Episode 31 : Redefining Healthcare IT Leadership in a Digital Age

SFTS-Russell Branzell: Audio automatically transcribed by Sonix

SFTS-Russell Branzell: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Intro/Outro:
Welcome to Smart From The Start, presented by Care.ai, the Smart Care Facility Platform company and leader in AI and ambient intelligence for healthcare. Join Steve Lieber, former CEO of HIMSS, as he interviews the brightest minds in the health provider space on truly transformative technologies that are modernizing healthcare.

Steve Lieber:
Hello, and welcome to Smart From The Start. I'm your host, Steve Lieber, and it's my pleasure to bring to you a series of conversations with some of the sharpest minds in health information technology. We'll discuss the smart directions healthcare companies and providers are pursuing to create Smart Care team. Today, I'm joined by a long-time friend and colleague, Russ Branzell, for a lot of our audience. Russ, you know, they may know who we are and what some of our shared past is, but I'll give a little more intro because there are a few people out there that'll be new to our world. Russ is the CEO and president of CHIME and has been since 2013, and Russ and I overlap during the last four years of my time as a CEO at HIMSS. Russ also is past previously CEO at the Colorado Health Medical Group, former CIO, and also a retired United States Air Force officer. So Russ, welcome and it's great to see you.

Russell Branzell:
Well, Steve, it's a pleasure to see you and a pleasure to be on your program. Thanks for having me.

Steve Lieber:
You bet. For our audience, Russ and I actually have shared the stage literally around the world. We have had some great times during the period we overlapped between HIMSS and CHIME, and in fact, I refer to it. Russ, I don't know that I've ever said it in front of you as kind of the golden age and the relationship between HIMSS and CHIME, and I really do treasure the years that we had where we collaborated. And that's where I want to go with. My first question is talking about CHIME because I did, I developed a very strong respect for CHIME and what you've done there and the culture, not only of the staff, because also, in full disclosure, I've done some work for Russ since I retired from HIMSS. And so, you know, you've got a great connection between CHIME and the CIOs. And it's like, how have you been able to do that? I mean, it's the gold standard of what associations seek to achieve.

Russell Branzell:
Yeah, I'd love to take credit for that. But I'll give a little bit of credit or a lot of credit to the forefathers, and I guess it would be for mothers as well. That really started intentionally, something different. There's places in our industry for all kinds of different associations and trade shows and those kinds of things. But I know a person you know very well, John Glasser, the first chair of CHIME, a mentor of mine for I don't know how many years, probably 17 years, was a mentor of mine. He had an idea for something different, along with some of his peers, and that was a place that could become a trusted relational environment, a place where we could come cry on each other's shoulders when we needed to vent when we needed to, but also find a way to build each other up. And I think those seeds of thought and success planted now 32 years ago were right on spot. And I think we've never lost that as we've grown and changed some of the, in there a long time ago. People don't like the loss of some of the things that may have started back then, but all change occurs, and most of it probably occurs for good. But I think what's really interesting is there is still a massive desire, especially now in these eras of digital health, where things become virtual, and we're doing events like this where we're just on a computer screen with each other. There still is a desire for close relational contact, and that doesn't always mean in person, but it also means it has to still be significant and meaningful. And the things that we do to take care of each other in this life during some really hard jobs and some really tough situations in organizations like battling through COVID wasn't just to deal with the situation, but rather to help the people through the process. And I think that's what's always been special about this organization and will be special long after I'm gone. And that is it always ends up being about the people in the family, and we intentionally refer to it that way. The family that takes care of each other.

Steve Lieber:
Yeah, and I can attest that culture extends through the staff, or as you prefer to call it, the team that works for CHIME. That same sort of feeling of family very much exists, uh, at that level as well. You were a member of CHIME for a long time before you became the CEO. You've seen a lot of your former CIO yourself. What are you seeing in the healthcare executive today? What do they have to do differently? Or what are they doing differently? Or who are they that's different? What's different in terms of that world today?

Russell Branzell:
Yeah, it's interesting because you even used the term at the beginning, the roles of the CIO. And I almost don't even use that term anymore because there's so many other titles. And this concept of being a digital health leader really expands way beyond. And sure, there's plenty of stills that have the title CIO and still do the traditional job, but there's chief digital officers and chief data officers and chief analytics officers, and all these really revolve around this concept that we're living in a world of digitization, that things that were built for the last 30 years are now coming to fruition, and we are now leading in a different way. I said it silly as I personally had my own little medical situation recently, and I was watching as I was inside one of the local hospitals in Georgia and I watched and went, you know what? We have digital housekeeping now and we have digital admittance cards. And we have, you know what? Everything in this hospital is digital. And they don't realize they are, but the revolution's actually occurred and they do their jobs differently. I mean, housekeeping, literally walking around with an iPad so they know which room to go to the fastest. And their whole workflow is mapped, and they can order their supplies to wait for them to the next room. An amazing conversation with a housekeeper. When I was a CIO, I would have never had a conversation with a housekeeper about how to use electronic workflow documents and ordering their supplies to be waiting for them when they get to the next room. It would have been about are you happy here or do you have good benefits? That kind of stuff. It would have never been about digital workflow, and I think what we're seeing now is even if they have the title of CIO, they've become the master digital architect and workflow specialist for their organization, and they know just about everything that's going on in an organization. They created the digital blueprint for these organizations, and now they have to manage to that digital blueprint and help these organizations become something different than they've traditionally been. That is an amazing amount of pressure on these people. They have become the stress-based change agents and organizations that I don't think I had to do. I had to figure out how to implement technology and put EMRs in and all those other kinds of things. I didn't have to figure out how to get an organization to act and look differently to the consumer-facing front.

Steve Lieber:
So, is that going to play out differently in CHIME? Is this an indication that CHIME needs to think about more than the CIO, or are you already?

Russell Branzell:
We already are. If you look at the CHIME logo on it, it doesn't say CIO anywhere on it. Matter of fact, here's where I give again our founders credit. Never once in the years of CHIME, even when I was a CIO, never once was a vision or a mission statement. Ever used the word CIO or technology? And we went back and looked as far back as we could. Never once did it say a group of CIOs. It just said leaders managing these things. And I think that's the reality of where we are now. Yes, a certain percentage of our membership have the title or had the title CIOs, but we have a whole lot of other people now. The other difference was when I was a CIO, I was the CIO, and then we had people that worked for me. Today, CIOs have people work for them. The difference is those people are executives now. They're CTOs and CISOs and CIOs and CTOs or whatever the title is, and these people are seasoned professionals. It's the C-suite of the CIO or the chief digital officer, whatever the title might be, they're six, seven, eight people that operate at the same level I did 15 years ago inside an organization. And some organizations, organizations say as big as, say, Crysta's. It might be 100 people where they used to have one member that was probably eligible for CHIME membership. Now, maybe it's 20, or 30, or 40, or 100 because they are digital leaders, and they need the environment to grow, foster, and network across the globe.

Steve Lieber:
What I'm hearing is increased complexity, more significant broader scope of responsibility, bigger challenges, a lot of things that both are challenges as well as opportunities. Over the past few years, we've seen a few fairly notable chief information executives, regardless of title, move out of the provider setting and move into companies. Is this any different? Is this a trend that's always played out, or are we seeing more of it now? What's going on within the provider end of the profession?

Russell Branzell:
Yeah, I think we're seeing a couple of things emerging. And, you know, we used to use somewhat rhetorically, but sometimes also seriously, we used to call it the light side and the dark side. Oh, they left the CIO world and went to the vendor world. I've never liked those terms, but I also don't like other terms at all. But I'm starting to see that as a very natural way that it would occur. People are leaving positions and transitioning, not because they just want to leave this job and go do something else. They're doing it because they need to understand that world to be successful in their jobs, and I think that's much different. We have 2 or 3 very notable, very seasoned digital health leaders in very large, very successful organizations. No one would have ever dreamt they were going to leave, and they leave to go become the head of healthcare of a major corporation. And you talk to them a year or two later and go. This learning curve was straight up. It was like the first day you were a CIO again because you're learning a whole new world. You're learning the business of healthcare, and we often don't learn the business of healthcare inside a health system. We learn healthcare inside the health system, not the business of healthcare, and I think that's a great learning experience for people. I'm doing a mentoring session tomorrow with a person who's been left. The CIO role has been on the vendor side for a few years, and now wants to know what's next. And I think that's the other change is right or wrong, depending on your perspective in generational shift, and you and I are a little bit of the older generation. Admittedly, next-generation leaders coming up, we're going to see them change jobs a lot, probably three and done, three and done, three and done. Why not? Because they're not loyal. They want a new experience and a new challenge, and I think we're going to see it.

Steve Lieber:
You know, you're crossing year 11 or 12 in this role. I was at HIMSS for almost 18. Those are numbers that are far more likely to be seen in the future with this group. And I think you make a great point there. It's the experience they're looking for. And it's not a matter of, I'm unhappy with this organization or disloyal, but it's the experience and the opportunity to broaden your horizons and experiences. Absolutely. You mentioned the business of healthcare, and reading an article recently out of Becker's, talked about the trend, which is not particularly new, of small independent hospitals being brought into large systems. And I ran the numbers, and using AHA numbers and Becker numbers, I come up with the ten largest healthcare systems, own or operate nearly 20% of all US hospitals. Does that have any meaning? Does that have any indication of what is going to happen in healthcare, or is it just a statistic?

Russell Branzell:
Well, there's always been at least a spotlight on mergers and acquisitions and what that can do. And you remember the days of the old Columbia before it was AHA, and they'd buy a bunch, and then they would sell a bunch, and they would buy a bunch, and they would sell a bunch, and they'd go, hey, we want to be in the X market, and they go, no, we don't get rid of them as fast as you can. So, I don't think this is a new phenomenon. I think what is new is there was at least a perspective or a perception that you needed to be a certain size from a financial to be able to bond and all the other kind of things. From a money perspective, you needed to be at $5 billion or $2 billion, but I'm not sure that's still as accurate as it was. You could do it through affiliations and partnerships. We've got a person on our board comes from a very successful single hospital, small system, and they're doing just fine, and they don't have any desire to join up with anybody. But you are seeing organizations figure out how big they want to be and how they want to compete, but you're also seeing the government getting a lot stricter about market consolidation. They don't want you buying your competitor across the street. It's okay to move out into a new market, but don't buy all your competitors in. Just pick an example, the general Atlanta area. So, what are we going to see in the future for mergers and acquisitions? I think we're going to see big systems continue to get bigger. I think we're going to see the critical access in the world find a way to partner better, but they're still going to want to stay critical access and worlds. And that's not the business of these big systems and these big academics. Those require an amazing amount of resources and focus that they're probably not going to want to be in that business, or at least that level of complexity of working in those smaller markets because it's just not the margin and the effort there for them to do that. So yes, it's an impact. We've seen it a little less as the government's tightened their screws down a little bit recently on some of these mergers and acquisitions and denying them, but we're also seeing maybe a little bit more geographical dispersion with these large systems where maybe they're mostly had been in the southeast. Now they're going to look at the Midwest or the West or the North and say, I'm not allowed to grow in my market, but I can grow geographically across the country.

Steve Lieber:
Yeah, CHIME does boot camp, and so you got an insight in terms of the developing professional along not only boot camps but other certifications and programs. Are you seeing a different kind of person coming into these roles, and is it related to the changing business of healthcare, or what are you seeing in terms of the professional and him or herself?

Russell Branzell:
Well, this was kind of like when I would look around when I was in the military, and I'd go, why is everybody so young? And I feel so old because they are so young, and I am that old, and I'm starting to realize that they're not getting younger. I'm getting older. What I do see is a different breed of person. And I don't say that to ever disparage the people that came along with me and the people that came before me. These are young, hungry leaders and professionals who are very, very articulate, sharp, and intelligent in a much earlier age. These are people getting their first CIO gigs in their 30s and 40s, where the average age of getting your first job was maybe in your late 40s, but usually in your 50s. That comes with both some pressure because they're learning jobs before, maybe they've gotten all the scars of life in business world, but it also does the other thing, they're doing things at an age that is not normal for a business leader, historically. Example, they're still raising young kids. They're still in an early stage in their family's life. They're having to get these jobs by moving a lot. What's weird is it's almost like where I was an officer in the military, where you're moving every 24 or 36 months and you've got kids. You're trying to balance that stuff. It's kind of the same lifestyle for them. They're living a different world than they ever have, but the technology is not emerging anymore to the same pace it was for the 20 years or so that I did that job, where something new was popping up every single day, and the systems were changing so fast, like EMRs. What we're seeing now is these people are trying to figure out how to do healthcare different, not put systems in.

Steve Lieber:
Yeah, let's pick up on that thought because we are seeing I think you're absolutely right. We are seeing how people are doing healthcare differently. You talked earlier about everything from housekeeping through surgery is all digital and that sort. And so, as we kind of look at what's emerging now in the topic of conversation that's coming up most often is virtual care, artificial intelligence, the merging of the two using AI within through multiple other applications. We are at some point on that infamous Gartner hype cycle. What's your read in terms of what you're hearing in the field about how people are feeling about the emergence of machine-assisted healthcare is what I'll call it now versus falling back on the AI term. But clearly, you know, there is a movement here where clinicians are gaining new points of reference and input in their clinical decision-making from machine learning.

Russell Branzell:
So part of this is a little bit like the past. I remember when the internet was the cool new thing. And what are we going to do with this internet thing and how will that affect healthcare? And it was a thing. It wasn't just the way we did business. And so I think what we're going to see is a natural maturation similar to that. I do think there's one fundamental difference. I think when you saw the internet, it was just piece and parcel to the information age. I think what we're seeing now is a fundamental economic shift in our economic revolutions. We're moving out of the information age, and most economists talk about this now, into a whole new era of business. It will be, for lack of better term, the AI age, where it's not just how do we figure out how to better to have people answer phones or we use a little bit of care management, it does a little bit of predictive modeling for re-admittance or in the hospital for sepsis. Those are all amazing and great things. I think we're barely scratching the surface. If you look at the world of all of it converging: robotics, AI, software, self-learning, all this stuff together. Fundamental way we live will change. No different than we went from the basics of a cottage industry to having steam power, to having the information age and mass production, all these kinds of things; we're going to see the next major change. You and I just happen to be, our careers are kind of ending at the end of the information age and the beginning of the others, but you and I don't remember when the information age started, but just was there sometime, and they didn't call it the Information age for decades. Well, we're in a new economic revolution. We just don't know it, just like we didn't know it back then. And so I think things are going to fundamentally and significantly change. I mean, there's I'll give you a short example as I finish this answer up. There's so many people going out there saying, you know what, jobs aren't going to disappear because of AI, and my answer is baloney. Tons of jobs are going to disappear. Jobs are disappearing today. Well, no AI is going to replace a doctor. Yes, it will. It's just a matter of time. There are tasks today that are doctor does. They don't need to do anymore because I can do it better, faster, with better results at some point. Guess what? The doctor's going to completely lose their job because of advanced technology. A nurse is going to completely change. Why do we need that? Because we have a shrinking work population like we've never seen in the history of humanity, and we need jobs to disappear, and we're going to have to do it at a pace that none of us understand. The labor statistics that came out Friday, maybe it was yesterday. Unexpected job growth of 280,000 jobs, with an unexpected exit to retirement of 420,000 jobs. No one on the TV talked about that. That's net negative. That means there was a whole lot of people no longer doing jobs. Your most experienced, seasoned workers. And they're people like you, Steve, who are boomers, who were I always use this term. It sounds derogatory, but I say we were dumb enough as boomers to work 18-hour days, six days, seven days a week. The next generations aren't going to do that. So they got to find two workers to replace the Steve. It's wrong. We have to fundamentally, economically change the way business is conducted.

Steve Lieber:
Yeah, total agreement with you there. And yeah, jobs are going to disappear. They're also going to be some that are replaced with something that doesn't even exist today in terms of people that are leveraging technology tools and resources that are being developed. Just a little tease to our audience, I'm working with Russ's team on the development of a model that is going to assess how facilities are adopting these technologies that, as Russ said, literally are changing the way healthcare is being delivered, and so more to come on that for sure. And thank you, Russ, for lending CHIME support and your team to that effort. So in wrapping up, Russ, we want to speak to the folks we know best. So, you know, the CIOs, the CDOs, the CMIO, CNIOs and all their the folks that typically tune in. What's the Russ Branzell best piece of advice? Best insight? The takeaway from today's conversation that you'd like to pass on?

Russell Branzell:
Well, I think this goes back to the golden rule, and it's the golden rule of health. It. And we can get enamored with the shiny things and the technology and the buildings and the process. Healthcare is a human business, and it sounds weird to talk about it, from a tech association. You ran a tech association. The success of those organizations were never about the show. They were never about the whatever we were doing. It was about relationships. And we live in a world where people crave meaningful relationships. And I think that's true as much as ever in a patient care environment, despite the technology, it's just as much with the technology organizations out there and the vendor community, the people that succeed both business. But also, I'd say there's another way of judging success in life are the people that put people first and then figure out the rest of it, and I think people are desirous of that more than they've ever been. It's, we're what, three years post-COVID? And I don't think we've gotten back to being humans like we were before. I hope we can, but I think if we can do that and if we can put the human beings back in healthcare and use technology to take some burden and stress off people, we've got a chance to fix a pretty broken system in a meaningful way. And that's not just a US problem. That is a global problem. You traveled the world. I've traveled the world. There's nothing unique about the United States. It's nothing unique because our payment system and we're fee-for-service, you can go to the most socialized medicine place in the world. They got the exact same problems we got. So that does tell you that we got a chance to fix a global problem, and I think we're going to do it.

Steve Lieber:
Early in this conversation, you attributed CHIME's success and its culture of relationships to the forefathers and mothers of CHIME, but you epitomize it. You are the master of the relationship, and you have certainly furthered the organization. And certainly, I really treasure and honor the opportunity to call you friend and colleague, and I certainly do appreciate you being with us today.

Russell Branzell:
Well, thank you, Steve. You've been all of those things and a great mentor to me for my life. So, I will always be in your debt.

Steve Lieber:
Great, thank you. And to our listeners, thank you for joining us. I hope this series helps you make healthcare smarter and move at the speed of tech. Be well.

Intro/Outro:
Thanks for listening to Smart From The Start. For best practices in AI, in ambient intelligence, and ways your organization can help lead the era of smart hospitals, visit us at SmartHospital.AI, and for information on the leading Smart Care Facility Platform, visit Care.ai.

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