This Week in Health IT
August 28, 2020

 – Episode #

Guest Information

Share this clip:

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

August 28, 2020: Join us for a digital transformation masterclass with Ed Marx, Former CIO for the Cleveland Clinic and Paddy Padmanabhan from Damo Consulting. Authors of the book The Big Unlock. Health care enterprises are having a hard time keeping up with advances in information technology. What does healthcare look like after digital transformation? For the patient? For a board or CEO? What can the clinician expect? It’s about building a comprehensive and agile enterprise digital roadmap. It’s about six steps. Digital strategy and enterprise vision, readiness and assessment and benchmarking, agile roadmap development, urbanization and dependencies, agile operating model and technology platform and partner selection. This is about as pragmatic as it gets.

Key Points:

  • The pandemic is a tipping point for digital health transformation [00:04:25] 
  • Think of the patient experience like a drive through Starbucks experience [00:09:20]
  • The four pillars; enrich the community, engage patients, enable care providers and drive compelling efficiencies [00:15:00] 
  • Become a digital transformation champion [00:22:40] 
  • It’s not technology that holds us back, it’s culture [00:33:25]
  • Digital transformation is IT enabled, but it’s not IT led [00:33:50] 

Healthcare Digital Transformation

Want to tune in on your favorite listening platform? Don't forget to subscribe!

Thank You to Our Show Sponsors

Related Content

Amplify great thinking to propel healthcare forward and raise up the next generation of health leaders.

© Copyright 2021 Health Lyrics All rights reserved

Healthcare Digital Transformation with Paddy Padmanabhan and Ed Marx

Episode 296: Transcript – August 28, 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: Clip notes is live. If you can’t listen to every show, but you want to know who was on the show and what was said, sign up for clip notes. One paragraph summary, key moments in bullet point format with timestamps and one to four video clips from the show. it’s a great way for you to stay current and it’s an easy way.

For you to share insights with your team, you’ll get the email. You can just forward it on to them. If there’s a specific video you like and you forward that on to them, this is a great way to maintain your commitment to their development. During these [00:00:30] extraordinary times, sign up today at any episode, page on this week,

Or you can send an email to clip notes. C L I P N O T E S. At this week in health It will kick off an automated workflow and you’ll get an email from me to get you signed up. So sign up today.

Welcome to This Week in Health It where we amplify great thinking to propel healthcare forward. My name is Bill Russell, healthcare, CIO, coach, and [00:01:00] creator of This Week in Health IT a set of podcasts, videos and collaboration events dedicated to developing the next generation of health leaders. This episode, every episode, since we started the COVID-19 series has been sponsored by Sirius Healthcare.

Now we’re exiting the series and Sirius has stepped out to be a weekly sponsor of the show through the end of the year. Special thanks to Sirius for supporting the show’s efforts during the crisis and beyond. All right. Today’s show is going to be a fun one. So a previous guests for the show Ed Marks, Former [00:01:30] CIO for the Cleveland Clinic and Patty Padmanabhan from Damo consulting, who also wrote “The Big Unlock”.

And it’s also the host of a podcast called The Big Unlock. If you haven’t listened to that. It’s worth listening to, he has some great guests on there. I have these guys on to talk about their new book, healthcare, digital transformation, how consumers of technology and pandemic are accelerating the future.

Great book, highly recommend. Here’s the show.

Today we’re joined by [00:02:00] authors of healthcare, digital transformation, how consumerism technology and the pandemic are accelerating the future. Ed Marks a previous guests on the show. Hey Ed, welcome back to the show. 

Ed Marx: Thanks Bill 

Bill Russell: And Patty Padmanabhan with Damo consulting. Is that right? 

Paddy Padmanabhan: That is correct. Thank you Bill, for having me on the show. 

Bill Russell: I’m looking forward to it and you’re also a podcaster. So I should probably do a shout out to your podcast. T he Big Unlock. Same as your previous book. 

Paddy Padmanabhan: Same as my previous book. Yes. Thank you. 

Bill Russell: And you’ve had some [00:02:30] great guests on that show and some great conversations. So highly recommend that podcast as well. Guys, congratulations on the new book, Amazon bestseller. In fact, when I put my order in, they said I would receive it sometime in late September or something to that effect. So I guess you guys are the books doing pretty well? 

Ed Marx: Yeah. The book has really resonated. Everyone talks about digital transformation and healthcare. And obviously with the pandemic, it really highlighted [00:03:00] the need for transformation. And so the book has really taken off. Yeah, we were very pleasantly surprised to be the bestseller for new books and disappointed though that it is on back order now, but the printers are working very closely with Amazon and the whole supply chain to catch that up.

Paddy Padmanabhan: Yeah, I think it’s the first book. that’s come out since the pandemic. So that really talks to digital transformation in the post pandemic [00:03:30] era. And so that I think, probably resonates as a message with our, with our audience. 

Bill Russell: Yeah, this is one of those books. I think you guys really hit on a lot of things here. I think this is a must read for anyone who listens to the show. here’s the reason I like that. You interviewed everybody. it’s like a who’s who you’ve talked to everybody, your focus groups bring great insight and color to the content. It’s not just like a bunch of charts and graphs and bullet points and those kinds of things.

You have, stories, from previous guests and others. [00:04:00] Daniel BarcL in there as well as a John Kravitz is, just a lot of, Geisinger, Providence, you name it. A lot of health systems are highlighted, which is great, but you also get very pragmatic. You suggest a structure to the digital transformation journey.

And, I think that shows that you guys are practitioners as well as authors. And that’s what I really appreciate. Let’s start with this question. What’s the pandemic, a tipping point for digital transformation in healthcare, or is it just giving us the illusion of a tipping [00:04:30] point?

Ed Marx: So I think we’ve been slow as an industry to digitally transform. I’ve often argued that we’re several years behind other industries and I think that pandemic certainly help push us towards a tipping point. I don’t know that we’re there yet. Bill based on some of the data and some of the discussions I’ve heard you speak about it almost seems like we’re going backwards a little bit now, but [00:05:00] before the pandemic, certainly we were getting a little bit of traction with the pandemic, a lot more traction, but like I said, coming back down, so maybe the first wave of a tipping point, Patty, what are your thoughts?

Paddy Padmanabhan: I think it’s a tipping point for certain aspects of it for digital health and digital transformation. I think it’s suddenly a tipping point for virtual consults. it’s a tipping point for certain aspects of the healthcare experience that are now [00:05:30] going online, allowing healthcare consumers to make a lot of choices and take a lot of actions, not directly related to the care experience.

All the administrative stuff and all that is moving online and it’s been forced upon us by the pandemic because physically you can’t go to a location. There’s a lot of restrictions on where you’ve been going to and so on. And I think it moved the needle. Significantly to one end of the spectrum.

But to your point, I think the needle is [00:06:00] moving back a little bit and the equilibrium has not yet been achieved. So I would say there’s definitely a tipping point. And I, at a very broad level, I would say that it has accelerated the timelines for transformation from years, two months. 

Bill Russell: Yeah. it feels to me like we’ve really accelerated the delivery of virtual care.

Care at distance. There’s a lot of conversations around it. I don’t know. I don’t know that we’ve really moved. I’m supposed to be interviewing you [00:06:30] guys, but this is what I’m hearing, and this is what I’m seeing. so we really moved that forward, but it doesn’t seem like the, enterprise strategy, the transformation of how we deliver care, being thought about across the entire enterprise has really taken place.

and I guess to that point, what I’d like to start to tap into with you guys is what does, what does healthcare look like after digital transformation? And let’s take this question from a couple different perspectives. [00:07:00] Let’s first talk about the clinician and patient, and then I’d like to break it out and start talking about what does it look like to a board, into a CEO, into a CIO. So let’s talk about the patient first. So once we’ve gotten begin with the end in mind, once we’ve gotten to the other side of this, what does the patient experience look like if they are going to a health system or a community of health providers that have digitally transformed?

Ed Marx: Yeah. So I think from a [00:07:30] patient point of view, it’s care anytime, anywhere in any way they want it. So that could mean for some that it is on their phone for others. It might be in their home, on their laptop or whatever, but it’s definitely a mobile experience. Now, there will always be a subset of the population that for one reason or another, want to go, you go into a hospital or that’s the only choice going into a physical location.

So we’ll have to be [00:08:00] multimodal. Bi-modal offering different channels for the patient. So the patient again, In my opinion would be multichannel, multimodal, depending on the situation, they would have many options, but they drive it, not the hospital saying you have to come to this building for this care.

No it’s going to be the patient that’s driving, where they access care. 

Paddy Padmanabhan: Yeah. I would say that, everything’s everything that Ed said is correct. I would say it’s going to [00:08:30] resemble more and more of a drive through experience. How for many aspects of care, especially low acuity care and care, things like that.

We, I’m seeing health systems investing in a lot of not just online self service tools that provides. Services in an asynchronous manner, which is what Ed was alluding to, but also a lot of contact lists and low contact experiences when it comes to visiting the clinic. So you drive [00:09:00] up to a clinic or a hospital you’re in the parking lot, you’re hooked up to your EHR mobile app, and the geolocation geo-fencing capability, which tells you whether you’re there or not.

And you’re registered for the wizard, remotely you’ve come into the facility when they’re ready to receive you. And then you minimize your contact with anyone on anything and you’re out of there. So think of it like a Starbucks experience. You place your order using a mobile app. You drive up to the window, you pick [00:09:30] up the dream and you’re on your way.

The Starbucks thing is extreme. But it will feel like that in many cases, like a drive through experience is not necessarily a bad thing 

Bill Russell: Yes with COVID and I’ve used this example a couple times on the shows where people are familiar with it, but I know I go to Great Clips and I go onto the app.

I schedule, I pull up and I’ve literally spent no time in their waiting room. I go in and get my haircut and I come out and. And that’s just that now it’s a very simple [00:10:00] business process, They rethought the waiting room and that whole thing. And every time I think about that, I think wouldn’t it be great if we could get rid of the waiting room and all those things.

So let’s switch gears here and talk about the clinician experience after digital transformation. What is the clinician? What’s the clinical clinician looking for from digital transformation and what can they expect? 

Ed Marx: Yeah, I’ll take a first stab and just talk about one thing. And then, obviously Patty will, we’ll bring up another example, but for [00:10:30] them, I think digital transformation means taking the hassle out of practicing.

We’ve heard this for years now because of the EHR and the way they were designed, it’s caused a lot of issues with physicians and frustration added a lot of debt to their work life in terms of having to deal with sort of manual things in their practice. So I see ambient voice as an example of digital transformation where it’s just, it’s the keyboard list, exam room or [00:11:00] the keyboard list in this case.

We would, might not even have an exam room cause it’s being done virtually. But it’s that whole voice capability. So it’s bringing back the, allowing them to enjoy the passion of why they entered medicine by taking away all the barriers that we put in inadvertently. so I think that’s one key way that things are gonna change.

And obviously with that means that they can practice. Just like we do now, right? Because of the pandemic from home. [00:11:30] So if the practice largely becomes mobile, they are able to take advantage of the same things. The rest of us are in terms of working from home. So I was speaking with. My clinician, my primary care doc recently, I had my annual physical and he was sharing with me how that’s really been a game changer for him in terms of bringing back the passion of healthcare, allowing him just to focus on patients, by being able to do things remotely, as well as some of the new technologies like ambient voice.

[00:12:00] Paddy Padmanabhan: Yeah. I think, what clinicians are going to have to prepare for is an era in which technology is going to play an increasingly important role in the way care is delivered. Now it’s not just in terms of decision support, but in terms of how care is delivered. So we saw that in the immediate wake of the pandemic, everyone had to learn how to do watch a concert.

They had to. There was no other way to take care of your patients. Now there’s a lot of change in war and going through [00:12:30] something like that. And that change was forced upon us. And it was compressed into a very short timeframe practically, overnight. But now that we are one or two quarters in, into that experience, a lot of workflows and processes are going to be permanently redesign to a model where the technology enables. You have to do a lot of things remotely through virtual concepts, as an example, but also a lot of other things, related to taking care of patients when they’re coming into [00:13:00] clinic. There’s a great example that I can talk about the, one of the New York hospitals.

They, brought in, they had a wave of COVID-19 infections and the nurses were overwhelmed. They just couldn’t take care of everyone. So they bought a bunch of these signs, monitors, pulse oxi meters and stuff. They hook them up to the backend EHR system. They all did in a very short time.

And now nurses don’t have to go around checking everybody f or the virus. There’s a middle that is strapped onto the wrist or some [00:13:30] part of the body. And then it just throws off the data. It goes to the back of the HR system. No, it’s going to look at 35 – 40 patients. And so having to walk around the building, thinking it’s not only more efficient and productive, but it’s also more safe for both the patient and the nurse.

That’s just one example of how technology is going to play increasingly important role in a digital future. 

Ed Marx: Yeah. And I think Bill we’re  obviously we’re limiting our answers but clearly, And we [00:14:00] probably can’t go there for the sake of time, but is all the cases, the abilities that we’re already seeing today, but again, with true digital transformation, we’ll be exploding and that’s all around AI and the capable you were seeing it already in radiology and pathology and, predictive capabilities and so forth, precision medicine, so much more down that stream.

But I think the real practical things right now are the things that Patty and I just mentioned, the other things are happening too. and we’ll explode as I mentioned, but these are here and now that we’re seeing, 

[00:14:30] Bill Russell: Yeah. I want to get into some of the pragmatic things that you guys put out there. You guys have a ton of stories, by the way.

you have the Kira stories, you have Providence stories, you have stories from, from New York, you have Mayo stories, cleveland stores. there’s a ton of stories to back these things up, which is one of the reasons I really liked the book. But given that  this podcast is really focused towards practitioners.

There’s just a couple of frameworks you have in here. I think they’re phenomenal, but I want to finish this question off a little bit. So you said that [00:15:00] digital transformation supports four pillars, enrich community engaged patients, enabled care providers and drive compelling efficiencies. how is it, how does a board or a CEO looking at digital transformation today?

And how can I, if I’m in a health system where I’m the CIO and my board and CEO still don’t get it, how would I want them to view digital transformation? 

Ed Marx: So before we go there, you, cause you’ve mentioned this a couple of times and I want to reemphasize this point because [00:15:30] there’s a lot of books about theory and those are good.

You got to have academics and consultants, writing books. But why Patty and I do this book was for the reasons you cited. I just want to call that out. And that is not only based on a lot of research. it’s, there’s a lot of research in there and Paddy drove a lot of that. like you mentioned the focus groups, but there’s also survey research.

There’s a lot of empirical research combined with the practical. And then at the end of each chapter, we give sort of some ideas about how you might want to take this [00:16:00] and make it real. So these are true stories based on empirical research and based on anecdotal evidence. And so it’s very  practical.

So we’re really proud of that. And that’s a differentiator for us now in terms of. Yeah. How do you communicate with the board CEO? Usually it’s the opposite I have found. So usually it’s the CEO and the board that’s interested in digital transformation, but it’s the, really, the CIO’s that are the laggards sometimes.

Not in all cases, but sometimes. Yeah. So you [00:16:30] really have to evaluate for self and the situation and determine which are you reacting to the CEO mandate for digital transformation or is it the opposite? You’re there already, but they aren’t to your point. So what do you do if you’re there and they aren’t, what do you do?

I think you have to show evidence and it can’t be theory. Again, theory is important. But you got to show practical things. So what I always recommend in anything, whether it’s digital transformation or otherwise is show it, prove it. And there’s ways of doing [00:17:00] that without having to go through and get it approval for a big project and tons of funds, the whole proof of concept ideas.

You’ll find someone you can find a partner, or maybe you can do it yourself, where you demonstrate some sort of value of digital transformation. Maybe it’s a small RPA robotic process automation and where you’re pulling out costs from the health system, because you’re able to automate something pretty simply.

And there’s all sorts of examples on how to do that. Or maybe it’s virtual visits and setting up some, you’re already doing some of [00:17:30] it, but maybe do some baseline, do some measurements. In showcase you have, what things were before and what things were like after, whether it’s satisfaction of the clinician satisfaction of the patient.

So you don’t have to start something new. So that example is to, is probably something you’re already doing, but you may not be measuring, so measure. And then you say, look, this is what we’ve done with virtual health today, we went from 2% of our visits. So 80% we’ve slid back to 40%. I don’t think we want to slide back cause that’s [00:18:00] really, you’re not the future.

So here’s some things we’re doing. We did these measurements and we’re showing the patient satisfaction is up. Clinician burnout is down. And we’re still able to bill and, generate revenue. So you can use some of those techniques to prove the point. And then when you get some of those small wins, you build credibility for yourself and your organization.

And then you can add on because they’re going to be interested in more and then obviously to give one last idea, and then Paddy will have some ideas as well is [00:18:30] don’t do it yourself. Don’t necessarily. You do want to be the leader. Yeah. We’ve talked about this before. Does a CIO, CEO do, are you the leader or not?

I say yes. Whenever you can, but you do it with someone else. You do it with your chief medical officer. You do it with your chief nursing officer and you get them to become the advocates. So when they become the advocates with you, it provides a lot more credibility plus they’re clinicians. And you’re not a clinician typically in that role.

And so that also helps bring credibility and helps deliver the message [00:19:00] is build that consortium of other individuals in your C suite. And then approach the board and the CEO and you’ll have much higher chance of success. 

Paddy Padmanabhan: No, I will tell you this for firstly. The idea for this book actually came about based on the work that I did for Ed when he was CIO of Cleveland Clinic and saw he actually worked together and built what may have been the first [00:19:30] enterprise. Comprehensive enterprise digital roadmap in healthcare. And we, everything that I just talked about, we actually saw it happen. And I’ve just had a couple of points toward is that first and foremost, digital transformation is CEO level priority.

It is not a CIO project. Second thing about it is that for it to be successful, you need to build an active and [00:20:00] engaged community of practitioners within your own organization. And Ed did a remarkable job of that Cleveland Clinic. we had at one point, not at one point, I think pretty much through the whole process of developing the roadmap. We had cross-functional involvement from the senior, most leaders in the company. It was like, eventually there were 50 or 60 people involved in developing the roadmap. So there was collective ownership for the roadmap. It’s not an IT project. I think [00:20:30] that, the notion I think is going away and people have recognized it, but just in case there’s any doubt.

And then we need to make it here. I’ll give you one other example, too. talking about priorities, my firm’s been doing work for several months with other large health systems where. The board actually approved multi-year budget for digital transformation. And this was done before the pandemic hit us. To their credit even after the pandemic , they did not get [00:21:00] distracted from the longterm goal for the enterprise. And they were fortunately in a place as an organization, financially and everything else. To stay the course and, they have the complete support of the board. Of course, the organization that is driving the digital transformation for the enterprise has to constantly check in with the board.

And informed them about the progress, seek funding, additional funding, or seek approvals to proceed with [00:21:30] this or that. But for the most, the board is modern and they’re committed to staying the course from, I’ll tell you, that’s the kind of example that we need to see. Across the board. I’m not saying that others are not there.

I’m just telling you from my firsthand experience of one health system or two, if you include Cleveland clinic, but this is really the way to go about it. 

Bill Russell: Yeah. it’s interesting. When I went into, when I was the CIO for a health system, 16 hospital [00:22:00] system, we went in and presented our digital transformation strategy and I remember having a one on one conversation with the CEO, our CEO at the time. And she’s I know, I absolutely know we need to do this. You’ve made a compelling case. And I said, okay, how much money do we have? Don’t worry about the money. I’m like, I need to understand how to, she goes, put the plan together that makes the most sense for our communities, for our clinicians, for our patients. And we will [00:22:30] find the money. If this is the right thing to do, it’s the right thing to do. And I’m starting to see articles written now by CEOs. There’s a handful of them out there and you work for one with Toby Cosgrove who’s a digital transformation champion. I hope we see more and more CEOs start to step up. And really start to consume this type of book, this type of content and become those champions. As you talked about Patty, I want to get into, and there’s the lawnmower as is [00:23:00] always the case.

So I want to get into the, the steps. So we talked about pragmatic and I love this. I have some CEOs I’m working with right now that I’m going to take this framework and we’re going to work through it. Cause it’s fantastic. So you gave a digital strategy and readiness set of steps and you have six steps. The strategy and enterprise vision readiness assessment and benchmarking agile roadmap development.

Urbanization and dependencies, agile operating model and technology platform and partner [00:23:30] selection. This is about as pragmatic as it gets. You have questions, things you should walk your organization through who you should partner with in the process. So what I’d like to do is step through these six real quick and talk about each one in a little bit of detail.

So digital strategy and enterprise vision, what are you looking to do at that phase? In an engagement with a health system. 

Ed Marx: Yeah, it really goes back to what we were just speaking about. And hopefully you’re [00:24:00] in a health system, right? Like you had the great fortune Bill to have a CEO that you had, where she was already there and understood it.

She  wanted you to go forward. And the key thing though, as we spoke about is developing these key alliances. With the rest of the stakeholders, because if you’re out there alone, you’re going to fail. There’s going to be resistance and you have to make it so that they own it. 

Bill Russell: So who are they Ed?

Ed Marx: So to me, it’s the members of the C suite, because if this is [00:24:30] coming from the CEO, it then becomes your C suite. So this is what we did. This is just one example, but it’s practical. So a lot of times organizations have it steering committees. But most often they’re mid level leaders who don’t have ultimate authority.

So what we did during this process abolish the it steering committee and the C-suite, my peers became the IT steering committee with the CEO as the co chair. So when we presented this digital strategy, I had every member of that [00:25:00] C-suite were part of the development of that digital strategy. So when it came to presenting, it was them who presented.

And when there was time for objections, there weren’t any, because they were all part of it. So the more inclusive you can be and transparent, the less resistance and the higher likelihood of coming to that point  vision. Like for us, it was double the number of lives touched. It was, then the next mantra was, and it really served us [00:25:30] serve them.

I believe in hindsight is 50% of our outpatient visits would be virtual 25% of our inpatient days would be at home and yeah, I’ll leave it at those two. So that was what came out of that is we’re going to double the number of lives, touch how digital transformation and the tools that come from that.

And that we’re going to move fast into this virtual space, with that declaration of 50% of outpatient visits, [00:26:00] this is pre coven. So that’s an example. Get that team together. I believe that C-suite, it’s your peers. Obviously you’re working the ground. They’re helping you work the ground in terms of all the clinicians support all the nursing support, finance, supply chain, all that kind of stuff, but it all rolls up to them.

So you really cover the continuum. 

Bill Russell: All  right. So here’s what I’m going to do. I’ll do that one with you. The second one I’ll do with Paddy. So Ed, if I hear you it’s drive the right, relationships set the goals of the objectives as an executive team at that [00:26:30] executive level, set the measure, the measurable, how are you going to measure your success in those things?

So Paddy, readiness and assessment and benchmarking. What are we doing during this phase? 

Paddy Padmanabhan: So what COVID-19 has done is it has exposed, many organizations to, structural weaknesses that they’re going to have to deal with at some point, especially in terms of their readiness for digital [00:27:00] health.

So what, what we’re saying in the book is that. All health systems must invest in developing a digital roadmap. It doesn’t mean you’re going to execute it all on day one, but you must have a roadmap. And we have given some very practical guidance on how to develop a roadmap, so tools and templates, frameworks, and so on, but it’s very important for a digital leaders and health system leaders.

First of [00:27:30] all, I’ll do a self assessment. They are in this journey and, there’s multiple tools you can use and be a provided several. And using that self assessment, you have to build a roadmap to where you want to be. And in what timeframe. Ed Mentioned the goals that they had, which was, more 50% of all our patient visits, too.

Child visits and that’s a great goal, but done in the next three months. Are you giving yourself three years to do it? What, and how are you going to get there? [00:28:00] So you have to have a roadmap for that. And I think that roadmap needs to be put together for the entire organization. Then you prioritize the initiatives within that, set some goals and move forward with it.

That is really what we’re saying in the book. 

Bill Russell: How specific is it to that health system? Can I just go take the Cleveland Clinics or take somebody else’s roadmap and say, ah, okay, these are ours. 

Paddy Padmanabhan: Yeah. Some things are going to be common. So it’s, if you say, look, I’m going to turn on a [00:28:30] virtual console capability.

That’s on everybody’s roadmap because that is, those are table stakes now. But when it comes to, if you look at a roadmap and there are 30 initiatives in the Cleveland Finette roadmap, those same 30 initiatives may not map to your own. if you’re another health system or on the West coast somewhere, they may not map to you because your populations are different.

Your organization is a different level of maturity, so many other factors. So off the third, you might find maybe half of them are common to [00:29:00] you and the other half may be specific, to your organization. And that’s what we’re saying, because my firm does these roadmaps all the time. And we have a comprehensive set of digital opportunities, digital engagement, touchpoints, and so on. It’s over a hundred of them. Nobody’s going to implement a hundred initiatives. Even if you look at a two or three year timeframe, they’ll implement a dozen, but the pick the top ones and more likely than not to be common to all the health systems. [00:29:30] And then there’s a few that are going to be specific to your markets.

That’s where you really have to make informed decisions and make an informed call about what you’re going to fund and move forward with it. 

Bill Russell: Yeah. And I want to tee you up with a, a topic I know is near and dear to your heart. So you have agile roadmap development and agile operating model. Talk to me about why agile is so important. It’s become such a buzz word, and I think people have a lot of [00:30:00] misconceptions about it. But I saw you implemented at Cleveland. And you’re a true believer in it. So talk a little bit about how, what is agile and how it applies to this process? 

Ed Marx: Yeah. I first was exposed to agile in a deep way through our project management office, actually a Texas Health rRsources, many years ago, then in New York city, I saw an accident again with our PMO when I was CIO of New York city health and hospitals. And I just saw the capabilities. And then when I arrived [00:30:30] at the clinic, I have to give credit to other people.

It wasn’t. my idea but they approached me and they’re like, we need to become agile as an entire IT. And I thought, wow, that’s brilliant. So I checked out, like Starbucks and some other IT organizations and thought, yeah, we really need to do this because it’s this value, There’s a speed to market.

So in the past IT, as I mentioned, very slow in healthcare to change, but in other industries they’re transforming all the time. And how is that is because they have an agile it. [00:31:00] So in order to do all the things is that we want to do for healthcare transformation. I don’t think you can do it not being agile.

So we actually trained everyone in agile. We reorganized our entire IT, we became we into domains. And if you understand agile language, I won’t go deep into it because not everyone will be familiar with the terms. But we switched completely how we operate. So it’s a whole new methodology of operations, just like all modern companies, Facebook, Spotify, they’re all agile.

So what that means is that, every two weeks we’re [00:31:30] iterating, we’re constantly meeting with our customers to make sure that we’re on the right track and that we’re prioritizing using things correctly. And we’re working off backlogs that they’re interested in a whole new way of thinking. We started putting out product, MVP most  minimally viable products and then iterate on it. And our customers, they were astonished by the speed at which it moved. So they were used to traditional legacy. You see it very slow with agile. We moved very quickly and we’re very focused hyperfocused on the customer requirements, what they’re trying to do.

So [00:32:00] it aligned perfectly with what we call the objectives and key results as a management methodology for our overall health system. And. Agile became so popular that parts of our HR parts of our finance adopted it. We’re like, Whoa. And it really picked up, we called it team of teams, but it’s the same sort of concept really picked up organization wide.

So in order to meet the demands of, a pandemic that shows up or digital transformation that your organization going through, you’ve gotta be agile. If you tried [00:32:30] traditional waterfall methodologies, PMO, you’re going to be hurting. Agile is really the only way to go. 

Bill Russell: Yeah, it says there’s a great story in the book.

It talks about Providence’s model and how they, they renew their roadmap. It’s a three year roadmap, they renew it every three years, but they updated every year as well. And they even have, within that year, they have updates that are going on there. They’re constantly adjusting based on. what’s going on in the COVID just changed everything. [00:33:00]

It’s taking into account that the world we live in, that the industry that we operate in is constantly changing. 

Yeah. So let me, let me close this out with a couple of quotes that you guys throw out so many interesting quotes. So I just start pull them out in a section I called quotes.

And, here’s a softball, it’s technology that holds us. It’s not technology that holds us back, it’s culture. And, we hear that all the time, but what can you leader [00:33:30] do around culture to prepare the culture for digital transformation? Or is the culture ready for digital transformation?

And we’re not moving fast enough.

Ed Marx: Patty I’ll defer to you to this. 

Paddy Padmanabhan: So here one of my favorite things to say about digital transformation.

Digital transformation is IT enabled, but it’s not IT led and I’d start with that because it doesn’t [00:34:00] have to be the CIO or the it leader that leads the digital transformation. It’s really the person who can reach across multiple stakeholder groups within the organization, build consensus, have the influence and the authority to drive decisions and drive the program to drive the change.

And that is all about an organizational culture. The people who are the most successful are the ones [00:34:30] who understand this better than anyone else. They’re the ones who understand what it takes to do the puts and takes within an organization to move this more massive program like this forward, how to make the compromise, how to take care of everybody’s needs and yet remain to, maintain the integrity of the transformation program.

That’s a very practical, never. And you can, here’s a lot of books you can read about what know, Oh, sorry. It’s strategy for breakfast. And those kinds of PPC things. But at the ground [00:35:00] level, this is what it really means. Someone who has the authority doesn’t necessarily have to be the biggest title in the room necessarily have to be the it person.

But it has to be somebody who can build this computer and drive change by having a really deep understanding of whatever it takes within the organization to drive change 

Ed Marx: Yeah, go ahead and bill. 

Bill Russell: No, please go ahead. 

Ed Marx: I want to add to that and just give some practical things that you can do.

[00:35:30] So to change it, one, you have to live it yourself and then your, it has to live it. So that’s why I was talking about agile. When people see you completely change and transform it, you get their attention, especially when it’s in a positive way, then you’ve got to start doing stuff. And so some of the things that anyone can do, we call them digital transformation minutes.

So once a week, I put out this email that would there then get propagated. And it was like three things in 30 seconds, a Drex directs , one of your, your, host co-host sometimes, [00:36:00] concept. So we would put out this email three things in 30 seconds, letting them know about digital transformation.

And then we put out a video. I want to say once a week, it’s probably once every two weeks on average. But it was one minute long had bumper music was well crafted and it was a clinician talking about something that it did for digital transformation over time. All these different messages multi-modality is video, email, those sorts of things.

Over time. People start understanding our culture is changing. We are becoming digitally [00:36:30] transformative, and those are just some practical things you can start seeding, they’re almost subconscious, but you’re talking about it. You’re showing examples. And then you just gotta be smart in terms of, every organization is different, but I’ll just tell you one thing that we did.

And I’ve done this many times in the past and anyone can do it. So I just repurpose some funds and everyone has budgets and you can do a little bit of repurposing, based on your authority. And so we repurposed something to really enhance our digital front door, if you will. And [00:37:00] so if I would have gone through the traditional channels, it would have taken two years.

What I said is I, you know what, we’re going to go light on this area. We’re going to take some of those funds, apply it to here show. So that’s what we did. We move some funds around. We did this development show, this new digital front door and everyone around the table was astonished. Wow, that’s great. What about this, that and the other? I said, yeah, we can do all that. 

We’re gonna need funding. And so that’s how digital transformation can begin and snowball. So those are [00:37:30] some techniques that anyone can incorporate in their particular organization. 

Bill Russell: No. That’s fantastic. Guys, how so clear clearly the book is out on Amazon, easy to find  healthcare digital transformation, how consumers of technology and pandemic are accelerating the future. How can people follow you? What’s the best way for them to follow you or to connect with you? If they have questions? 

Ed Marx: Yeah, for me, I’m on LinkedIn, both Paddy and I, because the book is out of stock, which is just [00:38:00] unbelievable to me. is it more of a reflection of supply chain, than anything else, but, anyways, if you want an a signed book, Paddy will tell you what his site is.

You can look on my LinkedIn. I advertise it. It’s the same price as Amazon, but fortunately, both Paddy and I had a few ahead of time. So it’s cause some people want signed copies. So if you can’t find it on Amazon, and don’t want to wait. You can go to my LinkedIn. That’s the best way to connect with me. I’m also on Twitter and things like that, but start at LinkedIn. Everything is there. and then Paddy definitely has his own site. 

[00:38:30] Paddy Padmanabhan: Yeah as far as I’m concerned, you can Google me. and you’ll come to all my sites. My personal website is And then my company website

You can find everything that I’m on LinkedIn. I’m on Twitter. The book, even though the print edition is out our stock, you can buy the electronic, you can buy the ebook, you can get it any time. And we are also putting out an audio book which should be available. For those who [00:39:00] like to listen to audible or a platform like that, we should have that available within the next two weeks, give or take.

And we also have an interview coming up because we’ve had a huge amount of demand from India and all our readers and. When is the India edition coming. So I think we’re trying to squeeze that into the schedule. Some it’s just a lot of moving parts, but it’s very exciting stuff, really pleased with the response that we brought for the book.

And I, [00:39:30] someone said, send me a note saying, I’ve read the book. It’s like a masterclass for digital transformation. I’m like, wow, that’s a nice way to put it. It’s really how it’s structured. Six chapters, very structured. Every chapter you have a bunch of takeaways, specific action items. Bunch of tools, templates, everything, to help you execute on this. Yeah, that was cool, but yeah, you can find it. You can get a copy of the book. It just may not be print at this moment. 

Bill Russell: I think they said September, but, I’ve received my copy on Wednesday, which [00:40:00] is fantastic. So I’ve got my copy here. I am going to recommend it to my clients cause there’s a lot of things that we can talk about.

if you’re not following these two gentlemen on LinkedIn, you should. Paddy is one of my sources for all my Tuesday news day articles cause he’s constantly hosting the news stuff and I just, I take those and go, Hey, somebody is doing research for me. So Paddy, thank you for doing the research and finding all the great articles and add, I think LinkedIn has become your primary [00:40:30] place for publishing articles these days. Isn’t it? 

Ed Marx: Yeah. Yeah. LinkedIn is good. Bill. Can I say one last thing because we didn’t address it upfront and I’m telling you both Paddy and I, you don’t get rich from writing a book. The intent of the book is not to make money. It really reflects our heart of who we are as people. And we know we’ve seen personally the power of healthcare transformation and how it changes people’s lives. It saves people’s lives. It enables the dignity of death when that time comes. [00:41:00] And we just want to propagate what we’ve learned and share it with others.

That’s the heart of the book. So it’s not a, you don’t get rich. as many people know who’ve written before, especially when you divide up the time that it takes to actually write it. And. It’s really about helping others. So I hope others, even if one hospital or health system grabs it and something changes as a result, then we’ve done our job.

Bill Russell: And that’s the goal of the show amplify, great thinking to propel healthcare forward. [00:41:30] Gentlemen, thanks for coming on the show. I really appreciate your time. 

Paddy Padmanabhan: Thank you.  

Bill Russell: What a great interview. I really like those guys and the work that they’re doing. And, but that’s all for this week and you guys almost know this end better than I do point don’t forget to sign up for clip notes, send an email, hit the website.

We want to make you and your system more productive. So thanks to our channel sponsors, VMware, StarBridge Advisors, Galen Healthcare, Health Lyrics, Sirius Healthcare, Pro talent Advisors and Health Next for choosing to [00:42:00] invest in developing the next generation of health leaders. This show is a production of This Week in Health IT. For more great content check out the  website thi or the YouTube channel. If you want to support the show, send an email, send a note to a friend, actually sign up for clip notes, get clip notes forwarded onto somebody and say, hey, here’s the stuff you’re missing by not listening to this show. That would be fantastic.

Remember, please check back every Tuesday, Wednesday, and Friday for more episodes. Thanks for listening. That’s all [00:42:30] for now.

Play Video