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Bill Russell: Today on Newsday.

Wes Wright: that's the fun part, but now I think the CIO is really dependent on that CTO to bring those ideas.

Bill Russell: 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. Newstay discusses the breaking news in healthcare with industry experts

Now, let's jump right in.

(Main) All right, it's Newsday, and today we are joined by Wes Wright, who has left me for quite some time to hang out with Drex, but is back, and I am excited for this conversation. How's it going, Wes?

Wes Wright: It's going super. Late summer out in Northern California. Weather's great. Skies are blue.

No fires in the area. Life's good.

Bill Russell: we have missed Drex. He has been at Burning Man. He's been posting, and so clearly they have internet at Burning Man.

Wes Wright: I tell ya, at Burning Man, a long time ago, I live in the country, so when I first got out here, I bought a Starlink Mobile, and so that's what he's using at Burning Man.

That's

Bill Russell: what he's been doing is Starlink Mobile. That's, I will have to talk to him about that. That's an interesting conversation to have. Anytime I get you on the show, I want to ask this question. What's the craziest thing, you work at Ordr obviously, Ordr Inventories, everything that's on the network.

What's the craziest thing we've seen on the network recently at Ordr at a health system? Craziest one

Wes Wright: item kind of thing. Guest network, we see a lot of stuff, but I don't think that's fair because the guest, guest network's pretty open. It's not as outrageous. I still see some deck 400s out there.

Occasionally we'll see one of those. But at

Bill Russell: least it's a computer,

Wes Wright: It is. The thing that we see most, and most people are surprised at, is, folks are coming in and plugging into your hospital charger, and if they're an employee at the network, they just sign their Tesla into your network, or their electric car in your network, and it gets all its updates over your network.

Not that there's anything, nefarious about that. It's just something you might want to know. I still

Bill Russell: remember in 20 11 at St. Joe's when I asked for an inventory and I saw , the number of Windows 95 devices on the network. Yeah. My, my head almost exploded. Oh my gosh, you're kidding me.

Yeah, hopefully there's less Windows 95 out there.

Wes Wright: I haven't seen a 95 box in a long time. XP? Yes it's still running on a bunch of medical equipment, but haven't seen a 95 box in a while, saw some 7s, and now the big one is the journey from 10 to 11 that folks are gonna have to make, and that's something, I remember when I went to 7 to 10 that was my morning question to my doctor.

Windows 7 desktop guy. How many did we do last night? How many do, how many we got left? And now all that stuff's automated. You can just get it, click of a button.

Bill Russell: I want to talk architecture. I, we could talk about stories. I'd love to talk architecture. You're a former CTO.

I'm a former CTO. So we're former CTOs. What makes that, people are always asking me these questions, like, why is healthcare behind? Why did it take you, 20 years to get barcodes into a hospital? And I'm like, it's a little more complex and you're dealing with people and you're whatever, but I'm not sure I can even explain why it took us 20 years to really take advantage of barcode readers.

Why is it harder for health systems to make those kinds of major upgrades on on desktop operating systems.

Wes Wright: Yeah, I think it all goes back to how we grew, Bill. And that, that health IT grew organically. And we don't get much, Aaron got a chance once at Walnut Creek or something, some Walnut, Aaron Mearing.

Stood up a brand new health system with the right tools right at the beginning, but most of us didn't get to grow that way. In most health IT, it probably started in the radiology department when the radiologists were putting together all their stuff, and then the lab people they started tying together all their equipment so that they could have one reporting place, and that's just If you think back 10 or 15 years ago, Bill, we didn't have the EPICS and the CERNers.

We had little pieces, like there was an ED, still is, EHR app for the ED, an EHR app for ambulatory, revenue cycle app for ambulatory, revenue cycle app for inpatient an app for inpatient. So I'm with you, but

So I come in as CIO and it wasn't immediate, but within the first two years, I looked at him, I said, look, I want three images for servers. And I want three images for desktops. Now my team's heads like are just, they're exploding. That's not possible. It's not possible. I'm like, I think it is. Oh, for sure.

And we walked through it. Now we didn't get to three and three, but it had the right directional impact. I think we got to five workstation and maybe six server images, but still directionally, that was a reduction of a huge magnitude because at the end of the day, once we get to that point and we say, okay, now upgrade them, you've just simplified that in that environment.

Have we not done that across the board? Have we not had the, don't know, maybe the backing of the CIO or the backing of the executive team to say, look, we need to get these things to a point where we can be more nimble and make these kinds of upgrades.

Wes Wright: Yeah, I think so.

I think one of the issues is we're a big, if it's not broke, don't fix it kind of place.

Bill Russell: Ian, it's a very tight financial time.

Wes Wright: Extremely tight, but I actually think by doing the kind of upgrades the stuff that's available now, you get an IJL0 client, no license you have to pay for that you got to pay for the IJL license, but no Windows license, that hooks up to ILM browser, that hooks up to WVD, and think of all the servers that you've just taken out of your environment.

Problem is, nobody's really got, I think this may, nobody has the time to do that experiment. Right now, nobody in the opera. I mean we were back in our day. You and I were experimenting Yeah, this is a great concept and they do it in the enterprise now Let's see if we can do it in healthcare We don't have a lot of people that are I wouldn't say willing they don't have the resource to actually Take on the risk of that experiment.

And I think that's what slows down healthcare so much especially in the large to medium size where those guys and gals are just tapped out. What's on their plate from an IT perspective. And they just can't, I'd love to be able to do that, but I don't have the resource. At Sutter, I had to cut out a pod of people that just did nothing but that.

So it's a resource thing more than anything, Bill.

Bill Russell: think it's an imagination and courage thing. And yes, I'm calling out some people here, but I think it's an imagination and courage. And one of my favorite CIOs. is Alistair Erskine out over at Emory. And Alistair asked the question, could we, so they're setting up a new hospital, he's could we only deploy Macs in that hospital?

Okay, first of all, how many CIOs do you know that are even going to ask that question? But Alistair stood back and he said, look, a Mac computer lasts probably least two more years than the average PC. If not more, it's more secure because it's a Unix based operating system.

And he just, he goes it's more energy efficient. He went through eight things. He goes it's just a better platform because it would stand to reason that if I'm going to. Stand up a new hospital system, I should do this. So there's the imagination of, is it possible? And then it's courage, because the minute he says, I think we can do this, how many people do you think in healthcare said, that's a great idea?

And how many do you think said, you can't do that? What are you, a knucklehead? Why would you waste your time doing that? I would say it's 80 20, 20 percent were like, That's cool. And 80 percent were like, why waste your time doing that? I think it's imagination and I think it's courage.

Wes Wright: I think there is some courage to it. There's a little bit of both for sure, but maybe a bigger courage component than my answer would have led you to believe, but yeah, you have to have the courage to take the risk Every time we did this kind of virtualization thing, the nurses the people who are seeing the patients absolutely love.

I got a quote from one of the nurses that says, it's been 17 years and this is the first good thing it has done. Yeah. And that was just bringing virtualization and. maybe CIOs were looking out at the business, trying to integrate with the business a bunch, whereas if we looked inside and saw, how can we help the business do better with what we have? Not build some ACO and digital front door or something like that, but let's take a look at what we have My deal as CTO was, make technology as transparent as possible to our clinical and business users.

And that's what we're not doing is we're stuck in that, okay, they're used to doing this login via this way and the time it takes and so on and so forth. So they're not complaining about that. So I'm going to let that go when that is one of the places that you could most delight your users is right there and speeding up what they have to do every single day.

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Bill Russell: I remember one of the first projects I did was your previous company. It was David Baker walked into my office and said, I think. I can reduce the initial login of every physician in our organization by 30 seconds and subsequent logins By almost 98%. And I was like, why aren't we doing this? He goes, I couldn't get the funding.

I I'm like, all right, can you do a pilot? He goes, I've been doing pilots now for a year, like it's ready to go. And he showed it to me and then we went out we took a department, we put it on it and the department was like, wow, this is the most amazing thing. They're giving you hugs and high fives and they're like, it's great.

Yeah. It's crazy to me that the culture kept that project from happening for over a year before I got there. And I don't understand it. The physicians and nurses were extremely happy that we rolled it out, but we kept it under under cloak for almost a year.

Cause we just couldn't get the excitement and enthusiasm behind it.

Wes Wright: I think all the cheese you're moving around, Bill, that's a lot of people's cheese you're moving. And Manish used to tell me there's organizational bacteria that, attacks, change, and good ideas.

Bill Russell: That sounds like Jonathan. Organizational bacteria. And that is absolutely true. by the way, I love the yellow hat behind you there. Appreciate it. Appreciate you being a part of that. there is organizational bacteria that attacks ideas that slows things down. I remember when we were going to roll out a portal, this sounds very simple thing. You were at Sutter. That's bigger than St. Joe's, I think. And St. Joe's was seven and a half billion, 16 hospitals. And when I said, hey, we're going to roll out a portal, they said, that's fine. You just have to get the approval of the Physician group boards, and I thought how hard can this be?

It turns out there's seven of them. Okay, so you go to the first one, I say, ah, you can do everything except for that one thing. We don't want you to do that one thing. And then you go to the second one, they're like, you can do everything except for that thing. I'm like what about the thing they want to change?

Oh, no, don't change that. And then you have to go back to the first one and get them to agree. And I'm like, oh my gosh, two boards just took me three months to get a portal out. And There is something about healthcare is in the business of mitigating risk. And sometimes they inappropriately identify IT as that foreign entity that needs to be, taken out, stop them, slow them down because they are going to create problems.

And they haven't always been wrong, to be honest.

Wes Wright: It's true, but yeah, I think there's a lot more courage in that answer than I said before. It is a matter of somebody having the courage to say, yeah, that's a good idea. Go run with it. That's what happened to me at Sutter is, John, that's a good idea.

Go run with it. And that's what we did. And there's got to be that courage to to be able to say, yeah, I'd do that again. It was a great idea. And it would have saved a whole bunch of time had it worked.

Bill Russell: minutes, just a couple minutes here about the

Wes Wright: CIO

Bill Russell: the

CIO,

CTO, The CTO was one of the most fun conversations I got to have because I found the CTO to be somebody who was creative. If you unlock them and said, Hey, I want you thinking about how you can make this thing work. Really saying and so I was constantly encouraging them. And so they would come to me with the goofiest things.

Like I could speak to Google device and it would provision servers in our data center. I'm like we're never going to use that. That's cool because it demonstrates automation and you sit there and go, wow, the software defined data center is really not that far away when you start to see those kinds of things.

And so the CTO was constantly playing around with those things to demonstrate, hey, this is what's possible, and if this is possible, therefore we can do X, Y, and Z. And, I think what he was looking for from me was a little bit of direction, but mostly yeah, I'll get behind that one.

I will get it funded. I will get you the air support you need, and we're going to do that.

Wes Wright: Yeah, I, I enjoyed my CTO gigs much more than I ever enjoyed my CIO gigs. Mostly a lot more instant gratification in the CTO gig. Hey, that works, kind of thing. Whereas the CIOs are slugging it out.

But that's to me is the role, is the, worked with Drex a couple times and, he'd go do his CIO stuff and then come back and we would have conversations about the conversations he just had, which would then enabled us to try and figure it out where we needed to be to meet the organization.

And then I would get to go off and with my, pocket protector and wire hair guys, and we'd have that same conversation, but we take it down to a smaller level and say, okay, what technology can we do? If they're going to be here, what And that's the most fun part about the job, in my opinion, is that taking where they want to be for a business and applying technology to help them get there, or to meet them there.

that's the fun part, and that seems to me to be Lately, more of a CTO's job than it used to be. That kind of fell into the bailiwick of the CIO gig a little bit, but now I think the CIO is really dependent on that CTO to bring those ideas.

Bill Russell: Yeah, the CIO job is a politics job. You are a politician.

You're trying to raise money at all times. You're trying to get enough money to keep IT funded. You're constantly running error cover. You're fixing broken projects or projects that are stalled. You're trying to gain support from departments or hospital leaders. interesting to me because I was an SVP, but there was a whole bunch of EVPs.

that were technically peers, but they were technically higher in the organization than me. And, so I was in this weird role, but I would say, gosh, 90 percent of my job every day was people. And people are very difficult computers to get to do what you want to do. Yes, computers are nice.

You just, you program them correctly. They do what you want them to do. People, they can respond differently from day to day.

Wes Wright: that's the whole CIO gig. That's the way we played it. He managed up and I managed down. \ Still people you got to operate with, but they're a little more logical, more computer esque than some of the people the CIO has to

Bill Russell: Wes I am so proud of you.

I've led you into so many dark alleys in this conversation, and you have adeptly navigated these conversations, which I so far. So far. I'll tell you what, we'll close with this. The cybersecurity. See I always make the mistake I say to Drex Hey, things have been quiet lately.

The minute I say things have been quiet, like a change healthcare happens. Or a CrowdStrike happens. And he reminds me, it's like, Yeah, it might be quiet where you sit because you're not reading the headlines, but it's not quiet on the front lines. feeling the same thing that there's Just a lot of stuff still bubbling underneath.

Wes Wright: Most of the CISOs I'm talking to and associating with and like a cat on a hot tin roof comes to mind. It's like they're a cat on a hot tin roof. They can't really find any safe footing. They know something's gonna come out of somewhere to get them.

And That's the way they live in now. Maybe that's that whole stress thing that they keep talking about in all these CISO magazines.

Bill Russell: tell people, I think the CIO role it was like dog years for me. I feel every year I was in the role. I don't know, let's say three years off my life.

It was incredibly stressful, long hours it was just, it was stressful. The CISO role today, I would feel the same thing. It's almost you want to give them furloughs from time to time. We might want to institute sabbaticals from time to time for these people cause is a constant,

Wes Wright: man, constant stress all the time.

And you're just waiting. I'm not sure I can do it anymore. I don't think I have the youngness in me that I need to have, but I don't think I can do it anymore.

Bill Russell: Yeah, but man, I appreciate the people who are in there on the front lines and doing the work.

I love the fact that. You've been coming to some of the city tours and meeting with them and talking to them. It's been great to hear the work and enthusiasm that they have. do believe it is a young man's game. And I appreciate them stepping in and being able to help any way we can.

Wes Wright: Yeah, we'll be out here, the old guys willing to offer advice and and mostly commiseration. Yeah, I know exactly what you're talking about. Wes,

Bill Russell: always great to catch up. Don't feel like just because, Drex is around that we can't, do one of these shows every now and then, so I Yeah, that's true.

I appreciate it. But I know you like hanging out with Drex. He's got a certain cool factor to him. And I will never be a burning man,

Wes Wright: just so

Bill Russell: you

Wes Wright: know. Yeah. I don't think I will be either. There's a certain coolness about you, bill.

Bill Russell: I'll tell you, don't talk to my kids. That's

Wes Wright: Nobody's cool to their kids, bill. That's just something you have to, that's just true. That's something you have to live with.

Bill Russell: Alright. Hey Wes. Fight the good fight and find some other crazy things out on that network for the next time we get together.

Wes Wright: I'll I'll start saving them build conversation pieces. Exactly. Alright, man. Take care. We'll see ya.

Bill Russell: Thanks for listening to Newstay. There's a lot happening in our industry and while Newstay covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news.

Thanks for listening. That's all for now