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Today on This Week Health.

since you've been in, healthcare IT for a long time, you've seen all the trends and all the investment.

And, I think the number one broken promise is, for the investment, we, haven't delivered on the outcomes.

Welcome to Newsday A this week Health Newsroom Show. My name is Bill Russell. I'm a former C I O for a 16 hospital system and creator of this week health, A set of channels dedicated to keeping health IT staff current and engaged. For five years we've been making podcasts that amplify great thinking to propel healthcare forward.

Special thanks to our Newsday show partners and we have a lot of 'em this year, which I am really excited about. Cedar Sinai Accelerator. Clearsense, CrowdStrike,. Digital scientists, Optimum Healthcare IT, Pure Storage, SureTest, Tausight,, Lumeon and VMware. We appreciate them investing in our mission to develop the next generation of health leaders.

Now onto the show.

    📍 all right. It's Newsday and today we're joined by Jon Kimerle with gosh, Global Strategic Healthcare Alliances with Pure Storage one of the fastest growing technology companies in history. Did I get that right?

You did.

That's amazing. I'm not sure people know that, but it essentially when it came out, it was pretty unique in its approach to storage. And it hit right at that time when we were looking for faster, and had all the solid state storage, which was of course, a lot faster than the spinning disc that we had before.

And I guess it just hit that perfect inflection point. And I think some of those design decisions that were made for certain reasons are, panning out now as well.

Security, specifically? Security,

the simplicity the ability to do non disruptive upgrades really allows, people to experience a cloud like operating model, but with technology that's on prem.

So, we're going to get to the news in just a minute, but for people who aren't familiar, you have... extensive experience in healthcare 13 and a half years with SSM out of St. Louis. So why the transition? How do you make this transition

from from a faith based healing ministry to a technology company?

Well, Actually, at SSM for 20 years, and really three roles Vice President of Clinical Transformation, so for about a decade, I owned the transformation projects, including the EPIC and enterprise imaging been. Owned and it was accountable for the clinical and revenue cycle applications.

After that sat in the CIO seat for a short bit, and then VP of IT strategy and planning, so stepped away from, delivery and owning applications and thought more about how all the investment flows through the organization to support their objectives. And there was some leadership changes and it was time for me to find a new opportunity.

But yeah I in many ways, the core leadership activity, both at faith based healing ministry and at PURE is the same. And that is, getting really clear on what you're trying to accomplish, getting clear on what problem you're solving, and making sure that that solution is going to help enable the realization of that value that you're trying to create.

So, in many ways, it's the same activity.

Well, cool. We have five stories. I don't know if we'll get to all five, but let's start where you brought up EPIC. EPIC had UGM a couple weeks back, and there's a story in Becker's Hospital review, Judy Faulkner touts new plans for EPIC.

Did you happen to make it up to UGM?

I actually wasn't there. I didn't make it up. Sometimes I do go up, but this year I had a different commitment. Did for, 18 years.

Well, this is the first time I was in the room. I was not an Epic client when I was a CIO. And it's funny because the, everyone assumed that I'd been there so many times.

You're everywhere else. Yeah, and I'd never been there. I was never an Epic client. So, and they were kind enough to extend an invite. To me, so I was able to sit in the deep space, listen to the talk that we're going to refer to. And they captured a bunch of the highlights here in this Becker story.

Judy really started with this. I'll just give you the quote. Things have washed away. Healthcare staff have left. Hospitals have closed. Important services such as maternity of clothes, access to many services have slowed down considerably. Appointments may take months, she told the audience, but we're going to make our new healthcare world better than it was before.

And then she went on to tout a bunch of different things. uh, AI was a consistent theme. The sharing of data, the whole idea of lookalikes. I thought lookalikes was one of the most powerful things that she shared from the stage, and that is the ability to identify people. Because Epic has Cosmos now, you're, you have the ability to identify people who have similar symptoms for rare diseases so that doctors can then collaborate on what they're seeing and what they're finding.

I thought that was pretty powerful. And they introduced this idea of Pals and Partners, and I thought that was probably one of the main themes was Pals and Partners. And to really drive that home, they had Satya Nadella come up and take the stage and had a conversation on stage. And I thought that was also sort of driving home this.

point, which is EPIC is turning a new leaf, which is we're not going to build everything, but we are going to find good partners who are going to help us to move forward. So that was my takeaway from it. I'm curious, what you've heard.

Well regarding from a vendor side EPIC has been very agnostic in Switzerland for decades.

But we did start to see a little bit of not favoritism, but a desire to try to shorten the pool of individuals that they work with, organizations to try to, increase the quality of delivery or whatever they're doing. So although I wasn't in the room as we have conversations, we're definitely starting to hear a little more of that type of talk.

the PALS That wasn't in the article. Can you elaborate

on? Sure, so yeah, the PALS and Partners. The two PALS that were there were a Bridge and were the two PALS. And so they have this new program. The PALS program is for smaller companies, startups. Who they will now get to work very closely with Epic Engineering.

And so I talked to both, I stopped at the two areas to talk to the people from TalkDesk and the people from Abridged. And they have been working for the better part of almost a year. with EPIC to have very tight integration. So if you can imagine something like TalkDesk is a service desk or a call center service desk solution.

And when they did the analysis they noticed that in the healthcare setting, A significant amount of the call centers, the staff, would spend time in the actual EHR. And so now you have this deep integration into the EHR. And so you can have these pop ups and whatnot directly in that single window.

So you're producing the number of windows that are going to be open in the call center at the service desk agent and give them access to the information. That they need access to and with the bridge, it was the same kind of thing. It's deep integration and working directly. So that's the PALS program.

The Partners Program is large. It's just, it's basically by size. Yeah. So you have somebody like Press Ganey, who was announced as a partner, and you sit there and go, yeah, they're, a multi... Definitive. Yeah large organization. They may not need as much help, but would benefit from a relationship between the two that would integrate the solution.

Yep. Back when I was at SSM one of our strategies either stated or not stated was that we really looked to Epic for all of our application needs. We tried not to go off and buy bolt ons and one offs even when there was, Pressure to do so, we realized that, EPIC may not have what we're looking for or what that individual was looking for today.

But, within 12 to 18 months, they usually do. So the hypothesis was that, while there might be a gap today, it's going to be closed over time. And so sometimes we were looking for short term solutions for that window, but, this sounds like a great strategy to close that window and bring some of that innovation in.

Let me run something by you. So I was talking to a CIO this morning they're going into a budgeting meeting. And one of the things that as the CIO, he is going to. Take the position of is by the way, they had the epic first strategy as well. Like we, this is our EHR. If they offer it, we're going to do it.

And then they have sort of this tier of, if they're doing it today, we're going to use it if it's on the roadmap, but it's three years out, we could consider using something else because. Sometimes those three year windows don't really amount to anything. And so they have this sort of framework.

But he's going to go into that meeting and essentially say, Look because money is tight right now in healthcare, in order for us to sort of hold the line on our expenses, we've got to stop being shoppers. Like every time people go to a conference, they come back and they're like, Hey, look, we could do this in a revenue cycle.

We could do this. And we end up spending millions of dollars for like small incremental gains in how we do things or how we interact with the consumer. And what he'd like to do in that meeting is sort of hold the line and say, look what we have is not perfect, but what we have is functional. And we have to start spending money like we're in a new norm.

Like this we're not going to see 10, 12 percent operating margins anymore in healthcare. This new norm sort of has us down at a much lower basis, which means. We have to learn to adapt our spending to this new model.

And since you've been in, healthcare IT for a long time you've seen all the trends and all the investment.

And, I think the number one broken promise is, for the investment, we, haven't delivered on the outcomes. And often, I think you describe the issue someone sees something that, has produced something they want to achieve, you bring it back, but they don't understand the complete solution not just the technology.

And so you ended up over time, just getting more and more applications, more infrastructures to support it, more people. And there definitely is, bloat. And it's probably not the most flashy IT strategy, but, just simplifying, we're, just getting rid of stuff I think is a real strong strategy.

So, your CIO friends idea of creating some organizational guidelines that hold that line and use what you have makes a whole lot of sense.

Well, I love the point you bring up of, we buy these solutions and. We don't get the complete value out of it, which takes us to the next story, which is top 12 things healthcare organizations want in IT vendors per class.

And I'm going to throw that as number one. I was talking to somebody. Oh gosh, where was I talking to them? I think it might have been at UGM. I was talking to somebody. they're looking for out of their partner. No, it was an interview. It was an interview I just recently did. What are you looking for out of your partner?

And they said, Everybody can sell you stuff. Everybody can sell you product and whatever. What they're looking for in a partner, when they imagine the difference between a vendor and a partner to them, is somebody who is selling them outcomes. So we are going to get this placed in your environment.

We're going to train the people to use it in your environment. We're going to be measured based on adoption the same way you're going to be measured on your environment and the outcome of that adoption. And it was interesting to hear that perspective because as we look at These 12 things from class.

Number one, proactive ownership of client issues. Could fall into that category. Ability to achieve outcomes is number two. Right, right. Quality of upgrade experience, development and roadmap communications. Communications around bugs and issues. System tailored to our specific needs. Access to actionable reporting and insights.

Implementation and training regular touch points and support of integration needs. And it goes from 44 percent down to 11%. And I think more and more when we're sitting across from our partners, what we're looking for is, Hey, put yourself in my shoes. Help me to achieve my goals. Yeah. And we will develop an ongoing partnership.

your observation is mine. As I read that article I thought, okay, what would I want out of a strategic partner? And that is someone to help me achieve my outcomes. And I liken it to, at S S M, our IT organization for. Many years was, customer focused.

so we were doing what was asked of us, which is actually a losing strategy. When we flipped it and we're working on becoming business partners where we were not only understanding the outcomes that they were trying to achieve the senior leaders, but often they really didn't know what those outcomes were.

Maybe it was, partially described. So it's very different than selling something to someone versus partnering with them to understand and help them clarify the outcomes that they're trying to achieve and then put together, the right solution and then manage that solution into existence.

And then the value as well. So, yeah it's really the same, relationships and all those other elements are like table stakes, but really what they're trying is, I need to get somewhere. I might not even know where it is, but if you can help me along the way, then that's what I really value.

Yeah, I enjoyed the partner conversations I would have where people would ask me about our objectives and it would start there instead of, a lot of people come in, they have a slide deck, They bring their boss with them or some other big person is like, well, you need to meet this person.

I'm like, well, I'll determine whether I needed to meet this person or not. I mean, let's have a discussion. And sometimes the solution was so important that I would stop them and I would say, Hey. I think you need to understand a couple of things about our environment. It would really help your presentation right now.

Like, we've already made an investment over here, or we've done these things, or we're thinking about moving to the cloud, or we're thinking about not moving or moving back from the cloud, I mean, all those things. Play a role in what you should be talking about. the good partners will start with conversation that essentially says, Look, have a lot of solutions.

People use us for moving to the cloud. People use us for moving away from the cloud. People use us because they're looking for more security amongst their environment. I really want to tailor our conversation today to what's important. If you don't mind, I'd like to ask you a couple of questions to really tee things up.

And then in the remaining 30 minutes, we can tailor our presentation to the things that would be relevant to you. I mean, in fact, you could just take those words, copy them down, and start your next CIO meeting with that. That would be great. I've had one CIO say to me, he goes, one time a partner started with a series of questions and he said, Hey, have you ever listened to Bill Russell's podcast?

He said, Oh yeah, I've listened to it. It's like, yeah, you should have listened to the one. that I was on before you came into my office. Ah, yeah. It's like, because I talked about all these things that you just asked me questions on and you get to listen to it on your car ride over and then you get to say, hey, yeah.

And actually, with the internet and everything else today, there's so many of the CIOs give their time to be interviewed and they give a bunch of information away. That you could walk in and be ready to have the discussion. All right. going to go a little bit over what I normally do.

I want to talk to you about generative AI, given your background and your experience. And this is a Healthcare IT News article. I'm just going to go to the why it matters. Health system execs are particularly excited about AI and automation potential to streamline financial and operational processes, tackle administrative inefficiencies, and reduce clinician burnout.

They see big opportunities for improving workflows. and clinical documentation, managing and analyzing data and more in the year ahead. Further out, in the next two to five years, hospital leaders say they're planning more AI powered initiatives around predictive analytics, decision support, guided treatment insights, and more according to the report.

The title of the article, so you think, oh wow, this is great, and you read the title there. Health system execs are bullish on generative AI. but still lack a strategy. I feel like with generative AI, in fairness, it was like Thanksgiving of last year that this came in to be the mainstream.

Yeah, just the mainstream, right? For those of us who are in technology, we knew generative AI was out there. And we knew things were happening around it. But you know, when it went to chat GPT 3. 5 and people started using it, they're like, man, this is amazing. And then they immediately went to four.

It felt like immediately. And then people were like, oh my gosh. That was amazing, but this is really amazing. And so now everybody and their brother is talking about it. In fact we're recording this about an hour before I have a webinar today with 3Leaders. So by the time people hear this show, I will have conducted this interview with Brent Lamm from UNC.

Mike Pfeffer from Stanford and Chris Longhurst from UCSD. And we're going to talk about this. We're going to talk about the potential and how they're using it and where it's being utilized. But it's interesting to me, it's been in the, in our minds since Thanksgiving of last year.

And. I still find a lot of organizations don't have policies written around it. I still find a lot of organizations don't have a strategy per se around it. Right. Is that just the nature of healthcare? Do we just move slow?

Well, yeah, we move slower than other industries but I think some of the same Issues.

When I read that article, saw all the promises, I thought the Gartner Hype Cycle, and we all know that the ascent to the peak of inflated in expectations, expectation is euphoric. So I feel like we're right there.

And then, As I was thinking about our conversation, I was going to say, Hey, Bill, do you, since it is so powerful and so promising, maybe we need some federal incentives for healthcare to adopt AI. I mean, what could go wrong there? Maybe 20, 20 billion dollars for meaningfully using AI?

Yeah. And here I come up with a name for it. It's going to be really meaningful use. We'll start with version one because there's going to be many versions. I've interviewed people who are around for meaningful use and they've talked about the unintended consequences and those kinds of things.

I, here's the thing, generative AI is amazing to me in that I don't think it's going to need any. In fact, if anything's going to happen, I think the federal government's going to step in and slow us down on this because we are so rapidly adopting this. we're seeing it utilized with notes today.

Epic was talking about it and each one of the organizations that I'm talking to today, amongst others. are using it to generate some basic notes to handle the inbox challenge that a lot of clinicians have. So that's one area where it's being utilized. It's obviously being utilized with clinical listening and transcription.

It's being utilized and pretty effectively, I would say. And in fact, that space is starting to blow up. It used to be, Hey, if you're going to do this, you had two choices. It was M modal or it was Nuance, right? So it was Dragon or it was M modal 3M. Now because these large language models are readily available and they're so powerful, I'm seeing these startups just pop up all over the place saying, Hey, we can do the same thing.

And you think, Oh, come on. And then you watch a demo and you're like. Yeah, I mean, that's essentially it. It's amazing how powerful. And I think as people start to sit back, they go, Hey, can we do something in the area of clinical summarization? Can we do something in the area of billing, coding?

And they see all these possibilities. But given your experience. From inception to actually implementing something, especially on the clinical side. That's a pretty long curve, isn't it?

It is long, and I forget the person that quoted, but we tend to overestimate the impact of technology in the short term and underestimate in the long term.

And in fact, one of the other articles from the A16Z group what I liked about her description of the companies in their portfolios, their startups was, they've got a 10 year time horizon, they're not looking for these things to really scale up significantly for, a half a decade or more.

So, yeah, definitely think it's a longer term, case to where we're going to see the actual productive value. And related in there. I don't know if you're familiar with Clay Christensen and his innovators dilemma and innovators prescription. But as I read that A16Z article they were listing out some of their companies in the portfolio like Cedars, which it's A tech and service around patient pay. So, the patient pay portion of our medical bills. And when I first saw that, I said, well, that's just a small piece, the larger piece is really where the complexity is. And so I, I initially dismissed it as something of value, but that's exactly, the issue in, innovator's dilemma, they take.

A piece of the pie that's small and they iterate. And then over time they are able to scale it up and go up market. But it seems like a great place to start real easy, straightforward, take that experience and optimize it. And then, at 3. you can move into other areas as you learn things.

So, yeah I really liked Julie's focus and realistic. She had actual experience with. The healthcare industry and coming from the outside.

Again, that's on healthcare dive. We didn't get to all five stories, but we got to four. So, that's doing something. Jon, I want to thank you for coming on the show. It's always great to talk to somebody who spent as much time as I did in St. Louis. And hopefully the Cardinals can rebound sometime soon, but I don't know, maybe we'll talk next year and we'll be talking about a pennant run.

Who knows? There you go.

Highly likely in the next five years.

In the next five years. Yes. We underestimate what can be accomplished in the short term. Oh man. Cardinals fans can't wait five to 10 years. That's that we are an inpatient group. Hey, thanks for your time. Appreciate it.

Thanks, Bill. My pleasure.

And that is the news. If I were a CIO today, I think what I would do is I'd have every team member listening to a show just like this one, and trying to have conversations with them after the show about what they've learned.

and what we can apply to our health system. If you wanna support this week Health, one of the ways you can do that is you can recommend our channels to a peer or to one of your staff members. We have two channels this week, health Newsroom, and this week Health Conference. You can check them out anywhere you listen to podcasts, which is a lot of places apple, Google, , overcast, Spotify, you name it, you could find it there. You could also find us on. And of course you could go to our website this week, health.com, and we want to thank our new state partners again, a lot of 'em, and we appreciate their participation in this show.

Cedar Sinai Accelerator Clearsense, CrowdStrike, digital Scientists, optimum, Pure Storage, Suretest, tausight, Lumeon, and VMware who have invested in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.