Jason Joseph This Week in Heatlh IT
December 18, 2020

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December 18, 2020: For a lot of organizations COVID was an accelerator. Jason Joseph shares Spectrum Health’s speed of lightning pandemic response. Managing virtual visits was the first piece of the puzzle. How did they put together virtual waiting rooms, digital check-in and COVID screening chat bots? Is there such a thing as a one-click telehealth visit? What tools did they utilize to get real-time information into the hands of the care providers? How did their leadership team adapt to working from home? How are they communicating? Can they maintain that sense of team spirit, comradery, collaboration and creativity? When you go fast with data and analytics, whatever tech debt you have on data governance shows up. If you don’t stabilize and understand where you are, you can’t make it work at lightspeed in an agile way and you definitely can’t predict where you’re going to be.

Key Points:

  • One of the first things we did when COVID hit was to reframe ourselves [00:05:37] 
  • We need to recognize that digital isn’t just about the tech. Digital is rethinking the way our business operates and how we actually perform those services. [00:07:15] 
  • One of the most heartbreaking things is how isolated people are in this disease because of the physical separation [00:15:30] 
  • We know that we can be as productive, if not more productive in a work from home environment [00:21:41] 
  • Agile not only helps the work get organized. It fundamentally brings the people who know what they need and the people who can deliver it and puts them together and says figure it out with a structure. [00:25:15]  
  • Spectrum Health

Digital Acceleration with Spectrum Health

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Digital Acceleration with Jason Joseph of Spectrum Health

Episode 343: Transcript – December 18 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: [00:00:00] Welcome to this week in health IT influence where we discuss the influence of technology on health with the people who are making it happen. Today jason Joseph, with spectrum health, the chief information and digital officer who is quickly becoming one of my favorite interviews. And I think after you’ve listened to this, you’ll understand why. My name is Bill Russell, former healthcare CIO, CIO, coach consultant, and creator of this week and health IT.

[00:00:24] As we come to the end of the year, I really want to call out our sponsors who have made the show possible. We’ve produced close to [00:00:30] 150 shows this year and without their support, we wouldn’t have been able to do that. I want to thank Sirius Healthcare for supporting the mission of our show to develop the next generation of health leaders, their weekly support starting during the COVID, the initial COVID surge, our COVID series, really helped us to expand and develop our service offerings to the community, and a special thanks to our channel sponsors. VMware, who is one of our first sponsors, StarBfridge Advisors, Galen Healthcare, Health Lyrics, Sirius Healthcare, Pro Talent Advisors, healthNXT, [00:01:00] McAfee and Hill-Rom for choosing to invest as well in developing the next generation of health leaders.

[00:01:05] We have a special treat coming up for you. We have our 3 end of the year episodes. We have our end of the year news day, which is really a recap of the news, which made this year special. We have our end of the year COVID series. As we did a daily episodes during the initial COVID surge for about three months. We did daily episodes and we capture the best thinking  and the shows that really the most watched during that COVID series. And we pull out , some of the highlights for [00:01:30] you. And then we have our annual. Top 10 countdown of the most listened to podcast for the year. And we’re excited to share those with you in the month of December, towards the end of this month, we’re going to be doing that until we get to the new year.

[00:01:43] And we have two and a half weeks left of our ClipNotes referral program. If you don’t know what clip notes is based on your feedback, we went back and created an email that goes out 24 hours after each show. And you get to see who was on the show, a summary of the show, bullet points of key highlights from the show. And then you have [00:02:00] four video clips that you can click on. They’re usually about two to three minutes long and capture some of the essence of the show itself. this was based on feedback. You gave us that you’re not able to listen to every show, but you want to know what’s going on. And you want to be able to share it with your peers.

[00:02:13] And this is a great way to do that. so we created this, if I were a CIO today, I would recommend it for my entire staff. It’s a great way to listen to what great leaders like today’s guests are saying as well as many others. And so if you want to participate in the referral [00:02:30] program, people can go out onto the website, click subscribe, and if they put your email address in there, you’ll be a part of the referral program. Just so you’re aware of it. A couple of prizes in there. One is we’re going to do a drawing on January 1st for a work from home kit from this week in health IT. Anyone who gets 10 referrals is going to get a black mole skin notebook in the, person who gets the most referrals is going to get the opportunity, to come on the news day show and discuss the news with me. And, just an [00:03:00] opportunity you’re not obligated to, but we would love to have you do that. It’s a lot of fun and we have a great time. And now onto today’s show.

[00:03:08] 

[00:03:08] Today we have Jason Joseph, the chief digital and innovation officer. I’m sorry, chief digital and information officer for spectrum health was with us. Good morning, Jason. Welcome to the  show. 

[00:03:18] Jason Joseph: [00:03:18] Morning Bill. Great to be here. 

[00:03:20] Bill Russell: [00:03:20] It’s great. On my show, I keep making mistakes. That’s a good way to start us off. It’s my way of making people feel comfortable. So how, the last time we spoke, you [00:03:30] were newly minted just into the role and it’s been about two years. Actually before we get into it, give us a little background on spectrum health and then we’ll get into your journey over the last couple of years. 

[00:03:43] Jason Joseph: [00:03:43] Yeah, no, that’s great. So Spectrum health we’re, located in Michigan, we’re an integrated system, so we have a health plan, and a care delivery organization. About 8 billion, will be about a billion for this year. And unlike many, [00:04:00] health plans slash delivery organizations or health plan is actually a bit larger than our care delivery in terms of revenue. So that’s a little bit unique. We’ve got over a million members in our health plan this year. And, as a total system, we’re about 31,000 employees and we have hospitals, treatment facilities, urgent care facilities, and physician practices primarily located in the Western Michigan area. But we have a coverage really through most of the state of Michigan. 

[00:04:28] Bill Russell: [00:04:28] Yeah. So, [00:04:30] It’s interesting. So you guys have a health plan and a care delivery network. So, and you’re the CIO, information for both. 

[00:04:37] Jason Joseph: [00:04:37] Yeah. So I’m the system CIO, and we really have three main divisions, health plan division, and then two care delivery divisions and then our IS organization is structured that we have some shared services, obviously security infrastructure, information management, analytics, some of our, end user services and kind of how we run the department are at the system level. And then [00:05:00] we have applications services, really focused on each division with some of those that are corporate, and shared across all of them like ERP. And then some that are specific to the divisions, like our claims processing system and our Epic teams, et cetera. 

[00:05:14] Bill Russell: [00:05:14] So you’ve had, you’ve had roughly about two years in the role. so you had a little runway before we, we hit this, hit the pandemic. Give us a little idea of the journey over the two years. What have you been focused in on? And, [00:05:30] And actually we’ll get into the COVID timeframe. And we’ll talk specifically about your COVID journey, but give us a little, two years 

[00:05:37] Jason Joseph: [00:05:37] Well it’s interesting. One of the first things we did was just kind of reframe ourselves. And I came in to the organization at a time when we had a new CEO as well. And, we had worked together before, so we were both actually at Spectrum Health prior. To filling into our current roles, which was very helpful, right. We didn’t have to hit the ground and learn a new system and spend a year kind of figuring out where the bathrooms were. So we got to hit the [00:06:00] ground running and developed a new system strategy, and then we reframed our IS strategy as well.

[00:06:06] And, really it’s, it’s very interesting. That strategy really revolved around consumer focused experience. Improving value and digitization. Right. And although we did tweak some things as COVID hit, and we’ll talk about that, that strategy and the S component of it, we didn’t modify at all. Once COVID hit, we started off with kind of that focus on digital [00:06:30] transformation and then our pillars and the things that we needed to do to enable that.

[00:06:34] And what COVID really did is just sharpened our focus. So we reviewed that. It’s a boy, what do we need to update? We came away and said actually nothing. Yeah, some tactics needed to change and we needed to reprioritize some stuff, but we were really on that journey. And it’s, you mentioned that my title is chief digital and information officer, which is, which is a relatively new change and really what that’s, it’s speaking to is that digital is the evolution of how [00:07:00] technology is going to be used in our organizations, right? You can’t separate digital and technology. These platforms are all interconnected. The way we engage with our workforce, our providers, the consumers, patients members, and our. communities is all going to be digital in the future.

[00:07:15] And so if we’re driving towards that, we need to think strategically about it, but we also need to recognize that digital isn’t just about the tech. Digital is actually about rethinking the way our business operates and how we actually perform those services. And that’s really the [00:07:30] renovation. So we’re retooling the way we think about that in terms of our skill sets and some of the things that we’re driving, but that is our focus. It’s at the heart of what I would say is that digital transformation has been our focus and continues to be our focus. 

[00:07:43] Bill Russell: [00:07:43] Yeah. So you guys actually started before COVID, but COVID for a lot of organizations was, and it was an accelerator of sorts. what. First of all, give us a little background of what it’s looked like in your communities, sort of the COVID, the pandemic in your communities, and then how [00:08:00] has health IT and technology really supported your efforts as a health system and as a health plan in those communities.

[00:08:06] Jason Joseph: [00:08:06] Yeah, that’s a great question. We, like many, when COVID really hit in the Spring shut a lot of things down, right. And we prepared, we stood up extra facilities. Did all the things that you would expect to do, but COVID, didn’t hit our communities that we care for really, very much in the Spring at all. So we put all of that in shut down, much of the care. Ev.Erything went to virtual [00:08:30] writers’ virtual visits went through the roof. We enabled. Hundreds of providers with virtual capabilities, literally overnight 7,000 workers went home. thankfully we are already on the Microsoft 365 platform.

[00:08:43] So we turned that corner like on a weekend and had very little hit, very few hiccups. So we were fortunate in that, that we had done that work a year ago. And it was interesting because a year ago when we were getting everybody off the InterCall system and the phone numbers and the other [00:09:00] disparate tools and putting them on Teams, people really had a tough time adjusting.

[00:09:05] It’s just hard. This is not how we work. What about the meetings? And so it was a really slow uptake, but we got through it in advance of COVID heading and when COVID hit, it just was. It was natural. I was so thankful that we had done that work. Many organizations really struggled just to be productive.

[00:09:22] We track a lot of our productivity and it blipped for a couple of days and it was right back. And actually we’re about 20% higher now and a lot of our IS teams. [00:09:30] But right now we’re in the middle of a surge. so we’ve, started that about. Two months ago just started seeing that uptick. We believe we’ve kind of hit a plateau here.

[00:09:39] We’ll see if the Thanksgiving work, really impacts us. But we’re managing to it well, but we are really, really busy and really, really full. And our teams of course, are focused on making all of that work. But this time around, unlike the spring, we are still trying to keep the other non COVID services running as much as we can and do so [00:10:00] safely for our patients and our community without overwhelming your system.

[00:10:03] Bill Russell: [00:10:03] Yeah, we’re going to talk a little bit about Karen to dissonance, but give me an idea, your telehealth, people have given me some drastic numbers of the uptake. It was yours. Where were you guys sort of trending there before COVID or did you really take a dramatic spike up? 

[00:10:20] Jason Joseph: [00:10:20] We had a dramatic spike and the big difference for us as our virtual health was primarily what I call convenient urgent care type substitutes. Yeah. I need care now. And I want to do it [00:10:30] virtually. We hadn’t put a virtual visit structure in across all of our primary care and specialties as a normal way of doing business. And so we had actually a separate service doing that. We still staffed it ourselves and we had the capabilities and the tech in place, but all of a sudden we had to say, well we need to do all of our primary care visits this way.

[00:10:48] We need to do all of our specialty care visits this way. So as we ramp that up, i, I don’t know if you were call the numbers here, but, I think we went from about [00:11:00] 5,000 visits a month to something in the neighborhood of 60,000 visits a month. So it was definitely a 10 plus fold.

[00:11:08] I think maybe at one point we peaked at about a 20 fold increase but a lot of that really became. it’s settled back down as our practices have opened back up and we’ve settled down to a plateau. That’s about three times our starting point. I expect that it’s going to now steadily continue to climb because we’ve kind of broken through that barrier.

[00:11:29] People are [00:11:30] getting more comfortable with it. Bill, one of the interesting things we found that you wouldn’t see otherwise is the barriers that exist to doing virtual for people that aren’t inclined to do it. Right. We didn’t see those because the only people that did a virtual visits are the ones that wanted to or could.

[00:11:45] And so now all of a sudden, when we didn’t have a choice, conductivity was an issue, downloading an app was an issue, right. We got a lot of pressure just to have like a one-click virtual visit experience that connectivity of just the workflow to get somebody into a [00:12:00] room and meeting with a physician on time, became harder to scale. And so operationally we really had to put a lot of effort in to make that visit experience as seamless as it would be in person. And we’re still working through that. But I think we’re getting much closer to that now, as I think most people in the country, 

[00:12:17] Bill Russell: [00:12:17] it is interesting. The barriers have changed. The barrier before, as, as a former CIO was sitting across from the physician and trying to convince them that this was a viable option for them, that it made sense and then COVID [00:12:30] hits. And of course that barrier turns into the exact opposite where the physicians are sitting across from you saying, I need this yesterday, get it done. And the other was this, the regulatory, we had, we had CMS and others sitting back and going well, is this really going to work? Is it going to improve care in our communities and those kinds of things to a well it’s necessary. And now we just have a ton of information. And we’ll have to sift through that information to see how much it really has improved care, but you [00:13:00] took down the regulatory, you took down the physician and now we get to identify the other barriers that are there and really progress through those.

[00:13:07] Jason Joseph: [00:13:07] That was actually, that was exactly it. Now, as care has come back and facilities is own, but some of those barriers creep in again, right? So, not all physicians love this idea. More are comfortable with it, right? Not all specialties it works as well, right? Not everyone is in the same boat, but I think what you’re seeing is we at least broke through that initial sound barrier, if you will, the resistance, and [00:13:30] now we’re going to be able to steadily accelerate this from what is our new normal on the way up. And of course the virtual visit is one piece, but we’ve done a ton of stuff just in terms of like virtual waiting rooms, digital check-in, COVID screening chat bots, and many of those things that are all surrounding the care experience, that have also, been very, very quick to implement and move moved forward to support COVID.

[00:13:56] Bill Russell: [00:13:56] So you just ran off a couple of the ways that you’re reducing touch [00:14:00] the chat box is interesting. And, but what were some of those things we’ve heard some really creative stories of, of use of iPads in the rooms, bringing families together, chatbots. I mean, there’s a lot of different ways people have done this. How have you guys really reduce the touch points? 

[00:14:15] Jason Joseph: [00:14:15] Yeah. So one of the early things we did certainly was the chat bot and it was interesting. The driver for that was just, we were worried, our call centers is going to be overloaded like with people just saying, do I have COVID right. So the chat bot was actually driven by that more than anything. We saw a really [00:14:30] big peak early. It’s kind of stabilized. Now, people are comfortable. Our call centers can handle the volume. People are settled into whether they should get tested. It’s not as big of a question. So we did that really. I mean, literally within three days we had a chat bot in our innovations team kind of. Ready to use for some different workflows and we just repurposed it. And it was very, very quick and easy for us to get it out there. In terms of the other use cases, as iPads on a stick, as we like to call them were not only useful for [00:15:00] consults where you have this physician consult need. Well, what if the patient is isolated with COVID and you don’t want to PPE off this was back when PPE was our biggest concern.

[00:15:09] So we. created some of that. We have some of our rooms wired for virtual ICU anyways, that you can do that easily. But for those that weren’t, we needed a mobile solution. So we’ve got some of those that allow the virtual consults to occur and extend it. We already had a virtual console infrastructure, just not to scale it to hundreds of patients all at once.

[00:15:27] So we did that quickly. One of the most [00:15:30] heartbreaking things of course is how isolated people are in this disease because of the physical separation. And so very early on, we did use an iPad based solution, to allow patients to connect with their family members via video. And we’re now going to kind of the next iteration of that to allow a new infrastructure that’s a little bit easier, a little bit more consistent can use some of the.

[00:15:52] The TV infrastructure in the rooms on occasion or a mobile device, for that. So we we’ve done some of those things as well, along the [00:16:00] way, implemented some text based interactions. I talked about the VR virtual waiting room. So we know that we didn’t want people waiting and congregating in the building so they can sit in the parking lot, send a text message.

[00:16:13] Do the check-in and all that procedure, essentially in their car and then get a text message when to come in and where to go directly. So we kind of avoid that, that distancing issues, but we also have, revised waiting rooms, just physically with more social distancing, put the plexiglass [00:16:30] up and done all of that stuff as well in the process.

[00:16:32] So if you think about the entire span of things, where we weren’t digital, we tried to drive some digital end and we sell more, more. Space to go. And then in areas where we’re physical, we just kind of look at how can we leverage digital and tech in it. In addition to just the basic stuff, to make that a safer and less touch.

[00:16:52] Bill Russell: [00:16:52] Are you doing anything out of the home? Are you, monitoring COVID patients out of the home or anything to that effect? 

[00:16:58] Jason Joseph: [00:16:58] We are, we’re not [00:17:00] doing a very broad like deployment of in-home monitoring technology. So we do callbacks and follow-ups, we’ve got a care management provider offices that’ll follow up, recommend a pulse-ox checking this kind of stuff. Check in every few days as the course of treatment for sure. Patients under our care, we usually kind of push that into the primary care lane. so in some cases, those are primary care physicians that are communities that are caring for those patients. and in some cases they’re, our, our own providers and it’s, [00:17:30] it’s in some of the more complex cases, we start to push remote technology out that they can actually connect directly to their virtual visit experience.

[00:17:38] But in most cases with COVID, we’ve just opted for kind of a chat-based, response system using some of our Epic tools, to capture that information and then to follow up with some care management. 

[00:17:52] Bill Russell: [00:17:52] You’re the, you’re the second CIO who’s mentioned to me this whole a one-click telehealth visit where there’s no app to download it. So [00:18:00] we’re finding that, on the other side, the patient side of this. That they’re struggling with the technology they’re struggling with scheduling and they’re struggling with downloading the app and doing that whole process. so are, have you, are you starting to move in that direction of, of one click, maybe even texting them a link that they click on it.

[00:18:24] Jason Joseph: [00:18:24] Yeah, we’ve been doing that for awhile. Our strategy has always been to really wrap our [00:18:30] virtual visit into our app and have it integrated so that the video, the check-in, the post check and experience a survey, all that stuff could be one unified experience. Well, the challenge with that of course, is you’re dependent on that video client and how that’s essentially going to work, in the process. And so we started early on with that experience, had some struggles with just getting it set up. And so, brought in one, piece of technology that allowed that, just text me a link and then we’ll do a quick video chat. [00:19:00] We’re now building that into our core. So that is something where as the provider gets in and says, I’m ready to go initiate this visit, it can send a link with a one-click visit and join, and that’s going to be part of our new framework so that you can do that within the app. Or we can actually initiate that with just a text message. And we found that to be a huge differentiator in many of our, for many of our patients as to whether it’s simple and easier.

[00:19:25] Bill Russell: [00:19:25] Yeah. I can see that. All right. So the nature of work has changed pretty substantially. You [00:19:30] referenced this earlier. in terms of the immediate productivity drop, but then the advance, you can call us our work from home experiment, sort of forced upon us experiment, but, how has that gone for you guys and how has your it leadership team adapted to it?

[00:19:46] Jason Joseph: [00:19:46] No, I think for us, it’s gone remarkably well. I will say that even my own attitude towards work from home, early on was how do you maintain culture? How do you communicate with people? How do you maintain [00:20:00] collaboration and innovation when everybody’s separate? And that, that was the concern.

[00:20:05] When we initially, and I mentioned this earlier, when we initially, COVID had, we had to go home that Friday, we said, pack your stuff up Monday or home. Nobody’s really been back since. Right. And so we were fortunate enough to have already been down the journey for creating a digital workforce digital works place experience, with our tools, our devices were already enabled with, VPNs that [00:20:30] only connect, soon as you’re on the internet, they can act so there’s no kind of. Leakage around the edges of those capabilities. Our digital workspace tools were already embedded. We had updated our technology. So most people had the camera embedded. And some of the basic things you don’t think about. It was, we still had some gaps, but it was a small gap rather than a huge gap for us to fill.

[00:20:52] And we got there pretty, pretty quickly. In terms of the overall experiment where we’ve communicated formally to our teams. Nope. We’re [00:21:00] not coming back into the office in any significant way. Obviously people who need to be there to do their job. They’re there in there now, PC techs, et cetera. 

[00:21:08] But for the vast majority of our office based workers, we expect they won’t be back in the office until June, ish. Right? Until the. The vaccine is widely available. And even then, we’re likely going to see that as a very purposeful interaction where you’re coming in the office for a team meeting that [00:21:30] requires interactive collaboration for team building purposes. For culture, those kinds of things. The productivity question in my mind has been largely you answered for most people.

[00:21:41] Yeah. We know that we can be as productive if not more productive in this environment. I think that the question that we’re, still looking to answer is a, what about those folks that struggle? Because there are a percentage of people just based on their personality, based on how they’re wired, they’re really craving that personal interaction. So [00:22:00] how do we help them? And then how do we maintain that sense of team? Spirit comradery, collaboration and creativity. That really comes out when you’re in a room with someone, right. We all know it feels different when you’re on a zoom call or whatever. So how do we actually go about doing that? So we’re going to probably tweak our way through that.

[00:22:18] I expect that, for the most part we will not see our entire IT staff or back office staff coming back in more than half time. And I say that, [00:22:30] plus or minus maybe ever, because we’ve reset what the new normal is, for the workforce and what’s possible. And, we can get a lot of efficiencies if we’re able to do that. Also expands the reach of the possible workforce, right? There’s more people we can reach. The downside is our talent is also under attack for people yeah, exactly. So, Hey, I live in grand Rapids, Michigan, which is a great community to live in and it’s a great asset of ours, but [00:23:00] boy, if I can live here and work for somebody in California, making a lot of money, doing something interesting over there. Now we’re competing with a whole range of companies that we never thought were our competitors. So it goes both ways. 

[00:23:12] Bill Russell: [00:23:12] Yeah. Yeah. You are information and digital officer and one of the things that have sort of marked those two cultures, information, officers, those organizations have traditionally move slow. Digital officers are the fail fast, move fast. And we’ve heard this term COVID [00:23:30] speed referred to the pace at which things really happened in 2020. How has your team been able to adapt and to keep pace with requirements of the pandemic? 

[00:23:42] Jason Joseph: [00:23:42] It’s a really great question. It’s a great experiment, right? Because as COVID hit everybody, we need to make decisions in the day, right. Or within the hour, not even within the week or the month. And so as you bring these two things together, we’ve been on a journey for agile for a while. And, [00:24:00] started implementing safe, which is a methodology to really drive agile into our organization in some cases several years ago, But really got serious in the last 12 to 18 months. And so when COVID hit, we just saw a huge opportunity to take that and focus it in there. And so we set up camps, we called them, which are essentially agile, trains or cars or working teams and, appointed somebody that was the decision maker to organize the questions.

[00:24:29] And that we [00:24:30] basically ran micro sprints through that. And each of those areas would have a cross functional team of people working on it. Some from my ass operations, clinical leaders there, we’re working on the lab testing problem. We’re working on the workforce problem. We’re working on the communication PPE problem.

[00:24:46] And, just work through that. And what, what I think was really cool about it is that demonstrated that Agile and this idea wasn’t about an away for it to work better themselves. It was a way actually to break through the decision-making [00:25:00] problem that we all face as CIO wasn’t as leaders in IS. Right. It’s been the problem on every CIO’s mind for a decade. And every time somebody says, we’re talking about governance, I’m interested because it’s like, how did you solve this? Because it’s so hard. To me, Agile not only helps the work get organized. It fundamentally brings the people who know what they need and the people who can deliver it and puts them together and says, figure it out with a structure and that whole idea of governance and decision-making shifts right now [00:25:30] you have strategy and you have long range, future state planning that can guide these teams, but you basically empower them and say, what needs to happen now?

[00:25:38] What’s most important. How do I get it done and removes all those layers of process and nonsense in the middle. And it, it’s hard, it’s an adjustment. Some teams that works beautifully well out of the box and some teams it’s like, Oh boy, how are we going to do that? But we’ve applied it now to our applications, teams or Epic sports teams.

[00:25:56] We’re applying it to our field services teams, our [00:26:00] infrastructure space. We’ve been doing our digital teams for a while. But, it looks a little different in each space, but to me, COVID speed. Just put a spotlight on, let’s accelerate this thing. We call agile and bring our business and clinical partners into it. And we’re seeing the benefits and it’s really helped us, respond, and prepare for COVID. 

[00:26:20] Bill Russell: [00:26:20] Do you think there’s any, are there any plans to take it system-wide outside of IT into the rest of the organization? 

[00:26:28] Jason Joseph: [00:26:28] As a matter of fact, our care [00:26:30] delivery organization, we’ve been in our health plan. Honestly, operating this way for a couple of years now, right? They call them fixed teams. They invest differently, make decisions, kind of an allocation team size and then prioritize within there. But then our care delivery divisions were driving that in this year. And I think the COVID thing sparked that we have a couple of early areas. Our pop health team, for example, has been operating this way for, since pre COVID and went from really kind of struggling to get [00:27:00] work done and prioritize to absolutely just laser focused and making progress on a regular basis.

[00:27:06] And what’s amazing is when you start down that path and these are clinical leaders, right? When you start down that path, the first. The first thing is, Oh my gosh, this is an IT thing. boy, I’m not so sure. I just want you to get what I want done. And if you take the time to wire people up and train them and say, here’s how we’re going to go. Just step through this a few times, they’re raving fans. They say, we didn’t really understand this, but this allows [00:27:30] us to really say we can reprioritize or prioritize and see progress every two weeks and every single day, we’re focused on the things that are most important and the things that we were anxious about so we had a list of 400 Watts that never make it into that sprint clearly, aren’t that important. And if they are that important, then we have an easy decision to make, which is how do we get more capacity or velocity into this lane? It’s a, it’s an easier way to look at it versus doing what I call multi-dimensional differential equations [00:28:00] to try to figure out how to balance resources and needs as we’ve tried to in the past, it’s just a simple way to do it. And yeah, our it’s, it’s not universal yet, but the areas that we’re having success, help us. And then we build and continue at it expanded, 

[00:28:16] Bill Russell: [00:28:16] I’m just hearkening back to my time as a CIO,  the amount of resources we had dedicated to waterfall and the number of times the answers that they gave were just wrong is staggering. 

[00:28:28] Jason Joseph: [00:28:28] It’s a false, it’s a false sense of [00:28:30] accuracy. Right? And so the question is really, what do you need to accomplish over the next quarter, over the next two weeks? And if you can do that repeatedly, all of a sudden you realize you’re actually achieving your goals faster, does it really matter, whether you were accurate, down the road a year or not?

[00:28:46] Bill Russell: [00:28:46] So talk to me about real-time information and data and analytics during the pandemic. That’s one of the areas we had to move very fast. What were some of the use cases for your team? What were some of the things they were asked to do? And some of the [00:29:00] tools that, that they utilize to get real-time information in the hands of the care providers and administration for that matter.

[00:29:07] Jason Joseph: [00:29:07] Yeah. this, this was an area where we probably started a little slower than we had hoped, honestly, because we, when you start off, you’re like, well, what are we trying to pull together? And so we went really fast and to gathering data, pulling it out of the systems and saying, okay, here’s our dashboard.

[00:29:22] And as we went through that we’ve used some predictive, tools. We’ve got, our BI infrastructure, a lot of what we present [00:29:30] as in Tableau, we’re using the Epic capabilities when we can as well. we built some new data marts and some, capabilities to really drive through that. and so we’re, we’re getting much better at the predictive side.

[00:29:42] Right. Which, which mostly for us looks like predicting. Inpatient admissions volumes and all that based on a bunch of data. But the other side of that, which is what do we really need to know whether we’re good on PPE supplies? How many days do we have? How is the testing going? How many people are [00:30:00] testing positive? What’s the positive rates? What about our employee population? Where are they getting it from? Is it in the community? Is it from exposure? Is it from each other? Starting to bring all of that together has been a, an ongoing journey and we’ve evolved it from very simplistic to getting more sophisticated now and more accurate.

[00:30:20] As we’ve learned, we’ve got analytics teams that are kind of bringing clinical operations data people together. We’ve organized them in an agile way. So we have an agile train [00:30:30] where these needs, as they evolve out of COVID just go into this Tina’s is the data problems and analytics problem? What tool are we going to use?

[00:30:37] The interesting thing that I would say is probably at the heart of this is. When you go fast with data and analytics. Whatever tech debt you have on data governance shows up. So if you didn’t have it solid to begin with, you’re not going to have it solid there in some things that have changed. Like what, how do you count a COVID patients?

[00:30:57] Simple question, right? Well, is it [00:31:00] somebody who had COVID who has COVID now who was diagnosed with COVID? What if they had COVID. A month ago, but they’re still here. Are they, a COVID patient, like all those counting mechanisms though, the way we define things become really important because if you don’t stabilize and understand where you are, excuse me, how can you predict where you’re going to be? And so we’ve actually found, this is really reinvigorated our program around data governance and what it means and how to make data governance work at [00:31:30] Lightspeed in an agile way. So that as you’re doing the work. You’re doing the data governance along the way. And that’s been a real interesting journey for us, but our goal is that, that information can be processed and available on the same day. And, is accurate in the process as well. 

[00:31:47] Bill Russell: [00:31:47] Yeah, that foundation is, is so key. we’re actually coming to the end of our time. I have like 15 more questions. Let me know if 

[00:31:56] Jason Joseph: [00:31:56] you need a longer show Bill 

[00:31:58] Bill Russell: [00:31:58] Let me narrow it down to [00:32:00] 2. One of the questions I want to get on the record, just because I’ve been asking everybody, all the CEOs I’ve been interviewing in the fall of the same question, and I sort of went, some of them have been going in different directions. And that is, what do you think the lasting impact on health IT will be as a result of the pandemic? 

[00:32:18] Jason Joseph: [00:32:18] Well, I think, I think this is, as much as COVID is the time for healthcare to really shine. I think the pandemic has spotlighted the importance of digital technology [00:32:30] data as a way to deliver that care. Right. I think in the past we may have still thought of it and technology is just something we had to do to run the place. And I think it’s been very, very, interesting and enlightening for so many to say no, no, no, no, no. It’s more than that. This is actually the way we’re going to make this all better.

[00:32:48] So I expect that the organizations that see that future will make very strategic investments in advancing digital data technology as a way to [00:33:00] drive their business and not see it as just a cost to manage within a threshold. Right? Because that, that doesn’t account for the fact that there are investments that you can make in this, that are akin to launching new businesses or having a positive return. I also think that we’re going to get clear and have better opportunities to articulate what that value actually is. Sometimes it’s a struggle to say, well, what’s the value of an EMR, but we can say what’s the value. Of automating these capabilities and creating this, [00:33:30] reducing this gap from diagnostic diagnosis to treatment. Those are very, very real things that have, not only financial return, but absolutely a quality experience return as well. 

[00:33:40] Bill Russell: [00:33:40] So, last question, and sometimes I put a date on these, just so if people are listening to it in the future, sort of marks it because it’s the 11th of December, we’re recording this. I think this episode will go live on the 18th. And we almost have an hour by hour fluctuating, challenge, which [00:34:00] is the vaccine  distribution. And you may or may not be ready to talk about this, but I’m just curious. what, what kind of things are you guys looking at in terms of making it the most effective they can be in your community. So there’s obviously a lot of challenges that you talked about definition, youed talk about tracking. You talked about to don’t. I mean, you didn’t talk about, but there’s two doses. We have to make sure people come back, Where are you guys at in that process? How do you feel about, [00:34:30] the, the program that’s coming together? 

[00:34:33] Jason Joseph: [00:34:33] So, I appreciate the fact that your data stamping this so that, a month from now, people can either say I was right or wrong, but I have really high degree of confidence in our organization. We are early on, we’ve got multiple freezers, so we can handle all the vaccines that we’re gonna need. We have the operational capability to distribute this, probably as fast as we get supply. We’re a little bit nervous that we’re not going to get as much supply of vaccine is fast as we will be [00:35:00] able to deliver it. And then it’s just a matter of us really going through and applying that prioritization matrix to who gets in when, in terms of the multi-dose tracking, we’ve already built that stuff into our EMR system, for our employees. We’ve tracked that into our, our system that we use for flu shots and everything that also gets into our EMR. So we’ve had a really good team talking about agile and COVID response in that space already planning on this quite frankly for months. And now as it gets [00:35:30] closer, we’re just refining those plans. So I think we’re as well prepared as hopefully anybody to really be successful and get this. 

[00:35:37] Bill Russell: [00:35:37] I think this is one of those areas where the digital tools really come into play. I mean, making the appointment, making sure you cue people correctly, making sure they follow up texting and other alerts to make sure that people come in for that. I think it’s like 21 days or 27 days. 

[00:35:53] Jason Joseph: [00:35:53] One of them was 21. One’s 28, I think, depending on the vaccine. So that’s the other confusion in this, right? Depending on. [00:36:00] You know which one you’re getting and, early on that won’t be as big an issue. But as we get the multi vaccines in the system, that’s going to be a real challenge to make sure we know which one we’re giving to whom and what the rules apply for those things. But, we’ve got, I feel really good about this. Again, back to that agile thing, right? We’ve got the right people from a clinical and ethics and operational technology working that problem end to end and wiring our systems to be able to do that. 

[00:36:27] Bill Russell: [00:36:27] Yeah. Well, thanks for taking that [00:36:30] question. I mean, in the middle of the, I mean, it’s the 11th. I don’t think we have distribution yet. I think distribution will start next week. So we’ll see. 

[00:36:38] Jason Joseph: [00:36:38] Well, as of today it sounds like we’re at least on the approved side of things and we’re hoping that by next week, we’ll see some things rolling forward and I’m very hopeful and bullish that, by end of spring, early summer, next year, we’re going to see that this thing is widely available and distributed and maybe life will resume to normal I think that there’s a lot [00:37:00] of folks that are hoping it’ll come quicker than that. I just, it’ll be interesting to see how people treat that interim period of some being vaccinated and not, and what rules apply to people. 

[00:37:09] Bill Russell: [00:37:09] Thanks. Thanks for your time. I know how busy things are. Let’s  not make it so long between the next visit. I’ll follow up next year and we’ll, we’ll get together and have another conversation. 

[00:37:20] Jason Joseph: [00:37:20] That sounds awesome. Thanks Bill. Thanks for having me. 

[00:37:22] Bill Russell: [00:37:22] What a great conversation. That’s all for this week. Don’t forget to sign up for clip notes. It’s a great way to support the show. It’s also a great way for [00:37:30] you to stay current. if you’re not familiar, clip notes is an email that we send out, immediately following the shows actually 24 hours after the show airs. And it’ll have a summary of the show, bullet points. Key moments from the show and also one to four video clips that you can just watch. Great way to stay current, to know who was on the show and what was said . 

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[00:38:05] This show is a production of this week in health IT. For more great content. You can check out our website this weekhealth.com or the YouTube channel as well. We continue to modify that for you to make it a better resource for you. Please check back every well, when to check back, we publish three shows a week we have the news day episode on Tuesday. we usually have solution showcase every Wednesday and then an influencer show on Friday. But right now we don’t have any solution showcases. So we are doing [00:38:30] multiple, influenced episodes. So a lot of content being dropped, between now and the end of the year.

[00:38:35] Hopefully you’ll like that. And also we have the end of the year episodes coming up and I’m looking forward to those. We have the best of the new stay show. So we take 10 news stories that we covered this year and, give you some clips, give you an idea of what we went through this year. Obviously COVID was the big story, but a lot of other things happen this year in the world of felt it, we’re also doing a best of the, [00:39:00] Of the COVID series itself. If you remember, we did three months of daily episodes and we go back and we visit that time. And just some of the wisdom that was dropped by the leaders during that. And then of course we do our end of the year, top 10 countdown of the top 10, most listened to shows of the year. So you’re going to want to stay tuned for that.

[00:39:17] That’s we take a break the last two weeks of the year, right? And during that time we don’t stop dropping content. We just prepare it ahead of time and, make it available to you. So hopefully you’ll enjoy those, this year as well. [00:39:30] thanks for listening. That’s all for now.

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