Cadillac Telemedicine at Craigslist Prices

With

Bill Russell / Dr. James Stallcup

This Week in Health IT Dr. James Stallcup Wilma P. Mankiller Cherokee Nation

About this guest...

Share Now...

Share on linkedin
Share on twitter
Share on facebook
Share on email

Show Sponsor(s)

July 17, 2020: Today we get an exclusive peek into the health system of Cherokee Nation, one of the largest Native American tribes located in Oklahoma. How do they manage modern day healthcare? What techniques do they use to handle COVID in this large rural expanse? Did you know that ZERO of their staff contracted COVID throughout the course of their duties? Joining us is Dr. James Stallcup Enterprise CMIO and Medical Director for the Wilma P Mankiller Health Center to talk about offering Cadillac telemedicine at Craigslist prices. 

Key Points From This Episode:

  • Learn about the biggest outpatient clinic that stands at half a million square feet [00:03:55]
  • At the beginning of COVID, Mankiller had about one fifth of the equipment in place, how did they scale up so quickly? [00:09:55] 
  • Find out which health systems are going to live past the pandemic [00:12:55]
  • Can a Kindle really replace a real live human check-in clerk? [00:15:00]
  • Ethical issues and consumerism in healthcare IT [00:13:50]
  • Learn great interviewing techniques on James Stallcup’s YouTube channel [00:24:30]
  • Bill and James also give their resume tips [00:26:15] 

Cadillac Telemedicine at Craigslist Prices with James Stallcup, MD

Episode 280: Transcript – July 17, 2020

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: Welcome to This Week in Health IT where we amplify great thinking to propel healthcare forward. My name is Bill Russell, healthcare, CIO, coach, and creator of This Week in Health IT. A set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

This episode and every episode, since we started the COVID-19 series. And now that we’ve exited the COVID-19 series has been sponsored by Sirius Healthcare. SPecial, thanks to Sirius for supporting the show’s efforts during the crisis. [00:00:30] And now beyond the crisis. So Sirius will be a sponsor moving through the end of this year.

So we are excited about that. Don’t forget we’ve gone to three shows a week. Now, Tuesday, we cover the news Tuesday news day, and we have interviews with industry influencers on Wednesday. Friday, we, we are just introducing a new thing called clip notes. C L I P clip notes for our interview shows what is clip notes?

Glad you asked, in conversations with leaders I’ve been asked if I can find a way to share with them a list of the [00:01:00] best snippets from the show so they can consume it and share it with others typically with their staff. This is step one of that process. For each show , if you sign up for this email list for each show, we will send you an email that has a summary paragraph of the show.

Bullet points on the key items covered in the show with timestamps. So you can go right to those spots, to hear about those topics and a couple of clips, actual video clips that we have selected, selected by the staff to capture what [00:01:30] we consider to be the. Best thinking on the, on that specific show, this is gonna make it easier for you to decide which shows are most relevant for which members of your team.

And you can even share just the clips via email with your staff. So if you want to sign up for this, please send an email to clip notes. C L I P N O TE S @thisweekinhealthit.com and you will be signed up to start receiving these to your inbox. Okay. Today we interviewed Niko Skievaski with Redox. we recorded [00:02:00] this episode a few weeks back and as some of, you know, Redox reduced their workforce by as much as 25%.

Since we recorded the show and what I consider to be a move, which shows the leadership that I admire in this company. and, and the team that makes up the leadership. They did an amazing podcast episode on the Redox pot podcast, where they openly discussed the decision of the reduction and solicited on behalf of their team.

That was let go to help them find work. I think it’s a great episode. If you get a [00:02:30] chance to Redox podcast listened to that episode, they have, one of their, one of their investors on there too to the leaders are on there and they talk through how they’re thinking about it, how the repositioning, or refocusing the company a great episode in worth listening to I’m excited to share this discussion with you with Niko Skievaski on today’s show.

Hope you enjoy. Okay this morning, we’re joined by Dr. James Stallcup the Enterprise CMIO and Medical Director for the Wilma P [00:03:00] Mankiller Health Center. Good morning, James. Welcome to the show. 

James Stallcup, MD: Mr. Russell. Glad to be here. Thanks for having me. 

Bill Russell: Mitch. Wow. I appreciate you calling me Mr. Russell. I don’t get that too often.

James Stallcup, MD: I like to heap on the respect. 

Bill Russell: Wilma P Mankiller Health Center. Give us, give us some background and, and,  on the name is as well as the organization that you represent. 

James Stallcup, MD: Okay, so, I’m James Stallcup, I’m an MD. I am a clinical informaticist. I am a boarded in primary [00:03:30] care family medicine and in clinical informatics.

And I work for the great sovereign Cherokee nation. Cherokee nation is the largest native American .Tribe in America. We are located in Oklahoma, our reservation, 14 counties. 10,000 square miles. We have nine big facilities, including a hospital. We have now just finished construction on the biggest outpatient, clinic I believe that any [00:04:00] travel systems ever has a half million square feet, we have a geographically, very rural population, which leads us to have a robust health IT response. As you can imagine, trying to coordinate care across all these venues and specifically. In addition to being Chief Medical Informatics Officer, I am a Clinic Medical Director of the great Wilma P Mankiller Health Center.

Shout out to all the Wilma P fam. Wilma Mankiller was female chief of the [00:04:30] Cherokee tribe. She did some very, very wonderful kind of groundbreaking things for the tribe. So very, honored to be at the, what I consider the flagship clinic of the Cherokee nation for 12 doctor clinic. We have optometry onsite pharmacy, physical therapy, our clinics have a very broad spectrum of services.

Even the rural ones have very broad spectrum of services. So yeah, we, have a patient population. Active, patient engagement every year, a better part of 200,000 [00:05:00] total patient, total eligible beneficiary population of somewhere over 400,000. We serve, beneficiaries, any federally recognized tribes.

It is not restricted just to Cherokee citizens. We are a compact and health system, which means that we are not an IHS site. We do work closely with IHS. We do joint ventures with IHS, but we actually. Minister and deliver our own health care. 

Bill Russell: Well, background, I think one of the things that makes your health system unique is, [00:05:30] is that geography? I mean, how did your system, let’s start with, how did your system experience COVID, across such a large geography and how did you sort of adapt to it? 

James Stallcup, MD: Well, so this is interesting and it is, you know, here we are, you know, we’re recording this in late June and it still evolving. And so we went through several phases of, I would say the sort of human acclimation to the fear of covert arriving.

So we had this early [00:06:00] warning that it was happening in other parts of the world. And, you know, kind of first, our first stage was denial, well that’s not going to come over here cause nobody saw SARS and MERS and we never really had to have a response to those. Yeah. So our initial phase was kind of denial. And then as it spread, we said, Oh, this is going to hit us.

But then, you know, the initial sort of reports where it was just very, very destructive in cities and urban settings and in rural areas, it wasn’t that much. Imagine our concern now, when we see States [00:06:30] like Arizona that are clocking, you know, over 3000 cases a day, you know, the Navajo nation, I know how to very, very heavy unfortunate impact of COVID on their community. So we were very proactive fact of in how we handled this. And I will say, I don’t believe in giving false praise, but when you do have the ability to give praise to something, you know, you should, So organizationally Cherokee nation, you know, not only our health services, but our [00:07:00] business aspect and had a very, very, immediate, very intense analysis of what we were facing. And it was daily calls long before work started. It was work groups. It was, we have our own infectious disease, you know, departments, obviously that was a huge advantage. It was as aggressive a response, as I can imagine. And even now that we’re able to look back, we are very thankful that we took the steps that we did.

We knew [00:07:30] that it was going to be a very broad area of Oklahoma that we’re dealing with. but we’d done this for years and we implemented a lot of the things that we needed to go forward. One of the, one of the more important. Things that we had done is we gave a talk. I did a keynote for weedy in 2015.

And the name of the presentation was. I think it was Cadillac [00:08:00] telemedicine at Craigslist prices. And so we never went with any kind of, for propietary telemedicine. I wanted consumer grade cameras that were 10 bucks that if you lost them, broke them, you know, a box of them wandered off. It wouldn’t matter.

So we had edconfigured our network and test, and then we were doing telemedicine in psychiatry, dermatology consultation, infectious disease consultation. We worked with IHS. echo on our hepatitis C program, which has just, we’ve got a great Hep C program. We [00:08:30] had all of the bricks and shingles and tar paper and everything we needed on the job site.

We just had to put it together. Had I known the equipment requirements I would have bought. Cubic yards of cheap cameras before they became impossible to get. This was one thing, you know, we, we never anticipated that we would need thousands of, of more webcams. but we did have a framework and infrastructure so that we could convert any room [00:09:00] in Cherokee nation in the exam room to a telemedicine room for about $35 and 15 minutes of work.

And that was a big advantage as we went through this, Do you want me to go ahead and get into the framework of how we handled it or should I …. ?  

Bill Russell: That’s a great question. It’s interesting. Cause we had a lot of conversations and you know, we talked about MacGyvering tele-health and it was the, you know, the first time that healthcare really had to scale up that quickly around telehealth.

[00:09:30] And a lot of them ended up doing what you’re doing, but that was like, there. a backup because some of the things we had didn’t scale, some of the costs, the training wasn’t done. I mean, did you have your training pretty well in place before COVID hit? Did you have a majority of that equipment already in place before, before it hit?

Or did, did you have a response as well to scale it up? 

James Stallcup, MD: So we had about a fifth of the equipment in place. If I was doing bar napkin math, we had about a fifth of our equipment [00:10:00] out in the field. We did have good provider buy-in to noon meetings, right? Noon meetings using teleconferencing because that’s how we would push out education.

So we already had provider, familiarity with that part, turned out to be a big, point. So. What we did as this started ramping up is, you know, I went to my health IT department. This will be the meat. This is what everybody I think will benefit from. But [00:10:30] then again, who knows? so when we started rolling out our response, I went to my health IT team and I said, listen, I’m not an expert on COVID, but I think we have to treat these patients like a source of radiation.

And everybody thought I was crazy. And I said, look, if you have a source of radiation, what do you do? The first thing you do is you avoid it. Right. You try not to have it around, but if you do have it around, you use protective equipment and you try to distance yourself from it. So how can we distance ourselves?

Well, you know, the obvious answer is you do telemedicine to people’s home, [00:11:00] but there are some less obvious answers for it. For example, you can have a patient come into your clinic and go into an exam room. Then the nurse can perform the patient intake from a different area of the clinic. Using telemedicine from the site into the room.

And now they’re more distant from the patient. They’re not within six feet right. After the nurse does the intake. Then the provider can join the call and now the provider can deliver the patient care, the office visit to the patient while they’re on site. [00:11:30] And then if the patient’s off site, you have a separate sort of procedure, but it all results in the same thing.

You’re keeping people separate. The patients were very fearful of COVID and they liked that they liked to be kept. Separate, during this process and it made it very scalable because the equipment required was so inexpensive. And we did have it on hand that we were, we rolled out a total of 16 service lines of telemedicine.

I won’t go through naming them all because it’ll take a while, but we rolled out 16 [00:12:00] service lines of telemedicine. Including EMS prehospital, and all of them have slightly unique workflows, but all of them adhere to our basic Vizio and then to train the providers on how to do this, we had noon conferences  every day. I can say that we use a Microsoft product for that Skype for Business link. and the providers, there was just an all provider, you know, all nursing email that went out and you could join every day. If you want to do, we had some providers that joined, you know, [00:12:30] eight days in a row, or if you got it the first time, Then you didn’t have to join again.

You felt like you were competent or if you needed to refresh or you could join. So that kept us out of the field. It kept, kept our it staff out of the field going and doing elbow support or anything like that. And it was very, very beneficial to be able to provide that training. I think training was a big part of it because the pro you know, we didn’t mandate anything.

We made it good enough that people wanted to use it. 

Bill Russell: Right. What do you think is going to live past the pandemic? I mean, one of [00:13:00] the things I found interesting. in our conversation is you had to think this way because of the geographic dispersion to begin with, I mean, to get specialists into such a wide geography is incredibly hard and I mean, do you think that tele-health will live there. The amount of telehealth you’re doing is going to live past. You think some of those, protocols of keeping a distance for intake and stuff are going to change or stay the same?

James Stallcup, MD: So there’s a few things that I think will live past this, [00:13:30] this phase of, I don’t know if COVID will ever go away.  I think it’s something we’re going to be dealing with concerned about for, you know, when I talked to my providers remainder of your career, you’re going to be dealing with this. I hope I’m wrong. Right. Hope I’m wrong, but hope for the best plan for the worst. It’s kind of a good mantra to have the few things that I think are going to be ingrained.

One of them is an ethical issue and I’ll kind of cover that last cause. That’s one of the more interesting points. I think that knowing that you have the ability. to put a [00:14:00] patient in a room and deliver health care to that person. The total in person time, the total time that you have a staff member within six feet of that person, where less than two minutes chaperone is that person puts them in a room, puts a vital sign monitor on it. The patient calls out the vital signs. Right? We want that person out of the room as quick. Quick as we can. In my facility, seeing COVID patient zero of our staff have contracted COVID through the course of their duties. Wonderful, wonderful, you know, kind of statistic. I think that once you have the ability to do [00:14:30] that, you are going to be willing to use, utilize that in other avenues of infectious disease, right.

There’s going to be more commonplace that you can deliver care outside the exam room. I believe that it is going to push telemedicine regulations forward and they may be scaled back a little bit as far as the payer side. But I think that there’ll be permanent changes the way we view telemedicine. I think that having hardware on hand for responses, you know, one of the coolest things that you can do is, Mr. Russell, [00:15:00] let’s say you got a clerk and the clerk has to welcome people to the clinic and check them in. Right? you stick a Kindle on a stand. You have that Kindle run, whatever platform you want to over your network. And then you put a Kindle in the back and now you’ve just replaced that video, audio communication. VIruses, not going to go through that network.

Right? So you can take any position and virtualize that with them, the network that you have. So that’s something that I think will stay there, that sort of response. And the last thing, this is the only original thought I ever had in my life. I had an original thought and [00:15:30] I said this at 2015 in the weedy keynote. It’s hard to have an original thought, but here’s my original thought. a patient who has autonomy, part of the patient’s autonomy is their choice in how to represent their concept of self. So you’re choosing to have a Zoom call with me and I am respecting that. That is you. That is yourself. Like Aristotle would say you can’t remove the ability to cut from the knife.

It’s no longer a knife. So this is your concept of self. [00:16:00] I believe that that’s you are. I respect it, right. if you call me on the phone, same thing, that is your choice in, in, in how to represent yourself. I believe in the future, there will be an ethical consideration that says refusing to accept. and agree to a patient’s desire to represent themselves electronically will be seen as a violation of the patient’s autonomy.

And then it’s ethically prohibited. You cannot violate the patient’s autonomy. And as I’ve [00:16:30] brought this up, I’ve had people who were critics and they said, look, you can’t argue that you have to let a patient do video telemedicine because it’s their concept of self because you may not have the technology to do that.

But if you are going to operate on someone, you have to get a consent form and your argument can’t be, we don’t have the ability to provide a consent form. Right. So I think that as we go forward, there’s going to become big ethical issues in how you actually deliver care. Like, do you [00:17:00] allow that person to get care?

Are we going to have systems that refuse to do it unless it’s done a certain way? There is a, you know, consumerism is a big part. This Ryan said the market may favor systems that use telemedicine, but I believe that it is at some point it will become so ingrained that you’re not really sure allowed to make a person insert a nozzle into a vehicle and put fossil fuel in it to get in it, to drive up to your facility just because that’s how you respect their [00:17:30] concept of self. And that’s kind of a, there’s a, it’s a, I know it’s an esoteric thing, but down the road, I think it will happen. I think that’s going to be a big issue.

Bill Russell: No, I think that’s, I think that’s huge. I mean, it’s. Yeah, I have a simplest form. It is consumer consumer choice, but you’re actually raising it into an ethical, level of ethical standard, which is, which is interesting in and of itself. Because when you were talking about setting up that room where the, the clinician comes in and whatever, and it sort of dawned on me as you were having that and [00:18:00] I’m sure this is not new to other people who have really spent time thinking about it, but, yeah, the reason the patient doesn’t want to see the clinician is because they’re they’re a potential carrier of the disease. And with our limited understanding of the, safety protocols that go on in hospitals, some people might even consider a clinician who is moving from room to room, patient to patient, those kinds of things, to be a high likelihood carrier of COVID-19.

And so, yeah, I. [00:18:30] I could see myself saying, look, I don’t want to come in contact with you. This is how I want to receive care. And yeah, you have to adjust to, essentially just a new norm. I knew if COVID is with us forever, then we are going to have to rethink a lot of the things we have done in the past.

And, You know, actually to close, I mean, because we’ve [00:19:00] chatted for a while here, but the thing I wanted to ask you is you purposefully, I think creativity happens in constraints. Right. The most creative people in the world to me are the people on license plates who like, say a complete sentence with six letters or seven letters you’re sitting there for, you’re sitting there at a stop light.

You’re reading it. And all of a sudden you go, Oh gosh, look at what that says. 

James Stallcup, MD: I stop for Twitter. Yay 8 characters, or what at seven characters. It’s amazing. I’m with you on [00:19:30] that. But I mean, I, I look at it. I love it. Okay. Just stare at that license plate. 

Bill Russell: So yeah. So you have, you have a set of constraints that you said, loo k we have this geographical constraint being that geography is so large. You probably have some financial constraints where you said, yeah, you know, we’re not going to spend a fortune and implement some massive tele-health system here. we’re gonna, you know, do a Cadillac service at a, I forget, what, what does the VW price 

James Stallcup, MD: Craiglist price. 

Bill Russell:  You [00:20:00] know  VW prices now are pretty, pretty up there, but the, but yeah, but I had a Craigslist price. So you have those constraints. Defining those constraints is powerful because now you can step back and go, okay, commodity hardware. We’re gonna utilize readily available, commercially available communication software that we can do a video visit, just like this. We can Zoom in, get enough quality, those kinds of things. Most phones we were talking [00:20:30] earlier about cameras. And you were talking about earlier on your podcast, you were using a certain type of camera. Then you went to a GoPro. And it’s crazy cause I found that the best videos I shoot come from this little device and you know, that same thing is probably true in healthcare. I mean, are there that many cameras that are 

James Stallcup, MD: Every patient and has a, every patient has a telemedicine station in their pocket. A smartphone penetration is very high in rural populations.

I can tell you that rural and [00:21:00] non-white relations are more likely to be reliant on cell signal is only form of internet. So that kind of adds credence to the argument of using the cell phone. When we predict who will use telemedicine, we take a map of the visits by zip code, from different zip codes.

And then we look at the broadband available, and then we look at the carrier cell availability and that’s a good way to kind of, you know, estimate where people will be eligible for services. And just to your point, I’m using a. [00:21:30] using a mobile device strategy, as well as your onsite strategy. there’s a lot of people who kind of talk about telemedicine who are hobbyists.

I don’t want to call them hobbyists, but you know, it’s not a big, you know, we had seven of our past nine weeks. We had more than 50% of our visits done by telemedicine across all 16 service lines. So this is, you know, a very big, it does work. People are happy with it. people don’t know they want rich communication until the first time they do it.

They think a phone is all right, but once you give them phone with video, [00:22:00] they love it. They come unglued. when we had, you know, when I’ve done it, working from home, they like it. Now they’re kind of like, this is the doctor’s house that I’m, you know, I don’t know what it is. There’s something like it’s a more intimate thing, but I’m going to say Mr. Russell, I forgot to say this earlier for those people out there watching this, you’re going to do telemedicine, allow your providers a way out, allow them a way out on every visit. So. On our sites, we have a escalation provider. This is a doctor onsite whose only job is to do visits [00:22:30] that are escalated less than 5% of telemedicine visits are escalated.

But when you have somebody with abdominal pain, they’re worked up in the room. All the labs are done. The radiology is done. Then our remote provider, our virtual provider pings the onsite escalation provider and said, Hey, I want to escalate one to you. They have this, this, this, that provider thing. He goes in and does the procedure, does the physical exam. Have a way that your providers can escalate the patients that need in person care and then you’ve removed [00:23:00] 99% of, you know, I mean, people are unfamiliar with technology. I get that. But if you allow them a way out, a way to escalate a patient, then you’ve just removed their fear, not scared of the technology. They’re scared of having somebody who needs in person care that they can’t get the care the patient needs.

So that’s my pro tip. Pro tip, give them a way out. 

Bill Russell: I lied. I’m going to, two more questions. One is broadband. So broadband cell access, somebody’s article I just covered was talking about broadband is really now defining the [00:23:30] haves and the have nots in our society. Do you have large sections of your geography that either are, or are not covered by broadband or not covered by cell service.. 

James Stallcup, MD: We do. 

We, we do, we have, you know, cell phone coverage is kind of ubiquitous, right? We have more trouble right now with, state medical board regulations than we do actual availability of some degree of coverage. So we’ve had patients who have driven down the road to park somewhere.

So that they could have a signal so that they could do a telemedicine, you know, [00:24:00] it’s uncommon, but it does happen. But we do have areas that do not have adequate broadband, what we would consider adequate broadband for video telemedicine. But these same areas are areas in which people have figured out that, you know, that that 4G LTE connection on their smartphone is better than the availability of internet in the community a lot of times.

So they just choose to use that. 

Bill Russell: Yeah, absolutely. I wanted to come back to you, your YouTube channel, cause [00:24:30] you’re doing a great service to the community. Talk, talk a little bit about what you’re doing. 

Okay. So this is going to be a 10 second. I’m not going to like plug it for a long time, like 10 seconds, you know, a little sales pitch.

So I teach interviewing. Right. I’m so impassioned about teaching people, having a job, 

Which side? So the interviewee or the 

James Stallcup, MD: interviewer? 

how to walk into a job interview where you’re trying to get a job and now compete everybody else. Who’s going do it because Mr. Russell is the only way you can have a super power on this earth.

Like if [00:25:00] tomorrow, if you decided to become a Grandmaster in chess, that ain’t gonna happen. If you decided to be a world, world champion boxer tomorrow, it ain’t gonna happen. But regardless of your innate skill, you can be a great interviewer. And the reason is cause nobody tries like nobody don’t, nobody learns how to interview.

I’ve done a bunch of interview. I don’t even know how many mock interviews I’ve done. I’ve interviewed a whole lot of people in real life. And I used to teach doctors. Here’s what you need to do in an interview. it got kind of popular. So we started making videos and got an online you to me [00:25:30] course, but it’s a, the YouTube channel is just James Stallcup S T A L L C U P.

You’ll see me on there. I’ve got killer mustache in the videos, like a gimmick. but yeah, just developing personalized content and figuring out how to deliver it. If you talking to the people who are going to a job interview, if any of y’all out there, think you’re going to go into a job interview and be yourself.

You’re going to get beat by somebody who knows what they’re doing. Your job is to develop, memorize, learn how to deliver personalized content. and then you’re going to go in there and kill it. It’s so easy to [00:26:00] dominate a job interview. I don’t know. 

Bill Russell: Well, 

James Stallcup, MD: I have no idea how somebody spends all these years of their life developing a skill, and then doesn’t even try and learn how to interview 

Bill Russell: Well, I’ll tell you what the, gosh, we gonna have a whole conversation on that. I’ve worked with people on their resumes now. It’s what I put out on LinkedIn post saying, Hey, I’ll help you. If you look for job, I’ll help you. You know, I’ll, I’ll forward your stuff around or whatever. And a bunch of people asked me to help them with their resumes. I looked at the resume. I’m like, okay, the first thing you need to understand is the resume is [00:26:30] a sales document and it’s going to be sitting there with 50,000 other sales documents. So you have to figure out what you’re trying to sell and, and that’s what you need to hit. And you don’t need to talk in terms of, this is what I did, then I did this, that I did this. You need to talk about what you created for the organization.

You know, I delivered this, I’ve delivered this, the organization move forward this because when I’m reading it, you get to think it, think it through from the other person’s eyes. When I’m reading it, I’m sitting there going, what can you [00:27:00] do for me? I mean, it is almost that crass because again, I’m reading a thousand, this is not an exaggeration.

There was one job. We got like a thousand resumes for it How much time do you think I’ve spent with each rev resume? I mean if I spent that, if I, yeah. If I spent a minute with each one, that’s a thousand minutes, I’m the CIO of an organization. I can’t do that. So essentially somebody else sorta calls it down and then I’m flipping through them and going.

Yeah. Yeah. And it’s interesting. Cause you just, you’re [00:27:30] just pulling out. I mean, you’re, you’re really pulling out snippets. It’s a sales document. People say I’m going to write, they spent too much time on it and they go, I’m going to get the job from my resume. No one ever gets their job from their resume.

James Stallcup, MD: Right. And the, you know, the, so this is a good point. Nobody ever gets the job from the CV. You know, you’ve seen my CV, it’s an infographic. I’m just got an infographic for my CV because when I send it out, they’ve never seen an infographic. Right. People like. This guy’s got little icons and what is it? It doesn’t let you know.

And so at least it’s [00:28:00] something right. It’s a strategy like walking into a place with blue suede shoes in 2020. And it was like, Oh, who’s this guy. So you nobody’s getting it based off the CV. I’m gonna throw this out there. Nobody’s getting it because they’re the most qualified. They’re getting it because they endear themselves to the person conducting the interview.

They’re the most, like if people like you in an interview, they will figure out a way to hire you. Yes. That’s one of the big things, you know, I’ve so many professional people. I know doctors are the worst about this. I’m in [00:28:30] doctors are in high demand and that kind of promotes laziness, but I’ve known doctors that they were like, I’ve done this, this and this.

I’m just going to go in there and they’re going to know I’m the most qualified and I’m going to get it. And I’m like, yeah, but somebody who’s really got an impassion story about how good they can. barbecue is going to go in there and beat you. And then they do people walk in there and beat them and they have no idea why I didn’t get it.

You didn’t prep. You didn’t do it. I mean, 

Bill Russell: I’ll tell you the other thing. When you get to the CIO level, when you get to a higher level, you’re going to interview with multiple people and doing the research ahead of time. like when [00:29:00] you’re sitting down with HR, that’s, they’re looking for something a little different than the CFO’s looking for, than the CEO’s looking for them and you almost have to figure out it’s like, okay, again, from their perspective, what is the HR person want to hear?

They want to hear somebody who really has a, you know, a certain approach to managing people, to being with people, to caring for people for following the. The guidelines that are set out by HR. I mean, they want to hear those kinds of things. [00:29:30] CEOs going to assume you have those things. They’re not going to ask those questions.

They’re going to, hey strategically, do you really know your, your space? And can you move the organization forward? CFO’s going to want to know, Hey. Are, are you somebody who just thinks that we should just spend money willy nilly? Or are you somebody who is creative and finds the best solutions for that for the right cost.

James Stallcup, MD: I was at an EHR a CMIO bootcamp. And it was so funny. I was like, why would an EHR company put on a CMIO bootcamp? But [00:30:00] they invited me. So I went and about five minutes in, they said, listen, Your job is not to police the finances of the organization. It’s to find the EHR solutions you like.

And I said, yo fam y’all are getting lied to, you need to say no, 99% of the time you will run out of money. You will bankrupt your organization. If you’re buying everything that comes along. If you get one out of four of these things implemented with any sort of outcome success or any sort of benefit to the patients, I’ll be surprised.

[00:30:30] And, it was quite the hot button issue. I ended up leaving that EHR conference in, I threw a hissy fit. I stormed down, forgot my iPhone, charger, had to walk back in and get my iPhone charger. And it was quite the, and we have, I’ve got a, I’ve got a guy that works with me as a PA. He’s awesome.

Like assistant CMIO. We’re kind of working through the job title right now, but in the middle of the hissy fit his name’s Jonathan. He’s a great guy. Super good at usability. In the middle of the hissy fit. I was like, I’m outta here. I’ve had enough of this. And I was like, [00:31:00] what? But Jonathan’s going to stay. He was like, there was a, it was a week long.

He was like, I had a week of sitting there having to put up with all these 

Bill Russell: people.

Yeah thanks for taking this time. I really appreciate it. That’s all for this week. Special. Thanks to our sponsors, VMware, StarBridge Advisors. Galen Healthcare, Health Lyrics, Sirius Healthcare and Pro Talentadvisers for choosing to invest in developing the next generation of health leaders.

If you want to support the fastest growing podcast in [00:31:30] the health IT space. Most of you can say this now without me even finishing it, the best way to do that is to share it with a peer stop. Right now, send an email, tell somebody. Hey, this is a great show. I’m getting a lot out of it. You’re gonna wanna check out these, these interviews and conversations.

The second best way you can do it is you can subscribe to our YouTube channel. We’re putting an awful lot of new stuff out there, and it’s exciting. The live show will only be available on the YouTube channel. It will not be dropped into the podcast channel. Some of you [00:32:00] asked me to drop it in last time.

But my team here internally wants me to stay focused on the strategy. And that is to have content that is specific to YouTube and, and to start to diversify our channels, if you will. So, some of that, some of our content will only be available on YouTube. So get over there and subscribe. So, you know, when it’s available, please spit check back off.

And as we’re going to continue to drop shows, On a daily basis through the end of June, or until we get through this pandemic together. Thanks for [00:32:30] listening. That’s all for now.