Below is a transcript for an episode of the 2-Minute Drill from This Week Health. Please read the transcript and respond ‘done’ when it is complete.

 All right. Today in Health IT, we're going to talk about HHS and the changes they're making over there, which I think mirror a lot of what health systems are looking at and doing today. joined with Sarah Richardson today, and I'm going to be talking to her in just a second.

My name is Bill Russell. I'm a former CIO for 16 Hospital System and creator of This Week Health. A set of channels and events dedicated to transform healthcare, one connection at a time. Today's show is brought to you by Panda Health. Digital health is hard, Panda makes it easier. Quickly and comprehensively vet digital health solutions and be fully prepared and informed for your next meeting.

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They can subscribe wherever you listen to podcasts. All right, we're going to dive into the story. And Sarah, welcome to the show.

Thank you, Bill.

We're going to do something a little different this week. We're going to go back and forth. I did it with Drex on Friday, and we're going to do that for actually every show this week you and I are going to go through them. The first story we're going is um, HHS is undergoing significant reorganization of its IT leadership and infrastructure. The restructuring includes creation of a CTO, Chief Technology Officer, role to oversee and unify IT efforts across the department.

The aim is to enhance efficiency, support digital transformation, and better align IT Technology with HHS's mission. These changes are critical for improving service delivery, managing resources more effectively, and ensuring that technology supports health care and human service initiatives. To be honest with you, when I read this story, Sarah, I was surprised they didn't have a CTO.

I'm always surprised when organizations don't have a CTO because of how integral it's become to today's operations, except for the fact they probably have those functions being performed organizationally. When you put a chief title on it, it gives it enough tooth to be able to make decisions on behalf or in conjunction with CIOs, and that's often where we get diluted and need the most impact.

So if you already have people functioning in those spaces, Have the conversations to make them the CTO because you need that bandwidth in your organization, and clearly the government recognized it and is taking that path.

Yeah it's interesting to me. think the reason I'm most surprised by it is following the pandemic, there was this outcry that, oh my gosh, we were so unprepared.

We tried to connect up the states to the federal, and we tried to, move information, and we realized. Wow, none of this, none of it worked. I was talking to these CIOs. They're like, yeah, we're trying to get the information to the state. They can't take it. Like we can't give it to them.

If we took it over to them and handed it to them, they wouldn't know what to do with it. Like, all so the states had an issue that they needed to deal with, but that was also being replicated from a public health standpoint. At a federal level, So let's talk about the CTO role for a minute.

Chief technology officer. So they are a very deep dive technical person within the organization. that's a real high level, but what are we looking for the CTO to do?

I think of the CTO role, and I remember presenting this at a conference a few years ago, like the Johnny Cash song, One Piece at a Time.

Remember, he took like a piece of a Cadillac for 25 years, and by the time they put it together upon his retirement, it had it just looks like this hodgepodge of all these different parts, because you did one thing at a time, and you weren't thinking collectively about what that impact was going to look like in the future.

And so if you really take that into a more Distilled version of itself. Every time you add technology, you're going to have a backend effect of how well it works to not be creating more technical debt and not creating more problems for yourself. I was talking to a team literally this morning who said, Hey, we're getting more and more into virtual care.

And this one company is buying another company and their devices are proprietary and they may not work. And so we may have to reinvest in a. project we have already invested in, and it's a pretty big scale. And so when you think about the role of a CTO, considering those pieces and those components, if that clinical team ran forward with this new business case without talking to the CTO as an example, then think of how much more expensive it gets because that role or those people in the organization weren't already involved in some of the conversations.

Those are the places where the CTO makes the most sense to me is. Yeah, it's not just about bits and bytes and your devices anymore. It is holistically, really from an enterprise architecture perspective that we talk about. These pieces have to be thoughtful because they can be expensive. There's long term integration perspectives that come with that.

And, The effective use of the technology. We always talk about people adopting things and making them simple. You get too many point solutions that aren't complementary to one another, you're creating different problems. CTO can help eliminate that. That

is, you're hitting the nail on the head so much here.

My path to the CIO role was through the CTO role. I've been a technologist my entire life. I'm Cisco certified, Microsoft certified, so forth and so on, understood how it all worked. And so when people were having these conversations in healthcare and they said we're going to do this and this.

My lens was more along the lines of that's awfully complex. That's going to be brittle. That's going to break. There has to be a better way to do this. And without that viewpoint in that room, we end up in dark alleys, abandoned, homeless. We just end up doing some really silly things.

You need that lens. As somebody who's looking at it going, Man, I don't think those two things are going to talk to each other. And if they do, Man, we're going to have to really Jerry rigged that thing together. that's not going to work for a health system.

It doesn't. And when you can have the conversation at a thoughtful level, you're not talking about it from a, Hey, I got to go build a bunch of interfaces and these languages have to speak to each other, that most of the people don't care about that.

They're like, how do you make it work? When you turn the conversation into how do we make this work as best as possible, organizationally, that does not have to be a conversation about programming languages that really is about what it would take level of effort. How much risk does it introduce? How much is it going to cost long term?

And what kind of other Opportunities does it create for us as we think about the bigger picture. And those are real conversations that happen across the continuum today. And if you're not having it in that type of format, then shame on all of us from the perspective we're trying to bring forward, but the CTO and other aspects of the org, that's something that if they can do that really well for you.

You have an entire, almost like an advocacy arm of your organization. Let's be honest, as a CIO, your whole direct reporting team need to be advocates of efficiency and integration and risk mitigation and cost across the board for the organization. It's pretty fascinating when you see it working well. We both have established shops where it has and we've also seen where it doesn't work well.

So when you have those perspectives, you definitely can bring a better view to the rest of the organization.

Yeah, and CISO have a same response from the organization. It's these conversations, like what technology we're going to bring in, they were a lot easier before you were here.

It's yeah, they were a lot easier before. But the experience after is so much better if you've taken it through security and you've taken it through the Chief Technology Officer. Sarah, great to catch up with you. I'm looking forward to doing more shows this week with you. That's all for today. Don't forget, share this podcast with a friend or colleague, keep the conversation going, use it as a foundation for mentoring.

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