In the constantly evolving domain of healthcare IT, there’s a pressing need to address the sometimes competing demands of providing quality care, employee productivity, and maximizing profitability. It’s clear that juggling these critical factors isn’t just a concern but an organizational imperative.

How do IT leaders craft a tech strategy that feels right, works efficiently, and aligns with our core objectives without any one aspect overshadowing the others?

Watch this video to get answers to many pressing questions, including:

• • How do we align the IT strategy with the ever-evolving healthcare landscape, staying focused on costs, employee well-being and productivity, and patient outcomes?
  • How do we contain our spending with breakthrough innovations to stay ahead?
  • How do we shift IT priorities not just to support but truly amplify the productivity of our teams?
  • How do we enable our teams’ efficiency and effectiveness with data-driven decision-making without straining them?

Transcript

Sanjog Aul [00:00:21]:
Hello and welcome to the CTN webinar. And the topic for today is finding harmony in healthcare. It patient value, team productivity and cost efficiency. And this is made possible by simpler I am Sanjog all, your host, and I’m the CTN founder and I’m here to help you get through these interesting conversations in as smooth a manner as possible and challenge you as needed. So with that said, what we will start doing is we will start taking the first step in terms of why did we even look at starting this or taking this topic and discussing it. So, I come from media CIO talk network, as I mentioned. And what we are finding is healthcare organizations are, of course, they have been always working hard, but they’re working even harder to create patient value, which is the noble cause that they wanted to pursue. But then they also have a business reality that they have to deal with.

Sanjog Aul [00:01:28]:
You’re talking about employees. They need to stay productive and effective, and the cost needs to be watched. And while of course, you have to deliver on that noble cause of patient value. But then, as we are looking at what’s going on, some of the top challenges or trends that we are finding are related to tech debt, which means you got way too much old technology, which they have to grapple with. Then there is security and compliance, which is being looked at as one of the top issue that they have to deal with, and with the technology becoming the very backbone for most organizations. So the solution providers start, they actually keep coming up with tools and solutions which are available. But frankly, on the buyer side, we are thoroughly confused on which one to pick and which is good for one. So way too many options.

Sanjog Aul [00:02:18]:
And then we also see employees trying to collaborate. Yes, they have some way of doing it. So right now. But there is a fundamental either inadequacy of the environment in which they can collaborate effectively and communicate effectively, or frankly, in some cases, it is surprising that that’s even absent. So there is no integrated employee communication platform that exists for the organizations. And finally, we are all talking digital transformation for many years now. But then, frankly, if you’ve got outdated processes and or the legacy systems, how do you deal with them? So now, with that said, we have other panelists who are going to help share their top challenges and then also share what they have been trying to accomplish with whatever they are trying to do with people, process, policy, culture, budget, tech leadership, et cetera, to crack this problem and bring that harmony. Now, for that, I would like to invite Stephanie Hines, vice president, peak region it lead intermountain healthcare as our panelists.

Sanjog Aul [00:03:22]:
And also we have Jackie Rice, vice president and chief information officer, Frederick Health Jeremy Miller, chief information officer, children’s healthcare of Atlanta. Parakul Karni, chief technology officer for Simpler Suresh Krishnan, vice president and chief technology officer for Cone Health. And Bakar Shameen, vice president of digital transformation and business process improvement for Summit Health. Hello, everyone, and welcome to this webinar. And the first thing I would like to start with before we get into the serious stuff, and I will start with you, Stephanie. And the way I’ll start is I’m going to ask this question. Plus also I’d like to ask you to share your top challenge, which holds you back from harmonizing healthcare it, whether it is patient value or employee effectiveness and productivity, and at the same time, cost efficiency. So here goes my question.

Sanjog Aul [00:04:20]:
The first question, if you had to describe your journey in healthcare, it as a movie title, what would that be?

Stephanie Hines [00:04:31]:
Oh, my gosh. I would probably need to think about that for a moment. Oh, my gosh. As a movie title, I, you know, there’s so many challenges, and it’s. There was an old movie, I think, that Gwyneth Paltrow was in, but I believe the title was like sliding doors, or I’d have to go back and look. But, you know, we have so many things going on. You know, that, or probably even better, Groundhog Day. I’ve been doing this work for, you know, 25 years.

Stephanie Hines [00:05:11]:
And as the technology changes, as the challenges change, people are relatively the same. And as we move through this work, as we move through, you know, the things that we need to do with healthcare as acuity increases, as new technology surfaces, there are so many things that are the same story just retold in different scenarios with different people in different decades. So maybe, maybe Groundhog Day.

Sanjog Aul [00:05:41]:
All right, so now, coming to the main challenge. So could you give a very quick background about your organization and tell me about your top challenge that you grapple with, which holds you back from harmonizing healthcare. It so that it delivers patient value and, you know, cost control and employee efficiency.

Stephanie Hines [00:05:59]:
So Intermountain Health, a large, integrated delivery network, really, in the northwest part of the country. Recently, I had a significant merger with SEl Health that has a presence in Colorado, Kansas, and Montana. I come from the legacy health side, and I am responsible for what is now the peaks region of intermountain health that is representative of Legacy SCL Health and historically a catholic organization. Obviously, midway through a merger and with a recent announcement of a decision to extend Epic, which is present within my region into the Canyons region, which is legacy intermountain, and also the desert region, where we have a large ambulatory and high population of folks that are in value based programs. Managing change is really probably the number one challenge for us. Obviously, cost and prioritization and demand are all things that we grapple with, but managing change and expectation in people, I think, is really probably the agnostic challenge that is tethered throughout all of the challenges and things we’re looking to do within our organization.

Sanjog Aul [00:07:17]:
All right. Hey, Jackie, you’re next. So you got to tell about your movie title and also your top challenge.

Jackie Rice [00:07:28]:
I don’t want to do a movie title.

Sanjog Aul [00:07:30]:
Okay.

Jackie Rice [00:07:32]:
I guess. I guess it would be maybe home alone, because you just have to think of all kinds of creative things to beat the bad guys out there. Right. So I’ll do that one.

Sanjog Aul [00:07:46]:
All right, good. So talk about your challenge.

Jackie Rice [00:07:50]:
Our challenges are, I’m the vice president and CIO of a small 269 bed independent hospital about an hour north of Washington, DC, and Frederick, Maryland. We are in a rate regulated state. We are suffering from the end of the tail end of COVID And what happened. Budget constraints and increased tech needs are our immediate problems for how can we meet those needs but do it on a very tight budget?

Sanjog Aul [00:08:28]:
All right, so now with that said, jeremy, do you want to take next?

Jeremy Meller [00:08:34]:
Sure thing. Yeah. I don’t know. I might say beauty and the beast budget and bandwidth, and it would be beautiful if it wasn’t for the amount of bandwidth we have to spend on the budget. And like a lot of organizations, I think we, most healthcare providers, I think, are struggling in one form or fashion with post pandemic expenses, nursing expenses, etcetera. And then we’re adding on top of that, we’re opening a new 500 bed children’s hospital as well in Atlanta. So, and we’re growing our organization. So that creates a lot of strain, I would say, on our budget.

Jeremy Meller [00:09:19]:
And it creates, you know, the. That combined with, I think, what’s going on in our industry, and so many cloud vendors are increasing prices, sometimes indiscriminately, and, you know, suggesting that if you just buy into their whole suite of products, the value proposition will exist. The problem is, is that so many of these, these portfolios overlap, and it’s impossible to actually do that. And so I find myself getting involved in that, the team gets involved in that, and that takes us away a little bit from the strategy, although we’re still doing pretty well with that.

Sanjog Aul [00:09:56]:
All right. Okay. So, parag, you sit at an interesting position. You work with an organization which works companies across industries and specifically in healthcare. Give us your outside in view on what is a pattern that you’re seeing with respect to companies or healthcare organizations trying to harmonize. Yet they face some specific challenges, some more than others. What does that look like?

Parag Kulkarni [00:10:24]:
First of all, great to be here. Sanjok. So we do work with a lot of healthcare, life sciences, and even biotech companies. And the reason I also called out biotech is sometimes it’s different in terms of what biotech companies are trying to do compared to more traditional healthcare companies. But even across that, the pattern that I have seen is I’ll call out three specific things, right. One is data. And what I mean by data is most of the healthcare companies have a lot of data, and it is very difficult to find the right data or find information from data. So that’s one challenge I consistently see, and that impacts productivity.

Parag Kulkarni [00:11:01]:
The other, especially in this environment, is applications for all of, and there are many numbers outside. You know, Gartner talks about it. There are other other companies that talk about it, but most companies have hundreds, literally hundreds of SaaS applications. And many of these applications do similar things. Companies go and end up buying applications thinking they’re best of breed, but they don’t talk to each other. And that causes all kinds of challenges. So that’s the second pattern I see. And then the third one, especially in this, and we were just talking about it prior to, prior to the webinar, is productivity.

Parag Kulkarni [00:11:37]:
And productivity in terms of what can be automated, how can it be automated, and where do we find the budget to do it? Because budget constraints are there. But if there is a way to actually show that certain things can have a significant improvement in productivity, it is possible to get the budget or at least reassign the budget. But these are the three things I see, right? Lots of manual stuff. Finding information is difficult and applications crawl.

Sanjog Aul [00:12:04]:
All right. You can’t get away without telling the movie title.

Parag Kulkarni [00:12:07]:
Well, that’s tough. The first movie, for whatever reason that came to my mind, was Edge of tomorrow, because it is like, literally, it’s like live, die, repeat kind of thing. You know, it’s a roller coaster, right. I don’t know why, but that was the first movie that came to.

Sanjog Aul [00:12:22]:
All right. All right, Suresh.

Suresh Krishnan [00:12:25]:
Hello, everyone. Good afternoon. I’m Suresh Krishnan. I’m the CTO for Cone Health. It’s a five hospital system in North Carolina. And in terms of movie title, I will say matrix, because I just arrived here a month ago and trying to get a grip of what is going on. This organization has invested heavily in it. One of the, like I mentioned earlier that we are one of the early adopters of epic on Azure.

Suresh Krishnan [00:12:58]:
So most of my application, like many health system, I have 702 applications and majority of them have been moved to Azure. That means, you know what that means to Azure bills and managing cloud expenses is going to be a biggest challenge. And two, this organization moved forward very quickly two years ago. Last year they had a really bad year. There was significant changes to staffing. So this year there is challenges to reduce cost even more. I manage biomedical engineering as well. They are all included in it cost.

Suresh Krishnan [00:13:36]:
So it cost right now is over 4% of revenue, which is high for a health system, about $2.7 billion. But that includes biomedical engineering. That is significant portion of my bill. So we are working through that and there will be challenges in parallel in terms of innovation. We have a health ventures team and innovation team which is always bringing up new ideas and try to move forward with from a consumer perspective and provider perspective. So my team will be very busy. So I’m looking forward to the challenge.

Sanjog Aul [00:14:14]:
Very interesting. So, Bakker.

Suresh Krishnan [00:14:16]:
Yeah.

Baqar Shameem [00:14:19]:
Hello, everybody. Bakashim. I’m the vp of digital transformation process improvement with village, Md. It’s a really great question. A lot of people are really struggling with this, and as I heard with some of my colleagues over here, our challenge is really around legacy systems, you know, and how do we drive digital transformation, really improve our patient experience and employee experience with legacy systems, right. How do we get to a future that we envision with all these legacy environment? How do we drive employee engagement and things like that? So I think we really have to think in terms of application rationalization. Suresh talked about cloud environment, looking at our legacy applications and rationalizing in terms of the cost benefits to move them to the cloud and drive that synergy and collaboration across the businesses. Um, data is critical, as Barack pointed out, in terms of really understanding the insights around the organization, in terms of what insights can be provided to kind of work on the right priorities.

Baqar Shameem [00:15:29]:
Right? So we, what we implemented is a demand management process, right? So really look at the funnel of opportunities that are coming in, right. And the pipeline that’s coming in and that’s going to generate the best ROI for us. Right. In those aspects of lifting our foundation, but at the same time trying to connect with the digital requirements for our business.

Sanjog Aul [00:15:55]:
And what’s the movie title?

Baqar Shameem [00:15:57]:
Movie title is Back to the Future. So I wish I could go back and change all the legacy systems.

Sanjog Aul [00:16:05]:
Okay, so I read about a book like prevent a problem, which is solved. So that’s what you’re trying to do, is to go back. Very interesting. Very interesting. No, this is great. So now that we know there is quite a few, some common themes, but I see a variety of different challenges. So, coming back to you, Stephanie. Now this is the time to discuss, what did you do to crack this change? Management is a perpetual process and sometimes are harder than others.

Sanjog Aul [00:16:34]:
So do you have any specific thing that you’ve done which has worked for you? That’s learning for all of us. Second, where you are stuck. What is that snag that you’re hitting? If you could get over the life will be beautiful. And that’s the snag once you tell. I’d love for all of our panelists to chime in and see what they could suggest as solutions. So start with what worked for you.

Stephanie Hines [00:16:54]:
Yeah, I would say we’ve really kind of addressed this at multiple levels. One of the biggest benefits for us within Intermountain, with Rob Allen as our new CEO, is really his platform coming into that role of simplification. And with that being a message that our organization is hearing, you know, across the regions, it just helps to support some of the things that we’re trying to do within it as it relates to, you know, whether it’s application rationalization, standardizing processes, getting clearer on how we manage demands, and ensuring that. Again, as we’ve talked about, we’re being asked to do more with less. I mean, you know, even getting into the space of automation and robotics that we’re really focusing, you know, the fixed, at the fixed resources that we have on the things that are going to bring the most value to the organization. So we’re getting that message from the top, and I think that’s absolutely critical as you bring that down. Right then it becomes, how do you execute that from a process perspective? And that’s really where we’re focused in ensuring that processes around how we go through our merger, how we make decisions around our systems, where we need to be standard, where there may be use cases for variation and how those are supported, how we’re managing vendor costs. I think Jeremy’s comments are very poignant right now around what is happening in the market just with, you know, inflation and there’s so, so many different vendors we’re looking to manage.

Stephanie Hines [00:18:23]:
We have an opportunity in a merger, you know, scenario where we’re making choices to try to combat some of those challenges as we look to standardize. But being really clear with our customers and our caregivers and the folks that we’re supporting on what those processes are and continuing to convey the reason and the message. Because I think one thing we’re all understanding right now, everyone’s feeling the pinnae of, you know, again, just performance, financial performance, costs needing to manage. And I think they’re starting to become even more of a recognition now around people. And Jackie had mentioned something, you know, earlier around, you know, shortages and trying to have, you know, staff, those numbers are shrinking. We’re already starting to see we’re going to have less, you know, less providers, less nurses, less folks available. So there’s going to be even more pressure to deliver and to, you know, have technology be a supportive resource for those folks. So I think that’s the middle layer and then the bottom layer.

Stephanie Hines [00:19:26]:
And this is the part that’s the hardest. It’s really developing a shared culture, especially for us going through mergers with three different regions that have three very distinct cultures and approaches, having those teams come together as we’re building those processes, as we’re driving those decisions, doing that as a team and really feeling like they are becoming one that’s critical in managing change, because when we are a unified front, not just within our it organization, but a unified front across the organization, that’s when it becomes a lot easier to manage those change and changes and make hard decisions that are going to be critical for the success of the organization.

Sanjog Aul [00:20:12]:
So you said these are some of the things that you’ve tried to do. If you were to pick one top pet peeve or one top challenge or which you would like to have the fellow panelists here to give you a solution, what would that be?

Stephanie Hines [00:20:28]:
I think the biggest challenge that we have given, that we’re all trying to move very quickly, perception of what is good or what has been effective versus really having the data science behind, being able to say what has generated the intended result. That takes time. It takes people, it takes data, it takes resources, and sometimes those are things we just don’t have. But they are very critical when you’re managing change to get the emotion out of the decision. You know, we’ve talked about the application sprawl. We all have folks who are very married to certain applications, married to vendors, maybe very deep with those vendor partners. To really move in the right direction, you’ve got to be able to, to bring the facts to the table. But bringing facts to the table is a very labor intensive activity to do sometimes.

Stephanie Hines [00:21:22]:
So I think I’d be interested to hear how others are managing, you know, being able to drive those difficult conversations by showing true results. Did this change provider behavior? Did it actually reduce costs? Did it create the efficiencies that were touted on the front end of purchasing, whatever that technology might be? Okay, now I’ve got to go take analytics resources that are at a premium, that need to be working on a lot of things to go, to go make a case or help people actually move through change. So how folks have managed the balance of that, I think is very interesting, and I would love to learn more about that.

Sanjog Aul [00:22:06]:
All right, so with that said, suresh, I will start with you. My request will be all responses would really help if we keep them very actionable. Right. Very short, sweet and actionable, which Stephanie can take Wednesday morning and say, hooray, I got some solutions here. Okay, starting with that, suresh, go ahead.

Suresh Krishnan [00:22:26]:
Yeah, I think I was going to comment on Stephanie’s earlier comment about standardization and reducing duplication. I think that’s one of the areas I’m going to be focusing on, like, for example, teams, webex and Zoom. What do you need all three in an organization? I went through what Stephanie went through when my previous health system, when multiple cultures come through, how do you merge those cultures into one? This particular health system is struggling with going from a community health system into a system, putting standardized processes across the system while trying to accommodate local cultures. It’s a tough act to do, I think. I like Stephanie’s approach of matrix based. I think we do scorecards. For example, my IT scorecard has number of televisits as a measure the thresholds and targets on my performance dashboard. One of the first question asked is why it is on the IT scorecard.

Suresh Krishnan [00:23:29]:
Because the technology investments we made through it and all that, they wanted it to be part of that success. So. Which I agree with. I think that’s a new approach, but achieving the target, even it doesn’t have direct impact, but they need to have a say in it. So metrics based management. I completely agree.

Sanjog Aul [00:23:49]:
Okay, Parag?

Suresh Krishnan [00:23:51]:
Yeah.

Parag Kulkarni [00:23:51]:
So I’m just going by a couple of very specific examples that I’ve seen, and I used to be part of an m and A team, actually, at one of my previous companies. I think one of the biggest challenges in an m and A is communication and transparency. Right. People. There’s always one set of companies that, people in a company that are nervous what’s going to happen to their jobs and so on. So one thing, and I was very impressed by this, is one of our customers what they did was when they bought a company, they almost started something called a campaign, like think of marketing campaign. But here it’s an m and a kind of thing where they had some very specific, actionable deliverables in terms of communication and engagement that they sent out to different groups. That was a very specific site that was created where they actually validated that people actually looked at the information, they understood the information, there are ways to do surveys and so on, and they continued it all the way through the whole m and a cycle.

Parag Kulkarni [00:24:46]:
So not special technology, but more in terms of almost leading it like a marketing campaign, saying, here’s why we are doing an m and A, here are the steps. Did you understand it? And creating a lot of transparency. And I thought it worked really well at this really large company, especially spread out.

Sanjog Aul [00:25:01]:
Awesome, Jeremy?

Jeremy Meller [00:25:05]:
Yeah, and I’ll agree that these are real problems and the solution of app rationalization mentioned several times. It’s just not easy because it takes usually massive expense to actually make conversions happen. Often you have hardware tied to software. It’s easier said than done. And I think that we’re all in an environment where we have to be realistic. There aren’t many organizations who are going to see their percentage of budget it percentage of budget increase. If anything, you’re just trying to hold on to what you have, and so it has to be around. And I love the comment, Sasha, about your balance scorecard.

Jeremy Meller [00:25:47]:
Ours focuses on reliability, cost, value, delivery, satisfaction, and people. And we try to show this. And one of the things that we’ve implemented I think that’s been pretty helpful is any project over a certain threshold has to have outcome metrics that we are jointly agreeing to that have an impact. Business outcome metrics either it’s saving money, it’s improving quality of care, it’s showing something. One of the lessons we did was a software application for our cath lab that provided better visibility and higher utilization of our cath labs. And that’s a real outcome that the organization can see is providing value. Again, I don’t think we’re going to see massive increases in budget because of that, but at least we’ll be able to hang on and focus as we work through this challenging financial period.

Sanjog Aul [00:26:33]:
Right, Jackie, now over to you. Now that you shared your challenges, let’s pick up the area specific things which worked for you briefly, and then where do you need help so that, like Stephanie had issues and then we had other team members jumped in and tried to give their perspective. Love to get your inputs on this.

Jackie Rice [00:26:58]:
So some of the things that have worked, you know, we really do try to stay, you know, hang on to our staffing and our people. If you lose some of your technology, staff that have that experience for a couple of years and it’s very challenging to bring someone on and get there. So we’ve done a lot about holding onto our staff. We have a hybrid work environment. We have all in days where everybody has to come in and the staff have picked up themselves and they have a whole theme every month for the all in day. It’s great. I didn’t have to do any of that, but they really value the team work. We don’t work in silos at all.

Jackie Rice [00:27:46]:
We have a daily, you know, we have a daily huddle where people are asking other people for help. It’s almost all my staff who aren’t on the help desk attend those. I think communication is just very important. And hanging on to the people you have should be one of your highest priorities because you cannot go back out there and find those people who have all of that experience. Most of them don’t have it, and if you get them in, it’s really, you don’t have the extra staff to train them up. Everybody’s so busy. So that’s one of the things that we have really put some time and resources into. Also, you know, what Stephanie and Jeremy have talked to about looking at applications, attrition, looking at everything we have, standardizing things, not having Webex and Zoom and teams and really, you know, getting that all cut down is also one thing that we’ve really spent some time on to do that things that we need help on, you know, really is, it’s just there’s this whole thing with AI coming out, and I do believe that’s going to be what’s in the future to help us utilize what we have and decrease that.

Jackie Rice [00:29:20]:
So we’ve tried some pilots with our providers using the voice recognition where they walk in and talk to the patient and the information goes directly into the chart. That comes with a cost. And yeah, I do think it’s there. I think patient satisfaction, but how am I going to spread that across? Are all of our employed providers? So, you know, and we work with there, we work with the vendors going, come on, guys, what’s up? What’s a better thing that you can do for me? And everything now is going to, you know, it used to be capital, so it would get capital. We could, we could, you know, handle our capital. Now everything’s going to the operating budget with all of the staff costs that are there. It’s just all going to operating with it all going to the cloud and that’s, that’s just such a, such a challenge. And, you know, they want to put in their contracts that they want to raise the rate, they want to raise the cost 5% every year on year on end.

Jackie Rice [00:30:25]:
I’m not making 5% more every year, the hospital’s not. So, you know, having those conversations are tough.

Sanjog Aul [00:30:34]:
So what would you say is the tips that the team here can offer you which will help make your day, the Wednesday morning onwards.

Jackie Rice [00:30:46]:
For me? What are you doing talking to vendors about the cost, the increased cost year over year for these cloud solutions?

Sanjog Aul [00:30:56]:
All right, anyone from the team here, raise your hand. Okay. Suresh, you want to go?

Suresh Krishnan [00:31:01]:
Yeah, actually it’s a very timely question because I’m going through that process right now. So one of the things I have as an advantage being a CTO, the previous CTO left a year ago, so they did not have a CTO for a year. So coming in new, I’m telling the vendors I better shape up. I’m looking for somebody else. So they are coming in a little bit scared. But there are certain vendors like Epic, Cisco, Citrix, there are certain vendors they are all stuck with. There is nothing we can do. So I’m trying to negotiate with them.

Suresh Krishnan [00:31:33]:
Even a multi year contract in this system and my previous system, like Stephanie’s environment, we are dealing with a large dollar amount. My Citrix contract is close to a million dollars a year. My mic, Cisco Smartnet is over a million dollars a year. So it’s. You are a lot more to leverage a little bit. At the same time, they know that they have you, you know, how do you balance that? So I’m trying to tell them as a new person here, I need to show some value, help me with that. So that way I can sign a longer term contract as well. So I just, in the process of signing a three year contract with Citrix, even though many of you know epic hyperdrive is supposed to eliminate Citrix, technically it’s not going to happen.

Suresh Krishnan [00:32:20]:
But it is that kind of struggle I’m working through. I think the negotiations at the time of renewal is the only way to do it because once you sign into that five year a year race, there is nothing you can do in between. And Microsoft, you have to be extremely careful. Their cloud cost is, there are so many hidden costs items. So I’m, I worked with, as a Microsoft partner for four years. I know a lot of the tricks. So I kind of meeting with Microsoft. I met with them yesterday.

Suresh Krishnan [00:32:51]:
I’m going to be meeting with them again next week. There’ll be a lot of conversations. So conversations is the only way to go.

Baqar Shameem [00:32:59]:
Bakar yeah, I think Suresh kind of captured in terms of the conversations with the vendors. But I also look at, in terms of what’s in our country, right. What can we do internally, right. Looking at how we are utilizing these applications, what users are on there, are we really driving the meaning and the benefit out of those, right. And how we can consolidate some of the users from that perspective and really aligning it to what’s a business strategy for that particular cloud application. So once you have a very crisp and clear kind of objective in terms of that application. Right. And you are able to get some benefits in terms of, hey, can we consolidate some of the user accounts in there? Can we consolidate some of the data? You have some upper hand when you are actually negotiating with the vendors, right? Because you can show your consumption has gone down for that particular environment.

Baqar Shameem [00:33:57]:
Right. So from a long term perspective, you might not continue with them with that particular agreement. Right. So there are certain levers you can pull from that perspective, not with the Microsoft chanel, but the other vendors where they definitely work with you. And we are going through the same thing. Vendors understand how healthcare is really transforming, and they want to be your partners, so they will work with you to come up with a different model. Could be a short term model versus a long term model.

Sanjog Aul [00:34:31]:
All right, parag, more of a follow.

Parag Kulkarni [00:34:33]:
Up on what I heard from Bakar, like, and maybe it’s more a question than a comment, like have you, as in when I heard things like, you know, we see this all the time, right, in terms of vendors and the contracts going up and so on. The key word I heard was adoption. Have you put in any, I’ll almost say automated measures that looks at the, the usage? And I’ll give you a very simple example. Right, Zoom and Google Meet. And if there are 100 licenses for Zoom and hundred for Google Meet, because that’s how big the organization is, if 50 of the people are not logging in every month, in one of the two, are you deactivating those licenses? Because that’s what I’ve seen. One is app rationalization, the other is a step towards app rationalization, which is regularly looking at adoption and deactivating licenses and saving money.

Baqar Shameem [00:35:20]:
Yeah. Now that’s a great point, Prague. And, and what we’re trying to drive is outcome based culture, right? So, yes, we’re collecting the data, but what’s the outcome from it. So to your point, I wouldn’t say everywhere. In some cases where we can, we are also relying on the vendors to send us that information, so they send us reports. In terms of, here’s your utilization for this month. This user has not logged in for the past three months, and we work with them in terms of, like you mentioned, in terms of. Of kind of terminating that license for that user or extending it.

Baqar Shameem [00:35:53]:
So we have certain aspects in place for that.

Parag Kulkarni [00:35:57]:
Yeah, because that’s one way to kind of save money. Right?

Baqar Shameem [00:36:00]:
I agree.

Sanjog Aul [00:36:01]:
Absolutely. So, Stephanie, quickly, we’ll move on then.

Stephanie Hines [00:36:04]:
Yeah. And I would just, I would add one thing, and I think it’s interesting, and with Suresh’s comments and being a little bit more aggressive, the more we do that and the more we move from one cloud vendor to the other, the easier it becomes. And right now, the barriers to moving are difficult and expensive. So the more we can drive that down, I think the more power we have.

Baqar Shameem [00:36:27]:
Right.

Stephanie Hines [00:36:27]:
In controlling the cost when it becomes easy to move from one vendor to the other. But I also think what we’re doing internally matters, and this is not a super sexy area to look at, but I’m going to put it out there because I think I’m finding that there’s lots of opportunity. And I don’t know, Jackie, if your organization is large enough where you’ll find this to be beneficial, but archiving, you know, if you are archiving in the cloud and as a clinician, everyone wants to put everything in the kitchen sink in there that they never, ever, ever go back and look at. Getting really focused on. Truly, what do you need to archive and being conscious and having someone focus on that. So you’re not continuing to add storage of things that don’t add value to your organization in addition to looking at applications that aren’t getting the utilization that you want to see, that is just that one area that grows and grows and grows and no one ever looks at it. But it’s expensive. It’s expensive to convert it, it’s expensive to store it.

Stephanie Hines [00:37:25]:
And, you know, in many cases, it just really doesn’t give you a whole lot.

Sanjog Aul [00:37:30]:
All right, so, Jeremy, let’s come to you. Your top snag that you’re hitting. But before that, very quickly tell us what’s new, more or different that you did with respect to the problem that you said you have and what worked, truly what worked on the ground.

Jeremy Meller [00:37:46]:
Well, yeah, I mean, I would say that, you know, one is we’ve got a big focus on opening the most advanced pediatric hospital in the country, mostly because it’s brand new. And so we are implementing things like enhanced communication, deep medical device integration with some predictive, more predictive medicine, location awareness for everything and everybody, robotics, and more advanced patient engagement and video integration. And so we’re really lucky to be in a place where we’ve got kind of a test bed to be able to do a lot of that and a strong interest in that kind of investment. But the question I would have for the group is, and I think, Jackie, you had raised the issue of AI, and that’s a really good one, because you kind of get it from both sides. On one hand, you have, geez, executives will feel as though we should be doing something more there. They’re seeing the popular press, they’re hearing that this is going to do away with lots of jobs and make everybody more efficient and dramatically change work. The other side of the thing, especially in healthcare. I don’t know how many of you in your organizations have blocked public access to generative AI tools.

Jeremy Meller [00:39:05]:
I’m told by our chime president that better than half of organizations, including us, are doing that now. So we’re under a lot of pressure to keep things secure at the same time, provide an avenue for that. And I think that’s just a big challenge. And so be super interested to hear how everybody is dealing with that.

Sanjog Aul [00:39:26]:
Sureshen? Suresh, are you able to hear me?

Suresh Krishnan [00:39:31]:
Yeah, sorry. Let me make a quick comment based on my experience. Last four years I worked for a Microsoft partner, and one of the last project I was working with was with Microsoft. Fabric and AI enablement in healthcare. And one of the areas people are interested and we pulled for one of the clients is like, we have disease specific care plans. EMRs do that, especially post acute care. There is standardized care plan for chronic illness and all that. Taking that standardized care plan into customer specific care plan, that’s one of the things AI can help, because if somebody had a workplace injury going to chiropractor three times, go to therapy these many times, go to ortho at this time, and all that there are standard plan.

Suresh Krishnan [00:40:19]:
But if you have enough data about patients who are similar, similar accident over the last ten years, the AI engine can tell you, don’t waste time with the chiropractor, go to this step, or after this step, skip this step. So creating a custom care plan is one of the areas Microsoft is working with my previous company. I see a lot of progress there. And another one is another one. Our health system has done already is summarization of incoming document. When patients are coming into your health system first time they are bringing visit summary from previous visit, they may be bring MRI report, a CT scan or x ray. And technically you tell me how many physicians read through all that document. Not many.

Suresh Krishnan [00:41:05]:
So if we can use AI to do, use text analytics to help, and use a one page summary, which is all the things you need to know, present them upfront within the context of API that has been helpful. So there are few use cases, I think. But like you pointed out earlier, I think there is cost involved with every one of these things. How do you justify investing that upfront? And our health system has done a good job so far. I think we will continue. I think.

Sanjog Aul [00:41:39]:
Yes, prayer. Go ahead.

Parag Kulkarni [00:41:40]:
A very specific example here, right. I think, Suresh, as I was hearing from you, one of our customers is a large biotech company based in the northeast. They grew like crazy during the pandemic, became a household name. I think they started around a year ago, started using a little bit of AI internally in terms of deflection of a lot of cases. Like they literally went through all the internal it, HR benefits kind of use cases, looked at, which could be resolved, and started implementing some of these AI use cases using a virtual assistant. And now they are rolling things outside. I know there are concerns about data and so on, but this is, like I said, a large biotech company, everybody knows the name, but they are actively doing that. And they are also now as AI, all these LLMs in Kuru and so on.

Parag Kulkarni [00:42:31]:
There are also companies that are developing very specific healthcare, healthcare related large language models and so on, which today most of these run in the cloud. But I think there is an option ultimately to run it, whether in vpcs or even on Prem. Right. But I’m seeing actually more and more companies. Look at that. We also have a customer that’s a large hospital in the Bay Area. They are trying things out again, starting small with a virtual assistant, first internal use cases and then basing, seeing how it works, then moving it out externally. And they’re actually working with the vendors, for the vendors to provide them with some ROI use cases and say, okay, I was able to deflect 20,000 cases.

Parag Kulkarni [00:43:11]:
What does that mean? And then. And then come up with some investment dollars there, or take it from somewhere else. See, I am seeing a trend all over.

Sanjog Aul [00:43:19]:
Great. Stephanie. So you’re muted. Yeah.

Suresh Krishnan [00:43:25]:
Stephanie.

Stephanie Hines [00:43:25]:
Yeah. I think this is a really interesting topic, and it is getting a lot of press. And, you know, it’s one of those situations. I think if you try to chase a thousand squirrels, you’re not going to catch any. And it becomes really important to get focused and have a strategic approach around where you’re going to get the most value. And I think also looking at what the risk is as we start to implement these new technologies. Some things are very low risk, some things have potential for high litigation if it is not done well. Where do you have the resources and the bandwidth to make sure what you’re doing is going to put your organization in a good light and protect the safety of your patients? But I think when we’re looking at opportunities in this space, it is very much focused on where do we have to solve problems that we know are coming, trying to skate to where the puck is going to be, the areas we know we’re not going to have human labor, we’re going to have shortages in certain types of physicians or shortages in certain types of staff.

Stephanie Hines [00:44:33]:
Also to a big challenge right now with the payers, let’s just be honest, they are investing a lot of money and time into generative aih that we’re not necessarily in a great position to respond to if we don’t have those tool sets as well. So dealing with denials that may come through, that’s really critical in keeping dollars coming in the door, maintaining the margins, and helping us operate. So there’s so much cool stuff out there and we all want to do it. I think we just have to be super pragmatic about what are we choosing and are we a solution looking for a problem, or are we being very focused on understanding what are we going to be facing in the next year, two years, five years, ten years? And is this going to be the tool in our arsenal that’s going to help us be effective?

Sanjog Aul [00:45:24]:
Suresh, very quickly so we move on?

Suresh Krishnan [00:45:27]:
Yeah, very quickly. I think the last HFMA conference, there are 300 vendors trying to sell a enabled revenue cycle management. So it has become a buzzword. Is it really a enabled or just Ba enabled. You know, you have to peel back the layers to find out. So that’s something you have to be careful. But as a health systems part of M and a activity in provider space was mostly focused around payer contracts, but indirectly systems like what Stephanie has and I have, there is a size enough to do more with it because we have a venture fund. Corn Health Venture is 17 startups associated with the venture fund.

Suresh Krishnan [00:46:10]:
And the one thing I found out from the CEO is that we are not investing dollars into those companies. We are giving them opportunity to be a test bed for equity in those companies. So that’s the thing. When you are bigger, you can pull those kind of things. But I was very impressed with what we have done. So there’s more to happen like that. The vendors are going to be guided by these health systems, larger health systems, and we can all reuse the results of that. You don’t have to invent the wheel again and again, so.

Sanjog Aul [00:46:40]:
All right, great. So, parag, coming to you. I know you have this unique position that you’re helping solve problems, but you’re also seeing a bunch of problems. So in the interest of most value that we can create for this discussion, where do you think are some of the most remarkable things people have done towards harmonizing it in healthcare? And where would you say is the top challenge, which you would like to pull the group here to say if they could help crack that nut for the rest?

Parag Kulkarni [00:47:12]:
Yeah, I think I touched on a few things. I just talked about how one of the customers that I was working with was using small AI use cases, things that were not something that they had face litigation for, but internal use cases, then building on top of that. So I’ve seen that a lot. I think what I would like to poll this team on is one of the themes was productivity. And what I have noticed in many companies is it is very difficult to find information, do things, even something as simple as onboarding a new employee can at times be a complicated task. And especially with everybody spread around, not everybody’s in the office. So are you seeing any specific tools, best practices in terms of, you know, searching information, getting insights from it that you were really impressed with or things that you’re looking to do? Because especially in large companies, I see that as a consistent problem. Right, where lots of information, but very little knowledge or insights from that information, and then it keeps increasing the cost.

Parag Kulkarni [00:48:17]:
You know, as I think I heard, I either, Stephanie, talk about where you take all this information, you move to the cloud, you end up paying large bills, but really, you’re not getting much insights out of it. So that would be my question to this team in terms of, have you seen things that are very innovative, things like that, maybe? Do you use things like enterprise search across your organizations and so on?

Sanjog Aul [00:48:41]:
So, Jeremy, you had raised your hand. Any thoughts there?

Jeremy Meller [00:48:44]:
Yeah, well, yeah, I was trying to track the question exactly, because I think it started around kind of productivity, then kind of got into the tools around productivity and that sort of thing. So the, you know, I mean, we’ve done some interesting things I think, related to productivity specifically and implementing agile. And, you know, like a lot of you, we’ve got a remote workforce and the remote workforce is dealing with the larger, broader societal, I would say, backlash, it seems, against remote work that’s coming from a lot of organizations, and it would be disastrous for us if we were to lose that at this point just because of the potential turnover and everything else that we’d have. And Atlanta is a pretty busy place, so we’ve had to really focus on employee productivity, how employees share information between each other, and how we show the organization that everyone is productive, that they’re working on value added work. And so the discipline of the stories and the information sharing, we’ve got a lot of skeptics within our IT organization who are like, oh, this agile work management is just going to be, it’s just going to be a drag on us. And we actually found that it adds about eight to twelve minutes of work a day. And from that comes all the benefit of our team staying more aligned, sharing information better. When we survey our team members after they’ve been on it, they kind of go through, there’s a hype cycle curve.

Jeremy Meller [00:50:17]:
They kind of go through. At first they kind of, they’re like, this is awful. This is, you know, and then they’re like, oh, I can see the great benefit from it. Then they’re like, oh, you know, it’s going to be more. And then eventually it levels out and they can really see the value. And what they’re saying is that they are just much more better coordinated and able to be more productive.

Parag Kulkarni [00:50:36]:
Jeremy, when you say agile work management, do you mean like, like literally like, you know, scrums and sprints that way? Agile scrum management, just like engineering does.

Jeremy Meller [00:50:44]:
Epic stories.

Parag Kulkarni [00:50:46]:
Okay, good. I just wanted to be sure that I was, I was understanding it.

Jeremy Meller [00:50:49]:
Epics user, user stories. And it’s, you know, it’s tricky in healthcare. There’s, you know, there’s a good mix of operational work along with project based work that lends itself a little bit easier to it, so you have to adapt it a little bit. But yeah, I think it’s providing the, at least the visibility. I think ideally it’s supposed to reduce the task switching. If you’re doing it right, there’s still human dynamics involved. When the ping goes off, I still want to look and see what it is, and that takes me away from the focus, which may be even more susceptible in our remote work environment. But overall it’s been good.

Parag Kulkarni [00:51:26]:
That’s great. I live in day in, day out, and there is no way I can go back to the old world.

Sanjog Aul [00:51:32]:
All right, good. So, suresh, you shared a bunch of different tips for different people as we spoke about. Yeah. So let me, let me get to you. But before that, I’d like to quickly get inputs from Bakr.

Baqar Shameem [00:51:44]:
All right, thanks, Sanjo. So, in regards to productivity, what we’re trying to drive is a self service culture, right? So we use tools like Servicenow. Right. A lot of orchestration in there, a lot of work for an automation in there.

Jeremy Meller [00:51:56]:
So.

Baqar Shameem [00:51:57]:
So to really drive that employee engagement and metrics through it. The other part that Jeremy mentioned was around agile, but over there, what we are trying to see is how the business sees what tech is doing, down to the team perspective. How do I connect that business objective down to this user story level? That is the problem that we are of trying to solve at this point is how does an employee who’s working on a particular product and their user story see that? The value that they are providing to the organization, that’s tied to that specific business objective? So we have certain tools that we are playing with at this point in trying to drive kind of that collaboration between the business and tech.

Sanjog Aul [00:52:45]:
Great. So coming back to you, Suresh, share your top challenge and or top area in which if the team could huddle up and give you some golden nuggets, what would that be?

Suresh Krishnan [00:53:03]:
Yeah, the top challenge is reviewing the staffing level. I think the organization has gone through a process of metrics based staffing, whether it’s gardener provided or class whatever, whoever provided those metrics, the infrastructure technology team has been staffed accordingly. Now, metrics based review of those, I think, for example, I look at help desk. Help desk is I look at service now and see incidents like I noticed this week, incidents not reviewed in the last 15 days. I asked the question, why? Why is it even there? If somebody is not working on it? Either it should be changed to a request or it should be closed. One of those two. So I’m putting a lot of pressure on the team to stay on top of metrics and I am going to. One of the challenges we always had with ServiceNow is that everybody has the best intention when they implement it year later.

Suresh Krishnan [00:53:59]:
Nobody knows what the intention was, I think. So having to review that, and actually I’m bringing an external consultant in to do a review of my service now. Right now to see is it holding the promise that it made originally? If not, how do we realign it? So that is a challenge with infrastructure and staffing management another last thing I would say is in the last organization we had the way like we used to compete with the legacy. I worked for Ascension. Ascension had very strict ways of doing things. For example, we acquired a medical practice. We do archiving using same platform. There is no choice given to the doctor and the AR is sold in 90 days.

Suresh Krishnan [00:54:43]:
Done. There is no variation to negotiation and all that. So as done by the book, same thing with helped us. We wanted a 50% 1st call resolution target. The way to achieve it is through knowledge articles, not through beating people up. I want to help us to have the tools they need to close 50% of the ticket, period. The current organization, I see a 37% on my dashboard. I wanted to raise to 50.

Suresh Krishnan [00:55:09]:
So those are my challenges right now. I want to get to a metrics based management and in a community health system that is a tough thing to do. I think there is some balancing act I had to do.

Sanjog Aul [00:55:22]:
So the way you explain it looks like it’s more of a project versus a problem, right? So you’re not hitting a snag. You are like, suppose I came 2024 and asked you these questions. You said, this is behind me. Is that where you would say these are?

Suresh Krishnan [00:55:35]:
Exactly. I think we do have a huge development shop and DevOps and we are doing a lot of that with a project management methodology. Operationally it’s more itil based. So I’m trying to make sure we are staying balanced. And I agree here. I would like to tell you that’s all solved.

Sanjog Aul [00:55:53]:
And is there any specific thing that you would like? I see Stephanie and Barker raising hands. So, Stephanie, start with you.

Stephanie Hines [00:56:01]:
Yeah, I did. You know, there was one part of that that I do think is a problem in healthcare. The needs that come into it are highly varied. You know, if you look in other industries, it tends to be, you know, those requests may be a little bit more linear. Servicenow is difficult. You know, you’re either going to spend a lot of money on the front end building out catalogs with a litany of things that people may need and you’re still not going to cover all of it to try to drive things. So you have those efficiencies or you don’t. I think, you know, Suresh, you’re probably in the same boat that the rest of us are in, where you’ve got a lot of gen requests out there and you’re trying to figure out, is this broken? Do I need to fix it? Is this a project? Where does this need to go? And we don’t always have a lot of, you know, sophistication, depending on who’s putting that request in, to be able to diagnose it, to know how to get it going, where it needs to go.

Stephanie Hines [00:56:57]:
So you end up with a black hole. I think in a lot of cases, this is an issue, and it is an issue that I don’t necessarily see our vendors helping us solve. And it’s a huge drain on our resources that we’re hopefully shifting more to doing strategic projects. And a lot of times, the things that get kind of hung up in service now don’t always fit into that strategic bucket. So I do think this is a very big challenge for us to solve, or we’re going to find that we’ve got continued resource drain in the space and then the perception. Right. Because if those metrics go out to your business and it’s, I’ve got x amount of tickets and something hasn’t been touched, or these things aren’t moving, they may not necessarily know that’s not a high value activity or it’s not broken, it just looks like, oh, my goodness, our IT department isn’t able to respond to the needs of the organization. So I think for that component of it, it is a problem, and I’m certainly facing that in my organization as well.

Stephanie Hines [00:58:00]:
So, you know, I would love to partner with you as you bring your consultant in to understand some maybe pearls of wisdom you’re finding.

Sanjog Aul [00:58:07]:
All right, so we are coming close to the hour, end of the hour. So, Bakar, I want you to, of course, you had a comment about this, but I’d like to dovetail that with your top challenge so we can have the team huddle up and we close it then.

Baqar Shameem [00:58:19]:
Sure. Definitely. I mean, in terms of the service now, I mean, it’s a tool. Right. So the process and the. And the orchestration that you build within your environment is really up to us. Right. So what we do is we have a demand management team that kind of really looks into what type of request it is.

Baqar Shameem [00:58:35]:
Stephanie, to your point, really trying to analyze, hey, what’s the requirement, where it needs to go? So we kind of shift the focus from, hey, this is more typical fix the issue versus this is more strategic project based, goes through a different pipeline. So that’s more of our orchestration that we kind of do internally.

Sanjog Aul [00:58:54]:
So, very quickly, your top challenge, which you feel the team could address.

Baqar Shameem [00:58:58]:
Yeah. I mean, one of the key things that everybody talked about was, hey, we have cost constraints, we have low staffing levels and stuff like that. Just wanted to get your thoughts around, how do you balance. You’re trying to drive digital transformation. You’re trying to help your business and patients through technology, but at the same time, you’re trying to keep the lights on. Right. And, Jackie, you talked about everything is through the operating budget. So how do you find the balance between the two with the business still looking for innovation, but at the same time, keeping the lights on?

Sanjog Aul [00:59:34]:
You’ve got to watch a good movie, I guess.

Jeremy Meller [00:59:35]:
I guess.

Baqar Shameem [00:59:36]:
Right?

Sanjog Aul [00:59:39]:
So. So, yeah. So, anyone? Jeremy? I know you know, we’re coming at the end of the hour. Any thoughts for Barker? For him to get that magic pill? You are muted.

Jeremy Meller [00:59:56]:
Oh, sorry.

Parag Kulkarni [00:59:57]:
There.

Jeremy Meller [00:59:57]:
Yeah, no, I know. I. Yeah, I mean, nothing specific other than I think that, you know, the. The way we go about this, we have to align with our leadership expectations. We have to set expectations, and we have to manage those with all of the stakeholders, I think, in our organization, and, you know, align that also with our staff. And, you know, one of the things I do with my teams is I try to make sure that they understand the value that they’re providing, how they connect to the mission of children’s, and how important their roles are, so that hopefully we get the best from them every single day.

Sanjog Aul [01:00:38]:
All right, any thoughts from anyone else for Bakker? Any unique recipes? Yes, Stephanie, go ahead.

Stephanie Hines [01:00:47]:
I would say, just again, a continued focus on the keeping the lights on activities and where there’s opportunities. And I think it does tie to application rationalization when you’re looking at operating budgets. And one of the things that we’re really trying to be mindful of is not being in that mindset of, I’ve got an application here that, you know, yes, it’s performing well. I’m not having any issues. And because there’s no gremlins popping out of it, no one’s looking at it, and getting more in that space of, hey, let’s go out and look in the market, you know, every three years, every five years, so we can at least try to drive some of those costs down. So whether it’s managing costs with your vendors, looking for operational efficiencies and keeping the lights on activities, that those things, if you can find them, because in our organization right now, if we’re spending, we have to find the money from somewhere. Right. That, to me, is there’s some nuggets in there.

Stephanie Hines [01:01:42]:
If you make it a continuous practice, and it’s not in a lot of organizations, it only happens when we feel like we’re under duress.

Sanjog Aul [01:01:50]:
What a great conversation today, folks. Special thanks to all our panelists for their contribution. Jackie Rice, Stephanie Hines, Jeremy Miller, Parak Kulkarni, Suresh Krishnan, and Bakar Shamim. Thanks so much again for contributing and hope these nuggets will help people around the world as they consume this content. And thank you. Especially simpler for helping putting this together, at least supporting it so that we have the value created through our forums. Thanks so much again. Have a lovely day ahead.

Sanjog Aul [01:02:21]:
Thank you.

Suresh Krishnan [01:02:23]:
Thank you.