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Today on This Week Health.

We can focus on our end users our patients, our clients, whatever industry you're in, but we also have to take care of our employees, right? We need to give them a great experience because if they have a good experience, we know that they're going to do a, better job. Serving our patients.

Thanks for joining us on this keynote episode, a this week health conference show. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health, A set of channels dedicated to keeping health IT staff current and engaged. For five years, we've been making podcasts that amplify great thinking to propel healthcare forward. Special thanks to our keynote show. CDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders. Now onto our show.

  (Main) 📍 here we are for another conference episode. And today we're joined by guest Luke Olenoski, CIO for Mainline Health. Luke, welcome to the show.

Bill. Absolutely. Thanks so much for having me.

Well, I'm looking forward to the conversation.

And you and I got to meet at one of the 2 29 events, and I learned a bunch about Mainline Health. But for those who aren't familiar, Tell us a little bit about mainline health.

Sure. So mainline health is a not for profit system, in the Western suburbs of Philadelphia. So, for me it's the community where I live.

Mainline has been serving the greater Philadelphia community for probably about 40 years or so, Bill. Two and a half billion dollar system. A lot of organizations, we have a kind of pretty substantial inpatient footprint, but then a lot of ambulatory practices as well in the greater Philadelphia community.

Yeah. And anyone who's familiar with Philly knows what the main line is. It's where the train used to go out. The main line train used to go out into the suburbs. So, but some people aren't familiar with Philly. So there you go. Hey, tell us about your path to that role as CIO at Mainline.

Yeah, sure, Bill. And it's actually pretty interesting when my first exposure to mainline was not through work. It was actually my kids were born at mainline hospitals. I did my undergrad at Villanova and actually started my career for the first 20 years in financial services.

And, I wasn't looking at the time, but the opportunity, I think, to join, a mission driven organization in our community as the CIO, it was just too good to pass up. So again, it was Kind of looking back on it, Bill, it was a pretty wild time to make that sort of move to jump into health care at the beginning of a global pandemic.

But just what a fantastic experience.

So, those who are watching on video are going to notice the planned office. That is not your office. You guys are in the process of launching a new pavilion. What goes into opening a new care facility?

Yeah, no. And it's interesting. So I am in the new pavilion for our little hospital.

And I think the biggest thing sitting in on the command center this week All the teamwork, right? Whether it's the facilities team, clinical teams, the I. T. Organizations, whether that's the field services, biomed side. So what's been really impressive to me is all the planning that went into it. But then all of those kind of last minute.

Really focusing in on the experience, doing all those technical dress rehearsals, doing all those kind of last minute adjustments. It reminds me of like wedding planning. I like the beginning, you have to pick your date, you got to pick the location, then you get a couple months off.

But that, like last two or three months is just, you're doing all those last minute details. And it's been really impressive to watch. And I think for me, what's been really unique is there's a lot of talk about the, kind of site of care shift. So, I don't know how many, big hospital openings I'll get to do in my career, but it's been really exciting to do this one three years in.

Was there a lot of interaction between the architect, the builder, the designer, and IT throughout the process? And what was that like? I was talking to a CIO yesterday that they're getting ready to open their facility and he was telling me how the architect and designer got way out in front of the I.

T. stuff and they had to come back in and say, well, you realize that these these closets on these floors don't line up, which means we have to run the wire from here to here. They looked at him like, Okay. Oh, yeah, that's gonna be a problem. Like,

And like, especially if you're adding on to an existing facility and maybe like the height of the floors isn't the same and you need to have that slow gradient that actually connects the second floor of the old building to the second floor of the new building.

But we are fortunate that In our project management office, we have a couple of resources that specialize in construction projects, whether it's inpatient, whether it's ambulatory. So they've built really good relationships with the architects. Now that's not to say that there aren't a lot of moving pieces and everything from, from the network side to even just.

The positioning of all the equipment in the room. That's probably been one of the biggest things for me is right. These are not just movable desks that you can just slide around and, and just grab your laptop, right. There's, these massive pieces of equipment.

So there's been a lot of prep and I'd say. Having a strong relationship with the architects and having an I. T. team that's done it before has just been invaluable.

What would you say is the most leading edge thing you're doing in this? Was there more of a drive towards standardization and, keeping it simple?

Or was there an eye towards? Hey, how are we going to be delivering care in the future? Yeah,

Obviously, a lot of emphasis. on security and on safety there. So we've actually got some real time location services that we've deployed in those areas to really just make sure that we can provide a safe, secure experience for the family. So that is one that I'm particularly proud of in terms of, Hey, we definitely want to be consistent.

We definitely want to have standards, but if there's an opportunity to innovate and if there's an opportunity to also push the experience, we'll look for that as well. Yeah.

You came in from finance. I'm one of those CIOs that came in from outside the industry. There's a couple of others interviewed a gentleman.

in South Florida, who came in from Disney, interviewed B. J. More came in from Microsoft and whatnot. Talk to me about the transition from finance to health care. I mean, what do you find the biggest advantage of making that kind of move is and the biggest challenge of making that kind of move?

The biggest challenge is probably figuring out the operating model and the people. Right. I spent 20 years in an organization, so not even just 20 years in an industry, but 20 years with an organization. So understanding, the people, that's, was part of the job.

I think figuring out that operating model and how it can best, work with our business teams, that was probably the biggest challenge, just understanding kind of what makes them tick, how they make decisions. I think one of the biggest benefits is. People are eager for your ideas, right?

And like, you've seen how another industry operates. So you can create those parallels. And, Bill, I'd follow the standard 80 20 rule. I think 80%, translates pretty well, especially on the infrastructure, side. And then there's that 20% that I think is industry specific.

And I think we also brought in a lot of people things and a lot of leadership culture things from the financial services model, whether it's getting out to campuses for recruiting, doing internship programs. So I think there's a lot that you can lean on. If you're considering a jump across industries,

In finance the internet was disruptive.

Mobile was very disruptive for finance. I think people feel like we're almost on the precipice of this AI push and we're seeing, ambient clinical listening. We're seeing computer vision. We're seeing Some AI models start to emerge. Having gone through some disruption in the finance space with mobile and whatnot, how can we be thinking about the disruption?

It will happen slower in healthcare. We generally adopt things more than other industries, but I mean, how do you prepare for disruption and how do you ensure that you're ready?

Yeah, no, Bill. It's actually something that. I've been spending a lot of time thinking about because, I forget exactly where I saw the study, but healthcare is one of the few organizations or industries that has added technology and maybe gotten less productive, right?

So let's think about that. We've added technology, right? People feel less productive. So when I think about disruption and I'm bullish on some of these things, the number one thing that jumps out to me is. You've really got to be walking hand in hand with your clinical leadership to really make sure that they're just not a yeah that they're, kind of part of, co driving this process with you.

If I think about the analogy, if you're in a car, right? I'm not sure who's got their hand on the wheel, but the other person's riding shotgun, right? They're not in the backseat, they're not in the trunk like they've got to be there with you. Or else I don't think that, look at the outcomes that we're looking for.

And we need those outcomes, right? Like when you think about What's happening in our industry, whether it's the kind of pressures on labor, the pressures on reimbursement, right? We have to leverage this to improve how we deliver care. So I think it's really critical that it's not being viewed as a technology thing, but, really is something that we're partnering on with our clinical stakeholders.

And just like one example that is who's scheduling the steering meeting, you're for this. Is it an IT PM doing all the talking or is it the business product owner doing, setting up. I look for those things to say, are we thinking about this next wave of disruption the right way?

Yeah. I had a CIO this week tell me he went out into his organization and he was telling people, Hey, we're going to probably put a hold on access to chat GPT for a little while. And a bunch of the doctors like, we're like, no, you cannot do it. And he's like, what? And they go, well, here's the use case.

Here's the use case. Here's the use case. And they were already. Already using it. So when he formed, I thought it was just interesting. He formed a technology group to look at this. And he put some of those doctors on that group, exploring generative AI and where it's going to go.

Because, they're already using it. They're already thinking through, Hey, this is how this can make my practice more effective. This is how this can make my staff more effective. Which is, it's, we serve a very creative group of people if if given the opportunity to innovate.

Bill, you probably know this as well as anyone, right?

There's what people think is happening on the front line and what's actually happening on the front line, right? So whether it's on the physician side, whether it's on the nursing side, financial analyst call center, right? Even as leaders, a lot of times we don't have the best idea, right?

So we might think that, kind of people might be leveraging technology in a certain way. But you know, if you actually get out there to the front line, maybe they've made a workaround for a process that you've made too tough.

I will never forget kind of one time I was shot in the call center. I had spent three months building this beautiful button. That would take them right to the next screen. And I sat there, I'm like, why aren't they clicking the button? They're like, oh, well, if I click that button, then I'd do these other two things.

I just go this way. So, I think it's just a good reminder that yes, you need to partner you with your stakeholders, but make sure that you're actually getting to the front line. And that leads me to another thing. It's like, make sure you're actually getting to the data that is telling you how the process is working.

Right. I think that's one of the other things that we also need to explore is like, What are the outcomes that we can measure? And actually make sure that we're hitting those as well, because it could be easy to fall in love with technology, right? Or like with the shiny objects. So,

yeah, it's it is interesting.

Measure is so important. A lot of a couple of the interviews I've been doing lately, the CIOs have been really stressing this idea of measuring. There's so many technology things going on. Plus the added financial pressure that's coming in. There's more scrutiny on. Hey, that million dollars we spent over here.

Did it actually deliver on the things that we thought it was going to deliver? But, along those lines, I You know, I know you're opening a pavilion and there are You know people who are listening to this who aren't cios there are seasons where You know the air gets sucked out of the room like you're focused on an ehr go live or an erp go live Or a new pavilion, but i'm sure as a cio you're juggling multiple balls.

What are some of the priorities right now at Mainline Health?

Sure. Yeah. It's probably going to sound, pretty similar to other systems, whether it's, you're reimagining that, patient experience, all the way from access, to where we deliver care.

Obviously. We're always looking at how we can be safer, better, faster, cheaper. But I think, when I think of the key priorities for us that side of care shift is big. How do we really grow our ambulatory presence, make sure that we're serving the community in the manner and which they want to be served.

So that's a big one for us. We're also looking at what's the care that, happens outside of our walls, so whether it's kind of hospital to home, actually keeping people out of hospitals is a big area of focus for us as well. And then on, on the nonclinical front, I think we're also going to be looking at, our internal corporates.

Systems and looking at some really exciting modernization opportunities there as well. And I'd say, one last thing. lot of emphasis on how do we deliver a great employee experience? I think that sometimes, I've definitely seen it as organizations. We can focus on our end users our patients, our clients, whatever industry you're in, but we also have to take care of our employees, right?

We need to give them a great experience because if they have a good experience, if they don't feel like they've got all this, extra burden. And if we can call, bringing the joy back to work, we know that they're going to do a, better job.

Serving our patients, serving our community. So employee experience is actually really bubbling up as a kind of key focus area for us

as well. That's fantastic.

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As you were talking, I was thinking there's this idea that there is no legacy equipment in finance, cause there's so much money there that there's no legacy.

In health care, we deal with a lot of legacy. I'm curious if you could compare and contrast finance and health care with regard to legacy equipment and what were some of the approaches and strategies to deal with dealing with legacy to maybe not make it as front and center.

So people didn't know that they were hitting legacy equipment. How did they do it in finance and how are we looking at it in health care?

Yeah, Bill, I mean, first of all I can't lie. There was just a little bit more flexibility, I think, to stay current. And the finance, and it wasn't just the money side, Bill, right?

Like, when you think about staying current on healthcare technology that's been FDA certified because it's, impacting care, right? Like, there's just more, steps to go. Through to keep that modern. So yes, there was definitely a little bit more flexibility, a little bit more margin to work within financial services.

But one of the things that we are working on here is trying to get across that it's easier to keep up than catch up. Right. And we're actually trying to take a risk based approach. To that maintenance, whether it sounds like, for me having up to date infrastructure is absolutely critical, right?

Because when I think about if you're things go wrong, my biggest concern are those larger pieces of infrastructure as opposed to an individual end point. So really taking what's that risk based approach. Or, what's that, revenue impacting approach that I can sit down with, our senior leadership and talk through, Hey, if we can't do everything, this is how I would prioritize it in terms of patient safety.

In terms of revenue opportunity and in terms of business impacts, I think you've got to turn it into that conversation and just that this is everything that I need and that you one of those things is, in like the cyberspace, right?

Yeah, I love that. I love turning it into a risk conversation.

So many times in those budget conversations. They look at you and go, can we get another year out of this? Can we get another one year becomes two, two becomes four. And then all of a sudden it's end of life. And you're like. Okay. All that money we didn't spend over the last three years or four years, we now have to spend it all at once.

And that's a hard pill. I want to, we only have about 10 minutes cause you have to get to the go live. I want to spend the last talking about the patient experience and the employee and clinician experience. So you talked a little about the priorities around the patient experience.

Talk about the process for determining, what areas you're going to work on, what areas are important to the patient and how that translates into their interaction with your organization and with the clinicians.

Sure thing. Yeah. Bill and I'd say I am very fortunate.

We have a dedicated team that has put a lot of thought into the end-to-end patient journey. This is our digital team strategy team, patient access team. And they've actually mapped. The entire journey and they were really thoughtful.

They did like an above the line, below the line in terms of, Hey, there's digital experiences, but there's also a lot of those physical experiences and that's okay. Like we understand that people might need to call in or that, but then they've actually gone through and said, where are we strong?

You're where are the opportunities? And they've actually mapped that out and, put a roadmap there, which has been really helpful because then it's less whack a mole. Right. We're actually going against the plan and just like, one tactical example, we have a lot of really strong adoption for our Epic MyChart experience.

But an area that we wanted to expand was in SMS, because we know that's where, that's one area where people are going, right? We want to text message them that, they have an appointment coming up or if they need to reschedule, they can do that through text, right? So that was an area we said, Hey, we feel strong on the MyChart side.

Like we feel good there, right? Like, like once we get them there, there's definitely an opportunity on, that, bi directional SMS communication. So, that's an area where we put a lot of work over the last 12 months and a lot of really good results there. Really, improved our, no shows, our reschedule rates there.

So, that's an example, but that wouldn't have happened if we didn't take the time to say, well, what's that end to end journey? Where do we think we're strong? Where do we think that we have opportunities? And I think for us, our key strategy has been let's leverage the main platforms that we have, but where can we innovate on the edges, right?

We know that, the EMR is a huge platform for us. It's a really key investment, great partnership. Where can we also innovate on the edges?

It's fantastic to focus in on a handful of things and make improvements on those things. I think one of the things that happens in IT is we get spread so thin.

Talk about the employee experience. You mentioned. How important that is. What are some things that are important to improving areas of improvement within the employee experience?

Yeah. Yeah. So Bill, for that one, and again, it's that similar theme, really strong relationship and a partnership with our heads of HR with our CFO to again, take a step back and, what I'll give the team a lot of credit for is instead of just saying we need a new platform, whether that's Workday, whether that's ServiceNow, whether it's PeopleSoft, whether it's any of those things they said, well, what's the end to end experience? What are we trying to solve for?

All right, so we're trying to solve for, we don't want people emailing HR. We don't want people calling HR. We want people actually interacting with us digitally. So that we can keep track of it so that we can measure it, so that's in a, key one for us of how do we engage with our people digitally?

Because we know that they're on the go, right? They're not always tied in front of a desk, right? If you're a nurse manager, you're up and about. So your kind of key thing for us was how do we meet people where they're at and then for our service providers. Like HR, like finance, how do we give them platforms, how do we give them access to data, how do we get the paper out of the process so that they can actually measure those those improvements on their end, and again, it's not about the platform, but we've had a lot of success actually rolling out kind of service now for our HR offer.

So if you are an employee at a mainline health, and if you need something from I. T. And if you need something from HR, you go to one portal, one portal for both of those needs. So we, again, we're trying to make it as easy as possible for them to interact with us. We don't always get it right, but we're trying.

You don't always get it right? Yeah, no it's I mean, that's fantastic. Let me let me give you a closing question here. I know you're keeping an eye on generative AI. I was gonna ask you a question about futures, but let me ask you this one. This is a interesting one. We have a lot of people who are listening to this and we're like, how did the CIOs think about partners and vendor partners?

And for a closing question, what have you learned about dealing with vendor partners over the years and what piece of advice would you give those trying to work? with healthcare organizations.

Bill, I think you mentioned the key word, which is partners, right? And I think that's definitely how you have to view it.

My advice would be threefold. And it's going to sound like I'm talking out of both sides of my mouth. Listen, have a little bit of patience. But be okay to, tell us what we need to hear, not what we want to hear. So, I think on the listening, that's like, again, what's the real problem that we are trying to solve, right?

Because sometimes I feel like, Hey, they're talking to us, but they should be talking to us and our end users so that they can actually hear what's happening on the front line, because sometimes we run into the. They work with I. T. We implement something, but it's not actually going to meet the, needs of the end user.

So really try to listen. And I think on the patients, I think to your point earlier, there's a lot of priorities and we can't do it all, every day. So we're trying to figure, well, when's the right time, what's the right sequence, how do we build that spot on the wall and actually build towards it, step by step.

And then that, last one of, It is okay to push us, again, I think it's important to tell us if we don't have the right operational leadership lined up, or if we don't have the technical expertise, don't shy away from that conversation. So I'd say, be bold, but be respectful, right?

So that would be, my advice. And a lot of innovation happens in that spot. Like where you're pushing us, but also listening at the same time.

So pavilion go live. Is that how many cups of coffee have you had so far? Cause I see you keep the coffee right out of

number two.

So,

yeah, I love those go lives and we have very, we have the H. R. We had a different go lives, but the camaraderie that's built up in addressing the challenge and being there and getting there at five o'clock or even before five o'clock just to be ready for all that stuff. Is it's the kind of stuff we talk about later as we're, hanging out, having drinks and that kind of stuff of how fun that was.

Yeah, no it definitely builds culture. Definitely builds relationships. They're fantastic. So actually brings me back to like my, kind of web development and like web deployment days back in the nineties and early two thousands when you be on there overnight. So it's been great.

Luke, I want to thank you for your time. Thanks for stopping in and sharing your experience. Awesome.

Thanks Bill.

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