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 Thanks for joining us on this week in Health IT Influence. My name is Bill Russell, former Healthcare CIO for 16 hospital system and creator of this week in Health IT a channel dedicated to keeping Health IT staff current and engaged. Today we have BJ Moore joining us with Providence Health. He is the CIO amongst other things and we always have interesting conversations and I think you're gonna get a lot out of this one as well.

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And now onto today's show. So today we are joined by BJ Moore, the CIO for Providence and, and much more. bj, welcome back to the show. Thanks, bill. Always great to be here. Appreciate it. Yeah, I'm looking forward to the conversation. Yeah. So you are more than ACIO these days. We were talking just prior to coming on the air that you've, you've taken on some, some additional operational, uh, roles and capabilities.

Uh, talk a little bit about that and then I'm gonna come back and get into some of the questions I sent over. Yeah, absolutely. So yeah, back in August two changes happened. One, I. Now report directly to our CEO Rod Hockman. So that's great being part of the, you know, direct executive leadership team and deeply engaged with the board and our sponsor so that, that elevation in the CIO roles, kinda the, the holy grail for for IT leaders.

But in addition, I also took on the real estate facilities for Providence, and so all of the hospitals and clinics and the operations of those now roll up into me as well. The ideas are synergies, you know, the, the feature isn't just IT and tech separate from real estate facilities, right? Those lines are blurring more and more.

And so, you know, maybe that's something we can dive into now or dive into later. You're, yeah. It's, you know, it is, it's interesting you were the. Third, CIO I've spoken to this week who has taken on operational capabilities. Now, there's a whole host that have gone in the digital direction, have taken on digital roles, but the, the operational role really makes a lot of sense to me when I think about it.

I mean, as ACIO you have to understand and know things at such a deep level. And then digital really changes the way we, we view certain things, doesn't it? . Yeah, absolutely. And, you know, as it relates to, to digital and facilities, right? It's, it's two things. One, it's the workforce of the future, right? The planning people at a, at a desk.

So smart buildings, you know, how do we, you know, do things in more of a green way? How do we leverage our facilities, you know, with greater capacity? And a lot of that's gonna be, you know, through technology as well. So. I'm excited. You know, when I took over the role, I, I pre predicted though, if we were the first, there would be many other companies that followed because I think, um, those lines of digital versus physical are being, being blurred for sure.

Carbon negatives. That's the, that's the first I heard that. That's pretty, that's a pretty aggressive goal. It is, it is. And as I've reminded, you know, carbon neutral is a goal. And then if you can just be one unit negative, you, you're officially carbon negative. And so it's, it's, it's more aspirational, but it's not that much more aspirational than being carbon neutral.

Yeah. And you, you were sharing a story, we were talking earlier of just how being head of facilities and someone says, Hey, more beds. Yeah. Really look at that. Very different. Let's plow under some trees and let's put up another building. Yeah. A year ago, a thousand new beds would've immediately conjured up a new hospital.

And a new hospital is a five to 10 year endeavor and a billion plus dollars. And then, you know, speaking, sticking with the green theme, yeah, it would be tearing down trees and, and building a new building. And obviously a lot of carbon goes into a building, you know, covid is proven care can be digital.

And so I think when you talk about a thousand beds. That may be physical, but really here at Providence, we think a thousand beds can really be virtual, right? That care at home. So a real example, at one point in time we had a thousand covid patients we sent home and we're, we were managing and monitoring them remotely.

And for those patients, they received fantastic care. And as an individual, if . If you weren't acutely ill and you had the choice of staying in a hospital bed or going home to your own bed, I think most of us would choose to go home and be in our own bed. Yeah. So in that case, they got great care and from our perspective, it freed up a hospital bed for more acute patients that did require hospitalization.

So simple example of how things are becoming more and more digital and uh, really where at Providence were, you know. Yeah. The taking digital beds as being the future. Yeah. I it you guys, uh, you guys really are leading the way in, in, in a lot of different areas. We had, uh, Amy on as well. Your chief medical officer.

She shared Fantastic. Yeah. She shared some just fantastic things that you're doing there. We've, we talked to Matt. From your, uh, digital team and they produce some really interesting materials as well. I mean, you just have so many resources available to you that we are looking to organizations of your size, scale, scope to sort of lead the way and, and set the tone.

But before we get there, , I get in trouble all the time because my listeners have asked me to start each show by asking the guests to tell a little bit about their health system. So tell us, tell us a little bit about Providence. So Providence is one of the largest health systems here in the United States.

We've got caregivers in basically the Western United States.

During Covid, we received the first Covid patient in the United States on January 20th that came into our, our Everett Hospital. And I'm happy to say we successfully cared for and, and, and cured that, that individual. And so, you know, as it relates to Covid, Providence was at the forefront, you know, receiving the first patient.

So that's it. A quick background on Providence. I could go on and on. Yeah, we, we could go on for a while, but let's, you know, I don't usually do this, but I can go in so many different directions with you. What, what are two or three things that you wanna make sure we talk about today that you're, you're excited about, that you're working on?

I, we've touched a little bit upon it. You know, we're in this, this covid world, but what's been important to us is how do we. Obviously serve our communities and, and, and respond to the pandemic, but how do we continue with our strategic betts, right? We couldn't just, it wasn't binary. It wasn't do one or the other.

It was continue our strategic betts while responding to the pandemic. And then the other one is how do we evolve healthcare? How do we. You know, there's been some positives that have come out of covid, like telehealth, like virtual care, like, you know, care delivery at home. How do we, how do we maintain those gains and accelerate it?

And so those are, those are two topics near and dear to my heart. And be good to, to cover those. Yeah. And one of the things I loved about working at St. Joe's, which is now part of Providence, was the, what was the presence of the sisters. And so, especially in a time like this. You know, there's limited vaccine no matter what market we go to.

Right. So there there's that challenge of Yep. Of taking that constrained resource and distributing it effectively. You wanna vaccinate as many people as possible. Yep. But I, I, I try to communicate this to people. It just, the, the sisters would be there and say. Always, what are we doing for the, the marginalized?

What are we doing for the disenfranchised? What are we doing for, and they, they would always bring the conversation back there. So it was always top of mind at health. Talk about, talk about that experience a. . Yeah. I mean that's different from coming from Microsoft. You know, that's one of the things that attracted me to Providence is, is that mission and that mission is to serve our underserved community, the poor and vulnerable, and so yeah, that the sisters are always that driving force, right?

You sometimes get involved in internal politics or. Administration or back office things, and the sisters are always there to remind you, Hey, it's, it's not only about the patients, but it's about our underserved communities and, and how, what are we doing to, you know, bring them to the forefront? And Covid was no different.

You know, how do, how do we have these emerging technologies like telehealth and make sure we're including these, you know, poor and vulnerable communities and not creating a digital divide? And so they're. Social conscious, and they're always there to, to remind us, you know, why, why we're here and what our purpose is.

Let's head. Some of this is, are the topics that you've given me, some of 'em are things I'm reading. So you, you did the, the significant Microsoft deal, I think it was a 10 year deal, is that correct? It was a five year, five year deal. Five year? Yep. Alright, so, so you've already been outdone because, uh, Kaiser did a 10 year deal with Microsoft.

Yep. I don't, I don't know if that's a better thing. Worse thing. Five years feels like a good horizon. So long enough to get things done. But you're not locked in for, for a decade, right? I Exactly. Decade's. A long time in the technology world, you have to be careful with 10 year betts, you know? Why was that important for Providence, that the Microsoft deal?

And so teams, that whole collaborative environment proved invaluable as we sent all of our caregivers home. . So boy, if we, we hadn't done that. I can only imagine where we would've been as a health system, you know, the hodgepodge of solutions we had just wanna work. So, so we, yeah. Obviously we didn't know the pandemic was coming, but that, that paid off more strategically.

How it paid off is, you know, during the pandemic, if you remember early on PPE ventilators, you know, were really in short supply. We didn't know if we'd have enough ICU beds. And so projecting surges were invaluable. We were about halfway through our journey, moving our on-premise data to the cloud, you know, Azure's data lake.

And because we had that data there and accelerated in Covid, we were able to use machine learning and artificial intelligence to predict. Where we needed more PPE, where we needed ventilators, where are the ICU surges? And we reached a point by probably May or June that we were able to predict with about 85% accuracy, two weeks ahead, where things were gonna be okay.

We're anticipating in two weeks things are gonna get better here in the northwest. We think in two weeks. . Things are gonna surge in Southern California. And so with that insight, we were able to move resources and assets and these, you know, precious items like PPE around to serve those communities. And so that, that was a strategic bet that that proved invaluable.

So I'd say Microsoft 365 and then the ML AI models that we are able to do for Stack gives you. So many more capabilities than you would've had on a traditional healthcare stack. Yeah, I mean, all of the innovation is happening in the cloud, whether it's it's healthcare or traditional companies, you know, like an ERP or ACRM vendor.

Everybody is doing the innovation in the cloud. And so if we hadn't moved to the cloud, embraced the cloud, these advanced compute capabilities just wouldn't have been there. You know, if we were, all of our data was locked on premise, we would've been, you know, stuck with traditional analytic models versus, you know, machine learning and AI really only can be done at scale, and that can only be down in the cloud.

Will will that end up being your, your IoT platform for hospital at home and those kind of initiatives? Yeah, absolutely. You know, the scale that we need, the volume of data that we need. When we talk about big data, you know, when I arrived here, our data warehouse was about 70 terabytes. We would call that big data, but it's 70 terabytes.

That's just not big data. Right? Big data's majored and, and petabytes are exabytes, and you're not gonna have exabytes of storage on premise. And so yeah, when you talk about IoT and streaming, you know, activity and heart rates and all these things. It'll all be into the cloud. And then when you're talking about that volume of information, human beings aren't gonna be able to run a query and say, Hey, how's Bill Russell doing today?

It looks like his temperature spiking, right? It's gonna be machine learning or AI bot that's monitoring your health and, and, you know, giving out instructions or actions for, for n nurses or caregivers to, to respond. So you, your, if I'm. That platform is gonna be real time. It's gonna be an an operational data store, as well as a, as well as analysis data store as well.

Yeah, I mean it's gotta be, you know, so we're moving, we're in epic shop, so our epic data will be in an Azure data lake and we'll have, you know, some latency on patient information. But as it relates to IoT and streaming, that's gotta be real time. And then the monitoring of that, it's gotta be real time.

So use my example of, of the thousand covid patients we sent home, the timing, we didn't have IoT set up, this is where we're going. Right. You would have a . A temperature monitor on you, and, and if your temperature changed, you'd want some bot monitoring your temp real time and alerting a, a nurse, right?

It's only valuable if it's real time. It can't be, Hey, yesterday at noon, you know, bill Russell's, you know, temperature spiked at 1 0 2, and the doctor's like, oh, I wish I would've known. I would've intervened. Right Soon as you get that IoT signal. It would reach out to a caregiver and say, Hey, Bill's temperature changed.

You know, set up a telehealth, you know, pinging, um, see, see, see if there's some intervention we need to take. I, I think that some people have this misnomer that, uh, we're not gonna be able to do high transactional kinds of things in the cloud, but the reality is. It's the only place that can be done. Yeah.

I, I mean, if you're gonna do the, the AI and the, the machine learning stacks Yeah. Are gonna be in the, in the. Um, yeah, I mean, I mean, you look at what Google does or Facebook does or any social media platform, right? They're, they're getting telemetry from all their users interacting with the, the platform real time, and their algorithms and models are responding to that.

So it's that precedent already exists, right? They're working with exabytes of data and in near real time able to respond to that so that. That compute capability that's used, you know, for good or bad in social platforms can be used for good in, in health systems. And it's the only place, you know, we can do that level of scale.

And as you know, burnout for our caregivers is one of the biggest issues. The last thing I can do is ask a caregiver, oh, by the way, every hour run a query to see how Bill Russell's doing. Like it just aren't gonna have the time to do it. So we're gonna have to have these proactive models that that monitor and then alert.

You know, in real time to, to take action. So, you know, every now and then I'll get an email from one of my old employees, which are now your employees, . Oh, no, don't tell me any bad news, bill. Only tell me the good news. No, but I, I understand. You're, you're finally taking the St. Joe's marketplace to, to Epic, so that, that's a Meditech shop, and you're gonna take all those, all those sites.

Over to Epic. Is it, it, I mean, what, what, what's the thought process behind it? Just to finally get everything on the, on the same platform? Yeah. I mean, it's been the vision, right? Like, like I said, we're primarily an epic shop. Epic's a good, good EHR. As you know, St. Joe's is on Meditech and, and Allscripts and old versions of those platforms, not even the modern version.

So yeah, in the, in the spring, we'll bring our Southern California. Uh, ministries and, and clinics on Epic in Northern California in October, and then March of next year, we'll bring Texas on and we'll have all of our, all 51 hospitals, all thousand clinics, all on Epic, to the best of my knowledge, will be the largest epic single instance in the world.

And yeah, just having all of our patients and caregivers on a single EHR just just makes sense. So you have to walk and chew gum. We're moving to the cloud, we're doing machine learning, ai, we're setting up IoT Hospital at home. And oh, by the way, we still have to make sure that these internal systems are, you know, current.

Yeah. And , you gotta have an anchor, right? And, and the anchor for our electronic health records will be epic. And so having that single source of the truth then allows us to hang off the IoT data, the streaming data, the, you know, big data that we get, otherwise, . You know, you're putting hodgepodge on top of hodgepodge.

I'm not sure what that would look like. No, no. Just, just for clarity, when you say. Epic is your anchor. You mean like, like you, you're grounding not anchor, like weighing you down . Right? Just, I just wanna be clear. Yes, yes. Epic is a good partner with ours, so I don't want to be disparaging anchor from, yeah.

Does a good job of capturing core. Electronic health record data. But you know, back to my 70 terabyte information, like 70 terabytes may be epic data, but you know, an exabyte is gonna be image data, DNA IoT streaming and that won't be an epic that'll be all adjacent sitting on the cloud. Yeah, no, I just, I just wanna be clear, 'cause team will pull out like quotes for social media and when pull out.

I and they attribute to.

You know, let's, let's talk about the, you know, you talked about, you know, it strategic betts and those kinds of things. Yeah. And obviously one of the strategic betts is here, but I, I saw some business things as well. So you guys have, have either spun out, I, I, I, I'm not sure I got this right, but essentially you've taken capabilities, you had internal, you spun them into a different organization and now they're delivering services not only for you, but externally as well.

Is that close? Yeah. You know, you mentioned earlier the, the sisters and making sure we're under serving those underserved communities. I'm happy to say, you know, last year we, we delivered almost $2 billion in services, you know, free health services to those poor and vulnerable communities, and the only way that can happen is by us.

Being healthy financially. And so yeah, we look at businesses like a service business that has higher margins. How do we, you know, we have aspirations to build a billion dollar service, uh, business that's called Teria. And so yeah, we add various assets like Blue Tree. We pull that, put under that for-Profit company, that for-profit company rolls into Providence.

And yeah, that goal is to, to, to grow that into a billion dollar services business. And then the profitability that we get from that helps, you know, fund our overall operations and helps us get back to the community. Yeah. And, and you got, you got that right. Yeah, so that's, it's, it's uh, it's epic GoLive and implementations.

It's me. You also had a Meditech Yeah, Meditech shop as well. So serving some of those rural communities. We're starting to look at Rev cycle services. How do we optimize our own rev cycle services? But is that ABPO service that we can provide to other health systems as well? So we're, we're looking multi multifaceted.

So that has its own CEO and you now deal with them as sort of a vendor at this point. I, you know, Providence, as you know, is a, a complex system. I think we've got 200 legal entities, I would think of it as just another legal entity. And so they're on our corporate network and on our Microsoft 365. So I don't see, we're not really a vendor to them, right?

They're really just, you know, we provide shared services to them like everybody else. The professional services they provide, . To it or, or my organization certainly is more of a vendor relationship where they'll come in and we'll pay for those services, but the goal is for them to sell services to other health systems.

That's how we generate, you know, free cash flow and, and really bring profitability to Providence versus left pocket, right pocket, you know? Yeah. More services they do for me, we're just moving, moving cash around the same entity. Right. And, and they've really been doing this for years. I mean, they're, they've been, they have been.

Yeah. So it's nice to have a brand or, you know, you can refer to and it's easier to say, Hey, here's Tegra, you know, potentially this billion dollar services business versus Yeah. Referring to the, the sub-brands. So, so let's talk about working with the innovation team. You guys have one of the more well known innovation teams in the healthcare space and.

Sarah and Aaron and, and everyone over there, over, over the years, you know, they have a stable of companies and initiatives. They're, they're working on, you have an IT operation that you need to run. How do the two come together? I mean, how do you know? They have a, they have a portfolio of companies that aren't necessarily Providence companies.

Correct. Uh, you know, how do, how do you work with them on that? Yeah, so Aaron Martin is a peer of mine. I think of him as the, the consumer facing or, or patient front door. So anything that's marketing, uh, website patient engagement. Patient scheduling is kind of that front office component Aaron and his team does as it integrates into things like Epic.

And then obviously the core is infrastructure my team owns, and so there's pretty clear lines of of division there. Overall, the, the partnership is good, you know, they. They do invest in companies. What's also super interesting is they'll incubate companies like Zelt, you know, where we'll be their first and best customer, and then they'll get spun out to be a separate entity.

And so we're, we're also adopters of those. You know, I use Zel as an example. They're one of the partners we used during the Covid crisis to do some really compelling things. So overall, yeah. It's, it's, you know, like any partnership, there's, there can be tension, but overall it's, it's a strong partnership and the lines of division are, are pretty clean and clear.

Yeah. You know, it's, it's, it's, it's, it's interesting to me just to ask the question and I'm not digging for anything. I'm more curious because all these innovation arms are very. Like if I went, yeah, I mean yours and maybe Jefferson's looked similar and maybe UPMC looks similar, but if I go down to Cedars, it looks a little different.

And if I go over to Yeah. Uh, and they're, they're all a little different. And the, some of the CIOs will say, you know, I sort of feel a little pressure. Here and, and, or I've had to give away some of this that I'd really like to have. Yeah. And, and so anyway, I'm just, I'm more asking the question outta, outta curiosity of how Yeah, I, I, I, I would look on the other side of the coin.

As you know, as an IT leader, we're encumbered with a lot of technical debt and baggage. And so if you've got an innovation team that that needs to deal with network availability and outages and cyber and technical debt moving to the cloud. It's tough to prioritize. Do we do this cool new innovative thing or I got a cyber attack going on and you know you're gonna do cyber.

And so innovation takes a backseat. So by separating us and saying, Hey Aaron, you get to work on, on innovation where BJ's stuck dealing with cyber attacks. It creates this nice division where Aaron. Knows I have his back and I'm working on a, on a cyber attack, and so I can take care of that. And it really frees his team up to focus on innovation.

Yeah. To wear both hats. Innovation is always gonna get the short end of the stick, and I don't think you, you innovate in the way that you can if they're separate. Yeah. And I, I love their approach. I, I love the fact that they're talking to the consumer. They're getting feedback. I love the different, their approach.

Exceptional. And I, and I've seen that at, at other systems. I've seen Jefferson bring in Yeah. Uh, consumer and patient groups as, as well. And every model has its pros and cons. Right. If there was an obvious right answer, everybody would be doing it the same way. So it's, yep. Depends on the maturity of the org, the goals, the objectives they're trying to achieve, how much technical debt they do or don't have.

Number of factors spare.

Uh, just from sheer size, you just have to have a fair amount. Yeah. Yeah. We did. We, you and I talked cloud and we talked, follow the sun support in our, in our first interview an.

Yeah. So, you know, US health systems by definition are 24 by seven operations. But being in the US you end up, what I found when I came into healthcare, we're trying to staff it with US-based workforce. So, you know, a year ago we had the foresight to set up a a Providence team in India. It was our first

International company at Providence, so they're sitting in Hyderabad. One of the things they're doing is that 24 by seven coverage network operations, cyber operations, and it's fantastic. Yeah. We're, you know, hospitals are, are 24 by seven operations, but there's less activity three in the morning and the US then.

You know, seven o'clock, you know, on a, on a Friday, uh, evening when, you know, maybe the ER is, is getting full. So having that 24 by seven coverage is, is not only helpful, but allows you to do some impactful things, you know, on off hours where minimize, minimizing the impact to operations. So and so have, have you expanded that then?

Are they, are they doing patches, are they doing that kind of work as well? Yeah, yeah. And I don't wanna minimize the team. So we're up to 300 caregivers now in, in India. 24 by seven coverage is one of them. But you know, the other reason we added that team there is it didn't have a strong engineering muscle.

So we're building an engineering, uh, team there. You know, we're doing a lot of healthcare analytics and business intelligence in India. It wasn't an outsource strategy, so we didn't take a function we were doing here in the US and, and move it to India. We really filled in the gaps that we weren't doing and couldn't afford to do.

So as we added attrition here in the us, you know, I, I took that instead of backfilling it in the us you know, I used that to fund these roles in, in India. But yeah, it's 24 by seven coverage. It's engineering. Some of our services business will do outta India. So that'll give us more, more scale from a service delivery perspective.

Wow. That's amazing. And, and that does of India. It's opposite from a timeframe depending on, yeah. Here on the West coast, depending on, you know, daylight savings, it's 12 and a half hours time zone difference. Yeah. So did you have to fly over there last year or did you forego that last year? I did. I flew over there.

You've been in healthcare for a couple years. Yeah. And you know what? You can and can't say. The thing I appreciated about your first interview is I don't think you knew what you can or couldn't say. Yeah. And you were, you were kind of freewheeling. It kind of, you know, what has been the most rewarding coming.

From literally decades in, in, in high tech. Yeah. The most rewarding is, is crystal clear what the mission is of Providence. Right. Giving back to our community, serving our patients, serving the poor and vulnerable. So having that connection to, to mission as. You know, super rewarding the fact that healthcare is so far behind.

You know, I, I estimated, I think in our first interview, and it proved to be accurate, we were about 15 or 20 years behind. And so accelerating the digital transformation, having that impact, getting the feedback from, from patients and caregivers, I've received more, you know, love emails, you know, my last two years than I.

You know, probably 27 years at Microsoft. And so I feel like I have a, a real impact and, and really making a difference. So I think, you know, the both are, are exciting. Can, can, can you move as making a difference and a difference that counts. Can, can you move as fast as you did it at Microsoft? We are moving much faster.

Wow. And not only did we deliver more change in 12 months than I ever saw Microsoft adopt, but there was less pushback. There was less noise. I mean, people, I mean we, we moved a lot of cheese all at once. By, by necessity because of the pandemic, right? Yeah. Sending people home, adopting teams, you know, new password policy.

Great. So you guys aren't 15 years be behind anymore, so No, and, and you know, if in a year from now, not only will we not be 15 or 20 years behind, we'll be caught up or even ahead of others, right? A year from now we'll be on a single instance of Epic, we'll be on Oracle Cloud. So we'll have a single ERP single HR system, uh, single supply chain system in the cloud, right?

How many $25 billion companies can say they are . On an ERP cloud solution, a single one end to end. You know, we may be the only ones of, of this scale, so yeah, we're, we're, we're catching up and, and passing people, which is, which is exciting. So this, this was part of your story coming in. You had taken this, this organization within Microsoft, and you had taken the entire thing to the cloud.

Correct. Do, do you still suspect that you're gonna be able to do that Pretty much across the board in healthcare? Yeah, obviously there's workloads that need to stay in a, in a hospital or ministry, you know, can't afford internet outages, you know, given the, the criticality. But from a volume and cost perspective, about 98% I.

We'll say 95 plus percent, we'll be able to move to the cloud successfully. The other thing that's been a gift in moving to the cloud is, is kind of like the house that you lived in for 30 years. You know, the things in the attic and garage you thought you needed until you moved, you decided you didn't really need that stuff.

Yeah. We're retiring 50 to 60% of the applications. We are determining, you know what, that's not being used anymore. We can consolidate that or we can archive that. So we're, you know, as we move outta data centers and we've now moved out two of our six data centers, we've retired 60% of the apps in, in those data centers.

That's amazing. Well, and I'm also looking at this, this IRIS foundation for Epic. And you know, if I'm reading this correctly, I mean it's essentially a. So they're able to really re-architect the entire Epic platform. You could actually see at least Dr. Go into the cloud, if not. If not full blown production of that.

Yeah, I mean, the partnership with Epic and Microsoft has been good on this front. Our existing Epic instances actually could move to Azure now, and we're in the month of March. We'll have two instances. Two of our legacy instances of Epic. Well, one Legacy and one Dr. Environment. In, in Azure. The reason we don't move our production instance to Azure is, as you pointed out earlier, when we move, you know, St.

Joseph to to Epic, it'll go from being able to fit on Azure to being too big. But we think we're 12 to 18 months away where the volume, the, um, virtual machines on Azure will be big enough. We'll be able to move our, our epic in instances there, both primary as well as Dr. If, if, if you can share it. What, what's been the biggest challenge or the thing that you didn't expect that has, that has been a struggle as it relates to moving Epic or just overall?

Oh, no. Moving into the CIO role. Moving into, into healthcare. It's the tech debt. I mean it's across the board. It's everything from our PBX, our, our networks, you know, local area networks, our wireless number of applications. You know, we have 4,000, had 4,000 applications here at Providence. You know, Microsoft, a trillion dollar company doing business and.

200 countries only had a thousand applications. Right. And so that's, that's been the challenge. You know, how do you, how do you keep the day-to-Day operations running? How do you simplify that environment? How do you retire and migrate folks off of legacy systems and still innovate? That's, that's been by far the biggest challenge.

Yeah. It, it, and I don't think, you know, and, and I, I gave some of this to you. I mean, we had a hospital that was on a 20 some odd year old PBX. And we were buying That was one more modern ones. Bill . Yeah. Well, we were buying parts off of eBay to keep that thing running and people are like, really? That's a hospital system.

You're running that way. It's like, yeah. I, I, I, I can't explain it, but there's just so much tech that. You have, you have to, you have to bite it in chunks. You can't take it all on. And those things like PBXs that just work until they don't, were easily forgotten. Right? And so you tell executive management, you've got a 20 year old PBX, and they're like, I haven't had a single phone issue.

Like, you know, why should I worry about it? You and I know you're one motherboard failure away from that whole thing coming down. And, and if you can't find that motherboard on, on eBay right. For 20 year old PBX, like, what does that mean? So, yeah. Well, yeah. Obviously we need to take care of those things and, and it's important when we are, but as you take care of that 20 year old PBX system, you're not, you know, doing IoT and big data because you

The bandwidth right.

The company that, that provides your, your PBX is called Nortel. Go find them on the internet . Exactly, exactly. Yeah. You hire, you hire, you know, young and career kids and Yeah, they're like, what's this Nortel thing you're talking about? Yeah. It doesn't exist. So, Hey, bj, it's always great to, uh, catch up with you.

Thanks for, uh, for coming on. Do you guys, do you guys have these backgrounds provided to you? Because Amy Compton Phillips also came on a very nice providence background as. Yep. It's something my team and the branding team partnered on. So we have it here in WebEx or in, uh, zoom. And we also have 'em for, uh, teams.

And so yeah, why not? You know, we've got the, the, the backgrounds that come with those great tools, but why not have a, a Providence branding go with it as well. Oh, absolutely. You know, one time I asked somebody, I'm like, what? You know what's really behind there? They took it off and he was actually in his garage.

He's like, it's the only quiet place in the house. He goes, but with the background, you don't know. I'm in the garage. I'm like, yeah, I understand. Well, I'm at work right now, but I'm social distancing. Nobody else is here, so I have an office myself. Well, hey again, I appreciate it. Thanks. What a great discussion.

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