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 Welcome to this Week in Health. It influence where we discuss the influence of technology on health with the people who are making it happen today. Second part of a two-part series where I talk to S Shade and David Mutz. Principles with Starbridge advisors. Uh, they are fantastic guests and we have had, if you were there, if you listened to last week, and I highly recommend you go back and listen to it if you haven't.

Uh, what we did is we played a little health it jeopardy. I gave 'em 10 topics, we broke 'em down. We go back and forth on, uh, major topics that, uh, are impacting health. It. And, uh, it's a fantastic conversation. So part one was last week, this week, part two. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health.

It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. This episode is sponsored by Health Lyrics. I coach health leaders on all things health. IT coaching was instrumental in my success and it is the focus of my work at Health Lyrics. I've coached CEOs of health systems, startups, CIOs, and CTOs as well.

Um, again, we played a little health it jeopardy. I think it's a, a, you know, fantastic episode. I hope you enjoy yo. Today I'm excited to be joined by two leaders of Starbridge Advisors, previous guest of the show show, uh, Che and David m uh, good morning you two. Good morning. Morning wwe and, and you guys are kind enough to be testing out this new format for me where we're trying to do, uh, three guests.

Uh, we'll try not to talk over each other 'cause the video sort of.

As previous guests, we're not gonna go into your credentials, but would it be fair to, to sum it up by saying highly decorated industry veterans, or is that offensive? Sue? Uh, back to you. Uh, it, operations, security, uh, let's see, those three taken. Mentoring, training, staffing innovation, or experience training.

I'm not sure what experience. Experience is a pretty broad, it's we, let's go with training. Training for, for a hundred, whatever. Alright, so where are we at today in terms of, uh, developing the. Uh, the, the right skills for the next generation and developing that next generation of people that, because we all have a, a little bit of gray hair.

Um, so, and, and actually we'll go, we'll go to chime next month and we'll see a lot of gray hair, quite frankly. Yeah. So what are we doing to mentor and train that next generation? Okay. And yes, we all have gray hair. Unfortunately. I'm not going to chime 'cause of our go live. Um, and, and, and let me just say this group, um, all committed to developing the next generation and kudos bill for, for what you're doing with these podcasts and just your focus in and your new services.

Um, that even get at that more so that's good. Um, what are we doing? Uh, you know, lemme start with the negative first. Um, it's disappointing to see that training budgets are still the first to cut. When you go back to the budget conversation, you have to make some cuts. And in the grand scheme of things, if you think about it, your training budget is probably

Small, it's a small percentage of your IT budget when you look at everything else you're paying for yet, it's an easy cut. So that's unfortunate, and, and I would hope that CIOs would find a way to hang onto that and get creative about, um, how they can use that money. Um, I, I think that, um.

Does this answer your question directly? One of the, I'm not sure. One of the things I'm excited about and why I love doing interims and being back in an organization, interacting with people and teams every day and helping solve problems and being part of it is I see, I see all these up and coming leaders.

I see young people who, um, are to learn from others and into their.

Senior leaders have identified as, you know, the next, and how are we gonna like, you know, convince them that they're right for management. We can, you know, we can support them and move them into that kind of role. So that's, that's encouraging. I think more and more, um, you know, our generation leaders recognizing that we will not be here forever and we've gotta be developing those folks so.

I'll stop in terms of, uh, where it's, where it's at today with David comment. Yeah. David, do you want me to Yeah, I love what you said, and by the way, you know, Sue is one of the best mentors I know, um, and spends a lot of time doing that. So she's obviously giving back for so many reasons and I think it's because we all benefited from, uh, mentors, whether they were go.

You wanna go ahead and say. Well, where, you know, we've benefited from mentors and that is by being taught directly or by observation. Um, and a lot of the lessons I learned was from just watching great leaders, not necessarily one-on-ones. Um, but the degree that you can get to do one-on-ones, it's fabulous.

Um, but I think. One of the issues is whether or not we should be, we should look at where we are and where we're going. And this issue of it being a commodity or not really impacts what it is that you're trying to train for. Are you trying to train for skill, um, which might be more technically oriented?

Are you trying to train for leadership, um, which helps you take advantage of the technical resources that you. We need both. Uh, and so you can't ignore either if you want to be successful. Uh, and I think it's really, uh, critical to try to give people a chance to do things. One of the things that I've seen is, and this is especially difficult for leaders, and you know, I, I always, and I'll just share some of my arrogance here.

I always figured if I could do something, I could do it better. And so that's part of my reason for being a leader is a certain amount of righteous indignation with the status quo. On the other hand, if I wanted to be successful as a leader, I had to give up the my belief that I was the only one who could perform the function, and when I learned to delegate.

And I mean, really delegate and accept that things weren't gonna be exactly like I wanted them. Then I found that oftentimes they were better or different. And so I think it's both mentoring and then letting people. Do things on their own. And so that delegation is probably one of the greatest ways to train people.

Uh, and you can do that as a leader, and that allows you to be a mentor because there will be lessons that everybody learns from that delegated responsibility. Sure. So if I can, if I can come back, um, um, one, one point I wanna make is, um, we're all continuous learners, right? We may have gray hair is, there's so much we don't know.

There's so much we still need to learn, you know, the number of times in a given day that I may say, okay, educate me about that. Help me understand that.

That, um, it is maybe connected to that. It is very two-way. I mean the, the, the things that we learn from others and that we learn from this next generation that's coming up and they're bringing some different approaches and, and styles to how they work. And it's very refreshing to be around them and learning from them.

So, um. You know, I'm not talking that specific, um, training and dollars and go to this class and, and, and this course, which is all comes into play, but just that continual learning environment. Everybody in the mix, learning from one another. And Sue, can I just jump on that because I, I love what you said. I just had lunch today.

And I was saying I am so grateful to the millennials because they do a much better job of teaching me about life work balance. Uh, and you know, that's one of the things, it's, it's not a question of is there work ethic and. Wrong. It's that my view on life work balance is much different than theirs. And so, you know, still learning a lot from the people I observe.

So, and the much younger people, which is refresher. Yeah. Uh, two things on the younger generation. One is, uh, I was just talking to somebody who perceived a sabbatical after working for a company for 15 years, so this is not Amillennial, and they said Thetical. And I thought a millennial would never do that.

That would not, but our generation would. It's like, well, we're needed. We've this implementation for whatever reason. That's, you know. The, this, you know, the, the millennial, the different age groups and whatever, they do act differently. They're, they were raised by different people. They, they do act differently.

The other thing is at the conference, I forget his last, but Justin was an 18 year old, uh, high school kid. Who, uh, stood in front of like four or 5,000 people at the Health Capitalist Conference, and I, I was just amazed by that, you know, I was in front of my high school class. I was nervous to like, stand in front of a small classroom.

He was standing in front of 5,000 people talking about machine learning and ai and, uh, what he's been able to do with the data and, uh, making that available. And, and, and I thought, you know what? In this area of mentoring and training, uh, there's this identification of special skills and identification of talents that, uh, I think is one of the roles of the CIO.

I think sometimes people get pigeonholed in our organizations and it's our job to see. More of what they can bring to the organization and to somehow, uh, release them what they're doing and give them opportunities to, uh, started. Oh, and this is like the next . I'm not sure I'm doing great with your format.

Um, the last word on this, you know, we we're all continual learners. We've gotta invest in our people. They are our greatest asset. Uh, and, um, you know, continue that commitment to the next generation of leaders that we all have. Alright, uh, David. Operations, security, staffing, innovation or experience? I guess security is probably the topic.

So it's IT operations and security. Go ahead. Oh, and security. Okay. Yeah. Well, you know, I, again, I've said one of the things is that you need to convert from being a. Uh, you need to convert to a utility and associated with that is security, and you've got to do a better job. And, you know, one of the things that I hear is all the time about people trying to balance all the old equipment, um, with, uh, budget.

You can't afford to, you know, you can't be secure if you can't buy the. The clinical device, um, because it's running on the old Windows platforms, uh, but it still is the human element that is the most dangerous. Uh, and no matter what we do, the bad actors are outside the institution, are not nearly as dangerous as the people that we're looking at inside.

And so, um, the breaches that I've seen or I've been involved in. Where our really happened because our own employees didn't do what we expected. And so, um, when I was in the government, I, I heard from one of the ladies who was the chief privacy officer, said that, and this has stuck with me, that you have to create a culture of privacy and security.

And if you don't, you won't be successful. And everybody has to own that responsibility. Uh, and so we have to do a much better job of doing. What would be considered normal? It's not just the training, it's the background checks. It's motivating people, recognizing people, being good leaders, good custodians, good servant leaders where you're looking out, uh, so that people don't want to do harm to the organization and empowering everybody.

Uh, and that is every single individual to be a, an agent of security. Uh, and so that's the kind of oversimplified, but extraordinarily difficult. Uh, measure to reach. Yeah. Uh, 25 million, uh, medical records have gone missing, uh, to the first half of this year, and that's really not okay. Uh, and as you state, I mean, it's a lot.

It's due to, it's due to us. It's due to, uh, uh. You know, it's mistakes, it's misconfigurations, it's um, it could even be people that are, uh, you know, I dunno, it's mistakes. Majority of these are just flat out mistakes being made by health. It, uh, it's not nefarious actors who are hacking in and doing these sophisticated attacks, for the most part, at least that we know of.

Um. When you look at the top 10 issues, uh, even the Equifax one, you just go, well, it's an unpatched server. It's, you know, that's basic hygiene in terms of, uh, uh, where we're at and where we're going. Um. Sue it, operations and security. Uh, you know, where, where, where do you think we're at? Where are we at? Um, is, is, is the si your answer,

No. You know, the si is. Okay. Say something smart. Um. I was gonna comment specifically about security and the importance of security culture, and I had that conversation just this week with people about, you know, is there a security culture in this particular organization, um, that there needs to be, and to stop start at the top, um, I, David did a, did a good job about some of.

Key components of security. But if your top executives are not totally, uh, bought in and understand the risks, um, you're not gonna get the support around policy. You're not gonna get the support on budget and be able to do the kinds of things that you need to do. Um, it operations, uh, what all, what all are you covering?

All of, um, all of infrastructure. Yeah. So let, let, let, lemme frame this up. Are we seeing, uh, disaster recovery plans in place? Are we seeing, um, it processes being followed? Are we seeing, uh, patch management or are we still sort of behind in saying, well, we're almost caught up to the patches we need to do, I, I'm not talking about clinical devices.

And in some cases it doesn't report into health It, in some cases it does. I'm just talking about the basic infrastructure. Are we keeping up with the, uh, with the basic maintenance of that operation? I think it's really variable. I think there's probably some very large organizations who are doing this very well, and there's a whole lot of organizations that need help that haven't made the investments that they need to make, don't have the, um, the leadership, the strength of the leadership in, in, in that.

That they need. Um, so there's plenty of opportunity to, to raise that bar in many healthcare organizations is my, is my sense. Alright, so I'll, I'll, I'll take the last word on this because when, when I came into the organization that I became CIO, uh, we had eight outages in our data center over six, uh, six weeks.

And that was a complete outage. The, the data center went down. And so, um, that was just a result of, we had just insourced from Perot after 10 years. Uh, we hired a whole bunch of people, but we didn't set up all the processes around it and all the, the procedures, uh, around it. And the, the, uh, bottom line is if I became ACIO for a new organization tomorrow, I would.

I would reset their expectations for all the really cool stuff we're gonna do. And I would say the first year is, is, is getting the operation right, getting the people in the right roles, getting them trained, getting the procedures done, uh, because everything else is. Is done on top of that. And even though you don't see it in a lot of organizations, if it's done right, you shouldn't see it and you shouldn't even think about it.

But that ha, that foundation has to be, and I'll tell you, when you do mergers and acquisitions, you almost start over. You almost say, all right, we're bringing these two together. Let's make sure that.

Basic operations. Alright. And I, you, you wanted the last word? Can I say one other thing about this ? Sure. Um, you both know that the interim I'm doing right now is as Chief Technology Officer and I tell people who know me well, don't laugh because I did not come up on. Side of it. Both of you are far more technical than I am.

I came up on the application side. I started as a programmer a gazillion years ago, and uh, I was hired in because they just needed to keep everything moving along and support of this big epic go live from the infrastructure side. They knew I wasn't the techie. You know, the technical wizard. I have to say that the, the deeper I get in it and, and the more I'm working with my folks in these projects, the more appreciation I have for the complexity of what our technical.

Staff does and the environments that they support. It's, it's incredible. And, um, I know you guys know that, but I, I, I feel like I've gotten a whole different view of it, um, doing this work right now. And I am, uh, I'm impressed. Fantastic. Uh, I, I forgot who's next. David are. I am happy to go next. I think so.

So we have three topics left, staffing, innovation, and more importantly, we have 15 minutes left, staffing, innovation, and experience. Which one of those would you like to talk about? Um, I think innovation is probably the. Topic that gets so much, uh, focus right now. And again, just my plea to people who are involved in it is to stay very practical and pragmatic.

Um, again, di you know, I I say, are you really involved in, in innovation, and I use the word hobbyist, uh, earlier. Um, you know, the shiny new object is great, but where does it fit? How does it align with the strategies? And so, um, I think one of the things that I look at in the, and I'm just gonna try to pull digital health back in here, but if you're gonna, a digital health, you've gotta do is use innovation in.

It really pays homage to the name. And that is not to use real world based metaphors to create new ways to do things. Uh, and I'll say that there's a difference. I think a lot of people talk about innovation. A lot of people talk about. Automation, but they use innovation as the way to describe it. Uh, innovation to me is not doing something that you can do in the physical world with a metaphor.

Like, we're not gonna take a piece of paper based material and then automate it. What we're gonna do is we're gonna thick air out a completely new way to use technology that people have never seen before.

Occurrence of that, uh, I was on a bus riding down the street so I didn't have to pay attention to driving. And I look out the window, and this is right after flip phones had been replaced or were were being replaced by smartphones. And one of the most innovative ways I saw somebody using a. Telephone was a woman who was standing on the corner and she had, she was holding her cell phone, which of course I used, you know, it would do all the things that smartphone would do, but she had turned the camera on and was brushing her hair.

And she had turned a cell phone into a compact and I thought, oh my gosh, here's somebody who is using a device that wasn't intended to be used for that purpose whatsoever in a way that I would've never thought about. And I've always said that the real innovation comes. Not when you take a people who are, uh, brilliant and, and, and well educated from a, you know, in a, in a, a formal way.

But if you can get technology out to the end users, they will do things with your programs that. Could have thought about or expected, and they will figure out solutions to problems that you didn't know you had. And so I think part of innovation is creating something new. I think part of innovation is just pushing things forward so quickly that the users can then turn around and figure it out a way to use them that we could not have professionals.

So.

Where do you point innovation at? You know, we've heard Alka talk about they route all their faxes through aws. Now it looks for consent forms and then it does a fire. Uh, because 60% of their faxes were consent forms and instead of somebody reading all those and whatever it now, uh, uses the machine learning and the technology, it finds the.

A, uh, fire call back, uh, through the AP back into the R consent form, and that's a's a innovation. Uh, Daniel was on talking about, uh, robotic process automation and how they're using that around billing and, and how it's, it's, uh. Really revolutionize what they're doing there. So that's one area. Uh, I was at Health two Oh and, and heard, uh, Aaron Martin and others talk about innovation around the consumer experience and those kind of things.

But I've also had conversations where people are saying, look, it's looking very real, like. Walmart and CVS are absolutely planning to take away the, um, the frontline of the hospital. And I certain people who say. That represents 20 to 30% of our business, which is only gonna leave us with X. Should we be pointing our innovation at those kinds of risks to the health systems business model, or should we be pointing it at the business model as it exists today?

And I'll throw it out to both of you. 'cause I don't think it's fair to point it at any one of you because I, I'm not sure I have a good answer for it. Okay. I'll, I'll, I'll take that first. And I'll also say that I use my phone as a compact. That's a good idea. , I've done that. Um, it works. Um, you know, I think, um, when you start asking this question, bill, I was thinking, you know, where to focus innovation.

I think, you know, three buckets for sure. There's, there's, how do we help the clinicians? How do we do better patient care, more safe patient care? What does that mean? Um, automation efficiencies. You know, where can we apply new tools? Um, there's, there's still an incredible amount of, um, inefficiencies within healthcare.

We know that, and Costco with that. And then, um, third bucket, the outward facing, you know, what's called digital health consumers patient engagement, et cetera. I think you gotta try to plan all of those. And depending on who's driving innovation for your organization, you may, you may be focused just on. Um, or you may be focused more on the outward facing consumer, consumer engagement.

Um, I think you gotta look at all of 'em. Your point about, um, the industry and, and, and risking our, our healthcare business models, I think is how you asked it, you know? Um. We should not be trying to protect a certain model, right? We need to have a more holistic view of healthcare and the health and the ecosystem of health.

And, um, try to have some breakthroughs that go well beyond the models as we know them now, which is why, um. Okay. I forgot. I'm sure you know Bill, 'cause you're up on everything. The company that was formed that AT Tool is now the president of, what did they name it? Oh, uh, yeah, yeah. I, I, I'm sorry, I forgot.

Okay. Stump the host. You know what I'm talking about. Um, you know, they're looking at different models, right. We, we, we, we should not, we should not, as healthcare providers, in my opinion, be threatened by the new models that are emerging out there. Because in the long run, what do we want? We want better. We want more cost effective.

We, for everybody. But you know, I won't go into politics.

You're welcome. . David asked me a political question on one of the shows, uh, the last we were, I'm not know. You have the, you have the power of the edit,

um, you know, staffing experience. Um, you know, I, I think we touched on, uh, experience so.

Uh, just a.

And, uh, I think when was on the show talked about, uh, the fact that s are technology

fronts, things up and down, different skills than potentially what we have. Um, what does, what, what can we do? Um, 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 is our responsibility, what are we gonna do?

David, I'll, well, I, by the way, I do think that training is actually a reward. For the people in it. It's a incredible motivator and so professional development seems to be a way to attract and retain people. Um, so couldn't agree more that doing that is important and it's important for selfish reasons.

The ones I mentioned. Uh, 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 is 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 with 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 them smarter next year than they are this year. So, uh. Having those kind of people around you makes you better. And you know, 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, you know that old joke, you don't need to outrun the berry, 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, well, 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 kind of interesting things to pay attention to. So. One of the things that I would say about staffing is there's a huge difference, uh, in the staffing challenges and probably strategies in markets that we've all been in.

Right? You know, I was in the Boston market for many years. You, you, uh, bill, we're in the, you know, LA. Southern California market. You know, 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 draw people, uh, you know, when an EPIC implementation is done at one major system in the, in the area, you know, that

You can get some of 'em 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, um, 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? Uh, 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, um, that you have to look at.

But you know, when it comes down to it, the culture of your organization, your commitment to. People you are 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. Absolutely. Uh, great point.

Great, great conversation. Uh, you know, I wanna thank the two of you for coming on the show and trying out this new format. It's, uh, it's greatly appreciated. And, uh, I, I'm just, just a ton of wisdom. I can't wait to, uh, to share it with everybody. Um, and, uh, hopefully I, I'll see you guys. Sue, we're not gonna see you at Chime.

David, are we gonna see you at Chime? Oh, yes. I, I gotta be careful talking about time specific things on the podcast, because you never know when it's

talking with you, bill. And of course. Absolutely. And I share exactly the same sentiments about the two of you. So thank you all. Thank you again. I wanna, I want to thank David and Sue for taking the time to join me in, in the conversation. Um, again, so knowledgeable, so articulate, really appreciate their support and their support of the show.

Uh, when we recorded this, they were not channel sponsors for the podcast. And now, uh, Starburst Advisors has become a channel sponsor for the show and I really appreciate that. So special thanks to all of our channel sponsors who make this content possible. Starbridge Advisors, VMware, Galen Healthcare Pro talent advisors, and health lyrics for choosing to invest in developing the next generation of health leaders.

Please come back every Friday for more great interviews with influencers. And don't forget, every Tuesday we take a look at the news, which is impacting health. It. This show is a production of this week in Health It. For more great content, check out the website or the YouTube channel. Uh, if you find this show valuable, please share it with peers.

Shoot 'em an email, let 'em know that, uh, you're getting value out of it. And that is greatly appreciated. Thanks for listening. That's all for now.