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 Thanks for joining us on this week in Health IT Influence. My name is Bill Russell, former Healthcare CIO for 16 hospital system and creator of this week in Health it a channel dedicated to keeping Health IT staff current and engaged. Today we are joined by Chris Nessa. She's the Enterprise Director of Customer Success at the Dell Medical School at University of Texas.

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We are trying to build a, a more broad community, so invite your friends in to follow us as well. We want to, to make this a dynamic conversation between us so that we can move and advance healthcare forward. All right. Today we are joined by Chris Nessa. She's the Enterprise Director of customer Success at Medical At.

Good morning, Chris. Welcome to the show. Good morning, bill. Thanks for having me. Well, I'm, I'm looking forward to this conversation. Uh, first of all, from the title standpoint, it's an awesome title and we'll get into what that means and whatnot. But just in our short conversation here, we realize we have a lot of connections over, over our history, and I didn't in.

It is, it is. I would completely agree. And it's funny how a lot of our paths always intersect and, and it's like family, especially in healthcare. It, you know, and family moves around the country or you're at a new healthcare system or like, oh, I used to be there. Things like that. , it's uh, it's always funny.

Is this why I look forward to getting back together eventually? You know, the conferences and whatnot to, to make those connections, those connections are, are a lot of fun. Alright, so I, I usually start the interview by asking you to share about your health system, but since Aaron was just on and shared about the health system and whatnot, I, I'm gonna just go ahead and refer people to that episode if they're interested about UT Dell School of Medicine.

It really is a fascinating place doing some amazing, innovative things. It and on.

Let's just dive right in. Let's start with the job title, enterprise Director of Customer Success. Give us an idea of what that role entails. One of my colleagues and I, her and I joke back and forth on how she owns the back of the house, and I own the front of the house at Dell, so virtually almost every entry point, whether it be clinical operations, clinical applications, informatics, finance, and even the patients, most importantly, uh.

I own that experience. I own the success of it. Some key words usually are, uh, translators. So being able to understand what it is we're trying to do from a business standpoint, clinically operational, understand the clinical workflow, and I. Able to design, translate it back into it, and maybe at a more granular technical level for some of our IT counterparts, but then also take the information that we have in it that might be too technical for a physician or nurse, or even someone in finance to understand and maybe change the language, change it back out so that I can communicate it back out.

So driving success for our business. Being proactive about it. You gotta love when the KPI is in the job title, customer success. Right. Right there. It's, we're gonna dive into this a little bit. It's really fascinating. But before we get there, you've had a lot of interesting roles. You've been at Cleveland Clinic, Cerner, you've been here at MCH.

Talk about the work that you did at those various places and how it prepared you for this role. That's such a great question and I, I honestly am very blessed and grateful for the path that's. Led me here, and I really feel that it has equipped me the entire way. I cannot thank Cerner enough. I, I think it's a, a, a great.

Spreading ground and Epic is very similar too. To be inside of either Cerner or Epic as a healthcare consultant early in your career and to get that training from either of those companies, I think really equips you to go work with any healthcare system and have a workflow conversation with any nurse or physician.

Even in the world, 'cause both companies are global. So the training as a consultant at Cerner, the product development years that I had there, so I can actually have a conversation even with vendors and discuss, hey, so in my years at Cerner when we were developing products, you know, we kind of went through this and we had these conversations.

I know technically you guys should be able to do this, haven't you? Started of this to have product development conversations, being able to work at customer sites, things like that. All of those were afforded to me at Cerner. So I worked at NCH while I was at Cerner. I met Sarah Richardson, worked with her for her as the CIO down there.

Like I said, it really equipped me for that next level. And that next level was going from a publicly traded EHR company. Over to a world renowned hospital system, the Cleveland Clinic, and when I was there at the Cleveland Clinic, I got the opportunity to work with Ed Marks and to actually get under his wing and see what it's like to work for the nonprofit global healthcare entity and what it takes to run an IT department.

Right? We were in the middle of, of building out and standing up the London hospital while I was there. And that is a great experience that I don't think everybody gets afforded. So working at Cleveland Clinic, that was like a, a relaxing time for you? I'd imagine. Not a lot going on. Plus working for Ed. Ed, ed is pretty much known as one of those laid back CIOs who doesn't, you know, doesn't have a lot of things that he wants to get done and, and any, I'm sorry.

I'm, people Dunno, sarcasm. I mean, Cleveland Clinic is doing stuff all over the place. And Ed has such a driving personality in terms of he, he, he wants to get to the future and just, you know, moves as quickly as they possibly could move. That would be interesting. What'd you learn from Ed in the short time that you were, you were with him?

You know, the key aspects there, like I mentioned a, a global company, so I was right there when we were building out London and what it was going to look like as a, a playbook from an IT perspective. So, you know, we've got hospitals. All around the globe now. And how is it that we are going to ensure that they are world class, right?

Innovative, that when you go there as a patient, you get the Cleveland Clinic experience regardless, right? And what does that experience look like? So building out a playbook, building out a global IT infrastructure, how are we gonna maintain it? How are we gonna innovate? How are we gonna deploy new things?

What if we've got some differences in global country state? Regional governance and how that impacts us from like an EHR build out. Some of our vendors could not operate operationally, have their product overseas because you've got all of those regulations. In London, in England that you don't have in the United States.

So there's a lot of great business skills that I learned from Ed and, and how to, uh, run it globally. Gosh, I could ask you a bunch of questions there, but let, let's focus in a little bit on UT and the Dell Medical School. Uh, I love your LinkedIn profile. It says this, providing enterprise wide innovation success for our customers, both internal and external, where technology, information operations, and business intersect.

The liaison and glue that combines these intersections for all parties to advance the care and health of our community and patients globally. And I, I read that and there's a couple things that jump out, but specifically where, where do you think we're seeing technology information operations and the, the business of healthcare intersect right now, at this moment in That is a great question.

If anything, the pandemic has even exposed some of these things, right? I always talk about, like, I have this soapbox when I think of healthcare and, and I'm in a business that 'cause you, you're a patient. I'm a patient, right? We're all patients, but we sometimes forget about that. The business of healthcare is a business that none of us think about using until we actually are forced to, to use it, right?

Until our family member is there, until our child is there, and when we are there and when we are living it and breathing it, it is one of those experiences that we expect World-Class Care. The intersections right now, and what the pandemic I feel has really exposed is telehealth. Destination health. How can you care for people while they're at home?

And a lot of the opportunities that we have there, there is no shortage of technology and innovation and things that are used in other business pillars in the world that we should be using in healthcare. We've always just been slow to adopt. I just, I really think that there's a lot of opportunities. We also have exposed where maybe some patients don't have the means to use some of the infrastructure.

So part of our community maybe doesn't have good high-speed internet to have that telehealth visit. So how do I as a healthcare provider organization enable my community so I AC actually can care for them while they're at home and that they have the best. Means for recovery and success. So we have that duality.

People can go pay for specialized destination healthcare, and then we also are supporting that community that maybe doesn't have it. And how do we then get back to that balance of gaining some of the revenue and things from here to share it over here so that we can, uh, help, help everyone. Yeah, I love those four things, technology, information operations, business of healthcare, and the only regulatory.

In healthcare.

What we're supposed to be doing. I guess. Let's go one step further. Let's talk about the consumer and the the customer of healthcare. What's the consumer looking for from a health system today, and how has that evolved in maybe just the last few years or maybe since the start of the pandemic? We're looking for the best of the best when we need it, right.

Similar to what we just discussed. I don't necessarily wanna be in a hospital, but when I'm there and I need care, I want it to be world class all the time. I also want ease of access and maybe more recovery time at home. And what's interesting is, is some of the talks of price transparency, right? So you mentioned how our government, how our policies impact us.

And we want the best care for our money, right? But that is a very complex web as well, where it's not just price transparency from a health organization. So if we expose our prices and what it costs for a colonoscopy, that's just our price. But you need to factor in what your insurance is at that moment and what it is that actually might be out of pocket for you as a patient.

So I, I really think it's using technology. Again, that's used in a lot of other industries, whether it be going to the airport, being able to quickly order something, Uber eats things at home, and how do we incorporate a lot of those pieces into concierge healthcare for, for all of us. Uh, today, I think it's interesting that patients want to recover at home, but during the pandemic, a lot of us experienced care being delivered.

From home, and it wasn't just those of us who were well and didn't want to go to a, an ED and whatnot who started to use telehealth. It's also some of the chronic care patients that early on in the pandemic, we had to figure out how to care for them in their home. How do you see the home really emerging as a locus of care?

Over the traditional approaches that they've been, and I could be mistaken, but I think there's been research over the past years on how, especially patients with chronic conditions. How their recovery at home, they actually might have a better chance of recovering and or be on a better path for health.

And I think it's just very obvious and transparent, like why wouldn't we utilize that? And it's an interesting business discussion, especially when you have it internally in your own business. Because we're used to standing up hospitals, we're used to standing up urgent care centers and a lot of brick and mortar things, right?

But those things cost a lot of money. And if we all could just pause and think through our business a little bit, and I know we're trying to play catch up, we're trying to get reimbursement models in place with the payers to pay us back for telehealth, pay us back for some home health and we're gonna get there.

It just might be slower than what we all desire, but back to, if we rethink our own business and, and the cost that it take to stand up brick and mortar, why wouldn't we take a chance, think innovatively and. Ship a a, a wifi router network box or whatever to somebody who has poor wifi at home, just to enable their home to do some of the basic bare minimum needs.

We could ship them a video camera. Those things are low cost. We could ship them a bunch of patient monitoring things that are, again, low cost and just monitor them at home, feed the data in. We've got our, we've all got our EHRs. We can use all of our research and our modeling. We can take their data, model it, and we can start providing care remotely.

It is, it's low cost, it's innovation, and it's just how do we get paid. But on top of that, the patient should be able, should be on a path to, to recovery. That's better than before. Yeah. I.

Vales home and to care at home. It seems obvious, but the other thing I think will be interesting as a I to get these things. How many beds do you have and you know, count beds and you add in there and go that many beds we have. I think it would be interesting to answer that question today. And coming out the pandemic, we have a thousand beds.

Inpatient beds. We have a couple of, you know, different kinds of long-term care beds and we have 5,000 beds in the community. And because it's just a new paradigm of saying, Hey, we can deliver care wherever you wanna receive care, and we can deliver care in your home. And we've just added 5,000 beds to the University of Texas, uh, medical

because. You make a really interesting point about that. Talk to me about the consumer, because one of the things, your role, I love your role and we're seeing them pop up in, in different places, and one of the things that I really value from the role is you have a way of, of really gathering the voice of the customer and give us an idea as you are trying to guide the efforts of, of the system, how do you, the voice of the customer, how do understand what they're for and what.

Navigate their care better. I ask them, , boy, that seems simple, . Um, how, how do you, how do you ask them? You just, did you go door to door and hey, what, what do you want from UT Medical Center? Or no? Uh, it's a great question. I didn't mean to be, uh, about it , but, but that, that is the right answer. At some point you gotta ask them, but, you know, how do, how do you do it?

No, it is, and it's one of the pillars that I live by even in my position. So whether it be the patient, customer, or like my clinical operations customer, it's having the conversation and just asking, being honest when it comes to patients, one of the things that we were doing at the Cleveland Clinic, which I think could be, and I think it is adopted by several other systems too, is we had patient forums.

We actually invited. A patient group to come in and give us feedback, and we had a few patient leaders that actually coordinated the group and they would meet monthly, they would come on site or we would do it via, um. Zoom, things like that. And we would ask 'em questions. So, Hey, here's our new rollout for the Cleveland Clinic mobile application.

We deployed X, Y, and Z. Take a look. What do you like about it? What don't you like about what can we improve? And they were patients of various conditions, ages, and they could even volunteer themselves. So we targeted some patients and some of the patients came on themselves. I think it's. Back to my core values, being transparent, open, and honest.

So invite the patients in, welcome, the feedback, and even those onesie twosies if it's a patient complaining about something. You need to hear it because there is an opportunity there, regardless of the ones that are like, no, everything's great. It's working fine. None of us are perfect. We all know we can improve somehow.

Yeah. I, I tell people, the thing which fuels me doing this is I get the emails that say, Hey, you're doing a great job. Really appreciate it. Learn this, learn this, learn this. But the other thing that fuels it is the people every now and then who shoot me a note and say, Hey, you know, you could do this better and that better because.

That tells us what our consumer is looking for, that we may or may not be meeting. Now, in some cases, we look at it and say, well, that's not really our core business, and they should really getting that from somebody else. But, but I, your your point of you gotta listen to 'em, you gotta figure out, talk about your internal customer.

How are the internal customers, the, the clinicians, the care providers, how are they experiencing healthcare today? I, I think a lot of the impact of regulations, especially recently, 21st Century Cures Act, things like that, it's creating this interesting dynamic imbalance between what we have technologically, what our vendors are developing, releasing what their roadmap looks like and what is.

The responsibility of operations and, and clinicians. We've had a lot of great conversations recently on, on that mixture. The re, the transparency, the information blocking, and how maybe a physician needs to be a little more cognizant of what they write in their note versus does the EMR have this capability to release this note?

Is it automatically releasing it? Do we have the control of it? Internal processes, again, core business values and what is what it is we wanna become as a business and navigating some of those processes are impacting them. I think the go fast, go fast with something and get it deployed and meet the needs of our customers versus our business strategy versus the pandemic and the money and revenue.

Everything that's happened in this past year has really shaken up all of us. I think as an industry, it made us reevaluate a lot, especially for our internal. Customer, so it is a great question. The last thing right now too. Holding. Holding our vendors accountable. So maximizing what it is we already have from a value perspective, because again, in this past year, we've all felt some shifts in impacts in various ways.

So knowing that maybe I can't go make a purchase that I intended to make. How do I pivot and utilize what I have in-House already, but work with that vendor maybe a little more strategically and maximize that relationship and that value with that vendor to achieve the goals that we're still trying to achieve.

Yeah, the pandemic created a sense of urgency that I, I don't recall. I mean, I'm sure somebody can point it out in, in, in memory, but I don't recall us moving that quickly. I mean, clearly in different areas across.

Disaster response and those kind of things. But this level of impact across all of healthcare globally, I was gonna say across the nation, but it it globally of everyone moving and having to adapt and change things. The nature of, of responding that rapidly. But does that continue post pandemic? Do we continue at that pace?

Have we created a new norm for how quickly we can move in healthcare? We, prior to the pandemic it, it's phenomenal how quickly we've been able to respond and move during the pandemic. But does that pace, is that now a part of our culture? Are we now able to, to maintain that pace, or is that gonna be too much.

Too much change too quickly to the organization. Is there a certain amount of burnout that comes with that? Hmm. That's a really great, great question. When you were asking, and I was thinking about my history, and I'm like, I have moved at this pace prior to the pandemic. So it's, is it really new those years, like in Cerner and even at the Cleveland Clinic prior to the pandemic?

I left the Cleveland Clinic right at the start of Covid to join ut. However, working at Cerner, we would rapidly develop and innovate and, and work with some of our strategic partners, Ascension tenant, things like that, and rapidly prototype and develop and get something in motion. So we worked at that fast pace at the Cleveland Clinic.

We worked at that fast pace. There as well to meet the strategic needs and goals of, of our organization and our patient. I think for the organizations who maybe haven't moved that fast before, this probably does create a new dynamic, but hopefully it also created that trust between C-E-O-C-F-O-C-O-O-C-I-O that they could all work together, trust each other, and they could rapidly move that fast together as an organization.

So I, I do think some will pivot and do this, but it comes down to the relationships and that trust together as an organization to continue to do it. There might be some organizations who could shy away because during that rapid development and deployment, they may be learn some things. Something didn't go quite right and.

Somebody could have suffered the impact of, oh no, we deployed this. It didn't work. It kind of made us look bad. But hopefully they can pivot and change from a technology and and data perspective. What are clinicians excited about that they're going to be able to do as a result of new technology or, or new?

Uh, methods around data and data delivery. What are hearing that they're talking about at this point? I do think a lot of it points to telehealth being a more standard thing. I was amazed that some clinicians weren't really using telehealth before. 'cause telehealth has been around for a long time.

There's been, you know, communities, organizations stood up for over a decade discussing it. Some just never really embraced it, or the organization didn't embrace it. So I really do feel that Telehealth is here to stay from a long-term perspective and is a way to reduce costs. Another thing which we've been talking about, home health, trying to care for the patient.

From a remote standpoint is a very exciting and intriguing thing for a lot of our clinicians, and how do we expand on that, especially from a primary care perspective. If I'm responsible for the patient holistically and in the community, how can I do this at a low, low cost, uh, but more innovatively and remotely.

Another thing is the data. Again, we are deep into several decades now of electronic health records and using other applications to meet the holistic workflow of the patient and being able to own that data. Now pivot to how do we use it effectively for research algorithms projecting, predicting a patient's health, and how do we successfully, proactively have that conversation with that patient and show them, if you continue on this trend here, here's what it looks like and here's how we can go together to maybe mitigate some things ahead of time that we couldn't years ago.

So the data. I, I think, is going to be very, very powerful in this next five, 10 years. No, no, I agree. Data has the possibility and the potential to really change how we, uh, deliver care, especially as the tools get more sophisticated. I, I, if you could change one thing in healthcare, this is the proverbial magic wand question.

What's the one thing that you'd like to see changed to enable better? In the communities that you serve at ut, the magic wand? Yeah. The thing I've learned over the years, it's never black, it's never white. The, the balance is truly the best path to gray and man, everything affects all of us from a health perspective.

How much money I have in my bank account, what I'm eating, what I'm ordering, the relationships I have, and I really think it's my core engineering skills. Technology is getting cheaper all the time, and how can I, as a health organization deploy cheap technology to my community to enable them to have the best possible entry access to me whenever they need me and, and to deliver world class health?

It's there. We just, we just need to partner and use it and enable our community, build up our community so that. They can access us and, and see us whenever possible. Yeah, yeah. Utilizing technology to improve access. And actually I like, I like the fact that you said inexpensive technology because there's a lot of really good solutions out there that are not all that, uh, pricey to implement.

You know, I actually. What's the makeup of your team? Like what, I mean, we talked about what your role is as customer success. Do you have a, a team of people that you work with that work within the organization and what does that team look like and and what's the makeup in terms of skills or background?

Yeah, from a bare bones old school IT perspective, I've got. The front of the house, the desktop team, clinical applications, clinical informatics, help desk, those things all report up to me and the makeup of the team really from a skill perspective, innovative problem solving, being able to communicate efficiently and effectively.

As I said, having the conversations and, and taking what we talk about internally, translating them out, but also taking things from the business perspective and bringing them in. The willingness to learn and problem solve, the desire to make something better. Nothing is ever perfect, but how do we innovate on this and make it better?

And just that balance between an honest conversation being transparent. So sitting down with the physician, they, they want something done because it's broken, and I need it done right now. So sit down, have that conversation with them. Understand the true workflow and what the problem is. Why is it so urgent?

And be honest. Okay? You need this done today. Here's what I can do today. It's gonna take this A, B, and C. However, if you give me 48 hours, I can maybe give you D, E, and F. So, honesty, transparency, . Well. You've been on the Cerner, on the consulting side, you've been now with two world class organizations actually on their staff and, and working.

But you know, for those people who are coming outta college trying to figure this out, you know, which I mean compare and contrast those two being on the consulting side, being, being inside the organization. Wow. That I've had a lot of conversations over the years about that, and I, I do think there is a lot of value that you can get by joining an Epic healthcare system or an Epic system and a Cerner system out of college, even gaining a few years of experience getting those core consulting skills, how to communicate with your customer.

Then going out to a healthcare organization. Um, and there is a lot of value starting out at a healthcare organization and understanding the deep business and the structure of that organization. I really feel if you want the best all round skills, you, you should work at both . Yeah. If you can, right? Yeah.

I, the thing when I'm talking to college aged kids and, and I'll say, look, it's uh, paid job hopping because you get to go from this health system to this health system, to this health system, to this health. You get the experience in a year of being with six health systems. 'cause you've worked on projects at all, all six.

Now you may not. It's a different type of experience, but still you get to interact with those organizations so it's paid job hopping. Whereas when you go into a healthcare facility, I, I like the words, I like the concept you gave, which you, you really get to become a part of it. The, the team that is working on specific problems for that community, you get a lot deeper.

You get to really move things forward. In a different way than you do as a consultant. As a consultant, you sort of fly in, you work on a problem, you fix a problem, you get something implemented and you go out. And a lot of times you don't even get to see the fruit of that or the fruition of, of those projects.

Whereas when you're with a health system, you, you can really see moving things in a community over a long period of time. It's really kind. Interesting. And you were with Cerner for how long? I was with Cerner for almost 14 years. Wow. So you've worked with a fair number of health systems then? I did. So at Cerner, I did consulting for three to four years, and then the majority of the time I was in.

I piece of product development. So I was actually developing, designing the products that our, uh, customers and clients were using. And then at the end of Cerner, I was in this niche role that was one of my favorites. I was running what we called an innovation institute. So I got to basically run my own company from start to finish and be innovative and develop products on the fly, use 'em at our hospital, but also use 'em out everywhere else.

But, um, to your point, during my three to four years of consulting at Cerner, I had 18 client go lives. That's 18 different health systems that I took live on a Cerner product. You don't get that in the course of your normal healthcare career to do that. And to your point, I was learning tidbits. And yes, you kind of fly in, fly out, but you get to work with them and design and you get to see a little bit of each of the organization and you get to see some trends and a little bit of differences.

But to your point, and then when you go out to like a Cleveland Clinic and you dive deep into that organization, you learn some of the things that you didn't see when you were a consultant, but then you also get a little confirmation of some of the things that you saw were the same. It's like, oh. We all kind of are the same or I'm having some of the same conversations that I had with this other healthcare organization.

So it kind of helps to affirm, I think, and so, uh, solidify some of the core skills to be a better global healthcare leader. And to give you some confidence, I think. Yeah, absolutely. Well Chris, thanks. It's great to meet you and thanks for coming on the show. I really appreciate it. Great experience, and I look forward to staying in touch.

Hopefully we'll see each other at an event sometime in the near future. We'll see. See if that happens. I hope so too. Oh gosh. I can't wait for those to start back up. , me too. Thanks again. Appreciate your time. Thank you, bill. What a great discussion. If you know of someone that might benefit from our channel, from these kinds of discussions, please forward them a note.

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