Today in health, it we're coming off a 2 29 project meeting. And as usually the case. I have a lot of interesting thoughts and ideas. And today we're going to talk about cloud. And change management practices of your cloud partners. That's what we're going to talk about today. Looking forward to it.

My name is bill Russell. I'm a former CIO for a 16 hospital system and creator this week health. Set of channels and events dedicated to transform healthcare. One connection at a time. We want to thank our show sponsors who are investing in developing the next generation of health leaders. Notable service now, enterprise health parlance. Certified health and Panda health.

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We during the 2 29 project meetings, the summit meetings, we have discussions. We just facilitate conversations between CIS. Or CISOs or other CXO leaders within the it organization. Within healthcare and. We had a very interesting one this time around change management. And it used to be that everything ran in your data center.

So change management was a discipline that you needed to have within your organization to make sure that one group wasn't making a change to say a storage array at a time when you were trying to do an upgrade to software or those kinds of things, and having those things clash or having. Or just having an understanding of what changes are being made so that if there is an outage, you can trace it back to a change that was made. So that you can roll back and do all those things.

There's a whole bunch of procedures. It's pretty well documented. But when it comes to cloud providers, one of the things we've done is we've moved a lot of these things to SAS base. Offerings. So now change happens in the cloud more frequently. A lot of these cloud players make frequent changes to their software. And some make major changes to their software on a quarterly. Or more frequent, maybe on a monthly basis. And, we're hearing stories of it causing outages. Serious outages, significant outages. Not to major systems.

So we're not hearing this on the EHR side, but they are major systems in that they're part of the workflow and they bring things to a standstill and it begs the question. With regard to our cloud partners, can we expect the same kind of change management, disciplines and procedures? To hold from within our organization to their organization.

So I wanted to talk about some of the things that we discussed and then some of the things that I've written in my notes as I was sitting there. Listening. And one of the things is, we've done this before, right? So as with anything that we expect third-parties or outside parties. To be a part of our internal process.

It has to be spelled out very clearly in the contracts and the service level agreements. So that goes without saying contracts, service level agreements, to the extent that you can bake that into those agreements and not sign the cookie cutter things that you get from them and bake them into your procedures.

That would be great. Next thing I was thinking about is some sort of cadence. Cadence is one of my favorite words. It denotes a repetitive. The line of communication between you and the partner. And so setting up those cadence meetings so that you understand when they're thinking about making a change or understanding their change process or how they communicate, what the. What they believe the change will affect.

So regular communication sort of a cadence between their. Organization and yours, you might even, if you think about what we used to do internally, We'd have a change management group that would meet whenever there was major insignificant changes. And you might want to think about setting up that same kind of change management. Governance or change governance would not best word change management board change management. System between that there's a group. Representative from them representative from you. That is talking about the changes that they're trying to make.

So communication is so key. If you're fortunate enough, some of these players are so big that they're making changes to not only your system, but hundreds of systems across the board. But to the extent that you can, if there could be a formal change request or change management process between the two organizations.

So as you're looking at some of the smaller cloud players, maybe they can set up a. An isolated instance for your organization or for healthcare? I don't know how that. They could potentially set up something for healthcare that falls under different guidelines. I don't know, but a formal change management process between the two of you, I think would be would be beneficial. Then you definitely need. Documented. Results.

So if they do cause outages, you want to do those same impact analysis, the same kind of procedures that you would do for an internal. Downtime and that was caused by change management and a communication procedure. So you wouldn't document completely. You made this change.

It caused this outage because you want to educate. That's the reason we do these things to educate and then to to mitigate those risks moving forward. So a documented impact analysis program, I think is so key. To that. And then obviously the, those same metrics that you're looking at, that the organization is looking at.

If they caused downtime. Track that. Make sure that's part of their SLS. And the problem is some of the rest of these are like, Hey, four nines. Oh four nine. It gives them an awful lot of downtime that they cause the problem is you have 600 systems. And if each one caused that amount of downtime, your system would never be up. So you can't have each system actually maxing out their amount of downtime. That would be a problem for your health system, but Elsa FLAS and performance monitoring in making them a part of that report out so that they understand. Where they stand and whatnot. Just tightening that up, tightening that whole procedure up. And making sure that there's a closed loop in terms of the communication. I think it goes without saying that we have escalation procedures documented either, either in the service levels or the contract. There should be a way for you to contact go through the help desk as you normally would, and that's standard procedure and you should be okay with that, but there should be a rapid escalation process that you can follow in the event that your health systems operations have been impacted. And so that should be well-documented. I don't know if you can do things between the two organizations. Where you're doing training between the two organizations to understand the workflows. So that I don't know, maybe the right people on their side would understand when they're going to make a change. They would be able to look at it and go. I think this might impact our healthcare clients.

We should contact somebody and maybe the change management board is not only between you and them, but it's maybe a S. Suite of health systems, a host of health systems in that player, so that they can go to one place and say, Hey, we're going to make these changes. Do you think this will impact your five or six health systems and that you can get that feedback? Trying to think if there's anything else with regard to that. Obviously you want to have great partners.

You want to have great relationships with anyone that is impacting your clinical workflow. But those were just some of the things I thought it was a great conversation when these conversations are going on. A lot of times I don't weigh in and. Just spout off all the things that are in my head, which is great for you because I get to think about it, write down some things and then share it with you on my today's show.

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