David Baker on The Wisdom of Epic and Google Gets Another Healthcare Star

David Baker This Week in Health IT
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This Week we sit down with David Baker the CIO for Pacific Dental who just signed one of the largest Dental contracts with Epic.  Plus, Geisinger CEO, David Feinberg joins Google.  Does he know something?

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Bill Russell:                   00:09                Welcome to this week in health IT where we discuss news information and emerging thought with leaders from across the healthcare industry. This is episode I don’t even know what episode this is. 47 I believe. Forty seven. Can you believe it. Big fifty. Do you remember what episode you were on.

David Baker:                 00:23                I was like number four.

Bill Russell:                   00:25                It was a single digit number and it was pretty early so you were on for the the HIMSS week.

David Baker:                 00:31                Yeah is a big week fun week actually.

Bill Russell:                   00:34                That was crazy. Well I’ll introduce you in a minute but this week we’re going to talk about Epic’s move into dental which is interesting. David Feinberg from Geisinger goes to Google which is big news CMS is now reimbursing remote patient monitoring. Wouldn’t that have been nice when we were at St. Joe’s. If they had done that we were trying to do so many things there and it’s just hard to get the funding well now.

Bill Russell:                   00:56                Now the reimbursements coming from Medicare so I think that’s going to spur a lot of things happening out of the home. So it’ll be interesting to talk about that. This podcast brought to you by health lyrics. If you’re moving in the cloud check out And take advantage of our let’s see about eight years of experience of moving health care to the cloud. So my name is Bill Russell recovering health care CIO consultant and writer. And who else am I.

David Baker:                 01:25                Who are you.

Bill Russell:                   01:25                I don’t know.

David Baker:                 01:26                Big time.

Bill Russell:                   01:27                You know I laugh now because everyone always introduces like I went to the Chime event on Tuesday. Didn’t see you there sorry at the Chime event. And as I go around people go oh this is Bill Russell you remember him. This is who he is the former CEO

David Baker:                 01:40                the recovering

Bill Russell:                   01:41                and a former like people always they always talk about who I used to be.

David Baker:                 01:46                What are you now. You’re a journalist now.

Bill Russell:                   01:47                Thanks for doing that No You know you’re going to find I still have some thoughts on being a CIO. So I’ll share some of those today. Today obviously returning guest David Baker now a CIO but I knew you when you were just actually I knew you when you were a consultant.

David Baker:                 02:05                Yes.

Bill Russell:                   02:06                You went consultant director V.P.. And then when you left St. Joe’s you became a CIO

David Baker:                 02:12                CIO SVP and CIO

Bill Russell:                   02:13                That’s like living the dream. I mean what do you attribute that to.

David Baker:                 02:17                Great solid mentors. Who scrutinized every every molecule of my work

Bill Russell:                   02:23                I was I was a little I was a little tough on you. actually I’ve told this story a couple of times. The thing that impressed me youre a consultant. I get named CIO you’re a consultant and you’re like trying to get on my calendar. You’re like feisty to get on my calendar you come into my office and you’re like. What’s the biggest problem you have. I guess the fact that I think the actual problem was the clinicians hated I.T.. Right. And you know at a certain point that’s unsustainable. You can’t do that. I’m like well the clinicians hate IT you’re like I can solve that problem and you started on that path and it started with easy pass then it went to 20 back 60 back. Yes the sixthly back. I mean you just did all sorts of things around the experience around the internal user experience with I.T.. It took us from a very low ranking to a very high ranking

Bill Russell:                   03:19                And when people ask me you know how did David get from here to there. I say. Anybody who walks into your office and says Give me your hardest problem I’ll figure out a way to solve it. That person is going to get your attention especially if they start solving the problem. And so I was you know I use that story to tell people take a risk. Figure out what the hardest problem is and see if you can solve it.

David Baker:                 03:41                No I appreciate that. It’s funny because I’m having some really cool conversations right now around a syllabus for some women in tech.

David Baker:                 03:50                Well I’m just trying to help contribute to. See I’m not a woman in tech yet. And I just want to say how can I think I can probably help folks with just through my own experiences you know some of that. The personal branding in your career. And then and then when when’s the correct time to step up put your head above the parapet and go and find those hard problems that folks are scared to address.

Bill Russell:                   04:18                Do you appreciate those people. I mean so it’s now role reversal. Right. So I was the CIO and you were the chair driving me nuts with Bill you’ve got to give me more money.

Bill Russell:                   04:27                We could do more things. Look at what we can do.

Bill Russell:                   04:29                Does that happen to you now or are you getting that kind of thing like your staff is as eager as you were

David Baker:                 04:34                all the time. It’s actually you know it’s annoying when i find myself sympathizing with you. Back in the day so Im like dammit I did use the I guess give you some grief but no I like it’s about channeling that energy right. You want that.

David Baker:                 04:46                I’d rather have someone in the office passionately fighting for something they believe in for for the greater good of the company and talking through that what it looks like than someone who’s just you know sat back just just going through the motions every day.

Bill Russell:                   05:02                Yep you want. You want a group of people that are waking up every morning thinking about how to do make. In Our case it was health care in your case it’s healthcare right. We’ve talked about this before. I mean

David Baker:                 05:12                tech oral technology. I mean I find myself. I like to look at myself as retail health care to be honest with you. But I mean technology in general but whatever industry you apply it to. How do you make. How do you make lives of folks better within the business in terms of giving them back. I always say minutes in their day that’s always been my big thing and it still is. And that’s that’s applicable across multiple verticals.

Bill Russell:                   05:37                Yea we had we used to always talk about you know the four areas where you need to really think about experience in the people’s experience. One is the clinician. The second is the consumer patient. And we sort of loop those together because every patient is really a consumer of some point and there’s consumers that aren’t even your patients yet but you need to think about them. Then there’s the system payer side. I mean there’s a whole bunch of people that are your your clients in that space and in the other space obviously it’s just the population at large. How do you get people to think about. I mean from a healthcare perspective we were like. OK 80 percent of the people we’re not going to see 80 percent of people in the markets that we serve this year they’re healthy they’re whatever. How do we keep them in that sphere of health. And you know we were always thinking about those experiences

David Baker:                 06:26                there were I mean. In fantasy you and I think something that you know I try and model and would try and pass on as well is making sure. and You did this and I made sure I did this but you have a seat at the business table and it sounds cliche now because a lot of people repeat that. But what does it mean. It means you’re not an order taker you’re not there just sending out technology upon request and then supporting something you’re given it means what are the business objectives right for the next and it would be great be great. if That was five years 10 years. Fortunate there. But what are the business objectives next year. What are you trying to do and how can I.T. help you on that journey in liberating some of those wishes and meeting some of those milestones. It’s really important that you that you’re discussing first and foremost the business level and then translating that technology level.

Bill Russell:                   07:19                Well thanks. Thanks a lot for being on the on the show. I clearly am not dressed for the show and they won’t pick us up on the podcast. But you are actually the most watched a full episode of the podcast so far.

David Baker:                 07:34                Really. That was the volume was a little bit scary. Maybe people just

Bill Russell:                   07:39                the volume on you. I think it’s I don’t want to go down the normal jokes that I would tell about you and whatnot but essentially you know I guess your your parents your all the people in Europe who saw you you know they all you know you have a huge Europe following European following

David Baker:                 07:57                really mad sort of. Right. The massive island of London. The United Kingdom. No

Bill Russell:                   08:03                I really can’t answer the question of why But it’s almost double any other full episode of the podcast

David Baker:                 08:10                I think its people think if this stupid dude can get a job anyone can

Bill Russell:                   08:15                let’s figure out how he got into the role

David Baker:                 08:18                exactly how did this foreigner roll up and get a job.

Bill Russell:                   08:19                You know what I do know how you got the role and I have talked to your the people you reported to since then I I’ve seen at conferences and they thank me for for for hiring you. And I’m like. And you know we we joke we do a lot of self-effacing humor. They really love the work that you’re doing. So the work that you’re doing. Made the news this week. Yes it did. So this is a pretty big deal so Pacific Dental is you know one of the top two or three dental practices are dental

David Baker:                 08:51                Come on dental. DSO. Dental services organization.

Bill Russell:                   08:56                there you go. So you provide back office for all these dental practices across the c ountry.

David Baker:                 09:01                We support dental owners Yeah. In doing better dentistry. I like to say there’s a whole support network behind the partnerships where where we will help the office with absolutely everything you know accounting recruitment finance I.T. services business coaching essentially

Bill Russell:                   09:21                and it’s thousands now?

David Baker:                 09:24                we’re 700 offices now

Bill Russell:                   09:25                700 offices.

David Baker:                 09:26                And yeah we have with some really impressive plans for growth next year. It’s no secret but you know barreling along towards the next hundred.

Bill Russell:                   09:34                Well anyone who’s followed the growth of Pacific dental knows that every years an aggressive growth

David Baker:                 09:39                that’s actually true. I made the fortune 500 5000 now a record number of times 14 16. I saw a badge on on the magazine the other day Yeah it’s fun it’s just super impressive and the fun thing for me is working with a true privately held company with just this breakneck growth that’s organic.

Bill Russell:                   10:02                Yeah. So it’s awesome so you make the news because the big epic announcement you actually alluded to this when we talked way back in February it’s been a long time coming you’ve been thinking about this for a long time.

David Baker:                 10:14                Yeah a really really long time it’s obviously not the sort of deal that you embark upon overnight. And there were lots and lots of conversations around making sure that it was a good fit on both sides

Bill Russell:                   10:27                because they didn’t have anything off the shelf. It’s not like you could you could demo the software.

David Baker:                 10:31                So you can as you know there’s just a handful of customers essentially I think less than 400. You know epic work with. So you have to be of a substantial size and the module sits within epic is essentially called wisdom. That’s a dental module and it is actually it’s live at multiple.

Bill Russell:                   10:55                So you’re not developing this from scratch. This is

David Baker:                 10:57                no not not total scratch. I mean we’re we’re obviously. We’re a Vanguard partner with Epic True partnership and we are building out the DSO. ready version of wisdom lets say like some improvements that will help an organization of our size be able to operate hopefully with real efficiencies and a great experience. But they are live in the country of Finland. The National Health Service I believe have both medical and dental. And then there’s a handful of other organizations using that foundational product currently. .

Bill Russell:                   11:41                What’s going To be the biggest benefit so paint us the picture of whatever it is a year from now two years from now when this is implemented and all 700 offices actually if you want to set the time you know I set timelines. So I’ll let you go ahead and set your own timeline. But what is it. Yeah I’d be like well yeah can we have it done in six months and the answer’s no. Because it’s organizational change there’s an awful lot of things that have to go into place.

David Baker:                 12:04                Yeah more about the organizational change actually than the product as you know with the consolidation when we did back in the day of. Of Meditech going down from the nine instances to the three was looking back naively at the time when I was you know fresh into healthcare oh that looks relatively easy it’s the same piece of software. How difficult could it be And boy it’s painful. So I got good grounding I think in understanding the pain that you inflict upon the poor. Clinicians major workflow upheavals and huge reeducation. And it’s a time suck let’s face it. So I think we’ve come a long way. Practice Management wise in general and I don’t think there’s a lot of options in dental outside of a handful of key enterprise players. But still the software is not as far from I would say an amazing integrated user experience.

Bill Russell:                   13:02                You’re not going from paper to electronic. You’re already electronic

David Baker:                 13:05                I like to think that where we have a huge set of obviously dental data. I mean our founding owner really I joked that he’s the original CIO because that’s how he started out. He put a practice management system in his father’s dental office back in nineteen ninety two or four. So yeah we’ve been on. We’ve been digital since you know office one. That’s the thing that’s what we’ve done extremely well. And the existing practice management system has seen us through really well. But it’s you know it’s an operational tool that was built a long time ago with probably the purpose of just getting off of paper. There’s no good work or enhancements

Bill Russell:                   13:53                probably client server probably creatures all sorts of challenges

David Baker:                 13:56                100 percent. Yeah. And you know there’s loads of questions obviously around you there’s multiple views as we know in epic for Sure. But the. I think it’s a really solid decision for us because we were able to build something out that is. Really meets dso of our size our needs. And at the same time I mean forward you know forward thinking like you say in terms of the integration opportunities.

Bill Russell:                   14:26                So if Im a CIO in a market let’s assume I’m a CIO in a market. So would I when I contact Pacific dental and say hey you’re on epic we’re on epic or even if I’m on something else. But we would we start trading data in terms of through an HIE or even directly.

David Baker:                 14:48                So it’s a great question right. We’re not at the moment. So this is kind of where our mindset is we’re a platform company. Okay so folks. Plug in we help support through multiple channels and ultimately you know multiple technology channels so yeah the option at some point for I refer to it all the time as imagined the dental health information exchange that also plugs into place with the health information exchange. Imagine the correlation of data that can that we can draw from. With regards to oral systemic health and those conditions that affect the whole body that are driven through the the window of the body which is the mouth.

Bill Russell:                   15:32                Right. That’s interesting because so Epic’s also part of sharing data with Apple and their iPhone. Oh gosh yeah.

David Baker:                 15:42                Their health record yeah.

Bill Russell:                   15:46                Application which is

David Baker:                 15:48                Im going to pull my phone up in a minute.

Bill Russell:                   15:50                But essentially so we could see in the not too distant future essentially information from wisdom in there as well so I could as as a patient be looking at potentially messages from you from my dental practice and information on prescriptions and those kind of things.

David Baker:                 16:07                Yeah for us. I mean it’s truly exciting. And I you know. I don’t think I’ve ever been more excited about liberating some of that data safely. But in terms of you as the patient can now see if you want to I mean lets think about EPIC right now approaches 70 percent of all of the U.S. population knowingly or unknowingly operate within some component of epic on their medical journey. And that’s pretty outstanding in terms of that volume. So imagine now. You as that epic based patient can begin to bring the full continuum in right of your healthcare information. The traditional PCP. And then your acute visit information as well. And a multitude of data around that if you wanted to like the imaging billing possibly I mean more than more than a lot of folks are utilizing right leveraging now are you add in. That for dental journey as well and you have the pharmaceutical. I mean it’s just you you’re never going to have the bigger view of your health information.

Bill Russell:                   17:19                So last question you’re starting on the cloud are you starting are you going to build that out internally and host it.

David Baker:                 17:25                Wouldn’t you be disappointed with me if I said I was going to build it out and HOST it.

Bill Russell:                   17:29                There are there are. Yes. I would The answer to that is yes but there are there are valid reasons and a lot of them are financial . It’s the some people have said that the cloud model is still a little pricey from Epic. I know this will probably get back to Judy and I apologize. I don’t even know the pricing model. Just heard this from some clients.

David Baker:                 17:53                Pricings relative I guess.

Bill Russell:                   17:55                Well if you’re just starting out you know you’re not you’re not replacing you’re not moving. Some people already have it on site. They already have the equipment that’s already in the data center. You don’t have to build anything new out there and then they look at the cloud pricing and they’re like well why would I do that. I already have all this stuff you would do it when that equipment becomes end of life and you have to do something.

David Baker:                 18:14                Yes. Plus as you know forearmed with a ton of information around what it costs to build out the practice management infrastructure architecture that sits on top of a huge VDI usually you know infrastructure. So forearmed with that where it’s really gonna cost to build out to see us into the next five years of growth. These things start to normalize.

Bill Russell:                   18:37                Also you won’t see this on camera but looking over your shoulder seeing a map of all the locations you guys are in.

David Baker:                 18:43                right

Bill Russell:                   18:43                and you almost have to be in the cloud if you’re going to be yeah servicing that kind of geography.

David Baker:                 18:48                Yeah we’re so distributed. Right. That’s that’s important especially from a latency standpoint if you like that where we’re set up you know in a good distributed way across the country.

Bill Russell:                   19:00                Well let’s hit the two other stories so you know we’re seeing we’re seeing a little bit of a brain drain here. So David Feinberg who I consider one of the really good thinkers within health care one of those people that was out there he’s one of the. He’s the CEO who said we want to eliminate the waiting room and all that it represents. And you know for a CEO to say that that was a pretty big deal because what it represents is that the physicians time is the most important thing and we’re going to cue people up and make it inconvenient for them because we want to queue up physicians time. So this is a CEO saying hey you know what we’re going to eliminate that waiting room not necessarily because we don’t value the physician’s time but we value our patients time as well. He was bringing GNomEx into the primary care area. So really forward thinking Toby Cosgrove former CEO from from Cleveland Clinic is at Google as well. So David Feinberg who Google Now Toby Cosgrove is at google SOMEONE we know went to Amazon Berkshire JPM. It feels to me a little bit like this is signaling that they’re looking at it going hey you know what. There’s only so much I can do within the health system potentially is what I don’t know. I don’t know what’s going on in their hands. I would love to interview any of those three. But potentially what they’re looking at it going I think I could have a bigger impact there either that the reach is broader I mean if you look at a Google you’re talking about potentially world health right you’re talking about global reach. You’re also talking about reaching people you know when they’re on the Internet and we all clearly were and we’re in front of the Internet a lot more times than we are in front of a physician or the

David Baker:                 20:43                That telehealth thing is that real now

Bill Russell:                   20:44                or actually it’s very real. CMS is going to start reimbursing it. So that’s also very real. So to a certain extent I think these people I think they’re looking at it going. Look I think we also know this that most visits start with not telehealth it starts with a google search. Hey I’ve got a sore on my foot. I’ve got you know I mean that’s where most health starts. So if you’re if you’re Feinberg and Cosgrove and they come to you and say look let us give you a little picture into what we have access to. I think anyone who’s creative and whatnot is going to look at that go. Oh. Gosh we could really impact global health. As opposed to say Cleveland Clinic even though they’re pretty broad they’re within a certain set of markets and Geisinger’s only really Pennsylvania and I think a little bit of Jersey maybe some new york. But essentially that’s the market they are in. And so they see this greater opportunity. do You think we’re going to see a lot of the. Innovation. I mean now you have these people going over there. Do you think we’re going to see these companies finally get really focused and really understand health care and how to apply these technologies.

David Baker:                 21:53                So I think there has been an exodus of a lot of the leadership and just the traditional especially acute model in general right I mean its been changing and morphing substantially over the years into. Into those smaller specialties. The build around those acute centers essentially and then you know the Joke around Health. It is real Right. I mean it’s been there we’ve been, I’ve used it I’m sure you’ve used it. We’ve deployed systems that we know. You know the numbers are there now so I guess the question I feel that it could go one of two ways because this is a hard industry to change in terms of just big health care population health management. Right. Big numbers. It’s very set i its ways even the thinking which is why sometimes you know in all honesty I stay away from some of the some of the events and particular tracks. I mean. Dreamforce for example right. You go to some of the really cool Executive tracks and stuff. I go hit the retail tracks a lot of the time. If I’m really worried about let’s just say security. At some point in time we want to go deeper into a certain area I’ll Go hit the finance tracks why because I’m going to areas retail they’re given an amazing customer journey it’s about the experience right. Finance Well there’s no one that cares more about the security of the information than some of those finance houses. So I guess my concern is does health care just talk about thinking outside the box and doing things differently have we really moved far enough in the last eight years I’ve been at it. I would probably say no in all honesty some pockets of certain companies you’ve seen move the market a little bit but it’s only when I think these these big changes in leadership happen that you know you’ll see some. Some some changes for the better. With that said. Google Amazon I mean I love some of the stuff I’m up to with him it’s great. And there are all these innovative pockets on the flip side. are They also too big to be as miopoly focused in that area then they need to be. Right. Yeah.

Bill Russell:                   24:00                There’s still billion dollar companies whose major source of revenue is advertising and those kinds of things Google search and advertising is still their. I think it’s like 90 percent of their revenue. I mean a significant number. It’s huge.

David Baker:                 24:15                So this is where they want to be disruptive. Right. Where I think it’s going, I guess to finish that point is Im pointing over there because there’s an orange county business journal somewhere there’s a I Can’t remember the name of the clinic opened up but it’s technology based membership primary care physician office essentially no insurance. You go in you Pay a membership fee. It’s funded by Ben Hoff. Is one of the financier’s there’s one that was up in San Fran and one that just popped open down fashion island here. They’re the folks that I think are pushing the boundaries because they’re saying. And you know unfortunately there’s a barrier to entry right. There really is. But in terms of are you interested in your care. Can you afford know true private care. Come and pay this monthly fee see us as much as you want. Do all of these amazing tests. That you want to do stuff that you’re never gonna get in a Traditional Health Care System. That’s the stuff that I really see pushing the boundaries as folks who want to take health into their own hands and want to throw the cash at it.

Bill Russell:                   25:19                Yeah I. The Jonathan Manis former CEO for Sutter I love listening to him talk and he and I had a conversation recently and you know one of the things he talked about at the Chime event. Gosh I think it was a year and a half ago was that you know digital transformation is happening to health care. The good news is it’s 10 year journey. The bad news is we’re eight years in. And he said and now all of a sudden he said you’re going to see the disruption start to pick up. And and he has just he just he just rattles them off. He’s like look this is in this oven. And as he goes through the list he goes. What you’ll notice is these people have come around the outside of the business and said what’s the high margin low risk business. They’ve said we’re going to take radiology. We’re going to take surgery centers we’re going to take. And they just boom boom they just knock them off until what’s left at the provider side is high risk low margin. Well that’s no way to run a business. It’s all high risk low margin. As the sisters used to say no money no mission. So you know if if you don’t have the money to invest and you’ve lost your high margin business to subsidize the rest of the business then you’re facing a world of hurt. I’m trying to think what. You know Google’s doing so I think one of the things these guys will do is help them to focus. They’re everywhere. I mean they’re like hey we’re going to you know we’re going to store your medical record was a long time ago. Then it’s hey we’re going to do contact lenses that can tell whether you have these diseases. And then obviously they’re doing the they’re collecting all this medical information with this project they’re doing now with artificial intelligence. And what not I think that’s their space.

David Baker:                 27:05                Yes I was going to say

Bill Russell:                   27:06                it is the artificial intelligence. They’re going to be able to make meaning of all this

David Baker:                 27:11                Yea because they’ve got I mean if you think about applying what are you really good at. So here’s the thing. Both Amazon and google are really fortunate. to work with some some really great minds in both those places a couple of weeks back. I was up doing a session at their briefing center up in the mother ship which is cool. Silicon Valley its really pretty amazing up there.

Bill Russell:                   27:30                Are you allowed to talk about that or do I have to cut this out of the show.

David Baker:                 27:33                Yeah You might have to cut it out lawyers will hit me. No I’m not going to give away any and anything I shouldn’t other than the fact that I think there’s a huge angle because of what they are good at. Right. With regards to those volumes of data and the worlds information is in applying that machine learning and AI and they’ve opened up their health care stack is open now right. The API library is there just it’s ready to be tapped into. So. Utilizing that against your own data sets is I think I think it’s going to be an amazing leap forward for lots of folks that tap into that next year. It’s there right now

Bill Russell:                   28:11                and that gives us the last story here is just CMS is going to start some CPT codes around remote patient monitoring they’re going to start reimbursing Is your . So dental I’m not familiar with dental. You know how complicated healthcare is. You know we have medicare payments we have you know payers for providers you know just a whole litany of things to figure out how we’re going to get compensated. Do you guys have a lot less of that. I mean is it a pretty closed system.

David Baker:                 28:40                Yeah it’s complicated. For sure it’s a lot less complicated than big Medical. Sure.

Bill Russell:                   28:47                So you’re not sitting around waiting for CMS to say hey we’re going to start reimbursing remote patient monitoring you guys you guys might have an opportunity to be more innovative or move a little faster.

David Baker:                 28:58                We are but it’s I mean for us there is slightly different set of of insurers sometimes right. And we’re still waiting for certain treatments to be paid on for example. Right. So tele health tele dentistry is the perfect example. There’s still. A little way to go. They are believe it or not some really cool use cases that tele dentistry that we’re working on right now. But obviously the model has to work.

Bill Russell:                   29:25                Do you have any anything you would do remote patient monitoring with

David Baker:                 29:29                remote patient monitoring. maybe from us from a specialist standpoint possibly that’s an interesting question. I mean yeah there’s no you know inpatient services right they’re all folks come in and go

Bill Russell:                   29:44                It just fascinates when we talk about dental it just fascinates me. it’s right alongside but it grew up differently. So it has different

David Baker:                 29:51                the redheaded stepchild unfortunately. Right.

Bill Russell:                   29:54                It’s so. It’s really interesting. So yeah so that’s that’s all the news I didn’t really prepare any questions I could ask you a couple questions. I mean you have a big EHR implementation coming up and you know how do you prepare for that. I mean what I mean do you have I mean this is pretty new. I mean do you have like a you know a team because you didn’t have a team of people before that knows epic so you have to build on that from scratch.

David Baker:                 30:22                we Have they been they’ve been really good in their partnership and helping facilitate that that build out

Bill Russell:                   30:26                so Epic will help you

David Baker:                 30:28                they’ll definitely help us. and We have a few select vendors that will so help us but they’ve been very methodical in how we build those teams because it’s not just a deployment initiative it’s a big build out. Right. So. They’ve been a great partner and quite frankly I’ve been fortunate in having some amazing resource internally as well and we’ve gone. We have. I see that my number one job is recruitment right now Bill so I’m out there pounding the streets as well as I can’t do this alone. And I really work hard at bringing in world class resource.

Bill Russell:                   31:01                So are you saying right now that you want as many vendors to call you as possible to help you.

David Baker:                 31:06                I don’t no more vendor help no I love my vendors right now. There are a lot of staffing shops out there let’s say. Right. So in Orange County there’s lots of realtors I’ve noticed and there seem to be a lot of agencies that specialize in finding the right staff member I believe that at this point in time especially in places like Orange County there’s an amazing network. I’m part of like Orange county technology professionals group Part of several other organizations even through LinkedIn where there’s there’s good dialogue. I’m always looking around we’re always looking for people and I think that if we post a job here I’ll start internally with our recruitment side of the house. I’ll pick that up and I’ll ping out and I want known entities people that are referencable by great people I work with there’s no there’s no better candidate and then a referenced candidate.

Bill Russell:                   31:58                Right. Yeah. As my as I brought him in as my friend Eric Herenkohl used to say past past performance is the best indicator of future results

David Baker:                 32:08                A-players. Good Book. I have to have him back. Where is. How’s he doing.

Bill Russell:                   32:12                He’s doing Well he. Yeah. So He wrote that book How to hire A-players and I love that phrase. Past performance is the best indicator of future results. And it really is true. I mean when you say well I’ve never done that before but I could figure it out. I appreciate that. I like people who say that but I’d much rather have somebody come in and he goes Yeah I migrated three or four health systems to epic revenue cycle or whatever. I know. I know the process and the good news for you is you’re not on the edge. I mean I mean there’s. Well as you said how many a couple hundred Epic clients.

David Baker:                 32:45                Yeah I think we’re on the edge in some of the. Aspirational build out we do. And in terms of the integrations we’re doing some really great integrations. But like you said it’s tried and tested and the attractiveness of that product as well is just the amazing rev cycle and back office functionality that we’ll be able to leverage out of the gate to an extent.

Bill Russell:                   33:10                That’s awesome. Well anything else you want to talk about. I mean I don’t have any other questions so what

David Baker:                 33:16                so was this did you have a pull out today and you’re like can I plug Baker in to come on the spot be honest now Bill.

Bill Russell:                   33:22                I am booked through the end of the year. And you know what happened. I kept looking at my calendar thinking I booked through the end of the year and I looked down and I was like I didn’t book this week. I even have next I have good I have a black Friday. I have that actually booked and I missed today.

David Baker:                 33:38                It’s always a privilege to catch up with you

Bill Russell:                   33:41                and to be honest people don’t think I’m busy because I show up in sweatshirts a lot. But there’s an awful lot going on in my life right now. So I’m glad to have the podcast booked through the end of the year and I’m starting a book book some really fun people in January.

David Baker:                 33:56                You’ve got some ballers on there. Like I said I mean it’s impressive. Some great some great content on there. So I was early doors when you were scratching around for people. N`ow I’ve come further up the list. I’m like wow I’m privileged This is great.

Bill Russell:                   34:10                I mean people don’t know how this how this sort of transpired was that just conversations with people and they’re like oh you know I said I would like to really record these conversations. People like you would be like yeah you should do that. Absolutely. Then I just turned around and go if you’re on the show I will do the show. And enough of you said yes and I’m looking forward to it. I finally got Darren Dworkin from Cedar’s he’s going to come on. And it took a little while to get him. And then just just a whole host of people have said yes I just need to follow up so I’m looking forward to some really fun conversations even through the next couple weeks and then into next year. We’ll definitely have to keep doing this because next time we’ll do it at a bar where you’re sort of dressed like this

David Baker:                 34:54                There you go and I’m much more comfortable in a bar. You’ll get a way more fun interview out of me anyway right. As you know so

Bill Russell:                   35:02                as I do know.

David Baker:                 35:02                I appreciate the congrats on the folks you’ve had on there. There’s definitely some some giants of the industry. And if anyone’s listening and watching and haven’t been on there that are upstanding in their community get on there.This is about paying it forward.

Bill Russell:                   35:18                Upstanding. It is about paying it forward. That’s what the show’s tagline is for the next generation of healthcare leaders. And I thought. You know if I had had this resource when I was a CIO they would have I would have just listened to it. Look for the videos and I would have just sent them to my staff all the time I mean to have John Halamka talk about block chain and Chad Brisendine one of the smart, he’s in that young category with you. I think he just turned 40.

David Baker:                 35:49                I did a couple of a months ago

Bill Russell:                   35:51                you guys were both in that exact same age gap

David Baker:                 35:53                Is that considered young still

Bill Russell:                   35:54                for getting to the CIO role. Forties Yeah I think that’s that’s you’ve accomplished something to get to a CIO role by 40.

David Baker:                 36:02                I just skate by my accent. It’s good.

Bill Russell:                   36:04                People just. That British accent make you smart. So. Yeah. And yeah I would have just been picking up that material sending it out. I would have if I listened to you know there’s just so much great content and people are like you know they just appreciate me bringing this.

David Baker:                 36:23                It’s like it’s like a quick education in certain areas. I feel I was saying I reference some of the material. Some of my favorite material when it’s a short blog post but so relevant. I did actually I should really say this was mine and you stole it. But

Bill Russell:                   36:35                by all means. Take whatever

David Baker:                 36:37                that’s what I do. It’s

Bill Russell:                   36:41                planes trains and automobiles

David Baker:                 36:42                planes trains and automobiles right. So it’s keep the trains running. Build new tracks and then build airplanes. And it’s so true. And if you haven’t I don’t know what that was early on blog post but I would say there’s nuggets in there because it’s so true. Check that out.

Bill Russell:                   36:54                I think in three weeks we’re having arch collaborative on and that’s something you’ll want. It’s because they went through and interviewed all the implementations, not all like 180 implementations of EHRs to good bad or indifferent and identified the seven or eight things that were common across the successful implementations and probably something to yeah get ahead of. And I’m really looking forward to that conversation. Some people have come on Lee Milligan had come on Amy Maneker come on and alluded to it and the gentleman from class agreed to come on and just talk about the research and

David Baker:                 37:31                that’s great

Bill Russell:                   37:32                stuff. So I think that’ll be that’ll be good.

David Baker:                 37:35                It’s nuggets right. It’s like life hacking my mentor Ferris. So I love very much

Bill Russell:                   37:39                and I make the three minute videos just for people like you. In fact the thank you gift for people who have been on the show is a book I just sent you a book. I don’t know why I sent you a book. You hate you hate these really thick books.

David Baker:                 37:54                What book is is? Does it have pictures in it.

Bill Russell:                   37:57                Are there pictures in it? No it’s The leaders myth and reality. General Stanley McChrystal

David Baker:                 38:04                I love. I mean No that’s good. I got plenty I’ve always to got books I like the tactile feel of paper. but It’s annoying carrying it around. There’s nothing better than a Kindle. when you just flip it out it’s convenient. but I’m Always book a month is my target How many books do you read.

Bill Russell:                   38:18                I don’t finish many books. I talked to a publisher once. this is really just us rambling. This is what the show was meant to be actually oddly enough. But I met with a publisher once and he said what they try to do because they know most people don’t finish books especially business books. They will take the meat of the content and try to shove it into the first three or four chapters. So I found that to be really true that I get to like the fifth six chapter and I start to get bored of the material. So I just I suck as much out of the first couple of chapters as I can. Plus I listen to a bunch of books while I’m exercising. So clearly I’m not listening to that many books.

David Baker:                 39:00                exercise Audible is awesome for that. I like to sit in the car right. The education machine otherwise known as the car. I’m always on calls Or listening to podcasts and Audible. OK. So number one Pod cast outside of your own.

Bill Russell:                   39:16                Wow. Andy Stanleys podcast on leadership is exceptional

David Baker:                 39:20                really.

Bill Russell:                   39:21                Yeah it really is exceptional. There’s another one I started listening to which is a story brand I can’t remember the guy’s name but he wrote a book by the same title story brand. And what he talks about is that when you’re building out a vision or those kind of things it’s just like writing a story. There’s a you know there’s an event or something there’s a there’s a villain there’s a guy there. And he talks about that whole aspect of it. In fact that’s part of the chapter I wrote for Ed Marks’s new book which the editors have not cut out yet.

David Baker:                 39:55                So really whats Ed got a book coming out on that book

Bill Russell:                   40:00                should be out. I think it’s coming out for HIMSS so it’ll go it’ll go to print in early January it’ll be published at HIMSS

David Baker:                 40:07                Ed is a champ. He’s got a good eye. He was a speaker at the CIO bootcamp over in Chicago.

Bill Russell:                   40:14                Oh yeah he does. He does the boot camps. Actually the lineup for the bootcamps now is just exceptional. I mean it is. Tim has done a great job bringing in what Jonathan Mannis was there Ed Marx was there this past week Sarah Richardson was there. I mean is’s just if you haven’t done the bootcamps it’s worth doing. I tried. I sent you there Jim.

David Baker:                 40:35                Yeah I did. Both of those. They are Good

Bill Russell:                   40:38                they are yeah. If you haven’t sent your staff to those those are those are worth doing

David Baker:                 40:44                Yeah good tools as well right. In terms of what in terms of that progression is thinking about managing up. What what does an executive team really need to see because the technology as we get a little bit deeper

Bill Russell:                   40:54                but all of my guys said the same thing the test was a little wonky

David Baker:                 40:57                the test at the end.

Bill Russell:                   40:58                Yeah there’s a certified CIO whatever it was a little wonky had spider diagrams.

David Baker:                 41:04                I think I failed

Bill Russell:                   41:06                goofy stuff like that.

David Baker:                 41:08                Good concept

Bill Russell:                   41:10                people asked me like Are you a certified CIO. Like No, I was I was an actual CIO but I was also certified certified goofy things that don’t matter anymore. like Citrix and VMware

David Baker:                 41:24                all right Bill, as now this is the David Baker show. One more question for you.

Bill Russell:                   41:29                You should do more. I should have you as a guest

David Baker:                 41:32                Let me co-host one let me stick a couple in there because I don’t have the discipline to keep putting these on. I’ve got like a profile bio’s thing I stuck up and its got blog Coming soon. Because you know I’m just not good at following through on

Bill Russell:                   41:43                how could you possibly do this job an epic implementation.

David Baker:                 41:46                I know there’s a lot going on

Bill Russell:                   41:47                hey if you happen to be in a bar with somebody and want to do a show let me know.

David Baker:                 41:50                OK I will if I ever find someone interesting I know a few people. OK. So let’s just say

Bill Russell:                   41:55                I see a picture of you in Benioff together if you can get Benioff on the show. Then by all means.

David Baker:                 42:01                Do you want me to, he’s on speed dial

Bill Russell:                   42:03                Im sure he is, what was your question. Now you’re just bragging.

David Baker:                 42:05                No I’m not joking. I wish what was my question. Oh yeah OK. Five five is a busy freeway right. Yes. OK. If you. Could put anything you wanted to on a billboard on the five. Just for the hoot what would you put on that billboard

Bill Russell:                   42:24                just for what.

David Baker:                 42:25                Just for the hoots just for giggles. What would you put up there. What message would you like to send to the millions of commuters driving past the busiest point of the five every day. You better not cut this.

Bill Russell:                   42:38                Yeah. You know that’s. That’s tough. I love. You have to really think through that because Aaron Levy who’s the CEO of box at one point put this really funny. That he used to really poke fun at Microsoft. So he used to put this really funny stuff up about Microsoft making fun of Microsoft on like highways in San Francisco.

David Baker:                 43:00                Really.

Bill Russell:                   43:01                Yeah. And you know so you fast forward about three or four years later and he’s trying to partner with Microsoft. you just never know what your future is going to look like so you just. You have to really

David Baker:                 43:14                don’t burn your bridges right. He’s like Hey about that skydives thing which is now one drive right

Bill Russell:                   43:19                one drive. Yeah.

David Baker:                 43:20                We’ve got an idea with this box being integrated can you help us. It worked out. They’re integrated.

Bill Russell:                   43:24                Yeah. You know I I would take just one of those quotes from you know we see them every now and pop up on LinkedIn. That just reminds people to you know invest their life give back. Surf. You know it’s crazy. The wealthiest people that have the best disposition are those that give a lot that do philanthropy and we don’t think that way we think oh they’re happy because they have the money. Yeah I think they’re happy because they’re giving the money and it’s people that give back it’s people that give back to the community it’s people who back. And so I don’t know whose quote I would use that wouldn’t be one of mine.

David Baker:                 44:05                It should be.

Bill Russell:                   44:05                I don’t know if there is a original quote from me but it would be something to the to the extent of. You know see the need around you and meet it just see the needs of the people and start meeting it. So that’s I mean that’s I don’t I don’t know what it would be. I don’t know what the quote would be.

David Baker:                 44:23                When’s the last time you gave back? Question.

Bill Russell:                   44:26                I don’t know

David Baker:                 44:27                Bill Russell

Bill Russell:                   44:27                you know what I have learned. One of the things I brought into our I.T. organization when I came in was the fact that we are not graphic designers so I actually put a graphic design budget together. We hired graphic designers to really help us

David Baker:                 44:42                really good .

Bill Russell:                   44:43                And all of a sudden people were like Yeah I really understand now what IT is trying. We were just bad communicators

David Baker:                 44:49                terrible.

Bill Russell:                   44:49                And we hired. I actually had a professor head of a department for one of the universities on speed dial and he would read our text and stuff and he would help us to communicate better and we had graphic designers we had videographers

David Baker:                 45:04                We had an engagement team project

Bill Russell:                   45:06                you created a couple of videos.

David Baker:                 45:07                That’s my secret sauce. Yeah. No the engagement team was really cool because it’s like this buffer right between if you stick sometimes a very technical person in front of your. You know your user. And it’s just like they’re speaking different language. And then people get annoyed with the IT not understanding so put a human in between. That actually is

Bill Russell:                   45:28                the other thing I love about this. This is you get those sound bites. And the person the person who is most impressive to me on sound bites is is Ron Hockman CEO for Providence. And we sort of joked at one point after problems came in and we merged with St. Joe’s we sort of joked because I asked his team on like what do I need to know about Rod. And they said Rod speaks in sound bites. So I asked Rod about it and Rod essentially said Yeah he goes you know why he goes you have to be clear about communication. He said so if I’m going to talk about you know what we’re doing in this area it’s these three points because you know what I’m gonna have to say it like a thousand times to a thousand different groups.

David Baker:                 46:13                right.

Bill Russell:                   46:13                And I want to make sure I’m communicating the same thing because if he wavers and it gets goofy you know by the time you get to the fifth sixth seventh group they’re like they’re not thinking the same thing that the first groups thinking

David Baker:                 46:24                right.

Bill Russell:                   46:24                And so he sits back at some point during the year. He’ll sit back and he’ll he’ll go through his things to say what’s the most important thing to say about our mission. What’s the most important thing to say about and he will just get those down because as a leader especially a leader of a 20 I’m sorry 20 something billion dollar one hundred thousand some people. I mean you’re communicating to a lot of people it’s almost like a presidential election. You are you have to drive home your talking points so people can act on them.

David Baker:                 46:56                So Rod was there was he was on

Bill Russell:                   46:59                Rod was on .the pod cast, yeah

David Baker:                 47:00                OK.

Bill Russell:                   47:01                So thank you again for being on the show appreciate it and look forward to hearing about your implementation I guess we’ll talk to you after you’re done your implementation so

David Baker:                 47:09                we’ll know before that.

Bill Russell:                   47:10                What’s that like three years from now.

David Baker:                 47:11                No three months No we’ll be quick. We’ll circle back Lets circle back in a year at a bar.

Bill Russell:                   47:21                Absolutely. And if you want to host somebody just let me know.

David Baker:                 47:23                I will do.

Bill Russell:                   47:24                And that’s all for us. That’s all for this week. And please follow the show Follow me at the @thepatientsCIO on Twitter and follow the show @hisweekinHIT. Thanks. thanks a lot for being on.


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