Leading Digital Health with Starbridge Advisors

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Bill Russell / Sue Schade / David Muntz

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October 28, 2020: Starbridge Advisors is a health IT advisory firm. Today Sue Schade and David Muntz are here to offer leadership coaching advice. What’s the number one thing they’re communicating to their clients right now? It’s all about relationships. And focus, focus, focus. What do you need to do as a leader to be successful with your cloud strategy? With security? With digital health and analytics? What about your enterprise data strategy? Budget constraints are huge right now but don’t ignore the revenue opportunities that exist out there and new ways to deliver care. Telehealth is a great example. And what about politics? If you hate politics you’re not going to be a successful CIO. The idea is to make sure you are seen as the peacemaker and figure out how to get people to do the things they don’t want to do. And that takes a lot of finesse.

Key Points:

  • There are so many opportunities to be a hero. IT has done things we’ve never seen done before. Things that have never been imagined. [00:07:25] 
  • Focus on taking advantage of the political capital you’ve built to create your future roadmap [00:08:10]
  • One of the things we have to talk about, as we develop this new broader future is change management [00:14:20]
  • Getting things done has to do with focus. It has to do with quick decision-making and painful decision making [00:29:10] 
  • If you want to be seen as a business leader you should think about outsourcing [00:35:40] 
  • www.starbridgeadvisors.com
  • View from the Bridge – StarBridge Advisors blog
  • David Muntz LinkedIn
  • Sue Schade LinkedIn

Leading Digital Health with Starbridge Advisors

Episode 321: Transcript – October 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: [00:00:00] All right. I just want to say thank you. I want to thank you for your input. If you’re watching this on YouTube, you can tell that we’re redoing the studio. We’re redoing the studio based on the feedback that you gave us at our 300th episode, a form that we sent out there. And we appreciate that. For those of you who are participating in our clip notes referral program.

[00:00:18] Thank you as well. Gosh, that is a it’s off to a great start. And we appreciate that. For those of you who don’t know a clip notes is a eclipse notes is something that you helped us design again, with your feedback. [00:00:30] You said, look, I can’t watch every episode, but I want to, what was going on. I want to know who’s on the show. I want to know the key moments and I want some of the key moments in video format that I could just click on and watch. And we created that email that goes out to you 24 hours after each episode is released. And it’s our fastest growing email lists. And now we have a referral program for that, and you guys have taken to that and it’s been fantastic.

[00:00:55] It’s really easy to participate, but first, before I tell you how to participate, let me tell, [00:01:00] great prizes that we’ve put out there. The first is that, if you get a single. referral and you’re going to be entered in a drawing and we’re going to have the drawing on January 1st, 2021.

[00:01:10] And we’re going to be giving away a work from home kit from this week in health. If you get up to 10 referrals, you’re going to get one of these black moleskin notebooks. I’ve talked about them a bunch on the show. I love these things. I keep notes. I’ve always kept notes in these and they’re fantastic. Has this week in health IT embossed on there. And it is always right next to me. [00:01:30] And the grand prize winner. Gets the opportunity to replace Drex DeFord for one week on the show and discuss health IT news the Tuesday news day show, it’s going to be you and me talking to the news that opportunity.

[00:01:42] You don’t have to do it, but we’re going to give you the, to come on the show and I think you’re gonna want to do it. It’s going to be a lot of fun. We always have fun taping the show and talking about, the issues that are gonna impact health IT so that’s what you can win. Let me tell you how easy it is to participate.

[00:01:58] When people sign up, [00:02:00] there’s a fourth field now that says referred by and they just need to put in your email address, anybody who puts in your email address? In that field, you will get credit for them as a referral. Send that email out, send the incentive copy of clip notes out and say, Hey, I’m subscribed to this thing.

[00:02:15] It’s been great for me. You should sign up as well. they can do that in a couple of ways. I could hit the website. And just hit subscribe and they can put the information in there. Make sure they put your name in there for, the referral. they could also send an email to clip [00:02:30] [email protected] just an email.

[00:02:31] It doesn’t have to say anything. It kicks off an automated workflow. They’ll get something back. They click on that and then they sign up that way. So we’ve made it as easy as possible to sign up. And, and you guys, it’s our fastest growing email list. It’s been fantastic. We want to get this into the hands of as many health it practitioners as possible. And we want to thank you for making that a possibility now onto the show.

[00:03:00] [00:03:00] Welcome to This Week in Health IT where we amplify great thinking to propel healthcare forward. My name is Bill Russell, former healthcare CIO, coach consultant, and creator of This Week in Health IT a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

[00:03:15] I want to thank Sirius healthcare for supporting the mission of our show to develop the next generation of health leaders. Their weekly support of the show this year has allowed us to expand our offerings and develop new services for the community. Special thanks again to serious health care. All right.

[00:03:29] I’m [00:03:30] excited today. We’re going to take a look at the impact of COVID on health IT and really the leadership ramifications for that and our leadership that, and today I have two great guests, former guests of the show, Sue Schade and David Muntz Principals at StarBridge Advisors. Good morning. Welcome back to the show. 

[00:03:46] Sue Schade: [00:03:46] Morning, Bill. 

[00:03:49] David Muntz: [00:03:49] Glad to be here 

[00:03:50] Bill Russell: [00:03:50] And Susan, Sue Schade in red and you’re sporting some new artwork behind you. 

[00:03:54] Sue Schade: [00:03:54] Oh yeah. Do you notice that? I think that fabulous new piece of RBG art I [00:04:00] bought at a silent auction for the Women’s fund of Rhode Island. Yep. 

[00:04:03]Bill Russell: [00:04:03] Was that a local artist or is it 

[00:04:05] Sue Schade: [00:04:05] it’s a local artist. It’s a digital image that they did. And, when I saw that, I’m like, okay, I’ll bid. And then I watched until the end and I was still the top bidder. So 

[00:04:16] Bill Russell: [00:04:16] Yeah, that’s those bidding things make people, you go to this really fancy thing and people get dressed up and they look all civilized until the bidding starts and then people are hovering around and anyway, it’s fun. That’s great. That’s [00:04:30] fantastic. And I’m glad you’re in Sue shade red. So it means we’re ready to talk about health  IT   IT  it just gets me go in there. It gets me fired up. it’s been, it’s actually been a while since we spoke. And, I guess I want to start with a pretty broad question, which is what are you guys finding out there? What are you finding in your practice and what’s going on in health IT? 

[00:04:48] Sue Schade: [00:04:48] First off. I just want to thank you again for doing this with us and, yeah. what  an and tell you what a great service you are doing to the industry. I have listened to so many of your podcasts over the [00:05:00] last six months and your field reports series, and I am in awe and great respect for all the CIOs and their teams and everything they’ve been doing during this period.

[00:05:09]I think what we’re seeing is, business slowed down because people focused on COVID. that’s what they needed to do. As business picked up and we got more calls. We’re hearing people who still have their strategic initiatives and priorities on the agenda that they can start focusing on again and in some respects those are [00:05:30] varying yet there’s some common themes, digital health being one of them. new ERP replacement systems being another obviously, along with, we’re seeing an uptick in coaching, more people calling and looking for coaching. And we can talk more about that, a little bit later, but, it really varies where people are looking for as they get it. it’s hard to say get past COVID when you see what’s happening this fall, but as hospitals get back a bit to, what else do we need [00:06:00] to be focusing on? And looking ahead to the future, those are the kinds of calls that we’re starting to get from people. 

[00:06:06] Bill Russell: [00:06:06] Yeah, absolutely. Hey, thanks for the kind words, by the way. I appreciate it. And everybody who’s come on. The show is they’ve just shared so much, Yeah, we were spotted instinctually to COVID and did some amazing work. And I think too, and we’ll talk about this a little bit as well. I think to a certain extent that’s raised the expectations on health IT which is something that leadership has got to deal with. David  what are you [00:06:30] finding? 

[00:06:30] David Muntz: [00:06:30] Yeah, what I found is that, and by the way, I would repeat what Sue said, but she said it eloquently. We are very appreciative of what you give back. So I thank you for that. And we all are very much appreciative. And one of the things that you do is you’re helping with the education process and bring solutions. And one of the things at that point now, when I talk about vendors is the communities that they have, but you’ve created your own community. That’s been plastic. And I think that’s one of [00:07:00] the great places that, builds trust and with trust, we talk about everything, moves at the speed of trust and so the ability to share those solutions.

[00:07:08] Bill Russell: [00:07:08] Fantastic. So that’s our show for this week. 

[00:07:10] David Muntz: [00:07:10] Let me go ahead and tell you what I have found and what I, what’s an interesting, missed opportunity. I think a lot of CEOs are missing out on. they have performed heroically and overused nowadays, but it’s because there are so many opportunities to be a hero and IT has done things that we have [00:07:30] never seen done before in a paste it’s never been imagined. And when you talk about it’s the deployment of the technology or it’s the expansion of the beds or it’s the expansion of the services, it’s really been extraordinary and. The CIO is and their teams. We know it’s always a team effort, have built political capital and they’re unaware of it.

[00:07:52]I don’t think they appreciate the gratitude that exists out in the community for what they’ve done. and so they have to be [00:08:00] careful now not to try to go back to the pre COVID world. The idea is use to political capital that you have to create a new roadmap for the future and focus on how you’re going to take advantage of the political capital that you’ve built.

[00:08:16]Now you got to balance that with expectations and then, Oh gosh, if you could do this so quickly, how can we do all of these other things? And so as we get down the conversation about what we’re causing clients, I’m happy [00:08:30] to talk about that as well. But I do think that we now see the greatest opportunity rich environment for IT I’ve ever seen. So I’m very optimistic about it. No, that’s not new normal because I don’t like that idea of, using the word normal again, but in much brighter future. 

[00:08:48]Bill Russell: [00:08:48] It’s interesting because I’ve heard it talked about so many times that if we need a seat at the table. COVID absolutely invited IT to the table. We were in those [00:09:00] rooms where we’re doing the prep. We were doing the escalation rooms we were in, we were in executive leadership. So there is that visibility. And, I know in my work I’m talking to  CEO’s and others and they’re. Incredibly appreciative of what IT has done. And there, some are actually amazed. They’re like, I knew we were throwing money out of them. I didn’t know. They’d be able to respond this way. and, it’s pretty, pretty interesting, but, before we get too far, I realized I’ve had you guys on the show a bunch of times. So we haven’t really talked about Starbridge and what you guys do. [00:09:30] And they’ll probably give people context for the things we’re talking about and the type of work you’re doing. so can you give us a little context on Starbridge. 

[00:09:38] Sue Schade: [00:09:38] Sure. Sure. So Starbridge advisors is a health IT advisory firm. We’ve actually been around now for four years. We had our fourth birthday or anniversary, whatever you want to call it what two weeks ago? And our focus is on providing interim management at all the senior health IT leadership levels. Doing IT consulting and advisory services on [00:10:00] a range of, areas really in terms of our expertise and leadership coaching, we’ve got over 40 advisors who are on the team. They’re at that senior level for the most part as CIO, CTO, CSO, CMIO, CNIO VP of apps, and they’re available to do interim work, or, as I said, a range of advisory work, I think what. Differentiates us in the market because you there’s a lot of consulting firms out there. You can call, we’re [00:10:30] small, we’re nimble, we’ve been there, we’ve done it.

[00:10:32] So we’ve sat in the seats and, we come in for relatively short engagements and, help out CIOs and their teams and are just very honest with our feedback and our approach. Again, because we’ve been there done it. so that’s the long and short on us. I don’t know if David wants to add anything to that.

[00:10:52] Bill Russell: [00:10:52] Well, and we’ve had, so we’ve had a fair number of your advisors on  They’re experts in specific fields. Amy Maneken was just on, [00:11:00] we talked on usability. Nancy Beale was on, we had Terry, I always struggle with his last name. Z Omniac who’s security, just some security projects for you. I think we’ve had others. I just, 

[00:11:11] Sue Schade: [00:11:11] Rich Pollock maybe 

[00:11:12] Bill Russell: [00:11:12] Richard Pollock as well. Absolutely. Yeah. So it’s a lot of people who have been there, done that, a lot of expertise in, in some core fields.  Let’s focus it on, on the health IT space right now. What’s the number one thing that you are communicating to, to your clients and [00:11:30] to leaders and what areas are they finding the most need right now?

[00:11:37] Sue Schade: [00:11:37] Sure. So in turn, I don’t think there’s any one specific area and, in terms of what we’re communicating, I’ll tell you and Bill, you and I have had conversations like this over the years. It’s all about relationships. If people know us and they know what we’re capable of doing, when the need arises, we’re going to get the call. And, I’ve [00:12:00] talked to, people in the recent period who want help with security assessments, with cloud strategy, with their enterprise data strategy, analytics. Digital health, eRP valuation as they focus on that, just really a lot of different areas. Yes. and I think one of the things that. I know I’m trying to emphasize when I talk to CIO is we can be flexible. I know budgets are constrained right now, so sorry. 

[00:12:28] Bill Russell: [00:12:28] There’s the clients reaching out [00:12:30] right now as we speak. 

[00:12:31] Sue Schade: [00:12:31] I don’t recognize the number. It’s either spam or yeah someone that needs us. sorry about that. What I emphasize is that we can be flexible. I know budgets are tight. So if you have a need, you want to bring us in, you want to bring us in some reduced way. Just to get, some initial work done, we’re just, we’re willing to be flexible and go wherever they need us to go. 

[00:12:56] Bill Russell: [00:12:56] Yeah what I’m telling people is, [00:13:00] conversations with me are free, right? So if you just want to call and have a conversation, Hey, how are things going? How can we help? Or just talk about how I’ve addressed that problem or how people in our organization have dressed up. that’s, we have those conversations five times a week. but when it, when it turns into, Hey, can you do something for me? That’s when it turns into a project, but, and you guys are doing a lot of that, allowing people to reach out and tap into your expertise. 

[00:13:24] Sue Schade: [00:13:24] I think that’s an excellent point. I do those calls too. and, when someone says this has been really a good call, let’s talk [00:13:30] again in three months and, we just schedule more time. They might want me to be a sounding board on something. And like you say, if it turns into more than, we try to shape that. 

[00:13:40] David Muntz: [00:13:40] Second I go ahead and just expand on one thing that you talked about what’s going on with health IT space, and right now the budget and the constraints, and this is what you can talk about, sue are huge and yet they’re not misplaced. That’s an appropriate thing to do on the other hand. The thing you don’t want to do is ignore the revenue opportunities [00:14:00] that exist out there and new ways to deliver care. And in a telehealth is a great example. And just last week, CMS approved 11 new, coverages for telehealth care.

[00:14:13] And so it’s expanding and we just have to figure out far better ways to do things. I think one of the things that I say that we are going to have to talk about, to the people, as we develop this new, broader future [00:14:30] is change management. We have to go back to the really basic thing, because the way that we’re going to conduct business going forward, it’s not going to pay the way that we’re going to conduct business or deliver care going forward. the hospital at home is a term that we hear a lot, but my wife happens to be a hospice nurse. And she says that’s a 70 year old concept. and she’s been doing acute care in the home for a long time, but with the ability to extend the technology and to do things, that are, that were very challenging [00:15:00] before, because you didn’t have the connection back to the, to the physician. anyway, it creates an entirely different approach. So I think that the key is to try to balance how much you’re going to try to take it out of IT, versus how much you’re going to invest in IT. So in order to earn revenues in the other place and what, see, and this is one of the, again, big opportunity for CIO.

[00:15:23] Is to change the way that people think about them. And, you were referencing this Bill talking to me about, I want to get a seat at the [00:15:30] table. I’ve always had a seat at the table, but one of my former employers, when something would break, I would always be the technology guy who would go up and fix it. The AV guy I used to be in high school. Whenever I went to my second employer, I recognized that didn’t want to be looked at as the technology guy. So when something would break in the room, they’d look at me and I’d go, let me call the help desk and field services and get them out. So that is part of the change management is to change the image that you have now [00:16:00] as the technology person and come in as the business person who knows how to work with the technology to get it installed and get it in place. And I think COVID has shown or given us the opportunity to do that, because I think a lot of, CIOs, are trying to pivot from just technology now to focus on business and thats a great opportunity. 

[00:16:21] Bill Russell: [00:16:21] No, I had two conversations in the past week, which were interesting when we were talking about the influx of people from the outside. So you have Nevada hired somebody from the [00:16:30] outside. you have CommonSpirit hired somebody from the outside. I just had heard of another one but pretty significant organization that hired somebody from the outside and actually both of those other organizations are significant organizations as well where they are, they’re bringing people in. And I think part of it is what you just described. It’s they’re looking for the business IT person. That’s going to sit down and talk about transforming the business and those things and I find that, that conversation in of itself is interesting.

[00:16:56] Then I had another conversation with a pretty high up [00:17:00] leader within a health organization. And they were saying essentially that CIO is really excellent, tactically, running the business of IT but we’re not , basically what they were saying is I’m not sure they’re ready to be the strategy person. that the person who’s looking five years out and being the strategy person, I sat back and I thought, I wonder if that distinctions going on all over the place and CIOs are trying to figure out how do I get positioned as a strategy person, within it, within an organization [00:17:30] and organizations are saying, Hey, who’s going to fill this void of really the digital strategy. And so you mentioned digital, one of the areas that people are looking at, how are you coaching CEOs in that area? How are you, helping them to start to think digital, to think business and to, to get out in front of 

[00:17:50] Sue Schade: [00:17:50] You want to take it? You want me to take it?

[00:17:52] Yeah, 

[00:17:52] David Muntz: [00:17:52] no, I’ve got to go ahead and jump in. One of the things Bill that I’m trying to do is to try, I know that sounds silly, it’s, what’s in the [00:18:00] name. That’s an important question to answer, and I’m suggested that all the people that I’m talking to change the term, get IT or information services out of the name. And use the term digital services has going forward. and the whole point is to try to take ownership of the digital strategy and too often people conflict the word consumerism and thinking that consumerism and digital health have the same thing. And they’re so radically different. Digital [00:18:30] services, digital health, and consumers, and there’s just a small part and the reason that people are going outside to look for those homes from a consumer oriented organizations is because as they do the two together. And so it’s really critical that you come up with a strategy that gives people a much broader understanding of what digital health is, what it means to be a digital health system.

[00:18:57] And, the idea is you want a [00:19:00] digital experience, but there’s got to be that analog human part of it. And so I appreciate that there are many smart people outside of healthcare who can bring a lot of creativity and innovation analytics in, but this deep understanding of healthcare and what it means in terms of analog versus digital is together and so a digital health system. Needs to figure out how to put both analog and digital together in a way [00:19:30] that’s going to give her give care. That’s both high tech and that’s a tribe-kind of a tribe term. That’s something really important. And I see that element of analog in the sector to the need for digital going too far.

[00:19:45] And the other thing is and, I don’t want to get too much on social soapbox, but there is the digital divide that exists in the country and huh, I live in Austin and, access to connections is really important. And you had in many of the [00:20:00] underserved communities here, there’s not a digital connection. So if you look at just that, it’s the approach that including the analog part know, missing huge farm population, the one who consumes more healthcare name, but they also. And so that conversation needs to be changed. And by the way, what they did in Austin is they put wifi. my five connections into school buses and drove them to the underserved communities which worked for awhile.

[00:20:27] But now that school has taken back, coming [00:20:30] back into place, the buses are no longer available. digital health has to look across the digital divide. And there are ways to do that because there is nobody on no, and I’m sure there are some exceptions to this who doesn’t have at least a digital phone. And so when you’re designing fancy systems, text-only has to be a, an option. And it’s our obligation to cover not just, digitally sophisticated, but that digitally incapable as well. 

[00:20:58] Bill Russell: [00:20:58] It’s interesting. [00:21:00] Sue. 

[00:21:00] Sue Schade: [00:21:00] Yeah. If I can just build on, if I can just build on the point about what are we advising, CIOs at this point, there’s no one size fits all if I’m talking to a CIO and they’re struggling with how to expand their role versus, the organization’s already decided they’re bringing in a chief digital officer and where do they fit in that? it’s where are they at? What do they want to be doing? How comfortable are they with that expanded role. Where’s your organization at, where are they in relationship to the executive [00:21:30] team and what they’re able to bring forward?

[00:21:31] So it’s really trying to understand their situation and advise them because I don’t think it’s. One size fits all. Not every organization is, approaching this in the same way. So you see all sorts of models at this point, in terms of CIO and expanding roles. The other thing I want to just make a plug, as we talk about digital health, David has done really an excellent, are we at four parts or five parts and to be fine 

[00:21:55] David Muntz: [00:21:55] four 

[00:21:56] Sue Schade: [00:21:56] parts series blog series on the Starbridge [00:22:00] advisors blog view from the bridge on digital health, it’s worth checking out.

[00:22:05] Bill Russell: [00:22:05] I saw. So what are some of the topics on that you did a, you did governance. I think that’s one of the places you started. What other topics have you covered?

[00:22:13] David Muntz: [00:22:13] I think the most recent one was, I think language, I get mixed up because there are so many of them, but it’s what does it mean to be a digital health system? How do you get there? The governance associated with it. But there are so many areas and this is such a, such an interesting fabric as you put [00:22:30] together, your plans. so I’m very hopeful that people will, take on the responsibility of being a digital health officer without having to have a separate digital health officer. the CIO role is to transform, to become digital health services, CIO. 

[00:22:50]Bill Russell: [00:22:50] I wanted to touch on this with you guys. Cause I think you have a lot of experience with your clients around this. We saw an uptake of ERP work just prior to COVID and it was, Hey, we did all the [00:23:00] clinical work.

[00:23:00] We did all the, all the EHR work for the last decade and we let our ERP systems atrophy is probably the best word for it. and we saw that those projects kick off pre COVID. Have they started to resume? Are we starting to see that work? Come back? 

[00:23:18] David Muntz: [00:23:18] Yeah, significantly. And when I talk about the expense reduction, it ripest forum is supply chain management.

[00:23:27]and you’ll read articles. I read [00:23:30] one today talking about how the, revenue managing, I’m sorry, how to manage the supplies. And this is the amount of cash that’s available to an organization. And it’s really difficult to do that. With the old kind of disconnected ignored systems. And so people were rushing toward the RPS and we have developed a very good set of tools that will help us choose this. 

[00:23:54] There’s not one of those 40, people that we have that hasn’t been through multiple [00:24:00] implementations of ERPs in the past and the present and. It’s astonishing, what a different kind of experience, the new ERP is for the employees and the staff. And there is, the fact is that it’s, to state the obvious and capital management, supply chain management and financial management and human capital management touches every single employee in the enterprise and often has to [00:24:30] reach over and take care of the providers as well who are sometimes employed. the impact of those can be understated and the enthusiasm is great. 

[00:24:39]Bill Russell: [00:24:39] th the selection of those tools to me has always been fascinating because, you just touched on, finance and human capital. And so you’re bringing those teams together to do a, an RFP process.

[00:24:50] And I don’t know about you guys, but it has felt to me like there’s a lot of give and take. In the, in that selection process, because either one [00:25:00] does the human capital really well, and the finance, okay. Or they do the finance really well. And the human capital is like just a module that’s bolted onto it.

[00:25:10] And so in some senses, somebody is walking away, not really happy with the decision. is that what you’re finding or are our tools starting to get really start to bridge that divide? 

[00:25:23] Sue Schade: [00:25:23] Let me, I think the tools are evolving and bridging that. But if I talk about it from a, a buyer’s [00:25:30] perspective, and, organization that we are working with now, we just finished the ERP selection.

[00:25:35]it was great to see that the collaboration between the domain leads and the recognition that, you know, in the end, the product that they were going to go with. Had strengths in some areas and not as much in others, but for the greater good of the organization and an integrated single solution, they were okay to move forward.

[00:25:56] So I think what you’re seeing is in that whole space, [00:26:00] a similar process and decision-making, as you saw with, the EHR, there’s give and take. Some areas might be strong. Some areas might be weak, but if we’re committed as an organization to go with a single integrated solution, then this is what we’re going to do.

[00:26:16] Yeah. 

[00:26:17] David Muntz: [00:26:17] Say that again. Perfect. And one things I’m excited is one of the other trends we’re saying is instead of operating as a loose Confederation of facilities, now, systemness is becoming something everybody embraces and [00:26:30] we see great embrace of that. It’s not like one group doesn’t remember doesn’t.

[00:26:35] Every single interview that we did with all the leaders in all the areas set the same thing for that and knowing what the other was going to say. And so I’m wanting to function as a team. Doesn’t have become the norm, not something you really have to find for change management, knowing that you want to operate collaboratively really changes the enthusiasm around change management.

[00:27:00] [00:27:00] Bill Russell: [00:27:00] So we saw huge telehealth gains. Wha what’s the CIO’s role in telehealth? Do you feel, moving forward to, you’re coaching and talking to a lot of people, is the CIO role, just the technology foundation or are they part of a, and if they’re part of a larger team who else is in that team, that’s really determining the direction of telehealth.

[00:27:19]Sue Schade: [00:27:19] it’s amazing how organizations were able to scale quickly with telehealth. can you hear me? Yeah, you can hear me? Okay. Okay. cause they had the foundation in place though. They were [00:27:30] doing small numbers and it was really about. adoption, and workflow with the clinician. I think the technology’s there and I think that the role of the CIO, to really make it stick at this point is probably, very much connected to the work of the CMIO, as well as the, the ambulatory leaders and the patient experience leaders to make sure that those workflows and access were close to the clinicians and the patient and the access is [00:28:00] there in a seamless way. So people want to continue to do it. It’s easy. It’s convenient versus, okay we did that cause the COVID, but now we’re going to go back to the office. 

[00:28:09]Bill Russell: [00:28:09] the word I heard the most during COVID was “focus” right? In it, it’s like we were focusing on three things, get people to work from home, stand up telehealth and security, making sure that there was no gaps during that process, that it was like heads down focus. Are we going to be, is that one of the roles of the CIO at this point is [00:28:30] to try to maintain some of that focus around telehealth to say, look, there’s a great opportunity here. And we’ve done a lot of really great work to that we can build on. Is there a role as a champion of sustaining the telehealth gains?

[00:28:46] Sue Schade: [00:28:46] Yeah, I think so. And it also depends, within the organization is telehealth totally their peer review or is it, off somewhere with a chief digital officer that they’re partnering with or a whole separate telehealth, area, but can I key in [00:29:00] on another. point you just made that’s not telehealth and that’s focus when . As I listened to all the field reports series, what people said over and over again, we were able to get things done in a matter of days, not months, years, and it had to do with focus. It had to do with decision-making, quick decision-making. and we all know the painful decision-making right. So I think, regardless of the [00:29:30] project and the initiative, those are some of the really important things that CIOs and health care organization leaders really need to make, stick that you can focus because you can easily get on way too many projects and none of them are going as fast as you want them to. And then that decision, that rapid decision-making. 

[00:29:49] David Muntz: [00:29:49] Yeah. Can I jump on that one too? Because. to me, focus is, requires better governance or more or focus on prints if you will, to use the word. And [00:30:00] that has become really apparent. And, getting this all involved as well is really important because I have seen the champions for tele-health moved other places, but the technology still is a requirement and making sure that the work process is done. I used to say something and it sounds like what a high school coach would say, especially if you’re from Texas, but the idea is we can do anything.We can’t do everything. And right now the demand for everything is [00:30:30] back on the burner. Again, it’s like what you did all of this in such a short period of time. I’m going to command back on the request queue. And again, good governance. getting everybody represented well is really important, multidisciplinary, and, inter energy. And, anyway, I think that’s the most critical part right now. 

[00:30:52] Bill Russell: [00:30:52] All right. I’m going to get everybody some free coaching here. So the three of us are going to take turns on this. Then we’re going to act as a coach. I’m going to give you three different categories as we move [00:31:00] through. let’s start with academic medical center. So we’ve all done work for, or been a part of academic medical centers. If you’re talking to an AMC CIO right now, w what’s one piece of coaching that you would give them and David we’ll start with you. 

[00:31:14] David Muntz: [00:31:14] Yeah, certainly. Politics, people always say they hate politics and it’s you hate politics you’re not going to be a successful CIO. and the idea is, make sure that you are seen as the peacemaker, and that you [00:31:30] figure out how to get people to do the things they don’t want to do. and that takes some finesse and, a bulldog approach and I’ve seen the political approach. And I think the political approach is far more important..So it’s not the big door that the politics are, try to increase it. but to try to use it for the appropriate reasons. 

[00:31:49] Bill Russell: [00:31:49] Sue, AMC, CIO, what are you telling them these days? 

[00:31:53]Sue Schade: [00:31:53] That’s a great question. I’m going to take it from the angle of AMCs that are closely affiliated with, or part of potentially a [00:32:00] university system. And I think you see a lot of different models there in terms of separate CIO is, or combined CIO is, or the university taking over. And, again, it’s looking at where’s your organization out, what’s the politics of your organization. And, doing the integration and shared services where it makes sense, but, never losing sight of the primary focus that the health delivery system within that overall ecosystem has, to deliver care to patients. And [00:32:30] it’s very different than, the university side, of that equation. 

[00:32:35] Bill Russell: [00:32:35] Yeah. if I were coaching an AMC CIO right now, I would say. Make a list of 10 ways that your AMC could start generating revenue. David, getting back to what you said earlier. I think AMCs have a unique opportunity right now. I saw that Southwest names Stanford as their partner in determining what their policies were for, go back to work, those kinds of things. [00:33:00] And I think those that’s just the tip of the iceberg of flood. First of all, the brand, the. Recognition the research, the tie with, there’s just so many opportunities, so that’s where I would go.

[00:33:10] Okay. We’re going to go second category and Sue we’ll go. We’ll go to you. And I’ll lead off the third one. 

[00:33:16] Sue Schade: [00:33:16] I’ve never been on a game show. 

[00:33:19] Bill Russell: [00:33:19] Yeah, you guys. So the second one is let’s just call it a medium size idea. Maybe, maybe, 10 hospitals. that’s a big, that’s [00:33:30] fairly sizeable, let’s say six hospitals serving a region, middle market region and maybe even one of the primary, providers in their state, what are you saying to that kind of CIO? They have a decent size organization, a decent sized budget. Probably not enough. And but they have a decent size and they have a good market share. Sue what are you saying to that CIO?

[00:33:52] Sue Schade: [00:33:52] Is there a particular problem they’re trying to solve? 

[00:33:55] Bill Russell: [00:33:55] So that’s where you would start it as, what’s the challenge.  

[00:33:58] Sue Schade: [00:33:58] I think, based if I [00:34:00] may, based on the profile on the size of the organization, you just defined, they may well be looking for, partners within that region. And, if there’s merger and acquisition activity going on, the CIO has got to be, front and center and part of that team, looking carefully at that and, maybe they’re looking at how they can, help increase revenue and bring value to, the growth of that organization in that market? Short of, a merger. 

[00:34:27] Bill Russell: [00:34:27] Yeah, the, so the middle size, [00:34:30] the middle-size IDN. I think these are the CEOs that are struggling to step up as digital leaders. They’re really good clinical informatics, but the EHR is probably functioning really well. They, they probably have a decent iT team, the systems don’t go down, good veteran, decent vendor management and those kinds of things. and I think the next step for them is to step into this digital side and the organization saying, okay, look, we do, we got at the EHR is functioning and we [00:35:00] pack systems run and we can share information across our network.

[00:35:03] This is great. What’s next? I’d like to. I would like to encourage them to start to step into that by creating a digital roadmap, create a digital roadmap and share with a couple people and see, get some feedback and be the cheerleader. If you will, on that. David, where would you take the, The middle market CIO.

[00:35:25] David Muntz: [00:35:25] Yeah. One of the, and I know this is going to be an unpopular opinion, but [00:35:30] the fact is I do believe that much of IT has reached commodity status. and so if you want to have, want to be seen as a business leader, you should think about some source of something like that outsourcing. in order to make sure that somebody else can add the headaches that are associated with keeping the lights on. So you can focus on the things that are more creative and innovative. and they’re, it’s possible by managed services to replace small [00:36:00] portions of it. And my whole career, I did selective outsourcing and found it to be very popular or very effective. and I was always asked by my CEO to, and we outsource you.

[00:36:10] So I would always go on and say, let’s try to outsource the whole shop and was able to prove that we could do it cheaper, but there were portions of the organization that could do it better outside. And so I think that looking at managed services is the smart thing for people to do in those middle markets in order to enable them to do exactly [00:36:30] what you do set.

[00:36:32] Bill Russell: [00:36:32] Yeah. So the last group I’m going to give you is the rural health system. And we all know, this, these are the people I have so much empathy for. Cause they’re. small organizations serving sometimes serving larger geographic areas than, some of the significant health systems that we’re used to dealing with. Plus I think this is also one of the loneliest jobs in the world, in that there isn’t a potentially a strong peer network for them to bounce ideas off of, and these could be people with. [00:37:00] 10 people on their it staff. I’ve heard one of them that had five people on their it staff. And, at that just boggles my mind.

[00:37:08] When you think about the regulatory challenges, the clinical informatics, Maddix, the reporting, all those things. I think what I’m saying to that group. Is, gosh, again, I would start with empathy and I’m not sure I’d get past it, but it would be, try to make as much of your budget fixed as possible.

[00:37:27] And I know that’s the opposite of what I would tell [00:37:30] some of the larger health systems, but the reason I tell the smaller health systems to fix their budget, like a certain amount to a vendor for, for analytics or something to that effect is because. when your health system goes up and down with the economy and you want to keep people from cutting things that they just shouldn’t cut.

[00:37:50] And one of the ways to do that is to have a three-year agreement or a five-year agreement so that they don’t come in and go. Hey, we need to cut. We need you to cut back on security, but if [00:38:00] we can’t come back and security, we can’t go back. You can’t come back on any of that stuff. So to a certain extent, I would, I think I’ve coached them to make that sex. And I don’t know if that’s good advice or not. let’s see, who goes second on this one? David, you go second on this one. What are you telling the rural CIO at this point? 

[00:38:15] David Muntz: [00:38:15] Actually I can give you some anecdotal evidence cause I’m working with a 15. go access hospital and it’s essentially, you said you have to outsource and what you do they don’t have an IT staff. They have [00:38:30] three people, essentially taking care of things and the nice thing about, and by the way, I came up in a smaller, the hospital and work with facilities in the large system. The thing that’s nice about that is that people there and everything, and there’s so few handoffs in.

[00:38:48]So there’s much more generalization of understanding of operations. So there, they do have an advantage in that regard, but. the capital requirements are killer. And so the ideas, I suggest that you don’t look at just [00:39:00] it three, five, but you look at seven and 10 year relationships. And the one thing I’ve coached, everybody I talked to them, this is regardless of size is make sure that you have.

[00:39:11]volume adjustment that allows you to go down when the costs, when you’re, when your scale goes down. So if you have to reduce the number of beds, then your monthly fixed fee will go down. But fixed fee is the only money for somebody to manage that. And they have to make partnership with somebody else [00:39:30] in the larger system to get the technical expertise that they need.

[00:39:33] And as you pointed out, it doesn’t matter what size your organization, the regulations don’t say. If you’re this size, you get to do this little security and everything is going to be the same quality is the same expectations. And you’re calling up here. Your, patients are the same, so you really have to have a long-term partnership. And there are vendors out there and I won’t mention them, but there are vendors who make special allowances, [00:40:00] so support the rural communities. And so those are the community. Those are the partners that I would seek out first. 

[00:40:07]Sue rural healthcare. What Bill Russell: [00:40:10] how’d you coach a CIO there? 

[00:40:11]Sue Schade: [00:40:11] I’ll give you three points. One, you already mentioned Bill and saying it’s a lonely job. There’s lots of resources to network with and learn from. Even though you may feel like you’re the only one doing this and you’re isolated as a CIO. Secondly, so take advantage of that. Secondly, if there are talks, if it’s not going to be an [00:40:30] independent rural community hospital, part of, some merger activity don’t view that as a threat, but view that as an opportunity, for you and your team.

[00:40:38] And lastly, with the. positive nature of work from home that greatly expands the talent pool for people who are trying to hire in small, more isolated areas, because you can hire people elsewhere that are gonna be on your team virtually. so I think that could [00:41:00] be a real positive opportunity.

[00:41:02] Bill Russell: [00:41:02] Fantastic as always, you guys do not disappoint. If people wanted to get in touch with you around, coaching around the work that Starbridge does. so many different areas, security, interim leadership, ERP and whatnot. how would they get it? How’d they get in touch with you. 

[00:41:18]Sue Schade: [00:41:18] check out our website starbridgeadvisors.com. We’ve got a blog there. I’ve got a blog, sueschade.com. Reach out to us on LinkedIn. you follow me on Twitter. [00:41:30] SG shade is my, handle. David. 

[00:41:35]Yeah, David Muntz is my TwitterDavid Muntz: [00:41:36] handle. And by the way, our email addresses are easy. It’s first name dot last [email protected] Happy to, by the way, Schade is S C H A D E. 

[00:41:50] Bill Russell: [00:41:50] Yeah, absolutely. Hey, thanks again for coming on the show. I think this is, again, invaluable. I was telling you guys earlier that one of your shows that was six months [00:42:00] old, got a huge spike. And, I think it speaks to the value of it. I think I’m speculating that a college professor essentially is saying, Hey or potentially a master’s program and saying, Hey, listen to this. there’s a lot of great information in this cause that doesn’t usually happen. You don’t usually have a big uptick, six months after a podcast, goes live. So I think that speaks to your experience and your wisdom.

[00:42:22]You started by praising the show, I’m returning the favor and I really appreciate your wisdom and the work that you’re doing in the, in healthcare. So thanks again for [00:42:30] coming on the show. That’s all for this week. 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, special.

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