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Today on Town Hall

What we didn't want it to become was like, oh, well, we'll just sip some coffee and come out. We wanted it to be, what are we going to do?

What are our priorities going to be coming out of this meeting? Get those priorities endorsed by the C suite. So when we came back from that event, we're like, this is what we're doing for the rest of the year.

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. Today's episode is sponsored by ARMIS, First Health Advisory, Meditech, Optimum Health IT, and uPerform. Alright, let's jump right into today's episode.

welcome to the This Week Health Community Town Hall Conversation. My name is Reid Steffen, CIO at St. Luke's Health System in Boise, Idaho, and I'm joined today by my friends Pete Marks, who's the CIO at WakeMed, and Sachin Mullet, who is the Director of Applications, also at WakeMed.

Welcome and thanks for making the time. Thanks. So let's start with some quick intros with both of you to talk a bit more about yourself and WakeMed. Pete, we'll start with you. Just take a minute and tell us tiny bit about your background and then a bit about WakeMed for viewers or listeners who may not be familiar.

It's great to be here and good to see you again, Reid. So I'm Pete Marks, I'm the CIO. I've been here almost seven years. I came to WakeMed with a very specific purpose. WakeMed is an organization that's built to take care of patients and families, regardless of their ability to pay or where they come from, their background.

And it's a place that people come and fall in love with, and so I came here, fell in love with it, and I'm here helping the patient and family experience.

All right, beautiful. And Sashim, take a minute and tell us about your background.

So, I've been at WhiteMed for close to 12 years now, so, I feel like it's it's given me an opportunity to really watch the organization grow and really expand or reach into the community and use the various applications just to help our patients and families.

And it's just been really a rewarding journey so far, just to be a part of this experience and really just see the connection that is so unique to WakeMed that we have when it comes to really reaching out into the community. So, It really is an honor to be a part of this journey so far.

All right, thank you for So today, I just want to talk briefly, because I think you're doing some really interesting approaches at WakeMed to help with, so I should say, you're an epic shop. And let's just start with a hypothetical. Let's say you're an epic shop, you've made that investment, but potentially there might be some perspectives inside the organization where Epic is viewed more as a necessary reality.

It's treated more as a vendor, as a tool, rather than a partner and a true platform and enabler to accelerate your strategy. Let's say that mindset is there, and it's not like, there's not resistance, but maybe there's just some reluctance to fully embrace EPIC and all the capabilities that are there.

So I know, Pete, from talking to you in the past, and then you said, hey, let's talk to Sasheen, who's been a great catalyst for this. You've had some great success working through some of that perspective by doing what's called an EPIC corporate visit. So, Sasheen, will you take just a minute and explain What that is, how you kind of came across that as a strategy, how you've approached it, and what some of the benefits have been as you've done those visits.

So, I think the first thing I would say is, IRIS, being here over 12 years, I've had the opportunity of working with previous vendors and also being a part of the whole implementation of EPIC to the organization. And so, because of that, It gives me a different perspective to really see how unique the relationship that we have developed with Epic is.

We, I've not seen it here or in previous organizations where we have had that type of relationship with others. So, The whole corporate visit is actually Pete's baby. It was his vision that we have all kind of taken and kind of expanded on. But concept behind the corporate visit is really just an opportunity for us to not only work closer with Epic, but gives others in the organization that may not have as much direct line of sight into EPIC.

It gives them an opportunity to be in the same room, collaborate not just with us, but with EPIC, and to really develop a shared strategy. So many times in these types of relationships, we take what the vendor gives and then we develop our own strategy with within the organization. And we, try to sell that.

This puts us at the seat at the table with EPIC to say let's talk about what WakeMed's vision is and what EPIC's vision is as well and let's see how we combine those two to continue to move our mission forward. So it really is a collaborative effort and one of the I'd say the most unique pieces of what we do as part of that meeting is really coming together together.

with each of our owners, because we have various owners, as we go into the meeting to say, you're the population health leader, so you're going to come with your vision, your strategic plans, and Epic is going to then take what they have developed around PopHealth. And so we combine those two, and those two work together as part of that meeting to come up with a presentation.

So it is not just Epic trying to sell Epic, but it is in Coordination with us to say, tell us where you're trying to go and let us tell you what we have and how we can help you get there. So it's very unique in that we're not just sitting in a room and hearing what the future stuff is that's coming from EPIC.

And EPIC is not just hearing, well, these are the problems that WaitNet is having and everybody walks away. And go back to do their thing. It's where we come together and kind of put the two pieces together to really develop that vision. And I think that's one of the most valuable piece of that process more than anything else, because as the person that is responsible for the applications, It helps me to then have that strategic roadmap moving forward.

It helps me to know what the priorities are for our leaders that's in the room. But it also helps me to know how EPIC can help me help to push that along. And then having Donald or CEO as part of this as one of the biggest supporters for this initiative really just It sends a message of the importance of this collaboration, when your most senior leader takes everyone from the C suite and say, stop what you're doing.

This is important. And this is not just a one day thing. We're usually there for two, two and a half hours. Actually the one we did this past July, we incorporated an extra day on the front end where it was just purely revenue cycle. And we have seen such significant benefits of just being able to sit in a room with Developers and just with other experts to say let's look at our system and help us figure out what the problems are.

Yes, you could do some of that over WebEx. Yes, you could do that by having weekly meetings with AFIC. But those impromptu meetings and those discussions that, oh, I know who can help you. And being able to just pull off and have those one off conversations we have. Definitely come back and seeing the benefits of those, and those are the pieces that, a lot of people ask me to, put a, what's our ROI on, on this overall meeting, and sometimes it's hard to quantify that, right, because then you're trying to say, how do I put a value on the fact that I'm sitting beside somebody that can say, hold on, I know a developer, let me go get him, let me pull him in the room, hold So there's a lot to it that's not necessarily monetary, but eventually it gets us there.

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  that's a great overview of the why. And as you were describing that, so Shane, I really, the words that came to my mind were, you've moved from this kind of reactive approach with Epic, where you get the quarterly update. You have the UGM what's cool ahead address. Like you're always like reacting to what Epic's telling you and they're just trying to be communicative and you've made it proactive where to your point, you go there, you then are having Epic be a partner to work with you and to have the EHR then work for the needs of WakeMed.

So in terms of ROI, you think about how much you spend on Epic. If you can more effectively do that. It's like a minimal investment of time and travel dollars to gain that clarity. So you talked about you have your CEO there. Who else attends? Like, how do you determine what leaders to bring to this event?

you know what, I guess I'll let Pete answer a bit because, like I said, he was kind of the first visionary in this and so he kind of helped develop, the right roles that we needed at the table and we kind of expanded from there.

Yeah, it was easy. So we knew that we had to bring the most senior leaders from the C suite.

So that's the CEO, The CFO, the COO, the CMO, right? Then we also brought, we knew kind of what our strategies were that we were trying to accomplish operationally and clinically. For the first one patient flow was our, one of our largest issues. And so we picked the six or seven strategies, got them blessed by the C suite.

They said those are indeed the things that we're working on. Then we brought those subject matter experts from those areas. And People who actually put their fingers on keyboards. What we didn't want it to become was like, oh, well, we'll just sip some coffee and come out. We wanted it to be, what are we going to do?

What are our priorities going to be coming out of this meeting? Get those priorities endorsed by the C suite. So when we came back from that event, we're like, this is what we're doing for the rest of the year. So, and it's endorsed by the entire C suite. So we selected the strategies for the first one that we thought were appropriate, got them blessed by the C suite.

That let Epic focus in on what they were going to talk about, where they were going to go. We married it up with our people who actually put fingers on keyboards, not just leaders like me, who never put their finger on the keyboard for Epic, occasionally. But it made it real and the strategy that came out of that was something that we could execute against.

So that's how we figured it out. How

often do you do these corporate visits? Once a year. Once a year. Okay. And then how long have you been doing this? When did this first start?

This will be our fifth year this summer.

Okay. So I think that speaks to the ROI question. Clearly, there wouldn't be the continued investment of the time and the travel if there were not realized value from that investment.

So just the longevity of how long you've been doing this, would say speaks volumes. think from this, there may be folks in the community that want to reach out with other questions. Our intent here is not to explain everything like A to Z, but just give broad brushstrokes of the why and the benefit.

Anything else that either of you would want to share with the community about this approach and the value that you've seen from it?

Just briefly you have to go in person. And Sashin and I, more Sashin than I, have written out the ROI. So we know how much it costs to go, but we also know what value we got out of it from a financial standpoint.

Just on the rev cycle stuff, Sashin did a calculation and said in the first two weeks, we made our money back just on the stuff we changed in the rev cycle. So it means it's just cake. And then. I think you have to bring your C suite. I think in the old days, the way that we used to think about IT was it can't really change the workflows of the people.

I mean, I'm talking old days, 15 years ago. Now, I think it's completely accepted that these solutions will affect and change your workflows. And so. You have to have that entire C suite plus those subject matter experts to go in order for you to get the best product at the end. We did it actually here in Raleigh one year in Raleigh, North Carolina.

We got about three people who came down from Epic. It was good, don't get me wrong but it didn't have the completeness of vision and We didn't have what I would say is the strength and strategy, and I'll give you a prime example. So there are things that will happen when you're at Epic that won't happen over email, and Sachin mentioned it.

If you talk to the developers or their lead developers in certain areas, they'll even talk to you about what partnerships they're moving into with certain companies. So one of the other things is we were considering moving into a partnership with a company. We weren't sure that they were going to have a relationship with EPIC.

That's not something that's going to come out through email. But when we sat there with them, they said, Indeed, we are going to have a partnership with that organization. Gave us the confidence to sign a contract that it would have been an unknown to us about that partnership level. So you have to go in person.

Yeah, I agree with Pete. Definitely having the C suite there is beneficial, but also having the people that are doing the work. So possibly you're, a director level of people. That's part of the everyday process is important because. Part of the benefit of this is really start tearing through your own data with EPIC in the room, right?

And so you need people that's familiar with those processes and with that data. And the benefits that we've seen from that, just from our revenue cycle alone, just as an FYI, a lot of our revenue cycle leaders that went were new to WakeMed, meaning they were here, maybe Three, six months when we did the trip last year.

So we, we brought a lot of new people, but they were able to get a deeper insight into their areas of ownership than we could have given them here by them. apart reports and so far as of today, some of the actions that we've taken based on what we saw in those rev cycle meetings while we were there, we've been able to adjust and clean up over $22 million in accounts.

So, and that's just one of the actions that we took. We developed an overall roadmap because that's the next key thing to this, right? What are you going to do when you leave EPIC? And so first and foremost, you have to have a strategic roadmap. So you come out, you come away from EPIC with a priority.

We're your leaders. So what we did was a vote. So all of the leaders in the room had to vote. What are the priorities for WaitMed as we're walking away? As Pete said, the first year it was patient flow because it was coming out of the pandemic. Patient flow was priority. Last year, rev cycle was the priority.

And so as we got that list we, I think we walked away with about seven priorities last year. We then developed roadmaps because now we need to put those things into action and having a good understanding that you're not going to see quick results. From this is also important. It is not a quick turnaround for a rev cycle strategic road map.

We are 41 percent complete based on what we developed last year, and so we have already seen some of that impact coming back in, but. It's not something, it's not a quick fix, so anyone doing this and thinking they're going to come back and have all the answers and see results within 30 90 days, that is not the expectation to go into this with.

Yeah, I think that's wise counsel. This has been a phenomenal conversation and we might do a part two down the road to dive in deeper into a couple of things you've talked about. But let me just add this exclamation point to what you both have said. So Pete, you and I, at UGM this last year, we were talking and you shared with me this approach and you said, I can't advocate strongly enough for the dividends this would pay if you can do a site visit with your leadership team.

So our CEO was there at UGM, at the council, so he and I talked. We arranged a visit in November after Thanksgiving, and it was phenomenal. And here's an aha for me. We always try and cascade roadmap and webinar information, what's ahead. It's, those that have been on the user web, like, it is a dense animal.

There is so much information there. And I think we don't fully appreciate, like, the epic team who live it and are immersed in it. They get it, it makes sense. Someone that just kind of comes in, episodically, they just don't have the time to absorb it to the degree they need to. At that corporate visit, to your point, Sashin, around the table, there came a clarity of understanding of Epic as a strategic tool, as a partner and platform, to the point that one of our leaders said, you know what, if we're looking for a capability, and it's on Epic's roadmap, In the next 18 months, we're probably better off waiting for that to develop.

Versus buying something different, installing it, bridging it, only to have to. We've been trying to advocate for that mindset for several years and could never get traction. That leader said that and there was immediate consensus around the table. So just that nugget and that buy in is going to pay dividends in the months and years ahead.

So I just thank you for sharing this approach with me personally and now with the community. I think it's great. I think you should approach your BFF. You should get honor roll credit. Every system that goes to EPIC for a corporate visit because of your advocacy, you should somehow, there should be an incentive that comes back to you.

So it's good for the community. So I'm, if you need a vouch for that, I'm happy to provide a letter of recommendation. Just let me know. Thanks for that offer of work. So we're, Sashne

is knee deep in honor roll. Maybe neck deep in honor roll right now.

Well, uh, Pete, Sashne, thank you. Just appreciate both of you.

Great conversation. Thanks for all you're doing for WakeMed, but also for the community as a whole. Appreciate you both and wish you the best in your future endeavors.

Thanks, Ray. Nice talking to you.

Likewise.

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