Ed Marx, CIO of Cleveland Clinic Shares about Life / Death and everything in between


Bill Russell - Ed Marx

Ed Marx CIO Cleveland Clinic - This Week in Health IT

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The VA CIO just stepped down. Ed and I embark on a thought experiment of what we might do if we were asked to step into the role. Plus seven rapid-fire questions from precision medicine to the future of work for Health IT. A packed 40 minutes of insight.

Bill Russell:                   00:01                Hey podcast listeners. Thanks for listening. If you’re enjoying this week in health it, we just wanted to give you some information on how you can support these conversations to keep them going. This week in Health its goal is to keep you your organization and your employees updated with the emerging thought and trends in the healthcare industry through our conversations with health care and technology leaders. The best and easiest way you can show your support just to go over to this week in health it on iTunes and leave us a review. Also, you can subscribe on Itunes, Google play or stitcher or go over to our youtube page and subscribe and hit the notification bell. Again, we really appreciate you spending your valuable time. Listen to this podcast.

Bill Russell:                   00:52                welcome to this week in health it where we discuss the news information and emerging thought with leaders from across the healthcare industry. This is episode number 15. It’s Friday, April 20th. Today we take on one of the hardest roles in the country as CIO veteran and I will play a little game on what we would do if we were named the CIO at the Va. This podcast is brought to you by health lyrics. Get ahead of the wave. We believe every health it organization has it within them to be great. It all starts with clarity. Visit health Lyrics.com To schedule your free console. My name is Bill Russell. Recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Today I’m joined by himss chime CIO of the year, I believe our third on the show, author of the book, extraordinary tales from a rather ordinary guy, former CIO at Texas health resources university, hospitals in Cleveland, the advisory board and current CIO of the Cleveland Clinic and a wonderful friend, ed Marx. Ed, welcome to the show.

Ed Marx :                      01:51                Thanks bill. Thanks for having me. I’m so excited to be part of it.

Bill Russell:                   01:54                Why? I appreciate you coming to the, uh, uh, normally I’d go through the bio, but you know, as with Halamka I can’t read your whole bio because you’ve done so many things. Um, I think a better way for people to get a sense of who you are. I was hitting your linkedin page last night and read your most recent article about your third brush with death. That’s a three more than I’ve had and uh, it’s really, uh, pretty, pretty compelling story. Um, can you share a little bit about that story to get to give people a sense of who you are?

Ed Marx :                      02:25                Yeah. I’m, I’m learning a lot more about healthcare and technology actually as a result. And so I’m very, very thankful despite the circumstances. Yeah. So I, you know, when it comes to health, I’m a pretty good picture of health. I, I take care of myself and so all my vitals are stellar. You know, my cholesterol is 140. My blood pressure is like one ten over seven resting heart rate because of all the exercise I do and perhaps some genetics 40. So, and I get taken care of all the time. I get screen. I do have some high risk things that I do when it’s climbing mountains or we’re competing internationally and triathlon duathlon so I get screened extra. In fact, a month ago I had some extra screening done just to make sure that, you know, I’m continuing to be healthy. Well anyways, so you take all that and I’m doing a race in South Carolina’s the 2018 national championships where USA team USA for Duathlon, it’s the sprint race.

Ed Marx :                      03:20                There’s a couple of different categories with wthis one happens to be sprint. And so I was tooling along towards the end of the race and I was laying down probably like six and a half minute miles and it’s a run bike run. So I’m on this last run and then all of a sudden I felt my chest tight just like you read about. Like it felt like someone’s sitting on my chest, my chest tightened. I thought, man, that’s weird. And I thought, well maybe it’s because during the bike you konow during the bike portion. It was raining and it’s, you know, you’re going about 25, 30 miles per hour. You’re holding on for dear life on that, on the handle bars because you’re literally like inch or two from someone else’s tire. So it’s bad news. So you’re really gripping down on the handlebars. And I thought as I was running, maybe it’s because I was so tight in the chest during the fight that it finally caught up with me and my muscles were freezing up a little bit.

Ed Marx :                      04:08                And uh, I had had no shooting pain down the left arm and no jaw pain, no nausea. I had no other classical symptoms with his tight chest. So I started reading a little bit heavier trying to get breath in and it was fine, but it definitely felt like something was wrong. And so I thought about, okay, I’ve got two miles left. Do I stop and try to find someone to help me? There’s definitely people along the course that could help. And I thought, well, something’s really wrong by the time the ambulance gets to me, it cuts through all the traffic. There’s high traffic area, there’s a race going on, it’s going to be 10 15 minutes. I thought I’ll run this thing, it’ll be fast for me to run. So I just kept running. A good friend of mine on the team has asked me and he’s like, ed follow me.

Ed Marx :                      04:48                Cause he knew I was going a little slower now and he’s like, follow me. And I tried to follow him, I just couldn’t do it. I was like really weird. But I was still holding about a seven 15 pace, still chugging along. So he was, I finished the race, you know, and I was like very excited about that. I Made Team USA for the next year’s world championships and, and, but I still felt this pressure. So I checked myself into the Bon secuors, had an emergency medicine there and I said, I, this feels really funny. I’m otherwise healthy male and something’s wrong. And so they did an EKG. There was enough to show there that there was a problem, stuck me in the ambulance. They did another EKG I definitely almost had a heart attack and yeah. So then yeah. So then by the time, the cool thing of the story, sorry, the cool thing of the story is while I was waiting in the Ed ready to get taken to the Cath lab, that interventionist cardiologist came out to me and my company, the place that I served at Cleveland Clinic already had been talking to him. So the number one foremost cardiologists in the world ready talking to this doc in South Carolina about what they’re gonna do and how to do and all that kind of stuff. He turned out to be awesome. The Cath lab was already prepared even though Saturday, early Saturday morning, cause it was another emergency right before me that they just finished. So I went from a bedside, not bedside, but door to balloon in less than an hour, which is very key. And then he allowed me to watch the whole thing. So I’m laying there flat on my back and I’m watching him perform his artwork and you know, stenting me, putting a stent inside of me through my arm.

Ed Marx :                      06:20                And it was amazing to watch the heart reignite with the blood and things started flowing and everything got back to normal. And so far and prognosis has been, I’m completely normal, uh, no damage to the heart, no permanent damage to the heart. And so now I’m just chomping at the bit, I’m allowed to do some exercise already chomping at the bit for more. But the cool thing is I’ve started to utilize, you know, uh, Bluetooth blood pressure, EKG, heart rate, all that kind of stuff. And I’m getting my cardiologist who’s hadn’t used it before, we’re putting it directly to our electronic health record so I don’t have to like go reporting annually. So that part of it’s kind of cool. It’s like I get to experience, but what we talk about digital strategy just to go, hell, we’re actually doing it on myself.

Bill Russell:                   07:00                And you know, I love this. I love the story from that aspect, but I also love the story from the other aspect where you, you really encourage people, you have 13 things in there, talk to them about, you know, things like reconciliation, identity, uh, personal responsibility. And you close with exhorting everybody to really live life to the fullest because this is the, uh, the, you know, there’s the only body we get and you know, make sure you make the most of it. It really is an awesome post. I think one of the things I do appreciate about you the most is you don’t shy away from sharing the personal, you don’t shy away from, uh, you know, talking about things that other people tend to try to keep it all business and you share well beyond that. And I appreciate that.

Ed Marx :                      07:45                I think it’s so important to be authentic. People want authenticity and I’m not embarrassed about it, you know? Uh, I definitely prided myself on being an athlete on team USA and all that kind of stuff. But you have to be authentic and, and, and then the more you share, the more benefit there is for other people. So I’ll give you an example. I had a couple people come up to me and I won’t give any more detailed than that. I don’t want to any way get away, I’ll speak with you. But since that time come up to me and confide in me that they had a similar episode in their life where they have a stemi. You’ve never told anyone, come on guys, we are in healthcare. Let’s share this information because maybe with you sharing, maybe I learned some life lessons through you. I don’t have to go through the same ordeal, but I learned to pick up the phone and call someone who I loved that I haven’t had a relationship for a long time because of your encouragement. You know what, what? That person could have done that or that person could have told other people about it and said, hey, even if you have a great health record, everything looks perfect. Do this test, do this calcium test, do this other thing. Because had I done it, I wouldn’t have had to go through that. So that’s why I think it’s so important to share with others. It’s like there’s so much, uh, that we can gain from other people’s experiences. No reason. Everyone has to suffer a heart attack to learn these things. Right?

Bill Russell:                   09:00                Yeah. And even the description that you gave of, Hey, this is what it felt like and this is how it sort of manifested itself. I have a history of heart, heart issues in my family. That’s one of the things I ask my dad. I’m like, how am I going to know when this happens? What’s it going to feel like? What’s, and, and we know that, that from the moment it starts to the moment you’re, uh, you know, you’re, you’re getting worked on. I mean that, that timeframe is very critical. So part of it, it’s identifying it and just hearing these stories helps people along the path. So one of the things we like to do before we really jump into the meat of the show is just give our hosts a, an opportunity to talk about, um, you know, what’s, what’s one thing that you’re, you’re working on or something you’re, you’re excited that you’re working on right now.

Ed Marx :                      09:43                Yeah. I’m so excited about digital health strategy and not just because it’s ironic in the middle of this all this happen. Um, but you know, when we started fairly new team and we had a heavy lift and we started seven months ago, the first thing we did, you know, stop the bleeding and you know, so we put together a cybersecurity plan. A little something, we said we got it funded and were kicking on it. And so we set up governance and our CEO’s that cochair of our it steering committee along with myself. And we got this whole PMO developed and we did select the basic stuff. The next thing was to develop an it roadmap. So with, with this governance structure, with this it steering committee, we developed the it roadmap four year roadmap, first year mostly funded. And so with the basics in place and we already have good analytics and we’ve got good electronic health record with all that in place, we were ready for digital.

Ed Marx :                      10:37                So we’re also at an agile organization, so we, everything we do is agile. So we took the same approach with developing our digital health strategy. So it’s six weeks. We did three, two week iterations. We develop this digital health strategy, which on Monday was endorsed for the next phase. So, so exciting. So that’s the one thing you know, I’m so excited about because that’s really the nirvana for us is how do we take advantage of all the technology that’s available today and do some things that will really enable the mission for our organization, save peoples lives. There’s culture and what we do at the clinic, which is cool. It’s really global. So whenever we do here, we work with our global partners are in a, our enterprises around the world. And if we need amazing things to help our caregivers give the best care of them.

Bill Russell:                   11:22                Yeah, I mean you, you really do have a great opportunity if somebody wants to ask me, you know, if you were going to go back to being a CIO, where, where would you go? And I said, Cleveland Clinic would be one of those places because you, you’re surrounded by such a great team and it’s such great innovators and, and uh, and really global reach. I mean, with the things that you guys are doing now.

Ed Marx :                      11:41                Yes. I was at lunch with someone today. And I was just sitting there thinking that that’s just not what my CMIO and I had the same conversation with her. It’s humbling, humbling, it’s honoring and you realize you’re in the midst of giants and you just want to do your very best.

Bill Russell:                   11:58                Yeah. And uh, just keep reminding yourself then on the bad days, just keep reminding yourself of that. Cause there, you know, any healthcare CIO will tell you there’s, there’s peaks and valleys. So, um, all right. So what we normally do on the shows, we take a look at the news, we do a leadership or tech talk, then we go into, uh, our favorite social media posts. We’re gonna, uh, we’re just going to do one new story this week and play a little game, not a game, but we’re going to play a little scenario with it because I really want to spend a little bit more time in the second and the, uh, so I’ll, I’ll tee up the story a little bit and give our listeners some background so that the VA CIO, Scott Blackburn resigned recently. It’s in the, if there’s a federal times.com story about it. And what I’m gonna do is I’m going to give a little background of what’s, what’s been going on there.

Bill Russell:                   12:46                It’s, it’s very public and hopefully set up a conversation that we can work off of some of the, some uh, uh, last articles you did for his talk around what you do to prepare to be a CIO, what you do in those first, the first day, the first hundred days, and what you’re trying to accomplish. So let me tee this up. So the VA exists within a larger ecosystem. You have the dod, you have the Coast Guard, and you have the Va. They all have their EHR stories. The patients obviously are our heroes. They’re, they’re brave men and women who are fighting for our rights and protecting us, uh, around the world. And we want to give them the best healthcare possible. Uh, the situation around the EHR is very public, uh, and, and very political, right? So the dod had one of the worst EHRs as measured by surveys that had been done over the years.

Bill Russell:                   13:35                And they launched a project to replace their Ehr with a Cerner millennium product in the project is called MHS genesis. And they are rolling that out and it’s getting pretty good reviews. At this point. The coast guard had a failed EHR implementation for whatever reason, could be changed, management could be whatever. But they had a failed EHR implementation with epic and uh, they hit the reset button and they chose to latch onto the dod projects. As they say, the requirements are relatively the same. And so they have sort of come together and now you’re going to see, uh, the same EHR product across the dod and the Coast Guard. And then the, uh, the Va, which was one of the pioneers for the Emr, has a product called Vista built on top of cprs, uh, and it’s built on top of an open source platform. So a really is available to anyone out there.

Bill Russell:                   14:29                They recently did a no bid contract, which was given to Cerner on their millennium product as well. Very public, very controversial. And uh, just one more piece of information here. So that the VA, as I said, was, it was a pioneer in 2008, ABC did a segment dedicated to the Emr and they, uh, and they, they talked about the VA and they highlighted how the electronical medical record had led to fewer medical errors as we know, more effective treatments, lower costs and higher patient satisfaction. So they were a pioneer there at the forefront and they, uh, really laid the groundwork. So there’s a, there’s a history of success to build on. Okay. So that’s the background. We just make you see, you and I, we just became a CIO for the Va. In fact, let’s do it this way. In 30 days we’re going to become the CIO for the VA and we’ll break this down into what are we going to do between now and the next 30 days to prepare ourselves to become the CIO for the Va. What, what would you tell people about the next 30 days as you’re getting ready?

Ed Marx :                      15:35                Yeah. For first as a veteran myself and the son of a veteran and brother and sister of veterans, I would feel very honored and humbled by that very sacred patients that they take care of. And so I would approach it very, you know, obviously very seriously and with purpose. And so you know like when I usually talk about is a in your preparation, the first pre 30 days is you always have to be true to your current and then true to your family because you know when you start this new job is going to fire a lot of effort, lot of extra effort and so you may not be available as much. So I really take care of those two things first, make sure it was good transition where I am and make sure that I take time with my family to the extent I can get involved still.

Ed Marx :                      16:23                I like to do that. I did that before arriving at the Cleveland Clinic, so I learned as much as I could about the organization. So I had them send me a bunch of information. So I requested a lot of information and then depending on that lead time, I had an opportunity to have weekly meetings. So I had about six weeks lead time. And if you have afforded that luxury, it’s nice just to get engaged a little bit ahead of time so that those, that sort of things I would do is whatever research I could do ahead of time so that when I arrived on day one I could sort of hit the ground running.

Bill Russell:                   16:49                Yeah. And there’s a lot of wisdom in that. Two things I would say is, um, I went into my role as a CIO with pretty bad habits. They don’t get better when you start the role they get, they get worse. So I ended up putting on 30 pounds and lived a pretty unhealthy lifestyle for about six years of my life. So I’d say if all you have is 30 days, make sure you get your habits in line. You know, spending the quality time with your family is important. Uh, health wise, important. So make sure you get all those things and recognize they typically aren’t hiring a CIO because everything’s going swimmingly. Very rarely is that the case. So your first, your first year is probably going to be a very busy year. So yeah. So getting ready. So what are you trying to do that first day? The first, uh, let’s just say the first 30 days, uh, you hit the ground running. What are you going to do for the VA in that situation? How are you going to engage?

Ed Marx :                      17:44                Yeah, so what I do next is really hit the ground listening. So no matter where the organization is and where the Va is today, it’s, it’s not going to get profoundly worse or better by you not getting super engaged. You know what I’m saying? There’s probably a steady state that’s occurred over time and that steady state is okay to continue. Now it’s different if you inherit a situation where things are tanking, but in the Va, you know, it’s, they’re, they’re dealing with stuff, but they’ve been dealing with the same stuff for a while. So you need to take the time to listen and to develop relationships because ultimately that’s what’s going to help you is knowing what the issues are. You only can do that by listening and meeting with people and then developing relationships because one person’s too small, a number for greatness. So you’re going to have to be reliant on a broader team, not just it, but also outside of it. So I’d be spending, I would be spending a lot of time with your group, with my direct reports, with the senior leadership, the organization, and then typically your time. It was a big place. And so it has a lot of sites across the United States is, you know, starting to slowly make my way out into the, developing these relationships and understanding what the, what the issues are. That first thing.

Bill Russell:                   19:04                Yeah. I think one of the mistakes we make early on in our careers, we make, you know, as we get older we recognize that this is not the case, but they’re not looking for a hero, but they’re, they’re not looking for somebody who’s going to come in with all these great ideas and change everything and that kind of stuff. It really, you’re, you’re coming into something that’s already going on. As you said, the Va has a long history. They’re doing a lot of great work. There’s a lot of great people there with good ideas and good thoughts. They, they, uh, I think Halamka sort of mentioned this as, you know, it’s the convener. It’s the person who’s, who can bring people together. It’s a generative questions that, that make everyone a little better. I mean that’s really the role of the CIO is to inject some of the technology and what’s going on in the industry. But for the most part, the people we’re working with are very knowledgeable. They already have a pretty good background on the technology and we just, we come into a story that’s already in progress and maybe add color and, and direction to it because of, uh, the distinctive set of who we are.

Ed Marx :                      20:09                Yeah. You had to take a very balanced approach and you have to respect those who are still there, those who have left and not think that you know at all. So there’s some expectation that people want you to come in and fix things right away, but you have to avoid that temptation because one, you can’t, you’ll fail. So I always look at it as a marathon. We’re talking about running earlier. You don’t look at it as marathon. It didn’t break in a day. It didn’t break in a month or a year. It probably broke over time. So you take some time to do it, right?

Bill Russell:                   20:41                Yeah. I mean there are some things you have to the, I mean, you mentioned cybersecurity. There’s some things you have to fix immediately. When I came in, the data center had gone down eight times in six weeks and it was welcome to the show, fix that immediately. So, um, do you set like hey and my first hundred days I want to accomplish this or is there uh, I mean first hundred days we look at the presidency and we say first hundred days mark. So pretty important. Is the same thing true with the CIO or is it more of a longer term view?

Ed Marx :                      21:11                I think you have to look at definitely at the long term, but I think it’s important that you have a plan for the first 90 days. So I literally had a plan which I shared on his talk cause you mentioned 120 day plan was the pre 30 and then the next 90 and then towards the next 90 you develop the next 90 day plan. And so that manifested itself and, and I developed that next 90 day plan with my direct reports so that they were involved in that planning effort. But I knew the basic things I needed to do. I had a list of everyone that needed to meet, there was over a hundred individuals that I want it to meet. The first, I think I did it first 45 days just cause it took a while to make appointments and things of that nature.

Ed Marx :                      21:47                So it was hit the ground listening. But I had a plan, I had it down to that detail level of who I needed to meet with and by what time and then you know, what did I need to understand and then what did I need to publish? So at 30 days I published, so this was my plan. I published my 30 day analysis and then I had a 60 day analysis than a 90 day analysis. And I shared this with my boss. I shared this with my peer group. As I said, these are my findings. This is where I think needs to have attention. And then within the, so if you take that 90 plus that 90 a deliverable and there was the it strategy, which we did.

Bill Russell:                   22:22                Is that the three year plan or the five year plan that you talked about?

Ed Marx :                      22:26                Four years. Actually, it could, I think it’s four or five year. It wrote, we call it an it roadmap. But yeah, I, in my plan, I said by month six we will deliver a roadmap and that was based on the listening tour. That was based on my team input, our external partner input, some personal experience and we put together this plan and we delivered it exactly to the it steering committee on my 180th day.

Bill Russell:                   22:52                That’s fantastic. I like the fact that you’ve split out delivering the plan from getting funding because I know for, you know, I delivered a five year plan and it took us almost six months of going back and forth to, uh, to get that funded. And that’s, that’s a completely different process a lot of times. So, um, all right, I’m going to, I’m going to the, you know, given what’s going on in the EHR project, is there any words of wisdom? I mean, there’s going to be a next CIO at the Va. Um, any words of wisdom you would give them to how to build consensus or alignment around either staying with Vista or going to another platform? I mean what would, what would you, what words of wisdom would you impart

Ed Marx :                      23:37                Bill this provides us option to be a little provocative and you know maybe it’s time to blow up the current model and try Something completely different. So, you know, when I think about how we, we deal with electronic health records today we, we have, we have the record and then we had, they didn’t have very good analytic capabilities to way to build analytic capabilities a lot of time externally. And then, uh, we had to build decision support sometimes separately or weight or catch up. And now there’s several other examples. Mobility. Now we’re dealing with, you know, digital health and sort of the future and we’re having to wait or catch up. I wonder what would happen if you’re in that role and there’s going to be a big spend anyways. Maybe it’s time to start from scratch and build something brand new that’s interoperable. Don’t have to worry about interoperability anymore. That incorporates everything in that whole life cycle of, you know, what we call digital, but all the way down to the more mundane things, that base foundation foundation and it’s this platform to which we can then add on anything that we wanted to in the future, you know, whether it was fire or whatever sort of KPIs that that to me is a provocative concept and maybe it’s the fire that’s needed to move legacy vendors into the modern era.

Bill Russell:                   25:06                Yeah. It’s uh, you know, it’s interesting that you say that. Just the, um, the discussion. So they did a, they did a survey of all the, they did a survey just in general, should they move, should they not move? And generally people are saying, hey, stick with vista. And um, I think I would take, here’s my approach. First of all, the Va doesn’t have to worry about billing for the most part. I mean, there, the federal government is paying for those services. So a lot of the EHR, innards of the EHR, if they go with epic or Cerner or whatever is around that whole billing mechanism and funding mechanism. And so a significant portion of that is almost irrelevant within the VA environment. So I tend to agree with you as a rethinking how they do it. I don’t, I don’t like the idea of rebuilding the EHR from, from scratch all only because it’s already there.

Bill Russell:                   26:03                And really what we’re looking for is a better transitions of care, better interoperability and integration with, with digital, uh, digital tools and digital strategies. So I would, I would clearly define the problem set that we’re trying to solve. And then I would take your approach and say, all right, these are the, these are the problem sets. Do We build on top? Do we allow this to run the, the hospitals and the clinics? And then we build on top of that, in which case you can be very prescriptive when you go to the EHR providers and say, look, you don’t own our data. We own our data. We need our data to be able to move in this way and really be prescriptive to that. I mean if you’re going to write a $15 billion contract to Cerner. You should be able to have some, uh, some sway into what they’re going to be doing, don’t you think?

Ed Marx :                      26:56                Absolutely. And that’s what I’m saying with that, with that sort of scale and you know, there’s, there needs to be a catalyst to help modernize the current state of things. And, and, and that might be why the catalyst, you know, to where like that

Bill Russell:                   27:12                it would be, it would be very proactive and very fun to think about. Maybe the, they’ll uh, maybe we’ll call you up after this episode and offer you the role and I know you’re very happy where we were at, so nobody should get too concerned at this point. Um, leadership or tap talk. We’re gonna, we’re gonna do something a little different here. I’m just going to rapid fire some questions. I’m not going to respond to them. I’m just going to give you the questions. I’d love to hear your thoughts on it. So I have seven questions. First one, how is precision medicine going to change healthcare in the next three to five years?

Ed Marx :                      27:45                Yeah, three to five years. I don’t think it’s going to have a massive change, but I think after that period and we’ll, we’re starting to see that benefit already taking a lot of genomics data, putting it together with our electronic health record data and being able to do predictive analytics on likelihood of a certain type of malady. And then as a result of knowing that again, the genetics and the overall health, being able to proceed with precision target, uh, a remedy for that. Um, so we’re seeing that already, but it’s early stages and I’m hopeful that, you know, towards the end of that time frame that it’ll be a major difference. I could see us doing three d printing for specific drugs. Right now everyone gets the same drug, right? You have certain Drg, you get this drug, but ethics is 50% so I can see in the future, hopefully closer to three years, but I’m thinking the backside of my gear part, we’ll see a big difference.

Bill Russell:                   28:38                Yeah, I’m in prep for that. I can’t keep my mouth shut. But in prep for that Geisinger is actually moving towards collecting genomic data on as many of their patients as they possibly can because I know it can have an impact. All right. Question number two, what do you think the, uh, what do you think innovation and patient engagement is going to look like from let’s just stay at the provider from a provider standpoint, what’s patient engagement going to look like?

Ed Marx :                      29:01                So I think it’s going to be, you know, wrapped around customer relationship management and really knowing the patient in depth level, not only at the, that genomics that we’ve talked about, but also from a social perspective. And like the example I was getting for myself now is, you know, I’m very connected with my provider unlike in the past, right? So they automatically get this feed of my EKG and my other vitals and, and they’ll have this real time data and hopefully we’ll, we’ll layer in the analytics, you know, whether it’s chat bots or machine learning or whatever we call it, augmented intelligence that will alert them. Not that, that they look at all that information because they don’t have time to do that. But there’ll be algorithms and bots that look at all the information. It alert them the issues.

Bill Russell:                   29:42                Yeah, I agree. And that was one of the biggest challenges. Doctors, we were trying to bring that data and the doctors were saying, no more data there. It’s too, too crowded, too busy right now. And, and I think that machine learning and AI and the bots are going to help them to sort of sift through it. A third question. So, um, this actually impacted me, so I really wanted to share it with others. So we had a conversation early on in my healthcare CIO tenure. And you said that you bring in a, you take your team out and you bring in people from outside of the healthcare industry to have discussions around strategy, trends and technology. Can you give us an idea of what you did, why you did it, and what a benefit was derived by your team and the health system by interacting with organizations outside of healthcare?

Ed Marx :                      30:28                Yeah, of course. So I think I first learned this technique when I started to be on a couple of boards for organizations and instead of being a bunch of healthcare CIOs there, a CIO from Kellogg’s, there was CIO from Colgate and Wrigley’s and, and I remember just learning a lot from them and different perspectives. I thought, wow, I want to hang out with that person and not just myself. I don’t want my team to hang out with that person. So then we started doing that. So once a year I pick a different company and we would meet, meet with those companies. I’ll give you one example. Pure one. So cure one was really good at data analytics. They, they had this amazing performance in revenue. And when I asked about how they went from a penny stock to, you know, a very successful company, it was all around analytics.

Ed Marx :                      31:10                And so we met with them and talk to analytics. We are about to launch a big bit bi analytics endeavor at my organization then and we learned so much from them. And one thing was they watermarked all their reports, whether they’re online or hard copy, there were watermarks was CEO and everyone knew that you can trust that data that came with that watermark cause it was part of their bi program as opposed to someone else creating the spreadsheet, giving out data. You don’t know if it’s accurate or not, but this meant was accurate. So that’s what we started to do. So you knew when you got this report that it had our watermark on it, you knew you could trust that source of information. So that helped with our credibility and the standardization and the, you know, going from many different data sources to one. That’s one example. So we do it all the time and we’ve got some plant here as well.

Bill Russell:                   31:59                Thanks for sharing that with me. That was very powerful. So question number four, um, are, are there any technologies right now that you’re keeping an eye on maybe that you’re not, you’re not implementing or doing a deep dive on but that you’re piloting or playing with?

Ed Marx :                      32:15                Yeah, we had an amazing development team. They do all the, I call it Jeeva is my term of that. They do also have to do with technology and one is um, you know, taking seven some tps capability. So we have patients that we don’t admit them to our facility, but we allow them to heal at home. Right. It’s a, that patient satisfaction is higher of care is the or better and the cost is half. So we developed this application for our, so we have ambulance drivers who go to make house calls essentially when they’re not providing ambulance service. They are making some house calls. So we have a gps. It’s embedded now in an electronic health record that they followed it. So smart gps. So it tells them where to go in order to see the different patients. And the stories you get to that is amazing.

Ed Marx :                      33:02                Just the customer service, but also from a healthcare point of view. It’s amazing. So some of that technology of using a gps and inputting it into the electronic health record, that’s something different. You don’t normally hear about that. So I give that one. I could talk about blockchain. So, but you know, we embrace blockchain. Certainly. I think there’s a lot of great future for it. So we watched carefully, we work with a select vendors and you know, in terms of blockchain, but I just think the real one that we’re actually doing is like this, these gee whiz stuff that are amazing development team.

Bill Russell:                   33:32                But you are, you are keeping an eye on blockchain and that’s that. That will be an interesting one over the next couple of years. We’ll want to, we’ll have to circle back with you on that. So, um, I want to talk a little bit about, so fifth question is really around the it worker. So healthcare, it used to be pretty intensive from a labor standpoint that’s really changed with cloud and automation. And what’s the message you’re giving to your frontline it workers around? Uh, the future of work and how they can maybe adapt or adapt their careers to, to stay relevant.

Ed Marx :                      34:07                Yeah. I’m like, wow, I’m just like a little kid, you know. So sometimes I watch a little kid to come on an airplane for the first time, you know, these two, two year olds or three year olds and they come around and they come around the corner that as it get on the plan, they look down the aisle and they’re like, that’s not our team. It’s like, I was like, do you realize that we’re at the tip of the spear, we are doing digital health, we are imagining things and then actually doing things and what a great opportunity and whatever training you need, we are there to give you that training. So I talk about it as a very positive thing. And so it’s like, whether it’s basic stuff like idols, so everyone has to be idle trade because I’m big believer in process or agile.

Ed Marx :                      34:50                So I’ve mentioned earlier we’re, we’re becoming a completely agile company or it first. And so everyone’s getting is agile training. We’re being certified and whether you need to be certified electronic health record or these other digital capabilities were sending people to training and leadership trading and investing in people because people make things happen. So even though our, our positions are changing and morphing with the times, it doesn’t mean that we’re still not needed. And so we continue to invest in our people. I tell them what an amazing opportunity that we all have. I’m so, I’m, so I’m jumping here. Let’s just so excited about everything that we’re doing.

Bill Russell:                   35:27                I guess the message is we live in a great time. Keep investing it. Look for a company that’s going to invest in you and keep investing in yourself. Keep reading. Then diving in and, and uh, learning new things because there’s plenty of opportunities.

Ed Marx :                      35:42                Keep growing. I always tell people is like riding a bike. You could most every once a while, if you don’t keep peddling at some point, you’re gonna fall over.

Bill Russell:                   35:49                So a six question is the obligatory question that every healthcare CIO gets asked. How is the role of the CIO changed in the last five years? Or or do you think it’s going to change in the next five years?

Ed Marx :                      36:01                I think it’s going to continuously change and so we’re seeing and I call it the post modern CIO and I know you’ve covered that topic pretty well, some of your past guests, but it really is more about the business and it’s about leadership. It’s like digital health, you know I got an opportunity and wow I’ve got to lead digital health or organization and the rest of the team is, they’re not in it. So that’s a beautiful thing. It wasn’t an it thing. It was cross enterprise initiative that we took on and the leaders of all these different journeys, I think I may have alluded to that earlier, they’re all non it people there. There are leaders or clinicians elsewhere in the organization, you know, whether it’s HR revenue cycles, supply chain and clinicians is across the board. We got to help, we’ve got to lead it.

Ed Marx :                      36:40                And so wow, what an opportunity. But I wouldn’t have been able to been afforded that opportunity if I wouldn’t have to learn and grown and morphed and learned about the business side. Learn about the clinical side. There’s all sorts of things that you know, we can do even if we’re not a clinician. I do have a slight clinician background. But even so I, I routinely walk in the shoes of our clinicians. I continuously try to hang out with our clinicians to learn about what they do, what their pain points are. I volunteered in clinical areas so I could learn more about nursing and what they’re doing. And, and so there’s things that we could do to immerse ourselves to better understand the business analysis side.

Bill Russell:                   37:13                Yup. Absolutely. The role is going to continue to change just like we’re talking to the frontline it worker, keep investing, keep reading, keep engaging. We’re saying the same thing to ourselves really as a CIOs. And then the last questions is selfish. Selfish question for me is how do you do it? So your work life balance, you’re in shape, you have a wonderful family life, you have a high profile career. Give us an idea of how, uh, how you make it all work and maybe I can apply some of it.

Ed Marx :                      37:41                Yeah, it’s probably different for everyone. I’ll tell you what, my grounding is my faith that won’t get religious on you or anything, but my grounding and my faith. So like faith keeps me grounded. It keeps me humble. I know, you know why I know why I’m here. So I have a sense of purpose. Um, so that’s, that’s one thing, but I, I have given up sleep so I will admit, um, so I only sleep about five hours to try to five hours a night to fit it all in. I tried for six. My goal is six. I know it’s important for health to have a good sleep and good rest for your mind and your body. Uh, my goal is six, but I wasn’t around five right now. Eight, I’ve not like work out as much as they used to, uh, for now. But uh, so I think getting good rest, but you try to fit it in when you can’t. So I’m an early bird. I get up early to work out so it doesn’t impact my family time. And so when I come home, I’m home so that, so that’s one way. And then also to delegate and building a great team. So if you build a great team, you don’t have to do it all. You should never be in a position where you’re doing it all. So only a great team. And then of course, you know you’re having an awesome family helps as well. Fortunate.

Bill Russell:                   38:48                Yeah, absolutely. And I assume there’s a bed right there in that office somewhere off camera that you take naps during the day.

Ed Marx :                      38:56                I wish that were the case.

Bill Russell:                   38:58                Yeah, that’s hardly ever the case. All right. Hey, uh, so let, let’s close it out. I’m going to share my social media posts and this falls into the category of, uh, pride comes before the fall. The Toronto Blue Jays, as you as everyone knows, there’s been a lot of baseball, uh, cancellations. I’m a huge baseball fan and the Toronto Blue Jays tweeted this out. Weather Update due to our stadium having a roof. Today’s game will be played as expected. And later on that afternoon, they tweeted Rogers Center, which is where the blue jays play their game with the Dome, confirms that ice from the CN tower has hit our roof and the building crews are unable to assess the damage and more ice could fall and they cancelled the game even though they had a roof. So pride does come before the fall. Um, to you, do you have, do you have something you want to share?

Ed Marx :                      39:47                Yeah, I love the clinic actually very progressive and it puts out a lot of, it’s social media is awesome with Cleveland Clinic and they put out some edgy stuff on Twitter, but. I won’t do the edgy with you, but the not so edgy, but very comforting is that coffee is healthy. They tweeted something yesterday for one of our docs talking about the health benefits of coffee. As long as you don’t add in all the other bad stuff.

Bill Russell:                   40:13                Wow. You just made my daughter very happy.

Ed Marx :                      40:17                Yeah, I thought that was good news and like, yeah.

Bill Russell:                   40:21                Well again, thanks for coming on the show. Ed. Can you tell people how they could follow you?

Ed Marx :                      40:27                Yeah, I’m on Twitter. It’s not all that exciting, @marxtango at Twitter and then probably linkedin is the best place. I, I’m starting to blog now on off of linkedin. And if you attach with me on Linkedin, there’s definitely a way to keep in touch, but that’s probably my primary.

Bill Russell:                   40:48                Fantastic. So, uh, you, you can follow me at, @thepatientsCIO on Twitter, my writing on health lyrics, website, health system, CIO, um, you know, don’t forget to follow the show on Twitter @thisweekinhit and check out our website at this week in health it.com. If you like the show, please take a few seconds to give us a review on iTunes and Google play. Catch all the videos on the youtube channel this week in health it.com/videos the easiest way to get there and please come back every Friday for more news, information and commentary from industry. That’s all for now.