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Today on Town Hall

most of our policies are unsearchable because we just don't have, good indexing, but if you throw gen AI at it

it creates this new sort of found life to the content you've had at your fingertips for years that people either forgot about or they hadn't been able to use because they couldn't search through it

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. Today's episode is sponsored by ARMIS, First Health Advisory, Meditech, Optimum Health IT, and uPerform. Alright, let's jump right into today's episode.

Hello, I'm Sue Shade, Principal at Starbridge Advisors and one of the hosts for the Town Hall Show at This Week Health. Today, my guest is Joel Vanko. He is the SVP and Chief Information Digital Officer at Hartford HealthCare. Joel has been in this role now for two years after serving close to 10 years as the CIO at Baystate Health here in Massachusetts.

Joel is one of my favorite CIO innovators. So I'm looking forward to talking with Joel today to hear what he and his team at Hartford have been focusing on. Welcome, Joel. Thanks so much, Suze. Great to be here with you. It's always good to see you, Joel, and you are one of my favorite innovators. No pressure.

So yeah, let's start by having you briefly introduce yourself and tell us a bit about Hartford Health.

Sure yeah, so Joel Vanko as Sude mentioned, I've been here for about two years, and I, really, I'm the the sort of the leader, if you will, of all things digital. Here at Hartford HealthCare, I'm the first Chief Digital Officer.

But the real challenge for me, and we'll talk about it today, I'm sure is how do you get to digital and what are the capabilities and assets that you need to get to digital as a healthcare system. So, I'm really pleased to, to be here to share that with you, Sue. Hartford HealthCare is A continuously growing and evolving organization.

It's now roughly 40, 000 colleagues strong and roughly a 6 billion organization and growing. And we've really expanded our reach across the state of Connecticut. Seven hospitals all straight A's, by the way, leapfrog, just a little plug but we continue to grow and figure out ways to really connect with our patients, particularly at the ambulatory level, you know, our, our strategy has always been to be within Five miles from the community members in our state.

And I think at one point when I was talking to my CEO, I sort of opened my mouth and I said, well, what if we were zero miles and that sort of launched the whole digital discussion and and, our aspiration towards digital, but you know, we're really just thrilled and grateful to be a part of this large community in Connecticut.

And we're so grateful to be serving the community members here. Thanks.

That absolutely, that's great. think I heard or read something where you talked about the five miles and the zero miles and by saying five miles, it means that every Everyone in the state of Connecticut is no more than 5 miles from some type of facility that Hartford HealthCare has.

Is that right?

That's right. Yeah, I mean, I think jokingly some of our legislators and even community members will say you guys are like on every corner. More than a Dunkin Donuts around Starbucks. So, yeah, you're, drive around Connecticut and you inevitably see Hartford HealthCare. And again, that's because our mission is to really be there for our community members.

And so, we're seeing really just a terrific kind of expansion of our services to our community.

That's great. Well, we'll get into the digital. For the people listening who do not live in a small state like the New England states they, geographically, I should say, they probably can't relate to the five miles away.

But you can. So let's get into digital in a minute. But it's also a nice segue to the first question I want to ask you, which is to hear about your first six months on the job. I think I. Either spoke to you or heard about it, read something about it, but you had a pretty aggressive kind of and diligent plan to get to maybe every location in those first six months.

How did you do that? How did you get up to speed and make sure you meet everyone across the state? Yeah,

Yeah, and even though the state is small, as it's still sprawling and to get to seven plus hospitals and really 400 locations across the state was virtually impossible. But, the first six months was really my focus was listening, learning and leaning in.

And that was really And so the opportunity to learn from my staff and my colleagues was really my main focus because I really needed to truly understand the operating model of the organization. It's culture find themes that really would resonate with the organization at large, but also, obviously I had a thesis coming in in terms of what I wanted to accomplish from a data and digital perspective, but you can't just sort of force feed, that thesis or that strategy, you know, Sue, it's, you really need to understand, what are the pain points and the needs of the organization?

What's the change management look like? And so those are the kinds of things that I was sort of looking for. And as we developed the themes, or as I developed the themes in my travels across the state that led to this notion of, well, what are the capabilities we need to be able to address those themes that I've been hearing?

And then, of course, once you understand the capabilities, what's the structure look like? And then, therefore the, really the overall sort of form and function kind of evolve, and then, you start to understand. Who are the people that are on your team? What do you need? How do you develop the folks to get to that strategy?

But it was that first six months was really a lot of learning and engaging and relationships forming relationships. And of course, it was difficult because, you're still kind of in COVID to a certain degree. But at the same time, that was sort of a benefit because people were so now used to having, Zoom meetings.

And so while I wanted to be. In front of them in person sometimes we had to be on Zoom, and it was I think some of the ability to get to some of the far, further places out in in Connecticut the Virtualness of our sort of current state really helped in that and sort of getting to know folks and getting to them across the state.

So that was really the focus of my first six months and in the seventh month truly, I presented to my president's cabinet colleagues and also the board what they had been really sort of waiting for which is how do we get to digital? But I had to share with them kind of, well, where we are today first and what we need to do to get to digital, right?

So that's the journey that we're on now.

Excellent. Great. So before we get into that a little bit more, I just want to come back around you. I think it was 3 L's, right? It was listen, learn and lean in. Right, so that you can develop the themes. Okay, great. That's just so on point and what I would hope any new leader does when they first join an organization.

So, talk to me about the digital strategy, what you presented, how you're doing with it, what the priorities are right now.

So, you know, one of the,, the great things about our organization and what I was really pleased with , is the vision of our organization.

And the vision is, to me, very simple, but really poignant and And so sort of on point with what we need to do, least from the IT perspective. And so the vision is to be the most trusted and personalized coordinated care. And I love that because, from just those words alone, you can really start to sort of distill from that, what does that translate to from a digital perspective?

And what is it that we need to do to get To create personalized engagement and personalized care. What is it we need to do to coordinate all of our services? Our 500 plus services and sites. We don't lack services. What we lack is the ability to provide a patient the specific journey for them to really care for themselves.

Right. So, so that really became our mantra and ITS and, and what we sort of, how, what My team and I hung our digital strategy around is that that very vision. And so, our priorities then became, okay, so how do we get to that, piece or that digital end point?

And, we looked at our platform and we knew we had to modernize. Our stack, we had to modernize our infrastructure, and you have to have a great foundation to build a great house or this on top of it. So, we did have a good starting point. I mean, we had our EHR and we had our ERP systems.

We had all of the core pieces. But really, I believe that any good digital capability and strategy requires the ability to harness your data. And so That was really what we were lacking was to be able to harness our data. And of course, to harness your data, you have to have infrastructure that's agile that you can rely on to have compute and capacity at any given time.

And so, we really focused on moving to the cloud. And then from moving to the cloud we really focused on creating a pathway towards developing our centralized data repository or data platform. And from that data platform not only do you have the ability to do advanced analytics and all the things that I know we'll talk about in just a minute with regards to AI, but, that becomes the source for your digital capabilities.

And so we call our central data platform, the Hartford Healthcare Data and Digital Platform, or what I'd like to abbreviate as H2D2, which I'm a Star Wars buff, so now, people at Hartford are going to realize that's what it comes from, but I thought it was kind of, cool.

A fun sounding name, but catchy. People don't forget it. but it's true to its form, which is, it really is the platform that is holding and curating keeping our most It's an important asset, our data, and then it enables our digital capabilities and our digital strategies.

So, that's really the current our current focus today and the way that we're sort of moving our organization and it's taken a good year plus to get two of our eight data centers into the cloud. And we continue to do a lot of work in moving our data, creating data liquidity and the things that are needed for digital in the future.

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Subscribe to This Week Health Conference and stay updated every Thursday.   📍 Okay, and I know you built out somewhat of a new leadership team. We did talk about that at one point. So I did get people in the right positions and starting that work. Yeah,

And that's a challenge to, as you know, you know, to get the right folks, but I also kind of, changed a little bit of the job descriptions, if you will, or, the leadership structures.

I, I felt like, there needed to be a bit of a change. Not that there's anything wrong with the traditional, ITS structure, but I, for example, created a VP of IT operations and technology platforms and that person actually owns the CTO role and the CISO role, but also, the cloud engineering role.

And so you need a special person who really can, work on the fundamentals, make sure. You're brilliant with the basics, but also still optimizing and I, we created a new role for a VP of enterprise applications and products which, at some level is akin to the traditional VP of applications role.

But the products piece was really about, looking at the assets that we have today and creating new products from them and. Working with business partners, particularly our clinical and some operational partners who are looking to develop new products and services. And so thinking about that product mindset was really critical.

Having a VP of data and digital platforms, which is akin to the analytics VP sort of the traditional team, but really this person is thinking about data products more broadly, thinking about AI thinking about how Advanced analytics can be supported. That person may not own it necessarily, we do have an organization that has distributed analytics across the enterprise, but what wasn't really solved for was the data piece, and so this individual really needed to have that skill set, but also this mindset of, data as product, and advanced data.

Analytics as a trajectory. And then the last one was digital transformation services. And so, that role is really in many ways. Connected to innovation, connected to business transformation. But really looking at how digital and data can really sort of transform the way that one works, whether you're a colleague or a consumer slash patient.

definitely a new organization and, some new Titles and roles the way you've scoped it out so that's good. I'm sure others will be interested in that, hearing how you did that. You mentioned AI. You want to talk about AI a bit? Sure, yeah. Anything that you're doing at Hartford HealthCare?

Yeah, AI is the it's like the, it's the buzzword these days, right? And \ in healthcare I think there's so much excitement we're all very excited about it, but at the same time, there's a lot of fear and and just, just unknowns, right? So I would say I'd say the first thing is that I'm so proud of our organization because we certainly didn't shy away from it but we also, out of the gate put together.

A little bit of a sort of a guidance document for our organization so that they understood, what's good, what's off limits what should you not do, sort of the, that not only the ethics behind safeties of AI, but, how do we ensure that we're, protecting our patients as well as our interests as we continue to go down this path of AI.

we've done a lot of education also across the the enterprise. And I think that's one of the things that I would encourage, others who are listening to this to continuously do. There's so many different types of AI that I think people initially were confused about, gen AI versus narrow or traditional AI.

And I think it's really important to know the difference because If you know the difference, then you can at the very least provide guidance on how to use it safely and what to use safely and what to use to actually solve some of your problems. So having said all that, focus really has been to experiment with our partners at Google, for example, and our partnership with MIT, and really, look to see how we can solve problems that are in our, organization that our patients you know, encounter, et cetera.

And actually, one of the things that we ended up, at least my team and I have ended up focusing on is are some of the, what I'll call low hanging fruit AI kind of, projects and, a lot of it has to do with the content that we already have. And what I mean by that is that, for example, in IT, we've got a lot of knowledge based articles that we've created.

We have lots of training materials that we've created. We also even have dashboards and lots of other data that we've, and developed over time. And the question that I asked my team and our partners at Google is, could we use a very sort of focused Gen AI technique called RAG which is Retrieval Augmented Generation.

You're probably familiar with it. And it's a really, in many ways, a safe way of using generative AI on specific content to allow you to search Through it in many ways in a more sophisticated way than just sort of keyword search, you can ask questions about it and, we're finding that's going to be for us a great way to sort of start using Gen AI internally.

And I can give you some examples of what we use, but, just even think about HR policies, for example, most of of our policies are unsearchable because we just don't have, good indexing, but if you throw gen AI at it and, reduce its ability to do, be too creative and just answer questions straight away.

It creates this new sort of found life to the content you've had at your fingertips for years that people either forgot about or they hadn't been able to use because they couldn't search through it. So, we're starting to use that as our kind of launching point for creating agents, if you will that leverage IoT.

Gen AI and use our content that we've delivered over the years. That makes sense.

Yeah, it makes a lot of sense. And I'm happy to see that you're trying to find ways to use it within IT, ITS, whatever you call the IT And both to learn, right, but also to have some value as a tool for folks in IT.

So I think that's a great example. I'm a little mindful of time. So, I'm trying to figure out where we want to go in our last few minutes here. I was going to ask you about your move from Bay State to Hartford. I also wanted to ask you about workforce challenges. You know what I wanted to ask you.

Which of those do you want to What do you want to cover? You want to talk about your move and differences in the roles between the organizations? You want to talk about how you are managing workforce challenges? You can cover both.

I'll do both really quick. So, I, the I love Bay State and, I was just, It was just an interesting opportunity for me to make a move to a health system that had a different environment.

Bay State was is a little bit more rural. I mean, it's, Springfield is not necessarily rural, but it's not also a big city. But, The approach to healthcare is a little different. We had a lot more population health there. It was a little more value based care focused and we didn't have a payer mix like we have it, in Hartford healthcare.

And certainly Hartford is twice the size of Baystate. So it was just an interesting opportunity for me, but I got to say my colleagues at Baystate, definitely lots of love to them and lots of good thoughts for them. But I got the great fortune of Being offered an opportunity that was really 28 miles south of me, which is really kind of unique.

And so I couldn't pass that up, but 10 years is a long time. And I probably could have been there a little bit longer if they would have had me, but, or I'm sure they would have maybe had me. I'm glad to have gotten the opportunity to make this move, and I'm looking forward to really impacting a different type of, healthcare environment.

And there's a little bit more competition down here, too. So, interesting. In terms of workforce development, I think this is really what we have been we certainly have been challenged with, not to say that my current staff isn't the right staff, but, we made quite a number of changes in a short period of time.

In terms of, our goals, right? So the organization itself was suited specifically for implementing, our EHR and technologies like that. I don't want to necessarily say cookie cutter, but you know, there's a path to that. We have eight to eight, really 10 data centers and and that's a specific skillset.

So you move everything to the cloud. you start to do things like more software type of development. DevSecOps is a big thing. Agile is a big thing for us now. But cloud in and of itself has been a big change for our organization. Mindset skill set, et cetera.

So, we've been really focused on Education virtual education partnering with Google to create education curricula. And that's been a big part of the last year and a half. I can't say it's been smooth necessarily because I think people struggle with change and on top of change, you have to, take on new skills.

But there've been there's been a lot of excitement about learning new skills particularly in cloud and AI. And even in virtual reality, if you will, and of course, 5G and, lots of other, sort of technologies coming down the pipe with connectivity, there's just a lot.

And data is another thing, right? I mean, this is truly a data transformation that we're undertaking. So, lots to learn and we're trying to, catch up with or keep up with creating curricula that's consumable by our teams without overwhelming them and providing them with time to learn, which is another part of this, because, you've got your own day job, and then you're sort of taking on more learning.

It's, it can be a challenge, but I'm hopeful that we've got folks on our team who are excited about learning. excited about bringing in other colleagues who, who know this stuff and learn from them and be elbow to elbow. So, we're continuously focusing on, uplifting and upskilling our teams.

But it's a challenge, for sure.

Yeah, that's great. One of the things I've always thought in terms of working in healthcare IT is that you're in an industry, healthcare, working with technology, and they're both constantly changing, so it is continual learning, really, for everybody. That's great. Is there anything you want to highlight before we close?

Well, you know, I do want to

say,

yeah, I mean, I'll say this one thing, and I think it's probably a topic in and of itself, but I know there's a lot of discussion about, is AI going to replace us, right? Because there's so many things that you could come up with that solve problems, but also solve challenges in the way that we work using AI.

I guess I would just say that, I don't think AI is going to replace us, but it really does. I think behoove us to learn about AI and understand what it means for us and how we work. Because I do think that the people that know AI and how it works in their jobs will replace those that don't, right?

So that, that's really the, I think the key piece here because, it is a force multiplier, no doubt about that. And we ought to, as leaders, the workforce. I really know how to harness it, so.

Right. Great point. Great point to close on, too. Joel, thank you so much. It's always a pleasure to talk to you and to learn from you.

So, thank you. My pleasure, Sue. By the way, you're the best. I gotta say, you're you are the benchmark as a CIO and I want to thank you for all your great work over these years. It's it's just a, it's always a pleasure to be with you, so thank

you. Oh, you're too kind.

Thank you so much. All right. Take care.

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