What 2021 Will Bring to Healthcare with Children’s Hospital CIO Theresa Meadows


Bill Russell / Theresa Meadows

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February 3, 2021: Artificial intelligence, chatbots, machine learning, remote work, price transparency, leveraging the cloud and 2021 technology priorities. Join today’s conversation with Theresa Meadows, CIO for Cook Children’s Healthcare System. Children’s hospitals are unique in that their interoperability strategy has to be REALLY good. What does it look like? What kinds of regulatory things must be considered? What does a children’s integrated delivery network (IDN) look like? Do these health systems rely on their EHR? Or do they use a third party? What about homegrown data solutions? The topic of work culture is huge in 2021. How do you manage productivity with a remote workforce? 

Key Points:

  •  IT projects are never over. They are living breathing entities that last forever. [00:09:50] 
  • Cook Children’s two IT goals: 1. To enable our patients to be more mobile. 2. To enable our employees to be more mobile and more agile in their work. [00:19:35] 
  • 21st Century Cures and price transparency [00:25:55] 
  • The technology priorities for 2021 are mobile and digital [00:19:00] 
  • There are a lot of repetitive things that we do in IT that RPA is perfect for. E.g. password creation and password termination. [00:33:10] 
  • Cook Children’s Healthcare System

What 2021 Will Bring to Healthcare with Children’s Hospital CIO Theresa Meadows

Episode 360: Transcript – February 3, 2021

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

[00:00:00] Bill Russell: [00:00:00] Thanks for joining us on This Week in Health IT influence. My name is Bill Russell, former healthcare CIO for 16 hospital system and creator of This Week in Health IT, a channel dedicated to keeping health IT staff current and engaged. 

[00:00:17]Today, we have a phenomenal conversation with Theresa Meadows. She’s the CIO for Cook Children’s Healthcare System out of Fort Worth, Texas, not to be confused with Chicago, Illinois. And [00:00:30] we talk about a lot of different things. We talk about remote work. We talk about priorities for 2021 and beyond. We talk about what a children’s integrated delivery network looks like. And again, I learned a ton of stuff in this conversation. I think you’re going to really enjoy it.

[00:00:43]Now somebody sent me a note and said, Hey, how can we help out the podcast? There’s two great ways you can help out the podcast. One is just shoot a note to a friend and tell them that you’re getting a lot of benefit out of the show and that they should really subscribe to it. But another way you can really help us [00:01:00] out is by, you know, whatever app you’re listening to the podcasts on.

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[00:01:22]Special thanks to our influence show sponsors Sirius Healthcare and Health Lyrics for choosing to invest in our mission to develop the next generation of health [00:01:30] IT leaders. If you want to be a part of our mission, you can become a show sponsor. The first step is to send an email to [email protected] Now onto today’s show.

[00:01:40]All right. Today we are joined by CIO for Cook Children’s Healthcare system, Theresa Meadows, RN. Good morning, Theresa. Welcome to the show. 

[00:01:48] Theresa Meadows: [00:01:48] Hey, good morning. I’m really excited to be here. This is a great opportunity. 

[00:01:52] Bill Russell: [00:01:52] Yeah. Yeah. I’m looking forward to this and so you’re working out of the office.

[00:01:56] We can, I want people to know that it’s your, your, your work office in [00:02:00] case they’re watching the video and they see all those. Know, all the disheveled books and stuff behind you. 

[00:02:05] Theresa Meadows: [00:02:05] Yeah, the mess is definitely how my work environment looks on a regular basis. 

[00:02:12] Bill Russell: [00:02:12] I remember when I became CIO for the health system and the gentleman who was before me goes, okay, everything’s on this shelf.

[00:02:20] And there was binders that were the thickest things you’ve ever seen. He’s like, I’m like, do I have to read that? He goes, well, that’s the, you know, that’s the EHR rollout plan and this I’m like, Oh my gosh. [00:02:30] And that’s, that’s what you have. You have really thick binders behind you, probably different work plans and stuff.

[00:02:35] Theresa Meadows: [00:02:35] That’s funny. Cause I think I, when I started, I started here in 2010. I think those binders actually are from prior to me starting here. So you’ve pointed out that I probably need to do some spring cleaning. 

[00:02:50] Bill Russell: [00:02:50] Yeah. That’s, that’s what happened to me after awhile. I I’m like, okay. I haven’t opened those yet. And it’s five years later, I should probably move them somewhere. 

[00:02:59] Theresa Meadows: [00:02:59] I [00:03:00] think I can’t recall the last time I touched anything on that bottom shelf, so that’s probably a good that that’ll be on my, to do list of things to do maybe in 2021. 

[00:03:10] Bill Russell: [00:03:10] Well, I’m glad we had this conversation next time. You’re on the show. We’ll be able to. See if there’s been any progress. Sorry about that. 

[00:03:16] Theresa Meadows: [00:03:16] Next time I’ll point the camera in a different direction. 

[00:03:19] Bill Russell: [00:03:19] Exactly. Like so your first time guests, it’s not the first time we’ve talked. We did a webinar together. I hosted a webinar on cost reduction strategies. You did that in the [00:03:30] fall last year.

[00:03:30] It was a lot of it was good conversation. But since this is the first time on the show, tell us, tell us about Cook Children’s a little bit. 

[00:03:37] Theresa Meadows: [00:03:37] Sure. Cook Children’s is a pediatric integrated delivery system. And our primary location is right in the heart of Fort worth. Every time I present people say, Oh, you’re in Chicago.

[00:03:51] I’m like, Yeah, real South Chicago, like this accident is not a I don’t think this is a Chicago accent, but right in Fort worth. [00:04:00] The cool thing about Koch children’s is, and then a lot of people don’t know is we’re actually made up of nine different companies. And so when people hear about Koch children’s I think primarily of our, our medical center, which is right in the heart of Fort worth 400 plus beds, a hundred.

[00:04:17] You know, room, private room NICU. So pretty typical pediatric hospital that you would think about, but we also have a physician network where we employ, you know, 450. Probably close [00:04:30] to 500 positions today, it continues to grow. We continue to acquire and bring physicians into our physician network. That physician network has locations throughout the state of Texas.

[00:04:40] We’re probably at about 90 locations providing primary care, specialty care and urgent care throughout the state of Texas. So even as far as you know, West is San Angelo and Our coverage area. If you looked at it on a map is about the same size as the state of New Mexico. Of course, Texas is [00:05:00] huge.

[00:05:00] So if you, if you looked at where we were covering, you would see that from our physician practices and we continue to acquire we have a home health business where we see kids. Directly in their homes. And we do durable medical equipment infusion therapies and, and skilled nursing to kiddos homes.

[00:05:19] And we also are a Medicaid health plan. So we administer Medicaid and ship and star for the state of Texas for about. 150,000 members give or [00:05:30] take. So a couple of joint ventures that we have, and then of course our health system and our foundation. So very diverse set of you know, activities, but also a lot of diverse technology, which makes this role really exciting because there’s a lot of variety. And a lot of challenges and opportunities there. 

[00:05:51] Bill Russell: [00:05:51] Pediatric IDN. So do you have like retail locations that are just for children out in the community? That’s what it sounds like [00:06:00] to me. 

[00:06:00] Theresa Meadows: [00:06:00] Yeah, we do. And so we don’t, we don’t the other thing is we’re not affiliated with any medical school, so most, a lot of pediatric facilities have some medical school or academic medical center affiliation, and we’re total standalone.

[00:06:14] So if you looked at the PA you know, the, our global business, we’re about, we’re almost a $2 billion business Overall, just with all of our different things that we did. Wow. 

[00:06:30] [00:06:30] Bill Russell: [00:06:30] Gosh, I have a, I have a lot of different directions I want to go with you. That’s fascinating to me, by the way, a pediatric IDN is you know, I don’t want to show my ignorance here, but that’s a first for me.

[00:06:43] I mean, I’ve talked to a lot of, a lot of ’em. Children’s hospitals and those kinds of things, but this concept of IDN, and a lot of them build out their networks with partnerships throughout the community, but to have that many physicians on staff. To have that kind of remote capabilities [00:07:00] I mean, is that pretty common or is that, is that distinctive?

[00:07:03] Theresa Meadows: [00:07:03] No I don’t think that’s common. I, you know, and we’ve been doing this as long as I’ve been here so well before I even got here. And so we were a very early adopter and I do think we’re unique. I mean, I think we’re one of the unique pediatric entities. We participate in children’s hospital association, so, you know, I have visibility into what other children’s facilities look like.

[00:07:27] And there’s maybe a couple. [00:07:30] Maybe a handful that kind of looked like us, but for the most part, they’re affiliated with bigger institutions. If they look more like us, well, 

[00:07:37] Bill Russell: [00:07:37] talk about, look like us. So you have the RN title. How many, how many, how many CIO RNs do we have out there? 

[00:07:46] Theresa Meadows: [00:07:46] You know, it’s very few I think that maybe growing I know about, I know of about five.

[00:07:54] Bill Russell: [00:07:54] So tell us about your role. How did you end up as a CIO going that, that track?

[00:08:00] [00:08:00] Theresa Meadows: [00:08:00] Yeah, it’s really interesting because if I, if I thought about what I was going to be, when I grow up, this would not have been where I would have even remotely placed myself. So I started my career in pediatric or not in pediatric in you know, interventional cardiology, cardiology, transplant as a nurse.

[00:08:19] That was really where my passion was. I always wanted to be in healthcare. I grew up my best friend when I grew up, she, her dad was a nurse anesthetist. And so I originally [00:08:30] thought that’s what I wanted to do is I wanted to, you know, be a nurse anesthetist. I went to nursing school and had one. Visit to the OR decided that’s not for me.

[00:08:39] And so I ended up, you know, doing, you know, an intensive care nursing and you know, floor nursing, which, you know, is where my passion started. And it’s funny, I worked at a really large teaching institution and in that in 1995 that institution decided they were going to implement physician order injury.

[00:09:00] [00:09:00] And the way they chose to do it is they said, you know, we’re going to take nurses. From each area 35 nurses and they are going to be the physician trainers. They’re going to do the building. We’re going to train them on how to build systems and they’re going to be that support for those physicians.

[00:09:16] And at that time we didn’t really, we had a dumb terminal, you know, on the, on the nurses station, we didn’t really have computers. And my nurse manager said, Hey, Theresa, you’re pretty good with physicians. Would you like to do this? It’s a [00:09:30] two-year project. You’ll do this for a couple years and then you’ll go back to your nursing job.

[00:09:35] And at that time, all I heard was no weekends, no nights, no holidays. Oh, sure. Sign me up. So I, you know, sometimes in life, if you take, you just sometimes do things that you don’t really a hundred percent know what it is. And what I learned through that was, first of all, IT projects are never over. They really are living breathing entities that lasts forever. And I realized that I liked it and I [00:10:00] saw the value in can you technology and improving outcomes and improving clinical care. So from that point I decided I would get a master’s in informatics. I worked at Ernst young and consulting. I worked at web MD and the.com era worked at McKesson for awhile, but my true heart is really and passionate is in the acute care space. And so that’s kind of how I circled back. I was at Ascension and prior to here. And then, you know, this opportunity came up and I’m [00:10:30] like, you know, I want to. I’ve always wanted to do that. And so, 

[00:10:34] Bill Russell: [00:10:34] You know, Theresa, as you tell it, as you tell that story, I think it’s two things. One is you have to be about 80 years old with that number of careers. And then the second thing is no nights, no weekends. And has that played out exactly how you thought that was gonna play out, 

[00:10:53] Theresa Meadows: [00:10:53] It has not. Especially the first go live back, you know, when we were implementing [00:11:00] TDS for any of you old timers who knew what TDS was Yeah. The first shift was a night shift and I’m like, what the heck? How did this happen? How did this happen? I was supposed to no weekends, no nights, no holidays. Right. So but you know, it’s all worth it. It’s definitely all worth it. 

[00:11:18] Bill Russell: [00:11:18] That’s fantastic. So I want to hit a, I want to hit a bunch of different topics. I want to talk remote work priorities coming into 2021 price transparency, just much a bunch of different things. Let’s, let’s start with [00:11:30] remote work. You know, culture productivity. These have been interesting topics coming into this year. We just came out of the JP Morgan conference. And I didn’t hear any CEO, even intimate that we were going to go back to the way we were before, where everybody works out of the office and whatnot.

[00:11:47] I think everyone’s saying, okay, that, that has changed. We haven’t determined what next is. But what I really want to do before we go to what’s next is. Yeah. You know, the [00:12:00] team is now, you know, a percentage of which is remote. You know, how have you done with regard to productivity? Let’s let’s start there.

[00:12:09] Well, first of all, what have you done? And then how have you sort of, have you been productive? How has that gone so far? 

[00:12:16] Theresa Meadows: [00:12:16] Yeah, it’s interesting because we, we already had a semi remote culture prior, at least in it, prior to the pandemic, we were, we had people who worked from home one day a week, ish. So it wasn’t extreme.

[00:12:30] [00:12:29] So we went from one day a week to everybody at home five days a week. So I think initially we struggled a little bit with productivity just because people were getting used to, well, how do I manage remote workers? How do I know things are getting done? And, you know, we don’t really have a detailed productivity measurement system.

[00:12:51] The way we measure productivity is we have 140 it projects plus About 20 pandemic related projects. And [00:13:00] the way we measure productivity is really based on delivery and customer satisfaction. And so our delivery has not slowed down. We continue to deliver, you know, solutions we’ve had even through the pandemic.

[00:13:14] We we took our health plan live on Epic tapestry. Doing fully remote support. So we’ve been doing so our measurement right now has been okay. Are we still delivering at the same rate and the level that the expectation was [00:13:30] prior? 

[00:13:31] Bill Russell: [00:13:31] Yeah. So how, how have you had to change your personal communication style and management style as we have moved through the pandemic? 

[00:13:41] Theresa Meadows: [00:13:41] It’s interesting. I hate video. Probably because I get, I don’t like seeing myself on video mostly. But we do a lot more video. I have kind of instituted in our organization our it organization. You have to be on video, this hiding [00:14:00] behind your, you know, your beautiful picture that you have for your zoom client.

[00:14:06] We need that. We need that social interaction. So one is we, we. Pretty much require that people be on video for A. For a couple of reasons, one to keep that social interaction, but to just, you can tell how people are doing. And that’s a huge concern of mine that people’s wellbeing is being watched.

[00:14:26] I ride a lot more communications than I used to because I [00:14:30] was used to getting a group together and it’s just talking about it. But now with everybody having scheduled so packed with video conferences and those types of things. A lot more written communication, which proves to be difficult sometimes because you’re like, I set out this communication, nobody read it.

[00:14:47] So I think people are getting overwhelmed there. We’ve taped, we’ve done like two minute video messages that we send out via email, so people can refer back and look at those two minute [00:15:00] video messages. Just a lot of different techniques. I think we’re still, you know, working through what the best thing is.

[00:15:08] Bill Russell: [00:15:08] Yeah. You know, the, the management by walking around, that’s how I was taught early on in my career. And so when I became a CIO, I I get it. I get in pretty early. So I’d get in around six o’clock, I’d get a bunch of stuff done before eight 30 or so. And about nine o’clock. I just started walking around.

[00:15:24] A lot of teams were doing their huddles and whatnot. We got to listen in on a bunch of huddles and then I would just. [00:15:30] Pop into people’s offices and talk to them, that kind of stuff. I’m not sure what I would be doing today as a CIO. You know, how do people pop in and talk to you? How do they, you know, initiate that sort of that conversation of, I have an idea.

[00:15:46] Theresa Meadows: [00:15:46] Yeah. So we actually do that a couple ways through Skype. A lot of times, you’ll see the Skype window pop up. And when people say, Hey, I’ve got this thing going on, or I have this idea. So we’ve been using Skype. We’ve also been using Teams. [00:16:00] We’re in a transition. We haven’t gotten to 365 yet. So we’re in that in-between stage or making a transition office 365.

[00:16:08] So we’ve been using some of the Teams functionality to, you know, do that pop in type of mentality. But I agree with you. That’s the one thing I miss the most because I was a walk around later too. And now I walk around and I look at empty cubicles that are still have Easter decorations for March you know.

[00:16:27] Bill Russell: [00:16:27] Oh, they’ll there’ll be appropriate in, in a [00:16:30] month or 

[00:16:30] Theresa Meadows: [00:16:30] So by the time I get back to what we’re doing, you know, everybody’s, we’re all decorated for Easter. But yeah, so that it’s been a struggle for me. And it’s been a struggle for our culture in general, because we are, we’re a walk around collaborative in-person culture.

[00:16:45] So it’s not just an IT issue at a cook children’s, it’s a global issue that we’re all struggling with because we are very collaborative and we’d like to see each other in person. And so it’s been a challenge to work. 

[00:16:59] Bill Russell: [00:16:59] Yeah. Have you guys, [00:17:00] have you guys started conversations and I think this is going to be a health system specific. I think it’s going to be geography specific. Have you started to have the conversations of what post COVID work looks like? 

[00:17:12] Theresa Meadows: [00:17:12] We have. And so we’ve gone through a process where we’ve actually taken our employees and we kind of categorize them. We actually have already determined 500 plus employees who will just stay at home permanently.

[00:17:26] And now we’re working through what we’re considering hybrid [00:17:30] workers, which were, you know, that definition is sometimes in the office. Sometimes at home. And then we have the, of course the people who are at work a hundred percent of the time. And so it’s that hybrid part in the middle. That’s the hard part because so we’ve kind of said, okay, if you’re.

[00:17:50] Less than 50% time at home, then we’re going to provide you an office and a parking space and you know, all the things you need on campus. But if you’re [00:18:00] greater than 50% at home, then we’re going to assume your home office, your primary office is your home. And now we’re looking at space. Reallocation and had, what do we do to reallocate space and parking and those types of things?

[00:18:15] The unfortunate part for us is we don’t lease space very often. So we own all of our physical space, so we could clear it out, but we don’t know what we’ll do with it. So, so we haven’t been super speedy at trying to get people to get moved out to their homes [00:18:30] because you know, we’ve got the space and we can use it. I think it’s really how do we use it in the future? 

[00:18:37] Bill Russell: [00:18:37] What’s your fiscal year at cook? Children’s 

[00:18:39] Theresa Meadows: [00:18:39] It’s October 1st. 

[00:18:42] Bill Russell: [00:18:42] You know, the reason, the reason I asked that is I’m going to ask what the technology priorities for 2021 are. Sometimes people, some people look at me like, Hey, you know, we have a June Cisco year in which case they’re already halfway through.

[00:18:53] Theresa Meadows: [00:18:53] And we’re in our second quarter, second quarter of 21. 

[00:18:56] Bill Russell: [00:18:56] So, I mean, do you, I mean, you were, when you were planning [00:19:00] this, we were mid pandemics. So what, what, what are the technology priorities to 21? What do they look like? 

[00:19:05] Theresa Meadows: [00:19:05] Yeah. Mobile and digital, for sure. I think that has been. We had that as a priority prior to the pandemic, but we’ve escalated that priority because of the amount of remote work.

[00:19:18] And because even through a pandemic, we’re building another hospital in North Dallas in in an area where the expectation from our [00:19:30] consumers is I want to do it on my phone and I want to do it. As rapidly and as quickly as possible. So we really have two paths, one to enable our patients to be more mobile.

[00:19:39] And the second is for our employees, how do we enable them to be more mobile and be more agile in their work? The second priority is really around data and, you know, data has proven hard through COVID and sharing the data specifically around vaccines and, you know, testing and those types of things.

[00:19:57] So we’ve learned a lot about how we want to [00:20:00] structure our data. Plan going forward because data is going to be and has been King. I think people just didn’t realize it until we’ve kind of gone through this change and how we work each day. So we’re asking a lot more questions and then using a lot more data than we have you know, in the 10 years that I’ve been here, which is just interesting. 

[00:20:23] Bill Russell: [00:20:23] So just out of curiosity, do you rely on your EHR? Do you have like a third party thing, like health catalyst [00:20:30] or something to that effect? Or do you have your own homegrown type data solutions? 

[00:20:34] Theresa Meadows: [00:20:34] Yeah, we have a combination of homegrown and the Epic data repository type tools. And then we use third-party visualization. So we have a data warehousing structure for all our data that’s not an Epic cause we’ve only been live on Epic for three years. So we have, we had a huge data infrastructure that was somewhat homegrown prior to going to Epic. So we kind of have a hybrid model [00:21:00] where we use, you know, products like Tableau or to bring those data elements together visually. And we have a pretty strong data integration team, which has been extremely helpful during COVID in this, this time period. 

[00:21:18] Bill Russell: [00:21:18] Well, that’s a, you know, I mean, that takes us to interoperability and you know, children’s hospitals are unique in that their interoperability strategy it has to be really good. [00:21:30] Because, you know, you’re connecting with so many people and you’re handing off your patients. Very few people have to plan for handing off your patients. But at some point they’re not pediatric anymore and they move, they move on. So what does that look? What does an interoperability strategy look like for children’s hospital?

[00:21:47] Theresa Meadows: [00:21:47] It has a couple of legs. The interesting thing about the Dallas Fort worth area, almost everyone’s on Epic. We were the last pretty much Methodist and then swear we were the last holdout. And [00:22:00] so a big part of our strategy is scary everywhere, just because of the amount of patients who move around between all the different entities in the Dallas Fort worth area.

[00:22:09] The second thing is, is we really You know, shared data a lot with other children’s hospitals. So our second strategy is how do we connect at the most efficiently with other children’s hospital? Because we do share patients back and forth depending on, you know, what specialties and what things we have.

[00:22:28] And so how do we [00:22:30] connect to those you know, those other children’s hospitals efficiently. And then the third leg is really around API development, because what we’re seeing is that. A lot of our families and kiddos are using technologies like apps to track their health. They’re using things like Fitbit and Apple watches and smart scales.

[00:22:54] And. All of these things. And so we have a strategy to use API APIs to connect to [00:23:00] those devices and really start to, you know, have, have kids really be part of their care at home. So our strategy is really how do we integrate to those kids at home through interoperability. And then we get tons of data requests, the research.

[00:23:15] And so we Have started sharing, you know, data with research networks and those types of things. So it’s, it’s a lot of different things. But our goal is to share as much as possible because we think that is really [00:23:30] important, not only for our organization, but for the ecosystem as a whole, to be able to do that.

[00:23:37] Bill Russell: [00:23:37] Yeah, it’s interesting. The digital strategies are increasing or touchpoints, so you’re interacting a lot more with your patients and it’s increasing, increasing the data points. Right? So we have this internet of health things out there now. How are you? How are you helping your physicians? I mean, obviously we start collecting all that information. I remember the pushback I got was the clinicians were like, [00:24:00] I don’t want it. And I’m like, all right, why don’t you want it? And they’re like two reasons. And it was very clear. It’s like two reasons I don’t want it. One is, it’s a lot of information and, and, you know, you’re just messing up the record.

[00:24:12] There’s just too much information for me to review. And the second is, if it’s in the record, I become liable for it. So they were worried about liability and they were worried about the amount of information. Are you doing something to, to address those two things? 

[00:24:26] Theresa Meadows: [00:24:26] We are. And so it’s interesting because what’s kind of [00:24:30] changed. And I think it’s because of the pandemic. Our physicians now are wanting to get data from kids at home. They don’t want them to come here. So there’s kind of been a shift about, okay, we want that data, but we don’t want everything to go into the record. So we have a process where they can actually accept the things they want and reject the things they don’t which is as proven, very valuable because some physicians like a lot of data. And other physicians like almost none. [00:25:00] And so they have the ability and then we have just a mandatory requirements where we say, look, we’re good. These kinds of things will come into the record because you need those from a liability perspective to do it, to make sure that you’re protected and the patient’s protected in the event, there was something negative occur.

[00:25:19] And so we work closely with legal on this and with Our health information management group on how do we, how do we, you know, define the medical record [00:25:30] and what’s included in the medical record versus what’s great data for research that we’re going to bring in, but we’re going to exclude that if somebody required, if somebody requested the medical record, we’ll exclude that. But we’ll use it for research purposes and other, other things. 

[00:25:46] Bill Russell: [00:25:46] That’s cool. So, no, I haven’t asked. I haven’t, I can’t remember asking a children’s hospital about this, but you know, what kind of regulatory things are you looking at? Are you looking at 21st century cures? Are you looking at [00:26:00] price transparency? What regulatory things are on your plate? 

[00:26:04] Theresa Meadows: [00:26:04] It’s interesting. We went live with our stoppable services on January 1st. And so we actually, if you went to cook children’s dot org, you could get estimates on 400. The 400 procedures that we’re required to do also in our patient portal, my cook children’s is what we call it, my chart.

[00:26:25] You can actually do pricing estimates in my chart today, where you actually can put in I’m [00:26:30] I’m having this procedure and we’ll provide the pricing estimate. And we also have the machine readable files that we’ve produced. We felt that it was important that we start providing that information to our patients.

[00:26:43] Other facilities have decided that they’ll just wait it out and see if I get fined and those types of things. But we, we decided we would go the more conservative route and just, just go ahead and bite the bullet there and start providing that information to patients, which I think is, I think it’s the right thing to do.

[00:26:59] Is it easy to [00:27:00] understand? Sorry, my lights just went out. That happens periodically when you don’t move around. Oh,

[00:27:07] Bill Russell: [00:27:07] I’ve had that in other interviews, by the way, I did, I did an in-person interviews and the lights went out on us. 

[00:27:13] Theresa Meadows: [00:27:13] It’s we, we have motion since slides. So if you don’t move quite a bit, you, it goes out. So we’ve, we’ve been doing that since the 1st of January, which you know, I wish I don’t have really a lot of data about how many people have used it. But we’ll be looking at that to see. How that, how that’s [00:27:30] going. And the 21st century cures act absolutely applies to us. So we’ve been working, we were thankful for the little delay from November to April, as far as providing, you know, real-time access to your medical record and being very transparent with your data.

[00:27:47] Because in pays, there’s a lot of sensitive data that we wanted to be able to go through more and more thoroughly. And not just have to release everything automatically to families and [00:28:00] patients. Cause some of that requires, you know, education and discussion to those particular patients.

[00:28:06] And there are some unique issues there. Cause each state, depending on their, their laws, some kids own their. Their patient record at age 13, 12, and 13. And so what’s the, you know, what’s the risk of, you know, sending a negative result or something that’s, you know, could change your life if a kid’s with 13 year old, just automatically.

[00:28:30] [00:28:29] So. We’re actively working through the information blocking provisions and the, the API provisions to be able to, you know, provide data to other applications if asked pretty much most of the things apply to us. If you looked back to meaningful use, that was a little bit different because of Medicaid.

[00:28:50] And that was really the state dependent. So like in our state, we just had to say we implemented something and we received meaningful use dollars. It wasn’t, as we weren’t judged, you know, we weren’t reviewed [00:29:00] on, on metrics, but that’s going to change over time. I think for Paige. 

[00:29:04] Bill Russell: [00:29:04] Yeah, the it’s, it’s going to be interesting that the regulatory path I’m going to be following the price transparency rule pretty closely. I think I’m asking every CIO who comes on the show about how they’ve implemented. One of the things I was, I was  talking to RobDeMichiei  about this who’s a former CFO for UPFC where we’re just discussing that, that there’s some problems with the role. And one of the biggest problems with the rules [00:29:30] is they didn’t tell health systems, where to put the data. And so we have to go find it. We go to their website, we have to find it and some are  in complete compliance, but it’s buried. You just have to do a lot of search to find it. 

[00:29:45] Theresa Meadows: [00:29:45] Yeah. And I could, I definitely see that more competitive markets, right? The more competitive your market is, the deeper you have to go to, to find the information.

[00:29:57] You know, we had a lot of discussions about that because it [00:30:00] is about competition somewhat and about where we would do it. 

[00:30:06] Bill Russell: [00:30:06] Yeah. I mean, I would imagine those conversations were interesting. All right. Let’s get to more technology topics and then we’ll close out. And any plans around AI machine learning, RPA, anything like that?

[00:30:19] Theresa Meadows: [00:30:19] Yeah, we’re actually looking at all of those right now. We had an RPA project slotted to start right before COVID hit. So it kinda got delayed a [00:30:30] little bit just because of the amount of work that it was going to take. But we’re definitely looking at RPA in our, in our finance and some of our Supply chain areas. Cause there’s a lot of opportunity there. 

[00:30:42] Bill Russell: [00:30:42] Can you share any specifics? Have you selected a vendor or heading in a direction? 

[00:30:47] Theresa Meadows: [00:30:47] We are in we’ve narrowed that there’s not a ton of vendors for RPA. So we’re at down to the final two. And I, if you thinking through my volunteer of, [00:31:00] I can’t think of the top two names, but yes, we’ve narrowed it down to two.

[00:31:05] And our team, and we worked with a consulting firm to at least help us set up some RPA governance structure because you know, everything’s not RPA worthy. But you know, people could think of a thousand ideas that You could use RPA for and then we’re also looking at artificial intelligence for things like some of the chat bot functionality.

[00:31:30] [00:31:29] That’s proven very useful during COVID where we’re using some chat bot technology for frequently asked questions about, you know, do I need to be tested? It mostly internally with employees, not with patients so much because you know, with COVID the interesting thing in paeds is we’re dealing with adults because all of our employees are at risk for COVID and then we’re also dealing with our patients.

[00:31:54] So we really, we had lots and lots of internal questions from employees about what to [00:32:00] do. So we use some of that chat bot functionality to kind of help alleviate the phone. 

[00:32:09] Bill Russell: [00:32:09] It’ll be interesting to see what we do with chatbots moving forward. Cause it’s now been sort of introduced into our vernacular.

[00:32:16] Theresa Meadows: [00:32:16] I was just going to continue to add machine learning, where we’re using some predictive modeling and different things. And some of our research studies that we’re doing. So I, I expect that just to grow [00:32:30] up. 

[00:32:31] Bill Russell: [00:32:31] I was talking with Lee Milligan who’s the CIO at Asante about RPA. And you know, one of the, one of the areas he said that they would love to have RPAs and testing around the EHR for EHR updates and those kinds of things. He was talking about beaker and how they have to test everything. He’s like, man, if we could just pop RPA in there somehow to do the testing, he goes, cause we have to test every single aspect of that. And it would be a great tool for that. 

[00:32:59] Theresa Meadows: [00:32:59] Yeah. [00:33:00] There’s a lot of it use cases. So I was I was. I was a huge proponent for it if nobody used it but us, it would be a win. Because there are a lot of repetitive things that we do in IT that RPA is perfect for, you know, password creation, password termination.

[00:33:20] Bill Russell: [00:33:20] Yeah. Yeah. That whole user provisioning process could really use RPA. 

[00:33:26] Theresa Meadows: [00:33:26] Yeah. So there’s a ton of use cases just in [00:33:30] it operations that I think where RPA could be extremely valuable. 

[00:33:35] Bill Russell: [00:33:35] Are you guys leveraging the cloud at all? 

[00:33:37] Theresa Meadows: [00:33:37] You know, we have a mixed strategy around cloud. We use cloud where cloud makes sense. That’s kind of our, our strategy. So We have a lot of third-party applications in the cloud. Our ERP is going, is pro we’re in an ERP selection process right now. And it will go to the cloud [00:34:00] regardless of the choice. So that, that will be moving in the near future. And of course our office three 65 implementation will take us more.

[00:34:10] We have not taken any of our electronic medical record. To the cloud. We were previous cloud medical record when we were with athenahealth. So we’ve had that experience and we have a lot of lessons learned there that we, if we do that again, we would not repeat. So I think 

[00:34:30] [00:34:29] Bill Russell: [00:34:29] it’s going to be interesting with Epic because I think this IRIS move is part of the journey to really see Epic, become a cloud provider.

[00:34:40] Theresa Meadows: [00:34:40] I think so, too. And you know, I always, I always joke. We’ve kind of all been cloud for a while. So, you know, we’ve had 95% virtualization in our data center for five plus years. So technically we’ve had our own little cloud environment over there with how we’ve chosen to deploy [00:35:00] applications and you know, work our remote work activity.

[00:35:04] So it’ll be interesting to see how it evolves. But I think we’ll see more and more, especially with remote work. 

[00:35:12] Bill Russell: [00:35:12] So Theresa, I guess, I guess action items from this call are to clean out that bottom row of binders. 

[00:35:20] Theresa Meadows: [00:35:20] Yep. That’s number one. Unfortunately, the top rows I still like a physical book. I try to read books [00:35:30] online, but, and I do that, but I love I love the physical books. I don’t know if I’ll be able to get away from that. 

[00:35:39] Bill Russell: [00:35:39] You know we, we just moved into a house and we gave a lot of our books before we moved to the local public library. But I found myself already amassing books. I I’m the same as you. I, I like taking notes. I like, I like the feel of it in my hands. I like taking it to the beach. I don’t, I don’t know how you, I don’t know if that’s just going to be a [00:36:00] preference forever. 

[00:36:00] Theresa Meadows: [00:36:00] Another interesting thing that I’ve started doing. My husband does this a lot too. Is. I’ll listen to the book and read it at the same time. And so sometimes, you know, so I can make notes and I do some similar things where I can listen to it and then also follow along. So it’ll be interesting to see if I can get away from it, but I love a good piece of paper book. 

[00:36:26] Bill Russell: [00:36:26] Well Theresa, thanks for doing this. I know we’re on different time zones. So you did [00:36:30] this pretty early and I really appreciate it. 

[00:36:31] Theresa Meadows: [00:36:31] You’re welcome. Thank you for having me on the show.

[00:36:35] Bill Russell: [00:36:35] Yeah, we’ll have to do it again. What a great discussion. If you know someone that might benefit from our channel from these kinds of discussions, please forward them a note. They can subscribe on our website thisweekhealth.com or you can go to wherever you listen to podcasts, Apple, Google, Overcast, that’s what I use. Spotify, Stitcher. We’re out there. You can find us. Go ahead, subscribe today or send a note to someone and have them subscribe. [00:37:00] We want to thank our channel sponsors who are investing in our mission to develop the next generation of health IT leaders. Those are VMware, Hill-Rom and Starbridge Advisors. Thanks for listening. That’s all for now.