CHIME Erica Williams, A Look Back / Forward
Episode 1602nd December 2019 • This Week Health: Conference • This Week Health
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 Welcome to this Week in Health IT events where we amplify great ideas with interviews from the floor. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcasts and videos dedicated to developing the next generation of health leaders. We wanna thank our founding channel sponsors who make this content possible, health Lyrics and VMware if you wanna be a part of our mission to develop health leaders.

Go to this week, health.com/sponsor for more information. This episode is sponsored by Health Lyrics. When I became ACIO, I was really overwhelmed at first, and one of the first things I did was to sign ACIO Coach . To walk with me through the journey. This was someone who had wisdom that can only be gained through years of experience.

d them to take a look back at:

Uh, you're gonna hear, um, what they're excited to have accomplished last year and what they're looking forward to accomplish next year. I asked each of them the same eight questions, and I think you're gonna be fascinated to hear the similarities and the differences based on where they're at, geography and other things.

Each of these interviews is about 10 minutes long, so you can listen to 'em really quick, and some of you listen at one and a half times speed, so it's gonna go like that. Uh, we're gonna publish one a day, uh, with a few Newsday episodes sprinkled in through the end of November. So check back every day for the next episode, and don't forget to look back to see if you missed any.

In our next conversation, I get to sit down with Erica Williams, who is the Chief Information Officer for our CHS in the Southwest market. And the thing I like about this conversation is it gives us a very different perspective. She is over a lot of, or she works with a lot of hospital hospitals, which are in rural markets, so different perspective.

Hope you enjoy. So we're here again from, uh, from Chime, fall Forum with another one of our CIO interviews, um, with Erica Williams, with, uh, CHS out of Austin. Yes. I'm based in Austin, uh, the market, CIO for Texas Market, CIO for Texas. How many hospitals in Texas? I have 11 in Texas and also supporting three in New Mexico.

Mexico. Okay. So that's that's a lot. Yes. , um, a lot of travel involved there or? Yes. And it, everyone is rural so there's not . It's not easy to just fly somewhere. There's a lot of, a lot of driving. So Austin is the most central. So it made sense for me to be there, to get everywhere easily. And I, my daughter's now going to Baylor and mm-Hmm.

uh, you know, we flew into Dallas and drove. Right. There's a lot of space between, between cities. Yes. And it's space. It is space. I mean, that's the best way to say it. Yes. When I was touring the hospital for the first time, I've been in my role for about a year. And, um, it was, I had some interesting stories of cattle in the road and, um, just in, in

Getting to the different hospitals. That was great. Alright, so what we're doing is we're, we're sort of, uh, eight questions. We're looking back, we're looking forward and um, uh, you know, one of the first things we we're asking people, you're new in this role for CHS, but Right. Um, how have you seen the role in the CIO change maybe over the last 12 months?

Over the last 12 months? I don't think, um, you know, macro level, I haven't seen a whole lot of change. It continues to be more and more integrated with . The business. So there's very little that, um, the business wants to do from a strategy perspective where it isn't there helping them get there. So I don't think there's been any major changes, just continuous, um, you know, relationship need and building there with business partners.

That's, that's correct. What, what, what are some of the, so what we've been asking is what, you know, what are three priorities that your health system has for next year? That health IT is gonna support? Our initiatives right now are really about, um, strength. Our foundation. So we're looking at, you know, getting our network a software defined wan and, um, you know, it, it's our clinician experience obviously is our biggest impact and where, where we can make that impact.

Um, getting our clinician experience so we can impact the patient experience. Um, on top of that is also looking at solutions like unified communication as a service and, um, Finn clients all really simplifying it. and also looking at ways to impact the clinician. So most of your, most of your hospitals are in rural areas.

Mm-Hmm. . Yeah. So I understand why you're talking about the network. That's, that's one of the, 'cause we were in some rural locations as well and you know, do doing your network build out in Southern California very easy. Right? But when you start to get into, you know, you get into places where there aren't as many carrier choices and there aren't as many, uh, services.

It, it does, that is a, uh, challenge. Does, does that impact? Uh, does that impact the clinicians? Uh, significantly. Well, yes. So the biggest problem that we have is, um, the last mile is shared. We have two circuits. Yeah, we have two different vendors, but still at the last mile of the hospital, it's the same, right?

So you have that, uh, one point of failure at risk. So the software defined WAN will give us the opportunity to reduce cost of having one circuit, and then give us the, the ability to leverage using, um, broadband and then . Tertiary, LTE and cellular. Yeah. So you have no out, essentially what you're trying to do is mitigate outages, right?

Yeah, absolutely. That's, that's the biggest impact from a, a network perspective is there's no network, there's no systems, and then, you know, we have to start there. It, it's, it's interesting because with all this talk of, you know, the CIO's roles being elevated, it's about the business, it's about this and whatever.

Every now and then, I'll say to somebody, yeah, but if your network doesn't work, you get fired . It's like you still have to have the data centers to run. The network has to run. The systems obviously keep running and that's, that's still foundational to the CIO role. Right. Um, you know, what's one initiative that you believe will materially impact the patient experience in the communities that you serve?

One initiative that we worked on this year, uh, community Health, is working with . To make the patient record available in Apple Health. Oh, okay. Which was huge. I mean, even as me as a patient, I was extremely excited to be able to have access to my own healthcare record because I mean, I, I believe, and I think that's where we're headed, is to have the patient to be the custodian of their own information.

So that was, I think, probably the biggest patient impact, um, that, that we had from a, a large scale. That's fantastic. Um, one, uh, one initiative that's gonna materially impact . Or has it materially impacted the, uh, clinician experience? The, our thin client, we recently in one of my hospitals piloted for the organization, the thin client environment.

So that's tackling both the clinician experience and also tackling the issue of lifecycle management. Right? Right. So, um, we have about a a hundred devices within focusing on the nursing areas and the physician areas, giving them, um, you know, they're not having to wait on a, a PC to reboot. They have a standardized view.

They, they . Don't log onto one PC on the second floor or the fourth floor. It looks the same. They can tap in, tap out, and, um, that, that one is one that's going to expand. So we started it this year and we'll expand it out next year. I, I don't think people recognize that, you know, when you have those, uh, those thick clients, you're, you have to upgrade 'em every three years or they're just not, I mean, three years is about, about the edge, right?

But in four years, they're too slow for those environments. But with, uh, thin clients. And you're building out that, that infrastructure really in the data center, right? The lifecycle. I mean, we, we increased our lifecycle to, uh, seven years, but I don't know if that was gonna work or not. , we were gonna find out, right?

I mean, that's, um, that's what we hear. The thin clients will have a, a longer lifespan, but we'll see. But the idea of just being able to easily swap it out, there's no really set up. You just kind of plug and play. So it's easier for our technicians to support. It does require a higher level of support, you know, from a cis admin perspective.

our health IT team has had in:

Oh, okay. Prior to me coming into, uh, the Texas market, each of my hospitals functioned completely in . Independent. And, um, so we had the, a corporate it, and then we had independent silos of it at each hospital that didn't really work together. So my, um, my goal this year, and we'll continue to expand on that, is creating a shared services market model support.

stic. Um, what's one thing in:

I don't know that it's a missed opportunity, but more, um, coming into this role and, and as I, as I mentioned, trying to build a market support level. It's really been, and, and with our initiatives being focused on the foundation, it's really been on the technical side, as I mentioned, on, on the, the text and the, the CIS admins and the, um, the help desk support.

So I wanted, as . Well, to bring in to those, the clinicians, the clinical informaticists as well. And a again, they're kind of siloed in my market still, so wanting to pull them in and I started that, but we have a lot more opportunity there. That's fantastic. Um, what's one area you'd like to see more innovation?

If, if the, if the health industry were to move things forward, what's one area they're like, I really wish we'd moved the needle there. Well, I think the consumer isn't that I talked about of, of the healthcare records being more available and, and having . Our consumers being their own custodian. And I talked about that a little bit, but another initiative that I worked on in my previous life was, uh, around real time locating and there's, we found some extreme patient, um, you know, experience benefits, but the cost.

So the infrastructure is just so prohibitive of being able to do those sort of things. And we did hand hygiene, which we made significant impacts on, uh, infection rates, you know, asset management, helping our clinicians, and also the cost benefit for that behavioral health rounding. There's so, so much that we could do to leverage the workflow of, of our clinicians and just what they do.

And it's just really the infrastructure to do that is really costly. Um, sorry, I'm just gonna have to ask a follow on question for that. So we're using, uh, like BLE. Using like Bluetooth low energy or what we were using? Um, rf. rf, okay. Mm-Hmm. . Okay. That explains, yeah. So Bluetooth, you know, is, you know, a, a possibility.

Haven't worked with that yet, but, um, finding ways for us to, in, within the healthcare area, being able to, to be able to capture those kind of timestamps and, and workflow pieces. But I, I understand what you're saying. There's a lot of value. You, you, um, you know, RFID, you can track the movement of the patients

You can, uh, identify bottlenecks within the, the system, right? You, uh, finding devices that are stuck in closets that you didn't know actually had someone's hidden somewhere. Yeah. Um, but RFID was, uh, uh, just a little cost prohibitive for doing that. It's extremely costly. Yeah, it's interesting. Yeah. I'd, I'd love to see, uh, progress in that.

Um, so, uh, you know, we did a survey of our listeners and one of the questions they want me to start asking CIOs is, uh, uh, what health IT roles do you . Expect to be hiring in the next year. It's gonna be, as I mentioned, with some of the lifecycle management and some of the projects that I mentioned. It's those higher level, it's gonna be, well, it's kind of a mix.

It's, it's that first year support at the service desk, um, and also the cis admins and network engineers for, for where we are as an organization. Okay. Yeah, I mean, the thing I love about . Um, this conversation is when you, uh, yeah. So we had Cedars on the show. Mm-Hmm. completely, you know, Southern California, different, uh, kind of thing.

Um, and I've talked to some, uh, small health system CIOs like, well, nobody will get anything out of it. I'm like, no, there's an awful lot of . Health systems that aren't talking about, you know, Hey, we're gonna do artificial intelligence in this way. Right. They're waiting for the industry to sort of do it and then they'll bring it into their system.

Mm-Hmm. . Um, 'cause they don't have the money to make those kind of betts Mm-Hmm. that could potentially pan out or not. Right. Um, but there's an awful lot of hospitals that are sitting there going, but. How can I attract my PA patients better? How can I engage them better in the community? How can I create a healthier community?

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