The VA CIO just stepped down. Ed and I embark on a thought experiment of what we might do if we were asked to step into the role. Plus seven rapid-fire questions from precision medicine to the future of work for Health IT. A packed 40 minutes of insight.

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Bill Russell:                   00:01               Hey podcast listeners, thanks for listening. If you’re enjoying this, we can help it. We just want to give you some information on how you can support these conversations to keep them going this week in health. Its goal is to keep you your organization and your employees updated with the emerging thought and trends in the healthcare industry. Through our conversations with healthcare and technology leaders, the best and easiest way you can show your support is to go over to this week in health it on itunes and leave us a review. Also, you can subscribe on Itunes, Google play, or stitcher, or go over to our youtube page and subscribe and hit the notification bell. Again, we really appreciate you spending your valuable time listening to this podcast.

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 15. It’s Friday, April 20th. Today we take on one of the hardest roles in the country as cio veteran, and I will play a little game on what we would do if we were named the CIO at the Va. This podcast is brought to you by health lyrics. GeT ahead of the wave. We believe every health it organization has it within them to be great. It all starts with clarity, phys ed health. Eric’s dicom. To schedule your free console. My name is bill russell or covering healthcare cio, writer and consultant with the previously mentioned health lyrics. Today I’m joined by hymns chime cio of the year, I believe our third on the show, author of the book, extraordinary tales from a rather ordinary guy, former cio at Texas health resources university hospitals in cleveland, the advisory board, and current cio of the cleveland clinic and a wonderful friend and mark’s ed. Welcome to the show.

Ed Marx:                       01:51               Thanks bill. Thanks for having me. I’m so excited to be part of it.

Bill Russell:                   01:54               Well, I appreciate you coming to the uh, uh, normally I’d go through the bio, but you know, as with allanco, I can’t read your whole bio because you’ve done so many things. Um, I think a better way for people to Get a sense of who you are. I was hitting your linkedin page last night and read your most recent article about your third brush with death. That’s a three more than I’ve had and uh, it’s really pretty, pretty compelling story. Um, can you share a little bit about that story to get to give people a sense of who you are?

Ed Marx:                       02:25               Yeah. I’m, I’m learning a lot more about healthcare and technology actually as a result. And so I’m very, very thankful despite the circumstances. Yeah. So I, you know, when it comes to health, I’m a pretty good picture of health. I, I take care of myself and so all my vitals are stellar. You knoW, my cholesterol is 1:40, my blood pressure’s like 1:10 over 70. My resting heart rate because of all the exercise I do and perhaps some genetics 40. So, and I get taken care of all the time. I get screen I had, I do have some high risk things that I do, whether it’s planning mountains or we’re competing and triathlon duathlon. So I get screened to extra. A month ago I had a some extra screening done just to make sure that, you know, I’m continuing to be healthy. Well anyways, so you take all that and I’m doing a race in South Carolina.

Ed Marx:                       03:13               It’s the 2018 national championships for usa team usa for duathlon. It’s the sprint race. There’s a couple different categories with at least sprint and so I was tooling along towards the end of the race and i was laying down probably like six and a half minute miles and it’s a run bike run. So I’m on this last run and then also sudden I felt my just tight just like you read about, like it felt like someone sitting on my chest, my chest tight and I thought, man, that’s weird. And I thought well maybe it’s because during the bike don’t do the bike portion. It was raining and it, you know, you’re going about 25, 30 miles per hour. You’re holding on for dear life on it, on the handlebars because you’re literally like to someone else’s tired. So it’s bad news. So you’re really gripping down on the handlebars. And I thought as I was running, maybe it’s because I was so tight in the chest during the fight that it finally caught up with me and my muscles were freezing up a little bit.

Ed Marx:                       04:08               And uh, I had no shooting pain down the left arm and no job paid. I know docea I had no other classical symptoms with this tight chest. So I started reading a little bit heavier trying to get breath in and it was fine, but it definitely felt like something was wrong. And so I thought about, okay, I about two miles left. Do I stop and try to find someone to help me? There’s definitely people along the course that could help. I thought, well, something’s really wrong. By the time the ambulance gets to me, cuts through all the traffic. there’s high traffic area, there’s a race going on. It’s going to be 10, 15 minutes. I thought I’d just run this thing, it’ll be fast for me to run. So I just kept running. A good friend of mine on the team pass me and he’s like, ed follow me because he knew I was going a little slower now and he’s like, follow me.

Ed Marx:                       04:51               And I tried to follow them. I just couldn’t do it was like really weird, but I was still holding about a seven, seven, 15 pace still chugging along. So anyways, I finished the race, you know, and I was like very excited about that. I made team usa for the next year’s world championships and, but I still felt this pressure. So I checked mysElf into the bonD, secures a emergency medicine there and I said, I, this feels really funny. I’m otherwise healthy male and something’s wrong. And so thEy did an ekg. There was enough to show there that there was a problem, stuck me an ambulance. They did another ekg, dental was having a heart attack

Speaker 3:                    05:25               and

Ed Marx:                       05:30               yeah. So then yeah. So then by the time the cool thing of the stories. Sorry. The cool thing of the story is while I was waiting in the ed ready to get taken to the cath lab, that interventionist cardiologist came out to me and like my company, so the place that I served the cleveland clinic already had been talking to him, so the number one foremost cardiologist in the world already talking to this doc in South Carolina about what they’re going to do and how to do and all that kind of stuff. He turneD out to be awesome. The cath lab was ready, prepared even though It’s saturday, early saturday morning beCause it was anOther eMergency right before me that they just finished. So I wenT from a bedside, not bedside but door to balloon in less than an hour, which is very key. And then he allowed me to watch the whole thing.

Ed Marx:                       06:10               So I’m laying there flat on my back and I’m watching him perform his artwork and you know, stenting me, putting a stent inside of me through my arm. And it was amazing to watch the heart reignite with blood and things started flowing and everything got back to normal months. So far and prognosis has been I’m completely normal, no damage to the heart, no permanent damage to the heart. And so now I’m just toughen up a bit. I’m allowed to do some exercise already chomping at the bit for more. But the cool thing is I’ve started to utilize a bluetooth blood pressure, ekg, heart rate, all that kind of stuff and I’m getting my cardiologist who’s hadn’t used it before. We’re putting it directly to our electronic health record so I don’t have to like go reported annually. So that part of it, it’s kinda cool. It’s like I get to experience, but what we talk about digital strategy it go how we’re actually doing it on Myself.

Bill Russell:                   07:01               I love the story from that aspect, but I also love the story from the other aspect where you really encourage people. You have 13 things in there, talked to them about, you know, things like reconciliation identity, a personal responsiBility and he close with exhoRting everybody to really live life to the fullest because this is the uh, the, you know, there’s only body we get and you know, make sure you make the most of it. It, it really is an awesome post and I think one of the things I do appreciate about you the most is you don’t shy away from sharing the personal. You don’t shy away from, uh, you know, talking about things that other people tend to try to keep it all business and you share a well beyond that. And I appreciate that.

Ed Marx:                       07:45               I think it’s so important to be authentic. People want authenticity and I’m not embarrassed about it, you know, uh, I definitely pride myself on being an athlete on team usa and all that kind of stuff that you have to be authentic and then the more you share, the more benefit there is for other people. So I’ll give you an example. I had a couple people come up to me. I won’t give any more detail than that because I don’t want to in any way since that time come up to me and confide in me that they had a similar episode in their life where they have a stemi. You’ve never told anyone to myself. come on guys. We’re in healthcare. Let’s share this information because maybe with you sharing, maybe I learned some life lessons through you. I don’t have to go through the same ordeal, but I learned to pick up the phone and call someone who I loved that I haven’t had a relationship for a long time because of your encouragement. You know why? What that person could have done that or that person could have told other people about it and said, hey, even if you have a great health record, everything looks perfect. Do this test, do this, calcium test, do this other thing, because had I done it, I wouldn’t have had to go through that. So that’s why I think it’s so important to share with others. It’s like there’s so much that we can gain from other people’s experiences. No reason. Everyone has to separate heart attack to learn these things. Right?

Bill Russell:                   09:00               Yeah, and even the description that you gave of, hey, this is what it felt like, and this is how it sort of manifested itself. I have a history of heart issues in my family. That’s one of the things I asked my dad. I’m like, how am I going to know when this happens? What’s it going to feel like? What’s. And we know that, that from the moment it starts to the moment you’re a, you know, you’re, you’re getting worked on. I mean that, that timeframe is very critical. So part of it’s identifying it and just hearing these stories helps people along the path. So one of the things we like to do before we really jump into the meat of the show is just give our host, uh, an opportunity to talk about, um, you know, what’s, what’s one thing that you’re working on or something you’re, you’re excited that you’re working on right now?

Ed Marx:                       09:43               Yeah. I’m so excited about digital health strategy. NoT just because it’s ironic in the middle of this all this happened, but you know, when, when we started faIrly new team and we had a heavy lift to do and we started seven months ago, the first thing we did stop the bleeding and you know, so we put together a cybersecurity plan. Alyssa, we, we set, we got it funded and we’re chicken on it. And so we set up governance and our, our ceo’s that cochair of our it steering committee along with myself and we got this whole pmo developed and we did love the basic stuff. The next thing was to develop an it roadmap. So with, with this governance structure, with this it steering committee, we developed the it roadmap for year roadmap, first year, mostly funded. And so with the basics in place, we already have good analytics and we’ve got good electronic health record with all that place we were ready for digital.

Ed Marx:                       10:37               So we’re also an agile organization so we, everything we do is agile. So we took the same approach to developing our digital health strategy. So in six weeks we did three, two week iterations. We developed this digital health strategy, which on monday was endorsed for the next day. So, so exciting. So that’s the one thing you know I’m so excited about because that’s really the nirvana for us is how do we take advantage of all the technology that’s available today and do some things that it will really enable the mission organization. There’s culture and what we do at the clinic, which is cool. It’s really global. So whatever we do here, we work with our global partners or around our enterprise, around the world, and we have amazing things to help our caregivers give the best care in the world.

Bill Russell:                   11:23               You really do have a great opportunity for. Somebody wants to ask me, you know, go back to being a cio where, where would you go? And I said cleveland clinic would be one of those places because you’re surrounded by such a great team and such great innovators and, and, uh, and really a global reach with the things that you guys are doing now.

Ed Marx:                       11:41               That was at lunch to someone today. And I was just sitting there thinking that I just met with my cio and I had the same conversation with her. It’s humbling, humbling. It’s honoring and you realize you’re in the midst of giants and you just want to do your very best.

Bill Russell:                   11:59               Just keep reminding yourself on the bad days. Just keep reminding yourself of that because they’re, you know, any healthcare cio will tell you there’s, there’s peaks and valleys. So um, alright. So what we normally do on the shows, we take a look at the news, we do a leadership protect talk, then we go into our favorite social media posts. Uh, we’re gonna, uh, we’re just going to do one new story this week and play a little game with it. Not a game, but we’re going to play a little scenario with it because I really want to spend a little bit more time in the second and the, uh, so I’ll tee up the story a little bit and give our listeners some background. So the va, cio, Scott Blackburn resigned recently. It’s in the federal times a dotcom story about it. And what I’m going to do is I’m going to give a little background of what’s, what’s been going on there.

Bill Russell:                   12:46               It’s very public and hopefully set up a conversation that we can work off of some of the, some of the last articles you did for his talk around what you do to prepare to be a cio. What you do in those first, the first day, the first 100 days, and what you’re trying to accomplish. So let me tee this up. So the va exists within a larger ecosystem. You have the dod, you have the coast guard, and you have the va, they all have their ehr stories. Uh, the patients obviously are our heroes, they’re the brave men and women who are fighting for our rights and protecting us around the world and we want to give them best healthcare possible. Uh, the situation around the ehr. It’s very public and very political, right? So the dod had one of the worst chrs as measured by surveys that had been done over the years and they launched a project to replace their ehr with a, a cerner millennium product in the project is called mhs genesis and they are rolling that out and it’s getting pretty good reviews at this point.

Bill Russell:                   13:48               The coast guard had a failed ehr implementation for whatever reason could be changed, management could be whatever, but they had a failed the ehr implementation with epic and uh, they hit the reset button and they chose to latch onto the dod project as they say, the requirements are relatively the same. And so they have sort of come together and now you’re going to see a, the same ehr product across the dod and the coast guard. And then the, uh, the va, which was one of the pioneers for the emr, has a, uh, a product called vista built on top of cprs, uh, and it’s built on top of an open source platform. So a really is available to anyone out there. They recently did a no bid contract which was given to cerner millennium product as well, very public, very controversial. And uh, I just one more piece of information here so that the va, as I said, was, it was a pioneer in 2008, abc did a segment dedicated to the emr and they, uh, and they, they talked about the va and they highlighted how the electronical medical record had led to fewer medical errors as we know, more effective treatments, lower costs, and higher patient set.

Bill Russell:                   15:02               So they were a pioneer there at the forefront and they really laid the groundwork. So there’s a, there’s a history of success to build on. Okay. So that’s the background we just make you see, you and I, we just became a cio for the va. In fact, let’s do it this way. In 30 days we’re going to become the cio for the va and we’ll break this down into what are we going to do between now and the next 30 days to prepare ourselves to become the cio for the va. What, what would you tell people about the next 30 days as you’re getting ready?

Ed Marx:                       15:35               Yeah. First, as a veteran, myself and the son of a veteran and brother and sister, I feel very honored and humbled by that very sacred patients that they take care of. And so I would approach it very obviously very seriously and with purpose. And so when I usually talk about is a, your preparation, the first 30 days is you always have to be true to your current and then true to your family because you know when you start this new job, fire a lot of effort, lot of extra effort, so you may not be available as much. So I really take care of those two things. First, make sure it was a good transition where I am and make sure that I take time with my family to the extent I can get involved still. I like to do that. I did that before arriving at cleveland clinic, so I learned as much as I could about the organization, so I had them send me a bunch of information so I requested a lot of information and then depending on that lead time, I had an opportunity to have weekly meetings, so I had about six weeks lead time and if you are afforded that luxury, it’s nice just to get engaged a little bit ahead of time so that those sort of things I would do is whatever research I could do ahead of time so That when I arrived on day one I sort of hit the ground running.

Bill Russell:                   16:49               Yeah, there’s a lot of wisdom in that. I went into my role as a cio with pretty bad habits. They don’t get better when you start the role they get, they get worse. So I ended up putting on 30 pounds and lived a pretty unhealthy lifestyle for about six years of my life. So I, I’d say if all you have is 30 days, make sure you get your habits in line, you know, spending the quality time with your family is important. Uh, health wise, important. So make sure you get all those things and recognize they typically aren’t hiring a cio because everything’s going swimmingly. Very rarely is that the case. So your first, your first year is probably gonna be a very busy year. So yeah. So getting ready. So what are you trying to do that first day? The first, uh, let’s just say the first 30 days, uh, you hit the ground running. What are you going to do for the va in that situation? How are you going to engage?

Ed Marx:                       17:44               Yeah. So what I do next, it really hit the ground listening. So if no matter where the organization is and where the va is today, it’s not going to get profoundly worse or better by you not getting super engaged. You know what I’m saying? There’s probably a steady state that’s occurred over time and that steady state is okay to continue. Now it’s different if you inherit a situation where things are tanking, but in the ba, you know it’s they’re, they’re dealing with stuff but they’ve been dealing with the same stuff for awhile, so you need to take the time to listen and to develop relationships because ultimately that’s what’s gonna help you is knowing what the issues are. You only Can do that by listening and meeting with people and then developing relationships because one person is too small a number of for greatness, so you’re going to have to be reliant on a broader team, not just it, but also outside of it, so I’d be spending, I wouldn’t be spending a lot of time with a peer group with my direct reports, with the senior leadership of the organization and then time moves a big place and so it has a lot of sites across the United States is starting to slowly make my way out into the developing these relationships and understanding what the.

Ed Marx:                       19:00               What the issues are. First thing,

Bill Russell:                   19:05               I think one of the mistakes we made early on in our careers we make as we get older, we recognize that this is not the case with. They’re not looking for a hero, but they’re, they’re not looking for someone who’s going to come in with all these great ideas and change everything and that kind of stuff. It really, you’re, you’re coming into something that’s already going on that, as you said, the va has a long history. They’re doing a lot of great work. There’s a lot of great people there with good ideas and good thoughts. They, they, uh, I sort of mentioned this as, you know, it’s the convener. It’s the person who’s, who can bring people together. It’s a generative questions that, that make everyone a little better. I mean that’s really the role of the cio is to inject some of the teChnology and what’s going on in the industry. But for the most part the people we’re working with are very knowledgeable. They already have a pretty good background on the teChnology and we just, we come into a story that’s already in progress and maybe add color. and and direction to it because of the distinctives of who we are.

Ed Marx:                       20:09               Yeah, you have to take a very balanced approach and you have to respect those who are still there, those who are and not think that you know at all so that there’s some expectation that people want you to come in and fix things right away. But you have to avoid that temptation because one, you can’t, you’ll fail. So I always look at it as a marathon. We’re talking about running earlier. You don’t look at it as marathon. It didn’t break in a day, it didn’t break in a month or a year. I probably broke over time. So you take some time to do it right?

Bill Russell:                   20:41               Yeah, I mean there are some things you have to. I mean, you, you mentioned cybersecurity. There’s somE things you have to fix immediately. I, When I came in the data center going down eight times in six weeks and it was welcome to the show. Fix That immediately. So, um, do you sat like, hey, my first hundred days I want to accomplish this? Or is there a. I mean first hundred days we look at the presidency and we say the first hundred days mark, so pretty important. Is the same thing true with the cio or is it more of a longer term view?

Ed Marx:                       21:11               I think you have to look at the longterm. I think it’s important that you have a plant that first 90 days. I literally had a plan which I shared on his talk as you mentioned, 120 day planned was the free 30 and then towards the next 90 years developed the next 90 day plan and so that manifested itself in that next 90 day plan with my direct reports so that they were involved in that planning effort, but I knew the basic things I needed to do. I had a list of everyone that needed to be. There was over 100 individuals that I wanted to meet. The first, I think I did it for 45 days just because it took a while to make appointments and things of that nature, so it was hit the ground listening, but I had a plan. I had it down to that detail level of who I needed to meet with and by what time and then you know, what did I need to understand and then what did I need to publish? So at 30 days I published, so this was my plan. I published my 30 day analysis and then I had a 60 day analysis than a 90 day analysis and I shared this with my boss. I shared this with my peer group. I said these are my findings. This is where I think needs to have attention. And then within the. So if you take that 90 plus 90 a deliverable and there was the it strategy which we did.

Bill Russell:                   22:22               Is that the three year plan or five year plan that you talked about?

Ed Marx:                       22:27               Actually could, I think it’s four or five year. It wrote. We call it an it roadmap, but yeah, I it my plan. I said by month six we will deliver a roadmap and that was based on the listening tour. That was based on my team input, our external partner input some personal experience. We put together thIs plan and we delivered it exactly to the it steering committee on my 180th day.

Bill Russell:                   22:52               That’s fantastic. I like the fact that you’ve, um, split out delivering the plan from a getting funding because I know for a, you know, I delivered a five year plan and it took us almost six months of going back and forth to, uh, to get that funded. And that’s, that’s a completely different process a lot of times. So I’m all right, I’m gonna I’m to the, the, you know, given what’s going on in the ehr project. Is there any words of wisdom, I mean there’s going to be a next cio at the va, um, any words of wisdom you would give them to how to build consensus or alignment around either staying with vista or going to another platform? I mean, what, what would, what would you, what words of wisdom would you impart?

Ed Marx:                       23:37               This provides us opportunity to be a little provocative and know maybe it’s time to blow up the current model price. Something completely different. So, you knoW, when I think about how we deal with electronic health records today, we, we have, we have the record and then we had, they dIdn’t have very good analytic capabilities to build analytic capabilities a lot of time externally. And then, uh, we had to build decision support sometimes separately or wait for ketchup and, and now there are several other examples. Mobility, now we’re dealing with, you know, digital health and sort of the future and we’re having to wait or catch up. oh, I wonder what would happen if you’re in that role and there’s going to be a big span anyways. maybe it’s time to start from scratch and build something brand new that’s interoperable. Going to worry about interoperability anymore that incorporates everything in that whole life cycle of, you know, what we call digital, but all the way down to the more mundane things. That base foundational foundation and it’s this platform to which we can then add on anything that we wanted to in the future. You know, whether it was fire or whatever sort of api that, that to me is a provocative concept and maybe it’s the fire that’s needed to move legacy vendors into the modern era.

Bill Russell:                   25:08               It’s interesting that you say that because the um, the discussion. So they did a survey of all the, they dId a survey just in general, should they move, should they not move? And generally people are saying, hey, stick with vista. And um, I think I would take, here’s my approach. First of all, the va doesn’t have to worry about billing for the most part. I mean they’re, you know, the, the federal government is paying for those services. So a lot of the, the ehr of the ehr, if they go with epic or cerner or whatever is around that whole billing mechanism and, and funding mechanism. And so a significant portion of that is almost irrelevant within the va environment. So I tend to agree with you as a rethinking how they do it. I don’t, I don’t like the idea of rebuilding the ehr from, from scratch all only because it’s already there.

Bill Russell:                   26:03               And really what we’re looking for is a better transitions of care, better interoperability and integration with, with digital, uh, digital tools and digital strategies. So I would, I would clearly define the problem set that we’re trying to solve. And then I would take your approach and say, all right, these are the, these are the problem sets. Do we build on top, do we allow this to run the, the hospitals and the clinics? And then we build on top of thAt, in which case you can be very prescriptive when you go to the ehr providers and say, look, you don’t own our data. We own our data. We need our data to be able to move in this way and really be prescriptive to them. If you’re gonna write a $15 million dollar contract to cerner, you should be able to have some, uh, some sway Into what they’re going to be doing. Don’t you think?

Ed Marx:                       26:56               Absolutely. That’s what I’m saying with that, with that sort of scale and spend it, there needs to be a catalyst to help modernize the current state of things. And, and, and that might be one of the catalysts to,

Bill Russell:                   27:11               it would be, it would be a very, very fun to think about. Maybe they’ll, maybe they’ll call you up after this episode and offer you the role and I know you’re very happy where you’re at. So nobody should get too concerned at this point. Um, leadership or tech talk. We’re going to, we’re going to do something a little different here. I’m just going to rapid fire some questions. I’m not going to respond to them. I’m just going to give you the questions. I’d love to hear your thoughts on it. So I have seven questions. First one, how is precision medicine going to change healthcare in the next three to five years?

Ed Marx:                       27:45               Yeah. Three to five years. I don’t think it’s going to have a massive change, but I think after that period it will. We’re starting to see that benefit already taking a lot genomic data, putting it together with our electronic health record data and being able to do predictive analytics on likelihood of a certain type of a melody. And then as a result of knowing that, again, the genetics and the overall health being able to, with precision target have a remedy for that. Um, so we’re seeing that already, but it’s early stages and I’m hopeful that, you know, towards the end of that timeframe that it will be a major difference. You know, I could see us doing three d printing for specific drugs right now. Everyone gets the same drug, right? You have certain drg you get this drug, but the ethic 50 percent. So I can see in the future, hopefully closer to three years about the backside of five year. Part of we’ll see a big difference.

Bill Russell:                   28:38               Yeah. I’m in prep for that. I can’t keep my mouth shut, but in prep for that, geisinger is actually moving towards collecting genomic data on as many of their patients as they possibly can because I know it can have an impact. All right, qUestion number two. What do you think the, uh, what do you thInk innovation and patient engagement is going to look like from let’s just stay at the provider from a provider standpoint? What’s patient engagement going to look like?

Ed Marx:                       29:01               So I think it’s going to be wrapped around customer relationship management and really knowing the patient ended up level, not only the genomics that we’ve talked about but also from a social perspective and like the example I was giving for myself now is, you know, I’m very connected with my provider unlike in the past, right. So they automatically get this feed of my ekg, my other vitals, and they’ll have this real time data and hopefully we’ll, we’ll layer in the analytics, whether it’s chat bots or machine learning, whatever we call it, augmented intelligence that will alert them, not that they have to look at all that information because they don’t have time to do that. But there’ll be algorithms and bots that look at all that information to alert them issue.

Bill Russell:                   29:42               Yeah, I agree. And that was one of the biggest challenges dr. We were trying to bring that data and the doctors were saying no more data there. It’s too, too crowded, too busy right now. And I think that machine learning and ai and bots are going to help them to sort of sift through it. A third question. So, um, this actually impacted me, so I really wanted to share it with others. So we had a conversation early on to my healthcare cio tenure. And you said that you bring in a, you take your team out and you bring in people from outside of the healthcare industry to have discussions around strategy trends in technology. Can you give us an idea of what you did, why you did it, and what a benefit was derived by your team and the health system by interacting with organizations outside of healthcare?

Ed Marx:                       30:28               Yeah, of course. So I think I first learned this technique on a couple of boards for organizations and instead of being a bunch of healthcare, there was a cio from kellogg, there was cio from colgate and wrigley’s. And I remember just learning a lot from them and different perspectives. I thought, wow, I want to hang out with that person and not just myself, I want my team to hang out with that person. So then we started doing that. So once a year I pick a different company and we would meet, meet with those copies. I’ll give you one example of pure one. So year one was really good at data analytics. They, they had this amazing performance in revenue and when I asked about how they went from a penny stock to a very successful company, it was all around analytics and so we met with them and talked to analytics and we’re about to launch a big bit bi analytics endeavor at my organization that and we learned so much from them and one thing was they watermarked all their reports, whether they’re online or hard copy.

Ed Marx:                       31:24               They were watermarks was ceo and everyone knew that you can trust that data that came with that watermark because it was part of their bi program as opposed to someone else creating a spreadsheet, giving out data. You don’t know if it’s accurate or not, but this meant was accurate. So that’s what we started to do. So you knew when you got this report that it had our watermark on it, you knew you could trust that source of information. So that helped with our credibility and the standardization and the, you know, going from many different data sources to one. And that’s one example. So we do it all the time that we’ve got something planned here as well.

Bill Russell:                   31:59               Thanks for sharing that with me. That was very powerful. So question number four, are there any technologies right now that you’re keeping an eye on maybe that you’re not, you’re not implementing or doing a deep dive on but that you’re piloting or, or playing with?

Ed Marx:                       32:15               Yeah, well we had an amazing development team. They, my interpreter that they do also with the technology and one is taking 77 pps capability. So we have patients that we admit them to our facility but we allow them to heal at home. Right. It’s a patient satisfaction is higher, the same or better and the cost is half. So we developed this application for our. So we have ambulance drivers who go to make house calls essentially when they’re not. They’re not providing ambulance service, they are making some house calls. So we have a gps. It’s embedded in our electronic health record that they followed it, so smart gps, so it tells them where to go in order to see these different patients. And the stories you get that is amazing, just the customer service, but also from a healthcare point of view. IT’s amazing. So some of that technology of using a gps and inputting it into the electronic health record, that’s something different. You don’t normally hear about that. But. So I give that one. I could talk about blockchain. So, but, you know, we, we, we, we embrace blockchain. Certainly. I think there’s a lot, have a great future for it. So we watched carefully. We work with a select vendors and you know, in terms of blockchain, but I just think the real one that we’re actually doing Is like this, this, these two lists, stuff that are amazing development team.

Bill Russell:                   33:32               You are keeping an eye on blockchain. That will be an interesting one over the next couple of years. We’ll, we’ll have to, we’ll have to circle back with you on that. So, um, alright. So I want to talk a little bit about. So a fifth question is really around the it worker. So healthcare, it used to be pretty intensive from a labor standpoint that’s really changed with cloud and automation. And what’s the message you’re giving to your frontline it workers around, uh, the future of work and how they can maybe adapt or adapt their careers to stay relevant.

Ed Marx:                       34:07               I’m like, wow, I just like a little kid, you know. So sometimes I watch little kids who come on an airplane for the first time, you know, these two, two year olds or three year olds. And they come around and they come around the corner that they get on the plan, they look down the aisle and they’re like, our team. It’s like, it’s like, do you realize that we’re at the tip of the spear, we are doing digital health, we are imagining things and then actually doing things and what a great opportunity and whatever training you need, we are there to give you that training. So I talk about it as a very positive thing. And so it’s like whether it’s basic stuff like idols, so everyone has to be idle trade because I’m a big believer in process or agile. So I’ve mentioned earlier where we’re becoming a completely agile company or it first and so everyone’s getting this agile training. We’re being certified and whether yoU need to be certified electronic health record or these other digital capabilities for sending people to training and leadership trading and investing in people because people make things happen. So even though our positions are changing and morphing with the times, it doesn’t mean that we’re still not needed. And so we continue to invest in our people. I tell them what an amazing opportunity, you know, that we all have. I’m so, I’m, so, I’m jumping here. Let’s just so excited about everything that we’re doing.

Bill Russell:                   35:27               I guess the message is we live in a great time. Keep investing it. look for a company that’s going to invest in you and keep investing in yourself. Keep reading and, and diving in and, and, uh, learning new things because there’s plenty of opportunities.

Ed Marx:                       35:41               Just keep growing. I always tell people is like riding a bike. You could, you can post every once a while, but if you don’t keep peddling at some point you gotta follow it.

Bill Russell:                   35:49               So a six question is the obligatory question that every healthcare cio gets asked. How has the role of the cio changed in the last five years or or do you think it’s going to change in the next five years?

Ed Marx:                       36:01               I think it’s going to continuously change and so we’re seeing the postmodern cio and I know you’ve covered that topic pretty well. It really is more about the business accurate. It’s about leadership. It’s like digital health, digital health organization and the rest of the team is on it, so that’s a beautiful thing. It’s. It wasn’t an it thing. It was cross enterprise initiative that we took on and the leaders of all these different journeys I think I may have alluded to earlier, they’re all non it people there. There are leaders or clinicians elsewhere in the organization, whether it’s hr or revenue cycles, and this is across the board. We got to help. We’ve got to lead it, so wow, what an opportunity, but I wouldn’t have been able to been afforded that opportunity if I wouldn’t have learned and grown and morphed and learned about the business side, learned about the clinical side. There’s all sorts of things that we can do. Even if we’re not finishing. I do have a slight clinician background, but even so I, I, I routinely walk in the shoes of our clinicians. I continuously try to hang out with our clinicians to learn about what they do with their pain points are I volunteered in clinical areas so I could learn more about nursing and what they’re doing. And so there’s things that we could do to immerse ourselves to better understand the business side.

Bill Russell:                   37:14               The role is going to continue to change just like we’re talking to the front line it worker, keep investing, keep reading, keep engaging. We’re saying the same thing to ourselves really as a cio. And then the last question is selfish. Selfish question for me is how do you do it? So Your work life balance, you’re in shape. Uh, you have a wonderful famIly life. You have a high profile career. Give us an idea of how, uh, how you make it all work and maybe I can apply some of it. Yeah,

Ed Marx:                       37:41               it’s probably different for, for everyone. And I’ll tell you what my grounding is, my faIth that won’t get religious or anything, but my grounding is my face. So like faith keeps me grounded, it keeps me humble. I know, I have a sense of purpose. Um, so that’s, that’s one thing, but I, I have given up sleep so I will admit. So I only sleep about five hours to five hours a night to fit it all in. I tried for six. my goal is sticks. I know it’s important for health to have good sleep and good rest for your mind and your body. uh, so always my goal is six, but I was around five right now because I’m not like workout as much as they used to, uh, for now. But um, so I think getting good rest but, but you try to fit it in when you can. So I’m an early bird. I get up early to work out so it doesn’t impact my family time. Uh, and so when I come home I’m a so that. So that’s one way and it’s also learning to delegate and building a great team. So if you build a great team, you don’t have to do it all, you should never be in a position where you’re doing it all. So only a great team and then of course you know you’re having an awesome family. Helps. Well, fortunate, blessed.

Bill Russell:                   38:48               Absolutely. I assume there’s a bed right there in that office somewhere off camera that you take naps during the day.

Ed Marx:                       38:56               I wish that were the case. I feel like.

Bill Russell:                   38:58               Yeah, that’s hardly ever the case. All right. Hey, uh, so let’s, let’s close it out. I’m going to share my social media posts and this falls into the category of a pride comes before the fall of the toronto blue jays, as, as everyone knows, there’s been a lot of baseball cancellations. I’m a huge baseball fan and the toronto blue jays tweeted this out. WeAther update due to our stadium having a roof. Today’s game will be played as expected and later on that afternoon they tweeted rogers center, whIch is where the blue jays play their game with the dome, confirms that ice from the cn tower has hit our roof and the building crews are unable to assess the damage and more ice could fall. And they cancelled the game even though they had a roof. So pride does come before the fall. Um, uh, I’m uh, to you, uh, do you have, do you have something you want to share?

Ed Marx:                       39:47               yeah, I love the clinic actually very progressive and put down a lot of social media is awesome with cleveland clinic and they put out some stuff on twitter, but not silly. I won’t do the with you, but they’re not so edgy, but very comforting is that poppy is healthy though. They tweeted something yesterday from one of our docs talking about the health benefits of coffee. As long as you don’t add in all the other bad stuff,

Bill Russell:                   40:15               you just made my daughter very happy.

Ed Marx:                       40:18               Yeah, I thought that was good news.

Bill Russell:                   40:21               Well, again, thanks for coming on the show. Ed, can you tell people how they could follow you?

Ed Marx:                       40:27               Yeah, I’m on twitter. It’s not all that exciting, but mark’s tango at twitter and then linkedin is the best place I, I, I’m starting to blog now on, off of linkedin and so if you attach with me on linkedin, there’s definitely a way to keep in touch, but that’s probably my primary.

Bill Russell:                   40:48               Fantastic. So, uh, you, you can follow me at the, at the patient cio on twitter, my writing on health lyrics, website health system, cio, um, you know, don’t forget to follow the show on twitter this week and h I t and check out our website at this week and help it that calm. If You like the show, please take a few seconds to give us a review on itunes and google play. Catch all the videos on the youtube channel this week in health The eaSiest way to get there and please come back every frIday for more news, information and commentary from industry influence.

Speaker 4:                    41:23               That’s all for now.


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