Tressa Springmann on The Program Formerly Known As MU and the Apple Health Record

This Week in Health IT - LifeBridge Tressa Springmann
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This Week, Tressa Springmann CIO of LifeBridge joins us to discuss CMS' big announcement around the future of MU or Promoting Interoperability. We also talk with Tressa about the Apple Health record implementation at LifeBridge.

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

Bill Russell:                   00:51                welcome to this week and health it where we discuss the news information and emerging thought with leaders from across the healthcare industry. This is episode number 16 it’s Friday, April 27th today we break down the changes in the program formerly known as mu and what this week’s announcement by CMS means to health it. We also get an update on Apple’s health record initiative from one of the users of the technology and a, and a lot more. This podcast is brought to you by health lyrics. Get ahead of the wave. We believe that every health it organization has it within them to be great. It all starts with clarity. Is it to schedule your free consult. My name is Bill Russell. Recovering healthcare CIO, writer and consultant with the previously mentioned health lyrics. Uh, you know, sometimes on the show we have people I’ve interacted with a lot and sometimes we have people that I’ve just interacted with from afar read their stuff, read interviews and uh, and the things they say resonate with me and I look forward to them being on the show and then I, I, you know, make the request and they say yes and I’m really excited when they, they actually, it actually sometimes it just surprises me when people say yes.

Bill Russell:                   01:59                Uh, because of how busy CIO’s are today, I’m really excited to have, uh, Tressa Springman CIO for lifebridge health on the show. Uh, Tressa welcome to the show.

Tress Springman:          02:10                Thanks for having me. Good morning and happy Friday.

Bill Russell:                   02:13                Yeah. Happy Friday. Casual Friday for you. Casual Friday for me. So I think most healthcare it organizations now are casual on Fridays aren’t they?

Tress Springman:          02:22                Yeah, yeah. I know it’s something we enjoy. It just inspires a little bit more informality, uh, in the day. And uh, you know, it’s a pregame to the weekend for sure.

Bill Russell:                   02:34                Yeah, I think Sarah Richardson was, was trying to push for two more casual days during the week. Um, I don’t, I don’t know if she’s going to get there, but healthcare is still pretty, uh, next to finance is still a pretty, pretty buttoned up kind of environment. So, um, let me get some, some, some of your background here. So, uh, you know, tressa CIO for lifebridge since 2012. Uh, lifebridge is about 2 billion. Uh, you, oh, you also took on the, uh, the role of performance improvement. A lot of times people are asking me, you know, where does the CIO going next or where do they expand to? And a, so you’ve, you’ve taken on performance improvement. We’ll talk a little bit about that. And so lifebridge 2 billion, 10,000 employees located in Maryland. Uh, you’re highly active in various things within the community. Chairman of, uh, your health information exchange called Christ, uh, health may, oh, you’re part of the advisory board for Towson University on their health care management program. You’re an adjunct professor at Mount Saint Mary’s University, uh, previously teaching a hit, which is awesome for their master’s program. You’re the past president of Maryland Himss, a certified professional in health information systems management, and also a CHCIO. And do you have your master’s from Johns Hopkins and a Ba in biology from Saint Mary’s College of Maryland. Is there anything I missed? Like, you know, you have a family that you’re really proud of or anything like that?

Tress Springman:          04:06                Yeah. You know, I think those accomplishments, uh, really Trump the litany of what you read. Um, Yup. I right now live in Maryland. I’ve got two sons and two crazy dogs and I am actually tonight struggling to get through turning in my final exam for wine chemistry class that I’m finishing up at Penn state. So, um, yeah, go, I’m going on and I appreciate you having me here for sure.

Bill Russell:                   04:36                Well, thanks. Wine Chemistry. No, I, the shows too short to go down that path. We’ll, we’ll be talking for hours

Tress Springman:          04:44                for another time for sure.

Bill Russell:                   04:47                What we’d like to do is we like to ask our guests, you know, what are they working on right now that they’re excited about that, you know, that’s really interesting.

Tress Springman:          04:58                Oh Wow. There are a lot of candidate ideas there right now. We’ve had a very successful year of evolving our telehealth strategy. We’ve got seven very unique first year pilot use cases, but a much broader strategy that we’re taking on in the coming year and really, um, wrapping our telehealth strategy around an entire digital health platform and integrated with both a clinical and administrative call center to, to really, um, strategically move forward reducing barriers and access to care. You know, whether it’s scheduling an appointment, talking to a clinician or just figuring out should I go to an urgent care or a primary care or the er, um, really creating choice points for our patients. Whether they want to interact with us in person over the phone or in a digital experience and making sure that we make that customer service interaction an easy one, we all know how siloed our industry is. And so, um, I, I’m just super excited about the opportunities that this provides.

Bill Russell:                   06:21                We’re seeing a lot of that. What is going on in the telehealth space is really exciting. We just hope that sort of reimbursement reform and whatnot catches up so that, uh, the payment models matched the technology and the desire that we all have to make it easier for the patients. So this is how the show breaks down. It breaks down to the three segments we do in the news. We do a leadership or tech talk, which we’re going to change up a little bit again and I’ll explain that. And then we do social media posts to end it. And, uh, you know, sometimes in the news the show just writes itself. Uh, this is one of those weeks Tressa and I got on the phone earlier this week, uh, to discuss, you know, what, what topics do we want to talk about, what stories are in the news? And I think we talked on Monday or Tuesday and then, uh, CMS did their announcement and that sort of became the, uh, the prevailing new story. So that’s what we’re going to, we’re going to jump into, there’s any number of places you can can read about this. The CMS website is probably the best. It was pretty clear, um,

Bill Russell:                   07:18                pretty clear description of, of what’s going on. So here’s the first, I’ll just, I’ll set this up and then we’ll go back and forth a little bit. So CMS proposed changes to empower patients through better access to hospital price information, improve the use of the electronic health records and make it easier for providers to spend time with their patients. So that’s the first line of the CMS. Here’s a couple of quotes from CMS administrator Seema Verma. Uh, we seek to ensure health care systems put patients first. Today’s proposed rules demonstrates our commitment to patient access to high quality care while removing outdated and redundant regulations on providers. So that’s the gist of what they did. The EHR adoption has created electronic silos. We had filing cabinets before. Now we have electronic silos. Data doesn’t mean anything unless it’s put into a format that’s meaningful to the end user, whether that provider or a patient, whether it’s, whether it be for provider or a patient.

Bill Russell:                   08:12                That is where we will be continuing to focus our efforts. So that’s uh, that’s why and a little bit of what, so let’s, let’s actually take a look at what happened and then, then we’ll get into it. So specifically CMS plans to change the EHR incentive programs, uh, in the following ways they’re going to make the program more flexible and less burdensome. There are going to emphasize measures that require the exchange of health information between providers and patients and they’re going to incentivize providers make it easier for patients to obtain their medical records. So this is where it starts. They renamed it,

Bill Russell:                   08:45                right? So it’s the, uh, the program formerly known as mu. So we’re doubling down on these efforts are announcer to complete. The overhaul of meaningful use is for the first installing or the first installment in that she said, referring to the recently announced renaming of Ehr incentive programs to promoting interoperability programs. Interoperability. So renamings not a small deal. It shows the focus of it. And the focus of it, uh, as we’ve highlighted on the show before has bipartisan support. So this, uh, what is generally accepted is that we created this environment where the data gets housed in these EHR, but patients don’t live only within one health system or only within one, only within an acute or an ambulatory environment. And a lot of times they are moving across a continuum. And we’ve created these, um, we’ve created these silos and as people like vice president Joe Biden have traveled around in supporte of the program, the foundation that he’s, uh, supporting, he has heard over and over again that this is one of the major things that’s holding back research.

Bill Russell:                   09:58                It’s holding back good care is interoperability. So they rename it has bipartisan support. We’re going to sort of move forward on that. So here’s where we start going back and forth. Here are some of the patient centered improvements. Uh, the first is patient has access to the record in downloadable format. The day they leave the hospital. Okay. So that’s, that’s one aspect. The second is our, actually let’s, let’s, so, uh, the quote here is when we go to the doctor’s office, we want to be able to have the information about what happened there. We want to be able to build our record from birth through our entire life. You want to be able to aggregate information from your medical record, from your devices so we can put the story together and see the, see your health and how it looks. So what we’re saying is now the patient becomes the center for that filing cabinet, right? So if they, wherever they leave, they’re going to get that medical record. Uh, in terms of interoperability, so what kind of impact, let’s start there on that one. What kind of impact will that have on your health it organization and what kind of benefit, what do you think that would have for patients?

Tress Springman:          11:05                So, you know, I think that the meaningful use program, and we all know that it really started in the early days is as use. It was use oriented or clinical data and data use available in physician practices and in hospitals. And have it stored at a somewhat standard way. Um, and it was the way, it was a great way to begin, but it was from the healthcare industry out. And what I love about the pivot now is this recognition of a digital economy and, um, consumer and patient comfort with technology. And I’m just so huge believer that whether it’s two or five years from now, that the ecosystem is going to be much more in alignment where it needs to be, which is the patient. And this is about the patient. And you know, I envision a day where our consumers, patient, our citizens have the ability because it’s their health information. Um, and they will move in and out of touch points of very various participants in the industry like lifebridge health and they will be the ones providing me their history and their information, whether it’s self reported or from other areas in organizations. And I think that’s a real paradigm shift. We’ve got to start with better interoperability between the entities in our ecosystem. Um, but I think it’s only a matter of time and velocity before it’s really back in the very capable hands of other patients or their proxies.

Bill Russell:                   12:52                Yeah. I think what people think is it’s just a matter of just opening up the data in a way. It flows. Interoperability is a very complex thing. As I found when I came into healthcare, our clinically integrated network literally had a hundred different Emr and it wasn’t just a matter of, okay, let’s get the data. I mean there’s, there’s contractual agreements to move to data. Uh, the data itself, how clean is the data? Uh, the format it’s stored in the quality of the notes. Um, the efficacy of the notes as well. I mean, there’s, there’s just a whole host of barriers and even within our four walls of our system, our clinically integrated network, our health system, we didn’t have full interoperability. This is, uh, this is a challenge. I agree with you. I liked the focus. So we are, uh, yesterday I heard Rod Hochman, uh, uh, CEO of Providence Saint Joseph Health speak and, and they have a simple moniker for their journey.

Bill Russell:                   13:51                You know, it’s know me care for me ease my way and it’s very patient centered. It’s really what we’re looking for is patients. You know, when we see the doctor, we want them to see our record and know us, we don’t want them asking us all the questions again. We want them to care for us. We want the best outcomes and ease my ways is the part that’s really starting to become central to health care. Now it’s uh, you know, reduce the, reduce the friction. I mean that’s the new buzzword. It’s reduced the friction of the transaction. Uh, what do you think? Well actually we’re going to talk about this in the next segment. So we’re going to talk about your apple health record cause I think this is, this is part of that. So, uh, so let’s go on to a couple of these others.

Bill Russell:                   14:30                This, this is an interesting one. So price transparency. Now you’re already required to provide price transparency as a hospital, but what they went one step further and there said, yet now you have to provide price transparency on the internet in machine readable format, meaning a new company, a new tech company could come out, collect all these machine readable pricing information and provide a sort of a snapshot of, of pricing. Is that really, is that first of all, is that going to be hard? And I mean from a technology perspective, probably not that hard, but uh, is that, is that going to be hard for you guys to do and, and do you think that will have much of an impact today?

Tress Springman:          15:10                so bill, I am bar none, any one of us at Maryland are the worst, uh, folks to ask about this because we don’t negotiate rates with different managed care companies and insurance.

Tress Springman:          15:24                We are given our rates. And so, um, I actually look at that requirement and scratch my head and wonder, wow,

Tress Springman:          15:34                is this going to be a requirement or, um, for us in Maryland when in fact we really don’t have prices. We have rates that are dictated to us by a commission. So, you know, we can make them visible, but they really are. Um, not our prices, so sadly I can’t really respond in an effective way to that, I think that, um, I would be misspeaking if I could talk about how easy or how challenging it is for people outside of Maryland. But for me, that is the singular element of the announcements this week that really gave me pause for thought because I thought, oh, here we go again. We’re starting with a new approach to this. This meaning the program. And yet there are already elements that, um, many of us, and I know we’re still in the comment period, so the people in Maryland, we’ll be, we’ll be speaking to this, that it’s a great, and it’s the right idea, but it’s really not relevant in our little geography here.

Bill Russell:                   16:39                Yeah, yeah. I, and I could see that. I think what they’re trying to do is create a market, right? So if you have transparency, you have a market. I don’t think we’re, I still can’t choose any doctor. Like, I can’t go to Kaiser. Kaiser is sort of their own little island. If I want it to in southern California, I’d sort of restricted based on my plan. Do you know? So I’m going to cover the last two real quick cause I really want to jump into the next section. So they’re reducing the burden and this is no small deal. And you know, every time I post something on social media, it’s at Dr. Green is quick to, to jump on it and say, you know, MU has been a failure. Those kinds of things. And you know, this interoperability is a big reason why MU has not, uh, realize its potential. And the second is, is just the burdensome reporting on this thing. So they’re going to reduce, let’s see, the prose rule reduced number of measures, acute care hospitals are required to report across five quality and value based purchasing programs. These proposals were moved a total of 19 measures,

Bill Russell:                   17:35                uh, from the quality programs and will de duplicate another 21 measures. And I’m sure that’s going to be welcome. But that was a, I mean, we have people dedicated to that actually. I mean it’s a significant significant deal.

Bill Russell:                   17:48                And then the, uh, the last thing just to note for health, it is a, the 2015 edition certified Ehr technology must include Api capabilities and that is what is going to be required for the 2019 certification as the 2015 edition. And that is to drive APIs and there’s a belief in the industry and I share this belief that uh, you know, APIs will enable a new ecosystem of players. We want to be able to invite this, uh, we want to be able to invite people from outside the industry, even from within the industry to develop new ways to, uh, drive patient engagement and, and being able to care for people outside of the normal visits. Um, I’m sure we will be talking more about this topic over the next couple of weeks and months, but, uh, you know, thanks for getting us started. So our next section, I want to jump into your experience with the apple health record. So you’re one of those, you’re, you weren’t the first a small group, but you’re, you’re a fast follower as they say. Um, so tell us what your experience has been so far with implementing the apple health record app at lifebridge and yeah, just give us a little background on it.

Tress Springman:          19:08                Lifebridge prides itself on, you know, being sizable enough to fund innovation and yet small enough to be nimble. So, um, when I saw the announcement by apple about the 12 initial health systems and I realized that a handful of them were either just down the street or in fact had a similar EHR infrastructure, um, similar to ours. I got on the phone, I started talking to people about, hey, have you done this elsewhere? Do it with me. And I’m next and I’m ready, and we can do this really quickly. Um, you know, we talked about interoperability as a key facet of, um, our next generation meaningful use. And in fact, the apple APP is utilizing the fire Api. So it’s, it’s really a very classic example, number one. Number two, I talked about our passion and interest in accessibility and if we step away, and sometimes that’s hard to do as an executive, but if we step away from the organization that we serve and we look at the greater healthcare community to the point that you mentioned, you know, we on our own healthcare journey or our own family, um, either insurance or our preference is navigating.

Tress Springman:          20:30                Um, the places that we go within the industry. There’s economics, there’s our care condition, there’s our pocket book and all of those influence our journey. And as much as I want stickiness and believe that health, uh, the health care delivery at lifebridge can be and should be the sole provider for people in Baltimore and in Maryland, that’s just not the case. And so, um, definitely we subscribe to reducing barriers in access by giving you your information. And so what does that mean? You know, here in Maryland, Hopkins and Medstar and lifebridge are all down participants within Golly, six weeks of that phone call. Um, with the publication of the upgrade of the apple app, the health app, the one with the little heart on it. Um, as long as you have, um, set up a portal at lifebridge health or any of our physicians that are affiliated and using our enterprise Emr, uh, you can go right into the apple app and see, um, a different, uh, more apple rendering and apple oriented rendering of your health information that you would find in your portal here.

Tress Springman:          21:42                Now, it’s not as interactive or robust as the portal app that our Ehr vendor has that we have made available on smartphones for, for folks who visit us. Or you can schedule appointments and ask secure message your clinicians and physician practices. But what it does offer is if you’re that person who has had to navigate to a Medstar facility, a Hopkins facility and lifebridge and if had to establish portals cause right, we all remember how hard that meaningful use portal requirement was, especially for hospitals. Like, Ooh, you know, it’s sad if you’ve been in a hospital yourself. So very many times that you need to do establish a portal. We see that much more prevalent in our physician practices and maybe a much more reasonable ask, but that was a high hill decline on meaningful use to make that measure. Um, and yet now with the apple app, the Health App, you’ve got the ability to visually render in realtime through fire Api of you, of your health data from all of our organizations on one app on your, on your smartphone. So think about that. We, you know, apple has created that layer above, um, so that these information silos have really just been kind of wiped away.

Bill Russell:                   23:07                Yeah. So we’re ending the portal ping pong as it were. Was it, was it hard? I mean obviously your, your Ehr Platform, which I assume is epic.

Tress Springman:          23:18                Fire

Bill Russell:                   23:19                Oh, okay. But has had the fire Api, so this was pretty, it was pretty straightforward implementation.

Tress Springman:          23:26                Yup. Probably the toughest thing was looking at all of the expectations that apple has that are somewhat non negotiable because they’re apple.

Bill Russell:                   23:40                You’re also sort of minimizing expectations here. I mean it’s not, uh, it’s a start, right? So it’s, it’s bringing in certain sets of data. It’s not as robust as your, your portal, but, but if you are somebody that moves around from system to system, now all of a sudden instead of having a it, my parents have this, a portal for one health system, a portal for another portal for another. Um, you, you can at least, you can see what it might look like in two, three, four years. We still have some of the same challenges. I mean, getting a common med list is, is almost impossible, right? I mean, if you have a med list from, from lifebridge and you have a med list from a discharge at Hopkins, reconciling those is very challenging. It was challenging in the portal world. I’m sure it’s going to continue to be challenging in the apple world, but it’s, um, but we could, we could do the 80 20 rule and say this is 80%. We now have the, the patient giving them a good snapshot at least of where we’re at today with their health. Is that, is that how you’re,

Tress Springman:          24:48                that’s right. That’s right. I mean, look, I look at it as a baby step. If, if you, um, if I pull it up on my phone and I’ve got my own records in there it’s a nice visual, um, it’s aesthetically pleasing. It’s very apple ish, but I can’t do a lot with it except look at it. But it’s the right step. And conceptually it’s a disruptor where there’s sufficient, um, industry interest in what does it look like and what can it become.

Bill Russell:                   25:19                Yeah, yeah. It’s, uh, it’s interesting. What do you say to the people? So we just had this Facebook thing and you know, people inadvertently shared their data. And one of the things that people like to point to with apple is you’re going to have the ability to share your data with a provider. Or with, at some point you’re gonna be able to walk into any health system and say, would you like a copy of my record and click a button and your apple health record, uh, we’ll, we’ll go over. And they’ll at least have that at the point of care. But what, what privacy people are saying. And, uh, some, some high powered industry people are saying is if we give people access to their health records, they’re going to get duped and they’re going to give away their health record. I mean, what, I mean do you, I mean, clearly it’s a concern, but, um, are you more worried about that? Are you worried about that and how, I mean, how do you balance that with putting people in the driver’s seat of their health?

Tress Springman:          26:11                Yeah. Wow. So, you know, we are always striking that balance and, um, uh, on a daily basis, you know, how rigorous and strong do you make authentication and passwords, um, and yet you don’t want it to be a barrier to having your clinicians as easily get in and be able to access information on the patient so that they can rendor care. We’re continually, um, teeter tottering on in an imperfect world. So, um, look, I just think we’re going have to continue to navigate that for sure. Um, one might argue that when you’ve got all this data that’s accessible, and I know our physicians argue it, they’re like, whoa, if it’s out there, um, does that mean there’s an expectation that I knew it was there, I looked at it and I’m accountable for it, that counterbalanced with the clinician saying, wow, you know, if we put it completely in the hands of the consumer or the patient and they’re electing not to share it with us, that can be pretty damaging to, um, you know, I think the reality is

Tress Springman:          27:21                as a patient, as a consumer, um, that’s really mine. It’s mine to make some determination over. And, um, and yet I think many people would agree that in a circumstance where, um, you know, let’s say there’s a horrific accident, you’re, you’re in a car accident and you arrive unconscious and an emergency room, um, that’s a circumstance where people can really wrap their head around the fact that they’d rather have their care providers and access them. Be overly concerned about the wrong person. Having the ability to, um, take care of them by having a barrier to that information. But I think it’s going to introduce a whole different level of conversation and complexity. For sure.

Bill Russell:                   28:08                I agree. The thing I would say to the leaders at epic and Cerner who quite frankly benefit from the data being closed off. I think they’re great people. I think they want to, they want to do what’s best for healthcare, but they are sort of proponents of this, hey, we’ve got to protect the individual. And again, I’ve had these kinds of conversations and it’s kind of abruptly ended them by saying, how can, how can an individual do much worse than the 24 million records that we’ve breached since 2016. I mean, quite frankly, I’d rather be responsible for breaching my record then just continuingly getting those, uh, you know, we’ll protect your credit history, uh, emails from the various providers that have had my record over the years. I, I’m not gonna I’m not going to have you comment on that cause I don’t want you to get into the same trouble that I get into. Um, yeah. All right. So here’s what we’re going to do. And we’re gonna have to do this fast cause we, we spent a lot of time. So, uh, this is really mostly, I’m going to change this to sort of a soundbite segment. I’m asking you six questions really quick and you know, one to two minute answers on these things. So what is one technology that has the potential to have the most impact on healthcare in the next five years?

Tress Springman:          29:20                Do I get a whole minute to think about it?

Bill Russell:                   29:28                No, you have, you have a minute to answer

Tress Springman:          29:34                when technologies that are starting to emulate the human senses, right? We all are learning a lot about voice recognition and optical character recognition and taking advantage of voice commands. Um, I’m starting to see the same with machine vision where, um, just the ability to leverage and take the sense of vision and apply it to, um, framing out a geographic awareness in an OR or navigating a, um, health care, a physical hospital. Um, so I think we’re going to see, obviously it’s a lot of artificial intelligence, but I think I’m getting very good at using those technologies so that we can revolutionize and make much more effective how we’re gathering information both from patients and providers.

Bill Russell:                   30:28                Computers are taking on a different role. It’s very interesting. Every industry that has digitized, has gone through this disruption really about 10 years post digitization. We heard that at the forum in 2008 9% of the industry had an Ehr in place. Today that number’s about 90 to 95%. Um, what are you doing to prepare for disruption or to promote disruption within your health system or your markets?

Tress Springman:          30:55                Yeah, well we definitely promote disruption. I know we talked about meaningful use and the new program. Look, the reality is as a CIO, we live very practically in that need to demonstrate competency and budget management and keeping the lights on and addressing the regulatory challenges ahead of us. But I have a real mindset that our real opportunity is to differentiate by innovating around the edges. You know, we want to keep our core sound and well controlled and reliable. And yet if we as the technology, one of the technology experts in a healthcare organization aren’t at the table partnering, whether it’s with marketing, um, to really enhance an address, this new era of consumerism or our innovation partner to work with different teaching institutions or startups so that we can identify not only small tests of change but perhaps ways to monetize or get very creative on finding different opportunities and funding sources to innovate. Then we as the CIO or are really missing out. So, you know, I always encourage my peers and I know organizations are structured very differently. Like you might have a chief transformation officer, chief digital officer, um, if that’s not you, um, you need to lock arms and really be at the table for sure.

Bill Russell:                   32:29                Yup. And people in the industry that have organizations of your size. I heard a panel yesterday, uh, you know, things like dignity and Providence, whatever or talking and you know, there’s $20 billion health systems and clearly they’re innovating, but the smaller you are, the more creative you have to be in the partnerships you have to do. And your partnership with Apple, uh, is, is you know, a testament to thinking, um, creatively about innovating around the edge as you said. Okay. So the work continues to change in health it. And uh, so I’ve been asking a lot of CIO’s this, this, this type of question. Um, you know, we don’t change tapes anymore. Well, you might take change tapes, there might be some legacy systems, but generally speaking, tapes are going away from health. It, what is the one thing you’re doing to prepare your team for the, the change in the work that is done within healthy?

Tress Springman:          33:28                Is that the bell?

Bill Russell:                   33:29                That is the bell. We’re going along. I apologize.

Speaker 6:                    33:35                Okay.

Tress Springman:          33:36                You know.

Speaker 6:                    33:38                Okay.

Tress Springman:          33:38                We, and, and information technology had been the catalyst for disruption for a lot of other players or associates in our own organizations. And yet, um, we’re going to have to change. And as a leader, I need to make sure that I’m creating and promoting an environment where there’s a readiness for change and not, um, the fear that might be attributed to displacing the way we’ve always done things. You know, when, when we look at ourselves as a leader with a group of technology, folks that spanned the skill domain from supporting mainframes and network infrastructure. And when we start talking about displacing to the cloud and really creating, um, maybe developing roles that are much more around interoperability or digital health as opposed to the traditional programming mindset, it’s super disruptive. And yet, um, like anything else as a leader, we’ve got to, um, manage the message.

Tress Springman:          34:48                And I think we’ve got to take, um, some of the fear out of that by creating a safe environment for the conversation and really to continue to educate where the industry is going and then personally commit to the organization I serve. And then the phenomenal associates I have working for me here. And there’s going to be a place for them. Um, they shouldn’t be intimidated. It’s still, technology it’s still creative design. So even though the tool in their hand, maybe a little bit different, um, the motivation that got them into this space and into this industry will remain.

Bill Russell:                   35:25                Yeah. As I tell my, uh, my kids recently graduated from college and moved into the work world and I think we’re telling them now that they’ll change what they do, you know, 10 to 12 times before they retire. And when we came in to the industry, it was, you know, you’ll change four or five times in your career. Um, I’m, I’m sure that 10 to 12 is, is accurate. I think the nature of work will change so dramatically that, um, what they’re doing is going to be interesting. So, um, so what’s one thing you would say to vendors trying to work with a health system? You know, I got, I got that email once the had dear, whatever, wasn’t even my name. You know, we have the greatest thing since sliced bread. You need this thing. Um, but I get this question a lot from vendors is, you know, what’s, what’s the, what’s the approach that resonates with the CIO?

Tress Springman:          36:16                Well, with a name like Tressa, um, nine times out of 10, they spell it wrong anyway, so thank you for the letter, but that’s not me, you know, Bill, I think you can relate to this. Um, and, and I can too, I’ve been a CIO now for over 20 years and a few different institutions, organizations, but that’s not where I’ve always been. Um, you know, we have a passion for supporting healthcare is an industry and, um, you know, as, as a commitment to doing a better job here in the u s with health, quality, health equality and economic value to the quality of care. And, um,

Tress Springman:          36:57                I’m most appreciative when vendors or other people in this ecosystem that we’re in approach us as prepares and professionals. You know, I think as you know, um, we have all worn different badges and sat in different seats. And I think if there’s, um, uh, participation in the dialogue about how we can solve a problem, there’s a higher probability that when we get down to the investments and tools, um, that we’re taking advantage of the players in the market who we really know understand that. So that may be kind of a philosophical comment, but I gotta be honest. I, um, maybe it’s a bit arrogant. I pride myself on knowing the 10 big things I need to solve in the coming three months, six months, nine months, and I go chase them down. So, um, when I know I need it, I’m calling that. So just having, um, a, a presence and recognizing that I’d rather talk about the problem that we’re trying to solve together than any specific method of solving it. Um, usually it takes care of itself from a product perspective.

Bill Russell:                   38:07                Yeah. And similarly, I say three things to them. I say, know my business, so I don’t want to keep educating you on my business. The second thing is don’t try to get to me through email. If you can’t get to me through another person, you’re probably not going to get the sale anyway. So either through a peer telling me, hey, you should talk to this person or somebody within our system saying you should talk to this person. So that’s the second thing I would say to people and the third is a traditional sales rep doesn’t cut it anymore. But when I talked to the sales rep, I want to be strategizing. I want them to know their product backwards and forwards. I don’t want to, you know, have a go between, oh, let me bring in this person, let me bring in this person. I want them to at least have a base level of knowledge that that adds value to our time is valuable. It’s the most valuable thing, which is why I appreciate you allowing us to go over today a little.

Tress Springman:          38:54                By the way, you are way more succinct and delivering kind of what I was articulating. Yeah, great list for vendors for sure. And you know, if there was any, I hate to do all of the negatives, but please don’t ask for an hour of my time to tell you what my goals are for the coming year so that you can try and figure out what that corner of that to sell into. I know what I’m going after.

Bill Russell:                   39:19                So one of your pad, and we’re going to skip the social media at the end, but to, to cut this off, but uh, one of your passions is the CIO needs a seat at the table. Um, and I want to touch on that as we sort of close out the show. So what’s, what does that look like? And if you were interviewing for a CIO role today, um, what’s, what would be the situation that you would say, yeah, I’m not going to take that position because it’s not structured correctly. I mean, do you need to report to the CEO? Do you at least need to be on a, you know, a President’s advisory committee? Do you need to have like a board sub committee that you’re reporting to? When you say a seat at the table, uh, give us an idea of what you are imagining, what you envisioned.

Tress Springman:          40:04                Yeah, I think the red flags for me is not being involved in organizational strategy development right now. If I’m offered an incredibly creative technical job, I’m not interested.

Tress Springman:          40:19                I am an executive leader who needs to continually balance how we use technology to enable and advance our mission, which is a healthier community. Um, and so, you know, it creates my own constraints for sure. Um, I’m at a leadership table where I’m equally responsible for operations excellence, lean project management, um, getting cost efficiencies and effectiveness out of our system. And yet I recognize that as we digitize healthcare, um, I have one of the biggest hands out at budget and I myself have to manage that conflict between being fiscally responsible executive who understands what those trade offs are when we make those decisions. And when I advance it. So for me, the red flag is that you’re just a technology expert and, um, you know, just go take care of that for us. Make sure you understand what these new federal programs are, but, um, what we’re talking about starting a new clinical program or a merger and acquisition or, um, you know, one of our key tenants at the board level that, that, um, I’m just not part of the executive team. You know, that’s, that would be a problem for me because I’ve had that benefit and privilege, um, for the last number of years.

Bill Russell:                   41:47                Absolutely. Have to be part of the table, I’ve seen, um, the thing I keep telling CIOs is you’re delivering outcomes and if you’re delivering outcomes, they’re typically business outcomes. And if you’re in those conversations, you’re at the, you’re at the right level. I don’t like being, I did not report directly to the CEO. Um, I did not find that to be a problem because I met with the CEO fairly often. We were in the same room fairly often. And whenever there was, you know, we’re thinking about digital transformation, those things, I was always, I was always at the table, so that worked. I didn’t have to report directly to the CEO. And I know a lot of CEOs can only handle so many people reporting to them and uh, they have to, they have to make decisions from time to time. Um, you know, thanks for coming on the show. Tressa how, um, how can people follow you?

Tress Springman:          42:38                Well, let’s see. I am on Twitter. @tressSpringmann but also #healthitchicks #tressspringmann. I’m also on LinkedIn. You can find me either through Chime or at Lifebridge Most of the time, I’m just hunkered down doing a job that we do every day I get the pleasure and opportunity to poke my head out, as you have given me the opportunity. Nothing better to learn from our peers and to add value where we can. So I really appreciate our time bill and I really enjoyed this. So it was really nice to meet you. You asked some provoking questions, just thanks for the opportunity.

Bill Russell:                   43:23                Well thanks, I learned a lot as well. There’s a great series interveiw done by HEalth System CIO of you, its a four part series of people that get the opportunity to go out there. I, I recommended there was a lot of great material in there as well. So, uh, you could follow, you can follow me on Twitter @thepatientsCIO, my writing on the health lyrics website. Health System CIO picks up my articles every other week. So you can just track them down out there. Don’t forget to follow show on @thisweekinHit and check out our new website this week in health If you like the show, please take a few seconds, give us a review on iTunes, Google play, catch all the videos on the youtube channel. We’re now up to actually with this show, we will probably crack a hundred videos out there on the youtube channel, uh, this week in health will take you directly over to youtube. Uh, and please come back every Friday for more news and information and emerging thought With industry influencers, that’s all For now.


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