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 Welcome to this week in Health It where we amplify great thinking to Propel Healthcare Forward. My name is Bill Russell Healthcare, CIO, coach and creator of this week in Health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders. This episode in every episode since we started the CVID 19 series has been sponsored by Sirius Healthcare.

Now we're exiting in that series, and Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts during the crisis and beyond. Today I am excited to have a returning guest, David Butler, Dr. David Butler, CEO of Calyx Partners joining us.

David, welcome back to the show. Thanks, bill. Um, glad to be back. It's been what, Maybe three, seven. I don't even know how many months this covid thing puts us in a new term war, so, well, when, when was, uh, when was UGM last year? Oh, UGM That's right. It was August. So it's been August since August, right? Yeah.

Wow. I we will have to remedy this going forward. It, it, it is been too long between the, uh, last time we talked. Definitely. Definitely. Yeah. And the last time you were talking about, it was after the conference, so you still had your bell bottoms on and those kind of things. , I was rocking the bell bottoms.

And just to be on note, just so you know, those are very underrated. Tell my wife anyway. We'll talk out line. How are they underrated? Are they're comfortable to wear? They look good. Oh. Oh no, I, I thought, honestly, I thought in my twenties I was all Mr. Oh, I hate the seventies. The seventies was terrible.

They had, the Nova came out in the seventies and all that. But as I become older. I realized seventies was the bomb in meaning in a colloquial sense, but those bell bottoms, I thought, you know, like the things they say, come around and come around. I thought they hit a tangent. But no, they came back and I'm rocking.

That's all I wanna say, bill. . Here's the best thing about having you on the show, is I, I, I don't think I smile this much through most of the shows that I do, so I, my job is to try to catch you off guard, just so you know. Okay. If we talk about tech. Okay, cool. I know tech, tech, we all know, we know tech, but this world needs now a little bit of humor.

I, there my thought. That is true. We are gonna hit some topics we're we will talk epic, we're going to talk burnout, diversity consulting. You and I are gonna compare notes on our consulting practice and maybe that'll help some consultants who are trying to figure this world out right now. But I wanna start with Epic.

You are one of my sources for what is going on at Epic these days. What's new at Epic? So what have you, what have you got for us? Epic. What's new at Epic? This was the first year that I actually did not attend the users group meeting. In 17 years. Yeah. Yeah. It's been 17 years. First time I didn't attend, it was virtual.

A lot of things were going on, so I wasn't able to attend Epic Tech. The telehealth boom, what they're doing with telehealth, I. Everybody had to move into that space. Epic continues to double down. The things I keep hearing from clients that call me, they wanna know more about man, just keeping up with the every three month upgrade, every three month patches that that epic kind of requires.

Now, uh, I think that seems to be taxing those, uh, companies a little bit more than possibly. Uh, they care for them to be taxing. But I heard a bunch of people doubling up, uh, because of Covid. They doubled up and it did. Essentially two, two patches this fall. Yeah. And, and they seem to be going, that seems to be working.

Is there any chance that people can start to take that kind of schedule as one every six months? Yeah, I think so. And I think, and Epic's really good about learning from their clients and listen to their clients. Maybe not so much the other side of the industry, and that's just facts or whatever that is.

So I think that's one thing that as the clients are doing and they're giving feedback what they can and can't do, I think that's, you see, I also know that Epic is also now because of the telehealth boom, everything, they're trying to get into end user training, remote end user training, because that's also a challenge.

Of some organizations training these new physicians coming outta residence or coming into their organization doing this thing. These classroom training sessions that we normally would have doctors do eight hours of training of this before you can get your password. Those are the things that are no longer acceptable.

And converting a traditional trainer who knows classroom training to something virtual is really difficult, very daunting. And that's part of some services that I would, I was offering called CREA Remote, EHR assistance. The first thing is the TE is to tr make sure that folks that are traditional teachers, now they have to do it virtually.

It's a lot to that. That's a big leap. So soft skills are tend to be very important at that time. I'll just leave it at that. Yeah. Not just the technology or when somebody raises their hand and say, why do you do this? Well just do that or, but I have printing issues that's not training inside that little virtual space.

So there's a lot of things there, but I believe they're gonna target that service. I think it's called end user. US end user training services that these are services Epic is now starting to offer. So it seem that they seem to be diversifying some things as well. You think that's coming out of the arch collaborative that they've seen how important training is and they're just beefing that stuff up?

Absolutely, absolutely. The arch collaborative is just, I think, invaluable to any organization that wanna understand like how, what are. What are the frontline users really feeling as far as the burn from the EHR technology, uh, and physician burnout out, things like that. And we can talk about that. So yeah, I'm, I'm, I hope they're listening to the Arts Collaborative, which I'm almost sure they are.

Very good. Taylor and Carl and those team, the upper level, epic, they seem to have pretty good relationships, so I'm almost sure they are. But what I just worry about is, is the. It's like you're training somebody on Outlook and every organization has probably put in Outlook or Microsoft differently. They may not have full teams integration or they may not have things like that O 365.

They may not, they may still have O 365 here, but over here they have the traditional. Outlook over here. So I think that could be the biggest obstacle that I've seen over and over with remote training, because everyone's epic is a bit different over the years. It has started coming into that whole something of the ui, the UX user interface and user experience has been better, but it is very difficult to understand.

How do you. Teach a client how to admit a patient online if you're epic. Epic doesn't see patients in Verona. That's, they're, they make the software, they have the experience. So those are all processes that, uh, I know I've run into when trying to create services and I'm pretty close to clients and all that.

So those are things I'm sure they'll overcome. But right now I believe they're gonna focus only for their foundation system. Folks who didn't change too much. Is what the word on the street is. Yeah. So talk. So, uh, recently, I think within the last two weeks, so Microsoft Teams integration. Yeah. Uh, into Epic.

So that can be the front end video. I, I'm not sure where that fits to be honest with you. I, I look at it and I go, epic has a, a pretty good integration and, and front end, which I'm not. I, when I saw it at first, uh, people were making hay about it and I'm like, it's interesting to me, but I just. I don't know that if I'm deploying it, but here's the thing.

I bought Epic, so I have their stuff and I bought Microsoft teams, so I have that as well. I don't know, maybe there's something there in terms of I own the license. Yeah. You know what you, you're spot on. So I'm gonna tell you a little story. It's gonna take one minute. You cut me off when I get too long when I like to tell stories.

So I've been in this, I've been in this space a long time, and that's when the GoToMeeting came out. Oh, it just, it was clean, easy to use and all that. But folks had already purchased Microsoft, so Microsoft's net meeting was a thing. I get to Texas Children's where I had, uh, over a 180 positions that I need to communicate with effectively about implementation, implementing Epic software for going from paper to, uh, the pixels, I'll call it.

Right? Microsoft was a partner at Texas Children's, and I saw they had something called SharePoint. I would always hear about SharePoint at Epic's users groups. When other clients were talking about how they implement it, they always talk about this thing called SharePoint, how they would put things on SharePoints and folks would collaborate.

I didn't know what it really was until I got section and I realized, oh my gosh, SharePoint is probably something we could use to collaborate. Internally securely, right? 'cause it's just free, quote unquote with Microsoft products. That's when Microsoft, I invited Microsoft to come in and help us to, because they were saying at the time like, look, we don't want to just be Microsoft Word, Excel, this and that.

We want to, we wanna make lemonade with you guys. Help us. We wanna be able to something more than that. Great. You invite 'em in. I say, okay, there's something called Zinc's Health. You may remember Zinc's Health, the order set. They create order sets and all that, and the biggest challenge was you can create 'em online, but they couldn't import in to Epic.

And also physicians weren't always going out there and updating and things like that. Long story short, invited Microsoft in to say, Hey, this is what we're trying to do. We're trying to create something where we're, before we go live six months, the physicians can collaborate and create orders, sets, vote on things, and just on a a, on a site that's asynchronous.

Right. And overall, we worked a long time but it just didn't work. And I think at the time it's 'cause they didn't have a healthcare vertical. Now good. The , four years later when I get there, same thing now they move from communicator, office communicator for presence indication to something called link.

Link was their presence indicator. I, I hated Link , but maybe your experience was better than that. No, I think a lot. I think a lot of folks did too. That's why we don't hear it about it too much anymore and it. By itself. It tried to replace instant message, but wanted to do other things. Licensing was weird.

From Link comes, they purchase Skype. Okay, need, need. I say more about Skype. I'll leave that there. . That wasn't a good integration. So long story short, now we evolved to Teams. Finally. The Slack killer, right Teams is awesome. It really is. And anyway, but during that whole time I described, that was a 10 year period till we get the teams integration this year.

Well, all that time healthcare clients have had time to figure out how to. Purchase things like whether it's Twilio, whether it's uh, video, whether it's these other kind of Adobe Connect to do healthcare visits and things like that. They've had the time, they had time to integrate with Teladoc and all this.

So now teams is going, wow, if this was out when we needed it. So I think they, I think they're behind the curve a little bit, so they're gonna have to catch up. But I do see is some clients that may not be able to afford it, or if it works seamlessly, then they could replace something that they may have purchased.

But I just don't feel like clients have that. I don't feel like clients have that the luxury right now to start playing. Yeah. Here's, here's my view of Microsoft. Somebody asked me, I, I made the point that Microsoft's a big healthcare player and they're gonna continue to be a big healthcare player. And one of the, one of the people said, oh yeah, what about Amalga?

And I'm like, how do you think they'll do based on what they did in Amalga? And my point is Microsoft is one of those companies that evolve slowly, but they evolve. You could look at Vista and say, oh man, they've lost all that market share in the operating system. No, they didn't lose any market share.

They just got better and better and better. Exactly. Yeah. I would not, I, I don't discount Microsoft at all. I remember when I visited the arresting, it was like in 20 11, 20 12, I worked with some of their . Healthcare guys, and we visited Resting, and I saw the cloud, I saw quote unquote the tour of that place.

And that's when, uh, bells went off, okay, this thing is about to get real. And so Microsoft's definitely gonna be a player in this game. And I wouldn't count 'em out either. And I just feel like they don't, they may not have the, the subject matter experts around healthcare. I spoke with a colleague of mine who.

One large system that I think Microsoft was trying to get in with the cloud game there and Epic and the cloud game, that's the game. The cloud Microsoft Dynamics, some of those things, if they can figure out the sweet spot with clients, 'cause they're already in, they already got paying a lot of money for certain things, but they're not leveraging the correct way.

I feel like that's what they're maybe missing is. Understanding how healthcare systems work so that they can then deliver the right packaged up tools together. Yeah, that Epic did it with Healthy Planet, healthy Planets is nothing but a lot of 80% of old Epic stuff repackaged and added 20% new in my opinion.

So , Microsoft. You know, for me really was the Bill Gates era, and then you had the Steve Ballmer era, and now you have the, the Satcha era. And they're really three different companies. And this company that Satcha is leading is very responsive and doing some really, uh, yeah, really interesting things. And, and by the way, I mean, we had a, a podcast guest from Cone Health on, and they talked about, they did failover for a full week.

On Epic, on Azure, and I think they're, they're one of the first ones to do that. And so that tells us that it is possible to run it on Azure. It tells us, and I asked him about performance. All right, so you went from on-prem to Azure. How did your physicians experience that? And he goes, they didn't know it was fine.

And I'm like, that is the biggest compliment you can ever hear from a physician around technology if they don't know and they do their job. Beautiful. Our, that naturally gets us into the next conversation, which is burnout. And I'll, I'll just start with scale of one to 10, how are we doing? 10 being physicians are still completely fried.

One being, Hey, we've gotten to where we need to get to. I think, I think they're, they're around. I think it probably ratcheted up two points, whatever their score was before Covid, you ratchet that up two points. So Covid itself, that's an important distinction. We, we've got a, there's a covid factor that increased.

Uh, I mean, it increased my stress level. Probably increased Yours, definitely everyone by two points just across the board. Mm-Hmm, . But how much is, uh, is, are we getting better with technology at this point? Uh, with regard to the physician burnout? I think we are, but what we're still not good at, we still haven't gotten great at is the integration of technology and the right workflow.

Uh, we were barely doing that when they, we were in clinic settings, and right now I'm gonna focus on the ambulatory primary care type providers. These are the doctors that went into to medicine. See patients, look at you in the eye, examine the bellies and all that. This was my practice. I loved it. And if you were to say, Hey, you can work from home one to two weeks remotely.

I'm like, oh, cool. That'd be awesome. But this, you're going in your fifth and six months because, okay. Those are the ones that I worry about to be quite honest, and these are my colleagues that I talk to every, all week. When I talk to 'em, like, man, this is crazy. We're still, I may, they actually may turn me into a telehealth doc.

I think that's what's going on. The friction to deliver care has gone up and they, I don't really feel like they're realizing it, why they're snapping at their spouses, why they're like maybe being more curt with patients or things like that in this environment. And it's, a lot of times it's due to that lack of routine and sitting at the same spot for 25 patients in a row.

And, uh, it's just what it is. So I feel like those are the type of things. They don't have the nurse that they can go in or the practice manager or things like that, or your colleagues just to chitchat with the decompress. Talk about a patient easily. You can type all day, but as you, this is very easy. Now, if I had to type all everything I'm saying right now, that would take a lot of energy and a lot of editing, and so I think that's what's going on.

Yeah, I, it's interesting the, uh, the impact of this on we, we've gotta remember that people are still people. They could be doctors, they could be nurses, they could be, thank you for saying that. Thank you. Yes. There, it could be you and I, it's interesting. My wife identified that probably one day every two weeks.

I, I have a, a bout with depression. It's not depressed and clinically whatever. It's just, I can't get work done. I'm, I'm just like. I, and I'm an introvert, but I still need a fair amount of people and I'm not interacting with as many people as I used to. Yeah, and you're doing this every week. You're talking to people interacting.

Why Bill? I mean, this is so great. No, because right now there's a, I read a really good article, I'll send it to you. It was about Zoom. Just Zoom or any kind of technology like that. They have to maximize lossless technology, right? Like. Certain facial nuances are are removed like this. And also you're three, two dimensional.

I can't look over here and talk to you just when I'm looking here. I'm not looking in that camera. I know that, but I wanna look at your face. I don't wanna look at this camera that doesn't, not gonna have a flip out there, but I don't. But those are the type of things I feel that are wearing on us over and over.

And then without the pop-off vows of say, restaurants or going to a nice dinner, relaxing, seeing past people talking, looking. Just me and my wife always have a game. What do you think They do? Silly stuff. like, oh yeah, that's, that's my game at the airport. I just sit there. Yeah. Yeah. I have my laptop going and I peek up over and I'm like, eh, I wonder what they're about.

Yeah, exactly. So I'm an extrovert, so this has really been hard on me. I also know, I think I'm really good with insight and I, I've talked with therapists and stuff like that too, and I think every doctor should, if you don't talk to a, and we're the, it is really difficult. My wife has almost convinced me you need to talk to someone i's like, why?

You're like, you're not motivated to do the stuff you used to do. And I'm like, yeah, I'm good. I just don't feel like it. What do you do? I can, as an intelligent person. Those are the toughest to diagnose with depression and dementia. The higher your iq, the better you can come up with. Coming up with reasons why you act the way you do.

Two weeks ago was National Physician Suicide Awareness Day. So just, I was telling folks just remember to reach out to your doctors and say, Hey, thanks for doing a good job. And try not to complain too much, but I feel we're all here, right? ? Well, we, we did a, we did a show early on in the Covid series and it was actually one of the first shows we did, and it was about how Covid was gonna impact people from a mental health standpoint.

And the company that came on talked about that they're offering, uh, to health systems for free. To their clinical network and I, I hope a lot of health systems them up on that. And I hope that's part of the benefits that systems are, are. Offering at this point. Yeah, I hope so too. I hope so too. Yeah. Uh, you're doing some work in diversity, right?

Yeah. You know what? Just probably two or three months ago, Amy, uh, Patricia Dykes is the president, Dr. Dr. Dykes at Harvard. Harvard. She's the president of Amy. And, uh, she's just sent out that just commitment to say, look at the processes that they use to diversify their ideas. And I like to say ideas because.

You can't diversify ideas with the same type of people in the room and the same type of people, then that leads to diversity, equity, inclusion. So diversity is just saying how do we make sure we have a pipeline of really cool? How do we make sure that we have structures set up so that we make sure we're not accidentally missing groups of people?

So yeah, with the task, it's a task force called diverse inclusion. Uh, task force is headed by Tiffany Bright, really bright, uh, PhD. She's worked for IBM Watson now. She's really doing a good job with that. And, uh, so we meet and we have three or four objective. We have a 30 day, 90 day, and one 20 day, and they seem to be serious about it.

We know AMIA is traditionally, in my opinion, Amy has always been the white academic informatics place. But that's my opinion. And the real question is that factual. And so data shows us, like everything else we do in in healthcare, let's look at the data and then let the data talk. So I think that's really what we're about.

Now we're just trying to say what does the membership look like? Do they attend meetings? What does the meeting content, when we put on meetings, do we actually make sure that there's some. Is relevant to everyone that we may have missed because we maybe had certain these homogenous ideas in the room as we reviewed the, the presentation content, things like that.

Yeah. So we're doing it like that. Really cool work. I think we're gonna come out with some cool things about it. I'm, I, I applaud Amy for even I attempting this, but it's a good thing to do. I'm a huge believer that you have to have. Uh, conversations, right? So we have to have really constructive dialogue.

And so my hesitation in having this, uh, on the podcast is the cancel culture's there, and I think it's stifling some of the conversation. Like you and I could have a, I, I know I, I have some dumb ideas in my head, . I know that to be a fact. I would like to be able to say something, have somebody go, Hey. Bill you, I, I understand where you're coming from, but you might want to check that fact.

You might want to check how you're, but yeah, what happens is somebody goes boycott his podcast. No one should listen to this ever again. Yeah, exactly. The cancel culture is outta control on certain issues. I'll admit that I said it, Dave Butler said it, but there's just some things I think that I always, and I have to always reflect on myself.

I was born in a small town, raised in a small town. We, vacation was a time of year, not a location. I'm gonna say that again. Okay. vacation was the time of year, it was summer. I grew up very country, small town Texas, like 30 miles from Waco, 60 miles from College Station, an hour and a half from Dallas. Why the mere fact, I have to say Waco and no one knows where Waco is.

That tells you how small it is. Well, now they know where Waco is 'cause of Chip and Diana and my daughter goes to Baylor, so yes. Ah, Baylor. Yeah. So yeah, Baylor Barrens, that was the team we rooted for. And then a and MI went to Texas a and m, so goodbye Baylor. Sorry, bill . Okay, so . So I grew up in small town Texas where we knew this side, blacks look white, whatever.

So these are the things that I think as I had to progress through predominantly pwi, I predominantly white institutions or whatever it was, things that you just got used to, you just knew what it was. And, and my mom was just like, work hard, be smart, and they'll have to invite you to the table, whatever they, whoever.

And the history is just history. Every country. Every country, every great nation, whatever, has some negative parts of their history. I think about my own self, my own, somebody asked me to write my history. Write your history, Dave, so that , there are large blocks I would skip if I was writing my history. Yes, I know I would not.

So my point, like every, everything. America's a great nation. We know it. No doubt. African Americans I've talked to, we're not trying to go anywhere or anything like that, and I can only speak for black African American professionals that I interact with right now. We're all very proud of this country, but we also, as a race, we just have to also identify our own history so that we could avoid it.

And so it's almost like the saying, whatever you love. You should be able to criticize, you should be able to have constructive conversations about right. In a safe way. But right now, I think it's, uh, it's that that framework of safe conversation is a bit disruptive or has been made to be political and it's not.

Because what I know is like for every silly Facebook post that I see from some of my friends from undergrad or wherever, I, I know that when I talk to them, if I see 'em in person, we could totally have a beer. Yeah, like individually, we are cool, we're per great, but when the herd mentality takes over, it's laughable.

And I think that's the human nature though. I think the tribalism and all these books have come out on this stuff, and I think it's as simple, but as complicated as that. This is a human issue. Yeah. I grew up in a steel town and I, I grew up on the working side of that and I, I sort of, the steel towns grew up basically based on when people were immigrating into the country.

And there was a, a significant Puerto Rican population that came into, uh, this steel town when I was growing up. I literally was maybe one of five out of 30 that wasn't essentially either first or second generation. In this country. So I grew up with that. But it doesn't mean that I, you know, I am completely enlightened and understand, can you really appreciate somebody else's journey?

I. In this country and specifically talking about black Americans, can I understand and appreciate it. It's about exposure, right? We call 'em bubbles. Whatever bubble it could be. A racial bubble, thought bubble, whatever bubble it is, there's no way for us to understand or even empathize and definitely not act.

Actively act against that type of behavior at a system level. And I think those is, this is simple as it gets. I've lived in four different states in 17 years and bought homes, moved my kids, they're 25 and 21 and we, and I was in Virginia, the swing state. I'm in California now. And so now, and that means four different ways of voting.

So now I realize, wow, it's easy in California just to do this or that. And that also made me aware like, oh, why isn't it like that in Texas? Or Why isn't like that wherever? But also see things that is terrible here, right? I'm like, they need to be more like Texas, or this needs to be more like Virginia or Pennsylvania.

You see? It's that exposure. And without that exposure, I wouldn't have the diversity of ideas or to be able to reflect back on things that were good about certain organizations we'll use that leave the rest. Like that. And so I think me and you consulting when you talk, speak with all these folks on this web, man, you are just, wow, I couldn't imagine the amount of ideas and new ideas or like someone says this, you can bring 'em together and synthesize it and know the way that no one else could because they may have just been over here, whatever.

So that's just my thoughts that I will echo. Diversity of thought has been amazing having done 300 some odd podcasts, talking to some just phenomenal leaders like yourself. Just over time, uh, I, I, I jokingly, I, from time to time, I tell people jokingly that this podcast is, I should just rename it, the education of Bill Russell.

And that's a very, that's awesome. Now you're that, what's the word, self-deprecating, I'll say. But that's a sign of empathy and that's beautiful. So I love your podcast. Well, well, what's, what's, what's the productive next step around diversity? And let's talk specifically around healthcare and healthcare it.

So if I'm ACIO Yeah. Or CMIO and I have a group of people and I wanna, I wanna push the envelope a little bit here. I want to have diversity of thought. I wanna maybe . Swap up how, what, what, what it looks, what our leader, executive leadership team, it looks like within health it. Mm-Hmm. , uh, what are some productive next steps?

One, I think is just that educating leaders, educating themselves, because I think a lot of the leaders in healthcare IT right now have come up through an age where get the best person, get the best person. Weeded out the non bests people. What happens is, like with surgical precision, sometimes those HR systems will weeded out certain idea types, AKA, whether it's race, gender, whatever.

For example, I don't have a clinical informatics certification. Now, if you're only looking for someone with a clinical informatics certification because your HR system has a checkbox, I'm not gonna get in that group. Now, I don't know the percentage of African American males like me that have one or don't have one, but statistically informatics has been very, a certain type of, uh, demographic.

So I think it's making sure that as a leader, you just question what you never had to question before to make sure your teams. Or have a diverse set of ideas and that you don't let HR and you don't let certain HR say . We just couldn't find any qualified candidates. The real question is, did you look at traditionally HBCUs?

Historically black college universities, they pump out some really smart folks and Google knows this. Do you really have to have a college degree for this position? Google knows this, like 15% of Google's employees are not, they don't have a bachelor's degree, but they have some really wicked certifications and can do the job.

So I think it's really a paradigm shift in the way we always used to think, if you're really trying to get . Diverse set of ideas or people and also, and have that one person in the room that may not be afraid to raise their hand and say, but why would we do that? That looks like this or that. Right. Uh, interesting.

Should your diversity mix look like your community? Because I, I, I'm just wondering. 'cause in Southern California, it, was it a third Hispanic speaking, it was a, a third Asian. Then other really was the other category. Should I be looking for If I, like I, if now I move and become the CIO in Iowa, am I worried about Asian or am I trying to match really what my community looks like?

You know what? I think it's two answers to that. The question is, who are you serving? One and this, I'm gonna approach this business, right? I'm gonna put on a financial hat. . The question is, who is your audience that you are serving and what you know is that audience may, um. Need for example. So who's your customer base and also where are you getting your funding from?

It's about money. Sometimes, a lot of times business-wise, that's money. The money, if the money is coming traditionally from, uh, that the 13%, the diverse population, if you look and realize, wow, we have some pretty diverse patient mix in this system, the question is how does our staff look so that those patient mixes can be comfortable or they can relate.

Two, those staff members, for example, nursing, if a large part of your nursing is of let's say, uh, African American, but you're in a predominantly, uh, Asian neighborhood. But, and the real question like, have we not, where are Asian nurses being trained? Maybe we Right. That's just a simple question. It's so easy to me to think about it, but I understand how folks have gotten in certain ways of thinking over the years that we call systemic.

Now. The systemic problems are what you were talking about earlier, and I really love that distinction of don't let HR rules. Keep you from becoming diverse and, and one of those we interviewed, a couple people have actually given me this idea of just make, making sure your slate of candidates is diverse.

That's right. So looking at your recruiting firms and looking at HR and saying, look, I want at least this many female candidates, at least this many culturally diverse candidates, black candidates. So depending on what you're, what you're trying to, to do within your market and really. Putting them back to work and saying, instead of letting them get away with, look, these are the people who applied.

No, that's not good enough. That's not good enough. Exactly. Yeah. And, and I think over the years I've, I've applied for so many jobs that I did not get. I did not, I have more jobs. I didn't get Bills CMIO position. I didn't get promoted here, there, whatever. I could go all day on that, but I choose not to focus on that.

I got a pretty good idea of maybe what happened. Maybe I was just a loud mouth. Maybe they felt like, ah, we don't, he is all over the place. Whatever. I blame myself a lot. Just move on. Personality. I don't know. And I can't prove it and nor do I have the time to go back and try to prove it so I move on. But what I do know is that they make mistakes by not hiring me.

I feel because wow, they said they want to innovate it. They want think different. Then a candidate that went in was like, that's pretty traditional. That's all . You get it. I don't, I don't feel that a lot of these healthcare institutions, whether, whether they're in healthcare, whatever, when they're looking at informatics talent, I'm not quite sure if they know how to Yeah.

But I, I will tell you, the first thing they ask is what's important to you? That really comes down to the health system. But the health system says, look, we're looking for a con convert, a culturally diverse group of candidates. They'll get it. Yeah. Yeah, no. And if historically there is a perception that.

If you get, say, African Americans, minorities, or underrepresented in places that they may not be as successful as, uh, traditional. I think that's just a, that's a fallacy that's been stuck in our heads for too long. I'm gonna cut you off 'cause I, I want to talk about the consulting business a little bit.

Oh yeah. And, and, and just. Anyone who just listened to that, that is two people having a conversation. I started this, preface this by, Hey, I might have some bad thinking. David said he might have some bad thinking. If you're upset by something we said, just shoot us an email. Yeah, that'd be cool. Yeah. Okay,

Alright, so let's hit consulting anyway. We don't have much time left on this. Covid has changed everything in terms of how we do business and how we interact. I, we were saying earlier, you and I were talking, I haven't been on site at a health system since February. And I'm hearing the same things, but this has impacted the consulting business.

People are really struggling on that side and it's something I don't talk about much on the show. How has Covid really changed your business? Covid has, has, uh, pretty much brought my business to its needs. I've been small shop. I. Less than 10 employees, but we have engaged at certain levels, but I find and at certain price points, right?

And that's like executive level consulting, advising on EHR implementation, advising on physician adoption engagement, things like that. I get called in when the CIO CEOs are really concerned that, wait, we spend a lot of money on this software, this technology, but we feel like the physicians have issues that.

We don't know if this is normal or not, so I'll go and assess things like that. So that's in a nutshell what I do also with some CMIO coaching, individual coaching that I do, and, uh, some speaking engagements, things like that, all that has to come to a crawl. And so I haven't been on site at a client since March, and that has been an issue.

And I think my last engagement probably was about four months ago. So for four months. There's no funds. Let's just talk Turkey. There's no money coming into Calyx Partners. My a hundred percent own company. Yeah. Now the real question is, do I go ahead and panic right now or do I tap into the my rainy day funds that I made sure that we're available in my a hundred percent own company?

And so I think that's what I decided because the environment was so weird and it's hard to predict where it's gonna go. Investing a lot of time in the things that worked last year. I didn't think, and I didn't feel like clients and they had the clients that healthcare delivery systems, cash went really low when they could, had to cancel all elective surgeries and things like that.

They let all consultants go. Most of them. They stopped a lot of epic implementations right in the tracks and the cost of stopping some of these implementations up to 2 million a month, just what it is. It could be really expensive, but that was a decision that was made. And so what I didn't want to do, and I think consultants, uh, probably shouldn't do, is try to continue to push your healthcare network, healthcare clients network.

Then they're going through so much things within their healthcare network. You don't wanna badger these CIOs. You don't wanna badger these CMIOs. And if I can coast on, as they say on Star Trek, if I can coast on impulse, power, remember Star Trek Bill, I got you on that one. impulse. I got you. Yeah, yeah. I just call down to Scotty.

Scotty, let's go on impulse power a little bit. Let's just coast this out. That's what we're doing. And let's just, why I see what makes sense. Other people are not, and so I'm not judging anyone if they have to continue to hit the grind and do what you gotta do because I'll work at wherever. To provide for my family.

So that's just start, that's just, uh, generalization statements on things. What are you saying, bill? Yeah, it's, it, it's interesting. Sales is the, you know, sales is the lifeblood for any consulting practice, and it, it really is hard at this point. Mm-Hmm. , one of the things I'm, I'm telling people is focus in on your existing clients.

People are like, I need new clients. Now is not the time to try to cold call anyone. Yeah. Especially in healthcare, they're, they're just too busy and so it's maintain the relationships with the people you already have. Give 'em a call. Hey, how are things going? People that'll take your phone call. Are the people you should be calling right now?

Yeah. Yeah. And I'm calling my, I'm calling my network just to check in on 'em while they're texting me. Hey Dave, how's it going? It's going great. I'm doing fine. How are you? Everything's crazy inside this healthcare system. I can't believe we're doing this. I can't believe we gotta buy this software. I can't believe our executives like that.

So now's not time. Oh, by the way, can you put me on, you know? No. Yeah. I'm actually literally wanna know how they're doing and the long game is all this is gonna come around. And every conversation you should be adding value. Yes, you should be providing that. Hey, I read something. Look, if you have time, you should be reading like crazy.

I read for about an hour and a half, two hours a day. Definitely. And so when people call me and say, Hey, what's new? I'm like On, on what topic would you like to talk about ? Exactly. Yeah. I've honestly, I've revamped my resume. 'cause I realized as I looked at, well that was pretty rookie, not rookie, but I just didn't have time to keep touching the resume.

It was not adding the value 'cause I was getting business. But now I finally have time to, oh, let me re-look at my res to make sure I actively reflect things on there that I've done. And I realized there was a lot of gaps in there. I'm like, oh, I've done that before. I've done that before. I didn't call, we didn't call it that.

We call it this at the time. Right. So just updating with the new terms LinkedIn, I'm about to update my LinkedIn now. Copy and paste some of those things from uh, my resume over to LinkedIn. That makes sense. I've now rebranded my business a little bit, where I'm the calyx is more about Dave now it's more Dave branding.

Right. Because I realized over four years that's probably they want me a lot of times if they, and once I'm in, they say, Hey Dave, do you know someone? Sure. This company can do that. Sure. That company can do that. Or, yeah. So I think those are the things that I'm preparing for the next. Wave of this. And I think that's smart business in general.

Investing in yourself, learning how to do podcasts, learning how to do lighting, stuff like that. These are things I just felt like this could last a while, and even if it doesn't, this still is gonna be around. Yeah, I, I, I'll tell you the other thing is you gotta put yourself in their place. One of the things I did early on was I offered free consulting, especially during covid.

It's, you know, I do coaching if somebody wants coaching. During Covid, I, I'm willing to do it for free for a period of time. I saw that. That was huge. That was huge. You, you're, you're doing your part, right? That's all. And, and quite frankly, it's, it's not that hard. It's, and it started, one of those led to a client and we essentially, we started off as, Hey, what are you seeing in the industry?

What he appreciated was during Covid, I was doing an interview a day. . And so I was able to say, Hey, this health system did this, one, did this one, did this . And he had, you know, direct access to, to me to have those conversations. Yes. Yeah. And, and then over time he was like, Hey, can you put me in touch with that person?

I'm like, yeah, probably. Exactly. And so at you're constantly adding value, put yourself in their space. They may not have money for you today, but if you're adding value today, they'll probably have money for you next year. That's it. That's, it's always a, I always say it's always a long game in any company.

All companies right now should be preparing for a long game, not the just the first down and don't think about the end zone, right? I'm always thinking about the end zone. You gotta have your tactics. My tactics right now is just to Reba re rebrand, revamp some things, make it image branding, stuff like that.

I just never had time for while I was so busy doing the work and now I'm actively every, I've actually had to, I, I've not accepted certain gigs 'cause I didn't feel like it was. I didn't feel they asked me to do things and I felt like, ah, that'll take 25 hours a week. And it's remote. It's, I don't really know the client.

I don't, and so how do I think it would be more stressful and less beneficial for them if I had have taken it? So that's sad to say. Who can afford to do that? I've been blessed last year. I can't really, but I'm going on. I, but I love your impulse power thing because I think as things go through a difficult stretch, what happens is people will fall out, so you're gonna have less competitors.

Come this time next year, and if you're still around, still standing, adding value to your clients next year, next month, next, whatever, that will bode well for you. I think, David, this was a great conversation. I appreciate uh, all the different directions we went in. We went all over. Sorry. I hate that. Sorry.

It's just caffeine. I, no, I, well, part of me, we hadn't talked in a year, so this is like our one year catch up call. We'll, we'll have to do this a little bit more often. So we're, we get a little more disciplined and focus in on maybe one or two topics each time we get together. I agree. I agree. Discipline is huge.

Focus me, bill . Thanks. Thanks for your time today. I appreciate it. Okay. Thank you. Take care. That's all for this week. Don't forget to sign up for our clip notes. Send an email, hit the website. Uh, we wanna make you and your system more productive. . Special thanks to our sponsors, our channel sponsors VMware Starbridge Advisors, Galen Healthcare Health Lyrics, serious Healthcare Pro Talent Advisors Health Next.

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