This Week Health

Tressa Springmann on The Program Formerly Known As MU and the Apple Health Record

This Week, Tressa Springmann CIO of LifeBridge joins us to discuss CMS' big announcement around the future of MU or Promoting Interoperability. We also talk with Tressa about the Apple Health record implementation at LifeBridge.


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Welcome to this week in Health it where we discuss the news, information and emerging thought with leaders from across the healthcare industry. This is episode number 16. It's Friday, April 27th. Today. Break down the changes in the program, formerly known as mu, and what this week's announcement by C M S means to health it.

We also get an update on Apple's health record initiative from one of the users of the technology and uh, and a lot more. This podcast is brought to you by health lyrics. Get ahead of the wave. Every Health IT organization has it within them to be great. It all starts with Visit Health Lyrics to schedule your free consult.

My name is Bill Russell, healthcare writer.

You know, sometimes on the show we have people I've interacted with a lot and sometimes we have people that I've just interacted with from afar, read their, read their stuff, read interviews, and uh, and the things they say resonate with me and I look forward to them being on the show. And then I, I, you know, make the request and they say yes, and I'm really excited when they, they actually, and actually sometimes it just surprises me when people say yes.

Because of how busy CIOs are today, I'm really excited to have, uh, RESA Springman, C i o for LifeBridge Health on the show. Theresa, welcome to the show. Thanks for having me. Good morning and happy Friday. Yeah, happy Friday. Casual Friday for you. Casual Friday for me, it's, uh, I think most healthcare IT organizations now are casual on Fridays, aren't they?

Yeah, I, I know it's something we enjoy. It just inspires a little bit more informality, uh, in the day and, uh, you know, it's a pre-game to the weekend for sure. I, I, I think Sarah Richardson was, was trying to push for two more casual days during the week. Um, I don't, I don't know if she's gonna get there, but healthcare is still pretty, uh, next to finance is still a pretty, pretty buttoned up, uh, kind of environment, so, Let me give some, some, some of your background here.

So, uh, you know, Tressa is c i o for LifeBridge since 2012. Uh, LifeBridge Health is about 2 billion. Uh oh. You also took on the, uh, the role of performance improvement. A lot of times people are asking me, you know, where does the c I o go next? Or where? And, uh, so you've, you've taken on performance improvement.

We'll talk a little bit about that. And so, LifeBridge, 2,000,010,000 employees located in Maryland. Uh, you're highly active in various, uh, things within the community. Chairman of, uh, your health information exchange, uh, called Crisp uh, health. Uh, you're part of, uh, the advisory board for Towson University on their healthcare management program.

You're an adjunct professor at Mary's University. Uh, previously teaching, uh, h i t, which is awesome for their master's program. You're the, uh, past president of Maryland himss, uh, certified professional in Health Information Systems Management, and also A C H C I O. And you have your master's from Johns Hopkins and a BA in biology, uh, from St.

Mary's College of Maryland. Is there anything I missed, like, you know, you have a family that you're really proud of or anything like that? Yeah. You know, I think those accomplishments, uh, really trump the litany of, of what you read. Um, yep. I, right now live in Maryland. I've got, um, two sons and, um, two crazy dogs.

And I am actually tonight struggling to get through, uh, turning in my final exam for a wine chemistry class that I'm finishing up at Penn State. So, um, Yeah, I got a lot going on and I appreciate you having me here. For sure. Well, thanks. Wine Chemistry. No, I, I, I the show's too short to, to go down that path.

We'll, we'll be talking for hours. All right. For another time. For sure. . Um, what we like to do is we like to, um, ask our guests, you know, what are they working on right now that they're excited about that, you know, they, they, uh, uh, that, that's really interesting. There. Wow. There are a lot of candidate ideas there.

Right now we've had a very successful year, um, evolving our telehealth strategy. We've got, um, seven very unique first year pilot use cases, but a much broader strategy that we're taking on in the coming year and really, um, our telehealth strategy.

And integrated with both a clinical and um, administrative call center to, to really, um, strategically move forward, reducing barriers and access to. You know, whether it's scheduling an appointment, talking to a clinician, or just figuring out should I go to a urgent care or a primary care or the er. Um, really creating choice points for our patients, whether they wanna interact with us in person, over the phone or in a digital experience, and making sure, um, that we make that customer service interaction an easy one.

Yeah. We all know how siloed our industry is. And so, um, I, I'm just super excited about the opportunities that this provides. Yeah, and, and we're seeing a lot of that. I've visited a couple health systems this week, and, uh, what is going on in the telehealth space is really exciting. We just hope that sort of reimbursement reform and whatnot catches up so that, uh, the, the payment models match the technology and, and the desire that we all have to make it easier for the patients.

So this how the show breaks down, breaks down three segments in. Leadership or tech talk, which we're gonna change up a little bit again, and, and I'll explain that. And then we do social media posts to end it. And, uh, you know, sometimes in the news the show just writes itself. Uh, this is one of those weeks Tress and I got on the phone earlier this week, uh, to discuss, you know, what, what topics do we want to talk about, what stories are in the news?

And I think we talked on Tu Monday or Tuesday, and then, uh, C M Ss did their announcement and that sort of became the, uh, the prevailing news story. So that's what we're gonna, we're gonna jump into. There's any number of places you can, can read about this. The c m s website's probably the best it. Pretty clear, uh, description of, of what's going on.

So here's the first I, I'll just, I'll, I'll set this up and then we'll go back and forth a little bit. So, c m s proposed changes to empower patients through better access to hospital price information, improve the use of the electronic health records, and make it easier for providers to spend time with their patients.

So that's the first line of the C M s. Here's a couple of quotes from C M Ss administrator CIMA Verma. Uh, we seek to ensure healthcare systems put patients first. Today's proposed rule demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers.

So that's the gist of what they did. The E H R adoption has created electronic silos. Uh, we had filing cabinets before, now we have electronic silos. Data doesn't mean anything unless it's put into a format that's meaningful to the end user, whether that provider or. Whether, whether be for provider or.

That's why. And a little bit of what, so let's, let's actually take a look at what happened and then, then we'll get into it. So, specifically c m s plans to change the e h r incentive programs, uh, in the following ways. They're gonna make the program more flexible and less burdensome. They're gonna emphasize measures that require the exchange of health information between providers and patients.

And they're gonna incentivize providers to make it easier for patients to obtain their medical records. So this is where it starts. They renamed it. So it's the, uh, the program formerly known as mu uh, so we're doubling down on these efforts. Our announcement to complete the overhaul of meaningful use is for the first install or the first installment in that she said, referring to the recently announced renaming of E H R incentive programs to promoting interoperability programs.

Interoperability. So renaming is not a small deal. It, it shows the focus of it and the focus of it, uh, as we've highlighted on the show before, has bipartisan support. So this, uh, what is generally accepted is that we created this environment where the data gets housed in these EHRs, but patients don't live.

Only within one health system or only within one, only within a, an acute or an ambulatory environment. And a lot of times they're moving across, uh, a continuum. And we've created these, um, we've created these silos. And as people like Vice President Joe Biden have traveled around in, in support of their, uh, uh, their, the program, uh, the, uh, foundation that he's, uh, supporting, uh, he has heard over and over again that this is one of the major.

Uh, the things that's holding back research, it's holding back good care is interoperability. So they rename it has bipartisan support. We're gonna sort of move forward on that. So here's where we start going back and forth. Here are some of the patient-centered improvements. Uh, the first is patient has access to the record in downloadable format the day they leave the hospital.

Okay? So that's, that's one aspect of it. The second is, are actually let's, let's, so. Uh, the quote here is, when we go to the doctor's office, we want to be able to have the information about what happened there. We want to be able to build our record from birth through our entire life. You want to be able to aggregate information from your medical record and from your devices so we can put the story together and see the, see your health and how it looks.

So what we're saying is now the patient becomes the center for that filing cabinet, right? So if they, wherever they leave, they're gonna get that medical record. Uh, in terms of interoperability. So what kind of impact, let's start there on that one. What kind of impact will that have on your health IT organization and, and what kind of benefit w do you think that would have for patients?

So Bill, you know, I think that the meaningful use program, and we all know that it really started in the early days as, as use, it was use oriented, you know, to get more clinical data and data use available. Physician practices and in hospitals, um, and have it stored in a somewhat standard way. Um, and it was the way, it was a great way to begin, but it was from the healthcare industry out.

And what I love about the pivot now is this recognition of a digital economy and, um, consumer and patient comfort with technology. And I'm just a huge believer that whether it's two or five years from now, that the ecosystem's gonna be, um, much more in alignment where it needs to be, which is the patient in this is about the patient.

And you know, I envision a day where our, our consumers patient, our citizens have the ability because it's their health information. Um, and they will move in and out of touch points of very various participants in the industry like LifeBridge Health, and they will be the ones, um, providing me their history and their information, whether it's self-reported or from other areas and organizations.

And I think that's a real paradigm shift. Um, we've gotta start with better interoperability between.

But I think it's only a matter of time and velocity before it's really back in, um, the very capable hands of either patients or, um, their proxies. Yeah, I, uh, Uh, the, I, I think what people think is that it's just a matter of just opening up the data in, in a way it flows. Interoperability is a very complex thing, as I found when I came into healthcare.

Um, you know, our clinically integrated network literally had a hundred different EMRs. It wasn't just a matter of, okay, let's get the data. I mean, there's, there's contractual agreements to move the data. Um, there's, uh, the data itself, how clean is the data, uh, the format, it's stored in the, the, the quality of the notes, um, the efficacy of, of the notes as well.

I mean, there's, there's just a whole host of barriers and even within our four walls of our system, our clinically integrated network, our health system, we didn't have full interoperability. So this is a, this is a challenge. I, I agree with you. I like the focus. So we are, uh, yesterday I heard Rod Hockman, uh, uh, C e O of Providence, St.

Joseph Health speak. And, and, and they have a, a simple moniker for their journey. You know, it's no me care for me ease my way, and it's very patient-centered. It's really what we're looking for as patients. You know, when we see the doctor. We want them to see our record and know, know us. They don't, we don't want 'em asking us all the questions.

Again, we want 'em to care for us. We want the best outcomes and ease my way is, is the part that's really starting to become central to healthcare now. It's, uh, you know, reduce the, reduce the friction. I mean, that's the, the new buzzword. It's reduce the friction of the transaction. What do you think? Uh, well actually we're gonna talk about this in the next segment.

So we're gonna talk about your Apple Health record because I think this is, this is part of that. So, uh, so let's go on to a couple of these others. This, this is an interesting one, so price transparency. Now you're already required to provide price transparency as a hospital. But what they went one step further and they said, yeah, now you have to provide price transparency on the internet in machine readable format.

Meaning a new company, a new, uh, tech company could come out, collect all these machine readable pricing information and provide a sort of a snapshot of, of pricing. Uh, is, is that really, is that gonna, first of all, is that gonna be hard? And I mean, from a technology perspective, probably not that hard. Uh, is, is that, is that gonna be hard for you guys to do and, and do you think that will have much of an impact today?

So, bill, I am bar none. Any one of us in Maryland are, are the worst, uh, folks to ask about this because we don't negotiate rates with different managed care companies and insurance companies and insure this company. We are given our rates. And so, um, I actually look at that requirement and scratch my head and wonder, wow, um, is this gonna be a requirement for, um, for us in Maryland when in fact, uh, we really don't have prices?

We have rates that are dictated to us by a commission. So, you know, we can make them visible, but they really are, um, not at our prices. So sadly I can't really respond in an effective way to that. I think that, um, I would be misspeaking if I could talk about how easy or how challenging it's for people outside of Maryland.

But for me, that is the, um, singular element of the, um, announcements this week. That really gave me pause for thought because I thought, uh, oh, here we go again. We're starting with a new approach to this. This meaning the, the, um, the, uh, program. And yet there are already elements that, um, many of us, and I know we're still in the comment period, so the people in Maryland will be, will be speaking to this, that it's, it's a great and it's the right idea, but it's really not relevant in our little geography here.

Yeah, I, yeah, I, and I can see that, I think what they're trying to do is create a market, right? So if you have transparency, you have a market. I don't think we're, I still can't choose any doctor. Like I can't go to Kaiser, I'm at Kaiser's, sort of their own little island. Uh, if I wanted to in southern California, I'm sort of restricted based on my plan.

Uh, you know, so I'm gonna cover the last two real quick, 'cause I really wanna jump into the next section. So, uh, they're reducing the burden and this is no small deal. And, you know, every time I post something on social media, Jump on it and say, you know, mu has been a failure, and those kind of things. And, you know, this interoperability is a, is a big reason why MU has not, uh, realized its potential.

And the second is, is just the, the burdensome reporting on this thing. So they're gonna reduce, let's see, the proposed rule, reduce number of measures. Uh, acute care hospitals are required to report across five quality and value-based purchasing programs. These proposals will remove a total of 19 measures.

From the quality programs and we'll deduplicate another 21 measures, and I'm sure that's gonna be welcome. That was a, I mean, we have people dedicated to that actually. I mean, it's a significant, significant deal. And then the, uh, the last thing just to note for health, it is, uh, the 2015, uh, addition certified e h R technology must include a p i capabilities.

That is what is going to be required for the 2019 certification is the 2015 edition, and that is to drive APIs. And there's a belief in the industry, and I share this belief that, uh, you know, APIs will enable a new ecosystem of players. We want to be able to invite this, uh, we want to be able to invite people from outside the industry, even from within the industry, to develop.

New ways to, uh, uh, drive patient engagement and, and being able to care for people outside of the normal visits. Um, I'm sure we will be talking more about this topic, over the next couple of weeks and months, but, uh, you know, thanks for getting us started. I, so our next section I want to jump into experience with the Apple Health Record.

You're one of those, you weren't the first small. Fast follower as they say. Um, so tell us what your experience has been so far with implementing the Apple Health Record app at LifeBridge. And, you know, just give us a little background on it. Sure. Um, you know, LifeBridge prides itself on, um, you know, being sizable enough to fund innovation and yet small enough to be nimble.

So, um, when I saw the announcement. Apple about the 12 initial health systems. And, um, I realized that a handful of them were either just down the street, uh, or in fact had a similar, uh, E H R infrastructure, um, similar to ours. I got on the phone and I started talking to people about, Hey, if you've done this elsewhere, do it with me and I'm.

Um, you know, we talked about interoperability as a key facet of, um, our next generation meaningful use. And in fact, um, the, the Apple app is utilizing fire APIs. So it's, it's really a very classic example, number one. Number two, I talked about, um, our passion and interest in accessibility and. If we step away, and sometimes that's hard to do as an executive, but if we step away from the organization that we serve and we look at the greater healthcare community to the point that you mentioned, you know, we on our own healthcare journey, either our own or our family, um, either our insurance or our preference is navigating.

Um, the places that we go within the industry, there's economics, there's our care condition, there's our pocketbook, and all of those influence our journey. And as much as I want stickiness and believe that health, uh, that healthcare delivery at LifeBridge can be and should be the sole provider for people in Baltimore and in Maryland, that's just not the case.

And so, um, definitely we subscribe to reducing barriers and access by giving you your information. And so what does that mean? You know, here in Maryland, Hopkins and MedStar and LifeBridge are all now participants within golly, six weeks of that phone call, um, with the publication of the upgrade of the, um, apple app, the health app, the one with the little heart on it.

Um, as long as you have, um, Set up a portal at LifeBridge Health or any of our physicians that are affiliated in using our enterprise E M R. Uh, you can go right into the Apple app and see, um, a different, a more apple rendering and apple oriented rendering of your health information that you would find in your portal here Now.

It's interactive or robust as the portal app that our e h R vendor has that we have made available on smartphones for, for folks who visit us, where you can schedule appointments and, and ask, um, secure, uh, message your clinicians and the physician practices. But what it does offer is if you're that person who has had to navigate to a MedStar facility, a Hawkin facility in LifeBridge, and have had to establish portals 'cause right.

We all remember how hard that meaningful use portal requirement was, especially for hospitals like who, you know, It's sad if you've been in a hospital yourself so very many times that, that you need to establish a portal. We see that much more prevalent in our physician practices and maybe a much more reasonable ask, but that was a high hill to climb on meaningful use to make that measure.

Um, and yet now, um, with the Apple app, the health app, you've got the ability to visually render in real time through fire, a p i a view of your health data. Organizations on one app, on your, on your smartphone. So think about that. We, you know, apple has created that layer above. Um, so that these information silos have, have really just been kind of wiped away.

Yeah. So we're ending the portal pinging pong as it were. Um, was it, was it hard? I mean, obviously your, your E H R platform, which I assume is, is Epic. Am. Oh, okay. But has had the fire a p i, so this was pretty, it was a pretty straightforward implementation. Yep. Wow. It really was. I, I think, you know, probably the toughest thing was, um, looking at all of the expectations that Apple has that are somewhat non-negotiable.

'cause they're Apple . Yeah. But you're also sort of minimizing expectations here. I mean, it's not, uh, it's a start, right. So it's, it's bringing in certain sets of data. It's not as robust as your, your portal, but, but if you are somebody that moves around from system to system, now all of a sudden instead of having a, and my parents have this, a portal for one health system, a portal for another, a portal for another, um, you, you can, at least you can see what it might look like in 2, 3, 4 years.

We still have some of the same challenges. I mean, getting a common med list is, Is almost impossible, right? I mean, if, if you have a med list from, from LifeBridge and you have a med list from a discharge at Hopkins, reconciling those is very challenge. It was challenging in the portal world. I'm sure it's gonna continue to be challenging in the Apple world, but it's, um, but we could, we could do the 80 20 rule and say this is 80%, we now have the, the patient.

A good snapshot, at least of where we're at today with their health. Is that, is that how you're looking at it? That's right, that's right. I mean, look, I look at it as a baby step. If, if you, um, If I pull it up on my phone and I've got my own records in there, it's a nice visual, um, aesthetically pleasing.

It's very apish, but I can't do a lot with it except look at it, but it's the right step. And conceptually it's a disruptor where there's sufficient, um, industry interest in what does it look like and what can it become. Yeah. Yeah, it's, uh, it's interesting. What do you say to the people? So we just had this Facebook thing and, you know, people inadvertently shared their data and one of the things that people like to point to with Apple is, uh, you're gonna have the ability to share your data with a provider or with, at some point you're gonna be able to walk into any health system and say, Would you like a copy of my record and click a button in your Apple Health record?

Uh, will will go over and they'll at least have that at, at the point of care. Um, but what, what privacy people are saying and, uh, some, some high powered industry people are saying is if we give people access to their health record, they're gonna get duped and they're gonna give away their health record.

I mean, what? I mean, do you, I mean, clearly it's a concern, but, um, are you more worried about that or are you worried about that and how, I mean, how do you balance that with. People in the driver's seat of their health. Yeah. Wow. So, you know, we are always striking that balance and, um, on a daily basis, you know, how rigorous and strong do you make authentication and passwords.

Um, and yet you don't want it to be a barrier to having your clinicians.

Information on the patient so that they can render care. We're, we're continually, um, tottering on, um, in an imperfect world. So, um, look, I just think we're gonna have to continue to navigate that for sure. Yeah. Um, one might argue that when you've got all this data that's accessible, and I know our physicians argue it, they're like, whoa, if it's out there, um, Does that mean there's an expectation that I knew it was there, I looked at it and I'm accountable for it.

Right? That's counterbalanced with the clinician saying, wow, you know, if we put it completely in the hands of the consumer or the patient and they're electing, uh, not to share it with us, that could be pretty damaging too. Um, you know, I think the reality is as a patient, as a consumer, um, That's really mine.

It's mine to make some determination over. And, um, and yet I think many people would agree that in a circumstance where, um, you know, let's say there's a horrific accident, you're, you're in a car accident, you arrive unconscious in an emergency room, um, that's a circumstance where people can really wrap their head around the fact that they'd rather have their care providers have access.

Be overly concerned about the wrong person having the ability to, um, take care of 'em by having a barrier to that information. But I think it's gonna introduce a whole different, um, level of conversation and complexity for sure. I agree. And you know, the, the, the thing I would say to the leaders at, at Epic and Cerner who, uh, quite frankly benefit from the data being, uh, closed off, I, I think they're great people.

I think they wanna, they wanna do what's best for healthcare, but they are sort of proponents of this, Hey, we've gotta protect the individual. My con and again, I've had these conversations and, and kind of abruptly end by saying, how can, how can an individual do much worse than the 24? That we've breached since 2016.

I mean, quite frankly, I'd rather be responsible for breaching my record than just continually getting those, uh, you know, we'll protect your credit history, uh, emails from the various providers that have had my record over the years. I, I'm not gonna, I'm not gonna have you comment on that because I don't want you to get into the same trouble that I get into.

Um, uh, you got it, . Yeah. All right. So here's what we're gonna do, and we're gonna have to do this fast 'cause we, we spent a lot of time. So, uh, this is really mostly, uh, I'm gonna change this to sort of a soundbite segment. I'm gonna ask you six questions really quick and you know, one to two minute answers on these things.

So, what is one technology that has the potential to have the most impact on healthcare in the next five years?

Do I get a whole minute to think about it? No, you have, you have a minute to answer . So, um, I have been really impressed with technologies that are starting to emulate the human senses, right? We all are learning a lot about voice recognition and optical character recognition and taking advantage of voice commands.

Um, I'm starting to see the same with machine vision. Um, just the ability to leverage and take, um, the sense of vision and apply it to, um, framing out, uh, geographic awareness in an or, or, um, navigating a, a healthcare, a physical hospital. Um, so I think we're gonna see, obviously it's a lot of artificial intelligence, but I think, um, getting very good at using those technologies so that we, um, Revolution make much more effective how we're gathering information intelligence.

Computers are taking on a different, it's very interesting industry. That has digitized, has gone through this disruption, really about 10 years post digitization. We heard that at the, uh, chime forum. Um, in 2008, 9% of the industry had E H R in place. Today that number is about 90 to 95%. Um, what are you doing to prepare for disruption or to promote disruption within your health system or your markets?

Right? Yeah. Well, we definitely promote disruption, so, um, I know we talked about meaningful for use and the new program. And look, the reality is, as a C I O, um, we live very practically and need to demonstrate competency and budget management and keeping the lights on and addressing the regulatory, um, challenges ahead of us.

But I have a real mindset, um, that our real opportunity is to differentiate by innovating around the edges. We wanna keep our core sound and well controlled, um, and reliable. And yet if we, as the technology, one of the technology experts in a healthcare organization aren't at the table partnering, whether it's with marketing, um, to really enhance and address this new era of consumerism or our innovation partner, um, to work with different, um, teaching institutions.

Or startups so that we can identify not only, um, small tests of change, but perhaps ways to monetize or get very creative on, um, finding different opportunities and funding sources, um, to innovate. You know, then we as the c I o are, are really missing out. So, you know, I always encourage my peers, and I know organizations are structured very differently.

You might have a chief transformation officer or chief digital officer. Um, if that's not you, um, you need to lock arms and, and really be at the table for sure. Yep. And, uh, you know, I appreciate, uh, you and industry and, and people in the industry that have organizations of your size. I heard a panel yesterday and uh, you know, si things like dignity and providence and whatever are talking and, you know, there's $20 billion health systems.

Clearly they're innovating, but when the smaller you are, the more creative you have to be in the partnerships you have to do. And your partnership with Apple, uh, is, is, you know, a testament to thinking, um, creatively about innovating around the edge, as you said. Okay. So the work continues to change in health.

It, and, uh, so I've been asking a lot of, uh, CIOs, this, this, this type of question. Um, you know, we don't change tapes anymore. Well, you might take change tapes. There might be some legacy systems, but generally speaking, tapes are going away from health. It. What is the one thing you're doing to prepare your team for the, the change in the work that is done within health?


is that the bell? That is the bell. We're going long. I.

We in, in information technology have been the catalyst for disruption for a lot of other players, um, or associates in our own organizations. And yet, um, we're gonna have to change. And as a leader, I need to make sure that I'm creating and promoting an environment where there's. Um, a readiness for change and not, um, the fear that might be attributed to displacing the way we've always done things.

You know, when, when we look at ourselves as a leader with a group of technology, um, folks that span, um, the, the skill domain from, you know, supporting mainframes and network infrastructure, and when we start talking about displacing to the cloud, And really creating, um, maybe development roles that are much more around interoperability or digital health as opposed to the traditional programming mindset.

It's super disruptive and yet, um, like anything else as a leader, we've got to, um, manage the message and I think we've gotta take. Some of the fear out of that by creating a safe environment for the conversation and really to continue to educate where the industry is going, and then personally commit to the organization I serve and, and the phenomenal associates I have working for me here, that there's gonna be a place for them.

Um, they shouldn't be intimidated. It's still technology, it's still, um, creative design. So even though the, the tool in their hand may be a little bit different. Um, the motivation that got 'em into this space and into this industry will remain. Yeah. As I tell my, uh, my kids recently graduated from college and moved into the work world, and I think we're telling 'em now that they'll change what they do, you know, 10 to 12 times before they retire.

And when we came into the, uh, industry, it was, you know, you'll change four, five times in.

Um, what they're doing is gonna be interesting. So, um, so what's one thing you would say to vendors trying to work with a health system? You know, I got, I got that email once that had, dear whatever, it wasn't even my name. You know, we have the greatest things since sliced bread. You need this thing. Um, but I get this question a lot from vendors is, you know, from, what's, what's the, what's the approach that resonates with the c I o?

Well, with a name like reso, um, Nine times outta 10, they spell it wrong. Anyway, so thank you for the letter. Um, but that's not me. You know, bill, I think you can relate to this. Um, and, and I can too. I, I've been a c i o now for over 20 years in a few different institutions, organizations, but that's not where I've always been.

Um, you know, we have a passion for supporting healthcare as an industry and, um, you know, as, as a commitment to doing a better job here in the us. Um, health quality, health equality, and a more economic value to the quality of care. And, um, I'm most appreciative when, um, vendors or other people in this ecosystem that we're in approach us as peers and professionals.

You know, I, I think as you know, um, we have all worn different badges and sat in different seats. And I think if there's, um, a participation in the dialogue about how we can solve a problem, there's a higher probability that when we get down to the investments and tools, um, that we're taking advantage of the players in the market who we really know, understand it.

So that may be a kind of a philosophical comment, but I gotta be honest, I, um, Maybe it's a bit arrogant. I pride myself on knowing the 10 big things I need to solve in the coming three months, six months, nine months. Yeah. And I go chase them down. So, um, when I know I need it, I'm calling them. So just having, um, a, a presence and recognizing that I'd rather talk about the problem that we're trying to solve together than any specific method of solving it.

Um, usually it takes care of itself from a product perspective. I, and, and similarly, I say three things to him. I say, you know, know my business. So I don't want to keep educating you on my business. The second thing is don't try to get to me through email. If you can't get to me through another person, you're probably not gonna get the sale anyway.

So either through a peer telling me, Hey, you should talk to this person, or somebody within our system saying you should talk to this person. So that's the second thing I would say to people. And the third is, a traditional sales rep doesn't cut it anymore. When I talk to the sales rep, I want to be strategizing.

I want them to know their product backwards and forwards. I don't wanna. Have a go between, oh, let me bring in this person, lemme bring in this person. I want them to at least have a base level of knowledge that that adds value to. Uh, our time is valuable. It's the most valuable thing, which is why I appreciate you allowing us to go over today.

A little , by the way, you were way more succinct in delivering kind what I was articulating. Yeah, that's a great list for vendors for sure. And you know, if there's any, I, I hate to. Please don't ask for an hour of my time to tell you what my goals are for the coming year, you know, so that you can try and figure out what, what corner of that to sell into.

I, I know what I'm going after. So, one of your pa we're gonna skip the social media at the end, but to, to cut this off, but, uh, one of your passions is the c i o needs to seat at the table. Um, close. What does that look like? And if you were interviewing for C I C I O role today, um, what's, what would be the situation that you would say, yeah, I'm not gonna take that position because it's not structured correctly?

I mean, do you need to report to the c e o? Do you at least need to be on, uh, you know, a president's advisory committee? Do you need to have, uh, like a board subcommittee that you're reporting to? I mean, what, when you say a seat at the table, uh, give us an idea of what your ima what you envision. Yeah, I, I think the red flags for me is not being involved in, um, organizational strategy development.

Right. You know, if I'm offered an incredibly creative technical job, um, I'm not interested, you know, I am an executive leader who needs to continually balance how we use technology to enable and advance our mission, which is a healthier community. Um, and so, you know, it creates my own constraints for sure.

Um, I'm in a leadership table where I'm equally responsible for, um, operations excellence, lean project management, um, getting cost efficiencies and effectiveness out of our system. And yet I recognize that as we digitize healthcare, um, I have one of the biggest hands out at budget time. I, I myself, have to manage that conflict between being, um, a fiscally responsible executive who understands what those trade-offs are, when we make those decisions and when I advance it.

So for me, the red flag is that you're just the technology expert and, um, you know, just go take care of that for us. Uh, make sure you understand what these new federal programs are. But, um, when we're talking about starting a new clinical program or a merger and acquisition or, um, you know, one of our key tenants at the board level, that, that, um, I'm just not part of the executive team, you know, that's, that would be a part for me.

'cause. I've had that benefit and privilege, um, for the last number of years. Yeah, absolutely. Have to be, have to be part of the table. I've, I've seen, um, the thing I keep telling CIOs is, uh, you're delivering outcomes. And if you're delivering outcomes, they're typically business outcomes. And if you're in those conversations, you're at the, you're at the right level.

I, I don't like being, I, I did not report directly to the c e o. Um, I did not find that to be a problem because I met with the C E O fairly often. We were in the same room fairly often, and whenever there was. We're thinking about digital transformation of those things. I was always, I was always at the table, so that worked.

I didn't have to report directly to the ceo E and I know a lot of CEOs can only handle so many people reporting to them. And, uh, they have to, they have to make decisions from time to time. Um, you know, tha thanks for coming on the show, Ressa. How, um, how can people follow you? Well, let's see. I am on Twitter, uh, at Tress springman, but also, uh, hashtag health it chicks.

Um, but again, hashtag trust springman. I'm also on LinkedIn. You can find me either through Chime Um, most of the time I'm just hunkered down here doing a job that we do every day. But when I get the pleasure and opportunity to poke my head out as you have given me the opportunity, um, you know, nothing better to learn from our peers.

And, um, Add value where we can. So I really appreciate our time, bill, and, um, I, I really enjoyed this. It was really nice to meet you. You've asked some provoking questions and, uh, just thanks for the opportunity. Well, thanks. I, uh, I, I learned a lot as well. There's a great, uh, series. Uh, interview done by Health System c i o view.

It's four-part series of people that get the opportunity to go out there. I, I recommended there was, uh, a lot of great, uh, material in there as well. So, uh, you could follow, you can follow me on, on Twitter at the patient cio, my writing on, uh, the health lyrics website, HealthSystem c I picks up my articles every other week so you can, uh, just track 'em down out there.

Don't forget to follow the show on this week. Uh, this week in h I t. And check out our new website this week in health If you like the show, please take a few seconds to give us a review on iTunes, Google Play, catch all the videos on the YouTube channel. We're now up to actually with this show. We will probably crack a hundred videos out there on the YouTube channel, uh, this week in health

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