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It. This is our final episode of the year, and this has been a year. It's really an era defining year, the kind of year that will change our lives and healthcare forever. We've had the chance to talk to so many great guests this year and, uh, they have shared their experience, their wisdom, and we are so appreciative of that.

I want to take this chance to thank Sirius Healthcare and our channel sponsors for supporting our mission to develop the next generation of health IT leaders and our work to amplify the best thinking to propel healthcare forward. In addition to Sirius, our channel sponsors include VMware, Starbridge advisors, Galen healthcare health lyrics, pro talent advisors.

And we did a recap of, of some of those shows and some of the, some of the great content that was shared with us. We also did a Newsday recap, and you'll want to check out that as well. That's just . The, the news throughout the year and the things that we were talking about, and we go into some of those clips, so hopefully you'll listen to the Covid and the, and the Newsday recap.

But this is the top 10 most listened to countdown. Eagerly awaited. So let's just get to it. Number 10 this year we talked to a lot of CMIOs, we talked to a lot of CIOs, CISOs, and others. And, uh, from time to time we get the opportunity to talk to both of 'em at the same time or, or multiple at the same time.

And one of the things I like to pose is the question of how do you work together? How do you get things done together? How do you collaborate on strategy? How do you collaborate . On supporting the business, and this episode was titled A Team Approach to Health It from Baptist Health in Kentucky. This is Tricia Julian, who is the CIO at Baptist Health, and Brett Oliver, who's been on the show a couple times.

Who's the CMIO at Baptist Health Kentucky. So kicking us off at number 10, Tricia Julian, and Brett Oliver is one of those areas where you guys could potentially fight. Brett, you might want more dollars and Trisha, you might want more dollars, or you might think your project's more important than the other.

So how do you, how does that work together? How do you guys work together on strategy?

So one of the first things we do, as you well know, and you just described how you played a supportive role in many of your businesses initiatives when you were CIO. That's true for us too. So first and foremost, we can't, it doesn't form their strategy, our strategy on our own. We have to understand what the business is going after.

As we understand what the business strategy is, then we ask ourselves, okay, where do they, where will they need technology? How ready is our technology to support those initiatives? So some of what we've sought to do is Brett and I with working with our leaders, and Michael's involved in this with his, the three of us are.

Intentional about seeking to understand in what priority are those given business strategies? So what's the timeline for a said given or a given business strategy? And then backing into that, how much lead time are we gonna need from a technology perspective to deliver to that? And that honestly is how we start to prioritize our funding within our budget.

And while Michael's . Security budget is separate from the IT budget. We even still look at it holistically because there are a lot of right security initiatives that Michael as the CISO leads, but in order to carry them out, he needs members from my team to fulfill them. So we have to have that ongoing transparency.

The collective three of us, the three chiefs in it. Have to appreciate what each other is being asked to do by their respective leaders so that we position the staffing. Because oftentimes I would say if there's shared staff, it's mostly team members from my group coming to support what Brett may need or Michael May need.

Do you think that's fair, Brett? Yeah. No, absolutely. Yeah. I think our organization has had a wonderful cultural shift over the last couple of years to want to include it early. I. It's been a more traditional way of coming in after a deal assigned, a vendor selected and the network doesn't work or something.

But when it gets notified that this project even exists, and the world that we're living in now is wonderful in that the vast majority of the time. The, uh, business leaders are asking the question, well, have you run this by security yet? Has, is it involved? What can Epic do this? Or some existing platform that we already have?

So that really helps our strategy become simplified, where if they'll just come to us with their business case problem, their business problem they're trying to solve, and then let us find the technology that we repurposed. A and so our. As the work pops up in our different, uh, verticals really are about keeping our head up for those new technologies that could in the strategy or business of the organization.

Honestly, there's not. There's not a lot of infighting over. Michael gets special treatment with security, but otherwise there's no infighting with our budgetary wishes and desires because they really come from outside of it, if that makes a lot of sense. I advocate for things and there are a few projects that probably wouldn't have happened if I wasn't advocating for them, but most of it we're supporting what.

What the business is asking for. Yeah, I really enjoyed that episode. Great, great content. If you had a chance to go back and listen to it, it's, it is worth, worth your time. Our next number nine, we have another pair, another twosome if you will. We have David Munson, Che, and we did this. I. Jeopardy type format early on in the year.

And we talked about the state of the industry and I had like six, six or eight topics. We actually had to split it into two episodes and I let them pick the topics and we then went through with specific questions on each one of the topics. And one in this clip what we talked about is, uh, preparing our staffs for what's coming next.

And we talk about professional development. The challenges based on maybe your market, your market size and those kind of things. So, uh, here's a great clip from, uh, David Mus and Susie. What can we do within our health IT organizations to prepare people for what's coming next? And is that our responsibility as CIOs of the organization?

And if it's our responsibility, what are we gonna do? David, I'll, I'll, I'll start with you. I, by the way, I do think that training. Is actually a reward for the people in it. It's an incredible motivator, and so professional development seems to be a way to attract and retain people, so couldn't agree more that doing that is important and it's important for selfish reasons.

The ones I mentioned. If you want to keep people, uh, what I used to tell people that worked for me and I found it very effective, and by the way I amend it, is that every year that you stay at this organization, I will find a way to make sure that you get some kind of professional development, and next year your resume will be so good that you wouldn't leave because the year after that it'll be that much better.

And the idea is I wanna make you prepared for the next job, but I want that next job to be inside my organization. And so it's not enough to change just the staff to, you have to change the environment in which you're working, and that's where you need to be looking for innovations and how you can use.

Technology that people haven't thought about and, and you have to move people's skills along. And it's true that there are a few people, a few percentage points of people who just don't want to change. They want to keep doing the same things for the same skills that they want. But in general, I find that the vast, overwhelming majority of people want to be trained.

They want to be challenged. They want you to ask smarter next than they this year. I think having those kind of people around you makes you better. And the idea is the smarter they get, the smarter you need to be. And so as ACIO, I've always felt pushed because they would always bring topics that I wasn't familiar with.

To me, and I felt like that, that old joke, you don't need to outrun the berry, you just need to outrun the, your friend or your companion in this case. And so the idea is you, I find that I probably get about a hundred emails from Listservs every day. Uh, and people go, that's ridiculous. And it's like. It may be ridiculous, but it helps me look for trends.

It also helps me look for what's new that I wouldn't have anticipated had the staff not bought it to me, uh, or brought it to me. And so I think those are interesting things to pay attention to. So one of the things that I would say about staffing is there's a huge difference. In the staffing challenges and probably strategies in markets that we've all been in.

Right. I was in the Boston market for many years. You, you Bill, we're in the LA Southern California market. David Dallas Market. You've been working with a client in the New York market. Very, very, very different in terms of competition, being able to. When an Epic implementation has done at one major system in the, in the area, that you can get some of them onto yours.

If you're not that far, and they don't have to move houses and change kids schools, they're ready for the next one. Right? But, but how many healthcare organizations and IT shops are not in those big markets who are. Just in the very same need for talent. And how do they find those, that talent, and how do they retain that talent and how do they grow that talent?

I'm in a market like that right now. It's, it's, it's beautiful. I love seeing the mountains every day in Burlington, Vermont, but it's a little far away and a little bit harder to recruit for. So those are really different staffing challenges. That you have to look at. But when it comes down to it, the culture of your organization, your commitment to your people, your investing both time and money, and training them and preparing them for the future, some of that is the same, but you have to recognize that you've got some different challenges.

So that's a, that's a huge record for us. That's actually almost two and a half times what it was last year. Go figure. And I, I wanna give you some of the things that sort of Fascinat me, fascinate me. Apple Podcasts account for 45% of the downloads, overcast, which is the, uh, app I use on my iPhone accounts for 14% of the, uh, downloads.

It's great application, by the way. You can listen to it a little faster. I've been told that I sound good at two and a half times speed. I can't imagine that that's the case, but some people have said. Uh, so overcast, 14%. Apple Podcast, 45%. Web brow web browser is the next highest at 7%. I find that interesting as well.

Devices are what you think they are. 76% of all people who listen to the podcast listen to it on their iPhone. Android is 10%, and, uh, windows computers are 6%. And, uh, final. Crazy, we'll, we'll do some other statistics, but . Where are people listening from? 89% of all downloads are happening in North America, 4% in Europe, 3% in Asia.

So those are the top three areas and those are just some interesting, fun facts that I thought I would share, uh, with you. A couple more coming a little later in the show. Alright, at number eight we have Judy Kirby. Judy is a friend. I've known Judy since I came into the industry and . Wanted to have her on the show to really talk about the process.

And I've done this as, when I, when I left St. Joe's, I interviewed for a couple CIO jobs. I go through the, uh, through the retained search process, and I, I had a bunch of questions and I thought you guys might have some of those questions as well. So we tapped Judy and asked her a bunch of those questions.

And, and one of the things was, uh, talking about . Preparing for the next interview and talking about video interviews, which is now really the norm. And so in this clip she shares some of some of the coaching that she gives to her clients. Is there a way I can prepare ahead of time for the interview? Is there, is there something like research that you tell people that to do or to prepare?

Do you tell them to, I dunno, do you tell them to do practice interviews? What generally coach people to. We coach 'em a lot when we're working with them, either as a candidate or a coaching client, because the video interview can either make it or break it for you. And now interviews, video interviews have become the norm and very few, few people have experienced to really do those well.

Everything from and.

Clutter to some people having animals jump up on the desk in front of them. But it, it all comes down to you've gotta do your research both on how to do an interview well and on the organization, on the position. You've got to make sure that you can highlight in your background what they wanna hear, but you also have to practice a video interview.

They're using that your bandwidth enough that it's not gonna hang up. These things are so important and as you and I were talking about first impressions and if you're late because you couldn't get your video working and you're in technology, that's speaks volumes. So you really wanna practice with somebody, record yourself, look at it, look for tells, look for.

Of the insurers with Rob Demer. Uh, I love talking to Rob. Rob is brilliant. Uh, he's the former CFO for UPMC. we met and he was actually highlighted on the, uh, COVID series as well. He came on a couple times. We were trying to make sense of what the financial impact of Covid was gonna be on health systems.

And he was, he was really helpful, uh, for me to really understand it. And one of the things we found was you almost had to look at it on a, a week by week basis, almost a daily basis at times, based on how the numbers were going based on how. Once we took the, uh, restrictions off of the electric procedures, how quickly they were coming back, we were, we were having conversations pretty often.

So here's Rob DeMay, former, uh, CFO. At UPMC at number seven, we're dealing with a 15, 10, 15% revenue loss. And then we have these, you know, hundreds of millions, billions of dollars of projects that we've done over the years that, that becomes a debt burden. Is that, how are we gonna juggle that? I think, I think we've, we've gotta stop the addiction to capital and the addiction to growth and healthcare, right?

The, if you look from an industry standpoint. Healthcare has one of the lowest sort of returns on invested capital. We create these, uh, facilities and locations, and then they're grossly underutilized in most cases. And that was all driven by this addiction to growth and, and the fee for service environment, I call kind of the golden goose.

The more, the more you do, the more you make, and. Like the golden goose. We're, we're killing it because our employers and our, our country and our GDP can no longer pay for it. So I think the, the, and this also becomes a cash conservation, uh, method, right? By reducing new capital projects and the cash consumption that's, that's related to them.

So this is no longer about growth. The, the capital needs to be spent on transformation. So how do we look at our existing facilities? What can we do to increase the throughput of those existing facilities? Okay. How can we consolidate? So it's actually, I. Fewer physical locations. How do we close? Uh, I can't say outright hospitals, but that may even be the case with, for a large system.

But how do we close physician offices? How do we close surgery centers to increase the volume and the throughput of the existing remaining facilities? So capital will need to be redeployed in a way which delivers productivity and efficiency and lowers.

Providing capacity for additional volume or amenities for patient experience. All right. Before we get to number six, just wanna make you aware that next year we are going to be doing something a little different on the Newsday Show. On the Newsday show. I'm gonna have a rotating list of people and it would, it is gonna be a duet.

From now on, we are going to have me and another person on the show. We have Drex De Ford signed up. We have Su Shade signed up. Let's see, we have . We have Ann Weiler, former, uh, CEO for a startup lined up, and we are lining up a, a handful of other guests that are gonna be recurring guests. Uh, so that Tuesday Newsday show is gonna be a little more dynamic, us talking about the news and what's going on.

We're gonna continue to engage with you on LinkedIn, so continue to do that. That's a great way for you, uh, to be a part of the community and be a part of the show. All right. On to number six, healthcare Digital Transformation is, uh, gosh, went into overdrive during the pandemic, and we had the opportunity to sit down with Patty Pad Manon.

And Ed Marks who had just written a book on healthcare digital transformation. And in this clip, uh, this clip is really Patty who's talking, and it's, it's him talking about preparing for implementing your digital transformation. It's really about developing your roadmap. This is a great interview if you get a chance to go back and listen to it.

It's also a great book. I. I crammed for this podcast. I got the book, I think 24 hours roughly before we recorded it, and I just sat on that couch over there and read the book and, uh, took notes and, and marked it up. And we then had the, the interview the next day. Great insights. I love the research that they did.

I love the real world, uh, experience that Ed brought to the, uh, conversation as well. So here it is at number six, the, uh, healthcare Digital Transformation Roadmap, Patty Readiness and Assessment and Benchmarking. What are we doing during this phase? The, uh, what Covid 19 has done is it has exposed many organizations to.

Structural weaknesses that they're gonna have to deal with at some point, especially in terms of their readiness for digital. So what, what we are saying in the book is that. All health systems must invest in developing a digital roadmap. It doesn't mean you're gonna execute it all on day one, but you must have a roadmap.

And we have given some very practical guidance on how to develop a roadmap, some tools and templates, frameworks and so on. But it's very important for digital leaders and health system leaders to, first of all, do. Self-assessment of where they are in this journey. And there's multiple tools you can use and be provided several.

And using that self-assessment, you have to build a roadmap to where you wanna be and in what timeframe. Ed mentioned the goals that they had, which was more 50% of all outpatient visits to visits. Now that's a great goal, but you want it done in the next three months. Are you giving yourself three years to do it?

And how are you gonna get there? So you have to have a roadmap for that, and I think that roadmap needs to be put together for the entire organization. Then you prioritize the initiatives within that. That is really what we in. All right. A few more fun stats for you. Uh, YouTube. We, we finally decided to get serious about YouTube this year.

We had been producing videos since episode, gosh, episode number eight. I think it was. I had, early on, I had some millennial consultants, like my, my son, my daughter, my nephew who were helping me out, and they all told me, you have to do YouTube. And I'm like, who is gonna watch this? And they said, no, no, you gotta do it.

You gotta, you, you just, you gotta do the videos. And so we did. And I did it reluctantly to start and now have seen the, the power of having these videos available for the community. Uh, so here's some stats from our YouTube channel. We we're now up to 600 subscribers on the, uh, channel itself. This year we had 17,000 views of our videos.

We had 1,700 hours of watch time of the videos. . The, uh, the videos are found predominantly through Google search. Google search is 25% of how the videos are found. Our, our website referrals are 15%. LinkedIn is 14%, and, uh, YouTube search is 2%, which is interesting to me that, you know, people aren't going to YouTube and, and searching from there, that they're finding it actually from the Google search.

So anyway, just thought I'd share some of those facts with you. I, I, I find them interesting. Alright. Coming in at number five, we, we, I actually came in touch with San Banerjee from Texas Health Resources. He was on a panel at the Scottsdale Institute that I was moderating, and I, I was really impressed, really had a great conversation with him on that panel and asked him to come on the show.

And he, he supports their digital experience at Texas Health Resources. And in this clip we started talking about what IT infrastructure, what, what are, what's the foundation from an IT perspective that is required for creating great digital experiences for healthcare. And this is, uh, Sam Banerjee sharing his insights at number five, head of IT infrastructure is required to get this right and really support a, a seamless.

Consumer experience across the entire journey. So that's a great question. So we are rebuilding and re-looking at the whole IT stack that we have today. Okay. Because the IT stack that we have today is to service our present or the past. It has service to our past. So we are looking at a new set of technologies that we can add to our stack or build something new so that we can service the consumer needs Some examples.

We are looking at a completely brand new CRM uh, system, which can act across providers, our businesses, as well as our consumers, right? So we are trying to build a whole CRM stack. We are also looking at the way we collect preferences from the consumers. It has to be in a central place so that we can act on that.

We're looking at an open API based structure so that we can connect with any external ecosystem that we need to. These are new muscle, which we never had. Yeah. And this is, if you, if you have to really think about it, is a parallel stack that is big getting built at this point of time. And at some point we'll fall back, whatever from our past has to come in that stack.

That's the path we are on. All right. We're getting down there. Now we're, we're at number four. And you know, actually one of my favorite interviews this year was with Aaron Mi. It is really the first time I had met Aaron was on the show, and that happens a lot more now than it used to. Early on, it was just me calling people I knew and my peers and the people within my network.

What happens now is I'll read an article, uh, or, or read some content out there and I'll say. That's, that's, you know, that's really interesting. And I have like two or three follow on questions and instead of sending an email saying, Hey, I have some follow on questions, I just ask him to come on the show and I ask follow on questions and you get to hear the, uh, response.

Well, Aaron is pretty active on social media. He's pretty active out there in the community. And, uh, every time I read some of his stuff, I think, you know, this is somebody I wanna have on the show. I invited him, he accepted, and uh, he did not disappoint in this . We, we actually talked about strategy, architecture, innovation.

We talked about a lot of topics. He's a, a great guest and in this, uh, clip we actually talk about a attracting and retaining, uh, the best talent for your health IT organization. This is a, a challenge that a lot of health systems have, and I really appreciate the wisdom that Aaron shared with us on the show.

So here's Aaron Mary at number four. From an operation standpoint, let's start with people. I. You know, Austin's a really competitive market, as you said, you know, Silicon Hills for talent. So how do you attract and retain the top talent for, for your health system? Yeah, great question. So a few things. What we have found is that top talent is attracted to top talent, right?

As you, as you said earlier, I chose to come.

People like Dr. Clay Johnston who was at UCSF and now he's our dean. People like, uh, Martin Harris, Dr. Martin Harris, who is CIO of Cleveland Clinic, who's now our Chief Business Officer. So I'm surrounded by people that are just brilliant in their field that literally wrote the book. Martin wrote the book on how to be ACI 20 years ago, right?

I mean, it's amazing the people I'm around.

Right. uts mission of the whole starts really is what

and different. Brings out some of the best, especially young talent that is more gravitated. Yeah, you could pay them maybe 30, 40, 50 K more if you go work for Google. And that's great. Google's doing phenomenal things. I respect them, but sometimes they wanna come to something that's a lot more than just money.

That's something about you giving back to the community that you're able to give back in a way to build something. And number three, how often do you really get a chance to start something new in a tier one R one academic world renowned university? I mean, that never happens, right? I mean, you've got the Harvards and Stanfords and the others out there that are just blisteringly amazing, but how often does this happen?

And so what? What I have found is that a lot of talent that is leaving their established places to come here, they're attracted to that. They're like, Hey, I get to learn from the best. I gotta part the best. I get to be a Longhorn, which is, you know, that's how I'm, and then last but not least, if I get to build something new, which is again, uh, a resume bullet that you really can't offer a lot of people, right?

It is gonna be a daily podcast that is five to seven minutes in length where we cover one new story a day. To subscribe to that, you're gonna have to go to today, today in health it.com and subscribe however you listen to your podcast. There, there's not gonna be video for this. It's just gonna be audio.

The thought process behind this is it's, it's a great way for you to stay current. You can listen to these on a daily basis. It's only five to seven minutes. It'll keep you. I I'm gonna pick out a new story that I think is relevant to health it, to specifically the things that you're doing within your healthcare organization.

And I'm gonna talk about those things for five to seven minutes. I'm gonna, um, share what's in the article itself. Uh, gives, give my sort of, so what. Why is this important and why does it matter? And, and how do I think about it as A-A-A-C-I-O? But I just wanted to make you aware of that. So today in health it.com, it's not gonna show up The, the shows are not gonna show up in this channel.

So if you're waiting for them to show up in the, this week in Health IT channel, it's not gonna be there. You're gonna have to subscribe to today in Health it. And those shows will start showing up on January 4th. So the fourth is gonna be when they're gonna show up. You're gonna wanna subscribe now to get it in line.

There's actually one show out there to sort of . It kicks it off and gives you a little background on it. So, uh, head over to today in health it.com today and get sub subscribed to that and we will see you in the new year. It's gonna be great. Alright, let's get down to number three. Number three, we had an interesting conversation with Chris Harper.

He's the, he's in charge of data and analytics at the University of Kansas. At least that's what his role was at the time of the show. And I, I thought it was interesting because he had taken an organization that was in advanced, that was struggling a little bit from the data and analytics side, and he was giving us sort of a roadmap that he followed to mature an organization to, to take over and then to mature an organization and.

There were so many things in this. There was a couple aspects of this. One is, I hear this conversation all the time. We are not as mature as we need to be in the data and analytics space. We could be more, more mature in in that space. I hear that from a lot of health systems, from some clients and others.

So this is a space that I think there's a lot of need. And clearly it resonated. To get up to number three means that a lot of people downloaded it and listened to the episode. In this, we talk about matching, uh, the specific needs of your organization, the culture, and really adapting that on an ongoing basis to make sure that you are meeting this specific needs of your organization around, around the data needs of the organization.

So here is Chris Harper at number three. You, you seem to be communicating that each organization's culture and data needs and maybe even systems and governance is a little different. So you almost have to spend that, that, that time digging into all those elements to make sure that you're identifying the right program.

It's not a one size fits all kind of thing for healthcare. Is that, am I hearing you correct? Yep. That's, that's, that's correct. And then you also have to. Look back and, and evaluate that every year. Right? So we essentially developed this three year roadmap to kind of guide us where we need to go, whether it's with funding, with additional opportunities, when, when I started that journey.

Quality and safety obviously is our number one focus. And so, but at that, at the same time, we had opportunities to look at our improvement as effort with cost opportunities. And so what I typically do is, since it's easy to count with your one hand, I look at five different. Opportunities or questions you're trying to address using data and really, uh, spending most of your time understanding not only where you're starting from a culture, technology, the people, and all of that, but also are the five most important things that your senior executives or your physicians are looking for, and really focusing on that to really understand where your starting point is.

And then really, if you wait. A year or two to get value out of it, you've already lost the battle, right? So you've already got funding for maybe supporting it for 12 months, but if you're not showing your incremental value and, and how you're, you're using this, this really resource to, to, to improve outcome, you're not gonna really get that next year of funding.

So, so really we looked at what are some of the five questions and then quick wins we can have. Alright. A little behind the scenes for you. There are times. prior to me getting, uh, my production team, there are times where . Quite frankly, I would get to a Wednesday and I wouldn't have a guest for a Friday show.

And so at that point I'd just scramble, I'd call some friends and, and get them on the show. But one of my favorite people to do that with is Charles Boise. Uh, Charles Boise is brilliant. He's a, a data scientist. He's an architect. Uh, he's worked for a lot of organizations. UCI in Southern California, Stony Brook in New York.

He is now the chief technology officer, I believe, chief Technology Officer for a startup outta Jacksonville that has done extremely well and they've, they've grown and, and, and, and done really well. And, and Charles is the person I call a lot of times when I have a technical question. And so I thought, alright, I call him up on a Wednesday.

I'm like, Charles, I wanna do a show with you where I'm the CIO. You're the CTO and we're gonna discuss the current healthcare challenges. And he loved the idea and we just, we started plowing through him. It's like, all right, Charles, we need to do this kind of reporting. All right, Charles, we need to do this for an interoperability.

All right, Charles, we need to do this around cloud. And we just . We just went at it for, I actually one of the longer episodes, I think it was like 40 minutes. And, uh, I, I just had a blast doing it. It was, it was a lot of fun. In this clip, Charles and I talked about cloud strategy and I just, I just threw out the question that everybody, everybody wants to ask, which is, what the heck is a cloud strategy and.

I, I love this conversation 'cause it now seems so appropriate given what we ex experienced since the pandemic hit and how important the cloud strategy was for our, for agility of the healthcare organization and our ability to adapt, uh, to the changing environment. So here we are at number two, Charles Boise with ACIO and CTO discussing the current healthcare challenges.

What is a cloud strategy? What is a cloud strategy? ? Um, so , I'll give you my definition of it. Um, it's not a choice.

What I mean by that is you have your own on-Prem Cloud. You could have a private cloud located somewhere else in a co-located environment. You've got Google, you've got Azure, um, you've got AWS, the whole ecosystem is a cloud. Does that make sense to you? You're not making a choice. You're in a cloud environment.

Now, whether you know it or not, and because of, you know how we are doing things now, from an API perspective, if I wanna run a workload in, in Google BigQuery, then I will run a a, a workload in Google BigQuery. If from a storage perspective, I wanna store all my data, OnPrem, great. If there's some tools within AWS.

Work in my environment, I can do that as well. So I can move workloads around as I need. Is it all or none? No, it absolutely isn't. And I think this is something that we'll see evolve as time evolves where I'm not making a decision to shut down my data center and move to, let's say, AWS I'm gonna do everything in aws.

No, there's interconnectivity between all those cloud vendors. Um, and I've used.

How are we gonna best utilize it? And from ACIO perspective, what I would say a cloud strategy is, it is you getting the most agility and efficiency for your organization, providing the, the most capabilities to your organization. The reason we talk about cloud at all is because cloud gives you the agility, the efficiency, and the capabilities.

We can spin things up. Overnight that we used to have to plan six months for and order servers and put 'em in your data center. All right, we're there. We are at number one. Before we get there, one last thing I want to do, I really wanna thank my staff. So this year, because we have sponsors, I was able to add staff and it, it made things so much smoother.

I want to thank, uh, Tess Russell, who, uh, is our head of marketing and social, uh, engagement, and Tracy Miller, who heads up our production efforts. I, I've enjoyed this year so much more because I can focus in on the conversations and I think it's really elevated the content I can focus in. I can give a almost a full hour of preparation to just, just generating questions that I want to ask this person and doing research for, for myself on some of the other things that they're saying, and I hope what I'm able to do as a result of that is just ask the questions, the follow up questions that aren't being asked by say,

A traditional journalist, but somebody who has an IT background really thinking through where they're going with these things. You know, I really enjoyed this year a lot more because of that staff. So I really wanna thank Tess and really want to thank Tracy. And if you're wondering who listens to every episode, those two, listen to every episode.

So over and above, just myself hearing every episode, those two have listened to every episode, and every now and then they'll say, well, I'm not a healthcare expert. But I, you know, the more and the more episodes they listen to and the more conversations we have, the more I'm realizing that these two are really, really picking up on healthcare, health, IT issues and those kind of things.

It's, it's, it's fun and I think that same thing is an opportunity for you and your staff. So thank you for listening. Alright. On to number one. Number one, healthcare in the 21st century with a niche. Chopra, uh, Anish is, uh, somebody I met early on in my CIO career. . and we were on a panel together. Actually, he was moderating the panel.

It was, it, it was unlike any panel I've ever been on. Uh, Anish engaged the entire audience. Usually a panel. You're just having the discussion with the people who were up on the stage. He engaged everybody and because of that, we had a topic we were going to cover, and we ended up covering a completely different topic because the people in the audience wanted to talk about a certain topic.

That's the kind of person Anish is. He engages the community, he listens to the community, and then he helps us to really think about how these things are gonna impact healthcare and how we should potentially be thinking about how they're gonna impact healthcare. You know, Anish is, is very engaged in dc, very engaged with the, uh, with HHS, with ONC.

The, uh, banks all within a regulated context. Why healthcare 10 years after the initial data set was published, why Bill has the healthcare industry not added a single data element beyond the minimum required in the open source domain? Have we just been so busy? We can't add a single element. In 10 years, it's been, uh, yeah, we, we don't tend to self organize the way you talk about, we tend to, I, I remember sitting across from another CIO and I said, Hey, and this was something simple, right?

So we had, we had in health information exchange in, in Southern California and I sat across from 'em. I said, Hey, we'd like to share our data through this HIE. And the CIO said, that's great. We don't wanna share our data with you. Right? And I'm like, and I'm not gonna reveal who that was because, but to be honest with you, at that point in history, that was well within their prerogative to say, yeah, it's not in our best interest to give you our, our patient data.

You guys can then go after our patients. We don't want that. And, and, and that's why you see the need, the what you just said is why Sima Varma said ATS a year and a half ago. When we were still meeting in person that effectively, and I'm paraphrasing you made me do this, you the industry in the failure to self-organize for any reason because of the financial incentives, the market dynamics, whatever that compelled, what she said was a sort of anti reg, not anti-regulation, but deregulatory agency leader.

To impose some of the strictest and boldest regulations on interoperability. We've had in the industry, in, in the decade, you know, amazing guests this year, amazing insights. I, I really have to thank all of them for, for coming on the show. I, I, I've benefited greatly. I think the community actually, the emails would tell me and the instant messages that I've received would tell me that people have really benefited from the show and the people that we've had on the show.

So I, I really appreciate everyone who has been, who has taken the time to, uh, sit down with me to record something that is going to last and, uh, really help people. I've had people just coming into the industry, new to the industry, young people coming outta college saying, Hey, this is really helpful. I've had people take over new jobs and said, Hey, I listened to five or six of your episodes on this topic, has really helped me.

That wouldn't be possible without . Our great guests, so thank you. Thank you, thank you for coming on the show. Uh, I, I just wanna recap top 10. Uh, number 10 was Tricia Julian and Brett Oliver talking about a team approach to health. It. Uh, number nine was David Mus and S Shade on the state of the industry.

And we were talking, uh, about really preparing your staff for what's next. Little did we know that what's next was a pandemic number eight, finding the next role with Judy Kirby. with Kirby Partners, uh, retained search firm. Uh, number seven was the post covid rise of insurers with Rob d mache, former CFO for UPMC, uh, number six, healthcare Digital Transformation with Patty Ped Manon, and Ed Marks.

Then we went down to number five, creating digital experiences with Sam Banerjee with Texas Health Resources. Another great conversation. Number four. We talked, uh, a lot of different topics with Aaron Mary, with UT University of Texas. Health system. And then number three, Chris Harper with the U University of Kansas, talking about data analytics and governance.

Number two, we had my friend Charles Boise, where we had A-A-C-I-O-C-T-O conversation around the healthcare challenges. And at number one, anise Chopra with, uh, healthcare in the 21st century. Talking about interoperability in the 21st Century Cures Act. You know, if you heard something and you're thinking, Hey, this is good stuff, go to the website this week, health.com, uh, check out the full episode.

So 24 hours after the show airs, you'll get an email telling you, Hey, here's who was on the show and here's what they said. If you want us to continue making this show, there are two things that really help us. One is send us a note. We love your feedback. We are constantly trying to improve the show to make it more valuable to you.

That is our, that is really our litmus test. Is this valuable for the people in healthcare? In healthcare it? So your notes help us to continue to strive closer to that goal. The second thing is to share it with the peer. Right. We want to get this content into as many healthcare practitioners, health IT practitioners as possible.

We believe that by growing the community and sharing these insights from these great health leaders. We have the opportunity to reimagine healthcare everywhere for everyone, and I hope you agree with that. So please share it with your peers if you have the opportunity. That's all for this week, and really that's all for this year.

Thanks for listening. That's all for now.