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February 11, 2022: What does it take for a CIO to be successful in the first 30, 60, 90 days in a new role? Aaron Miri, SVP, Chief Digital & Information Officer for Baptist Health walks us through the transition. What are the greatest challenges? How can you lead with authenticity in mind? How do you create the best culture possible? Staff shortages are leading CIOs to be creative. How can you go about attracting the best talent? What are other things can you do to develop your staff or really just get them motivated? And what would you tell vendors that could help them be successful selling into healthcare? 

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Key Points:

00:00:00 - Intro

00:04:20 - Anyone can do an IT job. But are you in it for the mission? And are you all in on 21st century technology?”

00:09:50 - You have to manage laterally as much as you manage vertically

00:28:10 - Natural language processing is the way of the future. We should get to a world where clinicians aren't at a keyboard typing.

00:30:40 - What is LiDAR technology used for?

Baptist Health


Today on This Week in Health IT.

When you take the approach of just being transparent and genuine and you really are that authentic leader and just a human being just how receptive people are to that. And they're willing to work with you. And that's, that's leadership. That's an inspirational leadership to me.

Thanks for joining us on this week health Keynote. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week in Health IT. A channel dedicated to keeping health it staff current and engaged. Special thanks to our Keynote show sponsors Sirius Healthcare, VMware, Transcarent, Press Ganey, Semperis and Veritas for choosing to invest in developing the next generation of health IT leaders.

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Today we're joined by Aaron MIRI, the CIO for Baptist health in Jacksonville. Aaron welcome back to the show.

Thanks so much for having me appreciate it.

When did you join Baptist Health?

Yeah end of September I joined Baptist as the Chief Digital and Chief Information officer for the entire health system. Baptist again, largest employer in Jacksonville serving the Northern Florida and Southern Georgia markets. We're a true in an integrated delivery network where we have both pediatric and adults. Large ambulatory care. Great partnerships in the region with affiliates and really a wide expanse of covered lives that we support and take care of. My span of control is again, everything IT and everything digital. In close partnership with our Chief Consumer and Marketing Officer and the digital health services team to really make sure that we're encapsulating the Northern market. And what I found fun.

Right. So with the past couple as I really have dug in and really sort of peeling back the onion is the culture of Baptist is absolutely fantastic. And that starts with the very top. So when it comes to leveraging digital tools or technology analytics or whatever else we're looking at, and trying to think about on a new frontier, it's an all in approach, which is refreshing compared to maybe other places which are very reluctant to even move the cheese per se and try something new.

I appreciate how you phrased that. You're transitioning to the new role. You're talking slightly faster than you usually do by the way. So I could tell that you have a lot, a lot going on. I've interviewed several people that are making this move. And most recently, Sarah Richardson came on and I'd love to capture the process that you go through going into the new organization. The process for managing the transition from your perspective. Give us an idea of what you're doing in the first 30, 60, 90 days.

Yeah. Great question. So first to seek, first to understand, right. I've spent a considerable amount of time rounding the hospitals, working with both leadership, as well as frontline nurses and physicians to truly understand, what are the bugaboos, right? What's broken? I'll give you an example. There had been an underinvestment in wifi and wireless coverage and the hospitals kept growing. But yet they were having very, very lackadaisical coverage. So immediately it was one of the first decisions I made was to make a significant investment in updating and adding more just access points, right.

Something that's very simple and basic as infrastructure. Right. And so it's identifying those low hanging fruits, talking to folks, rounding, listening like listening with intent and then spending time on your team, developing them, listening to them, adding where you need to add and making sure there's a good fit.

Our CEO is phenomenal about encouraging us to make sure we're looking for the best of the best who wants to be part of the Baptist Health mission. And so I take concerted amount of time to look for those characteristics and traits of people who aren't there just to do an IT job. All right. Anybody can do that.

Any company can do an IT job, but are you in it for the mission? Are you in it for what we're doing? And are you all in on 21st century technology? So for me, that's really been the past couple of months is listening making those decisions and then navigating some large, big rocks we're moving in the next 18 months. We opened up a new children's tower and in like three weeks, we have our Epic go live next July.

And we opened up our new Clay Hospital, Clay County hospital next December and that's on top of normal business and everything else we have going on. So yeah, it it's, fun. And we make it as enjoyable as possible.

Not to geek out a little bit here, but the wifi thing is not as easy as what people think. It's not just like, Hey, we purchased 20 more of these. We popped them in. I remember when we went into one of our hospitals, we had to do a study because there's so many areas that, you pop a wifi access point in and you get broad coverage in this one area. But you go into other areas and access point will only get you like three rooms because of the barriers that we, we have to put up in a hospital.

I dunno if there's a question there, but I think sometimes people think, oh, just buy some more access points, some more printers, and we should be good to go. And you're like, ah, these are virtual workstations. Let's talk about the printing. Let's talk about there's.

You're right. No, no and nothing has changed. So you're exactly correct. I'll give you some specific examples so things you have to think about, right. We have our helicopter pad right next to the medical office buildings and the acute hospital for our downtown campus, as well as multiple sites across the entire region. A radar from the helicopter will throw off an access point that is underpowered or that's old, right?

Because that radar signal just basically acts as a jammer and jams the frequency of those access points. So in a couple of lives ago, I had this problem where periodically we'd get a phone call saying all of our wifi just went out on this floor and I'm like, that's weird. And so we literally had one of our network engineers camp out, up there and they realized they correlated it to it, oh, wow. It just all dropped. And suddenly you hear the rotors of the helicopter and it's like, huh. So radar takes out access points operating on 2.4 gigahertz. The second thing, there are certain microwave's with dual magnetrons in there. Microwave's can take out your access points. So I've been in prior lives and we had to go through and IT bought new microwaves for everybody, because the microwave's that were there were old and they were putting up too much interference. So to your point, It's not just go grab a couple of more net year routers from Target or whatever and mesh them together and there you go.

I wish it were like that. It is a lot to consider in addition to segmentation, whatever else for cybersecurity purposes. So there's a lot. But right. But it hadn't been done. It needed to be done. It's the right thing to do, and it was impacting both patient and clinician experience. So we just had to bite the bullet and go.

How do you assess the health of the IT organization or practice during the first, however many days? For example, and I think I shared this story with you. I ended up having a breach in my second week as CIO, and I'm like, would I have redone my first week differently, knowing what I knew the second week was going to look like, and I'm not sure, I'm not sure I would've been able to get to it in the first five days, but are there any specific areas you're looking at that have to be healthy for IT to serve the organization well?

Yeah. So, so what I appreciate is we've been very, very strong and engaged board that had double-clicked on a number of different fronts for IT. Cybersecurity being one of those, the great audit committee of the board.

And we have a great enterprise risk management group rolling up through compliance and legal. So I knew the bones were there, but still it's trust but verify. That's part of my role. So we just completed our own internal assessment of all of our policies. We went back and mapped both to NIST CSF, as well as the HIPAA controls, the HIPAA army bus, just to make sure there's policy, there's process, there's evidence that we're doing it. And there's recent evidence that we went through it. A DR exercise, all those sorts of things. I literally just got the results last week. We did very well, there were some opportunities, but nothing there that was in the red that wasn't critical, so yes, cyber is one dimension, right?

You gotta be compliant. You gotta, you gotta have that buttoned up. Second thing again is infrastructure. And as I just alluded to you, that is one area of weakness, which we're quickly catching up right now and making those investments to catch up. So that way we can leverage more cloud and disperse type technologies more at the edge across the land more genomics at the edge, those sorts of things, which will then lead us into AI, but we're doing some simple AI and ML.

So analytics being the third dimension that I'm working at to make sure that we continue to grow that and really galvanize our ability to look at analytics. Using a multitude of tools, including those that are predictive. And then last but not least is the actual workforce. Making sure that people have the tools necessary to do their job.

We have a great HR team that I've partnered with and making sure we're doing career laddering, skillset training assessments, understanding, I have a very large IT team. And so I try to be as accessible as I can to them. And to help them grow and to make sure that they feel that. And it's true, this is an organization that values them, needs them, is investing in them and giving them what they need to be successful.

Yeah. And I'm going to come back to that cause snapping is an interesting challenge that I'm hearing from CIOs. What's the greatest challenge when making the transition from one health system to another? For me, it was moving my family.

I was about to say moving, moving, while you're working is a big job. I would say the biggest transition is making sure that folks understand what you're about, right? What's your vision? What are your early thoughts understanding that you are there to help enable them, your peers on the C-suite making sure they understand you are a resource for them to be successful.

You're invested in them as much as you're invested in your team. I had a mentor once telling me, Aaron, you have to manage laterally as much as you manage vertically, right? So can you go horizontal and vertical? And build trust in a coallition of the willing. And it's not necessary that you have everybody reporting to you.

That's not how you build trust. How you build trust is being an authentic and transparent leader and being servant-based right. And understanding that I'm here to help you Bill. I'm help. I'm here to make sure you're successful. I'm here to listen to what the bugaboos are and eliminate the bugaboos if I can.

Right. Or say, here's how we're going to plan to do it. And so I have a great C-suite that I'm surrounded with folks that are all in and they've been so supportive. Everything from delivering fruit baskets of Welcome to Florida all the way to, Hey, let me give you some insight on areas of opportunity, operationally that you can help us with and you can't ask for a better serving than that. 📍

📍 📍 Aaron I'm in Florida as well. So I, just had my first Florida orange. You would think they're everywhere. The first couple of times my wife went to the grocery store and brought home oranges. They were California oranges. Now I moved here from California. When we were in California, we couldn't get California oranges.

We got oranges from somewhere like. I'm like what's going on here that we like. So anyway I just had my first Florida oranges. They're fantastic. I really do love living in Florida.

I think it's a phenomenal state. The fruit aisle. I kid you not is something else. Right? So like you, you go buy pineapples, not normal pineapple.

You'll buy avocado. It's like the size of a watermelon. I mean, it's, it's incredible the state and what we're doing here. But more important. It goes back to the people here. I mean, and everybody's so friendly and so kind and just, I mean, joyful. It's having lived in different parts of the country, it's interesting how Florida is characterized sometimes. The reality is the state does operate like a family. And I know I've said that to you before.

Yeah. It's interesting. And I'm not going to get into the vaccine and all this other stuff, but it was interesting to me. I was having a conversation with somebody and they said, oh, you guys are nuts in Florida.

I'm like, help me understand that. They're like, well, nobody's vaccinated. I'm like, you realize we're at like 62% fully vaccinated. They're like, really? I'm like you could just Google the number. It's heavy, Google, Google's done a great job. You could Google vaccination rates at every city. And this person was from California.

I'm like your, your vaccination rates are 2% higher than ours as a total percentage of total population. We have to be careful. And I find where you live determines what you hear and what you understand about certain places. I find Florida to be a great place to live.

Plus I'm surrounded by Canadians. I'm surrounded by people from Boston, from New York, especially this time of year. They're all down here. It's a great place from that perspective. You just get a a lot of different people that hang out with.

You do and you've got a lot of good leadership here. Let's take my market for an example. Right? So Baptist health, right? Largest healthcare employer and the largest employers, pretty much in Jacksonville proper. Leadership here determined the board, determined that we would follow state regulation and federal guidance. We do have a vaccine mandate at this time. But what the compliance rate was through the roof.

I mean, over 13,000 associates, I want to say it was, it was just a handful that ended up that did not get the vaccine for one reason or the other and following good state guidance and Florida state guidance, which is continuing to evolve. So let's be frank with that, but it comes with leadership.

Right? Good leadership can inspire folks to take action, whether it's getting a jab or an exemption or some other thing they've got to do. That's what transparent leadership is and what I appreciate our CEO, Dr. Mayo, the board, others doing is sticking to the facts, repeating the facts, getting education out there, getting availability out there, right.

Going to communities, whatever else. That's not easy because you're not only providing vaccines to your employee base, which is spread out over a giant geography. It's also the city itself and the region. And that's hard because you're dealing with conflicting information out there. But if you stay with the facts and you talk about the science and the real right, you stay away from the drama, as I call it, that's out there on the ether, then people listen. Folks are smart. They want to do the right thing. They just sometimes do inaction because they're confused or they're scared, or they don't understand. But if you take the time to work with folks, and that's what I respect about Baptist, I look at the compliance rates I'm like through the roof because of truthfulness. Because of being a servant based leader. That's that's the win.

Yeah. And I liked the way you talk about leadership. A lot of organizations I go into people are like if you give me this role, I'll be able to get things done. And that leadership by title or position is the weakest form of leadership.

I've found I can hire a consultant and give them absolutely no title whatsoever and they can come in and organize and influence and get things done. That's the model, right? The coalition of the willing. They listen to people, they understand what the challenges are.

They present solutions to those challenges. The quick wins. I mean, all the things that we know lead to successful leadership, developing relationships and moving things forward. And that openness. Openness to listening is also important.

And being open. Open to being humble and willing to listen to constructive feedback and, and really being receptive. I know of a lot of very traditional leaders from my prior years that were very, like, if you dared mention anything to them that, oh the sky is kind of cloudy today. Boy, you'd get a scowl and like, how dare you even question me and say, the sky is cloudy. It's always sunny.

It's like, but wait we can, we can work together to make this better. So it's interesting when you take the approach of just being transparent and genuine and you really are that authentic leader and it just a human being just how receptive people are to that. And they're willing to work with you.

And that's, that's leadership. That's an inspirational leadership to me. Right. Being authentic is real.

Yep. Absolutely. In my recent interviews at various events I found that staffing was a high priority and you just touched on it. Most of the CIOs are saying, Hey, look we're struggling to find new staff.

We're struggling to retain staff. So staff shortages are leading CIOs to be creative. And I saw a social media post that, you put out there. It got a lot of likes and a lot of views. And you had the picture of the beach and all that stuff and saying, Hey you could come down here and this is where you could call home.

And this is where you could practice your profession. How are you going to go about besides that? I mean, that's that's a phenomenal strategy, but how are you going to go about attracting the best talent to Baptist Jacksonville?

So it really is a couple things. Number one, communicating our strategy and our passion for what we do. Right. There's a thing that I always tell my team, which is have fun and transmit joy, right? Joy of technology. Joy of what we're doing and joy is infectious. Right. Good programmers. Good engineers, good developers, good clinical informatist folks, good people in general that do health IT want to be in this profession because of the mission. It is not about your paycheck. What do you mean? I know people like to say hospital administration is one of the biggest causes of the inflation of the, of the bill that the patients get? Blah, blah, blah.

No, actually it's not. So the reality is we benchmark and baseline our rates against what fair market value is. And it's so far under what the for-profit side is. And I've been there, right? I was CIO at a cybersecurity company. So I know what those rates are. So we look for people that are in it for the right reason. That's number one, right? So if we communicate our mission effectively and people understand that people are drawn to it. Two, Location matters, Baptist Health matters. We're a relevant, large IDN. That's having fun, right? We have a healthy margin, right? You're not for profits, so you're not really looking at it like that, but we're able to do things and make investments, build buildings, bind to new technologies.

That is what everybody wants to do. If you were looking at machine learning and artificial intelligence, which we do, and you're looking at doing things at a next generation level, why wouldn't you want to be part of that in health IT. And then three is who makes up your leadership team, right? Who are the VPs that report to me and others and are they emulating the same servant based leadership and transparency that says, Hey engineer, Aaron, I know you were an entry-level server engineer. I know you want to grow up one day into a dev ops site reliability engineer. Here's the steps we need to get you trained at. Here's the types of technologies you want to expose you to.

Here's what we want to do. And so now you build a pipeline of growth and like people like that's exciting. I wanna be part of that. That's cool. So if I do those things, in addition to living on the beach I have found that most of the positions I have posted, I've been posting a lot recently. I'm getting applicants from across the country.

I've had several people move from Texas here. Right. They're like, Aaron, we want to go to the beach. I'm like, well, okay. But Texas is a great place. Right. I just came from there. So that's great that they see what I saw, which is the beaches is appealing. So for those purposes, that's what I'm undoing and Hey look, being happy and having fun and enjoying your job is something that, unfortunately not a lot of people get to experience and we do a darn good job of that. And that comes from the very top. It really does.

Yeah. It's interesting. We've hit on a lot of people things. I'm going to stay here for one more question, which is developing people. I love the fact that you're having the conversation with people of this is the role you're in now. This is the role you're going to go to.

I just talked to Sue Schade on the Newsday show and we were looking at the migration. People are leaving their jobs going somewhere else. And I said in my experience, the number of people, if you did a poll right now and a health IT organization and said is your current job role clear? And do you know what the next role for you is within the organization? That the number of people that would answer that and say, yes, I know what my role is. Clearly understand my role. And I know I have an idea of what would be next for me in the organization would be really low. That is one of those things that's important. What are some of the other things you do to develop your staff or to really just get them motivated in terms of what they're doing?

Yeah, so a few things. Number one, I'm very highly connected across the industry in terms of the way I give back and the services I do and things I do at the federal level and whatever else.

And so encouraging folks to explore growth opportunities, volunteering and boards. I have one of my leaders, she actually leads the Jacksonville women's club and mentoring young women that are up and coming engineers. Getting involved in these not-for-profit community type boards or federal level boards pull up policy helps grow people, right.

And encouraging them to grow and spread their wings. Cause you want to see them grow and really become successful. Number two is I have a question and I'm pretty famous for asking everybody that's ever reported me. What do you want to be when you grow up? Right? What do you want to go? You just sort of alluded to it with the sort of laddering and career architecture.

That's important, right? To have the you know Chief Digital Officers sit there with you and go, okay, you want to be a CDO one day. Here's what it takes. Right? Here's the things you need to be exposed to. And then I commit to them saying I will help find you opportunities to give you those experiences. I'll give you a specific example.

I had a number of people tell me Aaron, we would like to build apps on the fly that is not encumbered with bureaucracy and all this red tape. We want to just be able to go fast and solve problems. Well, lo and behold, this week Kronos, which is a large time and attendance system was hit by ransomware and so all their cloud services went down. We were a customer of theirs. That ran on the news last night. But we're going to make payrolls, no problem. But we built an app within one day on a low code platform to deploy, to automate timekeeping. Now, does it have all the fancy rules of shift dif and PRN statuses?

And are you in this department? It's a $3, wage difference. There's a support on our widget. No, we can do that with analytics behind the scenes, but if I'm capturing accuracy of times, getting data to correlate, I can then sort on primary and secondary keys, especially against a large data set to look at history and patterns.

Okay. So my team came up with this in partnership with payroll and others in one day. And we're in the process of deploying it right now. So that once we get past this pay cycle on Friday, starting next pay cycle, we're back to being as automated as possible. And then just doing some QA on the back end while we wait for Kronos to get their act together.

So that's type of stuff. And then I can highlight, I haven't been highlighting that to the executive team. That's the kind of stuff engineers make part of. That's the kind of stuff when people say, I want to develop a cloud engineer, okay. Here's a project. Go. Make magic, right. Make magic and have fun.

That's the kind of stuff we have to be doing together. So you know, that's the next part of it. Is, is making sure that as we develop folks, we're anchoring those wins. And then last but not least Bill, is making sure that when it comes to CHIME, HIMSS, speaking opportunities you've had some of my previous employees talk to you on the show and do these kinds of things.

You're investing in them. You're connecting them with people like you and others to highlight them and their career and their aspirations and their ideas. And that's how you grow the next generation. Look, I grew up as a software developer, right. I was coding not too long ago, but long ago. And I grew up into becoming a Chief Digital Information Officer.

Okay. Because I want ed that. There's that next generation that is incumbent upon us to shepherd and bring up. And cause they will be there one day.

Give me an idea of the Kronos outage sort of dates when we're recording this. I mean it's really top of mind right now and it's this serious issue.

I mean, making payroll and those kind of things. So did you have an environment already in place or did you just walk into the team and say, okay, we've got this problem and they started brainstorming and saying, now I, we could probably develop something on this or this or this?

So we, we started with a true brainstorm session. I call it a hackathon that went about an hour or two hours. So we had a list of about 30 ideas everything from standup and on-premise version of Kronos. Could we do it right? Maybe, maybe not all the way to okay to manual spreadsheets and fancy Excel macros.

All the way to, Hey, we have these other platforms and then by the way, we have a very simplistic, no code and low code platform, which we probably could cobble together along with analytics in the backend to do this thing. And so I said, okay, which sort these by work effort right. Lowest work effort, the highest work effort. Obviously highest work effort being set up an on-premise and deploy it and all that stuff like that.

Right. That would take weeks. And then this solution came up at the very top. It wasn't the easiest, just use manual punch cards and Excel sheets. And let the hiring managers deal with it across the entire workforce. But it was the first almost I would call it semi-autonomous but mostly autonomous solution that could be deployed within a day.

And I said, okay, build me an MVP in one day. And so this morning at 7:30, I got a phone call from my team saying, Aaron, we're ready to show you. And I'm like, holy smokes, let's roll. Test the heart of it and get it out there. So that's exactly what they're doing. I'm very proud of them, but it was a hackathon.

But that, that builds a culture and ethos that any problem is solvable. If you just simply have the willpower and the mindset to do it.

I love that approach by the way. And we have such creative people. They do things with computers that that we stopped doing about 10, 15, 20 years ago.

So, I do, I do miss some of the coding. It's fun to get that problem, sit down and get the computer to do what you needed to do. Well, that's, that's a phenomenal solution. I'm going to let you sort of decide where we go next. You mentioned AI, ML. I wouldn't mind talking automation.

Automation seems to be an interesting topic that keeps coming to front and center. So if I throw out those two, which direction you want to go?

Well, I think actually they're part and parcel together. So I think we talk about both as well as machine learning in the middle of that. And looking at where you are in a journey for that.

So let's, let's start with the bones to create analytics and eventually automation, right? Number one, most health systems have some form of analytic ability, one way or the other. You just have to these days, it's just like basic finance or basic FPNA back in the day. Now it's basic analytics, right? And if it's on spreadsheet, that's probably not where you want to be, but you're going to do some very basic analytical reporting. That's, you're typically gonna find quality reporting, meaningful use kind of push that, that avenue.

So your first step, as a leader is to find out where are those strengths, right? Who are those people that you can lean on to create those reports. Two is alignment with the executive leadership team? Where do you want the boat? Right. How do we work with now this bolus of folks that we've identified and sort of coalesced into a team of the willing and then you match it up with where the organization wants to go and what the organizations are proud of.

Right. They have to really develop and double down on that, but more importantly, you need to set a stage of, okay, here's what we've got to overcome. Whether it's developing new talent, bringing new people in really you know, cultivating those ideas to do bigger things, better things or analytics. And then once you know that, and you know what your data sources are, and you feel good about the cleanliness as data, and you have a team of the willing.

That's when you can talk about automation, because that's where you match up with man, we've always had an issue with a room turnaround times and cleanliness and predicting when those rooms need to be, have someone turn in. They're always 15, 20 minutes late. By the time someone calls EBS. EVS or, Hey man we have this equipment that just keeps walking out of the ED and we really can't find a wheelchair. It's almost like an operational process improvement issue that's come up. Where now you have analytics, you have OPI, basically you put two together and you find out, well, this is a repeatable thing, right?

We can really streamline this or phone calls coming into the switch. Whatever those issues are, you begin to boil this down and that's where RPA matches, right? Because now you understand what you're looking at, you understand what the intent is, and now you're able to automate and streamline and show what the return on investment or return on value is for that work done, which then leads you to higher level discussions has to, okay. One of the things we're doing right now is we're rolling out the DAX product from Nuance, right. Which is ambient listening in the rooms. I have a belief that natural language processing is the way of the future and that we should get to a world where clinicians aren't at a keyboard typing.

They're literally talking out loud to me as a patient one-on-one. And a template is being filled out based upon microphones in the room that filled out sort of a review of systems. Here's your basic demographics, blah, blah, blah, blah, blah. That's the only way we're going to get automated is to kind of just fill it in for you.

So if you take those kinds of things and now you have this other process on the other end, you're now able to look at those big bowls of data and go, gosh, look people are always asking for a transfer of their records from this one little clinic in the middle of nowhere here. And it takes days because they have no connectivity.

Can we automate that? Can we streamline that? Can we digitize that right? Now you're really starting to cook with gas as I call it and move and accelerate the velocity of the health system. Once you do that, and you have a big bolus of that, and you have enough of an N number statistically relevant to say this is happening in the aggregate, are there then points of machine learning and you build sort of an advanced clinical decision support logic to say, Hey, now we can do other things with this knowledge, which then leads to predictive, which is where AI starts coming into play. The problem with AI is compute. We're getting there with quantum, we're getting there with investments, with being able to burst through the cloud. We're not there yet as an industry. I was lucky at UT we had super computers on site and that everybody is UT Austin. But in general, I think we're going to have that ability in the next five years. So if you start now, you'll be ready for the time when that's generally available by some large cloud service provider.

You know what I love about the DAX solution, amongst a lot of things, but the thing I like about it is it cleans the data as you go.

Right? One of the challenges we have is no offense to our clinical colleagues, but they're not the best data entry clerks.

Yeah. Nor should they be right?

It's not what they went to school for. And so DAX takes all that information in audio form and then converts it into a note in a very strict repeatable way.

And now when you get that clean data, now you do the automation on top of that, we could start looking at clinical automation. We can start looking at additional areas. It's interesting that, and anywhere where I hear people talking about clinical automation, the first challenge you have to do is you have to clean, you have to clean the data.

Figure out a way to start to ingest the data in a more clean fashion or just find different streams. And that audio stream is near perfect. So is a video stream near perfect, right? Because it's not being interrupted. There's the video. It could be a dumb camera. It's just showing you what's in front of it.

I've some pretty cool startups even investing in LIDAR technology so that they try to avoid the privacy issue of a camera. And so using LIDAR, I'm able to tell features about you that are sort of unrecognizable outside of that camera. It's not like anybody can hack it and steal Aaron's face, but the LIDAR gives you enough definition to be able to do authentication of who's walking up to be able to say that Aaron said X, Y, and Z feels that he placed an order successfully, so that meadow, or it can be filled and meet the FIPSE standard for DEA compliance, all these kinds of things I think are on the horizon.

I think it's up to us as a technology community to look at that fourth generation of technology stack. I know that's something Russ Bransell talks a lot about and he's right, what does that fourth generation tech cycle look like? How do we double down in that? But as I was saying at the very beginning of this, of this session, we can't leave our staff behind.

We cannot leave people behind. Just because you've been a telecom engineer for 30, 35 years doesn't mean you shouldn't be trained in the latest solutions coming down the pipe or understand how to do a micro-segmentation and become a network engineer. Maybe you want to get your certification and become a true network engineer.

Great. We have to keep growing our staff. We can't leave people behind. And that's one of the biggest travesties right now across all industries is you have a large population of people that are being displaced by automation. What's going to happen to truck drivers. What's going to happen to these people that have a whole career.

And these are good people. But they won't be trained by their enterprises. That's unfair. Right? So in healthcare we can't afford to do that. And that's why I believe if we keep investing in our folks that helps drive everything forward.

Yeah. And I think now is an interesting time in our industry because everyone's overworked and there's a nurse shortage and there's so it's like, okay, we're going to start automating some things.

And they're like, that's fine. That's great because I can't keep up and I want to go home and see my kids. You're like, okay, then that's, that's where we're going to go. So have you put a platform in place to do automation or do you generally start with a platform? Or are you doing tests with just some tools that you happen to have in place?

Well, we happen to have a few tools in place right now that are pretty good. So I have not changed our existing platform. I try not to change tech out, sort of on a whim. They're pretty good tools. And like I said, we just had our first major enterprise success since I've been here using that platform. So we have a couple of platforms as most shops do. And I would say that my assessment phase will be coming very soon as you start looking at, what do we really want to do? Is this scalable at an enterprise level? This is how the capabilities we need. Because the ultimate power on a low-code or no-code platform is to open it up to your clinical staff, say, Hey nurses, you know what you were building in Excel.

Now you can just build an app and deploy it yourself. And it's secure it's HIPAA compliant. And by the way, you can push it out to all Baptist managed devices with the push of a button and say, okay, here's a rounding list that we're going to use for L and D at all, hospitals.

And it's going to be on every Baptist owned device. Boom. And it deploys right. I shouldn't have to get involved.

How do we keep from, how do we keep from that becoming the Microsoft access of 2020?

Yeah. So it's about training. It's about discussion and it's about making sure that there is an understanding of the use case and utility.

You're not going to be,Microsoft access. The problem, with Microsoft access wasn't that access was deployed and people's sort of building access database on the fly its because IT didn't embrace it in teaching the power of what it is at your fingertips. We did with SharePoint though. When SharePoint first rolled out, it had the issue of I'm about to become Microsoft access.

But the minute people realize, oh, I could use SharePoint for my magnet status and to grab all the documents to supply for magnet or those kinds of utility cases, then it became it moveable, right? It became part of the fabric of the enterprise. So we have to make sure that these low code and no code platforms, we learn from success, which is hand in hand elbow to elbow support and ensuring that it's a tool that's viable and secure.

Yeah. Just so people understand what I'm saying. When Microsoft Access came out, it was an amazingly powerful tool. I mean, you could tap into multiple data sources. You could create really cool front ends. And what would happen is you'd go from department to department at some point, you'd be like, okay, that's a security challenge.

That's doing this. That's doing that. But the reality was it unearthed so many use cases that people had creatively solved that we can now step back and say, all right, we're not just going to take away their Microsoft access database. That's a real problem that they've solved. And we, as IT need to figure out how to come in behind them and support that workflow, support that whatever they were doing.

You're exactly right. It's a mindset of IT knows best. And don't worry your pretty little head to, we are here to help you, right? I want to learn from you and what your challenges are. And here's all the tools in the tool belt, right. Let's decide together what the right tool is. And of course, I'm going to keep you from using a tool that's not HIPAA compliant, or it could get you at a hot, we got you. Well, I want to empower you. I want you to be successful. It goes back to what I was saying at the very beginning. It starts with people. So access problem, Microsoft access database problem wasn't the tech that was the problem. I mean, it was after you get to a certain role length and character size, but that's too geeky for most people.

The issue was the utility of it and understanding the why, right. Having CIOs engage and round the unit. And talk to people like I do, right? How can I help you? What do you need? It's amazing what you hear from frontline nurses and staff at all ships. They'll open up to you. And first of all, they're so grateful to see you.

Second is, Hey, can you help me? I need new keyboards here. I was on one unit that was missing one of the large monitors. That was one of the patient flow monitors for the unit. I said, why wasn't here? I was like, well, we ran out of budget a year ago, I'm like, it's a big 55 inch TV. They come at a couple hundred bucks these days.

What's the big deal I got it. Right. We'll just charge IT. I'll take care of that for you. Don't worry about it. You would've thought I hung the moon. I just bought him a TV so they could do the list of who's in what room? Things like that that are not easy. Right? It doesn't mean an extra access database. It's just listening and being there for people. That's what matters?

Yep. I remember there was a nursing station. Every time I went in there, I got a hug cause we put in a printer. You know, we put a second printer. They could never justify the second printer cause they were too close together. And when they went through the thing and what I'm like my gosh, it's 500 bucks. I mean, what are we doing?

What are we? Exactly. And again, I think it's a philosophical mindset of leadership, right? One is IT knows best. So we're going to keep you at a totty potty trouble. And so you better listen to us and thou shalt do. And another mindset of we only exist because you clinicians are doing your job.

You business people are doing your job. So we have to enable you. I've heard so many times, not really a Baptist, but other places that you know, oh, that's IT's money. No, no, it's not. It's the enterprise. It's the business money that we are spending together. And it's my job to implement what's effective for you.

So it's just changing the vernacular and the approach and you'll be able to win a coalition of the willing.

All right. Two closing questions. One, I'm going to use you to help me cause I'm doing presentations to various groups. And one of them is I'd like to offer vendor partners a little help in working with healthcare.

And I started posing this question. I just posed it to Daniel. Barchi. Got an interesting response. A lot of times I hear them say, well, I've, I've got to call on the CIO. CIO's have a ton of responsibility and as a group, they don't like when vendors waste their time. Right. It's like come prepared, know something.

What would you tell vendors? What would you tell them that would help them to be successful selling into healthcare?

Yeah, so healthcare, and again, I approach this both as currently, obviously in a provider world. And then prior to this, I was at a vendor, right. So I saw the other side of it and I, and I think most CEO's are acutely aware of sales cycles, QPRs your pipeline lead gen, all these things are important for a product company.

And why those high pressure sales tactics or inside sales reps or whatever are constantly calling you and barraging you as you were alluding to. So first of all, don't assume that we don't understand that we do numbers and we're respectful of it, right? I've never been rude to a salesperson, even cold calling me, even when they call my cell phone, I politely declined.

Say, please, it's my personal cell phone. Please send me an email. I'll happily get back with you or have somebody get back with you. You gotta be respectful. So most CIOs are there, right? I haven't ever seen someone be combative Two It's a partnership for the long run. Don't come at me trying to sell something, come out and be trying to understand me and say, Hey, how can I help you?

Can I connect you with a Daniel? Barchie who's brilliant right in New York that went through this six months ago because he happens to be my customer. But more importantly, he resembles Baptist. His health system does. So maybe the two of you can share ideas You're not selling me anything besides relationships that maybe I don't have, but I'll forever remember that.

And that's anchored in my mind that you're now a partner. You're not a vendor. And three, if you can, if you are at a large conference and you are bringing a CIO's together, try to find the common themes amongst all of us. We are all having challenges. I just gave you one today with time and attendance, right?

There are common challenges that all of us are facing. Right. Show the commonality and why we should listen to something so that we take the few minutes that we do have and say, yep, this is important because, and you have it all attention to like 30 of us together. Bill, you do a good job with this.

You're a chime this year, you were grabbing several of us to talk through things and just topical, Hey, what's going on in your world? Right? It's just conversation. It's partnership. It's building community that's healthcare in general, but that's also the healthcare it community as it stands

All right. Last question. And I may, I think I did ask you this question. I just don't remember the answer off the top of my head. Cause I asked like 20 CIO's is the same question, which is this is going to air in January. What is top of mind for 2022 for the CIO CDO of Baptist.

Yeah. So making sure that I'm going to put the pandemic aside for a second, because I think that's on everybody's top of list, right?

Just put a pandemic aside. It is ensuring that we truly are delivering omni-channel care whenever, wherever, however, to both our patients. Gaming our providers of tools. I need to our parents of our patients on our pediatric side and also understanding the needs of the underserved and delivering an equitable care delivery mechanism, leveraging technology.

So for me, digital strategies, technology and infrastructure availability software. Kara as a service, it's almost a retail type strategy, except it's more about precision of applicability and ensuring that you are not waiting to be able to be seen by the right place at the right time.

You know what I love about that answer as you started answering it, I remembered exactly that.

It's almost exactly what you said to me the last time. And I thought that's the mark of good leadership because you're going to get asked what's the vision what's top of mind. Probably, yeah, I don't know, 50 times between now and the end of January. And if you answer it the same way that consistency helps people that consistency of, Hey, this is what we're about.

This is what we're looking at, that omni-channel experience we're looking at really engaging people where they're at with digital tools and in, in bridging that experience, that, that that, that physical experience and the digital experience. Start to mash and it starts to become a, a seamless, as they say, frictionless experience.

Yeah. And I got to give credit to our board. Our is made up of people that came across multiple industries, not just all healthcare. And so I always get challenged. Right. I getting challenged by people who led some. Banks in the region asking, Hey, how are you handling your customers? And how are you dealing with these types of inquiries from a digital component?

Because they did it on the, on the FinTech side. I love that because I'm learning, it's a challenge. It's, you know what? Yeah. Healthcare has got to get better and sure. There's some regulatory differences in some ways. But the reality is it is about care right place at the right time. And so, yeah, we're, we're double down on that.

I will say before. For me then more to micro level, it is really about growing my team and making sure that they feel the support they have the tools necessary, and that we really are driving the next generation of workforce. As, as I get older I'm looking at the next couple of generations going, how do I make sure that then when they're in the mid to late stages of their.

They are doing the same thing and keeping it going forward because we, otherwise we're going to have a talent gap. We will

The interesting thing is you're you're when I think of the first year at St. Joe's. I said the first year, it's going to be about people and my team, and really coming together as a team.

And we're going to fix all the infrastructure stuff we're going to, we're going to lay a foundation for this whole thing. And I said, well, what about digital? What about all this other stuff? I said, well, that, that first year we are going to start. Listening and building a strategy that we're going to move forward with.

And they're like, well, there's a lot to do. I'm like, yeah, there's going to be, there's going to be plenty of time. But we need to, the first year is about building the strategy because you don't, we don't, we didn't have the it foundation to do any of the really cool digital stuff anyway. So it was like if, if our data center keeps going down, people aren't gonna trust us to do the really cool digital stuff.

So let's, let's get a a five nines thing going for a pretty consistent. For a, for most of this year. And then we will have the the trust of the organization to do the really fun.

Absolutely. And it's about energy, right? Your energy is infectious, right? If you are all in and you're able to articulate this and really connect the team back to the fabric and ethos of the health system, it is amazing what folks will do.

I, I, that's why I love healthcare. It, it is truly something special that I can't quite quantify or qualify for folks, but when you're in it you're making a difference and that's priceless.

Fantastic. Aaron, thank you again for taking the time. Really appreciate it. You're welcome.

Have a good one and we'll see us.

What a fantastic discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have everyone on my team listening to this show. It's conference level value every week of the year. They can subscribe on our website this or they can go wherever you listen to podcasts apple Google overcast Spotify Stitcher you name it We're out there Go ahead Subscribe today Send a note to someone and have them subscribe as well We want to thank our keynote sponsors who are investing in our mission to develop the next generation of health leaders Those are Sirius Healthcare, 📍 VMware, Transcarent, Press Ganey, Semperis and Veritas. Thanks for listening. That's all for 📍 now.


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