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So there it is, day one in retirement and the phone's not ringing and I get. anxious About this stuff. The first time someone comes along and says, Hey, would you like to help me out here or there? and you get anxious enough, you start jumping at stuff prematurely, and actually the hardest part from me in the whole thing. Sue Was for decades.

This sort of full-time professional, white collar, C-Suite type was my identity, and all of a sudden it wasn't.

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hello, I'm Su Shade Principal at Starbridge Advisors and one of the hosts for the Town Hall Show on the community channel Today my guest is John Glasser. John is executive in residence and program director for leading digital transformation in healthcare at Harvard Medical School and currently sits on many boards.

John and I have known each other since. 1999 when he was the CIO of Partners Healthcare now called Mass General Brigham. He hired me, took a risk on me as the CIO for Brigham and Women's. I've learned so much from John over the years and I'm looking forward to our conversation today. So welcome, John.

Thank you, Sue. It's a pleasure to be here. Yeah, I remember hiring you and thank you. First day was the, first of the millennium so to speak. So Y2K was the centerpiece of all of our attention on that, but has been, been a pleasure ever since.

Well, likewise. And that was quite a start.

So let's start by you introducing yourself and talking a little bit about what you're currently working on.

So I've been in this industry for a long time, 35 years 22 years as the CIO at the Partners Healthcare System, Brigham and Women's. Leading into that, and then five years as running the healthcare IT business for Siemens and five years with Cerner because we were required by Cerner at the time dealing with population health, et cetera.

So I've been retired, sort of a lowercase r as you and I have chatted about for the last two and a half years. And as you mentioned I teach course exec ed course and leading digital transformation in healthcare at the Harvard Medical School. Also do a fair amount of writings. Two colleagues and I produced a.

Came out last month on AI and healthcare now working on a Harvard Business Review article on telehealth and kind of what's next. It goes through there, and as you mentioned, sit on some boards of startup companies, but also boards like Scottsdale Institute, an N C Q A, and the American Telemedicine Association along with, as happens with people who hit my age spending time with grandkids, of which there are five.

So the usual glide. Had a full-time employment until, I'm not sure what but certainly enjoying it along the.

Well, you're getting into some of the things I wanna talk about in a little bit. Sure. That being the small r retirement as well as the book. And I should have mentioned that you do a lot of writing and you clearly have been an inspiration to me in terms of why you're writing.

What I wanna start with is the CIO role. Mm-hmm. , and we're coming up here on the chime fall forum. You're gonna be there, right? Mm-hmm. . Okay. And it's 30 year anniversary. I think you were a founding member.

I was the founding chair of the board

founding chair

way back when.

Excellent. So they're probably gonna celebrate you in some way.

Share your thoughts on the evolution of the CIO role over the years.

Oh, I think so,

you know,

30 year period of time has been extraordinary evolution, and we couldn't be surprised in the industry that changes as rapidly as the technology changes et c. You go back to 30 years ago, 1992, and Google didn't exist.

Amazon didn't exist. The, you know, business use of the internet really hadn't happened. There certainly weren't mobile devices and AI was sort of on again, off again, curiosity, more so than anything else. So either been a lot of changes you can put 'em into a couple of buckets.

I remember when I first started as a cio, I thought, what this job really was, was the application parade. Let's do a new pharmacy system, then a new lab system, and then a new revenue cycle system. And every five years we repeat that. It's just, this parade of applications advanced clinical systems.

Were in a small number of academic medical centers, but really not common at all across the board. So over time, you've just seen this. First of all, phenomenal progress on the technology. You and I are now zooming, which we weren't doing, at that point. And using mobile phones, which we weren't doing.

So just extra. In the technology, but also growing sophistication of the application base range. Going from let's get another thing for pulmonary function, to where we're now really worrying about EHRs and digital front doors and remote patient monitoring, things like that. So just the uses of the technology have been extraordinary.

Also remember at the time, you would sit in the C-suites and there was really little understanding of the technology, little experience with it, et cetera. It's very mystifying, arcane cetera. And now what you find is a couple of things. One is, the people in the C-suite, they've been there, they've been through implementations, they grew up with the technology.

They're much more conversant with it, much more comfortable. They're less starry-eyed, but they're also less intimidated by this thing. It also, the CIO is brought in to be the. Who was this sort of, digital smart person, and now you look around, you say it's a team sport, you've got CNIs and cmis and all

the,

csu, the chiefs in the IT realm, let along the whole thing.

So it really is becoming a team sport. I that it wasn't war. So you've got the threat of technology, you got the thread of, applications, you got the thread of actually sophist. Of this thing, plus to go with the sophistication. At the time, Sue, there was just this beginning of this idea that you could use it for competitive weapons, airline reservation systems and supply chain systems.

We've actually moved beyond that, whether you can get a competitive advantage to whether whole scale industries get changed forever. And so, retail's different forever, entertainment different forever. And so we've evolved in terms of potency of the technology and what it can do across the.

We've seen healthcare go through its own transition. Fee for service was the game, packed the place was the name of the game back in 1990, and that's still around. But there's value based care, and it used to be you're worried about the hospital and onsite clinics, and now you worry about an integrated system of care that spans the gamut and as much larger than it was before.

So the whole healthcare settings become larger, more complex, more sophisticated. And then the last point I think is d. Way back we started as sort of a chime bootcamp because you recognize that only you have to change, you need to elevate the skills. However good you were at communicating had to get better at communicating however good you were at forming teams.

You had to get better forming teams. And I actually believe that if whatever constituted a letter, grade A in terms of skills, five, 10 years ago is now a letter grade B, the bar is. In terms of skills, you just have to get better and better and better. Cuz it's more complicated, it's more sophisticated, and so don't rest on your laurels.

Even if you think you're the greatest communicator in the planet, you can't do that anymore. So I think there's a lot of change. It's clearly a harder job now than it was then. I mean, it wasn't easy then, but it's clearly a harder job. So I sometimes think, Sue, I got out just in ton, Peter, Principal, who would've hit the ceiling of, in.

And Bill at the right time along the way. So it's just been cool to watch and I think, going like you to this 30th anniversary, the kinda this neat time of reflection, you know, we're always bemoaning, we're behind, got this issue and that issue you say, Yeah, yeah, yeah, yeah, that's true.

But golly, there has been a lot of progress and a lot of change in the last 30 years.

Well, I think what we're gonna see as we, reconnect with people in person there that many, if not the majority have titles that are variations on Chief Information Officer. Yeah. CIO with Digital Data Analytics.

The roles have expanded and changed, so it will be good to be talking to people. This is a good lead in to the next question I wanna ask you, which is, what do you see in terms of some exciting new digital advances in healthcare , in the coming years, in the next few years.

You talked about some of where we've come from, but what he is seen in the next few years, and maybe you're covering some of it in your class that you're teaching.

Well, I think, a couple things. One is I've always thought that about every 10 years there's a classic technology information technology that arrives on the landscape and changes the world.

forever And so in the sixties it was the mainframe, it was seventies, it was the mini computer, and frankly the whole healthcare IT industry began. That Cerner, Epic, Meditech all started with the mini computer in the seventies. In the eighties it was the network personal computer. That's kind of when I got into the field.

And you had Yep. The ETS and the xts and all that other stuff. Yep. And you could connect them with ethernet and away you go. In the nineties, it was the. web So it was Amazon founded in 1994. Google founded in 1998, and all of a sudden, golly, we were using the internet for business and personal reasons. And the year 2000, it was a mobile device.

The iPhone debuted in 2007, and you think about that, it's only 15 years ago. That's nothing. And yet it's ubiquitous. I bet you when I go chime, there will not be a single person with an iPhone attached their body somewhere. It won't be one that we'll find there. Right? So, and then, 2100 I could argue it's really the era of the sensors and the big data will beginning.

The people sort of go, they got a smart house and got a smart car and the social media. And I think this decade it's AI that's coming through and all these things change the world, but they change over. time ECommerce, the web is, we're still dealing with web, impacts on elections, for example.

How do you sort of deal with pristine and pure and, information laden elections decades later. So it's a big deal. Now we're in the early stages of the Gartner hype. Lots of hype and lots of disillusionment of, Oh, I'm worried about bias, this, that, and the other. But it'll play out and it'll change the world over the course of, decades.

So, in a way, you say, What's gonna happen in three to five? We'll see that thing play. through I continue to go under that. Plus I, was looking at, how many different devices are attached to Alexa, across 300 million across World Holy Smokes, you know of in your everywhere. And, let alone your phone looking at whether you're gate indicates that you have early forms of dementia.

So prior eras are still playing through. You can never see the real leaps. You and I couldn't have gone to Chime in 1992 and say, I bet you sue. The Internet's coming. I guarantee it you know, it's gonna be your, You wouldn't have seen that. So nobody sees those. They do see the trajectory of stuff that is in play now as they, just hang onto your hat.

It's gonna be bigger.

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Let's you talk about AI and I will tell you many of the startup organizations that reach out for either help or, they need someone on the advisory board, but they're getting going. They, you know, AI powered Sure. Everything right now. Sure. Let's use this as a segue.

You can talk about your book. Is the book out already?

Yeah. So it's at, in August. I was, I wrote it with two colleagues, a guy named Tom Daven. Who's an academic who's, written a lot of stuff. And then Elizabeth Gardner, who is a reporter used to with Modern Healthcare, Healthcare, Matics and I've collaborated with Elizabeth on multiple articles over the years.

So three of us put this thing together, but it, they viewed in August.

What's the name? What's the title?

Oh, should, Yes. This is your, There you go. You gotta have a copy. There you go. All right. Advanced Introduction to Artificial Intelligence in Healthcare. Excellent. They're pretty, pretty snazzy title.

Excellent. You know what, I feel like I watch MSNBC a lot, no surprise. And if someone's got a book, it's on their bookshelf, behind them on the zoom call, there's usually a couple of 'em standing up or they're promoting in some other way. So fine for you to promote it here. I think.

Your next background's gotta be a

bookshelf with your book on it.

Well, see, one of the shows I really like, which I'm only allowed to watch when my wife's not here, is Ancient Aliens, which, you know how aliens walk. Oh. Anyway, great show. Okay. There's only 180 episodes, so it'll take you the rest of your life to get through them.

But they always have this interview with this sort of quote scientist. So there's this person, long hair, big beard, and a book wall behind him, and it's this Chuck Renoit scientist, and he's. They could have been here and wow, I got a real scientist with real books behind him. Let's know what he's talking about, et cetera.

So we're not gonna do that today.

Okay? All

all right. John, you, you crack me up. Anything else you wanna say

about the book?

Well, no, , I think, well, if people vibe, that's great, but I think the, No, just a couple of key points about it. One is the basic thing is, anytime I think you write and you've written a lot is you imagine you're in front of an audience say, Well, who is the audience?

And say, Well, they could be a ru full of CIOs, or whatever it is. And I have to explain something to that audience. And so how do I explain it and what do I wanna. So in this case it was us. Presume you're in a boardroom of a health system or the C-Suite and they say, John, you're the cio, the chief visual officer.

What should we do about ai? What are you gonna say about this? How do you think about this? And you say one thing that's really profound, it's gonna be a big deal, but it'll take time. When I say there's really two other fundamentalists. One of which nobody buys ai, people buy something that is better because of ai.

They buy a car that is safer because of ai. They buy an MRI that is better detecting and impending failure because of ai. They buy, an application that helps them manage prior authorizations or utilization management. So, You use the same set of skills, the same set of instincts you've done in any software decision.

What does it do? How well does it do it? Show me that it works, all this kind of stuff. And if you got the magic AI word, why do I care? What is it you're going to do? So just remember, you don't buy ai. Buy something else in that context. The second, you know,

know, like you've been around in this industry for a couple years is I remember when we first had internet strategy.

This is in the late nineties and you had a group of people for three years and you're trying to learn what's the technology, what does it do, and are there pitfalls? It's the way you learn about this stuff. And I say, Well, we're in a similar time now with ai and I think it would be prudent to put together analysis a group of people who's maybe led by the Chief Information Officer, whose job it is to figure out, let's learn about this.

Let's sponsor some pilots, let's talk to our vendors, let's talk to our consultants and engage in. And because it's going to be here and it's going to be real and the sooner we get our head around it, the better. You don't have to vett the farm on it, Nobody's asking you to, throw out your EHR to go to an A power gizmo of this stuff.

So I think those are the two, you don't have to buy the book now cause those are the two major lessons you know, And you just get organized around a multi-year learning process. Now if you see a breakthrough wrap, go for it. Yeah. Scale and all that other stuff here, et cetera.

But don't get all tangled up in the Star Wars robot AI doc and don't get all tangled up on, It's all bias and, favors Caucasians, but nobody else. And oh, for God's sakes.

So a very practical kind of approach.

When I'm here.

Yeah. Well, yeah, but that's what you would expect in front of a room full of C-suites.

Absolutely.

And what I would expect from you as well. Very much so. Great. Okay. Well people can buy the book I'm sure on Amazon or wherever, right? Yeah. And you'll be happy if they do. Okay, my last question, when we got together in July and I said, so are you retired? It was a quick, and I think from your wife Denise, too small R right?

it's a small R retirement, which I love the concept so. Tell me what small R is because you're awfully busy. And what's your advice for people late in their career to prepare for small R retirement?

Well, so like, like you, I know people who quote retired that I'm done with the nine to five schtick and they basically left their work world entirely behind them.

They became carpenters, they became or whatever it is, they just really, they walked away, closed the door. And that wasn't me. And partly cuz I am so boring, I don't have any outside interest that would occupy me, other than rearranging the furniture in the living room every day, which would get me shot.

So, and I like the work. I mean, I like chief colleagues like you and the colleagues will share together at Chime and the interest and the industry's interest. So I wanted to stay involved, but I wanted more flexibility And I didn't really want to travel like I was traveling, et cetera. So I think what my advice to those of people who are within the.

zone Retirement, whatever you think that happens to be. Maybe late fifties, maybe as early sixties is a couple things

later. Fifties these days.

Yeah. Yeah. Could be. You know, Is, and particularly with, the, i's taking a hit, it can depend on where you are is that, one is make some call about whether you really wanna shut the door or whether you want to continue whatever the path is.

I think five years before you think it's going to happen, you have to start working on it. So you might say, Golly, I want. to teach Fair enough. But it's not like the day you retire the schools start calling. You saying When can you teach? You actually have to go off and get these positions. You have to figure out whether you like it or you don't.

May sound good, but you say, I don't really like this. And they have to figure out whether you're any good at it, you know, or not. So you start that, you might say, Col, I really wanna write. I wanna do like John did, do these books. Sure enough, start writing. See whether, again, you like it, you're good at it, start getting a track record and real experience, and make sure it is really what you want to do and to do that and off to the side, but enough, while you're still gainfully employed.

So I think you wanna go off and just really do that such that when you do walk close, turn off the lights, you know what you wanna do and you're good at it and you've got some in. So I think you do that. I think it goes without saying that you wanna make sure that financially you can handle this, this is not going to lead to a really bad situation a couple years out.

Yeah. And all of this kind of stuff here. And the only other things that I would add along the way, or a couple things, One is sometimes you get anxious. So there it is, day one in retirement and the phone's not ringing and I get. anxious About this stuff. And the first time someone comes along and says, Hey, would you like to help me out here or there?

And the other, and you get anxious enough, you start jumping at stuff prematurely, and so you just be careful. Cause you know, don't worry that three months after the fact, you're still ramping up in a way. And then last one all is, and actually the hardest part from me in the whole thing. Sue Was for decades.

I mean 35 years, this sort of full-time professional, white collar, C-Suite type was my identity, and all of a sudden it wasn't. And so getting used to the fact that, I don't have, I remember going on LinkedIn and they say, what's your title? I thought, geez, I don't actually have a title anymore.

What am I gonna put here? And I thought used to be useful, one time was valuable. That's, well, I can't, that's not really kind of the image that I want. It's but sometimes put people put visionaries and this, that, and the other, but I didn't really want that either. So I think you have to get used to this big part of your identity being gone.

And it doesn't diminish your value or your worth or what you like to do. You just have to get used to the fact that you wanna travel somewhere. You gotta make the reservations. There's not some person, who sits out in front who does that on your behalf and nobody calls you fancy title this, or in your is your bedroom or whatever the world it happens to be.

So anyway, you just get emotionally ready. That thing, and that can actually be quite challenging. But perhaps like you, I am delighted that I did this. And I think you've made the right call to go off and do this. And I remember talking last couple of points is talking to a board member at Partners guy named Jim Cash, who was a board member who was the Harvard Business School, very smart papa guy, and asked about retirement.

He said, fundamentally, if you wanna stay in the industry, like you and I have done in this thing, and, at a perhaps reduced rate, but. He said, You've got 10 years to do that, assuming health holds He said, after about 10 years, you become increasingly removed from what's going on.

And so you're less and less attuned to the, you know, you and I were at partners. We lived in the middle of this thing. You don't live in the middle of it anymore. He said the second is your Rolodex starts to thin out. So all of your colleagues and your buddies, people you'd call, well they retire sometimes they pass away.

So one of the things that strikes me is going to chime is every year how I know fewer and fewer people because the cohort, does as you would expect life to do so anyway. There you go. But if it's 10 years, I'll take it. You know That'd be cool. And we'll see what happens after that.

Yeah. Lot of, a lot of great points there about identity when you retire.

I know. When Tom retired well in advance of me. He had all of that going on. I guess cuz of what I've stayed involved in and the work we're doing I'm not there yet. In terms of having that crisis, shall we say. I think your point about picking and choosing is really important too.

Mm-hmm. , you can say yes and no. You can say no to the things that you don't wanna do. And I do remember you mentioning when we saw each other this summer about the 10 year relevance and. I mean, 10 years actually might be long, especially in our industry with how fast healthcare and technology

build.

It's interesting, You know what I, things I find Sue is, the technology moves very, very fast. So in 10 years you really can be out of tech. Yeah. That being said, leading organizational change, persuading a CFO to invest big bucks in something that's timeless. Yeah. So whatever skills you have, those kind of things persist and you.

That, you're dealing with a small company being run by this really smart person who's in their late twenties and their umbilical cords still attached. So you actually have wisdom and experience that you don't appreciate yet and can be quite valuable. So anyway, you just have to know what.

Persistent is durable versus what stuff really is fleeting as you go through this. Yeah.

Yeah. Well, if you don't know enough people at Chime and I doubt that's the case, I'll hang out with you, John. Okay. ,

finally, I got a friend. You know you have a friend you, you and Mitch Brazel. All right. I got two. I got two friends.

Yeah, Yeah,

yeah. Is there anything else before we close out that you wanna comment on?

No, it's, first of all, it's a pleasure to always spend time with you. You're one of my favorite people of all time in this industry. So glad to spend time, whether it's dinner together in the summer or on this. And obviously we'll see you in a couple months into all the folks who listen to this help.

See many of you at Chime. Also, and again, I wanna thank you know all those people who commit their sessions. You're and me included to using the technology to improve the care that we collectively gave for. Because this is important work and will always be important work. So thanks for what you've done and thanks for what you will do.

And again, it was a pleasure to spend time with you, Sue.

Likewise, John. You're one of my favorite people, and as always, you are inspiring and grateful to everybody who's making a difference in healthcare. So thank you.

All right, I'll take care. I'll see you in a couple months.

Yes.

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