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Today on This Week Health.

It seems like things are cyclical. What's old is new again, as they say. But I think the inflationary pressures, the talent pressures. The extraordinary need to not take anything off the table in making our healthcare systems financially sustainable is driving that interest in managed services again.

Welcome to TownHall. 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 dedicated to keeping health IT staff and engaged. For five years we've been making podcasts that amplify great thinking to propel healthcare forward. We want to thank our show partners, MEDITECH and Transcarent, for investing in our mission to develop the next generation of health leaders now onto our show.

all right, here we go with a town hall episode. I'm excited to do this. I'm talking to. a colleague for many years Lacey Williams Carlson, Chief Client Information Officer.

And actually, she's going to share the transition that's going on and whatnot. Lacey, we met a long time ago. We met when I was CIO at St. Joe's and you were at Bon Secours. Bon Secours, right. It's great to catch up again. Tell us about your current role.

First of all, thank you for inviting me, Bill.

Great to see you again. And yes, our paths have crossed long ago, and it's nice to finally have time to catch up with you and do one of these interviews. My current role is the, as you mentioned, the Chief Client Information Officer for Nordic, which is owned by Vansafor Mercy Health System. And in many ways, that the job that I'm doing now is, Exactly the same job I was doing six months ago.

I'm serving as CIO for our health system from the lands of managed services provider and working closely with the now formally named new CIO for Bon Secours Mercy, gentleman I've worked with for a long time, Mike Hibbard. who's moving into that role while we take about 95% of our IT teams from both Bon Secours Mercy and Roper St.

Francis Health System, move them to Nordic as the foundation for our enterprise managed services offering.

Wow I've so many questions. I'm going to, I'm going to stay on the path for now because hopefully you'll answer those questions as we move forward. But let's continue to talk about you.

How do you envision it progressing from the c i o role to the new role and what, what's gonna be different about that role and what are the challenges in that role?

Well, first of all, let me say the role began formally on July 1st.

So I'm talking to you with the vast experience of 45 days. So I'll tell you what I think is going to be different. And what's going to be the same. And I think you also asked how did that role progress? So, it's a little bit of backstory on me. You mentioned you knew me with Bon Secours and then through Bon Secours Mercy.

I moved to Charleston a few years ago to become the CIO for health system here in Charleston, closely aligned with Bonn Roper St. Francis Health System. And it was actually the reason I did that is that we were working closely with Roper and I knew, um. they had a lot of challenges and I was working in kind of a consultative capacity with them through Bon Secours Mercy.

We kept recruiting for CIOs and for one reason or another, mostly the pandemic and trying to recruit people in a pandemic. Things just never seem to work out and there was this little voice in my head that said, maybe you're supposed to go do that job. And I loved it. It got me back to the roots of being a CIO for a smaller health system.

So went from a 10 billion dollar health system to a 1 billion dollar health system because they are closely aligned with Bonson for Mercy. I did not leave friends behind and I had lots of resources that I could call on. And so we ended up implementing Bonsacore Mercy's EPIC instance there in that health system in a whirlwind two years, and I really enjoyed getting back to the roots of being very much a hands on CIO.

And then the CIO who was in Bonsacore Mercy at the time, Matt Eversol, who followed me when I went to Roper had a great opportunity to, leave the workforce for a while and just enjoy life and hanging out. So, I was asked to return to Bonsacore Mercy. And since we were then fully live on Epic and it started integrating a lot of our systems with Bonsacore systems, it made sense to just wear both hats at the same time.

So I was the CIO for Representing Francis and Bonsacore Mercy which was actually a blast.

So you went from having one job... to taking a different look for 10 billion to 1 billion, and then you just took them both.

Right,

it was fun. love all of the teams that I get to work with at Roper St. Francis and Bon Secours Mercy, both those. in IT, as well as clinical operations. So it was a great two years. I mean, got me to beautiful Charleston, South Carolina. So, that worked out great too. When I came back to Bon Secours Mercy just about a year ago I Knew that we had plans to accrete, which is a holding company for some of our technology interests that we were looking at different solutions for managed services and, bill, I listened to some of your recent interviews and broadcasts, loved your interview of Craig Richardville interviewing you and some of your comments about the hardest job you've ever had was being a healthcare CIO, and I loved it. Because I kind of agree that it's a really hard job.

And I think to do it well, you have to know so much about healthcare operations. I mean, the points you made about, you got to go from supply chain to HR issues to billing transparency regulations and HIPAA privacy and all of that just in the span of your probably your 1st 3 meetings of the day.

So all of that complexity of being a CIO and then add everything that's happened to healthcare post pandemic. The inflation pressures, the no price elasticity or getting much of a break at all from payers. And honestly, I'm not a spring chicken. I've been in healthcare for quite a while and I think these are the biggest headwinds I've ever seen for healthcare.

It's just really tough to be a healthcare operator right now. So I knew returning back to Bon Secours Mercier that we would be laser focused on how do we continue to demonstrate excellence in IT and that.

Nothing was off the table in terms of what we were considering. I was thrilled that Bon Secours Merci acquired Nordic. I mean, obviously, its reputation is stellar. known, I think, for its implementation and advisory services for EPIC implementations, but its depth is much more than just that.

So, it's... Pretty exciting to me to know that we had acquired a company with such cachet and then to further learn that our vision was what is that saying? The best way to predict the future is to create it. So, if we saw that our future was we were going to start to leverage managed services for information technology.

Let's create that future and be part of something that is creative and make that future happen. So I was very excited to be involved in the planning for all of that. It wasn't apparent right off the bat to anyone, including myself, that I would elect to join Nordic and go with the team. In fact, I can remember a few meetings where folks were kind of surprised where I said, yeah, I think I'm going to move to Nordic 2 with the rest of the team.

couple of reasons that made sense for me. 1, this should hopefully be the last chapter of my career. So it sounded like something fun and different to do. Second, I really believe it's a good decision for Bon Secours Mercy to create this new enterprise managed services offering with Nordic, and that it should provide lots of value to our health system if we do it well, and it should provide value to other health systems too.

So I kind of saw it as a great capstone to end my career on over the next few years as I work on this. If It is as successful as we hope it will be, it should be a nice way to give back to our health system. 📍

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No, that's fantastic. I'm curious, so I came into St. Joe's after a 10 year outsource.

Now, we're talking managed services versus outsource. That 10 year outsource was not good. And that goes back to the day when a lot of healthcare organizations were outsourcing and the results were equally not as good across the board. And so we all insourced again, but there is this trend towards selective outsourcing and selective sourcing and managed service contracts.

We're seeing it in areas where there's challenges getting. The right talent, , like security is obviously a lot in that space. We've seen it over the years, especially in EHR implementations and whatnot, just in specific areas of that, where you, again, have trouble getting talent. But what are some of the ways that managed services is starting to take root and starting to be successful in health care again?

Yeah, you're right Bill, in doing our due diligence for would this offering be attractive to the health care market? We were working with McKinsey and other smart folks and knew that you're absolutely right. It is taking off again. It's interesting for you and me and others of us who've been around for a while.

It seems like things are cyclical. What's old is new again, as they say. And I certainly hope that this evolution will look different and have better outcomes for healthcare systems than maybe some of the early forays did. But I think the inflationary pressures, the talent pressures. The extraordinary need to not take anything off the table in making our healthcare systems financially sustainable is driving that interest in managed services again.

Yeah, you know, it's, by the way I, I can easily trace the St. Joe's the challenge with their outsource to the contract that was written. It was written so poorly and without an understanding for the delivery of technology, but you go back to that time. And, heck, we didn't have EHRs across the board.

It was early, early on in digital and people were just like, Oh, well, we can save money by doing this. And I think we've just grown more sophisticated in our buying. we understand that technology is a competitive advantage. It is an asset to be leveraged in the delivery of outcomes and other things.

And we're not looking to just save money, we're looking to create economies of scale, obviously, and some leverage, but I think we're just, we're more sophisticated than we were back then.

would agree. And I think you also speak to a really important part for healthcare systems that are considering managed services for information technology.

I think the why. Is really important and the why might lead you to different vendors that you would consider in this space. So, if you're in that place where, you know, financially, you've really got to turn things around and the main objective is. solely to cut costs. You might pick one kind of managed services provider and that would have a different kind of impact on your team and staff retention and so forth.

Whereas if you're well funded and you have a great strategy, but you're in a market where talent acquisition and retention is just really a challenge. My experience is that I've worked with great HR departments, for example, that are really good at recruiting nurses. Not quite as good at recruiting cyber security engineers, right?

So you could use these billets go unfilled for a long time and that's in attractive locations. We're a big health system. I think some of the smaller health systems would really be suffering. So if your why is. We just can't attract and retain talent than working with someone like a Nordic who has a very robust recruiting engine and expertise around tapping into IT talent.

Your contract would reflect that. If you want to take your investment in technology to the next level, but can't quite write the check right now, but know there's some promising Things out there that you'd love to start to leverage and you need help doing that. That's yet another reason. So I think understanding your why and then making sure that the contract reflects that why and will assure that you get the, you know, whatever it is, that, that is the reason driving that business.

So what does the managed Service offering entail at this point? 45 days in? I mean, what. What does it look like?

So, we have this idea of One Nordic. So, Nordic, as I mentioned, was already a well established company. It has what we call advisory services. It has a digital arm, a performance improvement arm around revenue cycle, and it's very well known work around EPIC.

as well as ERP implementation expertise, and in fact, we've just with Workday, and we'll have some exciting opportunities there. We've always had managed services, but it was more very discrete managed services. So, if you wanted to have managed services for your service desk, or customer facing service desk only, or just for your EPIC team, but not your whole IT organization, Nordic has over 30 customers in that space. Bonza4Mercy together with Roper are the first two clients who are doing an entire enterprise wide IT managed services contract. And to your point about the complexity of these contracts, I think we spent about six months. creating our first contract.

And at that time, little funny story, I was wearing the team bond support hat, right? And so there was a couple of times I negotiated hard for certain things in the contracts that my friends in Nordic were like, You're going to regret the day that you insisted that be in the contract. As I say to our operators and to our own team the start of our transition on July 1st, there was no capabilities fairy that flew over the team and suddenly, we have better skill Excellence around meeting our SLAs or capacity for every single project that our operations can dream of and wants to implement. So, Nordic is helping us up our game. And I, that's 1 of the things, frankly, that really excites me is I certainly hope our operators over the next year. We'll start to feel like.

Wow, we felt like we had a really good, mature, sophisticated IT department and it only got better.

Yeah, that's fantastic. Exit question, what I assume, and I think you alluded to this before, after the Bon Secours Roper agreement and implementation gets underway you're going to be offering this to other health systems.

What health systems would benefit the most from this kind of service that you're looking to take out to the market?

So I think if it's a healthcare system that is only looking for a significant cost play, like, we need to quickly reduce IT spend by 40%. We are probably not going to be the best fit right out of the gates.

We are looking for healthcare systems to join us right now, who would be in kind of the space of co creating. This foundation with us. Obviously, I'm very proud of the talent from both Roper St. Francis and Bonsecourt Mercy that joined Nordic and excited about some of the other health systems with which we are speaking and the potential of their talent also joining our teams.

I saw first hand when Bon Secours and Mercy Health Systems joined and basically doubled in size as one organization from each one was separately. The opportunity that economies of scale provides and You know, that we could do, we could leverage our resources to stretch to do newer technology and different things that we couldn't have done either one of us on our own.

So, I think healthcare systems that are looking for a way for their teams to. Not be affected in sort of a draconian and harsh way, more of a softer landing moving over to the IT organization in Nordic, the managed services organization who are interested in growing their career because we believe this thing will really take off and there'll be tremendous opportunity for early adopters.

The. Corporate ethos and guidelines and what drives Nordic, I think are very complimentary to not for profit health care, which is, where I've served my whole life. So, I think the perfect health system is 1 who understands their why and what they would be looking for in a major services agreement.

That's not looking to slash half their costs and have a draconian impact on their team. But is excited about working with us to co create a robust offering would be the ideal candidate.

Well, this is fantastic. I'm excited for you. Sort of sad that you see this as the last the last leg of your career.

But I am excited for the opportunity. It's going to be. Really interesting to, to go out into the market, to talk to the various organizations that are out there to hear the different stories, because, healthcare is not monolithic. I think when people say healthcare, they think, oh, it's, they're all bondscore, they're all whatever, but man there's as many different flavors of health systems and hospitals and critical assets facilities that all need that kind of technology support.

So. It'll be interesting to see how this progresses, and I look forward to hearing from you in the future as it moves forward.

Well, thanks, Bill. I appreciate that.

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