Microsoft does a major reorganization deemphasizing the operating system and Vanderbilt shows off NLP/AI for navigating the EHR. Could this signal a change in computing paradigms? How to grow the number of women in Health IT leadership roles.
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Bill Russell: 00:52 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 13 it's Friday, April 6th today. Does Satya Nadella know something that we don't Microsoft as a major reorg away from their windows operating system group. Does that mean anything for health it. We also take a look at an article about what physicians can do about the rising cost of healthcare. And we all were going to also talk about women in health it leadership roles. This podcast is brought to you by health lyrics, a leader and moving healthcare to the cloud to learn more, check out health lyrics. Com. My name is Bill Russell. Recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Today I'm joined by a friend of a friend and someone that has and has had an impressive CIO career. Sue Shade recommended that I reach out to her as a guest for her leadership. But it really was a chime presentation that I attended where I made the decision that I had to have Jamie on the show. It's in that presentation about digital transformation. She's shared a strategy for getting buy in that was powerful and yet fairly simple. Uh, but before we get there today, I'm excited to have Jamie Nelson, the CIO of the hospital for specialty surgery. Join us. Good Morning Jamie, and welcome to the show.
Jamie Nelson: 02:09 Good morning Bill, how are you?
Bill Russell: 02:11 Ah, good. So do you that chime presentation this past year, uh, you were talking about the need to improve the intake process for, uh, for surgery and you had a whole bunch of different technology tools that you were using and, and what you decided to do. Um, or at least what I remember from the talk is you brought the team and the executive team that people responsible for it and you said, okay, you're going to go through the process with the tools we have today for this and you know, and then we'll just talk about it when we're done. And when they were done, you had complete buy in that the process was a little convoluted and needed to change. Can you tell us a little bit about that process?
Jamie Nelson: 02:50 You know, we had so many tools, we had different ways of collecting data. We had portals, we had paper, we had research assistants, we registrars, nurses. We had just a wide variety of things and it really was not patient focused. Um, and what's really neat is that bring our leaders together. Many of us have been patients here. It's an orthopedic hospital. We all need something done. So understanding from patient experience was really easy for our leaders and we realized the necessity, to simplify, standardize and be really customer focused. And that's easy to say, hard to do because we all want our data. Um, but we're on that path making some progress.
Bill Russell: 03:31 Yeah. And you're in New York City, so you definitely have a lot of competition that actually, before I get to your bio, can you tell us a little bit about the hospital for specialty surgeries? Said it's not us. Yeah, no, please tell us. Tell us more about it. It's not a household name, although you, you do, you do sponsor the mets. So we're going to see it more and more if we are, if we're baseball fans. So tell us a little bit about, about your institution and what you guys do.
Jamie Nelson: 03:58 Sure. So hospital for special surgery we been in the business for about a hundred and fifty six years now and we are totally orthopedics and musculoskeletal medicine, so that's rheumatology as well. And we've been ranked number one by US News and world reports for orthopedics for seven years running. We're a magnet hospital, so we really do fantastic work here. And we have patients from all 50 states worldwide and people come here for very specialized orthopedic care and we're, we're proud of our results.
Bill Russell: 04:30 Yeah. And I apologize for saying that wrong hospital for special surgery. There we go. Uh, so here's your, here's your bios. Great Bio. Uh, go in reverse order here. You, uh, two ivy league degrees, University of Penn and Cornell, NBA and voted we'll actually, and then you have the consulting credentials eny first consulting group. You have a great health care background, Memorial Sloan Kettering, New York Presby and obviously where you're at now as the CIO, you are named, uh, one of the most powerful women in health it in 2017 by health data management. You, um, you have adjusted your organization to the changing needs within health care. You've created an organization that now has a Cmio, a CTO, CSO, VP of applications, ABP of business intelligence, data analytics. So you're seeing the trends as they're happening and adapting to those. And, uh, the, the thing we all went on our resume, top 6% of a successful Emr implementations that epic, uh, has highlighted for you guys. And, uh, HIMSS level seven. So these are, these are definitely some, uh, accomplishments that, uh, other CIO's can be jealous of.
Jamie Nelson: 05:41 I did not mention one other accomplishment. Mother of three.
Bill Russell: 05:47 It did, it didn't make it on the bio when your kids are going to be, one of the things we do with each one of our guests is we asked them to give us an idea of what they're currently working on. That they're either something you're working on or something they're excited about that they want to talk about.
Jamie Nelson: 06:03 Well, yeah, I'm going back to the presentation chime certainly on our digital journey and we're doing things like streamlining the front end, adding patient photos, adding patient texting a self online scheduling and those things sounds so fundamental. But in healthcare we're not there yet. Um, you'd have all that inbanking, but you don't have that in healthcare. So we're working on that. Analytics is the huge push for we do is all the data we're collecting and how are we going to use the terms of care. And then finally, telemedicine is just popping up all over the place. Every week, there's another request across our desks to provide telemedicine. So, um, lots of interesting technology based initiatives going on.
Bill Russell: 06:44 Yes. So your reaches is, uh, there's New York City obviously, but you're, you're expanding outside of New York City as well, aren't you?
Jamie Nelson: 06:51 Yes. Um, we, many of our patients come from outside our area and we know that every one except for people who come from the upper east side Manhattan have to pass some other very fine orthopedics department in a fine hospital to get to us. So we really focus on patient experience outcomes, letting people know why we need to come here with the values of coming to HSS. So yeah, we're, as I mentioned earlier, we're all 50 states, uh, try and I stay here and very strong and international.
Bill Russell: 07:25 Yeah. And so the, the followup, obviously the followup with telehealth and whatnot becomes, uh, becomes key and even presurgery, uh, becomes key as well. Absolutely. So here's how, here's how the show works. We, we a story for the first segment, uh, to discuss. And uh, you know, also I'll start us off this. Um, this is over the last a week and a half or so. Uh, Microsoft has reshuffled the, the corporate deck as it grapples was a world where PC does not dominate. That's the headline from the La Times story. And read a couple of things from here. Microsoft Corp, uh, chief exact Satya Nadella unveiled the company's biggest reorg in three years. Combining the divisions that focus on devices and software for businesses, for businesses while moving the Windows operating system unit into the cloud operations. He also created one and experiences and devices team. This group will focus on how people interact with various computing devices using multiple senses.
Bill Russell: 08:26 Uh, Microsoft said in the memo, I'm going to combine that with another story. Um, and the other story is Vanderbelt Creek's Ai and natural language processing, voice assistant courts, epic Ehr. Now we knew this was coming, but it's exciting to see that it's finally here. So here's a couple of quotes from this thing that the, uh, the idea to develop an inhouse voice assistant cane from the general frustration we heard from the users about the difficulty navigating the Ehr to find relevant information. Said, Yah, uh, doctor, Kuma Crystal East Star Core Design Advisor, assistant professor of Biomedical Informatics and Assistant Professor of pediatrics, pediatric endocrinology at Vanderbilt University Medical Center and Monro Terrell junior children's hospital at Vanderbilt. And went on to say there's a lot of information foraging that occurs in the EHR, although users often know the precise pieces of data they need to understand the clinical picture. So, you know, it's, it's interesting, I, the reason I combine these two things is I believe that there's a change going on in what we may be focused on within health it, and it's, and, and you sort of touched on it, it's, it's really around the user experience that the internal user and the external customer user.
Bill Russell: 09:44 And I guess my question is we have, we have Microsoft saying the Microsoft Windows operating system unit no longer exists and has gotten broken up. And so that's where a lot of our focus was maybe for the last five years, windows upgrades and we had teams and running around and doing those kinds of things. And we have the Vanderbilt, uh, creating AI to interact with the EHR. I guess, I guess my question to you is, are we at a point where every new technology we are bringing in to the hospital that we need to start looking beyond the traditional PC keyboard interaction and, and look to, uh, to the next generation of, of machine human interaction? Are we, are we at that point? Finally,
Jamie Nelson: 10:23 I think for physicians, we have to give them some sort of assistance. We've put this, the electronic medical record in front of them, but the user interface, the physician burnout that's created by constantly having to type is, is just overwhelming. So I think, I mean, these virtual assistance, um, and using artificial intelligence to help formulate that is, is really brilliant because they're going to stop using those records and they're not finding value. And we need to create an environment that they can use these tools because there is a tremendous amount of value of the data that we can harvest out of that in terms of improving care. So I think that what they're doing is, is, is just brilliant. And Microsoft, you know, doesn't want to be the next Kodak. So they, they have to move, they have to move with where the technology is or push us. And again, they're looking at the cloud, uh, Asia platform. It was very, very popular and I think from use cases, analytics and the cloud are, are just natural partners and that's uh, I think for many of us looking at cloud computing, that's a great first step. What kind of analytics can we not do on campus? Do you want to put up in the cloud just to test the waters and then maybe move in that direction? So I, I think they're doing very smart, uh, taking very smart steps here.
Bill Russell: 11:41 Yeah, I remember when Bill Gates are old enough, you could see my gray hair at the bill gates was talking about information at your fingertips and uh, it's really not at your fingertips. It's really at your, at your words. And we're seeing that with TVS. We can now change channels and do stuff with TVs. We can do that with music obviously with news, podcasts, you name it on Alexa and a, it seems like now what we're saying is there's this ton of information behind that front door of the EHR that we can get to with our voice to say, give me the most recent vitals. Give me, uh, you know, the, the information about the most recent uh, uh, image or those kinds of things. You know, you, you have been able to adapt. So you've created all those roles that we talked about earlier. Um, what, what are the next couple of roles that you think might, we might be seeing within health it if the keyboard, mouse operating system paradigm starts to shift to a more of a voice interaction and those kinds of things. Um, are we going to see more, uh, we've already seen some more chief digital officers. Are we going to see more chief experience officers? Are we going to start to partner with maybe, um, uh, digital agencies that are going to come in and really start to, to to look at how we interact with the machines or w what do you, what do you think the next role that we should prepare for it? It is,
Jamie Nelson: 13:08 well, one thing that we're doing is, is, um, for the patient piece is really coordinating with our marketing department because they're the ones that know about digital patient experience and make it more like a shopping experience. Something that we're all used to for other industries. In terms of, um, clinicians, I think you need to make sure that whatever you're doing technologically, that it's physician led, that they're there. The focus group, you can't build in Emr, put it in front of the clinician and expect them to use it. They have to be part of that process. I think that was one of our reasons we were so successful is that because that we included our physicians from what, when we were looking at a system to building it, testing it, implementing it, training, they were with us. So I think that with voice technology and usability, we're going to have to do the same thing. We have to have, there's a, um, a lean principle about going to where the work is done and having a workers make those decisions. Physicians are workers. We really need to allow them as these technologies come forward, will be easy to find is those physicians who have the time inclination to help us prepare this in a way this be useful for them. That's really going to be an important component.
Bill Russell: 14:18 Yeah, absolutely. And I know that the providence talking with Sarah and Aaron Martin that they, uh, they, uh, did the same thing around the consumer. They brought in a consumer focus groups and uh, specifically around a labor and delivery. They brought in a cohort of women that were, um, that were, uh, all along the process and creative that they're, they're a tool for that specific group, uh, with complete input from the, that were going through. And uh, you know, it really reflected what the questions they asked and what they were looking for. And we have to continue to, to do that. And that's one of the great skills of a leading CIOs. All right, so I'm going to take it over to you unless you have any closing comments, kick it over to you to, to take us to the next story.
Jamie Nelson: 15:10 Uh, one closing comment. I was at himss I assume you were to, uh, this month or last month, I'm losing track, but voice was really touted it as the technology of the future. Every session I went to saw that really circles back to what your point was, well, I picked an article by a doctor, uh, RKG that many of us have read some of his other works, but it was in the times this week and it was really about doctors being in the driver's seat of helping to control costs while still making sure the patients get the most effective treatments available to them. And I had just heard, uh, medical futurist or hospitals futurist Joe Flowers speak this week on the topic of waste in the system, saying that a third of what we do in healthcare is waste. And that's, that's a huge number and it's due to, you know, overdiagnosis over a testing overtreatment administrative waste.
Jamie Nelson: 16:07 All the things we know about this article really says that the physicians hold the key in understanding which treatments provided the most benefits to patients, but convincing patients, um, there's a really interesting statement where he said that there's this starling dissociation between cost and value. We all think things that have a high price have more worth, you know, and that's what the shirt you might buy or with the MRI you might buy, you don't mind spending $1,000 because you think it has more quality, but that may not always and is not always true. So this article really talked about the need to understand it's real analytics through, um, different types of analyses, what treatments really are most effective and using those and convincing patients that it's okay to skip a mammogram if you don't have a certain set of family traits or not to get the latest test because it's really not necessary from your condition. But that's, that's difficult.
Bill Russell: 17:13 Yeah, it is. It is an actually, um, he uses the example of for Atlanta and Plavix, which my father had a similar story. I keep using my parents' stories, but I guess when your parents get to be 80, some odd years old, that's, that's a, that's what we talked about. But he had that same thing and it was interesting to read the article and realize there's really only a 2% difference in outcomes, but there's a significant difference in costs. And, uh, and, and we experienced that as family. There is a significant difference in costs and as it, and he talked about the dilemma with doctor, um, that is their job to convince them that the 2% isn't really necessary so that they can stay within, uh, you know, within budgets and not overspend. And how much of this burden that we put on physicians that, uh, uh, it is a really fascinating article.
Bill Russell: 18:06 I really recommend people to see, it's in the New York Times magazine, a can doctors choose between saving lives and saving a fortune. But the one thing I wanted to focus in on with you is there are, so you talked about that disassociation between cost and value. So there's three major factors identified by researchers, administrative waste, pharmaceutical costs, and procedural costs may promote familiar sounding solutions to the costs of health care. Uh, decreased waste by removing unnecessary and burdensome paperwork, drive down pharmaceutical prices through negotiation on costs, for instance, or by enabling the introduction of generic alternatives for patient expired medicines and limit the use of high cost, low value procedures where possible. I guess my question really focuses around analytics. So you have an analytics team. Most healthcare organizations are, uh, are standing up these, these analytics teams. And then some are hiring data scientists, do you find that physicians want you to focus in on these kinds of things or the administration wants you to focus in on these kinds of things? Um, or are we, yeah, we'll let you go.
Jamie Nelson: 19:17 Is very focused on value. About two years ago, we hired a physician, Doctor Katherine McClain to be our chief value officer. And what we're trying to do is to use data. We have data scientists, we have analytics to try and really understand what the outcomes are of the specific procedures we do here at HSS. And talk about the value of what we do and why people should come here for care. Now when people come for second opinions, and I'm, I'm forgetting the exact percentage, but somewhere between a quarter and a third, we tell them they don't need the surgery, that they're local orthopedic surgeon tells them that they needed. Wow. So we're not about coming in. Yep. You're here. We're going to, we're going to operate on and we really do look at what's the best value treatments. So we're trying to put together data that helps us define that value proposition, um, and, and make sure that the patients are being given the proper treatment for what they were their ailment is. So we're very focused on this and you know, orthopedics is often looked upon as a high cost, um, segment of healthcare, but we want to make sure that the right people are being treated. so they'll trust you.
Bill Russell: 20:28 Can you give us an example of maybe some of the analytics, uh, maybe it was just one of the analytics projects you might be doing that, that would inform the, informed the organization or, or help the organization to make better decisions with regard to any area, administrative ways, quality, any, anything.
Jamie Nelson: 20:49 Uh, let's talk about go into a nursing home after you've had orthopedic surgery. We have Data around which nursing homes and have the best outcomes in our area. We are able to, and we can see that nursing homes that follow a set of guidelines that we provide for them to and have our nurses calling to check on our patients while they're at nursing homes actually have much better outcomes. So as this is not big data, crazy analytics, this is something that we can look at in a, in a very controlled environment. And you know, when you start there, you can just imagine with more data, um, and, and other types of tools we can come up with. But that's very simple. So shorter lengths of stays in nursing homes, less cost to the patient, less cost to the system. And we want patients home, we don't want them in facilities when they don't have to be. So that's a great example.
Bill Russell: 21:39 That is a great example and it's, it is interesting. I think sometimes we make analytics to be a way to complicated. There's so much data. I think the hardest thing is to determine what questions we're going to ask and what, you know, what, what things were going to, to try to solve
Jamie Nelson: 21:56 Well, we keep learning, uh, you know, it turns that whole thing upside down. Because when you're using machine learning, often the questions come out of the data because we can't think of every question. But that's a, that's a really exciting prospect of moving forward and using some more sophisticated tools as, as we really collect more data.
Bill Russell: 22:16 Absolutely. So, um, so let's, let's kick into our next segment. Our next segment is a leadership or tech talk. This week we're going to explore, uh, the glass ceiling in health it from a story that you wrote on Linkedin. So I'm going to highlight a highlight your story and a story title is lessons learned from shattering the glass ceiling. And you really gave us three concepts and I want to talk to you about these three concepts in terms of shattering glass ceiling, increase the pipeline of um, increased pipeline, exhorting women to really take risks. Yeah. And finally to be assertive. So let's, let's just go in that order. So let's talk about the pipeline. Um, what's the, what's the makeup? I mean if you have these numbers, what's the makeup of women and health it today or leadership positions and uh, w what, what are we doing today to maybe change that makeup or what can we be doing to change that makeup?
Jamie Nelson: 23:18 Sure. Um, I don't have numbers for you, but I can tell you from my own experience, there are a many seminar sessions I coach or I am the only female leader I just see later in the row or just female leader in the room period. And so I think there's a real gap in terms of women in leadership. Now, as I wrote in the article at hospital for special surgery, the, the top ranks are filled with women, which I feel very fortunate to be in this institution. But as you out into it, across the industry, um, that doesn't, it's not very, not really true. Women are very small percentage and we really need to change that because diversity of thought and diversity of viewpoint really, really makes for a better outcome in that stage.
Bill Russell: 24:03 So we have to increase the funnel is essentially that this concept. So is it, um, is it, should we get involved? How far down should we get involved? We get involved down into the grade school level colleges. Are there programs we should be maybe encouraging women or girls really, I mean girls my daughter's age to really pick up some of these skills and encouraging them that they, they can actually pursue careers in this field.
Jamie Nelson: 24:34 We really should, because I don't think we're going to solve this one woman at a time. I think we'd have to get a large Bolus of women who are young women coming through these stem programs through these technical programs. When you're the only female in a class of 10 engineering students, it doesn't feel right and you may not stay there. If there's four women, six women, then you start to get this wave coming through. And I think we need to do that. I can, I think once you start to get a larger group and then the pipeline really does start to fill out, I can't hire a female network engineer. They're not coming through the pipeline. They're not there as much as I would love to. So that's why we really have to start high school, College. I think that's the place
Bill Russell: 25:20 it's, it's kinda crazy cause that's really true. I just a, I just took my daughter on a college trip. In fact, I'm off this week so you can tell with the suit jacket that I'm off this week. We, uh, we visited some colleges and she wants to be in forensic science and you know, Abby from NCS has really inspired this next generation, uh, to pursue these kinds of careers. But still when they go around the room and there's, you know, 40, 50 people in the room and they say, who's interested in these, in these roles, it's still a majority for the science, technology, engineering. And it's still a majority male raising their hand saying, that's the program I want to go into. So there is something culturally that we need to, to change before, uh, before they're looking at colleges to get them to do that. And I think people enrolls.
Bill Russell: 26:10 People like yourself, like Sue, um, oh, and many other female leaders. You talked about your CEO. Uh, I also had a health system where Deborah proctor was the CEO. We had our chief strategy officer was female, our chief financial officer was female. So we had an organization that, uh, I think 50% of the president's cabinet, uh, was female, 50% male. And that diversity of thought I think really led to a really solid decision making, uh, looking at the entire process. Um, and really taking into account not necessarily that women think differently than men, although I think in a lot of cases they do, but just having that diversity of thought sparks the conversation. So
Jamie Nelson: 26:56 Bill, I think it's okay to say we different, we are different. We were socialized differently. We think differently. That's okay. Um, I think for many years we didn't want to admit that there were differences in women's just wanting to sort of fit in where they could. And I've, I've come to think that that's wrong, that we have to identify that there are differences, that those differences are positive and we have to, you know, really embrace them and move forward with them.
Bill Russell: 27:20 Right. So you, you go on, so you say, um, it, it actually, I find this part to be interesting. You say women need to take more risks and the, the how you highlight this as you say, almost, um, you talk about that men are willing to, to jump into the next role even though they know they're not qualified for it, but they'll figure it out as they go. Whereas women are more pragmatic and they say, well, no, I'm not ready for that role yet. And they try to get ready for that role before they step into it. Um, so, so what are you encouraging women to do here in terms of taking risks?
Jamie Nelson: 27:55 You know, when, when women come to talk to me, I tell them, don't, don't check off all 10 boxes if you can check off, three or four of your qualifications for that next role. Go ahead and try for it because we really hold ourselves back in this way. And I was listening a hidden brain new podcast this morning when I was walking my dogs and they were talking about how this happens from when girls were little girls are socialized, be careful, don't hurt yourself, don't, you know, don't run. And when you have that voice say go have fun, play, jump up y'all off the tree branch. So that's, it starts with when we're very young. So that's how it is. And we have to recognize that and say, okay, it's all right to take these risks. So I always encourage women, a few boxes as good, you know, tried. The worst that can happen is you fail and then you figure something else out. That's, that's how you grow.
Bill Russell: 28:48 Yeah. And I would think almost anyone, including myself, when I took the CIO role, I was not ready for that CIO role. Now I was confident in my skills. I knew I'd be able to figure it out. But first I'd say six months in the role, I was completely overwhelmed trying to learn. You know, all the things that you need to learn. And sometimes you just have to get in that situation to learn the situation. And I think that's what you're saying. You're saying, you know, check off a couple of boxes, be confident in your skills and then get out there, see what happens.
Jamie Nelson: 29:20 And we're never alone. You know, you try a new situation, you, you've built a network, you have people you can call and ask. And we have to learn to draw on those things and not worry about being perfect. Women. Women are socialized to be perfect and that's another, another issue. Got To get past that. It's okay to ask for help. Um, try new things. Fail a little bit. It's really, okay.
Bill Russell: 29:42 Yeah. So your last thing is be assertive as soon as they'd be assertive, not be aggressive, but you're saying, um, stand up for yourself. I mean, if the ideas are yours, you know, make your ideas known and, and those kinds of things. Um, so, uh, so what, what are you saying? Give us more detail on what you're saying by women should be more assertive.
Jamie Nelson: 30:05 Women have to learn to communicate so they're heard effectively. So I, and that's what I said in the article that you've really got to look at yourself. What is your communication style? Like what type of language you're using, where's your tone? Um, where's your eye contact? Where is your body language? And if you, if you're able to communicate in a way that you can be heard, then that's really going to help bring forward and not being talked over, being able to say, stop, let me just repeat myself. I don't think you heard me. It's an okay thing to do. But again, it's, it's getting out of our comfort zone and not worrying about hurting feelings or wanting to be like those are the things we've got to push aside and, and really learn to kind of defend ourselves as we communicate. But in a, in a respectful way.
Bill Russell: 30:51 Yeah. It was interesting a couple of weeks ago, John Halamka pointed out that, uh, that, you know, the, the new CIO is not somebody with it and he's got an MIT degree but not the most technical person in the group, but, but almost a sociologist and I, I pulled this and this the second week in a row, I'm highlighting the story and I think it's worth looking up. Korn ferry did a story, a the breakthrough formula for women CEOs and it's worth a look and they had six qualities for a future CEOs. And as I was reading this, I was thinking of Halamka comment, which is there is nothing distinctive, distinctively technical or male about these things. So it's a differentiating skills for future CEOs, engages and inspires, develops talent, builds effective teams, directs works, has courage, managers ambiguity. And you know, when I talked to my two daughters and even my son and I, we talk about these things, I say, you know, you probably need something to start your career that you, you're really good at.
Bill Russell: 31:54 And it could be accounting, engineering, could be technical, but at some point what the organization needs more than anything is people that can rally people, inspire people, develop the next generation, build effective teams. And that's a wide open game. And if you can develop those leadership skills, then you can actually progress. Even if you're not the best engineer, you can progress into leadership roles and you shouldn't consider yourself just because you're not the best engineer, not ready for leadership because you may have those skills and those qualities that we just rattle off a, I'll let you
Jamie Nelson: 32:31 If you look at my bio. You know, I have an Undergrad in the humanities and a graduate degree in business. I am not a technician. My my one coding courses basic that I took the Cornell many, many years ago. So my leadership skills are much more around the things that you were just describing, which by the way are excellent skills for raising families, I might point out. Uh, so yeah, I agree. And especially for women in it, leadership roles, you don't have to be a technician. Men Do not have to be a technician. It's about those other leadership qualities. So I think you're completely correct there. I'd love to read that article. I'll find it.
Bill Russell: 33:09 This show really does go fast. We try to keep it to a half hour so that busy people like yourself and your staff can, can just pick it up and listen to it. So we are, we're at the close. Here's what we're going to do. We always close with our favorite social media posts of the week and I'll share mine. You could share yours. So my, my post is from linkedin. It's kind of Goofy, but it's something that we all can relate to. And it's, uh, it's, it's one of those videos and it has a gentleman sitting in on a hood of a car. The car is actually moving down the road and he's actually in there working on the engine while it's moving down the road. And the, uh, the caption says fixing bugs after go live and any of us who've done these things and it's, it's, he's really fixing the car. He's doing some stuff while it's moved down the road. And uh, we all know how that feels. So, uh, Jamie to you, I'll let you close it out with your favorite posts.
Jamie Nelson: 34:04 I sent you the link so hopefully you can post it, but it was also from linkedin and it was about body language and communication, I thought was a good ending to our discussion today because it's very important how we communicate effectively to each other. So great one to check out.
Bill Russell: 34:19 That's great. So, uh, so that's all for now. Uh, Jamie, is there a way that people can, what's the best way for people to follow you?
Jamie Nelson: 34:27 Uh, linkedin. Uh, so Jamie Nelson and I post things there. I write things and that's where you can keep up with me and always feel free to find me here at the hospital for special surgery.
Bill Russell: 34:40 Sounds good. Also you can, uh, you can follow me on Twitter @thepatientsCio, my writing on health lyrics website, uh, and health system CIO. Uh, don't forget to follow show on Twitter @thisweekinhit and check out our new website. Thisweekinhealthit.com and if you want to catch some of our videos, we launched a youtube channel now has close to 70 videos out there, that little snippets from each one of the shows and you can get to that. The easiest way to get to that as thisweekinhealthit.com/video and if you get a chance to leave a leave a review for us, that would be greatly appreciated. Please come back every Friday for more news information and emerging thought from industry influencers. Thank you very much. That's all for now