Month: February 2018

Unique Patient Identifier, Where to Start with Artificial Intelligence in Your Health System

My friend Charles Boicey joins to talk practical Data Science and Artificial Intelligence. We also discuss the push to a national unique patient identifier in healthcare. Read More

CHIME on Bipartisan Budget Act, Allscripts on Azure, Klasko Welcomes Us to Brave New World

Should we grade healthcare on the curve? What is the real reason that Allscripts on Azure is a big deal? Why are healthcare startup investors in New York getting antsy? and Stephen Klasko from Jefferson Health welcomes us to a brave new world of digital transformation.

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An Amazon Hospital, SpaceX captures the imagination and Culture wins the Super Bowl

This Week Drex Deford joins us to discuss where Amazon fits best into healthcare. Why the SpaceX Falcon Heavy launch matters to healthcare IT and how “Culture Eats Strategy for Breakfast” and wins Super Bowls.

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Amazon and Apple make their Big Move, Plus Role of the CIO

We recap an exciting week where not only do Apple and Amazon make big announcements but they bring big successful players along with them with JP Morgan and Berkshire Hathaway. Plus a great discussion on the role of the CIO with Sue Schade former HIMSS/CHIME CIO of the year.

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Bill Russell:                   00:12               Welcome to this week in health it wherever we discussed the news, information and emerging thought with leaders from across the healthcare industry. It’s Friday, February second, today. Apple and Amazon make their big moves in the health care plus a discussion on the role of the CIO. This podcast is brought to you by health lyrics and leader in digital transformation in healthcare. This is episode number four. My name is Bill Russell, recovering healthcare cio, writer in consultant with the previously mentioned health lyrics. Today I’m joined by former hymns chime cio of the year and Veterans Cio from Brigham and women’s Hospital, University of Michigan Health System, and an interim interim cio at university hospitals in Cleveland and Stony Brook in New York and currently a principal at starbridge advisors, the amazing Sushi eight. Good morning, sue and welcome to the show.

Sue Schade:                  01:04               Morning Bill. Thanks for having me on.

Bill Russell:                   01:07               Oh, today I appreciate you joining us. It should be, uh, should be a fun conversation. A lot. A lot has happened this week. Question, we ask all of our cohost at the start of the show. What, what, what are you working on right now? What are you excited about,

Sue Schade:                  01:22               uh, any given day? Lots going on, but one of the things that I’m looking ahead to right now is a hymns and another month and I’m with my commitment to developing next generation of health it leaders. I said yes to a number of invitations and I’m also a person I think probably known in the industry who is willing to speak up on behalf of women and women’s issues. So I’m going to be doing, uh, uh, the health it chicks meet up panel. I’m preparing for a session. I’ll be presenting on advice for the aspiring female executive and I’ll also be facilitating one of the round tables that the women in health it mentor meet up. So starting to get ready for that as well as just working on a lot of different lead, uh, as we hear about transitions within the industry right now for cio, then look to place interim in different organizations. So that’s kind of my day at the moment.

Bill Russell:                   02:22               Okay. Your Day is different every day of the week. So it is,

Sue Schade:                  02:27               it is

Bill Russell:                   02:28               sturbridge, sturbridge. You founded that with, um, with a couple of, of luminaries and you’re, you’re doing interim cio placement and it give us a little idea of what you’re doing. Not a full blown commercial, but just a little idea and then we’ll transition into the, into the news.

Sue Schade:                  02:45               Sure, sure, sure. Not a full blown commercial. So I founded the firm, started with advisors that help ip advisory firm with David and brutish back in the fall of October. Excuse me, the fall of 2016. We have about 20 advisors on our team now with a national reach. They can serve as either cio, cto, CSO, cmio or CNI l. So we cover a broad range in terms of interim work and then do consulting and leadership coaching and we’re having a great time doing it.

Bill Russell:                   03:19               Let’s jump into the news. Here’s, here’s how this goes. I’ve picked a story. Susan picked this story. I’ll kick us off this week with the apple announcement. So apple to launch health record APP with hl seven, fire specification at 12 hospitals. Let me recap the story real quick. Apple is going to use the fire Spec to move data to the Ehr, to your phone, to obviously your iphone, your android phone at this point. Okay. We’ll start with allergies, meds, conditions, immunizations, and lab results. This is an extension of of Ios and will support notifications from participating health systems. When data is updated in the EHR,

Bill Russell:                   04:00               the data will be encrypted and utilize the normal apple mechanisms for access. Let me give you an idea. I’m going to go ahead and read the the twelfth systems. Johns, Johns Hopkins, Cedar Sinai, Penn Medicine, geisigner health, UC San Diego, UNC healthcare rush, university medical center. I think maybe health oschner health system, medstar health, Ohio health and cerner healthy clinic. I guess that’s how cerner does things. It’s age h e l t h e healthy like healthy intent. So let’s talk about this a little bit. I did write an article for healthcare it news this past week and I highlighted the five reasons the school maybe a big deal and five reasons why it may not be a big deal and uh, I’ll cover those. And then sue, I’d love to hear from you how how healthcare cio might think about this or how they might respond to it so that the five ways this could be a big deal is it’s a, it’s an ecosystem and platform play now while cerner and epic are starting to evolve their platforms for developers and starting to think in terms of an ecosystem, they.

Bill Russell:                   05:04               They’re not there yet and obviously apple has a a very mature platform for developers. I think this is going to reduce the burden on internal it. We’ve been selecting patient portals for years and if if apple’s able to take some of that and really deliver an experience, that’s going to be a good thing. It could empower the patient, but timing may be right for this. There’s a lot of pressure on a it organizations and health systems reduce costs and to improve the consumer experience. So timing is good. And obviously another reason this could be a big deal is it’s just it’s apple. No, the only thing that would have made a bigger splash than this, well I guess is the Amazon announcement or a tesla announcement getting into healthcare. That would be interesting. Why? Here’s a couple reasons why it might not be a big deal from the article.

Bill Russell:                   05:56               Again. Hi. Oftentimes Lisa, unmet expectations. It’s early. The EHR vendors are, you know, it’s challenging to get the data in and out. It may not be ambitious enough, they’re just nibbling around the edges with this. Uh, apple traditionally has taken a long time between iterations. I would like to see them go a little quicker and obviously there’s a whole bunch of things this doesn’t address that it doesn’t address tight integration with the EHR, therefore you’re not going to give it the EHR workflow and there could be some unmet expectations as we talked about earlier system. As soon as we, as we look at this announcement, one of two big tech announcements this week, how should the cio think about it and how should they respond?

Sue Schade:                  06:38               Great question and a great selection on the article. No, and it kind of ties into the other article that we’ll talk about, um, and, and overall for cio is I think that, um, they need to be broadly thinking about change and disruption and embracing it not being threatened by it. Um, and I think that a lot of ceos right now are going to look at this at this announcement from apple and this list of really leading organizations who are known for their innovation and their gonna take notice. I’m so many organizations are still struggling with some basic interoperability, uh, they may still be, you know, in very early stages of trying to develop their digital health strategy and how do they reach out to consumers beyond the basic patient portal. Um, and they’re still dealing with a lot of EHR optimization work that the clinicians quite frankly, are demanding and, and rightfully so need.

Sue Schade:                  07:39               So how can they play in this new space? I’m not sure for many of those organizations, but they absolutely need to be taking notice. I think that your comments about why it’s a big deal and why it’s not. I’m really hit on the mark. If I start with some of the not, it’s easy sometimes to look at is like, oh, hi, appears the latest and greatest, but is this really gonna take off and when you dig under the covers, what are all the challenges to participating in it? But, you know, it’s certainly something worth noting. And um, I will tell you if I was sitting cio and another organization right now, I’d be reaching out to some of my colleagues, uh, at the organizations on this list and trying to find out more and uh, how we might, you know, think about participating.

Bill Russell:                   08:24               That’s a good, that’s a great point. Actually perusing this list, these are, these are not small health systems, you know, each one is, is definitely over a billion, maybe even over 3 billion. If I thought about it and you know, each has sort of a different, a budget scale, a number of people, number of projects they can take on. I played golf at the time event last year with a small system cio and I got this perspective of, you know, we really do talk to two different audiences. We talked to an audience that has a $100, million dollar budget and we talked to one that has a, you know, $5 million dollar budget and those that have a $5,000,000 budget, they absolutely should reach out to these people and they’re not going to partner directly with apple per se until after apple figures it out. But these other ceos could be a good path for them to have conversations and see if they could piggyback on some of the things that they’re doing.

Bill Russell:                   09:25               The large system ceos, they, they may want to figure out how to get in and start to have conversations directly with apple. That’s a, that, that’s, that’s a different, different play altogether. The, it’ll, it’ll be interesting to see how this plays out. I, um, you know, I’m, I’m, I’m one of those hope, as I said in the article on, but what I was hopeful, optimist, that apple will be able to create an experience and if they’re able to create that experience, then we can just piggyback on that and, and do the things that we do well to really improve outcomes. Focus in on chronic conditions and those kinds of things, but you know, the, the cio, I believe has to put this in context for their health system, whether it’s a small system or large system, they have to have a point of view that they can talk to the physicians about An, a point of view that they can talk to the, to the leadership about where’s this going and what does this mean for their health system.

Sue Schade:                  10:29               Do you want to be proactive and you want to be part of it. Um, you know, forward thinking, um, executives and physician leaders to are going to be looking at this and going, okay, what about us? How do we get in on this? Right?

Bill Russell:                   10:46               Speaking of point of view and perspective, why don’t you go ahead and, uh, share the story of the week and we’ll, we’ll dive into that.

Sue Schade:                  10:54               Sure. So the other one that I don’t think we could ignore, um, with a program that we can help it. News is the one I’m about. Amazon, Berkshire hathaway, and JP Morgan Chase. So I’m a number of articles. There was one of the Washington Post by Carolyn Johnson on the 30th title was Amazon, Berkshire Hathaway, and jp Jpmorgan chase joined forces to tackle employee’s health care costs. Um, I’m going to refer to a couple of other articles as I talk about this in a, from a summary perspective. What they’re trying to do, according to the article is created an independent nonprofit. I’d emphasize nonprofits aimed at reducing healthcare costs for their employees. Together. They employ those big companies employ more than a million employees. Uh, the article talks about, I would frame it as being trying to be above the politics right now, going on around obamacare and, uh, instead focus on what’s going to be sustainable, how to better deliver service to employees and to patients.

Sue Schade:                  11:59               It’s not a health insurance company, not a hospital, not a Pharma Company, according to the article, but accompany to bring technology tools are to make healthcare more transparent, affordable and simple. So their initial focus, even though they’re an early planning, is on technology solutions. I thought it was interesting in the article that they say very clearly, they don’t pretend to understand all the complexities involved or have all the answers, um, but they’re going to try to tackle this and clearly given Amazon’s focus, the potential is there to create a more consumer focused model for healthcare. So I think it’s gonna be interesting to see what evolves and a, on this one and the next couple of weeks and months as we learn more about it. I would also point out there was a interview in records hospital review on the 31st with Dr Steven classical, who’s the president and CEO Jefferson health.

Sue Schade:                  12:56               He had very positive response overall to this development. And he talked about what he saw us three types of responses from his fellow executive to these kinds of changes and disruptions in the market in general. One is that the executives know they need to change. So they’re going all in and we’ll take some risks. Uh, another is that they’re just in denial, you know, this too shall pass all these disruptive announcements. And the third is recognizing that they have to transform. But the board that they are accountable to is looking for the least risky way for them to transform their organization. So I thought that was kind of interesting. Take from a, uh, a leading CEO and healthcare and then I would also just suggest if anybody’s really interested in how some of this came to be, there was a becker’s article also on the 31st that was the history of Amazon in this whole space. Kind of leading up to this. I found that kind of fascinating as I skimmed all those, um, key developed events and milestones. So, you know, it’s about disruption and change. And as I said earlier, I’m cio certainly need to be part of it and not reacting, you know, they’re all kinda heads down on the agenda and what they’ve got to deliver on for the, for 2018, but at the same time they need to have their heads up on what’s coming and how their organization is going to play in that and embrace it.

Bill Russell:                   14:29               Yeah.

Sue Schade:                  14:29               What are your thoughts?

Bill Russell:                   14:31               It’s look at the modern healthcare Dr Steven Glasgow. Thanks for bringing him up. He’s one of my favorite. He’s a quote machine. Here’s, here’s what he had to say. The announcement today is landmark event because a landmark event, that’s a big deal that he’s that in of itself because it means at the most innovative employers do not believe that most of us see the burning platform. They’re not comfortable with the only thing in there and their employees lives that is stuck in the ninety’s being healthcare at a time when Amazon has technology to enter the house the same day delivery or have a totally automated grocery store. They are not content with the lame explanations around transparency, inequities, equities, and even spending believable are sending in a believable, understandable bill. I believe this is Jeff Bezos, Jamie diamond and Warren Buffett doing there were mad as hell and we’re not going to take it any more.

Bill Russell:                   15:28               Speech into their own hands at and he goes on to and each one of these ceos took a turn this morning and this article, Dr Marc Harrison, intermountain. You know that this is indicative of the a rapidly changing healthcare landscape landscape order. Thomas Oschner, I believe this announcement say it’s just another indication that traditional healthcare organizations need to move faster. Uh, Dr William Conway, CEO of Henry Ford Medical Group, I think many providers would welcome this. The tape warm is an outrageous administrative costs of healthcare in the US and the expense of all the mental services. So, um, this isn’t, you know, to, to CEO’s talking and saying, Hey, this, this is something to keep an eye on. This is a big deal. This is CEO’s from across the industry saying, yeah, I think we’re starting to see this as the moment that we’re going to start talking about consumer driven healthcare made the transition, it made the transition to, of being mainstream something we need to have conversations with the administration and with our physicians and even the employers in our markets and the, uh, the consumers in our markets. We need to, I understand what they’re looking for and figure out ways to start to, to start to deliver on that promise of consumer driven healthcare.

Sue Schade:                  16:55               I absolutely agree. And I like the fact that you, and it’s not talking.

Bill Russell:                   17:06               Yeah.

Sue Schade:                  17:07               I’ve been in a number of organizations as a cio in the recent years and uh, you know, the strategies really very around digital health and consumer driven technologies and for some it’s still very much baby-step pilot projects, no clear strategy, um, but let’s try some things and I think that it’s really gonna is gonna really open up that, that discussion and, and put a lot more pressure on health organizations to deliver.

Bill Russell:                   17:40               Yeah. Know, it takes us into the next segment. I’m glad you’re on the show. You’ve written so many good things about leadership and we’ve had discussions about leadership and so let’s talk about the role of the CIO. How is it, how is it changing? How is it, how has it, it changed since you started in the industry and where do you, where do you think it’s going?

Sue Schade:                  18:06               I’ve been around awhile. So critical is that has become a strategic partner and the organization is highly dependent on it. That’s good and bad. I mean, you got to keep your systems up and running and performing well and reliable 24 by seven, three 65. Right? But you shouldn’t be there. And if you’re not, you got to deal with that. You as a cio really needs to be at the table as a strategic partner with everybody else in that c suite, uh, looking ahead at where healthcare is going. Um, so that’s, you know, over the years, I think that’s the biggest change and that’s not exactly, you know, any earth shaking kind of comment. Obviously that high dependency has a lot to do with the advanced clinical systems that we’ve deployed and are supporting in that, uh, our clinicians depend upon. Now there’s, you know, obviously as we’ve been talking about for the last several minutes with these articles, a lot more focused on here’s what health strategies and where that needs to go.

Sue Schade:                  19:06               Um, so that’s some of the changes that I see. I think that, um, you know, if you want to talk about some of the characteristics in terms of what a good a great cio needs to have at this point, I would emphasize the strategic thinking that partnership and relationship skills. And that’s what the executive. It’s with physicians, it’s with other innovators in the company. Uh, and that’s actually one of the challenging things about what we were just talking about. You might have a chief innovation officer, a chief digital officer, or you know, all these different roles that the cio might feel like chipping away at them, but you know, if they exist to partner with them, work with them, uh, you know, on behalf of the organization, as I said, you’ve got to be part of the executive team and view yourself that way, not just the it leader. Um, and you know, as I also said, the, the you gotta be really good at execution, focusing on cost, taking costs out and making sure that your processes are really tight. So that balance between solid operations and strategic thinking, which can be difficult in any given day, uh, but that’s the whole package that it takes. Now

Bill Russell:                   20:27               even get a seat at the table, fit your budget every year, liver, high end, highly efficient it operation. You have to be open to deliver uptime to your core clinical systems. You have to be a communicator, you have to be able to communicate well what it delivers to the organization. And, and, and promote your, your part of the organization that, that part of it is as well known. I’m curious, you know, you’re, you’re from places interim cio and does retain search. I’ve before I started health lyrics and in between the time I left St Joseph Health and started health lyrics, I entertained going back into the cio role and I interviewed for a couple of roles in interim roles and uh, I have found that the questions really end there and it really kind of surprised me that a lot of the questions from health systems were around how good are you operationally, can you, can you, we’ve had some problems with our data center. Can You keep going? Can You keep our EHR running? Can you work with the document? But that’s where the questions ended and that Kinda surprised me. Are you still seeing that or our system starting to look for a different type of cio or are they starting to fill the role or they’re starting to say the cio does this and the chief digital officer does these other things or, or that kind of stuff.

Sue Schade:                  21:53               Let me just ask you a question back overall or with a interim placement in particular?

Bill Russell:                   22:01               Well, I, I interviewed for two full time and two interim. So it’s, you know, it’s hard to hard to really say that the interim is, you’re, you’re right. If somebody is looking for an interim, they probably are saying you just just keep it running. We’re going to find somebody who’s strategic. I, I get that. But it was both.

Sue Schade:                  22:22               It’s a balance gesture, but it’s that it’s the balance of the two, the strategic thinking to take the organization to the next level. From a technology perspective. I think most organizations want. They also want to know that you can ensure the operation or smooth execution of any project goes well on time under budget and that the systems are reliable and all that, all of that is solid. So that balance between operations and strategy and some organizations more than the other, they’d have some security incidents, major data center problems, downtime, you know, uh, trends that they can’t figure out. They may in that interview process, focus on those more than they really should or want to for the long haul. If they are, um, you know, if they’ve got a lot of the core stuff done and they’re moving into a whole neck, you know, level of systems thinking, um, there are going to be looking for you to be more strategic.

Sue Schade:                  23:28               But any of these walls are not one or the other. There a particular balance of, you know, what we haven’t even talked about is mergers and acquisitions, which brings a whole new dimension to the skillsets needed as well as the work that has to get done. Maybe that can be a topic on one of your future shows, but you know, I would say about the interims that the interim situations really vary and it depends on whether someone’s retiring and been there a long time and going to do an ICO hand off. Um, or if someone, you know, analyses that are leaving and you know, 30 days they’d taken another opportunity and you know, there are organizations looking to fill a gap as they, you know, search for the next person. And they want someone to pick up quickly or a situation where it’s just not working out and someone’s been asked to leave and they’re looking for an interim to come in quickly, kind of stabilized, deal with staff morale, figure out what’s been going on and trying to get things back on track. So the interims, our whole different kind of ballgame. And you know, we have starbridge advisors work with all those scenarios and just figure out a what are the needs and how best to mansion.

Bill Russell:                   24:40               Yeah, overwhelmed. They’re like, should I be any HR expert in clinical transformation experts? Should I be a the cloud experts? Should I be data analytics, data science expert? Should I schendel blockchain and Iot and all those things. And uh, I think what we have learned, given our, our, uh, let’s just say length of tenure in, uh, in, in doing this is that the, the key thing is leadership. It’s not, it’s not being an expert on all those things. It’s leading well and being able to bring in the right resources at the right time, but also being able to identify is now the right time to be talking to somebody about data scientists now the right time to be talking to somebody about blockchain or is now the right time to be doing pilots, so our, our job is really as leaders to know when to pull the right levers and didn’t know when to elevate certain conversations, but not necessarily to be the go to person for everything. The job is too big.

Sue Schade:                  25:48               Yeah. I think it said it really well in terms of knowing which topics and pull those levers and make sure that you can find and bringing the right talent and expertise, uh, to do all of those specialized areas and the emerging ones.

Bill Russell:                   26:08               Well, it’s that time in the show where we start to wrap it up and we each. I would like to welcome every, every week with our cohost. We each select a social media post that we want to highlight that we want to talk about. Sometimes it’s funny, sometimes it’s serious. The, uh, I’ll start with this week, my post is from a friend of mine, Ken Veneer who’s the cio over at space x. This is a great example of creative communication recruiting with vision. So he posted on Linkedin the, he has a picture of spacecraft out in outer space with, you know, cool arm and he goes on to say no VBA or cul want to help colonize Mars, leverage these skills to make a difference at space x. and I think when you can, when you can recruit to the vision of the organization like that, I, I have no doubt that Ken is going to be able to attract some people. So overview. So it surprised me. W W, what have you got?

Sue Schade:                  27:09               Which one? I know I sent you three and you said, so I’m taking the one that I, and the person who posted it is ingrid. She’s a consultant training manager at St Louis University health network and it is a video of the command center week two of their big go live and it was called bring your kids night. And uh, what she says here is with parents working long hours and the command center week to have go live, bring your kids night was a welcome diversion and it’s uh, it’s a, you know, 12 second video of the command center and they, they pan over to this area where there are kids playing and adults with them and it just really struck me as that’s a family family friendly company and we all know how hard, uh, it, uh, folks and our users work, especially during that intense go live period and what people have to give up and a family wise and commit to during those times. So I thought this was a, a good one, a great idea. It’s had over 3,700 views. A lot of the comments are great idea. I hope my organization can do this, so I’ll leave you with that one.

Bill Russell:                   28:30               Yeah, I love that. I love that. One of my favorites. Definitely a visionary and definitely has a great culture that he’s developed with his employees. Well that’s uh, that’s all for now. You could follow a Sushi at SG. She’d on twitter and me at the patient’s Cio and don’t forget to follow the show. Also on twitter at [inaudible] this week in hit and check out our new [email protected] Please come back every Friday for more news commentary from industry influencers.