CHIME Darren Dworkin, A Look Back / Forward


Darren Dworkin

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The Healthcare CIO Look Back / Look Forward series with Darren Dworkin, Chief Information Officer at Cedars-Sinai

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 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 [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. 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 in the series is Darren Dworkin the CIO for Cedar Sinai in LA. Great conversation. Hope you enjoy. So Darren, thanks for joining us. Chime another, uh, one of the interviews. So we have a

Bill Russell: 02:08 eight prepared questions. Excellent. Cause what we’re going to do is we’re going to ask a bunch of CIO’s, same questions really. I look back and look forward

Bill Russell: 02:15 and, uh, we’re gonna start with the, uh, almost obligatory question, which is how the role change this year, not how has it changed over five years, but how does it change this year? Do you think?

Darren Dworkin: 02:26 I think this year more than most or maybe continuing of most, it’s getting harder and harder to pick what not to do. There’s a lot, there’s a lot of new technologies, new technologies, a lot of new operational imperatives. You know, the blessing of technology is that all of the operational, clinical areas want to embrace technology in some way, shape or form and get us involved. The curse of this of course is that every business unit and clinical areas priorities in some way involve it. And the reality is we can’t do everything well. And so this constant battle of sort of where we’re going to allocate time and resources is just getting harder and harder.

Bill Russell: 03:08 Do you try to focus on those things that you could really do well as opposed to doing five things mediocre? Is that a, is that a, a conscious process? You know, I’ll say that.

Darren Dworkin: 03:20 Um, uh, we’ve evolved a little bit. So I think that, uh, there’s no doubt that myself and many on my team have these like big views of what we can do well and where we should spend our time and what are, you know, a priority over another priority. The truth is that’s a never ending battle that I’m not sure you ever hit the right equilibrium. And so we’ve really embraced something that early in my career I was very opposed to, and that is turning over almost as much decision making as is possible over to governing groups. And when I say turnover, I don’t mean just sort of the dog and pony show of a meeting or two. I mean truly turning over and letting those groups decide and transparently see where all the conflicts are or competing priorities and ultimately help sort of pick where they want to go.

Bill Russell: 04:07 You’re like the third large system CIO who has said something to that effect of, um, I’ve removed myself from the decision making process. Not completely, I’m still an advisor, I’m still an I, I informed the decisions, but the business makes the decision on what they wanted.

Darren Dworkin: 04:24 The tricky part of that comes in two areas. The first is nobody’s gonna come to you and say, you know what? Yesterday, dial tone was spectacular. And I’ve been really thinking about this new upgrade plan I have for dial tone to make it even better. So, you know, we have to advocate for those projects. And then the other is that I think that one of the advantages that CIO’s have is it because we get to work across the organization, we can view and see the emerging platforms coming better than some of our colleagues. And so we often have to weave them together.

Darren Dworkin: 04:57 So I’ll give you a great example. Our uh, my counterpart in HR and my counterpart in finance, my counterpart in supply chain all are very excited about a new series of initiatives. They don’t naturally think of that as an ERP project. I think it’s our job to sort of tie those together into a platform.

Bill Russell: 05:17 Looking into next year, what are, what are maybe two or three things that you are going to do you think we’re going to focus in on from a health it perspective? Dial tone.

Darren Dworkin: 05:26 a yes to, I’ll tell it. I have this new idea for Deltona it’s going to be spectacular. Um, you know, I think probably the biggest challenge is going to be figuring out what the three of them are. Um, if I had to guess ahead though, I think one of them is we continue to grow and supporting that growth and really remembering that um, you know, when when we brought one area of the organization up to a certain level that becomes the expectation for the next level of the organization.

Darren Dworkin: 05:50 And so we’ve been growing quite a bit on the ambulatory side and so there’ll be a lot of that expansion, um, there’ll be the pressures and I would be remiss if I didn’t sort of highlight efficiency and trying to figure out how to do more with less than working smarter. I think automation has a big role to play there. I think a, what I’ll call operation or a practical AI will have sort of a real thread that can sort of weave in and then, you know, I think that there’s going to be sort of the everything else, all these other sort of new exciting areas. It would probably would be cliche to say it’ll be digital or digital transformation, but I think that we are going to continue that March towards thinking about it is not just its traditional B2B, but also now bringing in sort of our patients as consumers in the technology they’re going to want,

Bill Russell: 06:36 but that that’s, that is what it is. Digital transformation. When you talk about RPA going in and replacing yes, processes and those kinds of things.

Darren Dworkin: 06:45 I want to give you a great example because it just happened so on Sunday, my amazing team, while I was gallivanting here at Chime, I upgraded our EMR. They did a fabulous job. Not only did we upgrade the EMR, but we did four infrastructure upgrades. It went flawless, fabulous, fabulous, fabulous. But here’s the thing that we didn’t naturally think of. We notified everybody in the health system about the downtime really, really well and I’d like to think that we got a eight, a nine, maybe even a 9.5 out of communication. You know who we didn’t notify our patients that the portal would be down and some of their patient facing functions would be down and we just don’t think of that way. We thought of it the moment patients called our help desk to say, Hey, what’s wrong?

Darren Dworkin: 07:27 But up until then we hadn’t really thought about it. And I think we just need to start doing that.

Bill Russell: 07:31 I appreciate you sharing that. And which gets to the next question, which is, um, one initiative that you think will materially impact the patient or patient experience next year?

Darren Dworkin: 07:42 As we continue to offer digital tools to reduce the friction and access to healthcare. Unfortunately, um, we are closer to the DMV than we are to Amazon. One click and a, there’s not going to be an Amazon one click for healthcare. Uh, but there’s a lot that we can do to bring that closer.

Bill Russell: 08:02 But you’re bringing a lot of companies, through your accelerator. You’re bringing you a lot of companies in and there’s a lot of companies going after this patient experience space. Are we just not finding it or is it just too difficult to plug it all together?

Darren Dworkin: 08:16 Um, I think we’re finding it. I think though, um, you know, as the expression goes, healthcare is complicated and so it’s taking a little bit of time and like anything and you know, people process and technology. The reality is that technology is the easiest part. And so, you know, we’ve discovered with online scheduling is the actual digital tool of online scheduling is easy as can be normalizing schedules across ambulatory practices from the 1000 plus visit types to five that are schedulable, it turns out that takes a long time.

Bill Russell: 08:50 Yeah. It took us almost a year. Um, one initiative focused in on the clinician experience for next year. Do you think?

Darren Dworkin: 09:01 Um, we, um, are, um, amazed, um, or, um, continue to be amazed at the power of giving information back to physicians in their hands so they can see what’s happening. And so we have a couple of broad initiatives, but they all sort of boil down to the same thing of putting detailed information, report cards or other dashboard like things in the hands of physicians so they can see their own use of the system and so that they can be better at articulating where they want their improvements and where we can help support them.

Bill Russell: 09:37 Uh, greater success for it in 2019 quarterly updates?

Darren Dworkin: 09:42 Greatest success? Was probably in rounding out our team. Um, unemployment of technology in it in LA is a pretty low and we’ve made some really great strides of expanding and bringing in some really great people. And you know, it might be, uh, ironic to say, but um, the technology business runs on people and so without great people we’re not going to get great things done.

Bill Russell: 10:06 You know, it’s uh, it’s interesting cause I don’t think people recognize Southern California is really a hotbed for a lot of these companies are moving down for Northern California events. It’s, it’s the unemployment rate for technologist is really low and you still have to get cybersecurity expertise. You still have to get, uh, data, all sorts of data stewards and data scientists and whatnot. It’s the competition’s hard. It is, um, any missed opportunities for 2019 lots of them, any one come to mind.

Darren Dworkin: 10:40 I don’t think we spent enough of a focus of really, um, being able to launch our digital solutions, those sort of customer facing solutions and positioning them in a way that engaged operations enough. I think that we initially came out of the gate starting with them being very tech centric. I think we had a little bit too much of the disrupt first figure out what happened sort of next. And I think we sort of failed to understand the amount of process redesign that had to occur. And I think that, you know, honestly for a CIO and for many, there’s a lot of pressure that if you come out and say no to a digital solution, you’re quick to be cast as a Luddite or somebody that doesn’t quite get it. And I think, um, you know, one of my bigger regrets in 2019 was not finding the right balance between still saying yes to the very important initiatives that we wanted to move forward, but, uh, intertwining enough with operational engagement area.

Bill Russell: 11:40 Area you’d like to see more innovation at this point?

Darren Dworkin: 11:43 I think there’s a lot more we can do and everybody talks about AI. Um, I will say just reporting, uh, getting the right to the right person at the right time. Um, we have spent the last 10, 12 years painstakingly digitizing, enabling so much of the organization. You know, in our case it was really deploying the EMR. Um, yes, it’s true. We don’t have everything in structured data, but there’s so much more information we can figure out how to put in front of people at the right time. We have an unbelievably great leader over our data science and, uh, business intelligence team and I think he’s really helping me understand that the old worlds of self-service thinking it would be this magic button of you just sorta turn it over. It doesn’t really work because again, the data’s complicated.

Darren Dworkin: 12:34 But creating a service desk for people to go down the path of self service I think is really a big, big untapped opportunity.

Bill Russell: 12:42 So we’re not going to see the Google search button where I go tell me how many patients have whatever. That’s, that’s not anytime soon.

Darren Dworkin: 12:51 we might, um, and I guess the folks at Google will have to answer whether they’ll be anytime soon or not. But I think that, uh, my point I would make is that with all of the talk of AI and predictive analytics and fancy Google search buttons that I’m sure will be great. Um, there’s a lot of, you know, basic level stuff that we can do to make lives for our users a lot easier.

Bill Russell: 13:16 last question. Health it rolls, you expect to hire more and in 2020.

Darren Dworkin: 13:21 cybersecurity data visualization, um, you know, I, uh, those, those are two that come to mind. you know, again though not to be all over the place but not to also forget, um, you know, the, the folks that can do clinic, uh, clinical translation and help us continue to, to deploy and optimize and roll letter AMRs but those first two in cybersecurity, I think that there continued to be a big, big sort of, uh, amount of openings and opportunity there. And back to this data thing. Um, you know, I often meet folks and I tell them you should think about data visualization or a data role in healthcare and they say, Oh, I’m not a math person. I’m not a data person. Um, and especially to creative as I say to them that we need new ways to be able to view and consume the information. And so there’s just this amazing intersection going on right now and I hope the best people decide to hop into healthcare.

Bill Russell: 14:13 Fantastic. Darren, thanks for stopping by.

Darren Dworkin: 14:16 Thank you. Appreciate it.

Bill Russell: 14:17 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 if you want to support the fastest growing podcast in the health it space. Here’s a few ways that you can do that. The first share it with a peer, share it with a friend, share it with somebody who’s working right there next to you. Number two, sign up for insights and staff meeting. These are designed to help you in your career. Number three, interact with our social media content on Twitter and LinkedIn. Number four, post or repost our content. And number five, always send me feedback [email protected] your insights continue to shape the channel. This show is a production of this week in health it for more great content. You can check out our website at this week or our YouTube channel. Special thanks to our sponsors, VM-ware and health Lyric’s for choosing to invest in developing the next generation of health leaders. Thanks for listening. That’s all for now.

Bill Russell: 15:42 Our next guest in the series is there Dworkin the CIO for Cedar Sinai in LA. Great conversation. Hope you enjoy.