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with Rob Adamson.
He is the CIO and EVP of Robert Wood

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Johnson Barnabas Health.
For those who don't know,

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RWJ Barnabas Health is a health system
based in West Orange, New Jersey, with 4,

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500 beds, 11,000 providers,
and 19 hospitals.

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and is New Jersey's largest private
employer with 33,000 employees. Rob,

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thanks for joining us today.

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Hey, thanks for having me.
Good to see you again, Jordan.

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So for our most ardent listeners to
Healthy Data Podcast,

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you may recall that Rob looks a little
familiar.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/9-2
00:00:41.200 --> 00:00:46.901
He was last on Healthy Data Podcast
exactly three years ago in June 2023,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/9-3
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season one, episode 38.
And so a lot has happened since then.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/10-0
00:00:51.997 --> 00:00:54.356
Rob,
you completed your Epic conversion from

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/10-1
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Allscripts, Cerner, and Meditech, correct?

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We are all done, thankfully.

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So many of our listeners are still in the
midst of doing that or have recent

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/12-1
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traumatic memories of that.
Lots of budget there. Also,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/12-2
00:01:08.339 --> 00:01:12.999
last time three years ago,
you were going strong with Siesta Fiesta.

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How has that been continuing?

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So we still do some version of that,
and we tie that to basically where

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/13-1
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upgrades are going to be or something
substantial so that we don't allow people

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off when we desperately need them,
but at the same time,

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give them the latitude to enjoy all their
paid time off.

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So for our listeners,
that's just about blocking time and

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ensuring that there's time on and time
off,

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and we try to separate the two at Robert
Wood Johnson. Anyways,

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let's get down to it.
Today our conversation is going to be

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/14-4
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what happens when you stop treating IT as
a support function and start treating it

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instead as a strategic partner.

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There's a campaign at Robert Wood
Johnston Barnabas Health called the

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Driving Early Awareness and Partnership
for Innovation campaign.

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So before we jump into the mechanics of
all this,

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do you want to give an overview of the
campaign?

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Yeah, sure.
So one of the things we did is when I

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/16-1
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took over as CIO,
I asked a very simple question to my

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/16-2
00:02:12.708 --> 00:02:15.927
coworkers in our IT executive council.
I said,

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I want you to look at every meeting that
you attend, all of you collectively,

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and I want to see, is it early awareness?

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mid-awareness or late awareness in the
strategy.

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And what we actually found when we did
this is in 2023,

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70% of the things that we attended was
late in the cycle, late awareness.

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A little bit on the mid-awareness and
then 10% was early awareness.

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Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/20-0
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We feel advocacy is an offensive sport.
And I said,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/20-1
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let's go out there and let's get rid of
the things that are late awareness and

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get ourselves on those things that are
early awareness. And in 2026,

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that same group,
80% of all the meetings we attend now are

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strategic and are early awareness.

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and only about 5% is left at late
awareness. And you may say to yourself,

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So...

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go ahead.

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Okay, so no, keep going.
You may send yourself and then...

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Yeah,
so what I was going to say is you may say

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to yourself, what does that actually mean?
So as an example, in 2022,

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we were on 2 early awareness councils,
the Chief Medical Officer,

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the Chief Nursing Officer. Now in 2026,
I'm a member of the Board of Trustees,

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the CEO's Executive Leadership Team.

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We're on the construction and space
planning, the COO council,

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00:03:33.722 --> 00:03:37.688
mergers and acquisitions,
quality and patient safety. Very,

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very different complement of what we're
on. And why is that important?

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Because when a goal, a strategy,
or an initiative is being started,

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who's at the table? IT.

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What was happening is we would be
informed of something and nobody on this

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call is going to ever remember something
like this, but just go with me. Hey,

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Yeah.

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we're opening up a building and we need a
network spun up by Monday.

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Yeah.

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Even though you've been planning this
project for a year and a half,

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so early awareness gets you away from
reaction

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to proaction and that's when we became
not a division,

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but a service line that is thought of the
same as cardiovascular,

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oncology and the like.

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I can't tell you how many of our
listeners are often, one,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/32-1
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are asked to go through fire drills that
are preventable, and two,

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00:04:25.376 --> 00:04:30.882
are asked for a band-aid solution that in
reality doesn't address the root business

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00:04:29.117 --> 00:04:29.277
Okay.

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cause and use case that you need to solve
for,

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which just leads to a new request for a
new solution

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a few months down the road,
and it keeps going until somebody does

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Correct.

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the root cause analysis.
So before we go deeper into exactly what

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you've been doing the past few years in
this early awareness and partnership

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Mm.

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campaign,
I'd like to bookend this conversation

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with a thought that I'm then going to
mention again at the end of this

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conversation.

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So and that thought is about measurable
clinical impact. Ostensibly, IDNs,

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integrated delivery networks,
or large healthcare delivery systems are

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00:05:03.794 --> 00:05:07.825
all about, yes, they're businesses. Yes,
you need to be in the black instead of

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00:05:07.825 --> 00:05:11.000
the red, but ostensibly,
you're there to deliver healthcare in

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order to improve health outcomes for
patients.

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Sometimes you're managing at a population
level.

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A lot of times we're managing at an
individual level.

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And so I just want to bookend the
conversation like with why we're doing

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this.
What are the implications of having the

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00:05:26.569 --> 00:05:30.802
IT team separated from the business
owners, the service line owners?

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00:05:30.802 --> 00:05:35.832
And I just want to ask you to speak for a
moment about where you started in terms

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of your inpatient mortality index.

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And then we're going to go through the
awareness, the strategic IT governance,

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00:05:43.022 --> 00:05:46.710
the executive share goals,
and then the impact of all of those

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00:05:44.557 --> 00:05:44.957
Hussam.

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mechanisms,
those tactics on the strategy of having

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00:05:49.754 --> 00:05:52.799
where you ended up with measurable
clinical impact.

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00:05:52.799 --> 00:05:56.077
So would you please guide us through that
journey, Rob?

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00:05:56.317 --> 00:06:00.560
Yeah, sure. So,
and I think you talked about shared goals,

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00:06:00.560 --> 00:06:06.169
which I think is the secret sauce to get
to the clinical measurable outcomes.

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00:06:06.169 --> 00:06:10.915
If you take a look in 2022,
9% of all of our executive goals were

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00:06:08.517 --> 00:06:08.997
Mhm.

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00:06:10.915 --> 00:06:15.157
shared with some business, operational,
or clinical owner.

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00:06:14.557 --> 00:06:14.877
Okay.

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In 2026, as well as 2025,
every single executive in IT has a

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00:06:20.561 --> 00:06:24.243
corresponding shared executive goal with
an owner.

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00:06:24.243 --> 00:06:29.873
The one you're referring to is a project
that we're incredibly excited about,

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00:06:29.873 --> 00:06:34.277
and it's called the Auto Clinical
Documentation Improvement.

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00:06:34.397 --> 00:06:39.992
scenario. And essentially what this is,
is we know when a patient comes into our

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00:06:39.992 --> 00:06:43.515
facilities,
there's something called the mortality

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00:06:43.515 --> 00:06:46.831
index.
And what that basically means is if your

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00:06:43.757 --> 00:06:44.477
Mhm.

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00:06:46.831 --> 00:06:50.699
mortality index is 1,
that means if you came in and you

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00:06:50.699 --> 00:06:53.117
actually succumbed to your disease,

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00:06:53.597 --> 00:06:57.357
That was expected. A1 means it's expected.
If it's 1.3,

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00:06:56.957 --> 00:06:57.437
Mhm.

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that means 30% of people are dying more
than we expected.

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00:07:01.251 --> 00:07:05.951
And then if it's less than one,
less people are succumbing to disease

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00:07:05.951 --> 00:07:09.577
than we expected.
And what we found was we were doing

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00:07:09.577 --> 00:07:13.471
amazing clinical care,
but some of the problem we have is

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00:07:13.471 --> 00:07:17.769
documentation in nature.
And then we were underappreciating how

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/46-6
00:07:17.769 --> 00:07:18.037
sick

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-0
00:07:18.317 --> 00:07:22.211
our patients were.
So the Auto CDI program, when launched,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-1
00:07:22.211 --> 00:07:25.512
which is an AI platform,
gets launched into Epic.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-2
00:07:25.512 --> 00:07:29.670
It actually goes and finds about 15 to 16
different diagnoses,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/47-0
00:07:26.797 --> 00:07:27.397
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-3
00:07:29.670 --> 00:07:32.904
as well as things that are already in the
chart,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-4
00:07:32.904 --> 00:07:36.667
surfaces them for our clinicians to say,
oh my goodness,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-5
00:07:36.667 --> 00:07:40.363
I forgot to document these things.
They get documented,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/48-6
00:07:40.363 --> 00:07:42.277
and now we're getting credit.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/50-0
00:07:42.717 --> 00:07:46.877
for people and how sick they really are.
So what happened was is...

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/49-0
00:07:45.477 --> 00:07:46.237
No, hold on.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/52-0
00:07:47.397 --> 00:07:51.173
Just to jump in there,
you say services information that

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/52-1
00:07:51.173 --> 00:07:54.287
clinicians forgot the document,
but of course,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/52-2
00:07:54.287 --> 00:07:58.791
you can't service information that
doesn't exist in digital format.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/51-0
00:07:56.797 --> 00:07:57.437
Correct.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/52-3
00:07:58.791 --> 00:08:04.157
So are you talking about discrete data
elements as opposed to unstructured text?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/56-0
00:08:04.477 --> 00:08:08.523
So yes, so for instance,
I'll give you a very clear example.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/56-1
00:08:08.523 --> 00:08:13.630
We know when someone's potassium level is
very, very high or very, very low,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/53-0
00:08:12.917 --> 00:08:13.517
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/56-2
00:08:13.630 --> 00:08:18.870
this could have a major detriment to
people's mortality. And so it's in a lab,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/54-0
00:08:17.077 --> 00:08:17.317
Uh-huh.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/56-3
00:08:18.870 --> 00:08:22.717
we see it's high,
but nobody wrote it in the actual note.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/55-0
00:08:22.877 --> 00:08:23.357
Got it.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-0
00:08:22.957 --> 00:08:25.779
Somebody forgot to document it.
It's all there,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-1
00:08:25.779 --> 00:08:29.894
it just never got documented.
Now it gets surfaced so that it becomes

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/57-0
00:08:27.517 --> 00:08:27.997
Okay.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-2
00:08:29.894 --> 00:08:32.950
part of the note,
so that when you go through this,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-3
00:08:32.950 --> 00:08:37.242
it goes into the overall index.
And what's wonderful is we were starting

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/58-0
00:08:34.037 --> 00:08:34.517
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-4
00:08:37.242 --> 00:08:40.005
at 1.25,
meaning 25% more of our patients look

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/59-5
00:08:40.005 --> 00:08:44.237
like they were actually succumbing to
disease when they shouldn't have.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/60-0
00:08:44.597 --> 00:08:49.234
And in fact, now we're down to a 0.6,
which means it's 40% less likely you're

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/60-1
00:08:49.234 --> 00:08:53.930
going to succumb and have mortality.
And it's because we're actually doing two

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/60-2
00:08:53.930 --> 00:08:56.784
things,
the amazing clinical workflows that are

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/60-3
00:08:56.784 --> 00:08:59.875
being done by our clinicians,
and at the same time,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/60-4
00:08:59.875 --> 00:09:03.917
making sure that we're appreciating just
how sick our patients are.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-0
00:09:04.397 --> 00:09:07.041
So before we get into how you accomplish
that,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-1
00:09:07.041 --> 00:09:11.485
and that's going to be very exciting,
just to understand the number between 1.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-2
00:09:11.485 --> 00:09:14.410
25 and.6,
I can think of at least two ways that you

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-3
00:09:14.410 --> 00:09:17.842
might explain that. One,
the care being delivered is better.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-4
00:09:17.842 --> 00:09:22.173
More information is being available at
the right time to the right person to

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/62-5
00:09:22.173 --> 00:09:23.917
make better informed decisions.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/61-0
00:09:24.157 --> 00:09:24.717
Correct.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/63-0
00:09:24.157 --> 00:09:29.713
or maybe it never really was 1.25.
Maybe it was closer to like 1.0 or 1.1,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/63-1
00:09:29.713 --> 00:09:34.972
but now you're better able to capture the
accurate clinical diagnosis.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/63-2
00:09:34.972 --> 00:09:40.305
Can you speak about the different
explanations for how to interpret the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/63-3
00:09:40.305 --> 00:09:42.157
first, where you started?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/64-0
00:09:50.597 --> 00:09:51.237
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/65-0
00:09:59.517 --> 00:09:59.797
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/66-0
00:10:03.197 --> 00:10:03.717
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-0
00:10:03.757 --> 00:10:07.704
sick really are you?
And so what we did is clean up the bottom

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-1
00:10:07.704 --> 00:10:12.653
as well as the remarkable job on the top.
And when you put them both together,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-2
00:10:12.653 --> 00:10:16.099
you're right,
it's probably maybe a little exaggerated

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-3
00:10:16.099 --> 00:10:20.171
at 1.25. Nonetheless,
what we saw is an accurate representation.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-4
00:10:20.171 --> 00:10:25.120
And now what we see ourselves is we're
now a top quartile health system in the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/67-5
00:10:25.120 --> 00:10:25.997
United States.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/68-0
00:10:26.597 --> 00:10:29.127
Now,
I think that will capture the attention

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/68-1
00:10:29.127 --> 00:10:32.669
of a lot of our listeners.
I think everybody already knows the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/68-2
00:10:32.669 --> 00:10:35.312
answer,
but would you mind explaining what the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/68-3
00:10:35.312 --> 00:10:39.304
financial implications are to the
business of being in a top quartile?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/68-4
00:10:39.304 --> 00:10:40.597
Very brief, high level.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/71-0
00:10:39.877 --> 00:10:45.187
So what's interesting is the reason I'm
not going to do that is because we don't

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/71-1
00:10:45.187 --> 00:10:49.513
actually talk about that.
What we talk about in our health system

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/71-2
00:10:49.513 --> 00:10:53.773
is the quality of care and that and then
the patient experience.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/69-0
00:10:51.037 --> 00:10:51.517
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/71-3
00:10:53.773 --> 00:10:58.755
Now there is going to be financial
benefit to obviously documenting more in

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/71-4
00:10:58.755 --> 00:11:00.197
those kinds of things.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-0
00:11:00.437 --> 00:11:05.268
I will tell you that the back of the
napkin math is in the 10s of millions of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/70-0
00:11:00.557 --> 00:11:01.037
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/72-0
00:11:03.797 --> 00:11:04.397
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-1
00:11:05.268 --> 00:11:08.117
dollars,
like 40 to $80 million in additional

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-2
00:11:08.117 --> 00:11:12.453
revenue that goes out. Now,
what we actually get paid is a little bit

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/74-0
00:11:09.157 --> 00:11:09.717
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-3
00:11:12.453 --> 00:11:15.735
different.
And I don't want to go into the specifics

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-4
00:11:15.735 --> 00:11:20.256
because then it's kind of, hey,
how'd you get that arrangement with your

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/75-0
00:11:16.997 --> 00:11:17.877
Right, right, no.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/76-0
00:11:19.037 --> 00:11:19.317
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/77-5
00:11:20.256 --> 00:11:23.477
commercial payer? But the idea is,
is that at least

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/78-0
00:11:23.877 --> 00:11:27.877
We know it's been an uplift in terms of
the revenue in a large magnitude.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-0
00:11:28.197 --> 00:11:30.745
Right.
So basically what you're saying is you

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-1
00:11:30.745 --> 00:11:33.293
try to,
there's a bunch of programs to have a

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-2
00:11:33.293 --> 00:11:37.391
measurable clinical impact on more
closely integrating IT leadership with

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-3
00:11:37.391 --> 00:11:41.046
the rest of the business lines. So,
and there's financial impact,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-4
00:11:41.046 --> 00:11:44.536
there's improvement in patient experience
and quality of care.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-5
00:11:44.536 --> 00:11:47.028
So let's dive into exactly how to get
there.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/80-6
00:11:47.028 --> 00:11:51.237
Now that we're convinced that there's a
pathway to get where we want to go,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/79-0
00:11:50.037 --> 00:11:50.517
You.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-0
00:11:51.877 --> 00:11:54.356
You said, first of all,
about the meetings.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-1
00:11:54.356 --> 00:11:58.130
The meetings need to be early awareness
instead of late awareness.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-2
00:11:58.130 --> 00:12:02.355
I think our listeners may be interested.
How do you designate early, late?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/82-0
00:11:59.557 --> 00:11:59.597
Ohh.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-3
00:12:02.355 --> 00:12:06.073
And then more importantly,
once you designate and have a standard

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-4
00:12:06.073 --> 00:12:09.678
definition, how did you get,
how did you change those meetings?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/83-5
00:12:09.678 --> 00:12:10.917
A lot of times people,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/84-0
00:12:10.957 --> 00:12:14.074
They're just, how do you cancel meetings?
Everybody has too many meetings that they

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/84-1
00:12:14.074 --> 00:12:16.077
can't extricate themselves from.
How did you do that?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/86-0
00:12:17.397 --> 00:12:20.841
So I wanted everybody to do what I call a,
I said,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/85-0
00:12:17.717 --> 00:12:17.837
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/86-1
00:12:20.841 --> 00:12:25.973
let's do hygiene for your calendars.
Tell me what would happen if you don't

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/86-2
00:12:25.973 --> 00:12:30.363
show up to this meeting.
Explain to me what horrible event would

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/86-3
00:12:30.363 --> 00:12:35.157
happen if you don't come to this meeting.
And 90% of the time I got, I

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/88-0
00:12:35.317 --> 00:12:38.037
I, nothing. Correct.
Then why are you going?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/88-1
00:12:38.037 --> 00:12:42.691
I've always been going. Okay. Then I said,
where do you think you should be?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/88-2
00:12:42.691 --> 00:12:46.377
And they were very,
very articulate in why they should be at

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/88-3
00:12:46.377 --> 00:12:50.125
these other meetings.
They couldn't give me a good reason for

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/88-4
00:12:50.125 --> 00:12:54.597
staying at the meeting that they were
currently having on their calendar.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/87-0
00:12:53.557 --> 00:12:54.157
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/90-0
00:12:54.997 --> 00:13:00.233
The way we actually define it was early
awareness is simply IT is engaged before

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/90-1
00:13:00.233 --> 00:13:03.141
the strategy,
the decision is actually made.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/90-2
00:13:03.141 --> 00:13:08.506
You can't deshape it. On the other hand,
mid awareness is the direction is largely

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/90-3
00:13:08.506 --> 00:13:11.350
set.
They bring us in the end and then say,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/90-4
00:13:11.350 --> 00:13:13.677
hey, why don't you give this a look?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/93-0
00:13:14.197 --> 00:13:18.319
So there's at least something,
but all that does is it basically

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/89-0
00:13:14.437 --> 00:13:14.917
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/93-1
00:13:18.319 --> 00:13:22.884
preserves value, doesn't create any.
On the other hand, late awareness,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/91-0
00:13:20.317 --> 00:13:20.797
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/93-2
00:13:22.884 --> 00:13:27.577
there's a risk, a cost, rework,
all of that's done because we're woefully

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/93-3
00:13:27.577 --> 00:13:31.699
too late. And so I said,
let's categorize all our meetings along

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/92-0
00:13:27.997 --> 00:13:28.477
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/93-4
00:13:31.699 --> 00:13:33.157
those lines, because if

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/96-0
00:13:33.277 --> 00:13:37.699
Again, early awareness happens.
This is where advantage actually gets

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/96-1
00:13:37.699 --> 00:13:41.615
created if you're part of the strategy up
front. As an aside,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/96-2
00:13:41.615 --> 00:13:46.542
the way you take those meetings now and
then operationalize this to get great

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/96-3
00:13:46.542 --> 00:13:51.026
outcomes is those shared goals.
And I'm talking about incentive goals,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/94-0
00:13:47.037 --> 00:13:47.637
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/96-4
00:13:51.026 --> 00:13:52.037
not just a goal.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/95-0
00:13:51.117 --> 00:13:51.597
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/97-0
00:13:52.237 --> 00:13:57.708
Can you imagine your IT leader having the
exact incentive goal is your business

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/97-1
00:13:57.708 --> 00:14:02.016
owner, your chief medical officer,
your chief nursing officer.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/97-2
00:14:02.016 --> 00:14:06.804
Those are the kinds of people who have a
shared goal with, let's say,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/97-3
00:14:06.804 --> 00:14:11.317
our chief medical information officer or
our CNIO, or in my case,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/99-0
00:14:11.477 --> 00:14:16.225
I have shared goals with business owners.
So such that you definitely align,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/98-0
00:14:13.637 --> 00:14:14.197
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/99-1
00:14:16.225 --> 00:14:19.308
it's shared,
and the same person we all report to

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/99-2
00:14:19.308 --> 00:14:24.302
approves the goals to be cascaded amongst
two and three different people that we

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/99-3
00:14:24.302 --> 00:14:28.248
all share them together.
Suddenly you can unlock lots of things

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/99-4
00:14:28.248 --> 00:14:32.317
because you can't work in a silo.
It's not in your best interest.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-0
00:14:33.077 --> 00:14:36.707
So I think, I mean,
it makes a lot of sense from a common

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-1
00:14:36.707 --> 00:14:41.151
sense perspective, but obviously,
if this is something that is new and

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-2
00:14:41.151 --> 00:14:44.093
novel,
then it didn't make enough common sense

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-3
00:14:44.093 --> 00:14:48.098
for it to just already exist and not
require this intervention.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-4
00:14:48.098 --> 00:14:53.231
What have been some of the challenges to
getting a CFO and a COO on the same page

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/100-5
00:14:53.231 --> 00:14:54.357
as a CIO? Are they

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/101-0
00:14:54.597 --> 00:14:57.264
They're used to thinking about doing
something on their own,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/101-1
00:14:57.264 --> 00:15:00.237
maybe having more independence.
What kind of pushback is there? Oh,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/101-2
00:15:00.237 --> 00:15:03.779
if we involve it, it'll slow us down.
What kind of objections did you encounter,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/101-3
00:15:03.779 --> 00:15:05.877
and then how did you overcome those
objections?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/103-0
00:15:06.477 --> 00:15:09.697
Yeah,
so the strategy around that was knowing

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/103-1
00:15:09.697 --> 00:15:15.227
that I was not at the right table to
advocate for myself and then advocate for

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/103-2
00:15:15.227 --> 00:15:19.987
the colleagues that I represent.
And so the challenges that I first

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/102-0
00:15:17.237 --> 00:15:17.717
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/103-3
00:15:19.987 --> 00:15:23.977
overcame was IT is woefully too slow,
you take too long,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/103-4
00:15:23.977 --> 00:15:26.077
things never get done on time.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/105-0
00:15:26.197 --> 00:15:30.197
so on and so forth.
So what we did was I took three or four

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/105-1
00:15:30.197 --> 00:15:33.397
projects,
superimposed when everybody else knew

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/104-0
00:15:31.757 --> 00:15:32.237
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/105-2
00:15:33.397 --> 00:15:36.464
about all of it,
and when we were brought in.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/105-3
00:15:36.464 --> 00:15:40.197
And I said to them,
it's interesting that this 14-month

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/105-4
00:15:40.197 --> 00:15:43.797
project, all of you had 14 months,
and we were given.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-0
00:15:44.917 --> 00:15:48.801
four weeks. And I was just wondering,
why did everybody else get so much more

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/106-0
00:15:46.317 --> 00:15:46.917
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-1
00:15:48.801 --> 00:15:51.888
time to actually do this?
And you're telling me we're a major

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-2
00:15:51.888 --> 00:15:54.278
dependency and we had the least amount of
time.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-3
00:15:54.278 --> 00:15:58.261
And no one said a word and they looked at
me and said, wait, I got another one.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-4
00:15:58.261 --> 00:16:01.995
And I did the next project and then the
next project. And they said, well,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-5
00:16:01.995 --> 00:16:05.729
maybe you need to be right at the table
when we're making these decisions.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/107-6
00:16:05.729 --> 00:16:06.277
And I said,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/109-0
00:16:06.517 --> 00:16:10.460
Yes, I do. So they said, well,
why don't you start joining the COO

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/109-1
00:16:10.460 --> 00:16:15.168
council? I said, sounds good to me. Hey,
you should be a member of the board of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/109-2
00:16:15.168 --> 00:16:19.229
directors. Sounds good to me.
And so by educating them that, listen,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/108-0
00:16:16.997 --> 00:16:17.477
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/109-3
00:16:19.229 --> 00:16:24.113
I'm not throwing aspersions at everyone,
but if it's a 12-month project and you're

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/109-4
00:16:24.113 --> 00:16:26.997
giving me two weeks to do it and
everybody else,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/110-0
00:16:27.397 --> 00:16:30.882
gets 52 weeks,
how do you expect us to not do the same

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/110-1
00:16:30.882 --> 00:16:36.077
kind of quality and checks that you all
had because you were afforded a different

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/110-2
00:16:36.077 --> 00:16:39.942
level of opportunity?
And so educating people with cold hard

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/110-3
00:16:39.942 --> 00:16:44.186
facts and pictures work,
and you basically show them a picture of,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/110-4
00:16:44.186 --> 00:16:46.277
here's everybody else's timeline,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/111-0
00:16:46.477 --> 00:16:49.743
And you see that little thing at the end
there? That was our timeline.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/111-1
00:16:49.743 --> 00:16:52.917
And you're telling me we had the most
complicated part of all of us.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/112-0
00:16:53.237 --> 00:16:57.432
Was it difficult to do discovery on when
other C-suite executives first had

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/112-1
00:16:57.432 --> 00:17:01.737
knowledge about a project? I'm sure,
did you have to go through their admins?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/112-2
00:17:01.737 --> 00:17:05.877
How did you know about that if you
weren't, if you didn't know about that?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-0
00:17:06.037 --> 00:17:09.127
So I have good relationships with my
colleagues. I just said,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-1
00:17:09.127 --> 00:17:13.263
when did you get aware of this? He goes,
well, we started talking about this last,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-2
00:17:13.263 --> 00:17:16.901
I'm making this up, for instance,
last May. I'm like, oh, when was that?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/113-0
00:17:13.397 --> 00:17:13.797
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-3
00:17:16.901 --> 00:17:20.040
He goes, I don't know, first,
second week in May. Good enough.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/114-0
00:17:19.157 --> 00:17:19.477
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-4
00:17:20.040 --> 00:17:23.080
I found out about it in April,
the following year, not good.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/115-0
00:17:22.037 --> 00:17:22.197
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-5
00:17:23.080 --> 00:17:27.017
And so we had this discussion and he says,
that doesn't seem fair. I said, no.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/116-0
00:17:24.437 --> 00:17:24.997
Yeah.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/117-6
00:17:27.017 --> 00:17:29.957
He goes, you know,
you're a critical part of this. I said,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/119-0
00:17:30.077 --> 00:17:32.751
You don't say,
I have to look out for that.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/119-1
00:17:32.751 --> 00:17:36.641
And so I would, you know,
just have a good conversation with my

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/119-2
00:17:36.641 --> 00:17:40.956
colleagues. And at that point,
I think Epic also helped when we rolled

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/119-3
00:17:40.956 --> 00:17:44.845
out Epic and they saw just the value of
being on the front end.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/119-4
00:17:44.845 --> 00:17:48.917
I leaned into that and said,
now let's take Epic as a microcosm of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/118-0
00:17:44.877 --> 00:17:45.357
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/120-0
00:17:49.077 --> 00:17:51.397
all the things we do in this health
system.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/121-0
00:17:51.917 --> 00:17:55.552
So I think you've spoken a lot about
awareness transformation.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/121-1
00:17:55.552 --> 00:17:59.880
You spoke about getting on the same page
with these other executives. Now,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/121-2
00:17:59.880 --> 00:18:03.515
how do you align your goals in the IT
stack, the CIO vertical,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/121-3
00:18:03.515 --> 00:18:05.477
with the rest of the organization?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/122-0
00:18:06.277 --> 00:18:12.451
So the rest of the organization has a
strategic plan and strategic priorities.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/122-1
00:18:12.451 --> 00:18:15.968
What we did in our IT group is I said,
guys,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/122-2
00:18:15.968 --> 00:18:22.142
it's always going to be ever changing.
So let's simplify what we need to do as

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/122-3
00:18:22.142 --> 00:18:26.597
an IT team. So perhaps maybe, you know,
Jordan, another.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/125-0
00:18:26.757 --> 00:18:32.543
call maybe one day is how we organize the
strategic plan of IT into 4 words.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/123-0
00:18:30.797 --> 00:18:30.957
Mm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/125-1
00:18:32.543 --> 00:18:37.727
And those 4 words are real simple.
And we brought that back to them,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/125-2
00:18:37.727 --> 00:18:42.536
which was organizational enablement,
organizational resiliency,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/125-3
00:18:42.536 --> 00:18:48.397
and modernization was the other one.
And so I said, and then people, and then

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/124-0
00:18:45.117 --> 00:18:45.717
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-0
00:18:48.477 --> 00:18:51.552
customer experience.
And when you think about that,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-1
00:18:51.552 --> 00:18:54.686
everything we do lumps right into those
four things.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-2
00:18:54.686 --> 00:18:58.944
And so as they were getting facile of
what they were trying to do as an

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-3
00:18:58.944 --> 00:19:02.137
initiative,
we could become very organized because we

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-4
00:19:02.137 --> 00:19:06.987
had a very simple 4 words that we can,
or 4 themes that we can tuck you in under.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/126-0
00:19:05.437 --> 00:19:06.037
Mm-hmm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/127-5
00:19:06.987 --> 00:19:08.997
And that made us much more nimble.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/128-0
00:19:09.317 --> 00:19:12.602
The same thing is true as we brought back
what we wanted,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/128-1
00:19:12.602 --> 00:19:17.190
back to the board of directors or back to
the COO council or brought back to the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/128-2
00:19:17.190 --> 00:19:20.645
right C-suites to say,
here are the things we're thinking of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/128-3
00:19:20.645 --> 00:19:23.477
doing.
And then we did a reconciliation of those.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-0
00:19:23.957 --> 00:19:28.895
So in terms of defining incentive goals,
I think some of our listeners may be

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-1
00:19:28.895 --> 00:19:33.896
listening to this episode and thinking,
how do I replicate Rob's success at my

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-2
00:19:33.896 --> 00:19:36.871
IDN in the Midwest, the South,
the West Coast?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-3
00:19:36.871 --> 00:19:41.113
When you say incentive goals,
can you define them more clearly and

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-4
00:19:41.113 --> 00:19:44.404
concretely?
Because I'm sure there are many KPIs on

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/129-5
00:19:44.404 --> 00:19:45.797
everybody's dashboard.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/130-0
00:19:45.997 --> 00:19:49.317
Which incentives are you aligning?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/132-0
00:19:49.957 --> 00:19:55.444
So it could be something as simple as the
overall budget to the health system,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/132-1
00:19:55.444 --> 00:19:58.916
the overall budget, you know,
in your department.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/131-0
00:19:57.597 --> 00:19:58.197
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/132-2
00:19:58.916 --> 00:20:03.986
One of my shared goals with the CEO of
our medical group, as an example,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/132-3
00:20:03.986 --> 00:20:08.917
is to increase the referral footprint
with our joint venture partners.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/135-0
00:20:09.237 --> 00:20:14.640
increase the referrals within our own
group because we have friction in some of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/135-1
00:20:14.640 --> 00:20:18.625
the workflows. And by working together,
we would then say,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/133-0
00:20:15.717 --> 00:20:16.277
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/135-2
00:20:18.625 --> 00:20:22.677
we want to increase referrals by X.
And so that as the CEO,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/134-0
00:20:20.677 --> 00:20:21.157
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/135-3
00:20:22.677 --> 00:20:25.648
he's going to see that benefit.
As the CIO,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/135-4
00:20:25.648 --> 00:20:27.877
I'm going to enable that benefit.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-0
00:20:28.277 --> 00:20:32.860
And so we do those goals together.
Another one is looking at our labs,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-1
00:20:32.860 --> 00:20:36.604
our lab operator.
We were able to shave $5 million out of

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-2
00:20:36.604 --> 00:20:41.252
labs we just didn't need or we were
ordering them too frequently. Well,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-3
00:20:41.252 --> 00:20:44.673
the person who,
the vice president over our clinical

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-4
00:20:44.673 --> 00:20:49.579
service line was with the senior vice
president of the lab service line and

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/137-5
00:20:49.579 --> 00:20:49.837
both

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/139-0
00:20:49.917 --> 00:20:54.240
both of these ladies share that goal,
and both of them share the exact same

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/138-0
00:20:52.677 --> 00:20:53.277
Mm-hmm.

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00:20:54.240 --> 00:20:58.222
goal for their incentive program.
So it's those kinds of things where

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00:20:58.222 --> 00:21:02.659
they're trying to do an efficiency that
they're doing on the front end or the

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00:21:02.659 --> 00:21:06.356
workflow, but in the end,
you can't do anything unless it's been

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/139-4
00:21:06.356 --> 00:21:08.916
built, enabled,
and tested in the IT system,

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00:21:08.916 --> 00:21:11.077
whatever that system may happen to be.

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00:21:11.637 --> 00:21:14.894
So we're approaching the end of this
podcast episode,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/140-1
00:21:14.894 --> 00:21:19.416
and there's still one more important
bookend part that we need to address.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/140-2
00:21:19.416 --> 00:21:23.035
So we've addressed,
we started with the measurable clinical

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/140-3
00:21:23.035 --> 00:21:25.869
impact,
talked about awareness transformation,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/140-4
00:21:25.869 --> 00:21:28.583
aligning incentives,
executive shared goals.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/140-5
00:21:28.583 --> 00:21:31.477
We spoke a little bit about the strategic
plan,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/142-0
00:21:31.597 --> 00:21:34.597
and strategy,
making sure that you're at the right

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/142-1
00:21:34.597 --> 00:21:39.420
table at the right time and getting out
of meetings you're not supposed to be on.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/142-2
00:21:39.420 --> 00:21:43.478
Now we're at the end of this journey.
We've implemented all of these

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/142-3
00:21:43.478 --> 00:21:47.360
interventions where you're driving the
mortality index down to.6,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/142-4
00:21:47.360 --> 00:21:51.477
meaning 40% better than expected when
they presented at the hospital.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/143-0
00:21:52.597 --> 00:21:56.280
you know,
thoughts on where you are now and exactly

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/143-1
00:21:56.280 --> 00:22:01.520
how aligning all these incentives,
perhaps with one quick little anecdote

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/143-2
00:22:01.520 --> 00:22:05.557
about how you,
how do these changes led to that.6 score?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-0
00:22:06.597 --> 00:22:09.864
So these changes,
and so I don't want it to seem like IT

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-1
00:22:09.864 --> 00:22:13.588
drove this whole thing.
IT was just one of those groups that did

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/144-0
00:22:11.957 --> 00:22:12.437
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-2
00:22:13.588 --> 00:22:18.173
this together. However, having said that,
if I just enabled something in IT and

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/145-0
00:22:15.677 --> 00:22:16.157
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-3
00:22:18.173 --> 00:22:22.299
nothing changed on the clinical side,
maybe the numbers would have been

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-4
00:22:22.299 --> 00:22:25.450
marginally better.
If the clinical team did something,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/146-0
00:22:24.197 --> 00:22:24.757
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-5
00:22:25.450 --> 00:22:28.602
but we didn't enable things on the
documentation side,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/147-6
00:22:28.602 --> 00:22:30.837
maybe it would drove marginally better.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/150-0
00:22:31.037 --> 00:22:33.962
What this is,
is we think of this as a shared

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/150-1
00:22:33.962 --> 00:22:36.824
responsibility and that everybody owns
this.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/150-2
00:22:36.824 --> 00:22:41.783
One of the great things about the health
system is in the last several years,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/150-3
00:22:41.783 --> 00:22:46.934
everybody in the C-suite has a cadre of
about 9 goals that are pre-prescribed to

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/148-0
00:22:42.517 --> 00:22:42.997
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/150-4
00:22:46.934 --> 00:22:51.067
us that we all have to get behind.
And one of them is mortality.

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00:22:51.067 --> 00:22:54.437
So everybody who has a C in front of his
or her name

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/149-0
00:22:54.517 --> 00:22:54.997
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/152-0
00:22:54.717 --> 00:22:59.935
has the exact same goal of mortality.
So we all share that as one large group

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/152-1
00:22:59.935 --> 00:23:05.153
because this one clearly takes a village.
And so what we did is help expedite

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/151-0
00:23:03.837 --> 00:23:04.317
Mhm.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/152-2
00:23:05.153 --> 00:23:10.037
things from a technology standpoint,
but everybody leaned in to do this.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/154-0
00:23:10.437 --> 00:23:13.745
Yeah,
you can't improve what you can't measure.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/154-1
00:23:13.745 --> 00:23:19.120
You got to measure and an incentive
drives behavior and leadership drives the

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/153-0
00:23:13.837 --> 00:23:14.517
Black.

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00:23:19.120 --> 00:23:23.600
behavior of their team.
So I really do appreciate your time with

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/154-3
00:23:23.600 --> 00:23:28.837
us today, Rob. Any final parting words,
perhaps to yourself, two years ago,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/155-0
00:23:29.077 --> 00:23:33.534
After our first podcast,
but before you started implementing all

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/155-1
00:23:33.534 --> 00:23:37.374
of these changes,
any kind of suggestions to a Rob from

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/155-2
00:23:37.374 --> 00:23:37.717
2024?

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/156-0
00:23:39.077 --> 00:23:43.915
So you have a lot of ideas and always
make sure you have patience because

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/156-1
00:23:43.915 --> 00:23:49.080
whatever you do in a large group like
this is going to take time and you can't

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/156-2
00:23:49.080 --> 00:23:53.461
measure it on a daily basis.
You have to make sure you do check in

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/156-3
00:23:53.461 --> 00:23:56.664
periodically,
but just know that there's a great

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/156-4
00:23:56.664 --> 00:23:58.037
expression that says,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/157-0
00:23:58.357 --> 00:24:02.736
10 pounds of constant pressure will
eventually move the Queen Mary.

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/157-1
00:24:02.736 --> 00:24:06.729
And so the idea is it has to be constant,
always be vigilant,

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/157-2
00:24:06.729 --> 00:24:11.881
but always make sure you have the level
of patience to watch things mature over

03a288f4-0e71-4ea1-8d3e-5978f1adafe5/157-3
00:24:11.881 --> 00:24:13.877
time and don't get discouraged.