Atul Gawande a Disruptive Insider Takes the Reigns at JPM/Amazon/Berkshire Health

Ken Lawonn This Week in Health IT
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Ken Lawonn CIO of Sharp Healthcare joins us to discuss the selection of Atul Gawande as the new leader of the JP Morgan, Amazon, Berkshire Healthcare venture. Also, we look at the eight most disruptive forces in healthcare.

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Bill Russell:                   00:10                Welcome to this week in health it where we discussed the news information and emerging thought leaders from across the healthcare industry. This is episode number 24 its Friday, June 22nd today. The much anticipated jpm Amazon Berkshire announcement is Atul Gawande the right man for the job and what can he do to ensure success? Plus a discussion on eight sources of disruption in healthcare. This podcast is brought to you by health lyrics. Are your strategies constrained by infrastructure or are you tied into knot of applications? We’ve been in your shoes. We’ve been moving healthcare to the cloud since 2010. Find out how to leverage the cloud to new levels of efficiency and productivity. Visit health to schedule your free consult. My name is Bill Russell. Recovering healthcare cio, writer, and consultant with the previously mentioned health lyrics. Before I get to our guest and update on our listener drive, we’ve reached 180 of new of combined new subscribers to our youtube channel or podcast outlast either through, uh, through itunes or Google play, which means we’ve raised a thousand dollars for hope builders, which provides disadvantaged youth life skills and job training needed to achieve enduring personal professional success.

Bill Russell:                   01:17                I’ve hired the graduates and their stories are inspiring stories. Really of second chances. We have eight more weeks where our sponsor, we’ll give a thousand dollars for every additional hundred subscribers. And we are just 20 subscribers away from $2,000 to really two wins for the price of one. You get to listen to this great content from industry insiders and leaders and give back to the community while we do it. So join us today by subscribing. Tell your friends and don’t forget, we post a new video to our youtube channel every single day. So, um, so today’s guest, today’s guest is one of the elder statesman. I hope he’s not offended by me saying that for healthcare. Cio is a good friend, Ken Lawonn CIO sharp healthcare out of San Diego, California. Ken, welcome to the show. Thanks. Great to be here. You’re not offended by elder statesmen are, you know, I, I definitely relate to that. You’re not too far from retirement. We’re not closing the book on your tenure yet, but, but you’ve been at this for a long time.

Bill Russell:                   02:20                So when did, when did you start in healthcare?

Ken Lawonn:                 02:23                Nineteen 76.

Bill Russell:                   02:25                Wow. Bicentennial. That’s a, that’s a long time. Have you seen any changes since then? Just a couple. Yeah, there’s a couple. What were you doing in 1976? What were you doing? Mainframe or what?

Ken Lawonn:                 02:41                I was a programmer. They call me the junior programmer trainee because I was the new kid on the block and we were using punch cards and running actually at that time of burrows, like 1800 system or something a couple of years later. Went to an IBM mainframe. But yeah, I do a lot of developing some applications that are actually still running in some poor healthcare systems.

Bill Russell:                   03:03                That would not surprise me to see some kid walking through going, these are the punch cards that Ken Lawonn built in 76 still using. I think that would be a good. I would find it interesting to find some of the elder statesman to put on a panel and just talk about a healthcare from 1970 to 2017 and just march through the decades and talk about the different changes. Um, but that’s not, that’s not today’s show. So tell us a little bit about a sharp healthcare for those people who aren’t familiar with you guys.

Ken Lawonn:                 03:35                Yeah. Sharp healthcare based here in Sunny San Diego, California. We’re a integrated delivery system that’s based in San Diego County. We serve about, um, you know, the population of San Diego’s about three and a half million. We’re about 30 percent of the market. We’re kind of a, a little different than, you know, for those folks that come from other parts of the country. We’ve been in this managed care business, you know, competing with Kaiser for 25 plus years. So we have a lot of capitated lives. We have our own health plan provider sponsored health plan and then two medical groups, we work with a, one is a foundation medical group, which is California’s kind of approach to employment and then another is as a, a thriving IPA which there’s not a lot of ips that survive, but they, they do it for contracting basis and uh, you know, we are about three and a half billion dollars and a seven hospitals. So, you know, it’s, it’s an organization that’s been around a while. Not like some of them, you know, we started in the fifties and a really strong reputation for what we call the sharp experience. So we really built our last 19 years of growth around just, you know, how do you treat people every time you see them every day. And uh, I think, uh, pretty, pretty reputable organizations doing a lot of cool things.

Bill Russell:                   04:56                Yep. I do want to get too in the a soundbite section. We’re gonna talk a little bit about your manage care platform. I think it’s one of the areas that sharp really has excelled in the industry. Um, and actually it’s interesting. Your market is probably pretty similar to most markets, but almost identical to the orange county market. It’s a third, third, third, right. So, um, and I’m not going to give your competitors any airtime. So, um, until they choose to come on the market are come on, come on the show. So, uh, so one of the things we’d like to do is to ask our guests, you know, what they’re working on today, what they’re excited about. You could really talk about anything you can talk about. You talked about your kids, your philanthropy, your or things you’re doing at work and that kind of stuff that the floor is yours.

Ken Lawonn:                 05:40                Yeah. Well a couple things. One is that not too sexy, but something that I’m pretty excited about is we’re working on a set of tools that help us manage the day to day operations of it. Um, we started looking at how are we managing all the contracts we deal with. And when I got here, sharp had this cool little. A application is really old database that really managed and rated our vendors. And when we started looking at what are we doing around contracts and vendors, we decided to build an integrated solution that really looks at everything from the start of a contract, you know, when we’re going through a relationship to how we manage our vendors our applications our services and, and uh, it just finally getting, getting in there. And it’s a great way to really look at, you know, the people, the organizations we deal with, how we, how much business we’re doing with them, how well are they performing, you know, we see it as a big tool for helping us through Aftra, apple application rationalization as we go into that.

Ken Lawonn:                 06:41                But, you know, it’s not sexy, but it’s just kind of cool because I don’t know, it’s Kinda like the, uh, you know, the, the shoemaker’s kids, they don’t always have the greatest tools. And it is, you know, it doesn’t always have great tools to manage it. So it’s pretty exciting. The other thing I’d say is I had an opportunity last night with a couple of friends to go see Andrea Bocelli. And, uh, it was a fantastic concert and what I was really impressed by and I think we could learn from it as individuals and as an industry, as he surrounded himself with some fantastic performers, but yet, you know, he wasn’t afraid to be onstage with people that really were fantastic performance as well and let them and his performance kind of shined through and I think sometimes we’re afraid to be overshadowed by, by others and we don’t often take, you know, take an opportunity to learn from others. And I think it’s a, and, you know, share, share the stage, so to speak.

Bill Russell:                   07:39                Absolutely. That’s one of the things we, um, one of the things we’re both both came here from the Midwest and one of the things I love about southern California is just the access to a just great entertainment. And I, uh, um, I remember the one night at the Hollywood bowl, Christian chenowith brought a, a person up to saying one of her songs from wicked. And she shared the stage with this a music teacher she just pulled out of the audience and it’s on Youtube. It’s one of the most amazing things I’ve ever seen and they sang together and whatnot. There’s just so many talented people in this, in this area, and we get to see such great performances. Well, uh, I will stop rubbing it in a because we have the palm trees in the back. I don’t, although it’s raining here today, which is like an unusual, crazy, unusual.

Bill Russell:                   08:30                But, um, so, uh, let’s go to show format is in the news sound bites and then social media close. And uh, if you’re like me, I forgot to get a social media close. Hope you may not have one either, so we’ll just spend more. I didn’t do it either. I’m sorry. I know I do have a business to run. I got a little busy yesterday, so I apologize. So, uh, so let’s get started. So first story of healthcare it news, actually, any outlet that you can find today is talking about Atul Gawande to lead Amazon, Berkshire Hathaway, uh, and jp Morgan Chase venture. I wish they’d give it a name. We just keep having to say Amazon, Berkshire hathaway, JP Morgan Chase venture. Um, you know, I, it’s a, we know a lot about Atul Gawande He’s known in healthcare, he’s written some great books.

Bill Russell:                   09:20                He really exposed a no fee for service and the challenges of fee for service way back in, uh, in the early, early two thousands are actually 2009, I think is around the timeframe he really exposed to during that debate. He, uh, he did some really good research and wrote some good articles. Uh, he’s also talked about end of life, that topic that people just tend to shy away from and really addressed it in his most latest book. So he is really a maverick sort of, you know, he likes to push the boundaries. He likes to really address things with a data driven approach. Should be interesting. But I’ll give you the first pass on this one and you know, any first of all, any thoughts on the selection of Atul Gawande to lead it in? Uh, any thoughts on the promise of the venture itself?

Ken Lawonn:                 10:09                A couple of things. Obviously he’s a, he’s a, an outstanding individual who really understand some of the issues and the challenges in healthcare, as you said, He’s written some great articles, great books, um, I think he’s going to be a very good selection. There is a good selection. I think he’ll do a really good job of helping those organizations understand where the opportunities are with their, especially with their populations and, and how they can better manage the health of their employees and work with the payers and the providers to really kind of drive out some of the unnecessary cost. And I think, you know, as you said, he’s always been kind of a guy who’s out there and not afraid to challenge the status quo. So I think, you know, I think he’ll be good because he’ll be, he’ll be a person who’s thinking about things that are maybe a little outside the box, um, and uh, you know, it’s gonna be interesting to see what that venture really does beyond what they’re going to do with their own employees.

Ken Lawonn:                 11:10                You know, what can they do to really help transform healthcare. I think that’s the big challenge and, and even for him, you know, it’s easy for people to, to identify what the issues are, the challenges, what do you do about it, and this is not an easy industry to really make significant changes in. So I think the real key will be to see what do they do beyond just their own organizations to really try to influence healthcare and this can he actually, uh, helped, uh, implement some things that could, could help others transform the industry. That’s really the challenge. I mean, we, we have a lot of people out there that really can talk about what the issues are. It’s, um, what do you do about them that really, you know, I think the challenge.

Bill Russell:                   11:52                Yeah, I, you know, I, again, I, I agree with you, I love this. I love this selection. Um, and I, I’ve been talking to some people about it earlier this week and the, um, so here’s the things I love about it. One is he’s an insider, right? He’s a physician. He’s, he’s been in the, in the or he, uh, he knows just about everybody in the industry. Uh, you know, he can call up a leaders of Mayo and go visit there. Stanford could call either of us up tomorrow and obviously we’d meet with he is an insider. We all appreciate his, uh, uh, his, his skills, his background, his, uh, his insights. Um, the, uh, the other thing is he does rock the boat. So one of the, when I came into healthcare, one of the articles I was told I had to read was the cost conundrum.

Bill Russell:                   12:40                What a Texas town can teach us about healthcare. It was in the New Yorker on June first 2009. So this is right when the ACA was being waged. And you know, here’s just a couple of things that he said. So here along the banks of the Rio Grande, the square dance capital of the world, talking about Mcallen, Texas medical community came to treat patients the way subprime mortgage lenders treated home buyers as profit centers. So he really attacked this whole fee for service model. And at the time, what he had done is he’d done it and done all this research on the, on the data, and what the data said was that a Macallan Texas was a, was charging way more. It costs way more to care for the Medicare population than say El Paso, Texas. And uh, you know, he had that quote and he went on and says, you know, when you look across the spectrum of Grand Junction, uh, to Macallan grand junction being a great example of mccowen being the forest at that time and almost in the almost three fold difference in the cost of care, you came to realize that we were witnessing a battle for the soul of American medicine somewhere in the United States at this moment, a patient with chest pain or a tumor or a cough is seeing a doctor.

Bill Russell:                   13:50                And the Damning question we have to ask is whether the doctor is set up to meet the needs of the patient first and foremost, or to maximize revenue. So he really, I mean, this is somebody who’s going to rock the boat, which, yeah, which is good, but you know, he’s also not going to alienate people. He’s going to say, you know, we have, he appreciates the, uh, the history of medicine, the innovation of medicine, uh, and the players within medicine. So, so let’s, let’s take a couple seconds and just, you know, um, ms dot bounce back and forth. So what, what do you think he needs to do to be, uh, to be successful? Um, you know, his approach, I’ll start us off. So his approach has been really data driven. I think it’s one of the things we appreciate. He’ll help us to create a narrative, but it will be based on the number.

Bill Russell:                   14:34                So I think one of the first things he needs to do is probably two things is one, analyze his population. So He’s now got this pretty significant population of these that these employers entail. Second thing is analyze the cost. Drivers really crunched the numbers, like an economist can come back us and say, you know what? I know what drives the, uh, the cost of this population. I know what drives the health of this population. So these are maybe to the places to start. What are, what are some things that you would offer as a suggestion to him where he, where he could get started?

Ken Lawonn:                 15:07                Yeah, I think you’re right. I think he’s always been very data driven and I think that’s a key to what he’s going to work with this organization. I think, you know, the other thing is because as you said, he’s an insider. He really understands healthcare from the very basis of delivery is um, I think he can help look at the resources and the, and the, what those companies have to bring to the table and say where would there be something that I think could really make a difference, you know, so not only looking at their population, using data and understand how to, how can they manage their healthcare spend better, but then you know, where, where could they focus some of the capabilities that they have, whether that’s capital or the technology or innovation like Amazon and say, you know, what could we really do to help make a difference. I think that’s, that’s where for the broader scale, that’s where the opportunity is. I have no question he’s going to help those organizations really manage their costs and their spending, you know, I think that’ll be great. And then others can learn from that. Obviously other large employer, but it’s really about how can this collective, you know, a organization or venture, how can they really bring something to the, to the table that can help change fundamentally changed what’s going on in healthcare.

Bill Russell:                   16:25                Yeah, and I’ll close this out and then we’ll get to your, your, uh, story here. So, um, I, I liked the, I liked the choice of a doctor because I think he can reframe the conversation around health and not healthcare. Um, and so when he’s out doing town halls or whatever he’s going to be doing, uh, to address his, uh, the mission and the people he can really reframe it around. This is about keeping people healthy. It’s about keeping them out of the hospitals, which is, which is really, I think a physician is better suited to do the last few things I would say to him is, you know, find partners who believe in your mission, which I think is along the lines of what you’re saying is there’s a lot of great partners out there. Um, but the last one is just, it’s more of me pleading with him and that is open source your findings and your model.

Bill Russell:                   17:14                Do it for, you know, innovate around this, this group. And then, you know, let’s, let’s take it to every market. Let’s take it. Well Heck, let’s just take it around the world. If we’re able to really bend the curve, the cost curve, the health curve with this population, it really becomes A. I know they don’t want to be referred to it as such, but it’s really a great sandbox, great resources, great technology, great leadership. Uh, I liked the promise of it and I, and I think that’s, that’s what we’re hearing in the news stories this week is people like the selection. Let’s, let’s see where it goes. So, um, all right, so to your story, go ahead and kick it off and give us a little background.

Ken Lawonn:                 17:56                You know, is everybody gets the news articles that come across the come across your desk, uh, through the Internet. And uh, I saw the one in the health it news about a eight most disruptive issues in healthcare and it really struck a, struck a chord with me because it really related to some things that we’re really trying to deal with that sharp, at least some of those, some of those key issues. And I thought it was a pretty insightful about the things that are really key as you look at healthcare and what are really driving a change. And uh, you know, uh, it came from a Holly Buckley, she’s a partner in a law firm and, which was also interesting, but it was at Becker’s, a future of, of spine in the spine, orthopedic and pain management. So I thought, I thought it was, it was really spot on, um, you know, went through eight pretty significant areas, some of which are very related obviously.

Ken Lawonn:                 18:53                But, um, I think that the things that are really driving, you know, we all kind of are of the realization that things have to change. I mean, we’ve got an unsustainable system, uh, you know, we’ve got to do something to not only bend the cost curve, but you know, do a better job of keeping people healthy and well. And um, you know, I think for what it pointed out to me and as the people I shared with it is that, you know, there’s, there’s a change in pressures coming from all different directions. You know, it’s not only from the, from our largest payers, like the government, but it’s, it’s from our consumers from um, and then it’s from these industry giants and these people that are trying to, trying to find a way to help shape and transform healthcare. And I think when you start looking at the collective pressures when we will, you know, when we as a country really put our minds to something, we can really make some change.

Ken Lawonn:                 19:50                And I think for a long time there’s been a lot of things talk about what we need to transform healthcare. We need to do this, we need to do that. But it really hasn’t had the attention of the entire country and the entire set of industries. But if you look at it today and I think as we walked through it, you’ll see how many different forces are coming at healthcare. And it’s really putting the pressure as I look at it as how do we as providers become a part of this change, you know, to continue to be relevant or you know, or elsewhere. You know, we’re gonna find ourselves just providing some basic services. And everybody else is going to control what’s going on.

Bill Russell:                   20:25                So, so let’s do this. So there’s, there’s eight disruptive changes and um, I’ll go through all eight. And um, what would you tell a cio? What would you tell your peers and you give one, one thing you would tell your peers. I’ll give one thing on each one of these. So the first one, eight most disruptive issues in healthcare number, presidential healthcare policy. So what would you tell your peers about that?

Ken Lawonn:                 20:52                Well, I’d say that’s probably my least favorite of the, of the group, but you know, I’d say that this is an area where I often say, you know, we just, we just don’t want to get too hung up in what’s going on and in Washington or with going on with the administration, we have to pay attention to it. And I think the one message I’d say is that we’re always going to be under this some kind of influence from the, from the government. And the more you can make your organizations a more data driven, more nimble, the better you’re going to be to be able to adapt to whatever goes on in DC or at the state legislature and don’t get too hung up on the details or the specifics of it because that changes constantly. Um, you know, you got to just be prepared to, to have information to be able to make some decisions and change. And I think it really speaks to just let’s become more data intensive and data driven.

Bill Russell:                   21:46                I agree. It’s the one I liked the least and it’s the one that I think has the least impact. The one thing I will say about this is I think with this administration, um, you know, they are, they’re rolling back regulations. So we actually have a breather. And if I’m talking to my, my cio peers, I know the, uh, the eight years or so that I was sitting in the cio’s chair, I mean every year there was millions of dollars going towards regulatory compliance. Uh, and I think we have a reprieve, which we were asking for for every year. I was there to say, you know, can we, can we spend some money over here on innovation instead of, uh, instead of compliance. So

Ken Lawonn:                 22:28                I agree, we, it has been a bit of a reprieve and actually seeing some stuff being rolled back instead of continuing to add on.

Bill Russell:                   22:34                Yeah. So, and, and you know, that ebs and flows. Well, it’ll, it’ll come back eventually. So we’ll just have to take that as go. So eight most disruptive issues in health care. Number two, private equity investment in healthcare. So what do you tell your peers about a trillion dollars that’s being pumped into, uh, the investment in healthcare?

Ken Lawonn:                 22:55                Yeah, I guess the thing I’d focus on is that, uh, you know, we’re out here in California and other lots of other parts of the countries that are really have some really innovative and an incubator kind of startup ventures that go on is that, you know, this continued investment in healthcare and you have all these smart people trying to see how they can, how they can make a difference, you know, uh, whether it’s through some kind of technology, through some kind of analytics. And, you know, I think what, what I’ve seen over the last couple of years is that it’s, it’s really started to drive me as a, as a cio, and even my vendor partners to say, how can we work with these people better? You know, they’ve got a lot of ideas. We can’t solve all the problems, you know, the epics, the cerners of the world.

Ken Lawonn:                 23:41                They can’t do everything. So, you know, I think it finally driving us to say, let’s open up our, you know, kind of our platforms and let’s, let’s look at how we can innovate on the edges. And uh, so, you know, I think that’s my advice to cios is, you know, we’ve got to figure a way to really help these folks help us. And uh, you know, we all get inundated every day with phone calls and people that, you know, come want to do some things. And I think if we can find a way to more effectively embrace what’s going on and say, you know, a lot of this stuff is not gonna. Not gonna make it. But if it, if we can help figure out how to get the data available, how to let them try to drive some innovation and uh, and, you know, work with our partners to say, let’s, you know, let’s open up the data because the biggest challenge is always how do I get them the data and then how do I build this back into the workflow. And I think it’s really forcing the industry to kind of respond.

Bill Russell:                   24:34                Yeah, and Ken, I’m not sure I can say it any better. I would just close, you know, private equity, trillion dollars coming into the healthcare, a healthcare market. If I were your ceo talking to the Cio, I would say, what is our plan to have some of that money work for us as a system? That’s, I think that’s. You really nailed that one. So, uh, number three most disruptive issues facing healthcare, artificial intelligence. So what are you telling your peers about artificial intelligence today?

Ken Lawonn:                 25:02                Well, I think this is the promise. I mean, you know, it’s disruptive, but it’s also a tremendous, uh, opportunity and promise for healthcare. I was, I came away from the annual himss show this year for the first time in several years being kind of hopeful because I saw a lot of things that maybe they weren’t real today, but you know, how do you leverage artificial intelligence to really drive some, some changes in the way in which we do our business from, you know, how do you take steps out of what a physician is doing every everyday, you know, and you thought about it and I started to think about it and put it in the context of look at what we’re doing with, you know, with Siri or with Alexa and in our personal lives. And when did people think about the combination of voice recognition and artificial intelligence and machine learning on the back end.

Ken Lawonn:                 25:52                You know, there’s so much data and so much of what we do and providers do is, is driven around, you know, understanding conditions, understanding what’s been done for understanding, you know, what’s going to be effective. And I think if we can leverage computers to help us, you know, mine and process the data versus just continually throwing human humans at it. Um, I just think this is a, this is one of the biggest opportunities in the biggest promises out there is how can we leverage data and computers the way in which every other industry, every other part of our personal life is a in this, you know, probably the most data intensive industry in the world. And you know, whether it’s, you know, I, I kind of combined voice recognition with Ai. It’s really about if I think about a physician not having to use the computer or charting or whatever it is, but um, you know, just speaking to the machine and having it help them find the information they need.

Bill Russell:                   26:56                So you’re cheating now though, because we’re not talking about voice. We’re talking about artificial intelligence. So

Ken Lawonn:                 27:03                I know, but I, I just seen them together. I mean, I think it just, you know, like I tell my folks we did when we’re thinking about anything we’re doing today, it’s, it’s got to be consumer or patient centric, whatever you want to say. It’s got to be in gotta think mobile and you’ve got to think how can it be powered by ai? How can we leverage, you know, understanding the data using the computer to help us make decisions and help us drive things. I think it’s a big promise.

Bill Russell:                   27:33                Yeah. And, uh, so we’re in violent agreement, so I won’t repeat any of that. I’ll just get a little pragmatic and say, uh, I would say start today with your financial data and your bedside monitors. The data is clean and the technology is more mature than what people are letting, uh, letting leading us on to believe it is the technology is there to really start doing some interesting things. Number four, most disruptive thing coming at healthcare precision medicine. Um, you know, the thing I would say about precision medicine will try to pick this up a little bit. I could get in trouble for going too long. So precision medicine, we can’t do precision medicine without data. I would say we have to start collecting data, Geisinger is leading the way there. They are starting to collect a genomic data, uh, in their primary care visits, which I think is an interesting model. I have a plan for what you’re going to do to implement precision medicine. It is the future, I would say get in front of it. What would you tell your peers about a, uh, precision medicine?

Ken Lawonn:                 28:32                I think you hit it right on it. It’s about getting, collecting that data and being able to incorporate it in. It’s the key to, you know, get in around personalized medicine. Most effective treatments is to understand the genome and, and how it relates to treatments. And so I think you’ve got to start thinking about how are you going to collect and use that data. You’re going to do it internally, you’re going to partner with somebody, but you need to start thinking, having conversations about how do I get this and where do I start?

Bill Russell:                   29:02                And you have some great partners down there in San Diego. So, uh, next disrupted number five, a disruption in healthcare retailers as primary care physicians. Uh, what would you tell your peers about this one?

Ken Lawonn:                 29:14                Well, my biggest challenge here is be talking to your, to your primary care partners, your physicians about how do we continue to be relevant. You think about a pharmacy and if you know, many of us travel over in Europe and think about what you can do at a pharmacy without a doctor’s orders. Uh, I think this is a huge potential disruptor to the traditional primary care model that we’ve grown up with. Wherever everything kind of runs through your primary care physician. You, you know, you go there for any kind of diagnosis, referrals, treatment, and uh, you know, people are. People are disrupting that and saying not only do, do a lot of individuals not want to go through that model, but there’s a, there’s a lot of other people who could take up that space on the kind of, the, you know, the self treatment, the wellness, the kind of, the, you know, what do I need to do? And and where, where do I go to, to get information to try to keep myself healthy? I just, I’d say you need to be looking at how do you compete or partner because you don’t always have to do it yourself, but how do you compete or partner in this space because, um, if you don’t, you’re going to become irrelevant as primary care provider.

Bill Russell:                   30:26                Right? And, and uh, the term in other industries is called disintermediation. And if you allow someone to come between you and your consumer, you are just asking for a world of hurt. And that’s, uh, that’s what, uh, some of these

Ken Lawonn:                 30:40                players are partnering with the payers, you know, getting into this business that’s all about where they’re going to direct the care.

Bill Russell:                   30:47                Yep. Um, all right, so the three more are millennials as consumers, internet of things and not traditional entrance into the market, such as Amazon, Berkshire Jpm talked about that last one a bit, but yeah. So, uh, what would you tell your peers about those last three things? You know, consumers, Iot and nontraditional entrance.

Ken Lawonn:                 31:07                Well, I’d say, you know, consumers kind of goes along with what we talked about on the retail side. They talked really about the millennials and, and you know, they don’t want to go through the traditional process. So I think you have to start thinking about, you know, how do I serve a different kind of population that’s really about transforming what we’ve grown up as kind of a, an operational automation of points of care and in and removing the complexity internally and we’ve shifted the complexity to our customers and we really have to switch that model around and think about how do we take the complexity out of the interactions that we have with patients and consumers. And if we have to move a little complexity back inside, then how do we work on, you know, on automating and streamlining that. But you really have to shift your thinking as an organization from a, what I’d call a process and operational driven company to a consumer or retail type company.

Ken Lawonn:                 32:01                And, uh, and as part of that, you know, the Internet of things is all this information that can be collected in the patients are looking at on that, on their own. This is what’s the plan for incorporating that, you know, how are you working with apple or whoever to bring that data in and make it relevant to providers. So I think it just, it causes us as, for me, it’s really shifting and everything has to be thought of as more of a patient, consumer focused thinking not about how can I make this part of my operation more efficient and how can I make that interaction? Because as you said, you know, you don’t want to lose the, you don’t want to lose the relationship. Yep. And

Bill Russell:                   32:40                uh, you know, I’ve just close out this section with my story around our portal. So when I became the cio, we have a portal project under way at, first of all, the fact that we call it a portal said we didn’t really understand the consumer, but the next thing is that I, we had a list of eight things that we said, these are the priorities and it, and I sort of looked at the list and I said, you know, where this list came from, come from and it came internally and when you’re becoming a consumer company you have to develop a new set of muscles and those muscles are, how do you listen to the consumer. And so we decided to actually do focus groups. We just, we did a couple of things to get the voice of the consumer and it turns out that our list of one through eight was backwards.

Bill Russell:                   33:20                They took number eight and they thought it was the most important and our number one was there, number eight. And so, you know, number one was, you know, get that medical record right. And we were spending tons of time arguing, you know, getting the data of just right within that medical record. And what, what the consumers told us is if you could do patient scheduling and you can do a, uh, uh, to essentially text a secure texting with their provider, those would be the two most important things they wanted. And I was like, what 90 percent of our effort is around this, what is number eight in priority? So it’s just, it’s just a different set of muscles.

Ken Lawonn:                 33:59                Yeah. Just, it’s just a different view. Different Lens.

Bill Russell:                   34:02                Yep. So a sound bites. So I have five questions for you and you know, you know, one to one to three minute answers closer to one minute would be great because we’re already a. let’s start with the easiest one. So what makes a great vendor partner, uh, to a healthcare cio?

Ken Lawonn:                 34:21                Uh, yeah, that’s, uh, that’s the easy one, right? You know, I think it’s just, it’s about two things. It’s about relationship and it’s about an interest in helping the organization be successful. Um, you know, you talk about a lot, but it’s really getting to understand the organization that I’m, I’m working for and you know, what are their drivers and what do they need to do? And what can that vendor do to help help drive success and then trying to get aligned around that, um, you know, the more and more that people are, are driven in and then centered around what they sell and what the transactions are, I think the less the partnership can be, but how do you align yourselves around success and if we’re successful then you know, I think they’re naturally going to be successful.

Bill Russell:                   35:06                Yeah. And I would say the same thing as, uh, along those lines of, you know, stop talking about, you start talking about me. There’s enough stuff written about sharp health care that they can go out and read it before they come into my office and start pitching their stuff and realize, hey, what I’m pitching may not be relevant here. So in your, uh, so, uh, next question, how do you prioritize it initiatives within your health system? How do you determine which ones get the resources, the funding? Um, the priority?

Ken Lawonn:                 35:36                Yeah, it’s a sharp got out for a long time, has had a great, what I call governance process for it, it, it’s just a, you know, we’re just kind of embedded at the hip with the organization’s strategic planning. So first of all it starts with what are the overall strategy organization, how is it enabling or driving and helping drive that. So you set some big rocks, you know, some of the big things that have to be accomplished to help the organization be successful in this part of our five year planning process. We, we look at capital allocations, resource allocations around those things and then we have kind of brought them up a governance where we have our ias steering committees that really help us manage and prioritize on a day to day basis around those changes in those, in those small things. So it’s really being connected with the business and uh, you know, and then you know, being there helping drive overall organizational strategy and it just, you know, today there’s really not a separation of it in the business. I mean, it’s, everything in the business really has an it component to it, so I think it’s in our mind, in our process is pretty easy because it’s just a natural part of organizational prioritization and in capital allocation.

Bill Russell:                   36:45                Yeah. And I think part of that is you guys have such a great culture which leads to the next question, which is, you know, sharp has had two cios in the last 30 years ish. Um, you know, what aspects of your culture do you think allow for such longevity in the role of the cio?

Ken Lawonn:                 37:01                Uh, you know, I think it’s a, this journey called the sharp experience that we’ve been on for over 19 years now. I think, you know, if you go back 20, 25 years where sharp, went through some really difficult times and looked at actually doing a lot of outsourcing, maybe even selling to a for profit organization. And they came out of that. That didn’t happen. But they came out of that thinking we’ve got to change. We’ve gotta do something different. So they know, they did this whole study about, you know, they will look at the book from good to great and what happened as a part of that is the leadership of the organization not only bought into it but it really became embodied it. And so, you know, there has been tremendous longevity across. The leadership of sharp CEO has been here for over 20 years in the CEO role.

Ken Lawonn:                 37:51                We just had a new cfo that came from internally but the previous one been 25 years. So they just, you know, they got into this journey, they embodied it, it became really, part of who is sharp is the culture and people just, I think just kind of committed to, you know, this is who we are, this is the journey we’re on together. And, and you know, when you have, when you have stability in senior leadership, I think it helps drive stability across the organization. Many healthcare organizations have people stick around for 20, 30 years because they see it as a mission and something that they buy into. But you know, Sharp, just a embodied this sharp experience. Uh, they didn’t have the fat of the, you know, of every three years it was a, it was all about that and everything kind of evolved around that. So it’s Kinda, you know, you kind of became part of that journey realizing it was a multi decade journey and people just stuck around and, and, and it, it’s a great thing, you know, I’ve never seen an organization with such tenure in their senior leadership.

Bill Russell:                   38:51                Yes, I’ll change one of the questions on you. Was it, was it hard to follow somebody like bill spooner who had been there for decades? Um, and what’s it like following somebody who’s been there for that long and you know, and how do you, how do you make that transition?

Ken Lawonn:                 39:07                Yeah, I mean, I think it’s, it is hard obviously, uh, it’s hard to step in and follow someone who’s been such a success at such a large part of not only the organization but the industry. Um, but I think it’s really about, you know, for me it wasn’t about what’s, Ken Lawonn you know, going to be compared to what was bill spooner. It’s what, how can I help sharp continue on its journey and, and I think if you get, you know, in, in many ways it was great because we had a very successful organization, very stable, a organization that had, had valued it and made a lot of investments. I didn’t feel like I had to come in and make my own mark, right? I just had to come in and try to say, how can we make this even better? How can we look at it slightly differently? Take it to another level.

Bill Russell:                   39:53                Just don’t screw it up. Just keep on this trajectory.

Ken Lawonn:                 39:56                Hi, keep telling bill. I, you know, I’ve been here a little over four years and I almost got all his messes straightened out, but, but yeah, it’s, I mean I think you can’t get hung up on who you are versus who bill spooner was. You’ve got to think about it. How do I step in now? And I’m not going to be bill spooner. I’m not going to replace Bill Spooner. I’ve got to come in and just help move this. Continue to move this along.

Bill Russell:                   40:17                Great perspective. A last question. So I’m sharp as a lot of patients that are managed care contracts. We talked about that earlier. Give us an idea, right? Let’s focus it on this. So give us an idea of how the health system gets data and information into the hands of those that can utilize it the most. If they’re managed care contracts, the data becomes a critical. So how do you get it to the point, the point of care and the places that it needs to get to in order to be effective?

Ken Lawonn:                 40:43                Well Sharp recognizes they got into managed care, recognize how critical data was. So, you know, we started the, a data warehouse 25, 20, 25 years ago and started bringing that data together. Um, you know, whether it was clinical data, claims, data, whatever, excuse me, to really be able to understand how we’re performing. And as we evolved in that, we started identifying, you know, what does it, what do you need to really effectively manage and we’re, where are you going to get the most bang for your buck? So we started identifying those high risk patients and we’d, you know, we’d understand the population in and we take, okay, here’s our diabetics or heres our heart failure patients and we’d get that out of the data warehouse and we, we transferred, you know, we didn’t have the, all the greatest sexist tools, but we just say here’s the list and, and then we give it to the care managers and then they start looking at how can we develop some criteria about stratification.

Ken Lawonn:                 41:40                So they actually built their own risk stratification profiles in excel and uh, and then they said that we can understand where we want to focus. Um, so it was really about knowing you needed the data and taking the investments in the steps to collect that data and then start figuring out how to, how to get it there. Now I would say we probably are much better at understanding how we manage retrospectively then we are day to day. And that’s where we’re really trying to drive to now is how do you really get more predictive and more realtime in what you’re doing with the data and that that can really help us, I think, um, you know, scale the efforts we’ve had because we were throwing a lot of human efforts at it and if we can really automate some of those steps and say, and then even automate some of the interactions, we can really scale this managed care, this care management population, health management, whatever you say. So, but it’s really, it’s really the data you got to really grasp the fact that data is the key.

Bill Russell:                   42:37                Yeah, that’s a, that’s just a fantastic answer to, to close on. So, um, you know, thanks for coming on the show. I really appreciate it. So, Ken, is there, is there a way for people to follow you? Where do you normally, I know you’re a full time cio so you probably not posting all the time on social media, but when you do, where can people follow you?

Ken Lawonn:                 42:56                Yeah, you know, I, I out there once in a while, but uh, you know, just Ken Lawonn handle and out on twitter once in a while you’ll see some posts from me, but you’re right, I’m not one of those people that’s out there a lot, so you probably won’t see a lot of, a lot of, a lot of stuff for me, but

Bill Russell:                   43:16                well, you, you will see a lot of Ken LAwonn this week on social media, so it’ll be out on twitter. It’ll be on LinkedIn. And um, you’ll be out on our youtube channel with seven or eight videos, so it’ll be awesome. Um, so, uh, you can follow, you can follow me @thepatientsCio, uh, my writing at health lyrics, a website. Don’t forget to follow show on @thisweekinhit on twitter and check out the website And I’m obviously the video videos as well. And don’t forget our drive right now, share it with your colleagues, share it with your peers. If you’re a cio like Ken, you could share with your staff and say, Hey, here’s some, uh, interesting tidbits around this. We now have 168 videos I believe in. After this week we’ll be up close to 180, so I’m so you could catch those videos on the youtube channel. Um, and again, thanks Ken listeners, please come back every Friday for more news, information and commentary from industry influencers. That’s all for this week. Thank you very much.


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