Newsday - How Leaders Can Accommodate Teams and Patients In a Digital Future

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Sue Schade: Burnout and mental health is certainly an issue for many workers. It's certainly an issue for healthcare workers. They don't want to live like their parents. My two daughters they're born in 78 and 81. And I think for a long time, they've made it clear to me, as much as they want to progress in their career, they don't want to work like I've worked. They don't want to have what I've had in terms of the push and the responsibility and at times what that means in terms of the [00:00:30] impact on your family and home life.

Bill Russell: It's Newsday. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week in health IT. A channel dedicated to keeping health IT staff current and engaged.

Special thanks to Sirius Healthcare, Health Lyrics and World Wide Technology who are our Newsday show sponsors for investing in our mission to develop the next generation of health IT leaders.

We're excited about where the community will take this channel. The Academy is about training. It's about training the next generation of health leaders. Here's where we're going to be launching our new show. It's called Insights and the show will actually take highlights from our last five years and break them into 10 minute episodes for [00:02:00] your team and perhaps people who are new to health IT to come up to speed.

Finally, this channel, the one you're listening to right now will become our Conference channel. The same great content you travel across the country to receive. We're going to be bringing to you right on this channel. This show will become Keynote, where we do our long form 50 minute interviews with industry leaders.

All right. It's Newsday. And today, Sue Schade is joining us from a new studio. Can I call that that room a studio? Or is it your new office?

Bill Russell: I noticed Ruth Bader Ginsburg made the move with you. She's over there. What are the pictures on the other side? Is that artwork?

Sue Schade: Yeah. Yeah. Those good. You caught it. You can't really see it unless I move the camera a little bit, but I will.

Bill Russell: So you try to play every day?

Sue Schade: Oh yes. Oh, absolutely. Yeah, yeah. And work on new stuff all the time. Yeah.

Sue Schade: Ok. Ok.

I'm going to start with a Bloomberg article. From the great resignation to lying flat workers are opting out. If people don't know what lying flat is it's essentially great resignations is what's going on in the US. Lying flat is what's going on in China. And you have similar things going on [00:05:00] in Europe.

As I just rattle off some of that to get the conversation started, it's interesting as a manager to read these things, I mean, we have two Harvard business review articles today. We have this Bloomberg article. But it would appear to me that how people view work and work-life balance is changing. And that's one of the things that's causing the great resignation. [00:06:30] People are looking at the potential of dying, the potential of not getting ahead and saying, I don't want to live, like my parents lived. I don't want to pursue money my entire career. And part of that is leading to shortages. Shortages across the board for, for healthcare, but also across the entire economy. What are your thoughts as you hear those first couple of paragraphs in this article?

But I know you've talked recently about how many women have left the workforce during the pandemic, which is kind of whole nother issue that could be talked about. I think the, the concept of the point that they don't want to live like their parents and I get mixed up on the generations myself in terms of what those delineations are.

So they, they see me as a role model as a leader and as a woman. But not in how hard [00:08:00] I've worked, if that makes sense. Though, don't get me wrong. They work very hard. They're very competent.

Bill Russell: I understand completely what you're saying. Cause my kids would say the same thing to me. You traveled too much. You took on too much responsibility, that kind of stuff. And I look at them and I go, you all work very hard and they're like, yeah, but there's a different, like they won't trade some of the things I traded. They look at their life a lot more about life than about providing for the next generation, which is sort of my mindset.

Bill Russell: Let me pivot this to health it a little bit. So almost half of the world's workers are considering quitting, according to a Microsoft corporation survey. About four in 10 millennial and gen Z respondents say, they'd leave their job if asked to come back to the office full time. The global survey by advisory company, Qualtrics International Inc [00:09:00] found more than any other generation. And so as we, as we sort of look at that, And the reason I talk about this is to provide managers a context. So if you're a manager listening to this saying, what's the relevance to health IT? These statistics generally are talking about your workforce and we've seen this. We've seen people leave jobs. We've seen people leave and essentially say, look, I'm not going to get vaccinated and I'm leaving. And we've seen people [00:09:30] just leave. And and you mentioned the women in the workforce and I think the number was 3 million women have left the workforce.

And a lot of that was due to women bearing the brunt of, Hey, the kids are going to be home and they're not going to school anymore. One of us has to be there. Not only that we have to take on the aspect of educating them or a part of that. Making sure they go to class and all that stuff online.

Sue Schade: I'd say a couple of things. One, I think it's absolutely critical that managers and organizations provide a level of flexibility to their employees at this point. Because it is a workers' market right, right now in terms of they can move wherever they want. So flexibility, [00:10:30] I think is key.

I think that really knowing your people and they're particular, you know without being invasive and overly personal. Knowing their situation, understanding their situation and supporting them through whatever they're working through. I think that organizations and it's one of the points in one of the articles we're going to get into around leading a hybrid team. Make work purpose driven.

So making sure that they are very connected to the mission, I think is critical as well. Obviously your people supporting applications tend to tend to be a little bit more grounded in the mission and what the [00:11:30] organization is doing. So those would be a couple points that I would coach managers on.

Bill Russell: I coach CIOs, and I know that you have mentoring relationships with some as well. It was interesting to me, one of the CIOs I coach, early on in the pandemic, he essentially said, we've got to get these people back in the office. Right. And so that was sort of the mindset of how can we get them back in the office because we're missing out on too many things and whatnot.

And he said we have to be really sensitive to the journey our workers are on. And what they're trying to navigate at home. What they're trying to navigate. And so what they're going to do is they're gently going to offer them alright hey, we need you in the office one day.

Not that you have to choose that day, but that'd be a good day to interact with those people and have those, those conversations. And maybe bunch, some things on that day. And I think, I think that's how, I love the, it went from, Hey, you know what? We're getting everybody back in here because that's what we've always done and just feels right to me [00:13:00] to just thinking through it and really evolving.

And I think the managers that don't evolve through this, they're really going to struggle. They're going to keep losing people until they do evolve. Because people have a choice up to and including just leaving and not working.

Right. I think you've got to model, certain behavior. I'm going to be in the office these days because right. Here's the value of it. And I want my team to work with me in terms of, as you say in that example, the flexibility one day a week, which day is it going to be, provide some direction on [00:14:00] how the team works together.

How the teams interact with other teams? It's just, it's not binary. It's not, everybody's stay at home forever. And it's not, everybody's in the office every day. It's a whole mix to make work.

Bill Russell: CIO's, aren't remote workers per se, but if you took 260 work days a year, the number of days I was actually on site had to be at least 80 to a hundred days less than that.

And so anyway, as we're having conversations with CIOs. I do want to hit on some of these other articles. I want to start with the five rules of leading a hybrid team. You selected this article. This is from the Harvard business review. Great article. Has a couple of things. I'll let you set it up. You already touched on the first point, which is to connect [00:15:00] work with the mission of the organization to make it purpose driven, because people want to know that the work they're doing has purpose has meaning.

Sue Schade: Yeah. So, so let's give some context. This is by Laslo Bock who was at Google and is now the CEO and Co-founder of Humu, H U M U. Have you heard of them?

Bill Russell: No, they just keep making up words.

Sue Schade: It's an HR software company using people science to help people do their best work.

He's saying purpose matters more than ever. Research shows that people don't feel their work contributes to the company's mission are 630% more likely to quit their jobs than their peers who do. As I was reading it, I thought of something that I saw on LinkedIn from a former [00:16:00] colleague of mine when I was at the Brigham.

And she's now at Humana and she posted on LinkedIn, I really liked this. She said sharing part of my morning mantra, move the mission, mind the hearts and souls of those moving the mission. When stuck, take a break, then frame focus and finish the work. Repeat. It seemed like a very grounded kinda perspective to her work.

I mean it gets at broad direction where we need you to go. Not the how. Not the micromanage in terms of the how. And I think a couple more. He talks about learning the small moments.

Bill Russell: Let's go back to that. I love the trust your people more than feels comfortable.

I mean, just describe what you want and then let them, let them do what they're going to do and encourage them to come to you for questions and that kind opf stuff. But that is so important. And I think in this remote world, we have to trust our people. Right? That is, that's the number one thing I find when managers are like, Hey, we need them to come back in the [00:17:30] office.

I'm like, why do you need them to come back in the office? And more I push on it and the more I'm thinking about it, it feels to me like, it's a trust thing. It's like, I need them in the office because I'm not sure they're going to get the work done. Well the information that we have now would indicate that they do get the work.

There's that old thing flying around the internet and it gets attributed to Steve Jobs of, you hire great people. You've got to trust them to do it and just get out of their way. And it just, just let them do it. I think that's part of what we need to do is you know if we hired good people, trust them to do their job.

Bill Russell: All right. So you set it up. Learn in the small moments, send people on your staff nudges.

It's little reminders to do certain kinds of things. And I mean, quite honestly, if you're the kind of person who is kind of high touch and very connected with your staff. You might find this annoying, right. But if you're not and it doesn't come naturally, maybe those are really helpful. The nudges.

Well I receive 250 emails a day. That note was like it stood out significantly. And as a manager, I'm always telling my managers, Hey, think of creative ways to communicate with people. And not just the daily email, the weekly email. Talk to them about things more than [00:20:00] work. If you could figure out a way to talk to them about things more than work, you're going to connect on a different level.

Hey, I like these last two, by the way. Number four, provide clarity. Be more decisive than feels comfortable.

Sue Schade: The point that I highlighted in that one Bill, is that when it comes to company direction, policies and values, being clear is the kindest thing you can do. Even if your decision is unpopular, which I found that really interesting because there's so much time spent like, oh, how's this going to be received?

Bill Russell: I love that one. I love that sentence too, but the thing I say to people is, especially people I'm coaching. If I were to interview your entire staff right now and ask them what is the, career progression for you in your current role? How many of your people do you think would be able to answer that?

And that that's a simple fix. It's not a simple fix, but that's a fix where you can just have every manager document, sit down with every employee on a one-on-one basis, whatever that timeframe is. Some organizations did it every six months. Our organization did it every six months. And I [00:21:30]remember the managers every six months, they'd roll around like, oh, we gotta do this again.

I'm like, no, no, this is, this is, this is the job. This is like the thing here, you're going to, you're going to provide them clarity. It's like, how are they doing? What's next? How can they prepare for what's next? What can they do? That's a challenge. I mean, that question of do they know what's next in their career and if they can't answer that question, My gosh.

Sue Schade: You wonder how often is that the one of the responses in the exit interview. I didn't know what was next. It didn't seem like there was next. Right.

Bill Russell: There was no next for me.

So, we've obviously seen a lot of focus on organizational culture during this rather stressful two years for organizations.

Bill Russell: Yeah. I did an interview with Doug King CIO at Northwestern medicine. And one of the things I like about what he was doing, he he'd created this funnel of new labor coming in from colleges and that kind of stuff.

And people are like, oh, you don't understand that so many conversations for like, you know, when you're new to healthcare, you just look at it through a different lens and you go, you know we should be able to make this better.

Bill Russell: Michigan students.

And it didn't work that well that we would try something different. And we brought them in [00:24:30]and they got a month of indepth exposure and training to the product. And then we use them for the Go Live support shifts on the units. And it was tremendously successful. We hired a number of them after that.

And this is where back to your point about Doug. It's fresh eyes. They're not indoctrinated yet, so they can ask those questions. Like, why isn't this simpler? Why isn't this automated? So, yeah. Gotta to get those new ideas in and, and get people early in their careers into organizations. I'm a fan.

Sue Schade: Could say ran into him. He was my boss for 10 years.

Bill Russell: There you go.

Sue Schade: There you go. Boss, colleague, friend, mentor. What an opportunity to work with him. Yeah, he was the CIO for the whole system when I was the CIO at Brigham.

So he is, he is passing on. His expertise to the next generation. So he wrote an article five principles to improve the patient experience. I think someone with this much experience is is definitely worth listening to I'll tee some of this up. So, number one, patients as consumers. In healthcare the term patient and consumer were often seen as only loosely related. The patient is the [00:26:30] term applied to a person who is receiving healthcare. A consumer is a person who makes a decision about obtaining a good or a service and then proceeds or not to obtain it.

I didn't recognize that there's different ways. But you know, in the context of the other things we're talking about, people do have more of a choice today than they [00:27:30] ever have of what they're going to do, where they're going to receive care, or quite frankly not receive care. They might have a bad experience and just say, you know what, I'm going to live with this.

Sue Schade: I'm not sure that we did talk in my most recent organizations about patients that as consumers. So wouldn't [00:28:00] have had the opportunity for that pushback. I don't think they were there now at Boston children's they probably in the innovation area that was doing a lot in terms of digital front door might've been talking that way, but it's not been, it's not really been an issue. I think that his concept here is on target in terms of thinking about people, making a choice. Where they get their service, what kind of service? And that is the consumer aspect of it. And that's where you see all the push right now for it to make it easier to access healthcare [00:28:30] services. The digital front door, as it is still commonly called.

Bill Russell: Yeah. And then he gives a caution to us in health IT. Number two is the consumer experience is more than technology. We need that reminder from time to time, but essentially, we get caught up in the well we're going to give them the ability to do appointments online and but the experience is is broader.

We never actually pick up all the glass. We just, we find a way to navigate through it and navigate around it, instead of saying, Hey, you know what? These systems don't talk to each other. This doesn't work. This doesn't work. Let's let's fix. Because the experience is not good for the clinicians and it's not good for the patients.

It's the people they interact with. Once they get on site, it's the experience of moving from one care venue to another from one care provider to another. It is the it is the technology for sure. We've heard that through the [00:30:00] pandemic that the experience for telehealth can vary pretty pretty widely for different groups of people.

Sue Schade: Yeah. So, if I can use a very current example this morning, and it happened to me in this context. It's more than the technology, the process. So like, there's this, new, more advanced shingles shot that people of a certain age should be getting, even if they got one years ago. So I made the appointment.

I did all this online when I made the appointment. I answered all these questions. So I go back up to tell him, you should have this. Well, she wasn't there. And there was now someone ahead of me. And so I thought, okay, I'll fill out the form just in case I really have to. And there were some questions, like, are you sick [00:31:00] today?

Well, I made the appointment last week. So when I was online, I couldn't answer that question. Right. So I fill it out. I give it to her and I said, I did all this online. She goes yeah, we should tell people to bring a printout of the online form that's been completed because we don't have access here to that.

Bill Russell: Yeah, that's fascinating. Although, as a CIO, don't you get those stories? I know that when I was walking the halls, people would say, let me tell you something that happens. And then they would tell me, and I'd go, ah, I can't believe we do that. And I'd go back to the team. I'd say, well, why does this happen? And then they would lay it out. Why it's happening? And I'd be like oh that's not simple to solve is it?[00:32:00]

Sue Schade: Yeah. This, I don't know. This sounded simple to solve with my CIO hat on. I have all this information. I've scheduled the appointment online for that pharmacy. They should have access to the information.

Bill Russell: It was a Walgreens? Not to call them out, but. And Walgreens are not independently owned. They're nationally owned.

Right. But I was not trying to call out Walgreens. I was trying to generalize on my scheduling experience and how we can do better. And this was the long wait on the phone, finally gave up on the phone, went to see if I could A, do they give this shot at the local Walgreens? B, can I do it scheduling online, which I could and then I finally hung up. I'd been on for half an hour. Halfway in, I did the online, including the form that I had to do again today on paper. Anyways, I [00:33:00] don't want to call them out specifically. I think every organization and probably all of these retail organizations that are disrupting things are having similar challenges in terms of getting their whole workflow and systems to where they really need to be.

Bill Russell: Yeah and actually I'm going to point our listeners to this article. Five principles to improve patient experience John Glaser lays out a couple more of these points. Tech advances create opportunities to deliver exceptional experience. And it does and be careful about the meaning of terms in strategy discussions and thi s is interesting because he says care providers use the term digital front door can also [00:34:00] misdirect the strategy because it implies that care needs a building and is reactive. Beginning when the consumer rings the doorbell. The phrase journey to health may be better term. This phrase is clear about the goal for the person who is the consumer and a patient. And the phrase does not blend at the mechanics with the goal. Mechanics that can quickly become an anachronism.

Sue Schade: I have one more story. Do we have time?

Bill Russell: Oh, absolutely.

She goes, we really should, at this point get another bone density test. I'm like, great. I thought she was going to order it. Next day, I get a call from my health insurance and they said, we're looking at claims and we see that you had a fall, you need to get a bone density. And I'm like, did my doctor tell you to do that and they go, no, no, no, no. It's based on the claims and we're going to have someone in the area on September 15th and we can come to your home and do a bone density and [00:35:30] I'm like, great. Then I don't have to go somewhere. Great. But I'm wondering, is it really as good as the kind that you lay down on and get scanned?

She couldn't track them down. We finally figured out between the two of us that that home bone density tests had been denied by Medicare because it didn't meet certain criteria, so they didn't charge, they zeroed it out, but then they also didn't tell me any results or that it didn't work. And that I have to get a regular kind.

Bill Russell: Yeah, that story is an interesting one because it was such a, those are the kinds of stories we hear at digital conferences, right. At innovation conferences. Oh, look, this is what's happening. And I love the fact, cause I think you talked about that the last time and we talked about it in a positive light and now we're sort of coming back and saying, Hey this is the other side. This didn't, this didn't connect in complete the way we thought it was going to connect and [00:37:30] complete.

Sue Schade: Yeah, I wrote about it too, as just a really positive in terms of access and something in the home, but yeah the full circle story wasn't so positive.

Yeah. And it's interesting. Cause that's one of the things that's happening with CIO's anyway is all these advances are coming pretty rapidly and we're being asked to connect them all in right? Connect it into our communications platform.

Plenty to do.

Bill Russell: Plenty to do. W e ll Sue always, always a pleasure to catch up with you. And I'm happy to see that you're now in your new location and all it looks like it's mostly set up. Are you set up for the holidays?

Bill Russell: You didn't have much going on and you had the interim CIO thing and then you moved and then you have these stories to tell about the different appointments.

Sue Schade: Now I've turned into like a professional full-time healthcare consumer. I feel like, yeah. We have the cataract surgery too. That story and access there. So yeah.

Sue Schade: Before we close, I'm going to give you the kudos again, publicly on what 22 looks like with all your new four channels. Love it. And I've already subscribed to all of them.

Bill Russell: Yeah. You, like the way I called you out on the today show?

Bill Russell: It's so funny. Cause everybody has their pattern or things they do. And you walk the dogs. Some people exercise. I hope to be one of those people someday. But right now what I do is I listen to a lot of Scott Becker's stuff cause he interviews so many interesting people and I'll pop those on as I go for a walk and that kind of stuff. But yeah, I'm glad that the industry is growing. More people are doing [00:40:00] podcasts and next year we're going to have guests. What would are we calling them? Hosts. I'm not going to be on the show. It's going to be them interviewing their teams and things to that effect. We have Craig Richardville's. He's going to be one of the people who's going to interview his people in his network and he'll do 12 episodes next year.

Sue Schade: Thank you. I've enjoyed it.