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Welcome to this Week in Health it. My name is Bill Russell Healthcare, CIO, coach and creator of this Week in Health. It a set of podcast videos and collaboration events. Dedicated to developing the next generation of health leaders. This episode and every episode since we started the C Ovid 19 series has been sponsored by Sirius Healthcare.

Now we're, we've exited that series, but Sirius has stepped up to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show's efforts to develop the next generation of health leaders. We're gonna do an episode that I've wanted to do for a long time and I'm titling this episode Paving A Path to Success as a Healthcare CIO.

And I'm talking to a really good friend of mine, someone, full disclosure, someone who is a coaching client and we've gotten to know each other really well. Former guest of the show, and someone who has really been in this role probably for. I, I think about 18, 19 months now. And so we're gonna take a, a, a journey across the start.

Uh, the, the whole thing becoming ACIO and then what it's been since. So, Lee Milligan, CIO, for Asante Health is with us. Good morning, Lee. How's it going? Good afternoon from, uh, Oregon. Nice to see you, bill. Yeah, that's the good afternoon. Good morning thing is, is always . Yeah, in a podcast, I really shouldn't do that anymore because people listen to it.

When they listen to it for the most part. Just say Hello. Hello, hello, Lee. How's it going? Uh, I'm looking forward to this conversation and because I, I think your story is, is an interesting one, even from the point of how you became the CIO and then some of the things that you went through. But let's just, let's start from the beginning.

And so we looked around a few options, landed in Oregon, and at that time I always knew I wanted to go into technology on some level. But I also recognized that it was critically important to understand the clinical space and develop competencies as not just an intern and a resident, but as a practicing physician.

Developing those relationships, understanding the workflows, and really viewing technology from the inside out. As the end user of that technology. And so I did that for quite a while. It was eight, nine years or so. And then at that point I decided to go back to school to pursue computer science. And my wife was like, wait, what?

What's going on here? And so we had good conversations about what made sense and she was very supportive, uh, to her credit. And as I did that our system was going from paper to electronic health record. And we ultimately selected Epic. I got involved in that and essentially became an informaticist before that was even really a term around here, and that was a great experience.

So as I did that, I learned a lot about how, how older folks and physicians think and internalized new information, the concept of anchoring new concepts to old concepts and identifying what things stick and what things don't stick. I've, uh, affectionately referred to it as a hand-to-hand combat. With the docs in terms of getting them from paper to electronic health record.

But I learned a ton about our internal, uh, our system for our docs in terms of how they think and what our, what the, um, social relationships are here as it relates to technology. And I learned a lot about how, how folks do new things and how new things stick or don't stick. So that was a great experience and in the midst of all that, the former CIO decided to send a couple of docs back to Epic to, uh, do the physician builder thing.

And that's essentially where the doc learns to build as if they were an Epic analyst and they're given access to production and other environments to build things out, to have hopefully good ideas, create them and then put them into production. And I did that for a long time as a, as a pseudo analysts and working with the analysts learned a lot about change management, uh, the change process, how you can break production by not being, uh, very thorough and complete in your thought process.

And then after doing that for a while, I was asked to serve as the CMIO. They first called it, uh, medical Director of Informatics, but eventually switched to CMIO. And that was really about getting the whole system to a better spot. And I really began focusing on training and education as well as, uh, trying to understand where we could have better governance as it relates to getting the input from docs associated with, associated with, uh, the electronic health record.

And then as that went on, my then CIO, uh, asked me to lead our efforts to revamp analytics. And that's a whole story in and of itself. But I work with my team. We have some really gifted people here at Asante. Michael Olsson, who's now a director of, of Analytics for Asante, as well as innovation for Asante, mark Stockwell, uh, somebody who has led our data governance efforts.

The three of us really got together and, and work through how are we gonna recraft analytics associated with, uh, Asante. That was an awesome experience, a learning experience about deep diving and understanding the problem, creating a plan with the right people involved, presenting that plan to the executive team and getting their input and, and, and buy-in and support, and then eventually executing on that plan and creating hopefully a better experience for the end users.

In the midst of all that I was asked to take on, um, health information services. And so here's where it gets a little bit atypical. HIS or medical records isn't usually within the tent of ITS, but in this case it was, and I was asked to have them report to me. And at CMIO it was a great experience because I had a number of cost centers associated with, with my position, including the, uh, fish and builder cost center and the analytics cost center.

And then they were adding on top of that a fairly large cost center in HIS. That was a great experience learning about budgeting and planning and strategy and accounting associated with that. And that went on for a few years. And then almost two years ago now, uh, I was asked to step in as CIO and, uh, now take on the rest of it.

And I'm really grateful to my team because they really rallied to help me be successful in those first few months while I was trying to get up to speed. So basically with that background, you had it wired. You, you were pretty confident going into the CIO role that you, I'm just kidding, by the way, but, but you remember those first phone calls, but, you know, if people want to hear about your, uh, analytics journey, we actually did an episode back when you were CMIO and we focused in significantly on, on the analytics journey and what you guys have done, and there's a lot of great content in that.

But yeah. Alright. So they say to you, Hey, we would like you to, to step in as CIO. Do you, what's, what, can you have the call center experience? You've, you've got physician builder, you've worked with a lot of physicians, you've been there for a long time, you've got a lot of history, uh, good relationship.

They're asking you to be the CIO, so good relationship with management. Do you have any concerns walking into it or doubts? Yes, in a word. I will say that one of the things that worked out really well. Is that if you can step back and do some sort of a critical self-reflection and be honest with yourself, including identifying other folks who can weigh in, including yourself, you'll recall what do I bring, what do I not bring?

Asking your, your executive peers, asking the people who report to you. Those are hard things to do, but getting that level of feedback is critical to identifying where you should focus your time. So for me, I talked about this, uh, previously, for me specifically, I focused in on things like security. 'cause I hadn't had a ton of exposure to security.

And I recognized how critical it was to understand that and to be a good steward of that piece of, of it as some of the technical pieces focused on some of our infrastructure pieces. And I actually set up a, a framework with my technical, uh, services director to have folks from each of those areas. Come in and, and present every other month to me around the work that they're doing.

So can, I can have a clearer understanding of what that body of work looks like. And I can ask good questions in, you know, a, a focused environment, specifically focusing on things like security and servers and all the stuff that I hadn't had, uh, significant exposure to previously. So you, you saw it as a requirement of the job to really understand the, the technology and the technology platforms.

I, it's interesting 'cause I, I recently saw a picture of you, you're getting your CISO certification from Chime. Is that all part of it that you, you want to have that underlying technology background so that you can. Be a more effective leader in those areas. Yeah, I think that's fair to say. Prior to this role, I, I worked on getting, uh, board certified in clinical informatics, thinking that was gonna be my role moving forward.

And that was a great experience. I learned a ton and no matter where you are, uh, it's helpful I think to have kind a broad academic experience that allows you to see everything within that domain. And so I had a good experience with that. And so I pursued, uh, that, finished that up after becoming CIOI focused on the C-H-C-I-O certification with chime, which, uh, was a positive experience, learned a lot.

And, and then afterwards, now I'm pursuing the ciso, uh, certification as well. And so far so good. Yeah. I Lee, somebody's gotta be listening to this saying, why'd you even hire a coach? It sounds like you, you have the certifications, you have the background, you have the supportive leadership. Why would you even consider hiring a coach?

So the coaching piece to me was critical out of the gate, and when I came into my position, the, the day that I was asked to come into my position, my CEO, that was his first day on the job. I. And so we were in that interesting space where we're both looking at this brand new opportunity and I was, I have a good relationship with him and I think because of that I was able to ask him for a couple of things that I think would be really helpful moving forward.

The first was around a financial I. Uh, financial person who can help me focus on, uh, our budget, our planning, and our, our analysis of our, of how our spend is going. And that's been really helpful. And then the second was, uh, the idea of having a coach. And in my mind, the idea of having a coach is just, it's a no-brainer.

I think about Tom Brady, amazing player. You may like him. You may hate him, but amazing player, no doubt. But he wouldn't think of going on the field without a coach. He's got Belichick, he's got a quarterback coach, whatever it might be. In fact, I would say that the idea of a coach should go beyond the idea of technology.

I think physicians should have a coach. We have coaching in place through medical school, internship and residency, and somehow magically, when we graduate from residency, we no longer need a coach for the next 40 years. And even, uh, UL Gwan has talked about this previously. The concept of having somebody who can give you good feedback, can be objective, can tell you things you may not wanna hear in a way that you wanna hear it, that's critical.

And so I think the idea of having a coach for me is a no-brainer. Yeah, it's, it's interesting. One of the first things we did. Is we need to get feedback, right? So we need to get feedback from your team. We need to get feedback from your peers of how is health it going and where could we do better and what expectations do they have of the CIO.

And so back in the day, I flew up there, I met with those people, gathered that information and, and gave it back to you. What were, uh, just to, just to give people a, a lay of the land, what were some of the things as you came in that people were looking for from it and looking for from you as a leader? So I, I do wanna focus on, or I wanna separate out my team versus others.

So it is an interesting thing to do is to ask your team for critical feedback on how you're doing as a leader. And I remember having a conversation with, um, our head of HR around this topic. And there is a kind of an anonymous way you can do that within our system, but not, it's not very. Pointed, and it doesn't really give always very specific feedback to the leader.

So what, what we were proposing was really the next generation of getting feedback. And I'll tell you it made sense to do it, but after we made the decision to do it and you were on your way up here, I was like, wait, what are we doing ? What are we doing again? And uh, what's this gonna look like? Exactly. Um, so there's that piece.

And then getting feedback from others who you intersect with about the kind of job you're doing. Equally challenging, I think, to, to get that feedback, but I also think it's critical to, to develop the relationships with folks, and part of that relationship is built by them understanding that you're open to that feedback.

And you know, when I look back on our experience doing this, I recall, you know, there being a long list of things to talk about. I also recall you taking that long list and distilling it down to some digestible pieces and to have some, some bounded goals over the course of the next year that corresponded to that feedback and that piece was really helpful.

It's one of the mistakes of being a coach is that part of being a coach is being a cheerleader. But one of the mistakes is that's all you are. And the, one of the things that was interesting about that process is it also forms a baseline, right? So we interview your team, we interview the, and get the expectations of the organization.

We then do that every year. So coming back the next year and doing it and having the conversations, we're able to say, okay. Have we made progress? This, these are the things we were looking at. And there's a lot of things that you get measured on as ACIO, but it's interesting the things that people will give feedback a anonymously to a third party that, that you might not get in a, in a.

You know, standard scorecard or those kinds of things. And, and so it was inter, it was really interesting to see what had transpired in the culture of the organization. What had transpired in the perception of it as you moved into that role? I, to your, to your, sorry, just to your point there, bill. When I finished my discussions with my, my reports and others, I always end essentially the same way.

I ask, what can I do? For them in the next month, some timeframe. Um, and then I ask, is there anything I should be doing different from your perspective? And it's an uncomfortable position for people to be in to think about that and then actually give that feedback if it's really being honest right there in the moment.

And I infrequently get feedback. There's usually one individual who gives me, uh, pretty honest feedback in the moment, but for the most part, it's a hard thing to do When you came in. I think they had the capacity to, to give that feedback. A, it was a longer period of time to think about it a little bit, and B, it was not, they weren't looking at their boss.

They were looking at, you guys had developed some rapport and had a conversation and they could share that with you, which I think was healthy. Yeah, I, so let's talk about, so we, so I introduced a framework and we talked about a bunch of different things, but I wanna walk through some of those things around the framework.

So finance, operations, strategy, and people. What kind of challenges did you face in the area of O of operations as a new CIO? Did you feel like you walked into that and really understood it operations, or was that one of the areas where you needed to come up to speed a little bit more? Part of it is I had to come up to speed for sure.

The other part of it was that my predecessor been here for 24 years and the process had been put in place, worked for I think an individual who had been here for a long time. There was a lot of undocumented. Processes by which things happen. And it simply worked because he and that team had been here a long time.

But for a new person coming in, you're looking for documentation, you're looking for pathways, you're looking for the structure and the process and the workflow associated with it. And so I can give you, I can give you one financial example of if, uh, that's okay. Our process for tracking contracts was, uh, a bit disjointed.

In my simple er doc brain, I was like, all right, I need one spot where all of my ITS specific contracts are located. I need to be able to go through that and be clear that it is, it is complete, it is up to date. And then the last piece that, um, we added this year is the concept of having specific financial questions added to this, this central location for all of our contracts.

So when we review the contracts, when they come up for renewal, . We have the capacity to ask good basic questions about whether we even need it or whether we're calculating it correctly. Does the software overlap with anything else moving forward? These are questions that I ac, I actually, uh, stole from Will Wieder, CIO of, uh, peace Health.

I. He posted this, uh, a few times in the past, and he and I have had conversations about this, but it was really influential to me when I saw the questions he was asking and he'd been doing this for a long time. And so we incorporated that. So now we have a single location with all of our contracts. We've renew it, we.

As we renew it, we look at these nine financial questions that we ask every time, and we've cut a few things and it's all in one place and it triggers four months before it expires. So now I have confidence my team is doing the right work at the right time. So for example, if we don't wanna renew, we have enough lead time to be able to negotiate with the vendor around that versus that last minute hurry up scenario that can frequently happen.

So that's just one example. Yeah, and that's a great example. I actually, I had a similar story when I was CIO, just asking those questions when you come in, like, where are the contracts? Which one? And some of 'em were in it, some of 'em were in finance, some of 'em were right other places, some of 'em were at the hospital.

And you're like, whoa. How do we, how did, first of all, how did we get here? And I don't, I, I almost don't care how we got here. How do we bring it all in? We didn't, there was a lot of contracts that I would get an email. And you may have had this same experience, you just get an email and somebody says, Hey, you're, you have 30 days to renew your contract.

You'd be like, we can't live like this was the, the feeling. Talk a little Yeah. It's very, it's very reactionary versus having, being proactive and having time to think through it and have a, a polished response. Yeah. Let's, we, we could probably go into each of these specifically, but let's talk a little bit about your finance journey.

The first time you have to do an IT budget, there's a lot of . Generally there's a lot of learning, uh, that goes on in people's minds no matter where you sit. Within health, within healthcare, if you're not in it and you're looking at the healthcare budget, healthcare IT budget, you generally think, you know, we send them a lot of money.

Uh, a lot of people think too much money. I'm not sure what we get in return. So this, this lack of transparency and whatnot. So now you get behind the curtain and now you're the person who's on the other side of the curtain. What were some of the learnings as you went to the other side of the curtain and had to deal with the budget for the first time?

Yeah, the budget, I would say was the second most important thing I wanted to focus on. We talked about out of the gate, the kind of the, the things that we've identified that I do well versus where I need some additional polishing budget was one of the two things besides security, and so I spent as I.

Ton of time reading and learning and talking to people across, across the country. When I first came into the role, I was fortunate enough to be able to speak to a variety of CIOs across the country, ed Marks, John Halamka, a whole bunch of people who were kind enough to share their experiences with me and give me some advice and, and some, uh, guidance.

A lot of it focused on finance and I got a lot of good ideas about how I can improve my, uh, thinking around that. So I focused on that. As I said before, I brought somebody on board. Who I intersect with, uh, once or twice a week. Uh, and so we're constantly in contact and talking through issues as they have it.

I sat down with our director of finance and, uh, went through our current, uh, process for, uh, budgeting and tracking and all that jazz stuff I'd used before, but I need to take it to the next level and I need to look at it from a rollup perspective, uh, as CIO and really try to understand it. And so all those things came together.

Having said that the very first time you do a budget as CIO, it is a nearly overwhelming experience because you have so many light items and so many things going on that it's so complex that the only way to survive it, in my opinion, is be able to take all that information and then translate that into a story.

And that story that you're able to develop is what you'll use when you're in meetings with your CFO, with the other executives or your CEO when the discussion is just like you said, wow, we send you guys a lot of money and I don't know what happens with it. So to that end, some of the things that I did outta the gate was I asked our financial folks to give me the information on the last five years going back for ITS, what is our spend?

Over the operational spend, and we were coming in around 4.8 or 4.9%, uh, total. Now, mind you, our ITS framework here is a little different than most. We have medical records, we have training, we have biomedical engineering, so we have a lot of stuff that may not be typical for most places, but we were coming in at 4.9 or 4.8%.

I also reached out to Scottsdale Institute and Epic to benchmark. So I wanted to know, okay, where are we shaking out over time and how are we benchmarking against, uh, comparable, uh, community-based health systems? And so that was really helpful 'cause it got my head around, okay, here's where we are, here's how we compare and here's the trend associated with that.

With that information, I shared that with my directors and my managers, and we talked through how we can make improvements in that spend moving forward. There were a number of specific areas that, uh, we identified that we could work on. Everything from, um, being more detailed in our scrutiny of some of our bills, to identifying overlap of services that we were taking.

And I will share with you that we went on that 4.8 to 4.9% for five years. Last year we came in at 4.1%. And I think that was really, uh, essentially due to the team being, um, smart about critically evaluating how the spend is gonna be spent. Yeah. That's a, that's interesting. So compare and contrast. First year doing the budget to second year doing the budget.

Uh, have we, have you gone through the second year completely yet? Yeah, we're, we're almost done. It's, uh, October 1st, uh, deadline. So we're almost done. A few la last minute tweaks here and there, but we're almost done. . So yeah. So yeah, compare those two. So, um, Titan Day first, I, the processes have been put in place.

One of the things that I, I wanted to have in place to support what I was saying before around telling a story is I really wanted to be able to separate out our spend based on, uh, categories. A very big categories, what are we already spending and what's new and of what we're spending, which one is an operational imperative and which one is an operational option?

Uh, same thing for what's new. And one of the things that I think operational folks don't always realize is when a capital project comes through and it goes through your your PMO process and it gets approved, there's nearly always an ongoing operational opex spend associated with that. And so being able to specifically call out and highlight the additional costs allocated to ITS that came from their decisions about what to put into the system helps paint the picture and tell that story.

Yeah, that's interesting. So talk to me a little bit about the, I'm trying to figure out which way I want to take this. Okay, so you're in the role. One of the things that I've talked to you about is just the, the fact that I put on almost 25, 30 pounds in my first year as CIO within healthcare. So I'd been in those kinds of roles in other industries, but when I came to healthcare, I put on all that weight and that kind of stuff.

But you just went on a two week vacation. How do you, how does the CIO actually take a two week vacation? Yeah, great question. So I hadn't taken, uh, really any significant vacation, uh, for almost two years. So let's start with that. And traditionally, I hadn't been taking long vacations prior to that, you know, and my dad, when I was growing up, my dad would take a month off.

He had a different scenario. He was a cookie salesman for De Bisco, and so it was a different scenario, but they still had to meet their, their margin and they still had to meet their, uh, their sales goals, uh, et cetera. And as I was thinking through that, I thought my kids really deserve, and I deserve, my wife deserves focus time, or we can really peel away the lighter and really be able to connect on a, on a traditional vacation.

And so I had a conversation with my CEO who was very supportive and we decided to move forward. Having said that. I was concerned initially about how things were gonna play out during that time. I did meet with my team, talk through that a little bit, and we developed a framework for decision making while I'm gone, and it really boiled down to this.

Um, we have a daily standup now where all of the directors get together on a daily basis. It's very, uh, crisp process that is now in place thanks to Covid by the way. And they bring forth, uh, problems. They bring forth decisions, they bring forth things that are happening that will impact multiple domains.

So we'll cross one director's domain to another director's domain. And so we talked through that and we talked through the process by which they're gonna make decisions on something they otherwise would've brought to me. They were pretty, uh, clear on what that would look like. And I have to say, they did a terrific job.

They all have my text number. They all know they can get ahold of me. Uh, the only caveat to this whole scenario is two days into my vacation, we were going live on two separate quarterly updates and on base. And so for that specific day, I came outta hibernation and made myself available to one of the directors, Michelle Strickland.

And she and I communicated multiple times until, uh, we were both comfortable. It was going the right direction, um, moving forward. So that's the framework that was put in place. I have to say it worked really well this time. I don't know if we just dodged a bullet or if, or if, uh, things just worked out the way they were planned, but I'm really happy we took it.

You know, I'm gonna camp on this for a minute because it's not a topic we talk about enough. And, and actually I know part of your story. How valuable was this to you? How valuable was this to your family? Uh, yeah. Hard to put into words. I would say that the level of conversations were much deeper than they, uh, historically have been over the last, almost two years now.

It, it, it takes a couple days just to be on vacation, doesn't it? Absolutely. In fact, ultimately what I ended up doing was, uh, on your cell phone you can put multiple email accounts, and of course you have your work email on there. I actually took my work email off my phone. I. And that ended up being key to actually taking a real vacation.

Because I think without even thinking about it, you're constantly just looking. And if you see something in the subject line that looks enticing, you can't help but open it up and your brain starts going there. And of course, it's opportunity cost, right? If your brain is there, it's not on your kid. And I can give one example of where I think it was really impactful.

My, we're sitting around the campfire and, uh, talking through random things, and I've got a, a 19 year old boy, 17 year old boy, 15 year old girl, and a 12, almost 13 year old boy. So boy, girl, boy. And she's grown up in an environment where she's got all boys around her. And they, they frequently are boys. They have the capacity to critique and so she finds herself frequently in a defensive position growing up, uh, with the kids.

But she did something that really impressed me. She said, campfire. She said, you know what, and by the way, she's a straight A student. She's never not gotten an A and she's going in 10th grade. She said, you know what? I'm not a very good reader. I go to read my friends, we talk about reading and what I read.

It's, it's painful. Like I feel tired at the end and I just, it's hard to hold my interest and I don't know what to do. She said that and I was waiting for everybody to pounce on her and give her a hard time. 'cause the other, the boys are really good readers. They were reading Harry Potter when they were just in kindergarten and uh, but they came a little closer to her, started asking her questions about that.

And that ultimately led to a scenario where she and I decided to pick four or five books and read them together. Now mind you, she's going into 10th grade. Sounded like she's eight. Uh, but she was willing to do that. And so we picked out these books. I actually went to our local, Barnes and Noble and uh, spent time with, uh, this one lady who did a great job of kind of showcasing what would make sense.

And I wanted books that were about two years behind where she's at right now. So a 13 year old girl story would be perfect. And so we picked out four or five and began doing that. And as we sat down and began reading it, I tried to make it fun and she tried to make it fun. We went back and forth doing this on vacation, and about four or five days into doing this, I.

I realized she was flipping her words, so she was flipping word A with word B, and then even within a word, she was flipping her letters. I would ask her to spell the word and she would spell it, and she would flip the letters, and it became apparent at that time that she had at least a mild form of dyslexia.

Something I had never realized, uh, in 15 years, despite the fact that my wife and I spend a lot of time trying to focus on and support education within our home. You've been to our house, you've seen our education room, and, uh, but despite that, somehow we had missed this and felt really awful about having missed it, but also grateful that we identified it now.

And so we reached out to the educational system. Also some friends that are teachers, and we're starting to get her on the right track. And she and I still, every night when I come home from, uh, work, we read four or five chapters of the next book and it's been a fantastic experience. So that's just kinda one example of how a vacation led to some great stuff.

Yeah, and actually those, one of the best things about coaching you is I get to hear those stories firsthand as they're happening and it's just, it's fun. One of the things about you that people may not know is you're a phenomenal writer. I think you're a phenomenal writer. I've read some of your stuff.

You've written some things about your experience back when you were in the ED and whatnot, but I also read your letters that you were sending out to your team during covid. That's really where I want to talk about. What were you trying to communicate as Covid was sort of. Happening and peaking and there was a lot of questions.

What were you trying to communicate through those messages to your team? Yeah, in those early days, bill, I think I, I try to put my, myself in the shoes of frontline staff and try to understand what their fears and concerns, uh, might be. In the absence of information, we tend to fill it with worst case scenarios, and so I try to think to myself, what do they need to hear?

What are the messages that they need to hear? And as I thought through that, I thought there's a couple of things that that come to mind. First, they need to understand that there is a plan. To get through this, that we're still a team, we're still very much together and there's a plan. And I wanted 'em to understand what that plan looked like.

And, and that plan evolved as the incident command, um, structure is something that was quite nimble and had to pivot and adjust from time to time. But for the most part, there was a, uh, robust plan in place and I wanted them to understand they were part of a health system that was organized, was attacking this head on, and had a clear plan that was being communicated.

And then the second piece I wanted them to understand is that we're still connected. You know, I do think of ITS very much like my extended family. There's really amazing people within ITS and I continue to argue that ITS folks are usually the unsung heroes of the health system. They do so much to create the, uh, the end user experience and ultimately the patient's experience and frequently are unsung.

So I wanted them to know that we continue to be a family. And we continue to stay connected despite the fact that we're in the midst of this pandemic. The other piece I would say is I try to, um, break it up a little bit by showcasing some of the human element of what we're all going through. I. So I would tell some stories that I thought somehow related, in some fashion related to, uh, the work we do in it.

And, and that helped keep it real, I think, to some extent. So I'm grateful for the opportunity I had to, to write those out and, and get feedback from folks. And I consider it a, it's definitely a call it duty of the CIO is to stay in communication with your frontline staff and make sure they know that you're thinking of them and you care about them.

Yeah, absolutely. And. And you are a gifted writer, so if people search the internet, they'll find some of your stories from, from back in the day back when you were in the ed, and they're really, uh, moving stories. I also, I'd be remiss if I didn't touch on this, Andrea 10 Brink did a post on LinkedIn and it's pretty much viral at this point.

380 re reactions, 29 comments, and it talks about work from home. And, uh, it's a great picture. It's a picture of her and her, and I think her youngest. I can't, I actually, I don't know what age, uh, the child is. And she says, I've seen my kids more in the last six months than I've seen them since they were born.

And she says, let that sink in. I had them, and I've been missing, I've been missing all of it. And she goes on to talk about the benefits of. Work from home. I, I, I say that first of all, to make people aware of that post 'cause it's a phenomenal post and it's really touching. Yeah. But as you think about work from home, where do you think we're going?

Yeah, so just first on Andrea. So yeah, she's very gifted. She's our privacy, our privacy officer, and she's very gifted and has the ability to understand the human connection even within, uh, the domain of privacy that you wouldn't normally think is amenable to that. But she really brings the human element to it.

And I agree with you, that post was awesome. It caused me to self-reflect a little bit about the journey we've been on, both for myself personally, as well as for the division. I, I don't have a specific point in the future that I think we're headed to, but I do think the lid was blown off of the old model.

Here at Asante, how we've we're focusing on it is we have two sep, two separate, but related teams that have been put together to look at this issue. The first is, I'll call it return from work from home. So there are a few teams that needed to get back to on-prem. We, they pushed them, uh, to home, but probably overshot it a bit.

They needed to come back. So that team was dedicated to identifying . What are all the pieces that have to be in place so they can return to on-prem safely? And so we had our infectious disease physician specialist on there, hr, myself, others coming together to try to answer that question. And then the second, um, related, it's actually the same people, but different agenda at different day.

It's really around what is our long-term strategy around work from home. And when we think through that, there's a lot of things to consider. One of which is, how do we wanna hire. Our hiring practices will likely change, uh, moving forward. Previously we had to have people within our local geography and as I'm in southern Oregon, and that isn't always an easy thing to accomplish per se, but the way I sold it to HR and to the credit, they were very open to this was the concept that I.

It's not just us who are gonna be hiring, other folks are gonna be hiring. So if we don't have the capacity to open up that hiring to folks who aren't in our geography, so maybe they're in the northern part of the state, or maybe they're in California or Arizona or New Hampshire or whatever, we need to be open to what that looks like.

And that is happening now here at Asante or broadening that a bit. We're changing some policies and procedures to, to accommodate that. And then I think here we're also looking at what is the long term . Impact working from home? Look, so with my team, I've told my team plan on two years and I pick that timeframe two years from now.

In terms of having the same covid type stuff happening, and the reason I picked that timeframe is because I want it to be long enough that if you were thinking about doing something, but you were holding your breath to see what happens, that you wouldn't, you'd realize that you can't hold your breath long enough, that if you have to make a change, now's the time to make it.

So whether it comes to ergonomic. Stuff. Sit, stand, desk, the proper seat, the proper mouse, whatever it might be. Let's get that on board now so you can be effective. And so as we move forward, I think the question's gonna be, do we come back to the old system, which I don't think is gonna happen. Do we keep everybody at home or do we have some sort of hybrid scenario that allows us to be on-prem at the right time, but we can also work from home as needed?

Uh, Lee, I'm gonna, I, so I, I, I hate to end this, but I, I'm gonna end this and I'm gonna do it by making you feel uncomfortable, but I'm gonna give you a chance to do some shout outs here. And so the, the title of the episode was Paving a Path to Success as a Healthcare CIO. And one of the things I've learned from you, um, and because you've exemplified this, is you have a thousand coaches.

Which is beautiful. You, you, there's so many people that you rely on that it takes a team and you have a great leadership team at Asante. You guys work really well together. You have a great set of leaders, uh, peers and leaders within health it, but you also have reached out to Chime for their support.

You've reached out to other CIOs for their support and I can't think of anyone that I've ever seen. Uh, really has, has mobilized a community to make sure that the CIO at Asante is successful. And, and that's the, that's the takeaway for me is a, a path to success as a healthcare CIO is really mobilizing your team and expanding that to, to players that you may not have even met before, but who are willing to give you some time to, to help you think through things and to grow into the leadership role.

Yeah. Yeah. I would say that the first part of that is you just gotta recognize your own limitations, right? . It's pretty clear to me that there's a lot of limitations and this role demands a tremendous amount. And as soon as you have like a realization to get that mantle of responsibility on your shoulders, and you're like, oh, I.

This is a lot. As soon as you recognize that, I think it's critical at that point to say, okay, if that's what the ask is, what are my resources to fill that ask? One of the things I've been really surprised about is the generosity that's been shown to me from other CIOs and other healthcare leaders across the country.

I mentioned before about the CIOs that I reached out to. I reached out to 15 C CIOs, and I can tell you I had 15 discussions within a week. CIO's time is, uh, it's hard to get, but folks are very willing to do that. People like Ed Marks, John Halamka and, and others, they, they just shared their time because I think on one, on the one hand, they recognized that, that I had a lot, uh, to learn and they wanted to help out in that process.

And so, um, I'm grateful for them. I'm also grateful for my team. My team. This was an awkward scenario for them. This happened abruptly again, almost two years ago now. And it would've been easy to just shy away from what's happening. And again, hold your breath and see what happens. But I'm really grateful that my team rallied and, and came together and brought their expertise to these discussions.

We've also framed up our decision making pathway and process that is fairly inclusive, and I think that's helped, helped us navigate into these new waters. . And Lee, I just wanna thank you again for coming on the show. For those who are listening to the podcast, Lee now looks like a young Chris k Cringle from the, from the, the old, the Claymation shows that were out there.

Nice Covid beard you have going on there. And thanks again for coming on the show. I really appreciate it. Thanks so much, bill. Thanks everybody. That's all for this week. Don't forget to sign up for clip notes. Send an email to CliffNotes at this week in health it.com. Special thanks to our sponsors, our channel sponsors VMware, Starbridge Advisors, Galen Healthcare Health lyrics, serious Healthcare Pro, talent Advisors, and Health.

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