The Healthcare CIO Look Back / Look Forward series with Chani Cordero, Chief Information Officer at Carl R. Darnall Army Medical Center
The Healthcare CIO Look Back / Look Forward series with Chani Cordero, Chief Information Officer at Carl R. Darnall Army Medical Center
Bill Russell: 00:04 Welcome to this week in health it events where we amplify great ideas with interviews from the floor. My name is bill Russell healthcare CIO, coach and creator of this week in health it a set of podcasts and videos dedicated to developing the next generation of health leaders. We want to thank our founding channel sponsors who make this content possible, health lyrics and VMware. If you want to be a part of our mission to develop health leaders, go to this week, health.com/sponsor for more information. This episode is sponsored by health lyrics. When I became a CIO, I was really overwhelmed at first and one of the first things I did was to sign a CIO coach to walk with me through the journey. This was someone who had wisdom that can only be gained through years of experience. It was invaluable to my success in the role and I now coach CIOs through health lyrics.
Bill Russell: 00:55 If you want to learn more, visit health Lyric’s.com or drop me a note at [email protected] over the next three weeks. We have a huge treat for you. I’m really excited about it. Uh, I just got back from the chime fall forum in Scottsdale, which was a great event and we caught up with 12 active CIOs from various size health systems and asked them to take a look back at 2019 and I look forward at 2020. Uh, you’re going to hear, um, what they’re excited to have accomplished last year and what they’re looking forward to accomplish next year. I asked each of them the same eight questions and I think you’re going to be fascinated to hear the similarities and the differences based on where they’re at. Geography and other things. Each of these interviews is about 10 minutes long so you can listen to them really quick.
Bill Russell: 01:41 And some of you listen that one and a half times speed. So it’s going to go like that. Uh, we’re going to publish one a day, uh, with a few news day episodes sprinkled in through the end of November. So check back every day for the next episode and don’t forget to look back to see if you missed any. Our next guest is Chani Cordero who is the former chief information officer for the Darnell army medical center. She is now taking on a new role up in Monterrey, uh, is still with the military and she’s going to talk a little bit more about that. Uh, hope you enjoy.
Bill Russell: 02:13 So here was are from the Chime fall forum. I’m here with Chani Cordero. Wow. Look at all those ribbons. Bootcamp, alumni and uh, most wired, Oh, you guys were most wired.
Chani Cordero: 02:25 We were. So I’m really excited because this was the first time our hospital actually received that recognition and so I’m so honored to come and accept it on their behalf.
Bill Russell: 02:35 That’s fantastic. And that is a fair amount of work for that team. They really have to step up.
Chani Cordero: 02:40 It was, it was. And so the hospital is new. And so we had some, a little bit of help and assess because we were able to get our infrastructure in place compared to if, you know, if you have an older hospital that it has like old, you know, lines or whatnot. So we were able to do that and we brought in a lot of new equipment. So I think this year was the perfect time as we started optimizing what we had, we were able to compete for the recognition.
Bill Russell: 03:07 So you, uh, you have changed roles since the last time you were on the show and, uh, I mean, you’re prolific on social media, so I think a lot of people know, but w why don’t you give, so CIO and then you’ve moved to a new role?
Chani Cordero: 03:19 Right. So I cut, I just got there last week to Monterey, but I am now the, what we call in the military health system, a deputy commander administration. But it’s really essentially a COO role. And so when that role, I would be in charge of, um, our logistics, our, our budget, our, our managed care or the payer side in the sense of working out those network contracts or whatnot. And then of course the productivity side. So, you know, are we being productive in our, in our service lines?
Bill Russell: 03:51 Well, and how many hospitals?
Chani Cordero: 03:53 Um, so it’s just, they’re really actually kind of like super clinics and our two super clinics and we also have a, a share with the VA.
Bill Russell: 04:00 wow, that’s exciting. Are you excited? I assume you’re excited.
Chani Cordero: 04:03 I am. So, cause you know, even in, in private sector, you don’t typically see a lot of CIOs go to COO world in army medicine. And that’s not typical at all for us. And so we, you know, normally as a CIO, I stay in a CIO. So even though I’m not getting paid any more money, it’s essentially a promotion.
Bill Russell: 04:22 So yeah, as my dad says, we pay you an opportunity. So it’s, the army pays you an opportunity.
Chani Cordero: 04:29 Well, they sweetened the pot though, by allowing me to move from central Texas to the coast of California. So
Bill Russell: 04:36 yeah. So you’re up in, uh, up in Monterrey. Yes, yes. Monterrey is nice. That’s where pebble beache is, but it can also get pretty cold there too, can’t it?
Chani Cordero: 04:47 So compared to Texas? Absolutely. Absolutely. So I think the first night I went there, it was like 50 degrees and I’m like, I finally get to pull my Uggs out.
Bill Russell: 04:59 Yeah. We, I, I was up there probably about six months ago. I went up there and, and my son was up there as well, and he met up with me and he forced me to go play a disc golf. And I guess they have, they have a disc golf course where they played the U S open disc golf championship. We played that course. It was a lot harder than then really. I, of course, than I really should have been on. But it was a lot of fun.
Chani Cordero: 05:24 Yes. No, I mean, the weather there man is perfect all year around of me. So I’ve heard the only disadvantage of course is the cost of living. So I’m hoping I get to keep my two kidneys, but it’s debatable right now.
Bill Russell: 05:37 Uh, well, I’ll tell you what we’re, so I, I’ve asked these questions of 15 CIOs now. Okay. So, um, then my thought was it’ll be interesting to hear the different questions are different answers. And it has been interesting because I’ve just listened to all of them cause I did the interviews, um, you know, rurals, struggling with different things then then urban, then uh, different geographies have different challenges and those kinds of things. So it’d be interesting to hear, uh, somebody thinks from your CIO perspective, how do you think the roles changed over the past year?
Chani Cordero: 06:08 Um, so I think again, the role of the CIO is still to be a partner with like the proprietors and the clinicians or whatnot. Um, I think sometimes you still sometimes are, look, I jokingly say as the plumber, you know, making sure that technology works and not really being a place as a, as a partner. But I think as the organization continues to rely on technology, they’re recognizing that you have to partner up with it.
Bill Russell: 06:35 Yeah. So it’s moving from a plumber to maybe an architect.
Chani Cordero: 06:39 Good analogy. Yes.
Bill Russell: 06:40 So you’re sitting there planning the building and what it’s gonna look like with them instead of when they’re done planning it going, Hey, can you put pipes there? It’s like, no.
Chani Cordero: 06:49 Right. Exactly. Exactly. Exactly.
Bill Russell: 06:53 Uh, so I, I don’t know if you’ll be able to answer this, but you know, what, what are the priorities? What were the priorities where you were and how is health it going to support those priorities?
Chani Cordero: 07:03 No, I can answer that. Definitely. And so just like private sector, the military health system is looking at using a virtual health private or I mean a telemedicine. And so we, you know, my, my population is relatively healthy, right? I mean essentially we were service members or whatnot. And so I have that demographics that doesn’t require a lot of services. And so our bread and butter is primary care. And so when it comes to the telehealth, telemedicine space, it’s not as easy to go after a primary care in that setting. We’ve done quite well in the mental health space. And so if we have challenges, there is really more, more about the provider availability more so. And, and access more so than the technology.
Bill Russell: 07:48 So you guys, uh, you guys care for, um, the armed force, uh, the people within the army base, their families and anything outside of that
Chani Cordero: 07:59 and retirees. So not veterans, only retirees and their families.
Bill Russell: 08:04 Okay. That’s it. That’s interesting. So the reason I ask that question is that the next question I’ve been asking is, you know, what’s, uh, you talked about telehealth, but what’s one thing that if I were talking to that community, I could say, Hey, you can look forward to this, this, this is how we’re going to move the needle on patient experience.
Chani Cordero: 08:20 So patient experience is an area that we’re probably struggling more so than in private sector mainly is because my patient population is pretty well defined. So I don’t really have to market as much, if that makes sense. I’m not trying to be the brightest shiny object that come to my hospital, but our patients do have choices. So maybe not the active duty member. You don’t have a choice. You’ve got to come to us, but their families have choices. Retirees have choices and we are essentially a capitated model. So what does that mean is that we get paid to take care of those family members and if they choose to take their care to the sector that we’re going to be, we’re going to lose resources as well. And so we are looking at how do we, you know, how do we expand on the patient experience? But I had to admit it has not necessarily been one of our top priorities.
Bill Russell: 09:09 Well it’s interesting because on the other side, on the private sector side you would look at telehealth and go, well we can’t figure out how to get it funded. But on your side it’s completely capitated. Tele-health would be pretty well received. Hey and actually drive down a lot of the overhead of certain certain elements.
Chani Cordero: 09:29 Yes. The challenge that we have I think, and this Chani’s opinion is the security aspect of it. So we are very guarded with our information and we’re very guarded of who has access and ability and what platform it’s going to have access to that information. And so as we change our culture to partner up what some of those outside providers that allows for HIPAA compliant, um, applications of whatnot and allowing, allowing that to work, then I think will move the needle.
Bill Russell: 10:02 That makes sense. Uh, one initiative that’s focused in on the clinician experience
Chani Cordero: 10:07 clinic? No. So, um, I wish I could say yes, but not at my current hospital.
Bill Russell: 10:14 Yeah. Um, so thinking back to your team, what is chance to give a shout out to your team? What’s the, what’s the thing you’re most proud of that your team that you’re leaving was able to accomplish?
Chani Cordero: 10:27 So I think, you know, this may not something that’s very measurable, but I took a, it’s nothing very measurable, but I actually measured it, right? So when I first arrived, I did a real time survey on, on staff satisfaction and we did a, you know, using the application, web-based had up on the board for everybody can see. So when I left, I did that same survey and I wanted it and I compare the answers to see did we move the needle? And there were some areas that we moved the needle incremental. I mean we moved the needle. I, I had wished that we moved in more, but at least we moved it in all areas
Bill Russell: 11:12 and ended up positive
Chani Cordero: 11:13 in a positive direction. And so, but I, the lesson I learned from that though is you can’t change culture that quickly. And I really thought, you know, new leadership, you could change the culture really fast and it takes time. And I have to remember that
Bill Russell: 11:30 it’s interesting and there’s also a culture within a culture, right? So there’s the culture of the military and then there’s the culture of the army. Then there’s the culture that you have within your department.
Chani Cordero: 11:38 No, you’re right. Absolutely. Yeah. And,
Bill Russell: 11:40 and that same thing happens in, in the private sector as well. There’s the culture of the health system. Um, and I think it’s interesting cause we just assume, Oh, we came up with these core values and they’re just going to permeate health it. And it’s like, well you put us off on a building all by ourselves over here. And it’s sort of developing its own culture. So that’s something we really have to work at
Chani Cordero: 12:01 does we do we do. So one of my areas that I just really wanted to move the needle on it was just communication and not, you know, trying to break down some of the silos. And so again, you know, it wasn’t, you know, we didn’t reach the mountain top like I wanted to, but no one’s blocking each other on Facebook, you know,
Bill Russell: 12:23 moving it forward. Is there any area in healthcare as an industry you’d like to see more innovation
Chani Cordero: 12:29 specifically within, I’m sorry, within health?
Bill Russell: 12:31 Yeah, within healthcare that you think, wow, I really wish there was more innovation in that area that was moving. Uh, making things,
Chani Cordero: 12:40 it helps the health disparities. So you know, based on your zip code, your life expectancy is going to change. Right. And so, I mean, numerous studies have shown that that health disparities is real in the United States. And so, you know, our, you know, obviously the social determinants of health plays a huge role. Genetics plays a huge roles, but we need to be not, you know, as we try to keep people or patients healthy, we also have to recognize that not all patients are receiving that same level.
Bill Russell: 13:10 Yeah. Dr Klasko was talking, uh, in Philadelphia. He goes, you know, if you’re born in this hospital, that’s great. You know, mortality rate, we’ve done great work here. We’re phenomenal hospital. Uh, you’re, so you’d be brought in, but if you go home with a family that goes in that direction, your, your average age is going to be, you know, I forget what it was like 78 point whatever. If you go in that direction, it’s like 62. That’s like, so what’s different? It’s just zip code. It’s essentially, you know, in that neighborhood it’s harder to get good food. It’s, you know, there’s, there’s gang activity, there’s, there’s a whole bunch of issues that he goes, and the thing I appreciated about him is he goes, you know, I went to the board and we’re talking about compensation. They said, what’s important to you is that improving the health of the people in Philadelphia? He said, okay, my compensation has nothing to do with it. And they said, what do you mean? I said, well, let’s look at my comp. They looked at his comp, he goes, you’re right. It has nothing to do with the health of the people in Philadelphia though. All it has to do with this, the performance of the hospital. And so I guess, all right, if you want that to be, what, if that’s our goal, then I want 25% of my compensation to be the health of this community, which I thought was bold.
Chani Cordero: 14:28 So like you can’t do that by yourself. Right, right, right, right. And you have to care about the community and that you’re serving.
Bill Russell: 14:36 Yeah. Yeah. I agree with you. I think that would be, I like to see more CEOs sign up for that and say we’re going to, and you know, I, I, I’d be arrested. You don’t really do this. I, I surveyed the audience, the listeners, I said, you know what questions you want me to ask CIOs more in the future? And they said, ask them about what roles they’re going to hire. But you don’t really hire roles, do you?
Chani Cordero: 15:03 Um, you mean as far as in the whole slew, the CDO and chief innovation officer? Things of that nature? Um, as soon no, we do. I mean like I have a CTO, chief technical officer.
Bill Russell: 15:16 Do you hire them?,
Chani Cordero: 15:17 so, you know, it’s a misnomer. I’m really glad you asked that question. And just so, um, as we talk about our health system, uh, 78 people on my staff, only only two of us are active duty. The rest of them are federal contractors and federal employees. And so I have to deal with the same challenges that everyone has. I have a union negotiations. I have, you know, people calling out. I have vacation. I mean I have the same challenges. Um, labor issues I have, you know, if it’s a government shutdown, my federal employees may not come to work. So I mean, there is a lot of areas that we deal with and so, no, we, you know, we do hire, um, and um, and we have not, other than the chief technical officer, we have not done all the other alphabet soup.
Bill Russell: 16:08 It’s going to be because you’re in Monterey now, that’s you know, right down the street from Apple and everybody else. Um, it’ll be interesting to see, I mean from an health it standpoint, but you’re now over a larger group is still, it’s a challenge to hire in this.
Chani Cordero: 16:24 Oh no it is. Well it’s going to be well fine. Especially if you live on the coast. Right. So I have a resume for one of our positions and I don’t know if that person will be able to, how long they’re going to be here cause I don’t know. I’m not sure how they’re going to afford to live.
Bill Russell: 16:39 Yeah. somebody asked me about a roll up up in that area and, and uh, you know it’s interesting cause they said, well what’s the compensation? Who, you know, we went through the whole thing. I’m doing the math and I’m going. I I don’t think I can afford to take that job. I mean just based on the compensation and the area you have to move to and the cost of real estate.
Chani Cordero: 17:04 No, absolutely. That’s the one thing that I really appreciate the military do is that when a, the service members are looking to retire or transition to out, they have the, they have programs and one of the programs is actually teaching members that the compensation package rates in them. Why it matters, you know, the salary in California, it’s definitely going to be a different salary in Texas and what it matter, I’m say salary, but in a sense the impact of the, of your lifestyle and matters. So
Bill Russell: 17:32 well, congratulations on getting to California. The promised land. Well, we’ll find out.
Chani Cordero: 17:37 Yeah, right. Well the sunshine is already got me so,
Bill Russell: 17:42 well you had sunshine in the, in Texas.
Chani Cordero: 17:45 I had lots of sun I don’t know too much.
Bill Russell: 17:48 My daughter goes, Baylor
Bill Russell: 17:50 She left Southern California,
Chani Cordero: 17:52 I went to grad school. I went to Baylor.
Bill Russell: 17:56 Oh, did you? Yes. I’ll be on the phone with her and she was just walking around the campus. She goes, SIC ’em bears, what are you doing? So that’s sorta like saying hi, but her Southern California to uh, to Waco, Texas. I mean, her first thing was I, I’m not sure I was prepared for how hot it is and now she just called me and said it’s freezing. I’m not sure I even expected. Channi, thank you for joining.
Chani Cordero: 18:28 It’s always a pleasure. Thank you.
Bill Russell: 18:30 I hope you enjoy the conversation. Remember to check back often as we are going to drop an episode a day for most of November of 2019 following that, please come back every Friday for more great interviews with influencers. And don’t forget every Tuesday we take a look at the news, which impacts health it.
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Bill Russell: 19:49 [inaudible].