📍 Today in health, it we're going to talk about the value of getting something started. It's Friday, I just ramble about some things that are going on in my head. And how they relate to your healthcare. Journey and your health it department. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health. So the channels and events dedicated to transform healthcare.

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Like what, where do I start? What do I put on? It's why we love the internets. Why we love chats UPT. PT. In fact, it's like, Hey, help me with the first draft of this. A lot of people like that, some people don't like it because they're like, oh my gosh, it's just, now I've got to read that.

And I'm editing that and whatnot. But regardless, it is harder to start something from nothing than it is to actually correct something or move it farther down the field. And I'm not talking about turnarounds at this point, when things are completely out of control, that's a whole nother ball game. I'm just talking about the value of getting something started. At this point it's amazing to me. The number of people I have conversations with and they say, I want to do what you do. I say great record a podcast. And they're like I want to do that.

I got to do some reason. I said, look, I'll tell you the most valuable thing somebody said to me is just record a podcast. So the first thing I did is I grabbed my phone. And I think I went to the JP Morgan conference. I grabbed my phone and I said, all right, here are my notes. I'm just going to read my notes into it. If you go back and listen to that first podcast on this. No.

On the other channel on the conference channel. It's bad. I listened to it. It gets bad, but the good news is it got us started. It got something off the ground. It got me like, Hey, every Friday I'm going to do this. Put a marker in the ground and get it going. We came up with something or we didn't come up with a, it's a principle that others have given me, which is essentially crappy first draft.

And I give my team permission to do that crappy first draft. And it's look. Just get something out there, like just do anything. It could be a technical project. It can be a creative project. It's just get something out there. Directs is just starting on the show and he's putting some things together and he's I'm thinking of this.

I'm thinking of this. I'm like stop thinking, put something down, just put it out there. Get feedback. People will give you feedback. Your friends will call you and say, oh my gosh, what were you thinking? That's terrible. Or they'll call you up and say, that's fantastic. No one else is doing that. You'll get that feedback.

And then you can iterate. We have another principle, which is iterate to perfection. Don't start with perfection in mind, iterate to perfection that is get better and better as you go along. In one of the areas, I think we fail in healthcare. It is to get projects off the ground period. And I've talked about this at least once before on the show, but I've been doing this for four years.

So some of you may not have heard this. And that is we one of the things that just killed me as CIO was how long it took us. From the point we decided we were going to go forward with a company to the time they could actually start working with us, especially a new company. Now, if we had a company that already had existing contracts and stuff that, has less friction with it, less contractual stuff, it just didn't take as long.

But if we had a new company. Hey, we're contracting for this new AI thing. That was a big deal. So we would have to go get legal involved. We'd have to go through the machinations and stuff and it could be anywhere from. I don't know. At a minimum three months to six months from the time we decided, yes, we're moving forward with us until the time we signed a contract.

In fact, a lot of times when we were doing an RFP or whatnot, we said, Send us your contracts, let's start the process. And that would buy us a month or two months because we were already working on the contract. So we were looking at things going. Yeah, this isn't going to work and whatever. Whatever the stipulations were gonna be, we told them, Hey, we're going to require this kind of indemnification. If you're not willing to do this indemnification, we're not willing to look at your product because we have to have this identification kind of stuff.

So identifying things that are gonna be showstoppers upfront, put them on the table, let them look at it and say, yeah, we can't do that. Or, yeah, we can figure out a way to do that. Let us start working with our team internally. Get started earlier. That's one of the things, but one of the big things we did. Was we created a at least a two tier, if not a three tier, I am my. Brain's a little fuzzy on some of this stuff now.

Cause it's been eight to 10 years ago. But I know we created at least a two tier system. For contracts. And what we did is we created a, and it was based on risk, right? How much of how much connectivity did the new entry coming into our system require? Did they require access to data? Do they. Let me rephrase that.

They require access to live data. Did they? Require access to not live data. Did they require access to data, but it didn't even, it could be synthetic data. Didn't have to be real data. And so each of those think about those. Each of those has a different level of risk associated with it. If they don't need live data. Then they're not connected to our life systems and then they can't bring our lives systems down or they can't breach our life systems. Then all right. That's a different level of risk then, Hey, we just need access to your backup systems.

Or you could even give us a little pile of data. It doesn't even have to be the whole thing that we can play with, or even better if they can work with synthetic data. So then we sat down with our legal department, we said, look, We want to create contracts that we can. Contract that we can sign very quickly. Say within 30 days, because there's very little exposure to us and there's very little exposure to them. They're not putting up a lot of resources and software and that kinda stuff.

And we're not putting up a lot of risks on our side. And we did. We got a contract that was pretty basic. It said, Hey, you're only getting access to this kind of data and this kind of connectivity and these kinds of things, and your people have to be. And you have to sign off on these things.

And we had a 30 day contract. So when we had startups and that kind of stuff, and they didn't have big legal departments, we could say, boom, Hey, let's get started on something. 30 days we can start to do something. I think we, I know we had a two tier contract system. Obviously you have to go through all the machinations.

If they're going to connect into high risk, connecting to your EHR, connect into your live data, potentially move some of your live data around and that kind of stuff. That's high risk, high exposure. A lot of resources on both sides. Yeah. You got to go through all the machinations, but what I tried to do is get them started. I get something started. Get that 30 day contract signed, get them working while we're working on the larger longer-term contract.

How much work could we get done in those? Six months. It was going to take us to the big contract. If we could break the risk down. Into tranches and say, look. For you to get started? You're not, we're not going to, either of us are going to take that much risk and you can start getting started. And then when they hit the next roadblock and say, okay, now we need access to this. We would determine are, do you need the full contract on, or do you need this?

Are we at a stopping point or can we continue? With just adding a little bit of risk here and that kind of stuff. Or did we have to wait for the longterm? Large contract. Your legal departments can do this. And the reason I know this is because our legal department, when I broached this with them, they just looked at me and said, we could do anything with contracts.

Like we can do anything with words. We just have to protect our interests. We have to we have to evaluate risk. We have to mitigate that risk. And we have to do that with with contracts because we're corporate and legal entities. I give you that example to say, man, the number of people I hear that are waiting six and nine months. For a contract to get started is just unbelievable right now in the industry. And I'm not sure I understand. Why that is the case in less.

I have no idea why that is the case. You're accepting it, it doesn't have to be that way. It's just, I guess what I'm saying. The other thing is the When you're heading off into these huge endeavors. Figuring out AI across the entire health system. Figure out little things like do something that is your crappy first draft. My team is going to start utilizing it.

We're going to put, all of, I don't know, we're going to put a little bit of code through it in order to do an evaluation on the code, or we're going to document the code or we're going to, utilize. Large language models for whatever, or we're going to create a Jeep GPT in it, if you don't know what a GPT is covered in other episodes, but essentially they're small. Small modules within the chat CPT. Infrastructure is like little applications. Play around, get something started. When you get something started, you start to learn things.

And that's the important thing. When things are in motion, you tend to learn things when things are at a standstill, you tend to not learn nearly as much. You don't know what you don't know until you start getting into it. So allow people to do a, for crappy first draft. Allow people to to try to solve the problem of status within your organization. And they can solve that problem by looking at it a little differently and saying, Hey, why do we need the large contract?

And is there a way to start and step into some of these. Projects so that we can make progress while we're working out that six month gnarly contract. And they are, I get it. I understand why it takes so long, but there are steps you can do to get started and get things off the ground today. All right.

That's all for today. Don't forget. Share this podcast with a friend or colleague. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders. Notable service now interprise health parlance, certified health and 📍 Panda health. Check them out if this week. health.com/today. Thanks for listening.

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