Kristin Myers This Week in Health IT
August 31, 2018

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EPIC’s UGM was held this week at Verona Wisconsin. Judy was in rare form saying things like “When I go to an innovation conference, I feel like a piece of meat walking around dogs. And I like dogs.” We unpack this and more with our special guest Kristin Myers from Mount Sinai Health System in NYC.

Did Judy Really Say That? an EPIC UGM recap, Plus Diversity in Leadership

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Bill Russell:                   00:05                Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is episode number 34. Today we discuss epic Ugm in Verona, Wisconsin. Uh, diversity and crm. This podcast is brought to you by health lyrics. Health systems are moving to the cloud to gain agility, efficiency, and new capabilities. Work with a trusted partner that has been moving health systems to the cloud since 2010 visit health to schedule your free consultation. My name is Bill Russell. recovering healthcare cio, writer, and an advisor with the previously mentioned health lyrics. Before I get to our guests, I want to make everyone aware of a great resource for your it teams this week in health It has a youtube channel with great insights from industry insiders like our guest today, short segments, complete episodes, all curated for easy access right now, up around 275, 280 videos. I have a team of millennials working to make it very easy to, uh, uh, to identify, uh, videos just on analytics or videos just on Ai. And those kinds of things. So check it out [email protected]/video. Easiest way to get there or you can go to the youtube channel and just search for this week in health it. Today’s guest joins us from beautiful New York City. Kristen Myers, SVP for Mount Sinai health system. Good Morning Kristian and welcome to the show.

Kristin Myers:               01:23                Good morning. Thanks for having me.

Bill Russell:                   01:25                Well, I’m looking forward to our conversation because you are a freshly back from, uh, the epic Ugm conference. Couldn’t have found a better person to have this discussion with. And I’m looking forward to your insights later on the, uh, on the soundbite section. But first, before we get going, tell us a little bit about Mount Sinai health system.

Kristin Myers:               01:45                Sure. So Mount Sinai health system, it’s an academic medical center that has seven hospitals, over 6,500 physicians over 300 locations, 30,000 employees. So we’re the largest New York City employers and very much focused on an integrated health system and really ensuring that we’re able to provide care know from birth to the end of your life.

Bill Russell:                   02:14                Wow. Thirty, 30,000 employees. Um, I have a friend who always says that every business is a people business. Every problem is a people problem and when you have 30,000 people, I would imagine coordinating projects, rolling projects out, communication. That’s, that’s probably one of the biggest, biggest challenges for someone in your role. Um, and well actually give us a little idea of your role. I didn’t really cover it. So give us a little idea of your role at Mount Sinai and then I’ll go through some of your bio.

Kristin Myers:               02:45                Sure. So I oversee the application strategy and application portfolio here in the technology department and we have over 700 applications that was due to the merger that took place with Continuim health partners around four years ago. And there wasn’t a lot of synergies between the application. So what we’re doing now is looking at, you know, all of the roadmaps for the applications and working out how do we actually rationalize, come to enterprise platforms and be able to decommission some of the legacy system. Yeah, we have around 700 apps at this point and I think that our approach is really around enterprise platform, so epic for our clinical and revenue cycle, oracle for Erp and we’re also looking at a crm, a customer relationship management platform. So I have direct responsibility for the Epic team. Also the IT Program Management Office and Change Management Office. They oversee around $100,000,000 in capital projects a year, uh, interoperability and also clinical ancillary

Bill Russell:                   04:06                I mean we could do a whole show just talking about application rationalization and platforms. Platforms is the, is what every it organization is looking to get a, to get to platforms being open, the ability to programmatically access the information, create workflows on it. So yeah, those are some interesting. And I’ll look forward to. We’re going to talk about crm a little bit later. So Mount Sinai for about 14 years pm at Cap Gemini, but you started your career in Australia are clearly, that is not a New York accent that you’re sporting there and you did spend a couple of years with Cerner, although, um, I think we’re going to find out here that while we already found out that you are an epic shop at, uh, at Mount Sinai, so, um, so one of the things we’d like to do with our guests and uh, just to just open it up and say, you know, what are, what’s one thing that you’re excited about or that you’re working on today that you just want to share

Kristin Myers:               05:06                So I’m working on the customer relationship management strategy, uh, here at Mount Sinai. And that’s really exciting to me because being able to understand our patient population and have a 360 viewpoint on all of our patients I think is so important. And how do we personalize how we are able to communicate with them? What are their preferences in relation to text or email or phone? I mean, knowing that and being able to actually engage them in a better way. I think it’s important for health systems to be able to have that knowledge of the consumer. So that’s what I’m working on today. We’re going to be releasing a crm rfp in the very near future. We have crm already implemented in pieces of the organization such as marketing and a population health group and business development, but we’re looking for one platform across the enterprise and the use case is really around the center and you know, how do we provide our call center agents with one platform so that they’re able to see, you know, whether it’s a patient’s first day, how they want to communicate. What was their experience at one of the physicians offices? Did they make a complaint? Did they have a great experience? You know, what does the press Ganey scores, you know, all of that. I think it’s so important.

Bill Russell:                   06:41                Crm is interesting. When we took a look at it at the health system where I was CIO, you did have multiple, multiple crm systems in place. We had some clinical systems that we’re trying to do crm type features and then we had call center systems that we’re trying to do some crm type features. Um, but when you try to orchestrate a patient experience across, I don’t know, 15, 20 different systems, uh, you know, it was hard to move every patient touchpoint across there so that everyone sounded like they at least worked for the same company. Um, and I assume that’s one of the challenges that you guys are facing.

Kristin Myers:               07:24                Yeah and I was reading actually, some of the Gartner reports around crm and you know, only about 20 percent of health systems that actually are implementing crm are able to get an enterprise solution. And I think the challenge is who is the operational owner? Uh, it touches nearly everyone in the health system so I think getting that sponsership around, know who actually is going to be driving these decisions is problematic at many health systems. So we’ve been very lucky that our executive team clearly understand that this is a priority and they really supported the ability for us to go to RFP and have an enterprise strategy.

Bill Russell:                   08:13                So on our show, we do two segments. We do in the news where we each pick a story to discuss. Today we’re just gonna. We’re just gonna Focus in on the, uh, on the conference and talk about different aspects of that. And then we’ll do a soundbite section where I’m more of an interview type thing, just ask you a couple of questions, um, which we’ve discussed ahead of time. So people don’t think I’m just gonna try to stump you here. Um, so in the news, I’m going to have you kick us off since you were there. Give us some idea of, you know, what, what was, I assume it was a festive kind of mood and you know, what was, what was the atmosphere and then what were some of the key themes and topics from, uh, from the conference

Kristin Myers:               08:52                You know I’ve been there, at Egm for the last 13 years and this year was a great experience as usual. It was great outdoors theme and I think one of the focus areas for a epic is around patient experience and access. And so I was really pleased to see at some of the usability sessions, you know, focus on their, my chart, which is the patient portal and how they are ensuring that the Mughal version of my chart is exactly the same as the web based version and when we’ve had some issues here where, you know, we have initiatives such as open notes where we’re being very transparent about the progress notes that the physicians are writing on my chart, but that’s, that can only be seen on the my chart desktop, not on mobile and you know, many of our patients do not have access to the Internet and then not able to see that version of my chart so they only have the mobile version. So I think the ability to have all the functions a consistently is going to improve patient experience dramatically. Uh, they’ve changed the look and feel. I mean clearly there is a lot more focus on user experience and how to engage the patient. So that was a pleasant surprise that they’re really moving in that direction. I was placed with that

Bill Russell:                   10:27                mobility. The numbers continue to stagger me. I mean, just case in point, this, this podcast, I think it’s like 95 to 97 percent of all listens, will come on a mobile platform, a hits, hits to the website is, is almost a 95 percent from mobile phone as well, which actually I’m not surprised that it leans in that direction, but it’s a little high for me considering that a majority of our listeners are healthcare users and healthcare users generally, are web type users. But if that’s just the transformation that’s going on, people are mobile and so everything we do now, and it has to have a mobile component for how you’re going to show notes, how you can show the medical record, how are you going to do scheduling online. So that’s really fascinating. So let me, I’m going to tee you up and I’ll tee you up with some of the articles that have been written.

Bill Russell:                   11:24                Some of the tweets that are out there. We’re going to look at four main thing. So, uh, some, uh, Judy’s comments early on this, this is really around innovation and startups. A faulkner acknowledge that there’s a lot of buzz around digital health today. Many leaders in hospital it departments have words like innovation, uh, and have titles like innovation analytics, digital data, and their job titles. She said most of the titles barely existed 10 years ago. Uh, I assume you’re seeing these kinds of titles emerge. Do you, um, are you seeing that people with these titles of chief innovation officer and chief data officer analytics offers, are these reporting into it? Are you seeing them outside of it? And, and what kind of models do you see sort of emerging around these new titles?

Kristin Myers:               12:10                No, I think that healthcare as you know, I mean sometimes lags behind the rest of the industries such as retail, ect. You know, this has been going on in those industries for quite a while and we’re seeing chief digital offices and chief data officers in the business at other health systems. Uh, we recently actually were able to hire a vice president overseeing a consumer digital and you know, that person is in the business and I think that that is a model that you’re going to see more and more of a, not necessarily in the it department.

Bill Russell:                   12:57                Yup. Yeah, I think we are seeing them while we’re seeing a lot of different models. That’s why I put the question out there. I mean, we are seeing it really tied to the business. We’re seeing some in it and then we’re seeing some departments that are purposely being kept separate so that the, uh, I think, I think how Rod Hochman and described it as the organization, the culture of the organization doesn’t crush innovation, uh, is how he described it.

Kristin Myers:               13:24                we’re Very lucky. I mean we’re an academic medical center and so, you know, we have a lot of innovation occurring not just within the it department but also in operations and also in our research and genomics division. So, you know, there’s a lot of innovation occurring here and that’s, that’s what makes it exciting. And you’re able to partner with these teams and actually work to get great solutions out there.

Bill Russell:                   13:55                Yeah. And so, which is why I find these so innovation startup. So Judy went on to say, there’s so much money in silicon valley for startups. When I go to an innovation conference, I feel like a piece of meat walking around dogs. And I like dogs. She goes on things. I just found these kind of comical. Uh, I assume people laughed at that startup sit at one end of the spectrum of the technology business at the other end are a giant gadgets, gadgets and software makers like Amazon, alphabet, apple, uh, in, uh, in addition a faulkner mentioned ibm, Microsoft, Netflix, Walmart, uh, among others. We’ve talked about others on this show. It’s too early to say how they’ll fare, but some big companies from outside the industry who have struggled to impact healthcare in the past. Uh, see Google health and Microsoft health vault inside. Faulkner said in her keynote that it’s hard to make meaningful advances in the area as complex it.

Bill Russell:                   14:50                And she went on to say that the EHR is the most complex area in the world, which is health operates in the area that’s the most complex in the world, which is healthcare. She said, I think it’s more complex than rocket science. Um, you know, is epic saying, look, we’re in your corner as they’re saying to this crowd, which is health systems. We’re in your corner. Our intentions are good. We’ve made good progress together. Don’t look somewhere else for a shiny object to solve your problem. Uh, their intentions the silicon valley people may not be good. They’ve failed in the past as, as has been noted. Um, you know, this stuff is really hard. Uh, do you think these comments are a form of a a fear, uncertainty and doubt around startups and tech companies because they are starting to capture some attention within this space and, and, and do hold some promise. I mean, what, what do you think her thinking was behind it? Really those feisty comments about a tech startups and the established players.

Kristin Myers:               15:52                I think she’s concerned around some of these applications not being hipaa compliant. And, you know, I think that we’re all aware of what’s gone on with facebook and Cambridge Analytica and you know, I think that her concern is around patient data and making sure that, you know, patients aren’t being directed to inappropriate services or that the data is being shared in a way that, you know, clearly that the patient doesn’t understand and they’re being subjected to advertising, et Cetera. So know I think that that was probably one motivation. I think the second would be around fragmentation of workflow. And I think that that is one of the challenges as it relates to digital health is how do you incorporate these applications in such a way that it actually makes the workflows more efficient for our physicians and our other providers and nurses and within a hospital system or a healthcare system, but also from a patient access system. Um, and the consumer experience, you know, just having, putting apps out there. And is very confusing for some of our patients. I think that there needs to be an intentional comprehensive strategy around how do consumers and our patients actually access care at health systems. And it needs to be a very seamless experience and not a lot of healthcare systems are actually doing that from my opinion.

Bill Russell:                   17:35                Yeah. So, um, this wasn’t one of the topics, I was gonna take you down, but I assume there was a lot of conversation around physician burnout and making the system easier to use. I mean, what, what, what were some of the things that you heard around that topic?

Kristin Myers:               17:48                I think physician wellness is a huge issue and in fact we have a chief wellness officer at Mount Sinai and we’ve really aligned some of our optimization efforts, uh, with, uh, his efforts also, you know, I think that the way the systems are implemented at times, um, it is a lot of ways to be able to achieve, you know, the same workflow and then needs to be an emphasis on simplicity and efficiency and making sure that the physicians and, you know, their support stuff, you know, really understand, you know, the tips and tricks and the shortcuts to be able to get through, uh, their office visit in the shortest amount of time. And you know, I think that’s been an emphasis from epic that been, you know, very much focused on this and you know, being great partners working with us on our own optimization efforts,

Bill Russell:                   18:55                Yeah and a lot of the challenge you know 30,000 employees not all of them use the EHR. But what we found in having physician champions around the different hospitals was there was just, there were some physicians that were using the system so poorly. They hated the system, but when you sat there next to their elbow and said, hey, did you know this was available because they didn’t have time to go to the full training or they didn’t have time to do that. That a lot of it was just, which is training and, and communication of how to use the system better. That just takes time to propagate that.

Kristin Myers:               19:28                Well. And that’s the challenge for us is we have over 6,500 physicians in our health system and so we’re taking a two prong approach. One is to have optimization teams go out to the practices and actually shadow the physicians, which we find is pretty much the most effective way to teach them at the one on one at the elbow youknow these shortcuts. But we’re also taking an approach of trying to push content out in an enterprise way and deliver these 10 minute videos that are very quick that they can watch around these shortcuts and, you know, going to their departmental meetings, but it’s a huge amount of work and I think that it’s labor intensive and trying to find different ways of being able to do this at scale has been challenging. So we’re looking at developing the power users and the departments getting more physicians builders out there who can really work with the departments, you know, not independently completely, but you know, have a lot more autonomy, you know, we’ll still have governance that we need to be able to get a more of this configuration work out there in The department.

Bill Russell:                   20:48                Yup. Absolutely. So getting onto the next topic. So a interoperability, a judy said, enabling seamless data visibility across epic customers via one virtual system worldwide would improve patient care and allow for idea sharing that could lead to medical breakthroughs. A epic is working to take interoperability globally. Uh, Judy told the attendees, uh, you’ve, uh, let’s see. She goes onto say, you’ve eliminated the silos from within your organization, said Faulkner speaking at the conference. Now it’s time to eliminate the silos from outside faulkner’s referring to epics, one virtual system worldwide initiative which launched earlier this year. The initiative enables clinicians across all organizations using epic to more easily gather, share, and interact with health data, no matter the location and presents it in a unified view. So I’m going to, I’m going to spin this a little bit. Let’s take this from a different Lens. Um, interoperability, as we’ve talked about, is really good for patients. We believe it’s good for patients. How do you think you and I as patients will benefit from one virtual system worldwide? And are there any risks or drawbacks to us? The patient?

Kristin Myers:               22:02                Well, I get back to not every organization has a, uh, has consent, uh, implemented and in a way that allows a prospective consent, meaning the ability to share that data. And I would also say that many EHRs, especially in the ambulatory setting, uh, don’t necessarily have the capability of being able to share that data in a real way. Um, you know, there’s a cost associated, especially for voluntary positions that, you know, they may be solo practitioners or a very small practice and having the ability to actually share that data with large hospital system can be very, very challenging. So I think that, you know, while I shared the vision, uh, from an ethics standpoint, I think that, you know, on the ground, there are a lot of challenges surrounding this now when you’re going to say if you’re working at an epic to epic site, it’s amazing. You know, I have been a patient at a different epic sites and the ability for physicians to be able to see, uh, you know, the data from the other sites in a prospective way has been fantastic. Uh, the challenge is, you know, when you’re going to these small voluntary offices that don’t have that ability to share the data.

Bill Russell:                   23:38                I was with a kaiser physician last night, a kaiser permanente and I was just asking, you know, what’s the, what’s been the biggest challenge in benefit to the EHR? And obviously he was just talking about within Kaiser, but he said, he goes, yeah, we, once we got it implemented across the board, he said it’s amazing how much time it saved, how much it, uh, organize the care protocols. But he said, but for the patient, uh, within, within the southern California market for Kaiser, and he goes, you know, we just, uh, the communication is so good. And the, uh, the patient experience has gotten so much better because they, you know, he goes, I am aware of all the tests they’ve had. I am aware of their history, I’m aware of whatever. And so if we can create that across health systems, that’s great. As you said, you know, for an epic to epic shop, uh, I don’t have to worry about, you know, does my house have a good HIE strategy, do they have a good a mechanism in place? And uh, at least from, from that standpoint, and even you know cerner has their, uh, their, uh, ability to do that across their partnerships. Um, but it would be nice to see that across all the EHRs. And I think that’s what we’re. And, and Judy actually noted that they do share across multiple Ehrs with that platform utilizing fire standards, I believe is what she was talking about.

Kristin Myers:               25:02                Yeah. I think, you know, there are organizations, other vendors like Athena House that are really progressive. I think that they actually, epic and Athena health have the ability to exchange health records very easily and I know epic has exchanged records with many, many other emrs It’s unbelievable. But there’s still emrs out there that it is problematic, uh, to share. Uh, some of the data with

Bill Russell:                   25:33                yeah. And we’re not going to mention any names here on those difficult ones, there’s no wall of shame. so research and discovery. I thought this was one of the more interesting and, and, uh, I think hopeful things that was talked about the conference. So that’s a, what epic is calling cosmos and that’s the world’s largest, uh, a clinical database of information, a De identified information that can be used for, um, uh, be used for research and research purposes, which I assume as an academic medical center, uh, you know, this is, this is a huge benefit to organizations such as yours and the Biden cancer initiative and other things like that. Um, you know, I didn’t get much from the stories that are out there. I assume this is more aspirational at this point. Not there were there actually. Were there a lot of detail shared. I guess I should just ask the question on, on what cosmos is going to do when you can have access to it and who’s gonna who’s gonna benefit from it?

Kristin Myers:               26:29                you know, I did not see a lot of information, shared We had out shief research informatics officer, uh, also attend the session and you know, from, from that we decided that we’re going to bring epic on site, uh, for deep dive with our research community because, you know, the information that we received, you know, was, it was light on detail at this point.

Bill Russell:                   26:59                But it is exciting The more information that’s available to researchers such as the ones that Mount Sinai, it’s, it really is. It’s going to benefit humanity that we just have better research being done based on the data,

Kristin Myers:               27:16                the ability to share the identified data amongst other institutions and being able to collaborate that way is going to improve research exponentially.

Bill Russell:                   27:30                There’s a lot of arguments over how and who benefits and where does the money go and we’re gonna avoid those in this because you have a hard stop and I want to get to the other questions so safety and privacy. The last thing she has, she mentioned Zuckerberg going to the hill, Cambridge Analytica, you mentioned it earlier. Um, so epic plans to develop tools that went third party software applications, healthcare providers and Ehr vendors have being the other party’s ask patients for permission to access their medical records. Epic can tell the patient what the application is likely to do with their information. So epic’s going to act as this sort of gatekeeper to say, Hey, what, what are your intentions? And then they pass that information along. A critic of epic have previously called the company software closed platform and argue this software was limited and its ability to easily exchange data echo has muffled some of those critiques by configuring and keeping a tools to be able to share information that their participant obviously with apple’s health kit, uh, there they participate with fire, they’ve open API while they have apis through apple orchard.

Bill Russell:                   28:38                Um, and, uh, let’s see, social norms have changed and if patients want to share their data, they should be able to sit submit. Ronna Ronna said that a typical method, a medical record not only contains identifying information about patients, but also genomic data and information about their family and family history. For example, above all, people should keep in mind that longterm consequences of clicking I agree on a computer or smartphone apps, terms and conditions screen and she closes out by say or consider, consider the implications of uploading the protected health information of a minor as an adult. That could be a, could be very upset to find that mom opted to share their personal data with an APP 20 years ago in exchange for bonus points on their favorite game. Um, so how was this received at the conference? I, I’ll give you a, you know, just some, some things that I’ve heard from the development community. Uh, but how is this received and what your thoughts. I just, you know, how was it received at the conference? I guess

Kristin Myers:               29:46                for the people I spoke to? I think everyone thought that, um, you know, epic’s intentions were really good. I think the challenge is going to be around the vendor reaction around this and you know, are they going to be collaborating with Epic a long term if this is the way that you know, is going to be working with the third party. So, you know, I think more to come on that, but I’m interested to hear what you heard from the development community.

Bill Russell:                   30:17                Well, it’s interesting, the development community is scared of epic so it’s, you know, so I get these comments and I’m like, so do you want to come on the show and talk about this? And they’re like, no, I don’t know if I come on the show and talk about this, it could decimate my company. So I just, I just share what I’ve heard and really no commentary on it. Just, just, you know, the foundation for this thinking is that the patient needs to be protected from themselves or better yet that the patient no longer holds sway over the record because a, it really holds information about the family. If you get my DNA information, if you have my genomix, you’re really getting information about my daughters and my son and, and uh, and I’m, I’m sharing that information or I might share their information, uh, when they’re a kid.

Bill Russell:                   31:00                So it’s an interesting new tech take, but it’s the foundation is we need to protect you from yourself. The fear factor being you don’t want to be, I mean, the fear factor that she sort of laid out there was, you don’t want to be the next one on the Senate floor, like Mark Zuckerberg sweating while you know, you’re getting grilled. Uh, and it really is a fear, a fear factor, and it’s, it’s brilliant marketing. Also sort of pushing people in the, uh, in the epic direction. But here’s what I’m hearing is, um, you know, it, it, it really places the attendees in a position of a, first of all, they feel like they’re doing the right thing. They’re protecting the patient by limiting their options options to access the data. Um, and epic now access to the ultimate gatekeeper in the role. You want to innovate on our data.

Bill Russell:                   31:52                Uh, you have to ask permission, pay the toll, and we will determined if your attentions are nefarious. Oh, and by the way, if you read Epics agreement nefarious can be defined as bad for the patient or just bad for epic. If it’s competitive to epic, it can be bad. Uh, and so these are the things I’m hearing from the Development Community, which is, okay, so now epic controls that data. Um, and it’s not really epic’s data, it’s the patient’s data. And if it’s not the patient’s data, we can argue that it’s this health system’s data. At the end of the day, uh, you know, there’s, there’s, this is a very nuanced argument. I get both sides. I get, I get judy saying, Hey, look, we’ve got to protect. We’ve got to create a mechanism where people know what they’re agreeing to. We don’t want them giving away information to bad parties. I get that. I get epics intentions, but I also hear that the developing development and innovators saying, Hey, wait a minute, do you realize how much I have to pay Epic to get access to this data? And when I do, I have to follow their rules and I can’t compete with them and I can’t and they could easily come out with something that crushes our company in two years. Uh, so I, I hear both sides of it. I don’t have an answer. I’m just sort of teeing it up, I guess.

Kristin Myers:               33:06                Yeah. And I also think for the academic medical centers that, you know, are, you know, doing their own innovation and, you know, working on their own products that they ultimately commercialize, such as, Mount Sanai you know, we’re going to have to work through that with epic and how does it impact us as an innovative health system and you know, as well as other third party, uh, because sometimes epic does differentiate between, you know, the health system innovation and the third party vendor, uh, innovation. So that will be a nuance, will have to work through with them. And you know, the devil’s always in the detail with Epic and they do listen to customer feedback. So it will be a topic that we engage them on pretty quickly.

Bill Russell:                   33:57                Well, we’re going to get into the questions, but just so people don’t think I’m wishy washy, I’ve been very clear on this. I believe that the patient owns the record. I believe regardless of if we can trust the patient, uh, it’s not really a place to protect me from myself. It’s my data. It’s my health, it’s my children. I don’t want the government that tightly overseeing what I do. I definitely don’t want epic tightly overseeing what I do. I’ve been on the record as saying that I just don’t want to come off as wishy washy, but what’s that being said? I understand. I completely understand Judy’s intentions of protecting my parents who don’t know technology and can click on things which I get it. I understand where they’re coming from. I don’t like it, but I get it. It’s a very difficult problem to get. So let’s, let’s go onto the questions. Um, there’s a quick section, you know, shorter, shorter answers are great because we’re going to cut these up into videos and put them out there on the youtube channel and out on social media. Um, so five questions. Let’s just rifle through them. First question, uh, what are some of the new business models that you, uh, you’re seeing within healthcare and that are really changing healthcare at this point?

Kristin Myers:               35:06                you know, I think that health systems are moving in a direction of being integrated outcomes based and now being able to really support empowered consumers. And it goes back to some of the topics we were talking about earlier around mobility and customer relationship management and how do you engage the patients and I think that health systems are going to be exploiting digital platforms ultimately to support these business models.

Bill Russell:                   35:40                Um, so second question, um, what are, what are some of the digital trends that you’re seeing within healthcare?

Kristin Myers:               35:50                We talked about mobility. We talked about crm, definitely telemedicine, um, there’s a lot of trends in machine learning, predictive analytics. We actually had the head of our data science team do a great presentation at the epic Ugm, Robbie Freeman on some of the predictive models that Mount Sinai has developed independently of epic and then ingested it into epic around sepsis. So I think that that’s definitely going to continue to be a trend, wearables. Blockchain, um, you know, I think that they’re probably the major trends,

Bill Russell:                   36:37                I was at one day of a conference this week where I got to hear the head of Nividia talk about ai and it was fascinating to me to hear a one of, one of the more fascinating things that he said was, um, you know, that the next generation of data programmers are going to be the data scientists, not necessarily programmers to write code because the AI itself is going to write the code, but what you’re going to do is you’re going to present the data to the, uh, to the AI in a way that the, the, that is the person that’s really going to dictate how a new algorithms and new code gets written. And so I think, you know, the combination of all these trends, digital trends that you’re talking about is it’s going to be really exciting and impactful for healthcare. A third, third question here is we see some health systems investing in crm.

Bill Russell:                   37:30                So let’s go into the crm conversation a little bit, uh, more. Um, where do you guys seeing it? Where do you see it fit within your health system? And, uh, and actually I’d love to hear you answer the question of who does own it within a health system that has been one of the more interesting challenges. Is it a marketing initiative? Is it a pop health initiative? Is it a medical group, a initiative? Is it a, the call center initiative? Um, you know, where, where does it fit in healthcare and, and, and who owns it?

Kristin Myers:               38:01                Yeah. I don’t think that it fits into one particular group that really is the challenge. I think that it all comes back to governance and you’ve got to be able to work with a number of responses. So in our case it is the chief strategy officer and also the head of population health and ambulatory care who are driving this initiative that again, we’ve got governance that brings in every group across the health system to engage them. So we have a marketing there, network development, our access center, a hospital operations, you know, all represented in this governance model. So, you know, I think that we’ve got the right engagement. But again, this is why enterprise crm, sometimes fails in health systems, because there isn’t one owner, um, as you correctly identified,

Bill Russell:                   39:05                so you’re going to have your Ehr, you’re going to your Erp and now you’re going to have crm and these are going to form a, a pretty strong platform foundation across the board. And as we’ve become more customer centric, I see a lot of health systems looking at crm. I don’t see a lot of them implementing crm, uh, on a, on an enterprise scale. So we will definitely check back with you after you get done with the, uh, after you get done with the, uh, uh, the RFP and see how the implementation goes because I think a lot of people want to hear success stories around how it gets, how it gets done. So a fourth question, what challenges do you, uh, are you seeing it departments face and, and, uh, and how do I, do it departments really need to adapt or change, do you think?

Kristin Myers:               39:57                Few areas. One is many it organizations have built in a functional model and they’re organized in that way and not necessarily aligned with a service type model which is aligned with the business and I think that sometimes organizationally it needs to change to be more aligned with the business and I also think that the competencies and skill set of seeing when the it department is changing rapidly and we talked about both those digital health technologies and trying to get a, the technology teams up to date on what’s going on in the marketplace and educated in these technologies and again, giving them other skills. I think that the soft skills around emotional intelligence, communication, understanding strategy is going to be more and more important as time goes on and know many organizations are going through this where you know, infrastructure and legacy applications become commodities and become managed services or even offshored. So we need to focus on where the value is and the values with the business?

Bill Russell:                   41:21                This is becoming a recurring theme. So Ed Marks from Cleveland Clinic, talked about embedding it in stand up huddles and I know that Dr Anthony Chang, when he was talking about Ai, talked about how the analytics teams in those, uh, those lean huddles and those does rounding with the physicians as well.

Kristin Myers:               41:43                We, uh, we have business relationship managers that are rounding with hospital operations every single morning at every site.

Bill Russell:                   41:51                Yeah, it should become harder and harder to identify, you know, who the it people are and who the business people are. And we’re seeing a lot of clinicians, um, you know, head in this direction of an analytics career path or a or, you know, making, making sense of the Ehr or even programming the eHR. We’re seeing a lot of, uh, you know, people take that, that degree in and head in those directions. It’s, it’s fascinating to watch. Um, and, and you know, this is a topic I want to give you some time on because I know that you’re, you’re an advocate for women in leadership and diversity. We talked about this last time we were on the phone. Uh, why do you think diversity is so important to promote? And I think the following question for me on this, it’s going to be, you know, what, what’s some advice that you would give women in healthcare it at this point? So why, why do you think diversity is important and advice for women in health It,

Kristin Myers:               42:49                I think diversity is important. You know, we need to have different opinions at the table in order to solve really complex problems. And as you know, in healthcare and this specifically it, we’ve got a lot of complex problems to solve. I also think that, uh, you know, at the leadership level we need to have representation of our patient population and when you think about it, 60 percent of healthcare decisions are made by women. And so that’s why I feel pretty passionately that, you know, the leadership has to reflect, you know, outpatient population and where the decisions are being made. Um, in order to engage our patients. Also. And you know, I’m very lucky to be working in an organization where we have great examples of strong executive women. Uh, we had a number of them, uh, recognized recently in cranes and you know, we also the number one health system, uh, according to diversity or diversity and inclusion, and we’ve got a great diversity and inclusion program here. So again, an honor to work at Mount Sinai.

Bill Russell:                   44:08                Yeah, well that would have to be the case in New York City. It is literally the epicenter of a melting pot. Um, you, the, the patient community is very diverse and your care community is, is there anything you, any advice you would give to women? I mean, I saw, I saw a post, I think it was linkedin post where a health system team said just finished our strategy session are setting our strategy, whatever. Great meeting and a picture had a picture of all the people that were attending and I kid you not, I think it was like 14 men and two women. I thought, uh, that’s uh, that’s problematic. Um, but what would you, what would you tell, what’s your advice to women to get more women in that, uh, in that, you know, executive level, um, you know, a seat at the table talking about strategy. How are we going to do that?

Kristin Myers:               45:02                Well, I think ultimately it starts with the recruiting and the pipeline and you know, if you are an executive, it doesn’t matter what gender you are and you’re receiving the same resumes over and over. Uh, the question is why. And so you’ve got to go back to hr and you’ve got to look at the pool of resources that you’re trying to pull from. And that’s not just the gender, it’s also for underrepresented minorities. And so I think that that’s where it stopped. Um, I would also encourage female leaders to engage the men in their department as allies because just having a discussion with other female leaders is great and I think that it helps other women in the department. But ultimately we have to engage the men, um, in this endeavor. So if there is a room full of men, um, I think that, you know, the question would be where are the women?

Kristin Myers:               46:13                And I think that women leaders and men leaders need to bring in other women into the meetings, even if they’re, you know, directors or senior directors, just to give them that exposure. Gives them the seat at the table and hear what their opinions are and I think if more and more happens like that, we’ll get some progress. And I also think mentoring is huge. I know that, uh, you know, sometimes it’s a challenge for a women. I’ve heard many, many women say there’s not been mentored by a female leader, so I really encourage mentoring at our health system and you know, we’ve got a great program here, but I would encourage other health systems and hospitals have a mentoring program and have a women to women mentoring. It helps.

Bill Russell:                   47:07                Yeah. Be a montor seek a mentor. Um, and I think that’s a great way to, to end the show. Kristen, thank you very much for coming on the show. I know you’re very busy coming back from the conference and then your first day back in the office, uh, are, are you active on social media at this point?

Kristin Myers:               47:25                Um, mainly linkedin

Bill Russell:                   47:28                so people can follow you on Linkedin. Not too hard. A Kristen Myers a m Y, e r s at Mount Sinai health system. Find her on Linkedin a click follow and you could see what, what things she’s talking about. Uh, you can follow me @thepatientsCio on twitter. You can follow the show @thisweekinhit. Uh, you can check out the website Catch all the videos on the youtube channel that we talked about earlier And don’t forget to come back every Friday for news information and commentary from industry influencers. And that’s all for now.


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