This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

 Welcome to this Week in Health It, it's Newsday. My name is Bill Russell, former healthcare CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current and engaged. Today we catch up with Sux new interim CIO for Boston Children's. We talk hybrid work trends, our vaccination stories.

And whatever else happens to come up. Special thanks to Health Lyrics WW t Intel and Sirius Healthcare, our News Day show sponsors for investing in our mission to develop the next generation of health leaders. If you wanna be a part of our mission and become a show sponsor, send an email to partner at this week in health it.com.

One last note before we get to Sue and her big news. We launched our website redesign and we'd love your feedback www dot this week, health.com. We tried to unlock the insights that we've gained from three and a half years of interviews with industry influencers, and we want to know, let us know your thoughts, design, usability, ease of finding things.

Our guest today sent over a few comments already and we appreciate it and it helps us to make the resource better for the industry. In fact, if I go to the website right now as we speak. It has a nice little search bar at the top. I'm gonna put our guest name in there and see what comes up. There we go.

Put her name in there, S Shade, and it pops up with her contributor page. It pops up with all the videos of her and, and with David months, the Wow. You've been on a lot of podcasts, about 10 or 12 podcasts, an article we highlighted. So it's, we hope we've made it easier and hope you guys, you know, find it better, but we would love your insights into what we can do to make it better.

Sue, welcome to the show. Good morning. Good morning. Hey Bill, how are you? Pretty good. Pretty good. So what's new? What's new? So as I shared with you and I shared more publicly yesterday in my blog post and on social media, two weeks ago, I started as the interim CIO at Boston Children's Hospital and we are off to the races.

This is week three and definitely ramping up. Excited to be part of this organization even though it's, uh, temporary. They're a great organization. We can get into that more. Yeah, no, absolutely. Uh, we had John Brownstein on the show and that was a phenomenal conversation. I. He was on Good Morning America.

He was on all the shows talking about the pandemic 'cause he has a epidemiologist background, so he was a fantastic interview. To get to work with him I think would be a lot of fun. Oh yeah. We've already connected and very easy to talk with and connect with. I'm looking forward to partnering and we joked about his being a, a contributor on a, B, CI watch a different channel mostly, so I see different contributors.

But yeah, he's great. Did I even get that right? What is a BBC's show? Is it Good Morning America? Yeah, I think so. Yeah. ? I think so. I think so. I think that's what he says. tv. TV. At this point, I don't know about you, but uh, we as a family are binge watching stuff, so it's. It's been Ted Lasso. The chosen has been one of the things we've watched and now we're watching Escape to the Chateau, where this British couple has bought a 45 room chateau and they're rehabbing it.

It's like the ultimate rehab show. I've That's unbelievable. Yeah. Yeah. We do the binge watching too. Absolutely. And we just finished a series the other night, so we gotta find a new one. So what, what, what are you guys binge watching during the Pandemic? We, we do a lot of Brit box. A lot of English shows and I've got a list somewhere because I've got girlfriends I talk to every Thursday night from my Michigan days.

And one of the things we do, they're all retired. They were all VPs at Trinity and it at one point, and that's how I got to know them all when I was at Michigan Medicine and. So we exchange shows. But don't ask me for the list right now. Yeah, I My phone somewhere.

Saw all the work we've done in our house. We're like, have, have you seen this show? And I'm like, oh, I've seen so many of these shows. He goes, oh, you haven't seen this one. And he, he wasn't kidding. If you're into, if you're into rehab shows for, for homes, this is the next level of that. But before we get into it, I got my first shot at a mass vaccination event.

How about you? You've, you've been vaccinated? Yep. We got the, uh, second dose last Saturday. And it's through, it was through the town and it was at. The junior high school in the gym and first dose February 27th of Moderna and second dose on March 27th. Good experience. I made some suggestions after first dose on process improvements, and they definitely took one of the suggestions.

So that was good. . Yeah, it's, it's, um, I, I, I, I wanted to of our . It was fairly big. It was by the health department out of our county, and they took over a park and tried to do the throughput, like you, like we talked about on the podcast. So we talked to uc Health, we talked to Atrium. Mm-Hmm. . But they, they partnered with significant sports teams, so they had large parking lots that they could be very creative with.

Yeah. Uh, this park, well, it's a park, right? So a lot of windy streets and those kind of things. It did not work quite as well. We ended up spending about an hour, but you know, I, to be honest with you, an hour to get the vaccine, I was really fine with it. It probably took a half hour longer than it really needed to if they thought through some things.

So hopefully before I get my second shot, they'll listen to the podcast. Some of the great things that uc Health and and Atrium have had to share. Yeah. We've talked about this before and it was a rough start to the rollout. It appeared to be hitting approximately 3 million doses a day. You know that things have improved and smoothed out and that the organizations that are doing the, uh, administration have gotten it down.

The two you mentioned, uc, health and Atrium. Great lessons learned there and, uh, great workflow and efficiencies that they've been able to accomplish. Well, early on I was on the phone with some of my clients, we're talking through it, and I asked 'em how it was going and they said, look, if, if they were to give us another.

10,000 doses, they'd be in arms already. Right. We just, they just couldn't get the, the doses and the numbers I'm looking at now there, there's almost 150 million doses in the supply chain. I mean, that are actually out and about. Yeah. And maybe not unaccounted for, not at least not in arms yet. So the supply is there and I think the health systems have really learned from each other.

New England Journal of Medicine, uh, article you shared with me, sharing best practices, I think we, I. Uh, know what we're doing. I was actually kind of surprised it was the Department of Health and some EMT people doing the vaccine in our community and not the hospitals themselves. I, I don't know. I guess that just goes to show we have a lot of health resources in communities that we can do this through.

Right. It was EMTs for us. It was Okay. Yep. It's it's interesting vaccine. Part of it was. All of a couple of minute, not even a minute to be honest with you. Came over. Right, right. The stuff I was a little disappointed, we had to, they handed us a paper to fill out once I got there and I thought, man, they, this could have been done a little better, but that Do you mean the VA little vaccination card you have or something else?

We just, you know, I registered online, we checked in, they crossed our name off. We went through the process. I didn't have to fill out anything else. I'm wondering, will my information get into an EHR anywhere, or will it be in the county registry for vaccines? What? You know, where's that? I, nobody really wanted to answer my question as you could imagine.

I wanted to ask everybody questions. They were just gonna be like, keep moving, sir. Keep moving. . That's like me, when I'm, I call myself a secret shopper when I'm CIO in a hospital and I go for care and I'm like. I having the ambulatory visit, I'm like, oh, what do you think of this, that, and the other thing.

But I'm not secret. I tell 'em who I am and then I ask how it's going. You know, I don't think it's gonna get into the, your EHR without you doing something. So I got my second dose, and then I got something sent to me that says, keep this for your records. And what I need to do now is get that over to my PCP or upload it.

Do it as an attachment to, uh, communication in the patient portal. So my PCP gets it. Yeah. So the, the little card cracks me up because now we're hearing like international travel, you're gonna have to show your information. And I, I don't think this little card is really gonna suffice. I think they're gonna look at me like, what, what'd you make that Photoshop?

What did you know? It, it just. So it, it will probably have to be a digital record of some kind that we're gonna show. And so there's a lot of movement at this point on the, you know, the vaccine credential initiative. Obviously pulling all the information together, but some sort of wallet type thing that you can show record that you have got your vaccine.

And that's an interesting thing. I understand why we need to do it. I'm just afraid how far people will take it. I'm okay with . . Essentially governments looking at it and saying, Hey, we may or may not let you in the country based on your vaccine. I'm really okay with it on certain travel and those kind of things.

I'd like everyone who gets on a cruise ship if we go on a cruise to have had the vaccine. I think when you have those kind of close quarters, it's, it's important to have the vaccine. Mm-Hmm. I'm just afraid it might get, like, who can use it? Is my concern. You know, how far do we go? Sports teams? Yeah. If you go to a major sporting event, will you have to show it?

And if you show it, will they create a section that is non-vaccinated and vaccinated? You know, that feels weird to me. I. I also am not jumping up and down about having to show it to go to see a high school event where my kid is participating in things. So I, I'm more, I'm not worried about it from a pers perspective of making it available and having it done and done well.

I'm more concerned of who's gonna use it and how they're going to use it. 'cause we don't really legislate that. I, what are your thoughts on it? You know, we have different political views in general and. You're probably more concerned about that than I am. I'm more flexible and open on how it gets used.

I saw someone tweet the other day something about what we're talking about, and they said. Have you ever tried to get your kid into a public school? Right. I mean, you have to have the vaccinations, the immunizations. So we are used to this in some places at some level, and yeah, it, you just separate it out where you'd be okay and where you might not be.

I, I hope that we take a more progressive position on this and don't let anti-vaxxers or anti-whatever. Get in the way of how we use this information. That's my opinion. Yeah. And, and we can watch other countries as well to see how it works, uh, and the results. Yeah. I, I mean, I'm, I live in a community, it's not a retirement community, but it's as close as I live in Florida, so it's all over Retirement community.

Yeah. , the, so a third of the people who own homes in our area are Canadian and they've been telling me what's going on in Canada and I thought. I wonder if that would ever fly in the United States. It's, to say it's restrictive would be an understatement on one side, on the other side, to be honest with you, it, it doesn't impact the people of money, the people with wealth.

So one of the things is if you fly into Canada as a Canadian citizen, you have to, you essentially have to quarantine at the airport in one of the hotels on your own nickel. So if you leave the country and come back, it could cost you for a family of four, an additional five grand just to quarantine for the period of time that you have to quarantine.

Mm-Hmm. And I thought that's really interesting. So I, I said something to my, one of my neighbors and I said, blah, blah, blah. And he goes, oh, I'm not doing that. I'm flying to Buffalo. I'm renting a limo. We're going across the border and I'm going to my house. And I thought, yeah. It doesn't impact people of means, it impacts people who, who don't have the means to fly into Buffalo, rent a limo to go back to Toronto.

And so it, it just gets, and I, I reserve the right to watch how people are implementing and go. That's good. I like that. I. That's over the top. 'cause I think it can be used, uh, inappropriately. Alright, let's get to some IT stories. You wanna, we'll reserve the rights, I'll reserve the right to disagree on things.

Yeah, no, absolutely. So, uh, a lot of directions we can go. I've been spending a lot of time on return, return to work. Actually. Let's talk a little bit about your Boston Children's a little bit here. 'cause there, there has been some turnover in the CIO ranks. Why in interim. How long does it take to find a new CIO at this point?

Aren't there CIOs available? , of course. There's lots of people looking for new positions, whether they are in between or interested in leaving where they are. CIO, Dan Nygren, uh, physician had been there in the 20 year range and he left, went to Maine Health. They did start the search. But when he left and they did not land a candidate, uh, a final list and an offer, and they decided that they had some internal alignment around the E-H-A-E-H-R strategy to work on, and that they were gonna bring in, uh, external interim, uh, CIO during this period to help in that space in particular, that's kind of my highest priority while the search continues.

I'm looking at the EHR strategy with them and keeping other things moving forward and supporting the search firm to find the best candidate for the future at this point. Well, how long do you think a, a healthcare organization can go without somebody sitting in the chair? Now, obviously, you know, Dan and others, we all work with our direct reports and they're really running a lot of the, the day-to-Day operation.

Is it three months? If you think you're gonna replace it in three months, you could probably not do an interim. But if it's six, nine a year, you almost needed an interim to fill that gap, I would think. Yeah. You know, let me talk broadly about interims, 'cause I've definitely been tracking this over the past year.

'cause as you know, our firm, Starbridge Advisors, one of our core businesses and services is interim management. And it slowed down during the pandemic, even though there was a whole lot of movement of CIOs around the country. What I saw was there was a lot more, take the second, the most senior person second in command, have them do the

Internal interim role and not bring someone in from the outside for the period of time. I think it was both. It's a cost saver to have internal person do it, and if that person knows the organization, let's have minimal change and let's just have, you know. That person run things during the pandemic. I think it might start changing going forward.

In the case of Boston Children's, our VP of IT operations and CTO, Scott Ogawa, who I'm talking here next too. Did serve as the interim CIO when Dan left, and because the search is taking a little longer than they thought. They wanted Scott to be able to focus on what he was focusing on before and have me as an external person come in and do some of these other things.

So I think it's very situational. Situational organization to organization and searches can take. Four or six months, they can take a year or more depending on the organization. I've seen in academics where it takes a very long time, and some of that is the search committee process, the consensus, how many people need to weigh in.

I did, I went for a position at one point several years ago that I think I interviewed with 50 people over the course of the process. And it was confidential, so I was hoping none of those 50 said anything to the organization. I was at 50, so it varies. Wow, that's, that's a . Wow. I know. That's a lot. That's a lot of people.

Yeah. Yeah, yeah. It was an academic. Yes. Yeah. And yeah, but I'll tell you that alignment's really interesting. We hired an, uh, a head of HR for our health system way back in the day. and they had 'em interview with, they'd had the candidates interview with a bunch of different people, and to be honest, there just wasn't alignment.

And so it got to be very challenging to hire, to narrow it down to the right person because you had different camps looking for different things out of the role, which is normal. But a good search firm is going to drive that alignment, I would think. Yeah. And they're working on it. I'm working on it.

Person I report, she's working on it and it's early yet. This is week three. I am in the process of. A meeting, one-on-one with key executives, all of the department chiefs, and trying to get a sense of their thinking and where they're at at this point as part of that process. Yeah, and I wasn't talking specifically about their situation, I'm just talking in general, that alignment is so key.

Okay. Hey, managers roles are changing as a result of this hybrid work and it's, there's been a lot of work done by Microsoft specifically. They've done studies of their own staff. They've done studies of 30,000 people around the world in terms of their expectations, and it looks like a handful of things are really changing as a result of this one.

One of the stories, and I talked about this in the Today Show last week, was Microsoft looked at . Let's see, a hundred and 150,000 plus of their own employees and found that the Connectness, which is a, a metric that they get from their pulse surveys had gone from 93% to 71% over a over the last six months or so, and they were like, we, we appear to be doing the right thing.

So what? Why are people feeling less connected? And one of the things they said is our data tell us that employees need us as managers to focus on the basics first. Like work-life balance and prioritization before we start to do the really fun things, like a virtual happy hour and those kind of things.

Those things accentuate it, but we have to take care of that. You know, each individual's work-life balance. How do we help them to do that in prioritizing their work? 'cause those are two of the hardest things as we've come home. You know, what are you finding as you work with, you have a fair number of people you work with at STARBRIDGE Plus.

How is that going? How are, are, are we doing a good job or are we learning a new set of skills in order to keep people connected? You know, that's a great question and it is something that I asked my folks at Boston Children's when I started, because it's all virtual. I'm virtual. Virtual into June. There is a group that's trying to figure out the return to work plan.

Apparently this group of IT folks, they call the Department of ISD. I often forget to say ISDI just say it, you know what I'm talking about. They were doing a lot of remote work before the pandemic, so they were pretty used to it, but this is going on a very long time. So I think the work-life balance issues are that much more critical and they're, this is a great survey.

I, I went over it last night. Preparation for talking today as they break down the respondents between men and women ages, married single . I think we can get into that. It's not, it's not one story for everybody in terms of how this has impacted them. The, the work from home situation and the, I mean, specifically the work life balance.

You work from your home office and it's always there. It's. You have to be able to step away from it at a certain point. Yeah. And that, that, that speaks to why managers are so important, because you could do things on a broad level, but when you have 10,000, 5,000, 10,000, 20,000, you know, employees across an entire organization, it's not one size fits all because.

Not everybody has the same background, and as you said, business leaders married, working moms, gen Z, frontline workers, uh, new employees is an interesting category. So we now have a, a group of people that have been hired post pandemic, post the start of the pandemic, and those people didn't have the, the foundation really of the, the lunches and the relationships with the staff and whatnot.

As you know, Microsoft broke that down in the survey. They found a majority are surviving or struggling in that category rather than thriving. And so the manager, we always knew that the manager was important, but in this environment, the the one-on-ones, the personal interactions between the manager to help set priorities and understand your.

Specific situation and what they can do to help your situation. I think it, it is, is so critical. Yeah, it's absolutely critical. In the, in the survey, I think one of the last things was about people being more humane and the number of people now who have seen their colleagues, dogs or kids, you know. It's just, again, back to my current experience on Tuesday, we had a.

All it staff virtual meeting basically to introduce me. They do quarterlies and they've done a quarterly in February. And I said, well, we've gotta do one. I gotta see all the, I gotta see everybody. They gotta see me and let me tell them a bit about me and what I'm gonna be focused on. And we had plenty of time for q and a, and of the q and a half of the questions were about the return to work.

Partly it's getting closer. People starting to think about it, what's it gonna mean to me? But I encouraged people as we were hearing a few different stories, talk to your manager. Make sure your manager understands your particular situation and where you're at. And there are a lot of people that wanna keep working from home, but there are, I'm sure many who it's not working so well for.

One of the other stories I sent over to you, and I'm just gonna cover the headline, which is Citigroup, CEO calls for zoom, zoom free Fridays, and to promote a better work-life balance. And this really has to come down from the top. There's a certain aspect of this that the CEOs have to do and have to be, have their.

Finger on the pulse, but as ACIO and as a, you know, potentially a VP or director within it, there are things they're looking up for. They're looking for, are we prioritizing? One of the things that came out in one of the studies was not the connective connectedness within the teams, but we're losing the connectedness across teams where they used to work closely together and come up with solutions.

Let's just spitball a little bit here, you know. What kind of things should, could managers be doing to continue to, uh, we, we talked about the individual one-on-ones. Really understanding, having the empathy and designing a, an environment that works for each employee. Mm-Hmm. . But, but let's talk about.

Actually getting work done, which I think we've done a good job of. All the indicators have been good, but maybe there's things falling through the cracks that we're not, we're just not seeing yet until we get to a little further into this. Yeah. Um, spitballing. Huh? That's just Okay. We're just throwing things out.

I know. What could managers be doing? Yeah. What could managers be doing? Well, one thing I'll say, I, I think it's a good, and it gets to the zoom free Fridays and maybe it's partly the fatigue as well, and people talk about zoom fatigue at Boston Children's, the culture is you're on camera and I think that's good.

I did work with a . But that also adds to the fatigue. But I hope, I think it helps with the connectedness and being able to read people and body language and all that kind of stuff. I did do all virtual consulting project with, uh, health system last year. They did not have everybody have to be on camera and it was hard to read the room and get to know people when I couldn't see that.

So that's, I mean, that's one thing in terms of the connectedness. You know, I, I don't have a good read on, but you said we're spitballing the team connections and the team working together. Cross teams, I think probably individual teams are working well together and it may be more of a challenge for some of that collaboration.

I, I'm thinking ahead to, I'm thinking ahead to not everybody remote work, but more hybrid situations. Because I know there's organizations that are saying we're gonna be all remote. I talked to ACIO who said, we're staying remote. We're gonna do national recruiting. We're in a hard to recruit area. Right.

You can see, again, I'll go Boston centric. Boston is a hard commute. You know, I think organizations are gonna say, wow, if we can get. Happier people, more productivity. They don't have to commute every day. They come in some days. So I think if you've got hybrid situations, you're gonna have to figure out when should which teams be in the office together for collaboration.

I. Are you stag, are you staggering teams based on social distancing and how you're gonna use space or less space? But how do you bring people back in and make sure that you enhance the collaboration that's so important? I don't know. I, I don't have the answers. I'm, I'm gonna be talking to Scott, who is our point on the return to work.

Committee. In fact, I shared the articles that you shared with me with him and the, you had a Today in Health IT podcast where you talked about this, I think on Wednesday of this week. I listened to it. I shared that with him. A lot of good, a lot of good insights from these surveys. Yeah. I'll tell you one of the things is if you didn't have that connectedness before you went virtual, you definitely don't have it today.

And one of the things I found when I, a, for. We had just insourced from, from a, a national player and the mechanisms, the processes, and the, the communication wasn't really established or solidified by the time I got there. And one of the things I found was we, but between the department heads, the VP level, they didn't know what the other VPs were doing.

And so we set up a, what I call a cadence meeting, and the first one was four hours. And what we did is we had every project from . All of it come in and present, and they had essentially 15, 10 to 15 minutes to present their project. But it was interesting. We got done that first meeting and all the VPs looked at each other like, oh my gosh, I didn't realize we were doing that.

There were so many times where they were like, wait a minute. You should be talking to. I didn't realize you had those data needs, I didn't realize you had those development needs. And after that first meeting, they looked at each other like, alright, we, we need, this needs to be a meeting that we're doing at, at some level, at least monthly, so that we know what projects are going on across the board and we can help our teams to connect.

Yeah. Yeah. And, and so. I, I still believe that even if we were all in in person, we would still have this, this silo breakdown in, in a lot of organizations. And so it needs to be intentional and now we need to do it virtually. But quite frankly, I. What I just described can be done virtually and still create that connectedness across those silos.

I totally agree. I totally agree. And in big organizations, big TE IT organizations, you may have teams spread out in different office locations, or you may have them in a huge office location and people think that's that team over there. I maybe go see them once a week. So you have those silos even when you're in the same physical.

Space. Yep. Well, Sue, happy information blocking day, by the way. Okay. Yeah, this goes live. Let me tell you it. So I'll tee this up with an article that I just pulled up. MedCity News, HHS Information blocking Rule goes into effect on Monday today, and for nearly a year, providers and IT vendors. Have been racing to prepare, but they have faced several hurdles along the way, including figuring out how to handle scenarios that could make them non-compliant.

The, the rule goes into effect, but the expansive nature of the regulation and the lack of clarity around. What could be considered information blocking is making it hard. And so they cite a couple things here. Let's see. According to John Mass, Cerner's lead regulatory strategist, this is a lawyer and Dr.

He said, and that is a whole lot of information. North Kansas City, Missouri based Cerner is looking at all the products and services that they have to determine where those pieces of information live so that when they get a request, they can pull that data in as needed. For health IT developers, requests for information can come from anywhere, clients, patients, even third party entities.

So Cerner is also working to identify where requests are coming from. Mass said they're trying to tag each request they receive, as well as how to respond to each one of those requests. The gentleman from Texas Medical Association shared a story. For example, Schneider recalled how a physician recently went to the Texas Medical Association to sort out a data conundrum.

A data conundrum. That's interesting. The doctor's office had asked a local hospital for information on the clinic's patient that were also admitted at their facility, the office request. The office requested that the hospital send the information directly or via the local health information exchange as it had a non-Epic EHR.

But the hospital's Epic system could neither coordinate with the office's EMR, nor was it set up to integrate with the local HIE resulting in a potential information blocking violation. Alright, so that's a lot of background and by the way, that last scenario that absolutely should be considered information blocking.

They're not, if they're not communicating with the, the local HIE, that's the HIE, it's designed to receive information, they put the regional HIEs in place and said, okay, how can we get everyone to share with us? And Epic has ways to share the information that is a clear indication that somebody is not intentionally not sharing information because.

All, all entities were designed to share information. So that's my personal opinion on this. Mm-Hmm. . I'll preface this by saying, uh, I have not been hearing a lot of stories on this. I have not been following this nearly as closely as I should with, uh. With CIOs. I'll probably start throwing this into the interview question on information blocking.

You know, I, I, other than what we're reading here, I don't really have a lot of color to add. Uh, are, do you have, are you hearing anything at this point? It's struggles or, or positives on, on this? I'll admit I haven't kept up on that topic in terms of information blocking and. What's expected, but in the greater scheme of things, it's about interoperability and sharing of information, and you're absolutely right.

What are the HIEs designed for? The greater good, right? And to share information and every organization's gotta do it. It's some of the challenges that we've got where I am now at Boston Children's as looking at the interoperability. When you are a children's hospital and you get a lot of referrals and you're working with all the community hospitals and the community pediatricians, you absolutely have to have that easy.

Open data exchange. Yeah. And I make this point, every time we talk about this, they may have been sitting back and saying, oh, the Biden administration's coming in. Maybe this will change. But the reality is this started under the Obama Biden administration. Yeah, yeah. And it was continued through the Trump administration.

And I think if you think of two administrations that are more different, and it continued through those administrations, I think that would lead everyone to believe. This is as bipartisan an issue as we can possibly get and this is moving forward. Yeah. You know, I think, you know, to the extent that you can conflate this with the Interoperability Rules and Cures Act, it's.

Yeah. I, I, I. You know, as, as I talk to people, there's two sides that I sort of fall in and I can be caught in, in either direction. One is it's not like you didn't have a decade of knowing that interoperability was important. So there's part of that, but I, I do empathize with the fact that there's a lot of scenarios I.

There's a ton of scenarios we have to deal with here. There's, and, and they're, they're right in saying any number of people can make a request for this information. It's not only the patient, it, it could be a third party app that gets developed on behalf of the patient that makes the request for the information.

Then we have to worry about the security mechanisms and identifying the, the authenticity of that request on behalf of the patient, those kind of things. So there's just a whole lot of complexity to get through this rule. But again, we had, it's not like we didn't have a decade, but now we actually have, let's just say we're, we're not auditing the course anymore.

We now get a grade for our course, and the grade is, are we blocking information or not? Mm-Hmm. . And it's, yeah. This is, uh, this is gonna be hard to implement. Let's see. One more story. Mm-Hmm, . So, and actually we'll probably just hit the headline here. I'm just more curious what your thought is, and this is the Kaufman Hall study.

Mm-Hmm. That said, negative operating margins likely for 39% of the hospitals this year. What does that mean for health? It, yeah. I think it means tighter budgets. Hopefully it doesn't mean layoffs and people are greatest asset in organizations, but. I think it leaders are gonna have to find more ways to reduce costs.

The, you had a interview recently with, is it William Walders? Yeah. Yeah. William Walders with, uh, health First out of Space Coast of Florida. Yeah. He didn't he talk about out, he made a commitment in terms of taking costs out and didn't he talk about application rationalization, an area. A primary for many organizations, but what he took out, he wanted to be able to keep and reinvest, right United.

And actually he, he didn't keep it all, he kept, but he kept a, a portion of it so that he could reinvest and continue to modernize the IT side of things. And that was not only the app rat side of it, he was renegotiating contracts and, yep. Almost immediately coming in as ACIO almost immediately, he was able to save millions of dollars just by renegotiating contracts.

Yeah, yeah, yeah. You know, and renegotiation contracts, I think are some of the, we wanna call them the low hanging fruit. They take a lot of work, , but when you hear about 'em, you hear about X number of instances of the same product or multiple vendors for the same product function. Really, that needs to change, and I think.

Yeah. There's opportunities there. Yeah. That's what it means for it. All this stuff is leading towards more efficiency. Mm-Hmm. for the acute care and academic medical centers that are out there. It's, it's interesting, I, and I think this gets back to one of your fa one of David, M's. Your partner's favorite topics and you know, partner of STARBRIDGE advisors and he talks about governance all the time.

We talk to. Theresa Meadows, uh, I had an interview with her and she, and one of the things she said is, I said, so projects are, are the old projects kicking off? She goes, yep, the old projects are all kicking off again. I said, all right, uh, are they asking for new projects? She said, yep, new projects are, are being asked for.

I said, what about the Covid projects? She goes, all the Covid projects have to continue. I'm like. It's like everything is in addition to, we didn't, we didn't go back to saying, all right, we're gonna put everything through governance. Do we live in the same world we live in just a year ago? And are these things still priorities?

We just kicked them all back off again, and now we've got not only the projects that we were doing, new projects that are coming down the pike, plus the Covid projects. I, I'm not sure how you could do that operating in, in negative margin territory without . Not doing things well. So I, I am, I'm concerned about that.

And the greatest asset we had, the biggest silver lining we had during Covid was focus. Mm-Hmm. . We had a, a very few things that we were doing and we did them very well. And everyone raved about isn't it amazing how much we got accomplished over that timeframe. And I think this is one of the things as leaders.

We struggle with, we say, when we, when you say yes to something, you're saying no to something else. Yeah. And when we say yes to everything, we're saying no to either effectiveness, the ability to get things done, uh, in a timely fashion or whatnot. So this really is a leadership issue. I think. I think you're right.

It was focus and it, it was decision making, quick decision making clear the obstacles, do it. One thing that I would project, or a few things I would project is gonna come out of all this is greater standardization. Reduce the variation, more, more integration within organizations The pandemic had, has had a.

Effect on the entire organization and organization. Healthcare provider organizations have had to come together to deal with that. And if that has exposed, oh gee, they do it this way, we do it this way, going forward, we're gonna do it this way. Greater standardization, reduce the variation. I think that will be coming.

And that's also . A way to reduce the costs. Yeah. One of the most important hires I made within it was a, essentially ACFO for it. They didn't have that title, but they were essentially that person. They interacted with the finance arm. But the, the thing that person did for me was to constantly be looking at, I would give 'em scenarios, like if we need to do a 10% cut next year, so we're just starting this budget year, and I would say 12 months from now, if they asked for 10% cut.

I need to know where that's gonna come from and so we could be working 12 months ahead at reducing the cost within it so that we wouldn't have to do those, those staff cuts if we didn't, didn't need to do them when that time came around. Anyway, there's so many things here. I last , I said that was the last story, but let ask you this.

Amazon care. Is this a big deal or not a big deal? Are are people in, in, in hospitals and healthcare delivery talking about this? You know, it's probably a big deal. I really am not sure, but I. Again, . I think another positive coming out of the pandemic is the level of innovation that's happening within the industry.

And I think these disruptors are gonna continue and I think that's fine and I think that provider organizations need to figure out how to work with them. And one of the stories I shared with you was kind of . Uh, what was it? Amazon here joins Coalition to Expand Home Care. 14 Other Healthcare IT notes, it was in Becker's and those notes all had a link behind them.

And most of those notes were about partnerships that provider organizations now have with big players within the healthcare ecosystem. So I think we're gonna continue to see this evolve and that's good. I'd love, I love getting your thoughts on that and you get the last word today on that, so I appreciate it, Sue.

Good luck. Alright. In your new role. Thank you. You still have the old role. You're like, you have no governance in your jobs. You just keep adding to them. Yes, I still have the Starbridge Advisor's role as a principal and the business, but my focus is full-time, interim CIO at Boston Children's. Right now, I will somehow make it all work

Yeah. Uh, I'm looking forward to seeing how it goes. That's all for this week. Don't forget to sign up for clip notes. Hit the website, big subscribe button in the top right hand corner. Special thanks to our sponsors, our channel sponsors VMware. Hillrom Starbridge Advisors, McAfee and Aruba Networks for choosing to invest in developing the next generation of health leaders.

This show is a production of this week in Health It. Check out the website this week, health.com or our YouTube channel. Don't forget to check back three days a week for new shows. And don't forget, we launched a new show today in Health It our daily show that explores one new story each day. Thanks for listening.

That's all for now.