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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 gained through years of experience.

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 time 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.

I love the work that Geisinger Health is doing, uh, with regard to population health around genomics and other things. And I'm, I was excited to get the opportunity to sit down with John Kravitz, the, uh, CCIO for Geisinger Health. Uh, we have a, uh, wide ranging conversation and I really enjoyed it. I hope you enjoy as well.

Alright, so here we are, another session from the uh, chime fall forum. And we're here with John Kravitz, the CIO, for um, GEIS Geiser. And, uh, welcome to the show. This is your first time on the show. It is. Thank you. I'd love to have you on more often 'cause I, some of the things that Geisinger's doing is so fascinating to me, especially in the area of population health and, and the articles I've read because of your population in Western Pennsylvania.

Mm-Hmm. , you're able to do, uh, what do we call it? Generational medicine almost. We do, we, we actually . Uh, we do a lot of genomics medicine, so currently we've gen genetically sequenced over 200,000 patients, pop people, uh, in our area. A lot of that has helped us considerably in that, um, it helps in, in diagnosis for certain disease conditions that are not easy to diagnose, uh, and also helps with prevention, uh, or early, uh, detection of certain cancerous, uh, diseases that may have, and, and examples are for the female population, bro.

One, breast cancer or cervical cancer, uh, BRCA one, BRCA two genes that are, have a high prevalence, a very high prevalence of becoming, you know, a certain form of cancer, whether it's breast or ovarian cancer. Um, so that's, that's, uh, helped a lot of people who did not know they were susceptible to that.

Also, prostate and other types of cancers. Um, so yes. I think what's important though is, um, we utilize genetics and genomic data as part of our, um, our environment to support the care of medicine for our patients. Yeah. I was, I was, uh, have you gotten rid of the waiting room yet? No, that was Dr. Feinberg. It was Dr.

Feer. Your former CEO said, you know, we wanna get rid of the Yeah, we're . Actually we have a plan. And so the plan for that is part of our digital strategy that we are now, um, just about to get board approval to proceed with. Um, and a lot of that will be using technology to support that, that plan to make the patient's, uh, focus, that the focus all around our customer, whether that's in our health system as a patient or our health.

Plan as a subscriber. And we do have crossover, not a hundred percent, but about 40% of our health plan subscribers get care in our health system. So for those people, we can really do some phenomenal work, and that's helped a lot. I am, I am, I'm pulling for you guys. I'm cheering for you. I wanna see the waiting rooms go, go away.

Yes. But, uh, I, I want get to the questions. Sure. Those were pent up questions that I wanted, wanted to ask you. No problem. Um, so over the last, uh, 12 months, how have you felt the, the role of the CIO change in any way? I am starting to get a feeling, um, at least over the last 12 months that the, the CIO needs to be part of the c-suite.

Yeah. Um, because the strategic direction that the organization's going has to be enabled by technology to support that. Uh, if we don't have that technology in place, it's hard to move the organization forward. And if, and if you think about this or talk to any CIO . What in healthcare or other industries can you do without technology?

Practically nothing, right? 'cause everything's embedded with technology, whether it's IoT devices, medical devices, in the in, in the facility, electronic health record, every touch point uses technology. So, um. I think them, the CIO of the future must be heavily engaged and drive the business forward. Don't wait, don't sit back and be told what to do as if you're in the back office, the back room.

That's not what the CIO needs to do for the future. They need to be part of that group and really drive it forward, really informing the change. Uh, and you may have touched on one of these already, but, uh, what are three priorities that the health system has that height? Health it is gonna be asked to, to support next year?

Well, I'd say I, I did elude on this, on digital strategy is so important for us. Um, and actually part of that digital strategy is bringing together things like a customer relationship management module. Uh, and for us it's skinning down the IT stack, if you will. What I mean by that is minimize the number of applications because we have too many best of breed applications or one-off applications that may have a very small number of users and

Those applications cost money to support, keep them compliant, disaster recovery, all those components plus, you know, the, the personnel behind it to support them. So one of the things that we need to do is continually look at reducing that application and standardizing on a singular platform where if possible, um, the other thing is, uh, the movement of the cloud.

So at this point in time, 28% of our . Applications are hosted in the cloud, in private clouds, we're looking at public cloud. That's, you like the only CI know that if I ask that question, you could say 28%. Yeah. So you, so you're tracking it. This is a goal. We're tracking it. Yeah. And, and we, our goal would be to eventually, you know, LDAP enabled applications to be able to be moved to the cloud for security purposes and everything else.

Um, we'd be at a point where probably around 70% of our applications would reside in the cloud. There'll always be those large applications that will have a presence both at the edge and in the cloud. Yeah. I'll give you an example. We're we're working on a vendor neutral archive for all of our archiving solutions.

So things like a radiology PAC solution would be in the archive. Uh, but when you look at the volume of those images, your MRIs, your CT scans are so large that. It would take so long to pull them down outta the cloud. It would be prohibitive to our workflow for our clinicians. Right. And slow the process down.

So we'll have to have an edge solution as well as a cloud-based solution for that. And there'll be other instances like that, that we'll have to closely engineer them so that we can have maximum performance, low latency, and provide the service at the lowest possible cost. Yep. So. You guys have a health plan, are you the We do.

Is it separated? No, I'm Ccio O for everything. Cio o for the health plan. That's great. My parents are on the Inger Health Plan. They, they rave about it, so. Oh good. It must be a good health plan. Well, they must be in Geisinger Gold. 'cause that's, that is, that's really the premium, uh, where they don't have to, I don't know if it's still run or not, but they, they don't have to.

Pay out-of-pocket expenses for anything. They, yeah. It's really good for retired people. It's wonderful. And they, they came out to California, had had an incident and they kept receiving a bill and the, the people from SER said, don't worry about it. Right. And they made the phone calls and they got the bill straightened out.

You actually have coverage for a hundred thousand dollars. Wow. Just through that plan. If you're traveling, you know, different places, it's covered. We're not trying to do commercial for Geisinger Health. It's. Um, so, uh, one initiative that's gonna materially impact the patient experience next year that you think it's the digital strategy.

Hands down, it's every touch point where the customer's involved. And again, for us being integrated delivery network, whether it's a subscriber or the hospital patient, it's making it very streamlined and frictionless access to their information. So . Give you an example. Part of what we wanna do as part of our digital strategy is to have, uh, patient identification through facial recognition.

I don't want to have to use other biometrics. I'm gonna use someone's face. And as they walk in the building, there'll be cameras mounted when they come in the door. We're going to that zero waiting room. Right. That's the plan is, is having a device that can, that can function as a kiosk. It's, it may be an iPad or a Surface, you know, bolted to a desk.

They just walk up, picks up their, and it identifies them, and it, it, it acknowledges what the appointments are, they're here for, to move 'em through the process. I say actually as you're talking about that I, I'm reminded of, I walked into a conversation that you and Chad were having around this. Yes, yes.

And, and you guys started going back and forth and by the time you were done, I was really excited about the future. I mean, it's, well, Chad's a really bright young man, um, and he, he comes with a strong technology background. He's also a very good friend and colleague, so I really appreciate and respect working with him.

Yeah, absolutely. Well, I promise you, you have the chime shirt on, I promise you, 10 minutes or less. So we got, we got about three minutes here. Okay. What, what's one thing you're gonna do to materially impact the clinician experience? We continuously work with our clinicians. I round with my CMIO and Chief Nursing Information officer as well.

Uh, we are very tightly engaged with clinicians. We have teams of nursing informaticists and physician informaticists as well that are, that all report up through the IT pillar and uh, and this group that really is very closely engaged. So we continue to work to improve, uh, components of our EHR. And analytics is a big factor for us.

We really distinguish ourselves. We're, 'cause we're moving everything back. We were the third Epic customer in the country for 23 years now. We've been on Epic. But, uh, we've had to customize because we didn't have . Have all the modules that are now available in the foundation system. So we are implementing those to streamline our processes, clean up best of breed, and uh, and really leverage analytics instead of customization within the application.

It's analytics with ETL capability. Extract the data, transform the data, reload the data back into the system. Fantastic. Are you gonna get the quarterly updates, do you think, or? Oh, yes. Well, well, right now we do 'em every six months. Okay. We may not go to quarterly only because it'll be continuing . Is churn, right.

So, uh, the six month interval, we've done two of those so far. Just did one this past weekend and put up another new module, grand Central from Epic. Um, and had good results because we use RTLS too. Real time location system for our patients and equipment and providers. Yeah. So that's all integrated into our new Grand Central application.

So it's pretty sweet. Fantastic. Uh, what's the thing you're most proud of that your IT team was able to accomplish this year? I think, uh, we've done a good job on the IT team within our environment to support our customers. Customers with ServiceNow platform for service management solution. Um, we've, we've rolled out a lot of those applications with an IT asset management, uh, tracking.

We have end-to-end automation, right to our vendor, which is HP for a lot of this work. Um, and we can acknowledge, we have another vendor that does work with us to support endpoint. So everything's barcode, barcode, barcode, it's all seamless workflow all the way through without touching it, making mistakes, and it's, it's, uh, improved our turnaround time to five days for a new piece of equipment.

It's back on the desktop and replaced. So it's streamlined things considerably. Two questions in one minute. Here we go. Um, area, area in it, you'd like to see the industry, uh, you'd like to see innovation, um, you'd like to see more innovation within the industry? Well, um, analytics are important. Uh, we do a lot with analytics, but we also, I think an area of innovation would be most helpful.

For it would be ambient voice. Yeah. So the ability to take physician's hands off keyboards, still using CDI and clinical assisted coding, uh, with voice recognition, deciphering and separating the voice of the, the patient versus the physician or the patient, the caregiver and the physician. Focusing on only the physician notes.

We already do natural language processing. That's been around for a long time, so we create those notes, but to make 'em actionable so they don't have to go back and change any coding or anything else as part of that process. We'll be a game changer. I know a lot of places are working on it, but they haven't cracked it yet.

No. And that, that will be exciting when we get there. And then the last question, we did a, a survey of our listeners and they wanted me to ask CIOs this question, which was, what roles do you expect they anticipate you'll be hiring next year? Well, um, so our roles in it, we, we have an enterprise architecture team, which helps us out immensely.

It's not just the network architecture or systems architecture, but it's, they span all areas of the organization. So, . Whenever a new request comes in for a new system or, um, customization to a process, the enterprise architect team is very much engaged. I could see that expansion continuing. Uh, the deployment supports as well, and our project management team, very important as part of an IT governance process too, because.

Too much, too many, uh, expenses. Keep trying to creep into it with requests for new systems. Um, and we are very careful about that and we try to minimize those as much as possible to keep our budgets in check. Well, John, I appreciate your time. Anybody welcome with that many ribbons on their badge means they're very busy at this conference.

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