Building Health Communities with Reid Stephen CIO of St Luke’s
April 30, 2021

 – Episode #

397

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April 30, 2021: The CIO role is getting bigger and more encompassing. What are the loudest drivers that set your agenda as a leader today? How do you prioritise what you’re going to do each week? Reid Stephen, VP, CIO for St. Luke’s discusses the difference between urban and rural digital strategies and what it takes to have a high functioning team. What are the key learnings as we move through the pandemic? What interesting partnerships has St. Luke’s embarked on? Is the Microsoft and Nuance partnership on the exam room of the future good for healthcare? What sign posts show that you have the right culture? And for people early on in their career, what prepares them to be a good CIO?

Key Points:

  • Technical skills are much easier to grow and develop in people than the soft skills [00:12:35]
  • The three Cs of design disease [00:23:55] 
  • I think any CIO should be actively curating and cultivating a rolodex of peers that they can bounce ideas off of and share best practices [00:37:25] 
  • How do you ensure you’re addressing business priorities, IT priorities and experience priorities all at once? [00:27:50] 
  • Microsoft and Nuance partner on the exam room of the future [00:37:55] 
  • St. Luke’s

Building Health Communities with Reid Stephen CIO of St Luke’s

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Building Health Communities with Reid Stephen CIO of St Luke’s

Episode 397: Transcript – April 30, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] 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. 

[00:00:17]Today we’re joined by Reid Stephan. Reid is the CIO for St. Luke’s out of Boise, Idaho. And he is a thoughtful leader, someone who I really appreciate and I learned a ton from, and I think you’re going to really enjoy this conversation. [00:00:30] 

[00:00:30] Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health IT leaders. If you want to be a part of our mission, you can become a show sponsor as well. The first step is to send an email to [email protected]

[00:00:45] I ran into someone and they were asking me about my show. They are a new masters in health administration student and we started having a conversation and I said you know we’ve recorded about 350 of these shows and he was [00:01:00] shocked.  He asked me who I’d spoken with. And I said Oh you know just CEOs of Providence and of Jefferson health. And CIO’s from Cedars Sinai, Mayo Clinic, Cleveland Clinic and  just all these phenomenal organizations, all this phenomenal content. And he was just dumbfounded. He’s like I don’t know how I’m going to find time to listen to all these episodes. I have so much to learn. And that was such an exciting moment for me to have that conversation with somebody to realize we have built up such a great amount of content that you can learn from and your [00:01:30] team can learn from.  And we did the COVID series. We did so many great things. Talked to so many brilliant people who are actively working in healthcare and in health IT addressing the biggest challenges that we have to face. We have all of those out on our website, obviously, and we’ve we put a search in there and makes it very easy to find things. All the stuff is curated really well. You can go out on a YouTube as well. You can actually pick out some episodes, share it with your team, have a conversation around those things.  So we hope you’ll take advantage of our website, [00:02:00] take advantage of our YouTube channel as well.

[00:02:03] Just a quick note, before we get to our show, we launched a new podcast Today in Health IT. We look at one story every weekday morning and we break it down from a health IT perspective. You can subscribe wherever you listen to podcasts. Apple, Google, Spotify, Stitcher, Overcast. You name it, we’re out there. You can also go to todayinhealthit.com. And now onto today’s show. 

[00:02:26] All right. Today we are joined by Reid Stephan the [00:02:30] CIO for St. Luke’s health out of Boise, Idaho. Good afternoon, Reid. Welcome to the show. 

[00:02:35] Reid Stephan: [00:02:35] Yeah. Thanks Bill. Good to see you and good to be here. 

[00:02:37] Bill Russell: [00:02:37] Yeah, actually I guess we’re straddling the afternoon, morning. It’s still morning your time. As the people watching on the video, we’re going to see it’s 11:06 AM right over your shoulder.

[00:02:47] I can see that. So but I’m on the East coast. Thanks for coming on the show, I’m looking forward to this. St. Luke’s is obviously a significant player in the Idaho market. [00:03:00] Give us some background on St. Luke’s. 

[00:03:02] Reid Stephan: [00:03:02] Yeah happy to. So established in 1902 grown from there. So I know who’s only not for profits Idaho based health system.

[00:03:12] We cover mostly Southwest Idaho, a bit abuse and Oregon eight medical centers, the children’s hospital, a couple of hundred clinics, about 15,000 employees, 1500 licensed doctors that are hospitals. And really take a lot of pride [00:03:30] in kind of being community owned and based any of the investment that happens within St. Luke’s stays directly in the state of Idaho. And there’s a lot of pride of community ownership and benefits that goes with that. 

[00:03:42] Bill Russell: [00:03:42] So you’re not outside of Idaho at all. You’re just within the border.

[00:03:46]Reid Stephan: [00:03:46] Little bit of use in Oregon and then Southwest Idaho. That’s right. 

[00:03:50] Bill Russell: [00:03:50] Wow. So, but you do, but you’re the largest Idaho operated player. Obviously you have a Trinity’s there, Intermountain’s there. I [00:04:00] think Providence is there as well, but you’re the largest entity that’s that’s Idaho based? 

[00:04:05] Reid Stephan: [00:04:05] Correct 

[00:04:06] Bill Russell: [00:04:06] Wow. 

[00:04:07] Reid Stephan: [00:04:07] And the largest private employer in the state. 

[00:04:10] Bill Russell: [00:04:10] Wow. So talk a little bit about you know, so you guys given, given your scope is it considered more, I mean, could you have urban and rural, so Boise is considered urban.

[00:04:23] But then you have an awful lot of rural. You have a lot of land in between some of the places you’re talking about covering. 

[00:04:29] Reid Stephan: [00:04:29] Yeah, [00:04:30] absolutely. So we’ve got nice pockets of both. We’ve got three critical access hospitals. We have clinics that are in very rural settings. And so it really is kind of an interesting dynamic of meeting the needs of a, not just urban, but rapidly growing urban area. So Boise in particular, the last couple of years, just really kind of overwhelming growth and just increases in the cost of living based on home values rising. So you’ve got that kind of pressure on one end [00:05:00] and also like emerging entrance into the market who don’t have any connection with St. Luke’s like any kind of generational or historical kind of. Tie to St. Luke’s is now we’ve got this opportunity to capture kind of those minds and those lives as they come into the market. And then you’ve got these rural settings where, you know, their care needs and how we deliver that is just dramatically different than it is in an urban setting.

[00:05:25] So it really is kind of fascinating and fun to figure out how we [00:05:30] provide for both ends and do it in a way that feels unified and harmonious. 

[00:05:35] Bill Russell: [00:05:35] Yeah, I’m going to get way out of our swim lane already here but I mean, when you have a digital strategy is the digital strategy for urban and rural different?

[00:05:49] Reid Stephan: [00:05:49] Yeah, I think it certainly is. I think in an urban setting, you know, there’s much more of a likelihood that those consumers are going to have access to broadband coverage, cell coverage. [00:06:00] Some of our rural markets, you may not have that you may have dial up at home still. And so you’ve got to figure out that kind of last mile. You know, how do we make sure they’re not disadvantaged just based on where they geographically live.

[00:06:12] And so then you look at partnerships with companies to help extend that broadband connectivity. Or to look at remote based care options that are maybe a combination of low tech and high tech to be able to meet the needs of the consumer and the patient, like where they live. Not fair to expect them [00:06:30] to travel great distances or to potentially move somewhere, just to have access to the healthcare that’s offered in an urban setting.

[00:06:39] Bill Russell: [00:06:39] So how did, how did you get into this role? How did you get to Boise and how did you get into this role as the, as the CIO. 

[00:06:46] Reid Stephan: [00:06:46] Yeah, Idaho native grew up in North Idaho, which is kind of the Mecca of the state beautiful area. Went down to Moscow, to the university of Idaho and then out of school, settled in the Boise area where there were jobs and I [00:07:00] never, never set out to be a CIO never set out to work in healthcare. I spent the first part of my career, really doing high-tech consulting spent about a decade at Hewlett Packard. And when I was there really got into to cybersecurity, fell in love with it. Loved, I loved who I worked with. I loved what I did. But one night at dinner about, about 10 and a half years ago, my daughter was in kindergarten.

[00:07:27] She came home and they had a school assignment [00:07:30] to, you know, find out what your parents do for work and come back the next day and share with the class. 

[00:07:35] Bill Russell: [00:07:35] And you couldn’t explain it to her. Is that what 

[00:07:37]Reid Stephan: [00:07:37] Yeah she got like this Socratic method of, I could explain kind of what I did to a high level, but she kept asking me why like, okay, that’s what you do, but why do you do it?

[00:07:47] And it kind of left me haunted, realizing you know, and this isn’t a knock on HP. Great company, you know, great philanthropy, great history and legacy. But a lot of what I did day to day was focused [00:08:00] on a 90 day view of how do we make changes to bump up the stock price at the next shareholders’ earning report.

[00:08:06] So I left that conversation and talked to my wife and said, you know, again, I love, I love what I do. I love who I do it with. I really want to love why I do it. And so looked around. I’d actually consulted at St. Luke’s years prior. During the Y2K work that was prevalent and they had an opening for security manager and applied for it was hired.

[00:08:29] This was [00:08:30] a little over 10 years ago, the first dedicated cybersecurity position in the health system. So this incredible opportunity to. Build and grow a program from the ground up with a company that had a big enough scale and size to, to make it meaningful. And, you know, Bill you’ve, you’ve had career kind of twists and turns.

[00:08:51] There was just opportunities along the way that opened up. And as I pursued them, one thing led to another and before I knew it I’d left a [00:09:00] very comfortable setting and the cyber world as the CSO, because I could. I could go to any place in the system, be with any group of people and feel like, you know, I know as much, if not more than they do about cybersecurity.

[00:09:12] And then I went to a situation that was drastically different. And in most meetings I was in, I realized I know less than anybody else around this table about this topic that we’re discussing. And that’s both exciting and terrifying at the same time, but it’s those growth opportunities that I think really add to a rich [00:09:30] and meaningful career.

[00:09:31] Bill Russell: [00:09:31] This is probably the first time I’m going to admit this on a show, but I still remember that first year I used to, I used to meet with a group of men every Friday morning outside of work. And basically I was working on and I’m like, I’ve never been so out of my depth in my life. And this is I’m 46, 47, very accomplished.

[00:09:51] I’ve done a lot of things. And I’m like what do you mean? I mean, you’re, you’re a CIO for a health system. I’m like every meeting I go into, I feel like I’m taking [00:10:00] notes. I run out a meeting and I do tons of research. I call people it’s like, what does this mean? What’s this word? What’s this surgery, what’s this.

[00:10:06] And I’m like, I just feel like, I feel like a little kid who’s in charge of running something because there’s just so much to learn. It was, it was kind of, it really was overwhelming that first year. 

[00:10:18] Reid Stephan: [00:10:18] Yeah, that’s fascinating. And I totally relate to how you described that, but I think, you know, it’s maybe a better leader. Like it’s kept me hungry and it’s kept me vulnerable and I think kept me [00:10:30] authentic. And so as, as uncomfortable, it is at times I recognize the great value of that kind of experience provides to hone and refine you as a professional. 

[00:10:40] Bill Russell: [00:10:40] Well, actually I, you know, it’s interesting. I think you’re the first person I can remember who’s gone the security route to the CIO seat. I’m trying to think through all the people we’ve interviewed at this point. I can’t remember anyone who really had a cyber background and it’s, it’s it’s really interesting. So you come in, you have to [00:11:00] establish the foundations for a cyber program, but you also step into a CIO role.

[00:11:05] Talk about that. The steps you have to take when you first step into a role to really establish the right environment established the right mechanisims, culture and the things that you’re looking for. 

[00:11:18] Reid Stephan: [00:11:18] Yeah. Yeah. Happy to. And I think that as I look back on my career, I remember right out of school, like I’ve worked with some really brilliant technologists and people that I recognize that no [00:11:30] matter how hard I study, no matter how hard I apply myself I’m just, I have some internal deficiencies I’m never going to be kind of at that level.

[00:11:39] But what I found is kind of a, an ability that I was, I’ve been able to develop and refine over time with great help from others, is you know, I have an acumen for building high-performing teams. And I enjoy doing it. And so when I started in the, the CSO role, like building a team around me from scratch, [00:12:00] it was really interesting to be able to apply like all of these lessons I filed away over the years of, you know, what I would do if I were going to start over with something. And so I really placed a premium on cultural fit on kind of similar. mindset and approach for, for how you, how you do the work and organize it and operationalize it. Certainly you have to have aptitude, but man, if you don’t have some of those core foundational personality [00:12:30] interlocking pieces in place, it makes everything else so much harder. And some of the acumen, the technical skills much easier to grow and develop that in people then more that the soft skills. So I did that, I think, to a successful degree with the cyber team here at St. Luke’s. And so one of the things that I kind of wondered was, you know, that’s a team of 15 people would that kind of scale to a larger, larger organization.

[00:12:55] So as I progressed through different roles within the it department here and went from [00:13:00] that to a group of a couple of hundred, and then now an it department of about 450, what I found in both of these situations, when I would come into new roles you have to do some honest assessment of just the culture and again, the, you think of Jim Collins Good to great. Do I have the right people on the bus and are they on the right seats? And what I found is a lot of leaders are reluctant to address that they’d much rather kind of dive in and figure out their disaster recovery [00:13:30] strategy. Really kind of hone in on that. I’ve got smart people that will do that in spades all day long.

[00:13:37] If I surround them with the right team and the right structure to get the best out of them. So that involves when you first come into a situation like this honest assessment, having hard conversations, potentially moving people’s cheese changing roles. There are exits out of the organization. But what I, what I observed from that though, is people came forward and [00:14:00] they’re like, It’s so nice to feel like there’s a leader now that that kind of cares and gets this because for the longest time, you know, I’ve watched this dysfunction or whatever, it might be transpire.

[00:14:11] And I thought can, no one else see this. And if they don’t see it, then they don’t care. You know, how much should I care? It’d be kind of vested in this. So those, those conversations can be grueling and difficult, but the fruit from it’s you know, it can have a. A multi-month or a year impact on the [00:14:30] culture of your organization.

[00:14:31] So I always start there as assessing the culture and then not being afraid to make the changes to ushering in the kind of culture and the unity that you need. 

[00:14:41] Bill Russell: [00:14:41] Yeah. It’s interesting. There’s this aspect of wanting to be liked it. And I’ve heard managers say, well, you know, I don’t have that problem. Like, well then you’re going to have a different problem. But but you know we all have this aspect of wanting to be like, but the reality is if we don’t address some of those hard things, I remember when we [00:15:00] made some moves in the management ranks, some of the people from that were reporting into them, just like unsolicited would walk in and say, thank you.

[00:15:09] And it’s thank you for recognizing that this is really a stifling environment. I wasn’t able to really do what I wanted to do. And  the team wasn’t effective. And that’s really the role of the person at the top is to make sure that all those teams are really high functioning teams.

[00:15:27] And that means the right culture, the right [00:15:30] leadership and the right really framework for getting work accomplished. Yeah, exactly. Well, yeah, that, wasn’t a question I’m supposed to be asking questions. So let me go back to that. What are some of the signposts that you have the right culture that you’re trying to develop?

[00:15:48] Reid Stephan: [00:15:48] Yeah, I think, I think a couple of things. One is I’m always big on kind of assessing and querying whether it’s a survey or some other kind of vehicle, but my immediate kind [00:16:00] of a team. So my extended leadership team and really giving them, making sure they feel like safe. To be as candid and open as they, as they can be.

[00:16:10] And so things that I would hear that would let me know one way or the other, that we’re on the right track. If I hear people saying, you know, I’m afraid to speak up in a meeting or, you know, I don’t feel like there’s the right kind of level of trust we need within this group. Like, those are huge red flags that, okay, we’ve got to kind of hit this head on. The other side of [00:16:30] that coin to me, it looks like this and I’ll have people say you know, this is the highest performing leadership team that I’ve ever been a part of. I genuinely look forward to the time we spend together, I look for opportunities to work with and interact with my peers rather than kind of run from it because of the time we spend together it fills my cup.

[00:16:49] You know, it’s got this energizing effect on me and it brings out the best in me. So I think when you start to hear those things, that kind of the executive leadership team level. That’s a huge [00:17:00] indicator. And then I think you start to hear anecdotally and you have got to, you have to make the effort to solicit the information.

[00:17:07] So I have a series of weekly, small group meetings where I invite 15 to 20 folks in the department. We meet together virtually now, and it’s just an open forum. And you can draw some really interesting insights into is that culture kind of trickling down to the organization to the degree that you would hope and what, or are there kind of gaps in pockets that are happening.

[00:17:28] But from that group, I’ll hear [00:17:30] things like, you know, I feel, I feel like I have permission. I feel like the work I want to do here it’s safe. It’s celebrated, it’s encouraged. I don’t feel micromanaged. You know, I don’t feel like. I’m going to get my hand slapped if I take a reasonable risk to try something new.

[00:17:48] So I think those are the things you start to hear that indicates this is a culture that, that people are attracted to. And then you could see kind of a metrics. We have a pretty low attrition rate, which I take great [00:18:00] pride. And especially this day and age, when. There’s opportunities. And we know in healthcare there’s technology operations, outside of healthcare, that financially are more lucrative.

[00:18:09] And we have folks that are like, you know, I understand that. But I also understand that it’s more than just the dollars on my paycheck. Like there’s a hidden paycheck as a part of the work that I do. And that’s compelling to me and keeps me here. 

[00:18:23] Bill Russell: [00:18:23] You know, I would imagine St. Luke’s a little bit like St. Joe’s in Southern California. I mean, the sisters came into that community established [00:18:30] a, you know, a mission and, and did that whole thing there, there was a certain amount when you’re in the community and talking to people, they’d say, yeah, I was born in that hospital. Yeah. I, you know, I, in the various, I mean, you’re just such a part of the community.

[00:18:45] I would, I would assume that’s just the value of working there is, is in and of itself is really great. 

[00:18:52] Reid Stephan: [00:18:52] Yeah, that’s a great point. And absolutely like, even personally, for me, two of my children were born here at St. Luke’s. My father [00:19:00] and stepmother both passed away inside the walls of a St. Lukes facility. So you’ve got these incredibly impactful book end events and mortality. What other industry organization could have that kind of a heart to mind connection for you as an employee? None. And so that’s it’s hugely compelling. 

[00:19:18] Bill Russell: [00:19:18] So I’m always curious with CIO’s because when I was in the role, I felt like the role was big and every time I have conversations and we do two of these interviews a week, that the [00:19:30] role sounds like it’s getting bigger and bigger and encompassing more things.

[00:19:33] How do you determine what you’re going to doing that every week? I mean what sets your priorities as a leader and what, you know, what are the drivers that are sending the agenda right now for the CIO? 

[00:19:45] Reid Stephan: [00:19:45] Yeah, well like everyone else for the last year, you know, COVID has been kind of a firm hand on the rudder of where we’re steering.

[00:19:52] We’re starting to see that relax a little bit and a little more kind of personal choice come into to the work we’re doing. I [00:20:00] think for us, we’re really driven by this idea of experience trying to enhance that experience, whether it’s a clinician, an employee, a patient, a family member inside the hospital outside.

[00:20:14] So for me personally, what kind of drives the agenda? What we focus on is looking at. Just kind of instinctively, whether we hear it directly from surveys, we’ve done, whether we hear it from people in the community, what are those things that we’re just missing the [00:20:30] mark on in terms of experience. And when you start to look at it that way it’s a pretty target rich environment.

[00:20:36] And so you look at, you know, we talk about digital so much nowadays. There’s tremendous opportunity to improve that experience. When you compare a healthcare digital experience. And I speaking for St. Luke’s compared to what someone experiences in finance or banking or retail or travel you start to see some pretty wide variation and opportunity.

[00:20:59] So [00:21:00] that, that is really kind of the lens we look through to kind of hone in and get the clarity of what we should, we should focus on. And it it’s very easy at that point then to tie that back to the system’s strategic objectives that are in place that are supporting the supporting pillars to then accelerate that work and sequence it and prioritize it in the right way.

[00:21:19] Bill Russell: [00:21:19] You know, one of the beautiful things about working in healthcare at an organization we just talked about is people coming up and going, yeah you know, I love that you work there great event but the downside is you go to a party [00:21:30] and you say, yeah, I work at. St. Luke’s or I work at St. Joe’s and they go, Oh, let me tell you what happened to me.

[00:21:37] I went to schedule an appointment. I couldn’t do it through the digital tool because it doesn’t. Then I called it on. So you get all those stories. 

[00:21:43] Reid Stephan: [00:21:43] Yeah. And that’s funny because that was new to me when I joined health care. But people, when you tell people that you work for St Luke’s they automatically assume that somehow you have the authority to change anything from clinical practice, to the billing practice of the [00:22:00] scheduling.

[00:22:00] So I kind of cringed initially because I would have those experiences when people would they’d share good things, but then also would share kind of pain points, but I’ve come to like really embrace those. I mean, they’re a wealth of perspective and insight. And so I’m always very inquisitive and I really try and draw the details from people when they want to share those with me, because it’s a gift. But yeah, I, I know what you’re talking about. 

[00:22:23] Bill Russell: [00:22:23] And one of the most innovative people I had would actually do handshake agreements with some of the patients [00:22:30] where, he was just technologists who worked for me, and he would just follow the patients throughout their day. And it was just talked to him and, you know, and they looked down and they couldn’t find their next appointment.

[00:22:40] And they were looking at the signage and he made, he made suggestions for all sorts of changes, just because he followed the patients all day. And I’m like, how did you get your day job done? Like we’re paying you to do IT. He goes, no, you’re paying me to build a better experience using digital tools. He goes now, sometimes those tools are just signs on a wall that are better marked but, yeah, it was [00:23:00] just interesting. I mean, they’re listening, listening, and getting that. Are there different ways that you’re getting that information out of the community of what experiences they’re looking for? 

[00:23:10] Reid Stephan: [00:23:10] Yeah. And it was slowed down a bit by COVID because of some of the restrictions in terms of, you know, visitation. But what we’ve aligned on is this idea that we call it, go to Cambodia. And it’s attached to Christopher Charles, who was the kind of the thought genius behind the lucky iron fish, which is [00:23:30] the iron emic fish that you drop into your pot you’re cooking in and it’s a natural source of iron in your diet.

[00:23:37] Well, he came across that that hypothesis and proved it out when he was in Cambodia doing his research study. He could have stayed in Canada to do the study, but he wanted to immerse himself in the country and the culture of the people. And then came across this incredible opportunity. So we have that mindset here is we call the three Cs of design disease.

[00:23:58] If all you know [00:24:00] about the consumer or the end user and their experience, if all you know is gleaned from a conference room, a conference call or a cubicle, you might understand the functional needs of what they’re after. But you’re missing kind of the social and the emotional context that might really be the driver to truly innovate or truly meet their needs in a way that they embrace.

[00:24:20] So we’re all about telling people, just go on observe, like you think you understand how people are using the solution today, but you’re probably wrong. So spend [00:24:30] some, spend some time, just sit and observe, watch how they’re using it. Ask questions, be curious, ask like what questions don’t ask people, why they’re doing something, because sometimes they can feel like they have to defend what they’re doing, ask them what, like I noticed you doing this.

[00:24:45] What’s the reason that you do it that way, or what’s good about that. And that’s been a concept that’s resonated powerfully in our department. It’s great to get people kind of out of their normal setting and out into various backdrops to [00:25:00] kind of better understand how. Technology they support truly is used in a clinical or an inpatient environment.

[00:25:07] But it also helps us identify areas of non-consumption because sometimes people just struggle and they don’t even think to ask for a better way because they just think it’s just the way it is. You know, it’s just the tedious part of my job, and I’m just gonna suck it up and live with it. But if we’re there, we’re watching, we can sometimes help identify opportunities that a clinician or a patient or a consumer [00:25:30] wouldn’t even know to ask. 

[00:25:32] Bill Russell: [00:25:32] The, again, I’m going to go off-roading here, but is the tool set there? I mean, do we have the right tool sets yet that we can hear something like this and be pretty responsive and just tweak this system or tweak this digital tool specifically. I’m talking about the consumer experience more than the clinic, but I could be talking about clinician. Do we, do we have the tools that we can tweak? 

[00:25:57] Reid Stephan: [00:25:57] I think yes and no. I think it’s [00:26:00] very situationally dependent. One of the, one of the principles that we’re we’re advocating for and really promoting is not having people get tripped up with a false notion of innovation. So innovation doesn’t have to be a moonshot, right.

[00:26:17] It doesn’t have to be something like, you know, Elon Musk worthy is kind of a phrase we use. Innovation is simply doing something that you have never done before. It doesn’t mean that no one else hasn’t done it doesn’t mean they have been doing it for years [00:26:30] but if it’s new to you and if it fundamentally improves and enhances the experience in my book, that by definition is innovation. And so we find opportunities like that, where there are quick wins. There are things that we can do relatively simply relatively quickly. And it’s a great satisfier then for that person on the other end, we’re now working through the process of having some more rigor around the methodology.

[00:26:57] And rolling out a proof of [00:27:00] concept this summer, I’m going to convene a group of six VPs who are kind of like fast movers, innovative thinkers, get a core group together, using a tool to help have an intake engine for ideas around innovation. And also give us a way to put out challenges for the organization of problems that we recognize at the executive level that we want to really solicits ideas and input from frontline staff.

[00:27:25] So I think in the course of that, I think you find those things that are kind of quick [00:27:30] knobs. You can just kind of dial in, but you’ll also identify those things that maybe are, are much broader, much more complex, much more time intensive. But as you do both, I think it’s, it creates a groundswell on a rising tide that benefits everyone involved.

[00:27:47] Bill Russell: [00:27:47] Alright Reid. So there’s business priorities. You know, we talked about the experience priorities and those kinds of things, but there’s also IT priorities. How do you ensure that you’re addressing both? Yeah. I mean, you have those, those experience, but you also [00:28:00] have tech debt. You have a lot of mation, you have new stuff coming in all the time and EHR upgrades and whatnot. How do you, how do you balance those? 

[00:28:08] Reid Stephan: [00:28:08] Yeah, I think I’ll answer that kind of two ways. And maybe I’ll start with kind of a more tactical just day to day. And then the second answer will be kind of how I personally choose to approach it. So we, you know, we carve out and we’ve conveyed to the organization like just by virtue of St. Luke’s being open for business. You know, there’s a baseline operational [00:28:30] costs to that. These are a percentage of our, of our capacity of hours we have in any given year that it’s untouchable. It’s what allows us to make sure that our data center is functioning at a high reliability level.

[00:28:43] It’s what’s allows us to do break fix in a timely manner is what allows us to ensure that we’ve got good cybersecurity practices and hygiene in place that we’re keeping current on our systems, refreshing tech that to your point. These are things that. Can’t ever be [00:29:00] on the chopping block when it comes to prioritization or what we’re going to do and not do when we draw a line.

[00:29:05] And so that’s worked fairly effectively just to ensure that we don’t ever lose ground with things that we know. Foundationally have to be in place to operate as a health system. That then leaves us with a bucket of a hours of time then that we can use for more system directly kind of operational initiatives and desires.

[00:29:29] It’s, [00:29:30] we’re evolving our maturity in this space. You know, we’ve got a robust intake process now, and we’re really going through the idea of sequencing and prioritization. What’s been great about the silver lining of COVID is for the first time ever about a year ago, we did, we always talk about doing, like we said no to things.

[00:29:50] We stopped things. We delayed things, and we focus on these most critical elements that we knew we had to get rights in a short span of [00:30:00] time, remote work, virtual visits. Safety practices within the walls of the hospital. And we’d delivered an executed as a system in a way we never had before. And my goal now is to make sure that that incredible lesson is not lost and I’m starting to already hear kind of some of the murmurs of, okay, great things are kind of starting to subside.

[00:30:21] Now, all this work we’re going to kind of bring it back in. And if we do that and treat everything like as important nothing will be, and we’ll kind of [00:30:30] spin our wheels and spots where we have previously, and those ruts will just quickly become a parent again on the kind of the landscape. So it’s a, it’s an ongoing process.

[00:30:40] We carve out our operational capacity. We need to kind of keep the plane flying and then we continue to interact and talk with a business business and try and have. A really mature, robust way to truly measure and assess priorities and sequence the work and support it with the [00:31:00] resources it needs in a way that’s scalable. Personally for me, I I trust my lieutenants.

[00:31:07] Like I take a lot of my lead from them and what they’re kind of feeling and seeing and directing. I get asked on occasion, you know, one of the things that keep you up at night. And it’s not, it’s not a cyber breach. It’s not as Epic gonna go down. It’s not, is our network going to have an interruption.

[00:31:26] Not that I don’t, those things certainly occupies space in my [00:31:30] mind but I’ve got experts that they’re up at night worrying about that. And so me staying up at night, worrying about that. It doesn’t add any value and actually probably is a disservice to them because then I’m not focused on those things that, that I really need to be doing, which is ensuring that they have the tools and resources they need that they feel safe in their work.

[00:31:50] They feel they have permission to make decisions that they have the right budget to do their work. That they’re recognized and rewarded for the work they are doing. So in that regard, [00:32:00] like, I feel like the way I answer what I do personally, to answer your question is, is I wake up every day working for these 450 people in my department.

[00:32:09] Because as they do the best work, they can do some of those things solved for themselves. And I get great data and input from them that then arms me to have good conversations in the meetings I’m in. 

[00:32:22] Bill Russell: [00:32:22] And that’s such a, such a great answer. You know, actually building off of that, you talked about the silver linings of [00:32:30] COVID in terms of priority setting and that kind of stuff, but are there other key learnings that we have found moving through the pandemic or silver minings as you, as you refer to them?

[00:32:41] Reid Stephan: [00:32:41] Yeah, I think so. And this is, you know, I’m going to be repetitive I’m, I listen to your podcasts. This is nothing new but I think it helps just to reinforce. So for us, you know, we’ve learned that we can do remote work at a larger scale than we realize. And I think that’s gonna be a benefit from a [00:33:00] retention and a, an attraction standpoint as an employer.

[00:33:05] You know, I think personally for me, when I do these weekly kind of small group meetings, I talked about. That is the number one question that is always asked. Is, Hey, when do I have to come back to the office? What does that look like? And it’s interesting because there was never a mandate that people had to work from home. You know, we’re critical infrastructure so that was never a requirement. There’s not going to be this date we set when it’s like, Hey, back in the office now. But I think that we’ll [00:33:30] align on this and maybe not out of the gate, but my vision is we align on this future state where. You know, we really treat our employees like the professionals.

[00:33:38] They are you know, they understand the work they need to accomplish the outcomes expected of them. We can give them and their leaders, the space to then kind of manage what that looks like and not be overly prescriptive about when and where people are working. And I, we’re having really great dialogue currently about this and what a playbook looks like with [00:34:00] HR and others and legal.

[00:34:01] I’m of the opinion of, I want to trust people and yeah, you’ll have some outliers and bad actors along the way, but you deal with those. I would rather be occasionally disappointed then continually suspicious. And so that’s kinda, my mindset is the majority of our staff are high functioning and they’re going to do great.

[00:34:19] Let’s treat them that way. The results we’re going to get in return are going to more than offset any of the wrinkles we’ve got again, we have to smooth out. So that’s one and telehealth is the [00:34:30] other one I would highlight. We have really accelerated what we’ve done in that space, which has been super exciting for our team because we’ve had these tools for years and just haven’t had the right, the momentum or push to kind of get some of them off the ground. And COVID has introduced that. The communities responded, you know, there was great, certainly in the early days of COVID wide adoption and great use of tele-health, it’s declined a bit because people do like the in-person experience, [00:35:00] but I think we’ll now have that at a baseline level that would have taken us so much longer to get to. And now we can kind of build on that and we’ve got a kind of a case study of data that we can rely on to help move the needle even further in that space. 

[00:35:17] Bill Russell: [00:35:17] I mean, again, great answers. I have so many more questions I want to get to that I don’t want to build off the questions I just asked.

[00:35:25] Let me ask you about partnerships and I’m going to leave this purposely broad. [00:35:30] What interesting  partnerships are you exploring or do you have going on right now? And the reason I’m going to be vague is obviously you can talk about an Epic. Epic’s a great partner. And you talk about Microsoft. They’re a great partner or whatnot, but I’m more curious about, you know, something that we wouldn’t normally recognize as a traditional approach. 

[00:35:54] Reid Stephan: [00:35:54] Yeah. And maybe this isn’t kind of doesn’t address that last statement [00:36:00] super acutely, but for me when I think about the partnerships I, you know, I have curated and I try and really cultivate a deep connection of, of peers in healthcare and outside of healthcare, both in the CIO role and CSO and others.

[00:36:19] So for me, when I think a partnership, my mind always goes there before I start to think about kind of vendor partnerships and collaborative opportunities. And I think that’s important because [00:36:30] and this is me, but I. I don’t have a ton of like original you know, lightning in a bottle kind of thoughts.

[00:36:40] I’m sure it’s happened in my career, but I don’t have a bunch that kind of come to mind that I could refer to. I have several experiences where I’ve been talking with somebody and they’ve kind of shared something they’re doing and their inspiration then kind of supercharges mine. And so I’ve gleaned great value from being a [00:37:00] fast follower. And so when I think about partnerships, it’s folks in other organizations and having regular touch bases with them, sharing things we’re doing hearing from them and in the course of that, a lot of ideas and Genesis of inspiration come. So that’s kinda my first reaction to that question is I think any CIO should be actively curating and cultivating kind of a virtual rolodex of peers that they [00:37:30] can just bounce ideas off of share best practices. Sometimes just to vent to. There’s tremendous value in that. When I think about more traditional kind of vendor partnerships, You know, I think voice recognition is really compelling opportunity for us going forward, especially kind of the ambient listening space.

[00:37:52] So really interested in the, the Microsoft acquisition of nuance. It was announced yesterday and kind of what that’s gonna mean because we’re partners with [00:38:00] both, but actively looking at ways that we can better leverage those capabilities. To improve the experience for the provider. Cause the number one concern I hear from providers, especially in our clinics is, you know, the worst thing that I do is I turn to the side type in the computer and I still try and like maintain a peripheral vision with the patient, but it just, it feels so impersonal and it fills it impedes with what I’m trying to do there in [00:38:30] terms of the relationship and really seeing them and hearing them and understanding them. So if you can take that experience away of having the turn and type on the keyboard and just have it, the ambient experience capture all that. And then the intelligence built in to where the doctor has to do very little kind of modification.

[00:38:48] They just simply sign it. I mean, that’s huge to me. Like I just, if I were a doctor. I would be all in on that kind of a patient experience. 

[00:38:57] Bill Russell: [00:38:57] You know we use one of the most cutting edge [00:39:00] platforms for transcription for these episodes. And what we’ll do is we’ll drop the audio and video and it’ll still come back with maybe 3% error rate, maybe even 2%. It’s really good. I mean, I’m, from where I sit we have to do very little to correct it and everything that needs to be corrected is underlined because it’s like, Hey, we’re making a guess this word.  They sort hhighlight but still 2% in healthcare. Yeah. That’s a big number.

[00:39:29] Reid Stephan: [00:39:29] Yeah. [00:39:30] Yeah. And that, that kind of number is not going to fly. And so we’re working with Nuance is set up a little, like a demo room here on our floor, got an innovation lab where we can bring doctors through and let them experience that ambience kind of workflow. Firsthand, but then also provide, I think, good feedback too, to nuance on ways that they can further reduce and fine tune their products.

[00:39:54] So that number gets to zero and it just works theory when I try and talk to it. [00:40:00] And you know, it’s an argument at the end of it. 

[00:40:02] Bill Russell: [00:40:02] It’s interesting. Somebody asked me about the acquisition yesterday. It was like, do you think this is good for healthcare? I’m like, I think it’s great for healthcare. And the reason I think is great for healthcare is because I think nuance didn’t have the cash to develop all the clinical vocabularies that they needed to develop.

[00:40:19] And they were just doing them one at a time. Well, I think they just got access to a very wealthy grandfather who might help them to develop that a little faster. 

[00:40:28] Reid Stephan: [00:40:28] Yeah, totally agree. [00:40:30] Like it’s good for healthcare. Like it all works together in a weird way. It’s I feel like I get a little more bang for my buck and our Microsoft EA renewal and we write that huge check.

[00:40:40] Now that’s a little, just a tiny bit more palatable, not fully. But then it, you know, it supports the hello. Epic has that functionality kind of comes out. So it is, there is some nice interconnections there that will benefit the community. 

[00:40:55] Bill Russell: [00:40:55] Yeah, it’s I’m not going to push it anymore on that. I, the [00:41:00] Microsoft agreement back in the day when I was doing it was one of the hardest to sign because I just looked at it and I went, man, this is an awful lot of money but you’re talking to, for us, it was, you know, 21,000 users and you just do times whatever the number is.

[00:41:14] And it just it’s a big number. All right. Let’s talk about priorities. 2021’s here pandemic isn’t in the rear view mirror yet. But as you know, as we’re talking, you know, we’re getting to the point where we’re getting pretty close to 200 million [00:41:30] shots and arms at this point, across the across the US. That’s not complete vaccinations, it is doses delivered.

[00:41:38] And that’s sort of my so anyone who gets mad at me for saying, you know, anything that would indicate where beyond this. We’re not beyond this, but we’re, we can, we’re further along than we’ve been at any point. So you can see, you can see the light at the end of the tunnel, 2021 priorities from a technology perspective. What are you looking at? 

[00:41:59] Reid Stephan: [00:41:59] Yeah. So there’s a [00:42:00] couple of things that come to mind and I totally agree with how you kind of characterize that. Like we recognize we’re still in a pandemic. However, we recognize that to your point, it’s getting better every day. So we don’t want to suddenly react, you know, four months from now, whenever it is like we want to start to kind of jogging into that, that entry point and be able to start running. Digital front door is a hugely important topic. That’s that’s on our radar and there we’re focused on that’s been, and we’ve talked [00:42:30] about it for a few years, but again the experience with COVID has kind of brought it front and center and in particular, in the eyes of our executives the last few months, as we’ve tried to, like everyone else respond to the vaccine workflow needs standing up clinics, adapting to kind of shifting guidance from our local state governments.

[00:42:53] We’ve had to be agile and have recognized that, you know, an Epic is a great partner. But we [00:43:00] have, at this point, they completely own that digital front door experience with our consumers. You know, we use the stock, my chart application. Which while functional we found that there was some unique needs we had and the ability to kind of modify the app to meet those needs in a timely manner was impossible.

[00:43:21] And even sometimes a couple of things like just changing some texts in a few of the screens, which you would think, you know, like on a website, you should be able to change the text, [00:43:30] push it and be good. Well, no, we’d have to reboot all of our, my chart servers which is a, you don’t just go and do that.

[00:43:36] That’s like a 24 hour kind of a cycle thing, because you’ve got to do this drain stopper approach where you stop all sessions on one server and once everyone’s logged off, you reboot it. Then the next one, then the next one. So like, it just became a, an opportunity to recognize that we need to. Be a little more deliberate about charting our course and likely [00:44:00] developing an app that kind of provides that front door experience.

[00:44:03] So we control that and we are the one that are interacting with. Our community and their needs that we know and should know better than Epic. And we would never expect Epic to know them or to tailor a tool meant for a broad population to our unique needs. So excited about that, that that work is actively underway.

[00:44:23] And then really looking a lot of of RPA kind of opportunities. We have a lot of excitement from [00:44:30] finance and revenue cycle in this space. They feel like there’s, there’s so many processes today that they’re doing that are manual and repetitive. So it’s, time-intensive, it’s costly. It reduces human error.

[00:44:43] And so super excited about the the interest and the lean in from those leaders to look at ways to start to use RPA in a very meaningful way that delivers operational benefit, but also bottom line benefit.

[00:45:00] [00:45:00] Bill Russell: [00:45:00] Yeah. That’s well, RPA is going to be interesting. Digital front door is going to be interesting.

[00:45:06] I’ve gotten into the habit at this point, cause we’re coming up on our time and I want to respect your time here. The I actually asked the question, is there a question I haven’t asked? Is there something that, you know, there’s a topic or something that you’re either surprised I didn’t ask or that you think, Hey, this, the community would benefit from talking about this.

[00:45:28] Reid Stephan: [00:45:28] Yeah. It’s not something I’m [00:45:30] surprised you didn’t ask. And I guess I’m not quite sure how I want to approach this. I’m just going to kind of just going to start talking and then, you know, you can edit this with your magic. This last year has been really fascinating. Kind of a human experiment, observational opportunity in particular around COVID.

[00:45:50] So generally people that are your friends, people that you interact with on a regular basis, you’re fairly aligned on your life perspective. How you [00:46:00] kind of view things and assess things. And this year more than any other has kind of introduced this not really a rift, but just kind of, you know, showing that there’s a little bit of separation and how people think in particular, when it comes to COVID the virus, the vaccine.

[00:46:19] And it’s been, I’ve had a lot of conversations with people about this because, you know, I talked to our COO and really respect him and he shares that, [00:46:30] he’s like a hundred years ago, the average life expectancy was in the mid forties in the hundred years since then, he’s like 30 years of an added to that average life expectancy.

[00:46:40] And he says, we’ve done that through public health initiatives and through medical science. And yet right now in this very hour of need, those two things will help us get through this pandemic and continue to improve and expand on the length and quality of life. People are turning away from. Based [00:47:00] on bad science, based on conspiracy theories.

[00:47:04] And so what’s been personally interesting to me is watching that come into like my circle of close friends and acquaintances where I never would have thought people would believe some of the things they do. So I have a friend who was sharing that his son right now is doing a research paper about how MRNA vaccines are not safe and not effective.

[00:47:27] And he’s telling me how his son has [00:47:30] 11 pages of references he’s found already. And we’re kind of talking through it and I left there realizing and his son is in high school he’s a, I think he’s a sophomore. And so he is he is banking more on his sophomore son’s perspective and these internet website articles then like a licensed certified, respected medical professional.

[00:47:54] And I just, I think we need to talk about that because it’s [00:48:00] not unique. And I think within our department, we likely have these kinds of different viewpoints on this as well. And I think it’s going to be an interesting journey to navigate going forward because that potential misalignment or kind of a different viewpoint, it could be something that erodes culture, it could be something that causes contention and friction that is counter to what we’re trying to accomplish as a team.

[00:48:25] So I’m just mindful of that and want to make sure that I’m, again, I’m not [00:48:30] talking about group think or forcing ideas on people. But how do we talk about this in a way that’s not combative that doesn’t try and have either side trying to win based on their position, but just open conversation and kind of finding that middle ground where we can accept the different viewpoints, but still be united in our purpose.

[00:48:48] Bill Russell: [00:48:48] You know, you, this is a great topic I mean it’s impossible for me not to say anything at this point. That’s all right. The, [00:49:00] you know, I’m looking at, I’m getting ready to prepare for today’s show. So we Today in Heaklth IT every day and tomorrow or  Friday, will be on the COVID and vaccine update.

[00:49:10] The biggest story right now is why Mississippi has fewer takers for 73,000 COVID shots. And you go to the next story. Vaccine supply increases all demand falters in Ohio. You go to the next story and it’s COVID-19 vaccine supply is starting to exceed demand in Fargo. And by [00:49:30] the way, there’s six of these.

[00:49:31] I mean, you know, state supplies in the code vaccine are now being sent to primary care doctors because supply outpaces demand. And same thing in Kentucky, we’re seeing this, and this is just, you know, there’s, there’s people that are making decisions based on politics. They’re making decisions based on internet articles.

[00:49:54] Now there’s people making decisions based on history. We have we have populations [00:50:00] of people that have not been treated well by the healthcare  community over the years. And that has, that has really saturated that culture. And we have some work to do there. And so and then there’s people that have concerns around vaccinations and those kinds of things.

[00:50:18] But I think that group has actually grown as a result of the pandemic, which is really interesting, but I, you know, rather than go down that path and I will say this, I [00:50:30] think it’s more important today than ever to remind yourself of why you like these people and why you respect these people. I have people that I vehemently disagree on a lot of things that are happening, like vaccine passport and a couple of my ongoing guests on the Newsday show, we’re just on completely polar opposite sides. But at the end of the day, I respect who they are. I respect their opinion, how they got to that opinion and I respect the work they do in healthcare.

[00:51:00] [00:51:00] And so I’m not just going to shut them off and say, because you believe that I can’t listen to you on any other topic, because that would just be. But it’s somehow we have to re maintain and re rebuild the lines of communication. 

[00:51:16] Reid Stephan: [00:51:16] That’s exactly right. That diversity of thought can actually make us stronger and better to your point. I just want to make sure it doesn’t become divisive. And so that just occupies some thoughts in my mind. 

[00:51:27] Bill Russell: [00:51:27] Thanks for bringing that up. I, you know, to be honest with you, I [00:51:30] normally wouldn’t bring that up with the CIO because I don’t want to put you in that spot to talk about this stuff. So I appreciate it. Thanks for your time. Always, always fantastic to talk with you. 

[00:51:42] Reid Stephan: [00:51:42] All right. Thanks Bill. Have a good day.

[00:51:44]Bill Russell: [00:51:44] What a great discussion. If you know someone that might benefit from our channel, from these kinds of discussions, please forward them a note, perhaps your team, your staff. I know if I were a CIO today, I would have every one of my team members listening to this show. It’s conference level [00:52:00] value every week. They can subscribe on our website thisweekhealth.com or they can go wherever you listen to podcasts, Apple, Google, Overcast, which is what I use, Spotify, Stitcher. You name it. We’re out there. They can find us. Go ahead. Subscribe today. Send a note to someone and have them subscribe as well. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom, StarBridge Advisers, Aruba and McAfee. Thanks for listening. Tha`t’s all for now. [00:52:30]

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