David Bensema on The Strategic Imperative of Telehealth and the Role of the CMIO

This Week in Health IT - Dr. David Bensema, M.D.
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Dr. David Bensema joins us once again to provide insight on the recent announcement from the VA on removing the state barriers for telehealth. Also, a conversation about the role of the CMIO from someone who has been a practicing physician, CMIO, and CIO for a health system.

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Bill Russell:                   00:01                Hey podcast listeners. Thanks for listening. If you’re enjoying this week in health it, we just want 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 healthcare 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 listening to this podcast.

Bill Russell:                   00:49                Good morning. 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 19 it’s Friday, May 18th today we talk about the present and future of telehealth and the role of the CMIO. This podcast is brought to you by health lyrics, get a plan for agile, efficient, and cost effective It from people who have been in your shoes. Get ahead of the wave. Visit Health to schedule your free console. My name is Bill Russell. Recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Uh, before I introduce our guests today, I want to share with you an exciting opportunity. We’ve reached some milestones on the show around listeners, production quality, and just the, the wonderful guests that we’ve been able to have on the show. Um, based on your feedback, we know that the content is relevant, timely, and very useful.

Bill Russell:                   01:40                Uh, over the next couple of months we are going to focus on getting this content into the hands of more current and future healthcare leaders. That’s why I’m really excited that our sponsor has agreed to give $1,000 for every hundred, do youtube or podcast subscribers over the next 90 days to an organization called hope builders. So hope builders provides orange county’s most disadvantaged, youth the life skills and job training needed to achieve. And during personal and professional success, I had the opportunity to hire some of these graduates. Their stories are really incredible. Anytime uh, somebody chooses to reboot their life, uh, I find that to be heroic and it really points them in a great trajectory. So I’m really excited about this opportunity. We hope you’ll join us by sharing the show with your peers and friends, uh, to maximize this opportunity. Um, so today’s guest is no stranger to the show hes been on with us before Dr. David Bensema, former CIO for Baptist Heath and, uh, first three time co hosted the show.

Bill Russell:                   02:40                Good morning, David. Good Morning Bill. I appreciate the chance to be back with you. Yeah, I’m, I’m looking forward to it. It’s a, it’s been a little, been a little while, but you are, you were one of the people who I love having back on the show for the, for the fact that you’ve been a Cmio, you’ve been a CIO, a practicing physician, so you have so many different perspectives to bring to the show. And that’s, um, you know, and I just find that so valuable. So I’m looking forward to our conversation. I appreciate it. So we have, we’ve, we’ve modified the show a little bit since last time you were on. And we still do, we do in the news, we want to make sure that we’re, we’re , hitting the current news that’s going on. We did not do a section called soundbites where I put the, uh, the cohost on the spot and ask them, you know, four or five questions and give you a two or three minute, uh, answers to come back every now and then.

Bill Russell:                   03:33                One of the, one of the cohosts we’ll fire a question back at me and catch me off guard, which is what David once did last week, which was a lot of fun. He asked me a highly charged political question, which is fun to try to dance around, uh, which he got too much enjoyment out of, but we’ll see where this one goes. Uh, and then we have the social media close. And, uh, I, I really love your post for this week. I look forward to getting to that. So we’ll get started. I, uh, so I, I picked, I picked the story da finalizes interstate licensing rule that will open the aperture for telehealth. This is on fierce health care and um, you know, the story is that the Department of, uh, I’m just going to read some of it. The Department of veteran affairs finalize the much anticipated rule that allows providers to treat patients across state lines using telehealth.

Bill Russell:                   04:24                A critical element of the virtual care initiative launched last year. Currently the VA patients can receive care via telehealth by going to one of more than 700 community clinics. So not directly to the home. They actually have to go to these clinics. That’s how it was before. Now they’re going to be able to do these telahealth visits to the home, uh, bypassing the state licensure requirements, the regulations. So the new rule overrides state licensing restrictions. So clinicians can treat veterans anywhere in the country. The rural is critical piece of the anywhere to anywhere telehealth initiative launched by Secretary Shulkin. Um, the finalized rule is limited somewhat, but the, uh, the House and Senate are looking to address that. It doesn’t cover the VA choice program providers. So, um, I’m gonna, I’m gonna stop there. I’m gonna come back to the story, but, uh, you know, one of the things I’ve heard over and over again as I’ve talked to healthcare leaders is that they believe that telehealth could be an amazing opportunity to reduce costs, increase access, but the state run medical licensure prohibits physicians from practicing medicine across state lines where they are in license. So this, this, this roadblock to tell it’s really a roadblock to the proliferation is telemedicine. I was curious from your physician’s perspective, is the state medical licensure still relevant today? Are we going to see that sort of go to the wayside? I mean, what, what’s your personal thoughts on this? I

David Bensema:            05:58                think the state’s licensing is still relevant. Um, I think because of that type of impediment to telemedicine development into the movement of physicians into areas of need, um, including the fact that, you know, Kentucky is a state that borders on seven other states. We have the most borders of any state in the union. We recognize the need to simplify the licensing process. I’m not in favor of the federal government and jumping, um, the chain and going ahead and just bypassing the states cause I’m kind of a state’s rights person is bluntly, but we’re already working with the interstate medical licensure compact and 22 states have already passed legislation allowing their physicians to participate in the La Compact rather than strictly with their state licensure board. So their state licensure board works and contractual agreement with contract compact and allows a physician who’s, let’s say he’s getting licensed in Tennessee, is also then able to be licensed in 21 other states at the same time.

David Bensema:            07:01                It allows us as physicians and the states, um, to ensure that the vetting process is written, is strong, is thorough and is consistent with their desires. There’s eight more states that have introduced legislation, so that would be 30 now we’re at a tipping point with this. I would have really preferred the VA had thrown the weight of their, of their organization, their department and the weight of our veterans. Our veterans would get this done and then we could do it within the states with the control by the states without bypassing them. So that’s my political take on it. Now. My Cio hat and CMIO hat is, the sooner we get telemedicine to be fully robust and without barriers, the better the patients need it. We don’t have the ability to put mental health providers, primary care providers in every single site where they’re needed. We don’t have specialty access everywhere. We need it. Telemedicine provides that bridge and it’s going to be critical. So I don’t like the way they did it. I completely agree with their goal.

Bill Russell:                   08:14                That’s interesting. I always, I was not really aware of 22 states and eight eight are in the process of passing. So 30 states out of 50. That is definitely a tipping point. Um, that’s interesting. I, I, I may throw it together, that map just to see where we’re at. I know that, uh, you know, some states I’ve heard, uh, you know, the, the CEO for Jefferson talked about the fact that they can see the New Jersey border from their hospitals, but they can’t do telehealth. Sure. That state line. And, uh, and, and, uh, it would be interesting to see who the, who the hold outs are on that because I think we all agree, but you know, for, for followup visits, for tellapsych, I mean there’s, there’s just so many opportunities to keep people out of the waiting room to, to reduce the pressure on our, uh, on our ers and those kinds of things. Um, this, we’ve gotten to the point where this, this is really necessary.

David Bensema:            09:17                Yeah. I think about my orthopedic colleagues, postop orthopedic visits are largely driven by a goniometer to measure the angle that the patient can achieve and to make sure the wounds okay. You can definitely do that with a telemedicine visit. You can accomplish that and save the patient the trek up. Um, if they’ve already traveled three hours to have their surgery, why should they be coming back three hours for post op visits?

Bill Russell:                   09:43                Yeah. And I had, uh, a friend of mine, a friend of my sons was saying, hey, you’re in healthcare. Let me tell you my story. I mean, he told me this story of waiting 30 minutes in a waiting room, getting in and waiting another 30 minutes in the exam room. And then he saw the doctor and the doctor says, yeah, I looked at your results. They looked fine. Uh, you know, Diet and exercise, you should be okay. And he thought, I just waited an hour, isn’t there a better way to do this until I auth would be a good way of him to just, you know, to just have that, that console and the way they go

David Bensema:            10:18                and in line with your barriers, some, you know, one of the barriers has always been reimbursement. And for once, and actually more often than people think Kentucky leads the way. And in this case, Kentucky’s leading the way because we just passed Senate bill 112 that allows an impact, requires equal reimbursement for equivalent care. So if I can do a telemedicine visit for mental health or a followup visit through telemedicine, that is equivalent to what I would’ve done in the office. It requires the insurers to provide equal pay to the physician for it. That’s been a barrier all along. If I’m not seeing a decrement in my revenue stream, then I’m going to participate more. And once we get the patients demanding it and the physicians not resisting it, it’s going to take off like a jet.

Bill Russell:                   11:06                Yeah. So that gets the next part of the story where they talked about some of the percentages. So during 2017 12% of the VA patients recorded, at least one encounter with the system received a portion of their care via telehealth, and that translated into more than 727000 veterans engaged in some form of telehealth. Now remember they had to actually physically go to a location in order to get this telehealth visit, but it’s still equated to about 2.2 million visits. And, and so now we’re going to have the ability to go directly into their home. I think we’re going to see a significant uptake and success in this program. Now, as you noted, one of the benefits of the VA is that there really isn’t money changing hands. So we don’t have this, this reimbursement, uh, challenge. Uh, but you’re starting to see movement.

Bill Russell:                   11:58                I mean, you’re starting to see moving in CMS, you’re starting to see states, uh, insurance carriers. You’re starting to see movement in this reimbursement model. Um, and, and again, I’ve talked to some leaders that are saying, you know what, even without the reimbursement, we see this as a strategic opportunity to provide a better experience, better care for our communities. Plus, they want to establish, uh, the capabilities operationally and technically because they see it as an opportunity that once those barriers come down across the states that they’re going to be able to expand their markets, uh, and expand their presence without really expanding their overall cost structure. Right. and be able to service a lot more of their, uh, a lot, a lot of other and new communities. I mean, do you slowed or do you see that as, I mean, what are the implications to healthcare longterm, but let’s, let’s, let’s fast forward three years. Let’s assume that the barriers come down, reimbursements there and you could practice, uh, all the states have signed an agreement. So all 50 states you can see somebody via telehealth. What do you think the implications are for healthcare and healthcare it in that scenario?

David Bensema:            13:12                I think the cost savings are huge. It’s so much easier to scale up telemedicine because to your point, you don’t need additional infrastructure to manage additional volume, um, as opposed to clinics or bricks and mortar, which are quite capital intensive. So I think that will help people to expand their offerings and their availability. Um, for the healthcare it, the complication becomes are we going to store and retain all these video, um, visits or are we going to really, really push the envelope of natural language processing and get that to the point where we’re able to extract the needed documentation without the physician having to distract themselves in. And I’m looking over here, oh, I’m here with the patient or you’re not, you’re, you’re doing typing and in the office we already complained. The disconnected in a telemedicine visit is so much easier to have happen if my eyes avert. So I need to figure out if I’m a CIO and the CMIO and Ehr provider, how do I build the television in, in a way that allows the providers stay in contact with the patient because the patient is going to notice when I lose eye contact. And that’s all we got going right now. And it’s so critical.

Bill Russell:                   14:36                Yeah, and I think we will see more of that we will bake it into the Emr. bake it into the workflow and you’re, so you’re going to see, because you’re going to see it become tightly integrated with the EHR. Cause right now a lot of people are doing uh, solutions and there they’re great solutions, but they have to be integrated after the fact to the Emr and, uh, and, and that creates an interoperability problem, a data record, problem, documentation problem. Um, but you know, people think this whole thing of doing these video visits is easy, but you know, the minute I take my eyes off and look at the notes for this meeting, you know, it looks like I’m not paying attention. It is, there’s actually a certain amount of discipline to, to conducting these video calls so that people feel like there’s a connection, that eye contact and it’s, um, you know, and so we will have to make, I don’t know, I think the other advanced I’d like to see in technology is, uh, the camera to be embedded somehow right behind the screen. So I could be looking at the screen and not the notes and not have to worry about it. And, and, and you know, cause my cameras at the top of my computer at my notes are down here. I think that would be a great advance for for an apple or a uh, uh, or, or Dell or one of those providers to put that camera somehow figure out a way to embed that camera right there at the center of that screen I think would be it.

David Bensema:            15:56                I agree. I agree. Keep the, keep the contact because it’s got to have the warmth and we’ll talk about this a little bit more later, but it’s got to have the warmth, the relationships, um, have got to be built.

Bill Russell:                   16:07                So I’m going to kick it over to you. And in fairness, you didn’t select your own story. I don’t want people to think you’re a narcissist here. I actually asked you if we could talk about your story because I thought it was so good on the, on the role of the CMIO. So I’ll let you set it up.

David Bensema:            16:23                You and I both have the pleasure of working with health systems, and Kate gamble has been a good friend to both of us. And she asked me if I could try to take a look into the future, uh, regarding CMIO roles because of my kind of unusual perspective on things. And so I started thinking through this and what I realized is we are in a world of specialists and we tend to become focused on our specialty. And I wanted to direct CMIO’s in particular though I think it’s valuable to all leaders to become a generalist in your knowledge and a specialist in your focus on the population or the team or the group that you are serving. And so my push for Cmios, um, was really more about them becoming more diverse in their knowledge base to read about finance and read about nursing, to read about, um, uh, business operations to make sure that they understood the needs of their customers because the whole healthcare system is the customer of the CIO and the Cmio, but to know their needs and then be able to anticipate where that puck is going so they can be more useful.

David Bensema:            17:40                The other thing that I see for Cmios is the need to take what is already a physician advantage. The integrative mindset. We listened to disparate information coming from the patient. We have the chart, we have labs, we take all that disparate information and we integrate it into a differential. And then we test our hypothesis and make rapid course corrections to arrive at the correct diagnoses and treatment plan. Well that’s integrative thinking. If we can apply that to the rest of the healthcare system and to our interactions with the healthcare system, we will be more useful. And then finally, uh, really develop your skills and strategy and ensure that you are in a position to influence strategy and have a deep knowledge of what system strategy is. So whenever folks are coming with the bright and shineys, you can point them back to the system strategy. You know, is this really helping us move forward? Is, is this in the same vector direction as our strategy or am I pulling energy in another vector direction? Cause if I’m starting to pull in multiple directions, you know, and I know the cart doesn’t move very fast forward and in fact, you usually gets tipped over.

Bill Russell:                   18:56                Yeah. The, uh, you know, one of the things I’ve been thinking about is the CMIO role. Just like the CIO role. Um, you know, the, I stands for information, so chief medical information officer and, and, and in so many cases now we’re talking about innovation, intelligence. Um, I really, those two are the only ‘I’s I could think of. Uh, you know, the chief medical intelligence officers sorta talks about where we see the, the, the CMIO fitting in. So every, every specialty has a need for intelligence. They’re gonna, uh, advanced analytics, AI machine learning, and how, how is that going to be applied to their practice? And I see the CMIO being one of those key people at this, the translation between, uh, the practice, the algorithms that are going to be helpful, uh, the algorithms that we can actually get data and make practical too, to that specific practice and, and translate it to that also to the, to the, uh, systems and understanding the systems, which is what you were talking about. So it’s the person that can bridge that gap between understanding, uh, the, the technology and where, where it’s at. And we’re not not understanding of deep dive into hey, here’s how we make, here’s, here’s the framework for setting up, um, artificial intelligence for our healthcare system that’s on the technical side, but really being able to say, I know what it’s capable of. I know the information we have, I know the needs of the practice and we’re, I can help us to map that course for applying advanced analytics to cardiology, to oncology, to our practices.

David Bensema:            20:35                Yep. Absolutely. Absolutely. And, and becoming an enthusiastic, um, change management change leader, helping people understand the value of the change as opposed to focusing on the pain of the change, helping them to find a reason to want to change. Part of that requires that you know what is in the digital space, that you fully understand it and you understand that to your point, you know which algorithms, which products can benefit your particular system and every system is going to be unique. That’s why at the end of the article that I wrote, I said, there is no canned formula for this. There is no program. Every system is going to have unique needs at a unique moment. And trying to be like everyone else is really not your best choice. Being the best you or being the best system you can be, where you’re practicing is the key. And so I think the CMIO really needs to be a discerning enthusiast for the it world as opposed to a, gosh, let’s play with all of it cause it’s all cool. It’s all techie, it’s all, you know, it’s all fun. Um, but let’s focus on what’s really beneficial to us.

Bill Russell:                   21:48                So strategies, strategy, technology and practice. They’re the person who sits in between those three and really makes it work. Um, what’s the, what’s the mindset that you would not to take it a negative. What’s the mindset that you would caution people to warn them against? Um, you know, cause we’ve all run into is that they really see their job as protecting the status quo or those kinds of things. But from a CIO, CMIO perspective, what, what’s, what mindset would you, would you like to see if you were hiring a new CMO right now?

David Bensema:            22:22                Yeah. If I was hiring a new CMO CEO, I would look for somebody who does not speak defensively, um, regarding their physician colleagues, but instead a speaks engagingly. So the difference is I’m not going to protect my physicians from change because change is inevitable. How am I going to engage them and change? How am I going to engage the nursing staff and change when I hear that from a CMIO who understands how they’re going to help move the system forward and how they’re going to help lead change. That’s the person I want. Not The one who says, you know, I’ll, you know, physicians hate clicking through all this. Physicians hate the EHR. Okay. I think we’ve heard that before. Tell me something positive. You know, it’s the same thing you’ve always looked for and that you, and I’ve had this conversation. I look for the person who’s bringing solutions, not personable, spring and problems. I’m fully capable of identifying every problem I can look for negatives. I need the person who’s bringing solutions, not panaceas, not pablum, but real solutions.

Bill Russell:                   23:26                Yeah. And the thing I’m always give, give me a list of the problems that you want to try to solve and when, when people are saying, well, I want to protect this or I want to protect that, that’s usually a red flag for me. When they say, you know what, I see that these clicks are causing a physician and I want to figure out how to solve that problem. I go, yeah, all right, that’s a good problem to solve. Or I want to figure out how to bring augmented intelligence in. I don’t think that computers are going to replace physicians, but I see a place where they can help physicians to be more focused during that, that visit, or I want to take computers out of the room. Or I mean, when they start saying, hey, here are the problems I feel like could make it have a meaningful impact. I go, all right. Yeah, those are the right problems to solve. Let’s, let’s move forward. Um, all right, so we introduced a section called soundbites, uh, since the last time you were on during this section. Toss out some questions, one to three minute answers. And uh, you know, if you want you to throw back some questions with me, but, uh, let’s start. I, I only have four questions for today. So what is the distinct advantage of being a physician CIO over a nonphysician CIO?

David Bensema:            24:39                Tell the distinct advantage of being physician, CIO is, I have been through the workflows that we are impacting, um, in particularly being a primary care physician who also is old enough to have practiced in the hospital and then let us, uh, um, hospitalist program. I know the workflows that we’re impacting and I can identify more readily and empathize more readily with the pain points that we inadvertently sometimes create, but I can help us to avoid some of that. So I think that’s one of the big advantages.

Bill Russell:                   25:17                Experience and empathy Yeah. And typically when I hear systems going, hey, we’re going to hire a, uh, we’re looking to hire a physician. Cio is because of the previous CIO did not show empathy or take the time to really spend understanding the clinical workflow and its challenges that we’re facing. So I love that answer. If you had the power of what changes would you make to the Ehr to make life easier for physicians?

David Bensema:            25:44                This is one of my favorite subjects and in fact I was talking with doctor Brett Oliver who replaced me a CMIO my, you know, I had the dual role and Brett became the CMIO as I left while Trisha Julian became the CIO. Brett’s a voice you oughta hear. Brett is a phenomenal voice. But first and foremost the things that are immediately achievable is voice recognition for order entry and notes so that we can get so many of our colleagues who struggle with the keyboard off of it and speed the order process. Um, another area would be to enable, um, I don’t want to say this better, exchange, which actually requires that we tell the EHR providers that you have to have the standard format and the process interoperability is only going to happen with a deadline. And with some mandates, the EHR manufacturers and systems that like to protect their data are not going to come to table until there’s those two pressures, time pressure and um, mandated structure.

David Bensema:            26:52                Um, that that’s critical for exchanging patient data, um, so in a meaningful way so that the physicians can use it within their workflow as opposed to looking at horrible line after line after line of, um, some of the formats that we’ve seen. And then third, um, in this one’s kind of conjecture. Um, it’s a little aspirational. I’m not quite ready yet, but get the analytics, get the artificial intelligence thoughtfully built in with input from physicians as you know, this time around, let’s not build it and then put it in front of physicians and say, use it. Let’s get the physicians to help us build it. Get the at artificial intelligence in place and create the ability to say you cannot be as good as a physician as you want to be without your Ehr. Because for precision medicine or all the things we want to move through population health, you can’t do that without an Ehr. I can’t carry that data in my head. You and I can memorize a lot of things. We are talking to a very smart audience. They can memorize a lot of things that can carry a lot of information, can’t carry all of it. So we need the augmented intelligence of the artificial intelligence. We need that, but we needed in a way that we can say, you can’t be as good a physician is you want to be

Bill Russell:                   28:15                without it. Yeah. I think one of the exciting things is that, uh, the Va did finally sign that $10 billion Ehr contract with Cerner and, but part of those stipulations are really around the adoption of fire opened interoperability and whatnot. And I think, you know, when you get a $10 billion enabling contract and you have those kinds of stringent requirements tied to it, that I think you’re going to see Cerner’s product get a lot better over the next couple of years with regards to interoperability just based on that contract. Plus, um, you know, I think, I think the fire movement has really left the, uh, left the barn. And I think the, uh, I’m hoping that the people in Madison and Kansas City do move this thing forward. We can’t do it without them.

David Bensema:            29:06                Yeah. Well, I look at what’s come on to app orchard in the last year and the number of Apis and the facility of working with those is so much better than it was even 12 months ago. So I think you’re right. I think it is moving. I think you’re correct that Cerner is going to move forward more quickly because of the VA contract and that’s going to catch everyone else in the draft and they’re going to have to do that to keep up and remain competitive. But we still, you know, I think ultimately we still need to put some timelines on them. Um, because you know, we don’t prioritize until we have our reasons for prioritization and deadlines are terrific prioritization tools,

Bill Russell:                   29:49                So you do a lot of successful it projects. Um, and I asked a similar question last, last week for David months. He said, you know, we, we looked at 120 projects a year. You don’t typically get to to, you know, call your shots, call your timeline as a CIO, unless you’re doing successful projects. What’s the one thing you would share that has lead your teams to delivering successful it projects?

David Bensema:            30:13                I think we ultimately put it into three words and it became the motto of our culture, which was one with intent and it meant that our it team, even though we’re divided across seven or eight hospitals now across an entire state and 240 ambulatory sites of care, we’re one. And so we communicate aggressively with each other. Meaning I am transparent with the senior team. Now Trisha is transparent with the senior team. You make sure everyone stays in the loop and it gets passed on so that everyone’s on the same page. So when they get an ask a question in the markets, they’re giving the same answers. What are the prioritized projects? What is your list of projects? Everyone’s up to date and we keep up to date. Um, the with intent means that we do some of what I talked about with the CMIOs. We study our customers, we studied their workflows, we study what they need so that we can be intentional in how we prioritize projects.

David Bensema:            31:11                We understand how they interact with one another. We understand where the benefit is in, um, sequencing so that we don’t get a project that’s really waiting for two other projects to be fully utilized. We get them in the right order and we’re able to explain that to the c suite and to the president’s out in the markets. Um, so intentionality is I think the number one thing that we brought that we were able to change during my tenure from the previous reactive. Here comes another one over the wall type. Um, typical it shop response to, hey, if you really want to move, here’s how you can sequence these and here’s how long it’s going to take. you get some realistic numbers to things. And then as always, you, you don’t budge in terms of, you know, holding back and creating false numbers, but you still drive, outperform your promises. And if you do that with intentionality and then outperform your promises, um, they allow you so much more leeway and allow us to help drive the tactics if not the full strategy.

Bill Russell:                   32:21                Yeah. I was talking to a client this week and we talked about why, what and how, and why is the vision, what is the strategy and how is the tactics? And one of one of the things that gets it backwards, they start with tactics. They say, oh, this new thing just came out and it’s really cool. It’s really awesome and we should implement it. And you know, even if it’s part of the EMR suite and those kinds of things that they, they just unilaterally make a decision that, well, this came out, we’re going to implement it. And, and I was talking to the CEO and I said, you know, you just gotta flip that on its head. I mean, why are you doing it? What’s your vision for the organization? And then, you know, what, what are you trying to do strategically this year? If you’re strategically going after expanding telehealth or expanding your clinically integrated network, then your project, your, your, how should align with those things. Not, not the other way. You tactics shouldn’t wag the dog in terms of that. Um, all right, so last question here. Let’s assume right now you’re, you’re able to this on this podcast, every it person in the country is going to be tuning in. What’s the one thing you would tell all these it people that they need to hear from a practicing physician that they may or may not really appreciate or understand.

David Bensema:            33:46                When I ask for customization or personalization, please understand that it’s driven by my customized, unique patients. Every patient is special. Every patient comes a little bit different. I don’t get the opportunity to have a standard patient interaction. Every patient comes with their own needs and expectations. I’m trying as a clinician to adapt to that and to provide the most personalized care that I can, the most focused care that I can to that patient. That’s sometimes causes me ask it to do things that it really can. So hear me with empathy and explained to me in a way that I can understand how you can get close through personalization, how I can learn other workflows in the Ehr, but don’t tell me no, no. It’s the wrong answer. It’s, have you thought about this? Have you done this? Because I need to, as a physician to tell you every one of the patients I deal with is special.

Bill Russell:                   34:54                Right. All right, well we’re getting close to the end of our time. So we’ll do the social media close. I’ll let you kick it off with your, uh, with your post.

David Bensema:            35:05                Yeah. So I was looking on Kevin Md. And by the way, if you’re a CMIO, CIO or c suite, the occupant, you ought to pick up on Kevin MD. Um, it is your best access to just keeping a finger on the pulse of physicians throughout the country. What our physicians thinking because as a blog aggregator, uh, Kevin Fau has done a wonderful job of bringing information together. The one this week was physicians let us rise, let us lead. I’m always been in leadership in my medical and I started in practice in 1990. I was already taking time out every week to, uh, uh, contribute, uh, a lot of our colleagues do what you’re hearing this voice, and we’ve heard it before. But as I said in my, uh, little, uh, note to you, the forcefulness of it, the committed, tone of it is different and we need to be aware of that. The physicians have finally hit a point where, you know, we didn’t like DRGs, we didn’t like 95, 97 coding guidelines, still don’t. Um, but now we’ve coupled it with the hrs with coupled it with didn’t demands of acos and population health and all these other things we’re asking the physicians,

David Bensema:            36:22                they’ve hit the point where they’re going to push back and the way they pushed back because either they’re leaving medicine, we’ve talked about burnout before, or they’re going to rebel in a way that is going to be painful for systems. Make sure you hear the voice. That’s my message to CMIO’s and CIO’s is make sure you’re aware of the voice of the physicians. Make sure that you’re thinking about how to help them join you in leading, engaging your physicians is a whole lot better then being fought by your physicians.

Bill Russell:                   36:57                I love that post. If I’m going to skip mine just to read a little bit of this. So, uh, just read the part of the end here. So let us ride. Let us, this is what it says. Let us rise. Let us lead. Let us show humanity what we are, what we can do. We cannot move forward with a culture of infighting and antagonism. We cannot move forward with expectation that everyone around us will see the world as we see it and we cannot move forward. Speaking partially informed truths or pointing fingers. This is a call to action to my physician colleagues. Be Angry. We’ve earned it. Be Skeptical. We’ve earned that to our profession has been taken advantage of and abused. But then let’s take a step back. Gather ourselves and begin moving forward. It’s time for us to stand up and lead by example.

Bill Russell:                   37:41                Let us lead with patiences. Clarity, strong backs and integrity. We can say no with dignity and grace. We can move forward with strength and collaboration and above all through our actions, our advocacy, our work in our words, we can hold fast to our oath, to our promise to do no harm, no harm to our patients, no harm to each other, no harm to society, no harm to our profession, no harm to progress, let us rise. But I think that’s a great ending to the show and I think it’s a great call to action. So, uh, you know, thanks again for coming on the show. How can people follow you?

David Bensema:            38:18                Um, I’m on Linkedin so they can link in with me and follow me through linkedin and if anyone needs contact me. The email and phone number on my linkedin profile.

Bill Russell:                   38:29                Sounds good. Awesome. You can follow me on Twitter. @thepatientsCIO, my writing on the health lyrics, you can follow both David and I on the website. They pick up our articles, uh, pretty often. Uh, you can follow the show on twitter @thisweekinhit and check out the website If you liked the show, please take a few seconds, give us a review on iTunes or Google play. Catch all the videos on the youtube channel now, up over 120 videos, and after this week, it’ll be 120 627 videos and we’ll share those out on social media and please come back every Friday for more news, commentary and information from industry.


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