Today in health, it,
Bill Russell:Another one of our interviews and action.
Bill Russell:This comes from the healthcare to healthcare event, which I was a guest
Bill Russell:at from the serious health care team.
Bill Russell:It was in Montana.
Bill Russell:And I was able to sit down with a handful of CEOs.
Bill Russell:And I'm going to share those with you here shortly.
Bill Russell:My name is bill Russell.
Bill Russell:I'm a former CIO for a 16 hospital system and creator of this week in health.
Bill Russell:It.
Bill Russell:A channel dedicated to keeping health it staff current and engaged.
Bill Russell:I hope you're enjoying these interviews and action.
Bill Russell:We were able to do these interviews at the health conference, the
Bill Russell:chime conference, and now the healthcare to healthcare event.
Bill Russell:I've really enjoyed doing them.
Bill Russell:, just a reminder.
Bill Russell:We're going to get back to our normal programming where I take
Bill Russell:a new story, break it down.
Bill Russell:And talk about why it matters to health.
Bill Russell:It.
Bill Russell:We're going to be doing that as soon as the interviews are done we have
Bill Russell:done 10 from the chime conference eight from the health conference and
Bill Russell:we have five from the healthcare to health care conference so i hope you
Bill Russell:enjoy another one of these interviews
Bill Russell:alright.
Bill Russell:Another interview from the healthcare to healthcare conference, this
Bill Russell:is a, a severally conference.
Bill Russell:It's an invitation only event by serious healthcare.
Bill Russell:And so we're talking with Dr.
Bill Russell:Stephanie LAR again, it's been a while since we've talked as it
Stephanie Lahr:has been always great to talk to you.
Stephanie Lahr:That always
Bill Russell:great.
Bill Russell:Um, so we're in your neck of the woods.
Bill Russell:And now we're we're in Montana, but, but you classified it
Bill Russell:as your neck of the woods.
Stephanie Lahr:Yeah, well, I, yeah, I was saying I live in rapid city,
Stephanie Lahr:South Dakota, which is about 725 miles from here, but it's a day's drive.
Stephanie Lahr:So, you know, out west, if you can get there in a day, it's
Stephanie Lahr:local, I did grow up here.
Stephanie Lahr:Now
Bill Russell:you grew up in Montana now you're at monument health.
Bill Russell:Yep.
Bill Russell:So, uh, we haven't talked in a while.
Bill Russell:What's due at monument health.
Bill Russell:Well, you guys.
Stephanie Lahr:Yeah.
Stephanie Lahr:Um, gosh, there's so much fun stuff happening right now.
Stephanie Lahr:Um, you know, I think as we are coming through COVID, we are, um, we're, we're
Stephanie Lahr:still faced with a number of challenges.
Stephanie Lahr:I think there are some new things that have really come out of it that
Stephanie Lahr:we're all experiencing, particularly as it relates to, um, staffing
Stephanie Lahr:shortages, uh, the, the expense of, of those, um, resources, burnout, you
Stephanie Lahr:know, and those things extend into.
Stephanie Lahr:Technical teams.
Stephanie Lahr:They extended to our clinical teams.
Stephanie Lahr:All of our teams are kind of stretched and, and dealing with
Stephanie Lahr:challenging issues right now.
Stephanie Lahr:And so I feel like that is such an amazing opportunity for technology
Stephanie Lahr:to be able to come in and help relieve some of the burdens.
Stephanie Lahr:And I'll say, you know, I mean, I think right now my number one goal
Stephanie Lahr:is to bring back the joy to medicine.
Stephanie Lahr:And, and I don't mean that just for my clinical.
Stephanie Lahr:I mean, really for everyone who is involved in the care delivery, um,
Stephanie Lahr:you know, part of the system, we need to bring the joy back to their work.
Stephanie Lahr:And I think that, you know, looking at technology right now, we're
Stephanie Lahr:right, for those opportunities, there's automation opportunities,
Stephanie Lahr:there's efficiency opportunities.
Stephanie Lahr:And, and we're also at a point where we have some great
Stephanie Lahr:foundational systems in place.
Stephanie Lahr:So now we can start building on that, um, foundation.
Bill Russell:You talked about bringing the.
Bill Russell:Back to medicine, but you're one of the reasons I like talking to
Bill Russell:you is you have to be pragmatic.
Bill Russell:It's not like some of the larger health systems or, you know, I, when I was
Bill Russell:CIO, I had 750 people reporting into me.
Bill Russell:You don't have 750 people.
Bill Russell:And, uh, we also had an innovation budget, those kinds of things.
Bill Russell:And there are those health systems that are doing that, but
Bill Russell:you have to be very practical.
Bill Russell:Talk about some of the, some of the practical ways that you're trying
Bill Russell:to bring joy back to medicine.
Stephanie Lahr:So, um, I think, you know, one of the great things
Stephanie Lahr:about being an organization, my size
Bill Russell:decision
Stephanie Lahr:making is very, we're very flat.
Stephanie Lahr:Um, I can have great conversations with all of our executive leadership,
Stephanie Lahr:um, our physician leadership and, and really come to some conclusions
Stephanie Lahr:and execute on those things quickly.
Stephanie Lahr:So that makes it easier, um, in some respects, but, you know, I think things
Stephanie Lahr:that we're looking at right now, we've, we've created some really strong.
Stephanie Lahr:With vendors like nuance, for example, where we're leveraging ambient clinical
Stephanie Lahr:intelligence, um, and allowing our providers and to have that relationship,
Stephanie Lahr:bring that intimacy back to the relationship with the patients.
Stephanie Lahr:Exactly.
Stephanie Lahr:Yes.
Stephanie Lahr:Not sit with our backs to the patient's sitting at the computer.
Stephanie Lahr:Um, and it's not, it's not a tool that everyone needs, but we've
Stephanie Lahr:identified a way to be able to sort of, um, select providers that we
Stephanie Lahr:think that that is a great tool for.
Stephanie Lahr:And so.
Stephanie Lahr:Rolling that out to them.
Stephanie Lahr:We, um, are looking at automation in a variety of other respects.
Stephanie Lahr:You know, we're, we're working on a really great project to be able to, um, take some
Stephanie Lahr:of our clinical workflows, um, monitoring what's happening throughout the hospital.
Stephanie Lahr:I think you've maybe even talked to the, the CEO of that company recently
Stephanie Lahr:artist's site, um, but had some really exciting conversations with my, um,
Stephanie Lahr:health system board and our finance and investment committee, even just this.
Stephanie Lahr:And there's a real understanding at that board level, that
Stephanie Lahr:transformation is not optional.
Stephanie Lahr:We are going to have to do something and we, and we won't know exactly what the
Stephanie Lahr:right fit is going to be until we do it.
Stephanie Lahr:So we're just going to jump in and we're going to start doing some of those things.
Stephanie Lahr:And I, and again, I think that's one of the great things about being our
Stephanie Lahr:size is that we can just do that.
Stephanie Lahr:The
Bill Russell:artist's eye conversation was interesting.
Bill Russell:And it's interesting that I'm talking to you about it because when people hear AI,
Bill Russell:computer vision and those kinds of things, No large academic medical center out of
Bill Russell:LA or know that's what they're thinking, but you're implementing that there.
Bill Russell:And how does that lead to again, I'm just going to keep coming back to
Bill Russell:this, bringing joy back to medicine.
Stephanie Lahr:Yeah.
Stephanie Lahr:So I think it does it in two ways.
Stephanie Lahr:One, um, it allows us to gain an understanding of what's happening
Stephanie Lahr:within our walls and within the health.
Stephanie Lahr:That to a level of granularity we don't have right now.
Stephanie Lahr:Right.
Stephanie Lahr:All of the documentation, all of the data points that we have
Stephanie Lahr:are actually, you know, sort of representations of the real information.
Stephanie Lahr:But for example, when a document comes out of an exchange between a
Stephanie Lahr:patient and a provider, that's not truly what that conversation was.
Stephanie Lahr:It's a representation of it.
Stephanie Lahr:Any box that I check in the EA.
Stephanie Lahr:That's not actually when it happened and what happened.
Stephanie Lahr:It's a representation of that created typically after the fact.
Stephanie Lahr:And I think one of the things that's really awesome about technology like
Stephanie Lahr:artist's site is it's going to allow us to have a much more granular,
Stephanie Lahr:real time understanding of what's happening so that then we can look
Stephanie Lahr:at processes and improve them, reduce friction and create efficiency.
Stephanie Lahr:And then the other piece for me, when we talk about the joy of
Stephanie Lahr:medicine, you know, there's a lot of statistics out there that talk about.
Stephanie Lahr:You know, an ICU physician spends 14% of their time with a patient.
Stephanie Lahr:An ICU nurse spends 34% of their time with the patient that other
Stephanie Lahr:big percentage of the time is on administrative and other kinds of
Bill Russell:tasks specialists who also practice medicine.
Stephanie Lahr:Exactly.
Stephanie Lahr:And, and we can flip those ratios and get them spending 15% of time
Stephanie Lahr:on the administrative tasks by automating them in the background.
Stephanie Lahr:Again, if I had an exchange with you and we can turn that into a doc.
Stephanie Lahr:Or if I can understand that the patient is moved from here to here
Stephanie Lahr:and this person needs to be notified, why would I ask a person to do that?
Stephanie Lahr:Why would I ask a nurse to be managing those things?
Stephanie Lahr:We've done it because it's been the easy answer.
Stephanie Lahr:Oh, the nurses right there have them do it.
Stephanie Lahr:We we've come to a breaking point.
Stephanie Lahr:We can't ask them to do one more thing.
Stephanie Lahr:And in fact, given the staffing shortages, if we're going to ask them to do one more
Stephanie Lahr:thing, it has to be something clinical.
Stephanie Lahr:So we're gonna have to take some of the other stuff off the
Bill Russell:plate.
Bill Russell:Specifically, let's talk about the nursing shortage.
Bill Russell:Cause it's, it's one of the things I'm hearing.
Bill Russell:I'm also hearing an it shortage by the way, I'm hearing it for sure.
Bill Russell:Challenge to hire those.
Bill Russell:So let's go in those two directions.
Bill Russell:So nursing shortage, um, I assume that's hitting you where you're at.
Bill Russell:Absolutely.
Bill Russell:Are you having this issue?
Bill Russell:I'm hearing this over and over again where people are leaving
Bill Russell:to become traveling nurses.
Bill Russell:They're making five times what they're making locally.
Bill Russell:They're going to go do that for a year or to pay for their kid's education.
Bill Russell:Then there.
Bill Russell:And worked for you and you're going to take them back because there's
Bill Russell:a nursing shortage where you're at.
Bill Russell:How, how are you guys thinking about that problem?
Stephanie Lahr:Well, I think the number one thing that we're thinking
Stephanie Lahr:is how do we make our place, the place that people want to work?
Stephanie Lahr:Um, the money is only one part of why a person chooses to work in a certain place
Stephanie Lahr:or go down a path with their career.
Stephanie Lahr:And so our differentiator to your point, we're a not-for-profit community health.
Stephanie Lahr:We're not going to pay the most.
Stephanie Lahr:Um, but we can look at other things that make us attractive,
Stephanie Lahr:make us a great place to work.
Stephanie Lahr:Um, that can be other things that our, our HR teams and
Stephanie Lahr:experienced teams are working on.
Stephanie Lahr:But again, I feel like that's then a big burden on my shoulders, which I'm
Stephanie Lahr:happy to take on to sort of say what would differentiate us, what would make
Stephanie Lahr:a nurse say, gosh, when I go work at Monmouth, I get to spend all my time with
Stephanie Lahr:the patients cause all these other, so, I mean, I think it's all tied together.
Stephanie Lahr:One, we may need fewer nurses possibly over time.
Stephanie Lahr:If we can really start automating some of these processes, but even if we don't,
Stephanie Lahr:even if we need the same number there.
Stephanie Lahr:Much happier doing the work that they spent, all of their
Stephanie Lahr:clinical time training to do.
Stephanie Lahr:Nobody went to nursing school or medical school.
Stephanie Lahr:So they could be like, I'm going to be the queen or the king of the EHR.
Stephanie Lahr:This is going to be fabulous.
Stephanie Lahr:They did it because they want to be interacting with patients.
Stephanie Lahr:Okay.
Stephanie Lahr:It's
Bill Russell:interesting to hear you talk about one of the things you've
Bill Russell:done is building community remotely.
Bill Russell:I've been talking to CEOs about this, and to be honest with you, one of the things
Bill Russell:I've been saying is I'm, I would have struggled to make this transition to.
Bill Russell:You know, seeing everybody through a screen, I like walking into their office.
Bill Russell:I like talking to them.
Bill Russell:I like the informal conversations.
Bill Russell:It was, ah, it was, uh, it was part of the reason I love the job is, is the
Bill Russell:community that you're able to build, bringing people together that people
Bill Russell:used to make fun of, you know, the birthday parties and that kind of stuff.
Bill Russell:But I love that stuff.
Bill Russell:That was, that was great stuff.
Bill Russell:But you've made you seem to have made that transition, so I'm sure
Bill Russell:you love the face to face, but, but how are you able to make that.
Stephanie Lahr:Yeah, I, I do love the face-to-face, but I think we can do a
Stephanie Lahr:lot of those things in different ways, but get a lot of the same fun out of it.
Stephanie Lahr:So, um, you know, my team we've had a real focus and this does get
Stephanie Lahr:to, you know, the shortages of it.
Stephanie Lahr:People I'm now competing with health systems in New York and Ohio, and wherever
Stephanie Lahr:that may allow a person to stay in rapid.
Stephanie Lahr:But work for them remotely.
Stephanie Lahr:And so that has really changed
Bill Russell:the landscape.
Bill Russell:I can hire in 48 states now.
Bill Russell:And I'm
Stephanie Lahr:like, wow, I know I said, which two are the ones you're not cut?
Stephanie Lahr:I was hoping maybe we'd be one of them.
Stephanie Lahr:We're not, um, or actually I should say we are, they can hire in our state.
Stephanie Lahr:And so one of the things, you know, I've worked hard on,
Stephanie Lahr:I I'm a very social person.
Stephanie Lahr:I needed the social interaction, even if we couldn't be in person.
Stephanie Lahr:So, um, my team and I have created.
Stephanie Lahr:To be able to do that.
Stephanie Lahr:Even still virtually we have, um, fun all hands meetings.
Stephanie Lahr:We play games, which help people get to know each other.
Stephanie Lahr:It helps people take some of the, um, the intensity off of the work.
Stephanie Lahr:Um, and you know, th there are just like, you can do a comedy show virtually.
Stephanie Lahr:There are ways you have to do it a little bit different, but it's actually
Stephanie Lahr:pretty fun and a way to be creative.
Stephanie Lahr:I'll give one example last year, over the holidays.
Stephanie Lahr:What we used to do was we had a.
Stephanie Lahr:Who would go to people's offices and kind of like create a little bit of havoc
Stephanie Lahr:and be, you know, uh, uh, decorated.
Stephanie Lahr:And then that person would gather all that stuff up and go and take it to a
Stephanie Lahr:new office and elf that person's office.
Stephanie Lahr:So last year during COVID, I was like, well, we still want to do this.
Stephanie Lahr:How can we do this?
Stephanie Lahr:So what we did instead is we put together eight boxes of Elfin fun.
Stephanie Lahr:And during our all hands meetings, we would like the publishers clearing.
Stephanie Lahr:Show up at somebody's doorstep, you know, in our region, it's not hard to do and
Stephanie Lahr:close enough for our teams to be together and we'd knock on their door and we
Stephanie Lahr:would deliver them their Elfin package, and then they could do it within their
Stephanie Lahr:home office or whatever they wanted.
Stephanie Lahr:You just have to be creative.
Stephanie Lahr:You know, we still, we can still be very personally connected.
Stephanie Lahr:I'm very excited to get back to the point where we can be doing more together.
Stephanie Lahr:I think hybrid is absolutely.
Stephanie Lahr:I'm going to be the ideal.
Stephanie Lahr:I will have a lot of people who like being home at least a good part of the time.
Stephanie Lahr:And that again, creates retention, um, opportunity.
Stephanie Lahr:But I think we're, we're going to want to have a blend and we have a lot of
Stephanie Lahr:fun trying to think outside of the box on how to do some of those things.
Stephanie Lahr:I'm going
Stephanie Lahr:to
Bill Russell:come back to you on Montana trivia.
Bill Russell:But before that, w it's interesting.
Bill Russell:I was at the health conference and the health conference.
Bill Russell:They really strive to have a, um, representation of male, female.
Bill Russell:And they weren't able to even get close this year.
Bill Russell:And one of the things we heard a stat, I think it was yesterday.
Bill Russell:You heard a stat of the number of women who are leaving the workforce and they
Bill Russell:were, they're given a choice and they chose their family and they're doing that.
Bill Russell:But I mean, you, the pandemic was challenging for you too.
Bill Russell:I mean, you're, you're at home a CIO doctor and.
Bill Russell:Your kids are like right in the other
Stephanie Lahr:room doing their thing was like, when are we going
Stephanie Lahr:to talk about the math homework
Bill Russell:and eight year old, they respected your office.
Bill Russell:And,
Stephanie Lahr:um, I mean, you know, she respected, I don't know about that.
Stephanie Lahr:Actually.
Stephanie Lahr:It was, it was actually maybe a kind of fun for them to my eight year
Stephanie Lahr:old in particular, um, not, not shy.
Stephanie Lahr:So he's known to sort of peek in on meetings at times and want to say hello
Stephanie Lahr:and, you know, get to know the team.
Stephanie Lahr:A lot of my.
Stephanie Lahr:No, it was my kids.
Stephanie Lahr:Right.
Stephanie Lahr:And they probably know them better now than they did before.
Stephanie Lahr:They maybe saw them at a team picnic twice a year.
Stephanie Lahr:Now they actually see them quite often.
Stephanie Lahr:And that's been something we've reciprocated if it's we've made
Stephanie Lahr:it okay for others as well.
Stephanie Lahr:Right.
Stephanie Lahr:We all just had to kind of navigate our way through.
Stephanie Lahr:Um, and you know, it's been a lot at times I was happy for
Stephanie Lahr:the schools to open up again.
Stephanie Lahr:Um, but I do think it has been nice to.
Stephanie Lahr:Make it okay.
Stephanie Lahr:To understand that people have these lives outside of their work
Stephanie Lahr:and they can blend if they need to.
Bill Russell:Yeah, my wife and I we're actually we're in the opposite joy.
Bill Russell:Our youngest is 21 and in college.
Bill Russell:So when the pandemic hit, she was forced home and you know, the pandemic
Bill Russell:has some silver linings and one of them is just being with family.
Bill Russell:Yeah.
Bill Russell:One of the things I remember a saying in the middle, I'm like, man, I'm
Bill Russell:glad our kids aren't that age, that little age where it's like, I need to
Bill Russell:get out and need to all those things.
Bill Russell:On the
Stephanie Lahr:flip side, I will add just given your earlier comment
Stephanie Lahr:about women leaving the workforce.
Stephanie Lahr:This is a really concerning issue to me as I think about, um, you know, women
Stephanie Lahr:as, as a constituency of our workforce, whether we're talking about in medicine
Stephanie Lahr:or, or anywhere and maintaining that diversity and, um, and thought process.
Stephanie Lahr:3 million women left the workforce, um, in the United States.
Stephanie Lahr:And, you know, during this time period.
Stephanie Lahr:And so as we look at nursing shortages and you know, it shortages and all
Stephanie Lahr:of the things that we're seeing, 3 million women left the workforce.
Stephanie Lahr:And I think we're going to have to dig in and understand I had the luxury of
Stephanie Lahr:finding a way to be able to balance both.
Stephanie Lahr:But what that tells me is we've not set our infrastructure.
Stephanie Lahr:To support that more broadly.
Stephanie Lahr:And I was very fortunate to have a situation that I could make that
Stephanie Lahr:work, but a lot of women apparently didn't feel like they could.
Stephanie Lahr:And I think we're going to have to walk through that as we recover
Stephanie Lahr:from, this is how do we, um, reinvent and reframe some of how we do work.
Stephanie Lahr:Some things, obviously a nurse cannot bring their child to the hospital
Stephanie Lahr:while they're providing beds.
Stephanie Lahr:But maybe our organization could be providing childcare directly or
Stephanie Lahr:more directly at this point, right?
Stephanie Lahr:Yep.
Stephanie Lahr:That would be an option.
Stephanie Lahr:Or, you know, maybe we need to have childcare at the hospital
Stephanie Lahr:in the middle of the night.
Stephanie Lahr:Maybe we have a single mom who would be happy to take the night shift,
Stephanie Lahr:but there, you know, all, there's all kinds of ways that we might need
Stephanie Lahr:to just be thinking about it, but we can't just absolutely absolutely
Bill Russell:types of license plates are there in the state of Montana.
Bill Russell:And just on your slide, you don't remember.
Stephanie Lahr:No, I totally know.
Stephanie Lahr:It's two hundred and thirty two hundred thirty, one hundred and thirty different
Stephanie Lahr:license plates in the state of Montana.
Stephanie Lahr:Literally, as you drive down the highway, you will think you're seeing a whole
Stephanie Lahr:bunch of different states represented.
Stephanie Lahr:No, just look closely.
Stephanie Lahr:It's probably yet another of the Montana license plates, which I think is fine.
Stephanie Lahr:It's 230 license plates.
Stephanie Lahr:There's less than a million people.
Stephanie Lahr:So you know what I mean?
Stephanie Lahr:Like you kind of really, you can have a pretty unique
Stephanie Lahr:license plate and that's pretty
Bill Russell:interesting.
Bill Russell:Just
Stephanie Lahr:crusted over a million people in the last census.
Stephanie Lahr:And we can
Bill Russell:look in every direction and we don't see all that many
Bill Russell:people where we're at a distance from one end of Montana to the other,
Stephanie Lahr:uh, on I 90, I think it's right around 515 miles on interstate 90,
Bill Russell:90 starts.
Bill Russell:I 90 starts where
Stephanie Lahr:I, 90 starts in Boston finishes in Seattle.
Stephanie Lahr:Wow.
Stephanie Lahr:And, uh, funniest story.
Stephanie Lahr:I, I, before I lived, um, in rapid, I lived in Coeur d'Alene.
Stephanie Lahr:Another, I like to live on nine 90 apparently.
Stephanie Lahr:Um, and, uh, uh, there used to be a joke that you could make it from
Stephanie Lahr:Boston to Seattle without stopping if you made the light in Wallace, Idaho.
Stephanie Lahr:So Wallace Idaho was like the last place that I, 90 was kind of
Stephanie Lahr:formalized, tiny little town, um, mountain town, and there was a stop.
Stephanie Lahr:Uh, they're on for many, many years, about 15 years ago, or so they
Stephanie Lahr:finally fixed that, but yeah, that
Bill Russell:was, and you used to live in Montana.
Bill Russell:So for many years though, they did not have a speed limit on some of these roads.
Stephanie Lahr:Yeah.
Stephanie Lahr:I still get asked that people are like, wow, it's so cool at Montana.
Stephanie Lahr:Doesn't have a speed limit.
Stephanie Lahr:Well, it was three years from 1998 to 2001, um, didn't last, super long.
Stephanie Lahr:And actually there was a speed limit.
Stephanie Lahr:It was called reasonable.
Stephanie Lahr:So for me, I type a overachieving.
Stephanie Lahr:Don't want to break the rules kind of person.
Stephanie Lahr:It was actually really stressful because I didn't know which line to be in.
Stephanie Lahr:I would see a police
Bill Russell:officer on the major highway doing 35,
Stephanie Lahr:like, oh, is this okay?
Stephanie Lahr:Yeah.
Stephanie Lahr:Um, so for me personally, I'll, I'll take a speed limit any day, but
Stephanie Lahr:yeah, it didn't, it didn't last long.
Stephanie Lahr:The, the statistics that went along with the outcome of that were not favorable.
Stephanie Lahr:Stephanie, thank you for your time.
Stephanie Lahr:Great to talk to you again.
Bill Russell:Don't forget to check back as we have more of these interviews
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