June 23: Today on Townhall Mark Weisman, CIO and CMIO at TidalHealth interviews Anurag Jindal, Executive Director Regional CMIO at Providence St. Joseph Health about his new role as a CMIO as well as the lessons and challenges that the role has brought forth in his first 90 days. Anurag brings forth a refreshing perspective in this episode, his mindset when taking on a new role is one to adopt. With his inspiring positivity, he answers the following types of questions: Who does he see as his support group in the new role? What advice would he give someone for their first 90 days as a CMIO? What has success looked like for him since he’s stepped into this role?

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Today on This Week Health.

The challenge has been not knowing what you don't know. There's some conversations happening somewhere, somebody buying a new piece of equipment or technology, which then becomes the CMIO or the informatics team's job to integrate it with our information system. That is a challenge. I don't think that is something that you can learn in a classroom.

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All right. Welcome to town hall this week. My name is Dr. Mark Weisman, and I am a CIO CMIO practicing physician. And I have a special guest with us here today. I have Dr. ANUG G from providence st. Joe's and he is a Lucy IO. I'm gonna let him introduce himself further. Anurag welcome to the show.

Thank you. Mark. And thank you for having me here. Yes. This is a very new role for me today. It's 79th day since I took on this role. And I'm an ER, physician practicing ER, physician at one of our hospitals. Started this three months ago. And prior to that, I was system provider informatics.

This, this a role given to I was chairing the ER informatics group for our system of 54 hospitals and all the urgent cares as well. So when the position opened up, I was asked to join as a C M I O. And A lot of questions about it. And hesitatingly, I took on this role and I am finding out finding my feet under me and liking what I'm getting to do.

Now. It's a different opportunity.

Fantastic. So that's what this episode's gonna be about is really about that new

CMIO. What are you encountering? What are you feeling? What are your goals and objectives? What do you want to get done in the first 45, 9, 60, 90 days? I'm gonna let you take it away. Tell us how it's going.

So it's going alright, it's going well, I don't think there was any a roadmap or a book to follow on what the role will entail. So I had all those questions. So what is my role? And all I was told was, well, it is Customer service, make sure that your physician's needs are met and you tell them how to use technology, how to use the information system.

So I tried my own path. I talked to a lot of others. Yeah. My OS to find out what this work is. It's easy integrating somebody in the emergency department is the easiest thing. Compared to what this role entails, because there was no way there was no training, I guess you get trained on the job because last 11 years has been spent in informatics governance of some sort for the emergency departments.

But I know, ER, I know ed, I know the ed directors this role involved getting to know all the leaders in your region going to surgery conferences going to anesthesia. We kind of know of, but getting to know about it in greater detail was a problem. So I started off starting to meet who are the influencers, who are the decision makers in my region, what is my region?

So it was the whole organization first. So getting to know the region first, which was thought to be something that I already was aware of when I took on this role by. People who thought I would be a good fit for this job and come to think of it. I did not know anybody outside the ER, when there's a code blue in the ER or you are responding to it, your hospital kind of, I did not know my hospital.

I know where I have to go. I take somebody from the ER, who knows the hospital and likewise for the. I started going around and finding out who these people are getting to meet them. And it was great. So I set up some goals for myself, what I need to do in the first 30 days, 60 days, 90 days. I mean, these are part of what we do when you're running a project.

And I treated this as a project. So I started off meeting all the service line directors. I, had a list of people that I wanted to meet the execs, the CMOs, the chief of staffs for medical executive committees. It is a 10 hospital region and it has a pretty big footprint. And my role was. Limited to the acute side of things ambulatory had its own governance process.

But as you're aware, mark, there is a crossover for the ambulatory providers work on the inpatient side. So you become the face for everything to do with informatics. So we had to set our house in order first, I had to get to know our team. So it was initially just lot of flurry of meets and greets. I would say like 35 or 37 people in the first month that I met.

And that is pretty much from the start of the day to the end of the day, getting to know what their perception is. Everybody likes to think that informatics is one of the big, I mean, they don't like the thing. I think it is a fact they informatics touches everybody's lives, every caregiver, every clinician.

So. They had a lot to say, and I was very pleased that they felt comfortable talking to me. So I kind of know what to do, but I started off first by know, getting to know our own team. We have a great team of clinical informaticists there's managers who manage them. And then how do we organize that team?

How do we, what is informatics? It was just a CMI O CNI initially. So now we have a team of four executive directors which work with is. Collective technology services. So we just sit together. We are trying to form our own team to make sure that all of us know any request coming to anybody. We have visibility into that.

So breaking down silos within our own team was priority. Number one for us. And the second was getting to know all the influencers and decision makers. I think we have work to do a lot of work to do internally within our team, but at least I think the visibility to the people who make decision the region, I think we are getting there and they're getting to know our team.

And hopefully by the end of this year, we hope that it'll be. Smooth as we hope that it can be. The second piece we wanted to work in was also communications. There is so much being sent out to the bedside clinicians today from so many multi sources, that whatever message that you have to communicate gets buried in there, and nobody pays attention to it.

I mean, you would've seen in your own organization. There's an upgrade coming up. There's a new project coming up. You can send out 10 emails, newsletters, and everything. And on the day of the upgrade, say, Hey, what happened? This looks different. And nobody has read your communication. That is a universal challenge.

We are trying to get. To do better. And there are certain things that we have done. I'll spare you the details about that. But we have worked with our communication team and everyone else. So there's only one person sending that message rather then multiple channels.

When you solve that communications thing, you let us all know cuz that's, that's a Nobel.

Prize in there for you. So, alright. So you're a regional CMIO in the Puget sound area if I recall. And so there's other regional CMIOs when I first started out, there was a couple of people I latched onto. Are you finding that other regional CMIOs or who's your support group? Who do you go to? And you're like, all right.

How did you handle this whatever issue it is that came up? What's your, what's your method for building your support team?

So we are very fortunate. I think with a big organization comes a lot of in those support there's people who have already done this role, who first started off as bedside clinicians who are now CMIOs and went down the informatics path.

So my call is to those regional. CMIOs is the first thing that I do. I have recurring meetings set up. One-on-ones every two weeks with two of the regional CMIOs, who I'm constantly troubleshooting with how to, and what they have done in their regions. They have few years already under their belt, and that is the people I go to.

I'm very fortunate to have a CMIO who has been doing this in this region for the last three years. So she has been wonderful to work with. So our partnership within our own team is excellent. So they are also my support system.

Talk to me about the relationship with your C N I and. Where that ranks on the importance of people to engage with.

Cause all your new CMIO, you've gotta hit 15, 20 people. Your first one, for sure. C's gonna be in that group. Is it number one, number 30? Where do you put that relationship?

The C is one of the most important relationship that I have. That is somebody who. I think if not hour by hour, at least several times a day that we are communicating whatever.

So communication. Yeah. Yeah. It is the it's impossible to reach out to everybody. And I think due do the bulk of the work, which is non-physician related. So getting your, keeping your to the ground is only going to happen if that relationship develop.

I think that's good advice for new CMIOs or even new informaticists is it is easy to create all the alerts and have it hit the nurses, but they may not like that.

You might wanna think twice about that. So that landline,

yeah. I think physicians learn better from physicians nursing staff and everybody non they learn from their own leaders because they identify them as their peers. It is hard for a nurse, for a physician to know the nursing work. I don't even know the nursing workflows.

Mm-hmm to articulate that well,

it's in so important too, also to understand where that handoff happens between the physicians and the nurses and. As a CMIO. That was one of the things you're right. I, I, when I was in the role, I, didn't really know the nursing workflows, the impact that the nursing workflows are gonna have on what I was trying to do and getting exposure to all of the ancillary allied health services.

Respiratory therapy was one that I have no idea what their documentation looked like or what, when I write in order the impact of that downstream. So I agree with you. There's definitely some key relationships there on those clinical, those key clinical leaders throughout the hospital.

We have cm, so we had a big restructure just before I took on this role for informatics, the way is delivered. We have we are pivoting to a virtual and online support model and that was a big change and to get the operational leaders to buy into that, that was a big area to work on.

And so that is where our teams are working on. Our CIS, who used to work at the bedside with the physicians. They're a big source of support for our team as well, besides the C. So they are talking to me about anesthesia. That's a foreign language for me, anesthesia up time. I have no idea about those applications.

Right, right. one of the, what, what's your biggest challenge right now as a new CMIO? What do you like? Well, I wish I had class or school on this particular topic. What is it that, that you struggle with?

There is so many I think my biggest challenge is not knowing what I don't know. I think it is not a class, a particular class that I would, because I'm finding out for this job.

You don't have to be the expert in every single thing. You have to be able to connect people to the correct resource so that they get the help that they want when they want it in a timely manner. So, My biggest challenge. I've been doing informatics governance in some form for the last 11 years.

The challenge has been not knowing what you don't know. There's some conversations happening somewhere, somebody buying a new piece of equipment or technology, which then becomes the CMIO or the informatics team's job to integrate it with our information system. That is a challenge. I don't think that is something that you can learn in a classroom that is something you develop by breaking down the silos and that.

is Our biggest that is my biggest challenge. Getting to know that and to find out, go borrow trouble and it Ends up being a lot of hours in a day, but I think it is worth spent. And I think my personal goal was for six months, be available 24 7 to everybody so that they develop that trust. Then they'll come and you become that person for them to be able to help them navigate the informatics waters.

and Talk about that technology. I think that is my role as I see it, I don't think it is something. Yeah, sure. You can have your MBAs and other classes and power BI and tools that you use for day to day work. That is all good. We can do that, that can come after the fact, but that is not something that I've found as being limiting me from carrying out my work.

I would say the biggest, my suggestion to you. My biggest problem that I experienced when I was starting out is time management is getting sucked away by this doctor. Who's got this idea. They think it's the greatest thing. And it's gonna be just for them. It's this one off little thing that they, it's just their area of research that they love.

And they think it's so important. And you now serve a bigger community. And yes, that whole 24 7 availability thing is going to kill you, my friend. So be careful that one,

I hear you. That is a very good advice. And thank you for that. Yes. I'll like I said, six months, how many he essays, but we'll see how that works.

Thank you. That is very good advice.

Well, let me wrap up here. With one last question. If there's a CMI or informaticist, who's next in line behind you. What's the advice that you would give them for their first 90 days?

I would hope that the person who's wanting to adopt, they have an informatics background for sure.

And so that is first 90 days for them would be get to know, develop your core group of people who you can trust for advice that you can get on because it's not possible for you to know, develop that relationship with your C N I O. It is absolutely essential. And get to know your CMOs so that you're able to have your year close to the ground and develop that relationship.

And I think those relationships are the ones which are foundational for you being able to carry out your work. That would be my biggest thing, because most of the times the problems happen that you're not communicating with them enough because these are the people who will communicate to their end users communicate to the execs and the region.

And so that relationship is foundational.

Thank you for coming on the show today. I really appreciate it was just what I was hoping to get was a really tactical hands on feel for what it's like to be a new CMIO. Appreciate it. Hope to have you back on again soon.

Thank you, mark. I appreciate the opportunity, but to the new CMIOs, it is good once this started I think you guys know how to do this job and there is not going to be a roadmap.

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