilize and kind of get comfortable in our new setting, we're, as John mentioned, we have a big pilot.

We're we wanna ramp it up, as quickly as our care team members and our clinical partners are ready, our teams are ready to get going on that as well. So we're excited. And, And like John said, the data coming back is very, very positive. And so we feel like. We made the right decision and we've got the right pilots in place to give us, what's working well, what do we need to tweak?

But more importantly, we're ready to go. So

great. That's great. Congratulations on the opening that was in June, the new building. Yes. Yeah. Yes. Excellent. Yes. Excellent. So, what advice do you have for other health systems that may struggle with their innovation model? The structure of the teams, how they govern?

Because I gotta tell you, I think from my experience there working with you, John last year that the model at Boston children's is a very good one and better than I had seen in some other organizations that I've seen. So.

Well, first of all, I mean, if you don't have the buy-in from the top and if you're the organization is just creating an innovation function to, to check a box that we're trying to be forward thinking, but not actually investing in it to actually do anything or.

Give it some real ability to be part of the transformation process. That's super key because I see many places where they have a great chief innovation officer or, but then they've sort of undercut that person by not actually giving them any. Resources or any ability to do something. And the reporting structures such that they wanted the the role, cause they felt it was important, but they didn't actually want that role to do anything.

We were also put in a position where we didn't just have an ability to like talk to startups and then hope that someone. On the clinical side would wanna work with them. I mean, we are a resource in a way that we could stand up certain pilots and actually, scale things in a way that was more substantial.

So our team isn't just about like, you know, Ideators whiteboarding, workshopping an idea. We can actually do something we can help implement, and our teams implement things from virtual care to remote patient monitoring, to online second opinion programs. So, and we run those programs. It's not just that we, identify the need and then hand those off so I think that's key. And then I think that we spend a lot of time. Educating the organization about the kinds of things we wanna do. We're not just off saying something's important. We're taking either operational directives of what is important that we need to go after what topic areas or we're identifying key pain points from within the organization and making decisions on what we do based on that.

And we're not doing those things in a vacuum. So you. It's I think appropriate resource appropriate sort of ability to actually implement, but then it's being lock in step with the organization as we make decisions on what to do

your last point about the operational piece and looking at the pain points and being in lockstep, I think is critical.

Cuz critical become organizations. The innovation team is. Over here somewhere mm-hmm, very disconnected from what the, day to day kind of operational challenges are exactly that's critical. Heather, how about you? What, advice would you give, think about talking to your fellow chief information officers about this?

I mean, I was so impressed and when I was going through the interview process and talking with John. And Jen and some of the team. And I was just so pleased to hear that it, like, as John mentioned, there's support. Up and down. And he's absolutely right. Having that support, from our most senior leaders is, and the funding, let's be honest, it's not just, the bodies, but it's true funding that we've been able to do things.

And then, What I'm so happy with is that we have a strong governance and, it's not just it and innovation at the table. We have finance at the table. We have clinical operations at the table. We have administrative, operations at the table. We've got. everyone as many, skin in the game, folks that we can have to listen in and have, and we afford people the opportunity to push back or to ask why or say, why haven't we thought about this?

So, having good governance, Married with the support that we have that this is just, this is a pillar, in our core mission and our strategies, I think is important, in coming from other organizations where you. you had pieces of it.

And as John mentions, when you don't have that whole thing. I mean, it's hard. And then you feel like you're pushing that string up the hill or trying to get that flag on top of the hill and you just there who's around you to support you. And I'm just, I'm so happy that I work for an organization that affords.

The dollars and the people and are excited to take that innovation to the bedside and into research. It's so exciting to me. And, but yeah, governance is key. Always always, always,

always, always I would agree with you there. Great. That's terrific. Anything else you guys wanna highlight about the work you're doing?

Working together? Anything about Boston children's before we close?

Well, I'm excited that we've landed on our enterprise EHR vendor because that's, I think, John and I chuckle, I mean, we think about a lot of. The customizations or some of the, the workarounds that we've had to do with even some of our innovations.

I'm just hoping it's gonna make things a little bit easier for us. And we're gonna get some good data out of this and we're gonna design really streamlined workflows to support, the, we don't want the technology being the tail, wagging the dog. And so, yeah, I'm really excited to see as we kick off our project in January of 2023, that we're gonna have some really good design and it'll be okay.

There'll be some things that. Now we don't need we'll rationalize some of that and, and that's okay too, but just to be able to have a true enterprise platform that we can do this stuff, this cool work on, I think is gonna be exciting. It's not gonna be easy, but it's gonna be exciting.

Yeah, I agree. you know, We have a really interesting environment. It's an academic medical center that has some of the brightest minds. And so, it's an interesting place because we are constantly blown away by the kinds of things that the organization does, the research products, the advances.

But sometimes, we do have trouble getting out of our own way, because you're in an academic medical center, the view is that, and often we have a lot of the answers. And so, I think working with Heather has been fantastic because we're carefully balancing the fact that.

We can't discount the fact that there's amazing insights and advancements coming from the institution. But if we don't think about bringing ourselves to a level playing field with other organizations that are taking advantage of best in class technology on the outside to get us to the baseline where we need to do, then we will not be able to make the most out of the innovations that are coming out.

So it's this tight rope. I think we're doing a pretty good job of managing that. And excited for what the next couple years will bring for this organization.

Right. That's great. That's great. So congratulations on that decision as well. And the plan to move ahead. So I just wanna thank you both.

It's so good to see you again, and wish you all the best on everything you're gonna be doing. So thanks again for taking the time today.

Thank you so much.

  I love this show. I love hearing what workers and leaders on the front lines are doing.

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