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Bill Russell: 00:51 Welcome to this week in health it where we discussed the news information and emerging thought with leaders from across the healthcare industry. This is episode number 18. It’s Friday, May 11th. Today we’re gonna talk about, uh, tackling the growing talent shortage within it. This podcast is brought to you by health lyrics, changes everywhere in healthcare. It, get a plan for agile, efficient and cost effective it from people who’ve been in your shoes, get ahead of the wave, visit healthlyrics.com To schedule your free consultation. My name is Bill Russell, recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Um, you know, healthcare is loaded with, with really good people, people who are on your side who are ready to be in it with you at, you know, at at a moment’s notice. Um, and no one epitomizes this more than our guests today. Today I’m joined by David Muntz, principal at starbridge advisers. David, welcome to the show.
David Muntz: 01:44 Thank you. I appreciate it. The opportunity is really nice.
Bill Russell: 01:47 Yeah. I think sometimes, you know, you’re, you’re such a luminary, you’ve been around for so long that people would think that maybe you’re unapproachable, but you are clearly one of the most approachable people. See you at a conference or whatever. They should just walk up and introduce themselves and you’re one of the most approachable people and, and willing to willing to help. And that’s what I’ve, I’ve really appreciated about you.
David Muntz: 02:08 Well, I tell people the strongest ability I have is availability. So it’s around long enough. You get to have a lot of great experiences and I love sharing it. So thank you.
Bill Russell: 02:19 Well, I’m looking forward to this, you know, with the, with the combination of our gray hair, we should have something, something to say. Let me, for people who aren’t familiar with you, let me give you a loan, a little bit of a, of the bio here. So you began your career as a biostatistician well, what is, what exactly is a biostatistician?
David Muntz: 02:37 It’s somebody who takes up statistics and in my case worked in cancer, Lukemia research hospital. And uh, so I made, uh, the data speak and tell the story to the physicians taking care of the patients there.
Bill Russell: 02:54 Wow. And so that somehow led you on a path to become a CIO. So you became a, uh, eventually became CIO at Texas health resources for 15 years and then five years at Baylor healthcare system, I guess before the Baylor Scott and white, um,
David Muntz: 03:11 merger. Actually I was a part of that Activity. So it was a really interesting, uh, you know, it’s always interesting to go through the merger and acquisition discussion.
Bill Russell: 03:20 Yeah. So this latest round of m and a is not, you know, if this has happened before and there’s a lot of experience out there around it. So in a, so it gets really interesting here. So in 2012, you accepted a White House appointment, uh, to serve as the first principle deputy national coordinator, uh, chief of staff and CIO at the onc. What, so for all of us who are wondering what’s it like to work in the federal government around healthcare?
David Muntz: 03:47 Well, actually financially it’s terrible. Every other aspect it’s just fabulous. The fact is that it’s really like getting a crash course in an area where you really have no exposure experience before. And I’d done a little work in the state, um, but nothing to compare with a federal, uh, activities and working inside health and human services was really an honor because of the diversity of the activities associated with health. Can we talk about the health care continuum and there is nobody who has a broader view of the continuum. Then HHS and because I was a political appointee, I got to sit in the meetings where we discuss policy and it was fabulous, uh, to actually watch the formulation of policy even though they say there are two things you should never watch is sausage making and policy making.
Bill Russell: 04:42 Yeah. And I think because of there’s maybe cynical view of the government or legislature one, I might think that, uh, you know, these aren’t the smartest people in healthcare, but they are some of the, I mean some of the things that people are doing at the government level in terms of bio defense and cybersecurity and, and policy, these are some of the smartest people in health care. Uh, and we, they just don’t operate in the limelight. So we just don’t see them all that often.
David Muntz: 05:11 It’s been very true. And the fact is that these people feel a passion for what they do. They’re public servants and the kindest a way that you can take that word servant hood is, is how they live. And you know, I had a secretary who was a lawyer and assistant who was a work for me who was also a, had a MBA and it was a CPA. And so people doing just normal jobs had these extraordinary credentials. But every one of them shared a big heart and dedication. And it’s the permanent staff there that makes uh, the government work well. So now when people say it’s good enough for government work, I always correct them and the government work was some of the most effective I’ve seen. Now, whether or not you agree with what the decisions are are, is another issue. But the one thing I would like to say to people is in the reason I went to the government is if you don’t like what’s doing what, what’s happening, you need to express yourself or you need to join and help try to make the changes from inside of, there aren’t enough people there who have experience in health it.
David Muntz: 06:22 And I think that was the advantage I brought to the position.
Bill Russell: 06:25 Yeah, I hear that a lot of people go, well, I don’t want those people making decisions. And you know what, there’s a great example. You know, that stuff’s out there for comment now, so comment.
David Muntz: 06:37 Well that’s, that’s how it got there. I used to raise my fist and go, what are you thinking? And I got a, and I was on the board at chime in charge of policy at the time, assistant about, by the way, a lot of very brilliant CIOs. Um, but I was always the one that would do the final editing. And so I communicated frequently my displeasure with the programs and what I wanted to bring to the government was a practical and pragmatic approach. Right.
Bill Russell: 07:04 And when you raise your fist, they assume that you’re raising your hand. So when they say it’s like, Hey, that guy has his hand up.
David Muntz: 07:12 Yeah. By the way, when I got there, I continued raising my fist.
Bill Russell: 07:16 So a CIO getwellnetwork a member of the board of directors there still and uh, also a board of a Hema. Um, tell us about that work a little bit. So you were there for three years or you’re currently there for three years?
David Muntz: 07:34 No, I’m not finished. It’s not our middle of the year
Bill Russell: 07:40 cause. You can know chime, they get up there and talk about a Hema, a he a and I forget the other one sitting back going, oh, that’s way too many acronyms. So, so tell us a little bit about that
David Muntz: 07:52 if you don’t like acronyms watch the government. But the fact is that a Hema really is one of the largest organizations for healthcare and we think of them as the old medical records group and they have far more capable than that. Uh, it’s some of the most dedicated people I’ve ever worked with and um, they are frequently unsung heroes when it comes to moving data around. So there’s nobody who really has a more end to end view of what goes on in health care. Then the people who work in health information management. So it was a pleasure to be on the board there. And what I kept pushing them to do was to be ill behaved and to try to get a chair at the table with the CIO. And I would love to see a greater partnership between the people in Angina
Bill Russell: 08:45 But knowing you, its be ill behaved so get noticed. But do it in a respectful way.
David Muntz: 08:48 Absolutely. There are ways that you can say things with candor and kindness at the same,
Bill Russell: 08:57 you’ve led a tons of great teams, uh, you know, in your bio that, you know, at any given time, and people don’t recognize this as a CIO, you oversee a lot of projects and you note here, you know, more than 180 project go lives annually. And most people outside of our industry, which say that’s crazy, I can’t believe there’s that many. But those of us who have sat in the chair go, yeah, that’s about, that’s about the right number for the size organizations you were doing.
David Muntz: 09:25 Oh yeah. Give you some context. We used to say that a project was anything that involves more than 40 hours, I’ll give you a sense of it. So it could be something as large as a Ehr or as small as an implementation of a departmental system.
Bill Russell: 09:45 Okay. So you were a two times two different organizations, Chimes innovator of the year and uh, in 2014 Chimes and presented you with your CIO legacy award. So, I mean that’s, that’s a great bio and probably the most time I’ve spent on anyone’s bio, just so you know, I mean there’s, there’s, there’s so much that, I mean, it’s like multiple careers here. I mean it’s, it’s very fastinating. Um, now one of the things we like to do with our cohost has given me an opportunity to talk about what they’re currently working on or what they’re excited about. So, you know, this is, this is your couple of minutes to sort of share what’s going on.
David Muntz: 10:21 Sure. Well, after serving as a CIO for a very long time, I decided it was time to come back to Texas family and wanted to have a little more freedom. And so consulting is how I started in, uh, after starting my own company, I decided at the invitation of sue shade and Russ Rudish to join them and start, start bridge advisors. And you know, only too well, and I’m sure every CIO in the country knows only too well, that there is far more demand than supply. And so the focus of our company is really to give additional bandwidth to CEO’s. And one of the things that’s fascinating is what it takes to start up your own company as you know, only too well. Uh, and so I’ve been engaged in activities that are designed to provide interim support, uh, to provide consulting services and also to do some coaching.
David Muntz: 11:19 And mentoring in the idea is not that the CIO is incapable of doing that or either CMIO, Cnio, CMO or CTO, but, um, they don’t have the time to pay attention to all the things that you want them to. And as you noted from my resume, when we’re doing that many projects, you can’t pay attention to more than a handful. Um, and so by the way, I was blessed in every organization by having wonderful employees around me and take care of me. So that’s the key to my success. And by the way, a very patient family. But I enjoy offering assistance to those people who just don’t have the time to do the work themselves.
Bill Russell: 12:01 Yeah. And it’s, I was in two rooms this week with a different groups of CIO’s and a, it’s interesting and we’ve highlighted it on the show. Some people come from clinical backgrounds, some people come from a technology background, some people come from, neither just come from a business background and just know how to get the most out of people. Um, and the good CIO is recognize when there’s areas where they’re, you know, they could use some help on the tech clinical or, or the business side. And I know that people have brought you in on the business side a lot to say, you know, how do we handle this transaction? How do we handle this interaction with the federal government? Uh, given your background, I mean, you, you have some, some great insights into those things. So that’s, that’s where they, they pick up the phone and call Starbridge and, and uh, get you guys engaged.
Bill Russell: 12:47 All right. So as you know, um, uh, you know, we sort of format of the show is we talk about the news, then we do a little bit of sound section where we put you on the hot seat. And, uh, then we, we do a social media close, which is just a little bit of fun to close out the show. So I’ll kick us off with the first story. And you know, the biggest story from last week may not have been in health care, but it really does impact healthcare. And that is a, the u s unemployment rate is now the lowest it’s been in the century. Right. And, um, it’s, uh, it, it becomes a challenge for healthcare to find great talent. And you know, how bad is labor shortage? Wall Street Journal had an article, uh, two weeks ago that talks about cities will now pay people to move their cities, will pay people to move there.
Bill Russell: 13:35 And I’ve had, I’ve had conversations with CIOs where they said, you know, and we talk about all this really cool stuff and what you can do with lambda architecture, that kind of stuff. When they say there are no people in my city that understand the technology that you are talking about, we are going the Microsoft route. And that is a very valid and actually pretty wise, uh, you know, way to look at it is to say, what can I do with the talent I have not what is the really cool and exciting thing that’s right around the corner. So, you know, these two stories provide us with a snapshot of what’s happening now and probably what’s going to happen over the next two to three years. So, you know, whenever you have this kind of tax cut, we saw a major boom and after Reagan did that massive tax cut and we’ll probably see just I’m an economics major.
Bill Russell: 14:25 It just based on pure economics, we’ve just poured a ton of money into the economy and it’s like, it’s like a log on the fire. So, um, for the foreseeable future there’s going to be this talent shortage. And so let’s, let’s go back and forth on, on a couple things of how CIO’s might think about this or just how people might, let’s start with, uh, kids going to college. I remember when I was going to college in 19, whatever, um, 1980, uh, they were saying, Hey, get your computer science degree. And everybody did. And then when we came out, everybody had a computer science degree and so there was an abundance. But what, what’s the, what’s that major you’re telling college kids as they’re going in there, they say, I want to be in healthcare. It, I want to be an IT technology some way and I want to be in healthcare. What’s, what are those degrees that they should be pursuing right now?
David Muntz: 15:20 Tough question to answer. And everybody’s situation is different, but generally speaking, I say that there’s one thing that they have to concentrate on that’s a skill that you need, no matter where you’re going to be in whatever profession. And that is the ability to communicate verbally. And that’s either orally or in writing. That’s really number one on your list. So if you don’t come out with good communication skills, you won’t be able to sell yourself. He won’t be able to explain things and you’re just not going to be able to succeed. Um, but is that there are many different pathways into healthcare. And so I happened to be a premed major in college and in English with a minor. And of course nobody can see the straight pathway, but I love that, that a country western song that says God blessed the crooked path that led me straight to you.
David Muntz: 16:13 Yep. And so the real key is if you know that you love health care, the idea is to pursue something that compliments the activities that are going on in your area of interest. Now I happen to be married to a nurse, the father of a nurse who married a nurse. I have a niece and uh, so I’m very nurse friendly. So if I had to say something, it’s, you know, follow a clinical pathway. There is never going to be a lack of lead for health care professionals. And if you don’t mind me switching to a tactic that I used to use to fill positions and I was a strap for people who had clinical experience. I used to call the presidents of the organization together, both at THR and Baylor healthcare system. And say we’ve got this big, we’re going to kick off and I don’t have enough people with clinical skills.
David Muntz: 17:13 I’ve got plenty of people with technical skills. But when I’m going to do is I’m going to find who are the best people in each one of the areas where we’re implementing the software and I’m going to pull them onto the project team. And if you don’t say, ouch, I haven’t found the right person yet. And so we would populate our projects with the best of the people in the clinical areas. And generally speaking, once they got into healthcare, it, it wasn’t touching one person at a time. It was touching hundreds or thousands at a time and it was easy to dram over. So, um, I would say you don’t need as much technical skill as you need a human skills.
Bill Russell: 17:54 Wow. John Wooden is quoted as saying the team with the best players usually wins. And so if you can gather those great leaders, that is always extremely helpful. Um, you know, the clinical side, we are seeing more and more on the clinical side. People getting that clinical background and then making a, a, a move either towards analytics or towards data science or uh, you know, just all, all areas within, within it because it’s, it’s fascinating to them how much, so they got into healthcare because they want to help people. They’re generally high, very caring people, a high empathy and we need more of that in it. Oh, have always needed more of that in it. Um, but their, their understanding of clinical also helps them to be empathetic towards the other clinicians as we’ve rolled out some bad technology that has been designed by, by technologists over the years.
Bill Russell: 18:54 And so we get, we get a bad rap from time to time from the clinicians have, do you know how many clicks it takes to get this data? Why can’t we visualize the data in this way? And you know, having those clinicians there to, to, to ground us in terms of the process as well as very attuned to the patient’s very attuned to the, uh, the consumers of health care. And what they’re asking for as well. So that’s a, that’s a great, you know, I typical technologist, I’m going to say analytics, if I’m talking to a college student, analytics will, will, will not steer you wrong. Uh, data science is not going to steer you wrong anytime in the next decade. I don’t believe, uh, AI programming is one of those things that I believe we’re going to need more of. We’re going to be teaching the machines how to think, how to process information.
Bill Russell: 19:47 Um, you know, we’d have a digital vision, digital, uh, you know, obviously, uh, machines are hearing us now and we’re going to need people that can sort of build those new constructs for us. And then security. I mean, we’ll get into security in your article that you shared. Um, there’s, you know, we’re at war right now. I mean, there’s a cyber war going on and, uh, you know, need people to sign up for that. So, uh, you know, you gave us one of the strategies, uh, you know, give us some of the other strategies that CIO’s can employ to find the best talent.
David Muntz: 20:24 The best approach that I’ve used that worked well was the summer intern, uh, activity. Uh, we used to beg, borrow and steal to get into the budget, enough money to do things. But, um, you can take students from anywhere and everywhere. And to let you know, the only time that we brought on a student stay with us was one who wanted to move back to be close to her parents. But we used to get five to eight people, uh, every summer and grow our own. And the fact is the enthusiasm is really a great quality to find in any employee. And these people would start at the lowest level to get a good understanding. We put them at the help desk and that would give them an exposure and a good test of patience. But it would also allow them to see the diversity of needs. Put them floor doesn’t have them do.
Bill Russell: 21:18 So what are the steps to set up a good internship program? Cause here’s when, when I went to Saint Joe’s, I was kind of surprised we didn’t have one within it. We were bringing out, actually we were bringing high school students for one week over the summer. And that was, that was fascinating. It was great for my team, my team loved that week of working with those high school kids. But how do you put together a good uh, uh, program that’s going to appeal to undergraduates as well as graduate students to bring them in and expose them to healthcare?
David Muntz: 21:49 Well, truthfully I have to tell you that my administrative assistant is the one who made this a success.
Bill Russell: 21:55 We’ll have to, we’ll have to have your administrative assistant on.
David Muntz: 21:59 She’s fabulous. One employee of the year in the healthcare industry in Dallas. I’m in Dallas, so I’m really telling you that she deserved the credit, but there are enthusiasm. Those kids to getting experiences is huge. And so the pool is very large, larger than you can possibly imagine. So I would call together my direct reports and their direct reports and we would scour through the, the resumes and um, you know, we, we made guesses what would be good fit based on what they had as experience and what they put down for mission and goal in life. Uh, and we really didn’t focus as much on the technology things as we did on again, on the soft skills. Um, because if you hire the right person they can pick up the technical skills. And um, again, having, being very deliberate about the time, making sure that you have somebody administratively taking care of the program is a real key to that.
Bill Russell: 22:58 Yeah. One of the things I love that our data team did was they started tapping into the Grad, the various graduates and even phd programs. And we set up a way for them to access anonymized data within our system that they could, they could, uh, they were doing really neat things. And part of that was almost a retraining of our, of our data team internally because, they were coming face to face with the most and we were not an academic medical center. So we didn’t have the access that most of that, at least an academic medical center would have to that, that level of academic rigor and whatnot. And so by partnering on that level, we were seeing all sorts of new ways of visualizing data, of really breaking it apart. So don’t just look at the college interns, you know, the kids with no money. Um, also, you know, try to figure out ways to tap into those phd programs cause you know, what they want access to healthcare, they want access to the data. Uh, it’s so benefits them to partner with, with a health system that has, uh, at least their act together in terms of providing access to that, that level of depth within a healthcare organization.
David Muntz: 24:10 Yeah. And just one more little trick or tip. We also would look at projects that were three to five months in length and we would go to graduate schools just like you suggested, which I think is great and we would say, we have a fixed program that we want you to complete. Can you make this one of their senior projects and because of the remote nature now of work, it was easy to get that done and they actually had a real world deliverable that we would actually put into production at the end of the process. Now, we only did that a few times, but we were successful in each case.
Bill Russell: 24:45 Well, great. I’ve been going long on this show the last couple of weeks, so I’m going to kick it to you for the next story and we’ll probably only spend maybe five minutes on the next story.
David Muntz: 24:54 Okay. I’ll try to speak a little faster. The drawl is slowing me down. One of the things that happened this week that I thought was very interesting was that rob joyce lift the White House is the cybersecurity a chief and John Bolton is pushing to eliminate debt. And that caused me a little heartburn. And so I’m curious about what your reaction is to the White House taking its eye if you will offer changing its focus.
Bill Russell: 25:24 Great. So you’re going to ask me a political question. I’m going to quickly steer this back towards cybersecurity in healthcare, but yeah. Is it the right move? I don’t know. But, uh, here’s my gut. Cybersecurity should be handled by the military and homeland security. The reason I believe that is because it’s, it literally is a war. If you go in and look at your log files of who’s, it used to be that we would say, you know, it’s still true that a mojority of cybersecurity incidents happen internally. So it’s your people that are actually trading data, um, for whatever reason. And then, um, and in nation states was this little subsection of people that we’re trying to get into your data that has not completely flip flop, but that nation state attack has grown exponentially, uh, over the last, uh, I would say two to three years.
Bill Russell: 26:21 And most of the malware and stuff that we’re looking at today was developed. It was developed by governments, if not our government and you know, has fallen into the wrong hands. So I think it’s a military and a homeland security thing. So, you know, only in the federal government do we create a job and think it can never go away. I don’t think we lose any focus. Uh, every branch of the now has a cyber command and the cybersecurity, uh, groups, uh, homeland security does, the FBI investigates. Um, so it’s not for lack of a cybersecurity focus. The question is how does that information and stuff get to the president? And you know, there’s a secretary of defense, there’s a secretary of homeland security. It can filter up through that. So I, if we were going to Reorg it like a business, we would look at it and go, that’s a redundant position. That’s, that’s my gut. I don’t want emails on politics or whatever. So let’s flip this to health it. So what we’re talking about how to Reorg the government, how do you reorg it? So what’s the best way for it? Cause that’s really the question. What roles need to be in place in healthcare? It in order to have a very good focus on cybersecurity and be able to inform and educate the board and, and the various things that need to happen. I mean, what’s, what’s the best, I’m turning this right back on you. What’s the, what’s the best organization and waited to get ready for that?
David Muntz: 27:49 This is an interesting time. And people say that they want the cybersecurity people reporting up to compliance or to the board itself and to take it away from the CIO. And um, I’m not so sure that I agree with that. Uh, and the reason is that they’re the people who are wonderful. It cyber security, you have to be a little bit paranoid. And that paranoia is not based on a false concerns. It’s based on a reality, but they’re always just this balance that you need to make. And so the question is, who’s the best risk manager in your organization? And if the CIO can play that role, then cybersecurity security should probably report to them. Um, the reason I suggest the CIO is because they speak some form of cyber security probably more effectively than many of the other groups that have been typically assigned as we’re making reassignments of cybersecurity. So I still think the CSO should have a reporting relationship to the CIO. And I think if that’s not the case, there should always be a CIO and CSO in discussions where you’re trying to make decisions about how to take care of the cybersecurity, uh, or, or actually all of the it assets that you have responsibility for. And it’s the trade between access and security that always is the most difficult things.
Bill Russell: 29:21 Um, yeah, I’ll give a little different spin on that in that when I came into Saint Joe’s of all the security reported up through me and one of the first things we did is we hired a chief security officer, not a chief information security officer, chief security officer who had it, had a digital background and that compliance, so oversalt physical security, I mean you name it, a building security as well as uh, really compliance around information security, which was interesting. So I now had a peer who, uh, you know, the two of us would always go together to the board and present because he would present, hey, here’s the, here’s where we’re at. And I would talk about the very specific minutia of, okay, here’s, here’s the investments that it’s going to take. Here’s what we’re trying to defend against. And those kinds of things. I would be very focused on, um, on cybersecurity and, and so we sort of tag team there.
Bill Russell: 30:20 The thing I liked about it was he was very focused on education. And quite frankly, the biggest risk we have is 23,000 employees clicking on an email, giving away their credentials, reusing passwords and externally and that kind of stuff. And so, uh, you know, that that element of the training and education he was focused on, uh, every day. So I, I think, you know, cybersecurity, most CSOS I’ve met are really strong technically, but when you talk about influencing an organization, they almost need to be at the c level in terms of how do you drive education programs and those kinds of things. So, so we had a little, I don’t know if it’s different, but we had a, a little different bent on it. Uh, you know, we, we stole a guy from MD Anderson and, uh, and he became our chief security officer and he was phenomenal, um, and, and a great partner for me and a pain in the ass. But anyway, but, but that’s, that was his role. His role is to get in my face and say, we’re not making enough progress in these areas. How are we going to move the needle? He never said, this is how I want you to move the needle. He would say, how are we going to move the needle in these, you know, he had uh, you know, he had 10 different areas that he was measuring across for us.
David Muntz: 31:38 No, I think by the way, I think I love that idea. I think, you know, the security at that level makes perfect sense. So good model.
Bill Russell: 31:46 Yeah, there was, there’s a lot of different ways to do it and uh, you know, I’m sure people have different models. So, um, all right. We’re going to, we’re going to jump to the soundbites section and I have five questions for you and I’m just going to ask the question. You get about two minutes to answer and we’ll, we’ll just move on. I’ll try not to comment on your, your answers. So given your government background, assuming there’s no changes, that it goes through the comment period and no changes, what do you think the impact of the new MU program promoting interoperability is going to be on healthcare?
David Muntz: 32:20 not enough. The reason is that we keep pushing interoperability. That’s based on patient managing and um, I think except for actually positive person identification, all the pieces that we need already in place in the private sector. So I have pushed for a private sector approach to this. Um, but I think having the onc push me in operability is really important. Uh, I would like to see them look for a bound combination of biometrics and a user’s selected identifier or like we use with every other product that we have, for example, email, Facebook, whatever, uh, to be able to help identify those naked and unconscious people who show up in our eds. And not to mention the people who come through the front door but have very common shared names.
Bill Russell: 33:17 Great. I’m going to hold myself to not commenting on that because there’s a lot of ways we can, we can approach interoperability. So that’s, that’s, that’s fascinating. Okay. So, uh, you’re a part of a group that’s looking to hire a new CIO. So you guys do interim CIO placements? with Starbrifge. So you’re looking to hire a new CIO. I’m now putting you on a board for health. What are the three most important attributes here you’re looking for in your next CIO?
David Muntz: 33:43 Well, we happen to be comprised of people who have a lot of experience and so I’m always interested in people who have experience and depth. So that’s one, but diplomacy, uh, is probably the other and under diplomacy, I am cheating because under the policy I’d make a list of characteristics including communications, empathy, et Cetera, uh, that, uh, I would, uh, think are associated with diplomacy. And the other really is optimism, which underneath it would have energy as well. So those are probably the three things that are most important to me. And ultimately, by the way, as you, as you know, too well, every relationship is based on good chemistry. So what you have to be able to do is look at that combination of characteristics, make sure that the profile of the organization is consistent with the profile of the individual who you might be putting forth as a candidate.
Bill Russell: 34:42 Yup. And I had a, I had an article I wrote on health system Cio about hiring the best CTO candidate. I had the five C’s. In order to derive hitch to that article, you’ll have to go to a health system CIO and see what the five cs, where that I gave. So. So you have a unique perspective here. I’m going to a little twist on a question I asked you earlier. So you’ve worked with the health systems, uh, private sector. You’ve worked in the public sector at ONC, you’re talking to a college student who wants to have an impact on health care. Which direction do you point them in? Do you point them into the private sector or do you point them into the public sector or you know, or what attributes of the person would point you to how helped you to guide them in either direction?
David Muntz: 35:22 It depends on whether you want to work on a micro or a macro level. And ultimately if you’re interested in the macro, I think the government is a great place to work. Um, I would suggest that you have experienced before you come with the government. So I’d you toward the micro. Um, the fact is that policy made with that experience and pragmatism is not necessarily going to work. It would be surprising if it does. And so you know, that practice pragmatism and practicality is critical. So head toward the private sector first, then when you’ve gotten to the point where you can make a contribution, policy is a great place to join. And by the way, you can make policy on the local level, the regional level, the state level and the national level, which is actually exactly what I did in my career.
Bill Russell: 36:13 Right. And so working in either, it doesn’t break you for the other, if you spend too much time in the private sector, you could still go into the public, you’ve spend a bunch of time in public, you can still go on to the private.
David Muntz: 36:23 Yes And the important thing is to maintain that optimism regardless of which direction you too.
Bill Russell: 36:29 Yeah. You seem to have the right temperament for both. For both. So, uh, what, what is something that the onc does for healthcare that may surprise healthcare leaders?
David Muntz: 36:38 Yeah. You know, the, the thing that people don’t really associate with the ONC is there laser like focus on making sure the data is available to patients and providers and what they see is, oh, they’re just in here to regulate features, functions and to provide some money. And that is not why onc exists. Onc wants to make data accessible and the products that are out there don’t always make that so easy. Hence the reason, so that’s part of the reason that you’ve seen that and you need somebody who’s still passionate about interoperability lead that effort.
Bill Russell: 37:20 Yeah, that’s great. So 180 project, go lives. I’d be remiss if I didn’t ask you this question. You’ve had some level of success because if you’re, if your first 10 fail, they don’t let you do 180. Um, give us, give us a handful of things that, uh, that health it can learn from your success. So we want to replicate your success over 180 project Go lives. What would you tell us?
David Muntz: 37:46 I would say, you know, it really gets down to the man management no matter what else you’re doing. You have to have a very strong governance process.
Bill Russell: 37:55 So you’re controlling the funnel.
David Muntz: 37:57 Exactly. And one of the thing you have to, part of the reason for governance is not just to control the funnel, but to get the people engaged in the, I’m never led a governance committee. Uh, I always would set it up, do the, all the work that had to be done, take care of all the administration. But the people who populated those committees were all from the operation side. And we would always have a president who had some sway and that one of the hospitals chair the committee, and interestingly enough, it had no vote on any of the prioritization or project approvals. And the idea was the operations is earning the money to operations is doing clinical work. Operation should make the decision about what the priorities should be and the order in which things should be done. Our job was to talk about what makes sense and there are some dependencies there.
David Muntz: 38:54 Um, but having brilliant people working for you as I have enjoyed my entire career is the key. Um, but I can’t tell you how powerful it is to ask people what they want and then let them make the decisions. The challenge we all have is it people, is that when I did surveys of people who had the same kind of discipline that we did and we’re tracking numbers, the lowest demand to supply ratio was five to one and people were, sometimes it’s 16 to one. So the idea is you cannot, you know, there’s no, and I attributed those to coach. No coach ever said this, but it sounds like of the coach would say, w and I used to tell my staff all the time, you need to focus on this. We can do anything. We can’t do everything. Uh, and you have to be able to have to say no and you don’t create a backlog in that process. You say, well, this is what I’m going to do this year and then I’m going to ask you again in another year what you want to do for the next 18 months after that. Um, so that you don’t have this heavy weight on the staff of it or the organization. And because things change as you know, every day in healthcare and priorities will shift from here to here.
Bill Russell: 40:09 Yeah, no, that’s, that’s, that’s great wisdom and advice in that area.
David Muntz: 40:15 Can I do a little bit of advertising. Sure. The Gardner article that was published about what we did at Baylor, if you want to see in a lot more detail what it is that was talking about.
Bill Russell: 40:26 Is there a, is there a title for that article?
David Muntz: 40:29 Uh, Baylor healthcare system offers strong example of a pmos ability to help healthcare systems manage high it demand.
Bill Russell: 40:37 Wow. There’s the answer. Great. Well we’ll definitely have to pull that article up and reference it in the post. So we’re at the close of the show. We close with our favorite social media posts of the week. Uh, I’ll go first. So this past week I got to attend the inaugural health conference at the Aria in Vegas. It was interesting, there’s about 4,000 people there. It was highly tech centric in terms of just the, you know, it’s all around innovation and those kinds of things. Pretty well attended. Very well run conference. So I dunno, I dunno. I Dunno if I’m recommending it, but I’m saying it was, it was fascinating and good speakers, uh, David Feinberg, CEO of Geisinger, uh, did the keynote and he had this quote and he said, quote machine, I love people like this. So at Geisinger health we have 13 hospitals. I think my job is to close all of them.
Bill Russell: 41:28 I know that if we use proven and behavioral techniques to get us healthy, half of the 2000 beds I’m responsible for would not be there. Um, just a, an interesting approach is the same guy who said, you know, we want to get rid of the waiting room and all that it represents, you know, think about those quotes there. I don’t think that’s, uh, an announcement that we’re going to get rid of every hospital in Geisinger, but it’s saying we can do better at keeping people out of the hospital and that should be our focus. So it’s very interesting. So do you have one?
David Muntz: 42:03 The one I would suggest that you look for that Jonathan Perlin who is the Cmo at HTA, talked about was the virtual virtuous cycle and how that was related to analytics and what they had done to work on a bloodstream infection. So just fascinating. And he’s one of the most brilliant, eloquent speakers I know. So it’s well worth it.
Bill Russell: 42:29 Well, thank you you for, thanks for confirming that you are a nerd and I, we, we appreciate it. We appreciate it.
David Muntz: 42:36 I’ve got my pocket protector to prove it.
Bill Russell: 42:39 A biostatistician to CIO. What’s the commonality? Yeah, you love, you love getting down into the minutia of, uh, of how, how things work. So, uh, thanks. Thank you again for coming on the show. Um, so give us an idea of how people get to give people, follow you on social media at all.
David Muntz: 42:56 Sure. Um, I do have David Muntz tweet, Twitter handle and then, uh, as part of Starbridge advisors, there’s an @Starbridgehit a that we use. And I’ve tried to push people to uh, Starbridge advisors.com where we highlighted this week that sue shade was one of the top 15 women in healthcare. It not an uncommon place for her to be and very proud of what she’s accomplished.
Bill Russell: 43:24 Absolutely. Former formerly on the show and uh, I’m sure we’ll be, again, I’m looking forward to having her back on the show. So, uh, so awesome. You, you can follow me on Twitter @thepatientsCIO, my writing on health, on the health lyrics website, I noted Health Systems CIO, picks up an article every other week. Uh, don’t forget to follow show @thisweekinhit and check out the website. Thisweekinhealthit.com. If you liked the show, please take a couple of seconds to leave a review on iTunes or Google play. And, uh, we are now up over a hundred videos on this week in health it.com/video and that will take you to our youtube channel. We every show we cut into one, two, three minutes segments about five or six a week. And we put those out on social media and we put them up on the show.
Bill Russell: 44:11 So we’re going to start organizing those by topics, uh, the role of the CIO, uh, AI, data analytics, those kind of things. So we can, uh, so people can get more out of the, the channel itself. So, uh, last thing I want to say is if, you know, if someone you’d like to have us have on the show, please let us know. Just us on one of the social media platforms and, uh, you know, just the direct message me and, uh, you know, I’m always open to that and I’m always curious as to who people recommend it’s, it’s fascinating to me. Um, and please come back every Friday for more news, information and commentary from industry influencers.
David Muntz: 44:50 Can I have one last word? Make sure that all of us who appreciate your thought leadership. I get a chance to say thank you for what you’ve done for the industry.
Bill Russell: 45:00 Thanks. I appreciate that. And I will give you the last word. That’s all for now.