1 00:00:00,245 --> 00:00:02,615 - This is Laura Dedo with the Becker's Healthcare Podcast. 2 00:00:03,195 --> 00:00:05,295 I'm thrilled today to be joined by Chris Bergman, 3 00:00:05,765 --> 00:00:07,495 vice President and Chief Financial Officer 4 00:00:07,495 --> 00:00:08,695 at Dayton Children's Hospital. 5 00:00:08,785 --> 00:00:10,815 Chris, it's a pleasure to have you on the podcast today. 6 00:00:11,885 --> 00:00:13,385 - Thanks, Laura. Thanks for having me. 7 00:00:14,045 --> 00:00:15,545 - Now, I'm looking forward to our discussion 8 00:00:15,545 --> 00:00:17,545 because I know there's so much happening in healthcare right 9 00:00:17,545 --> 00:00:19,185 now, and particularly learning more about 10 00:00:19,185 --> 00:00:20,945 what you're doing at Dayton Children's 11 00:00:20,945 --> 00:00:21,985 and really tackling some 12 00:00:21,985 --> 00:00:23,865 of the challenges in healthcare today 13 00:00:23,885 --> 00:00:27,065 and in some, you know, for all healthcare institutions 14 00:00:27,065 --> 00:00:29,665 and some particularly for, um, children's health. 15 00:00:29,725 --> 00:00:30,905 But before we dive into that, 16 00:00:30,965 --> 00:00:32,065 can you tell us a little bit more 17 00:00:32,065 --> 00:00:33,305 about yourself and your background? 18 00:00:35,005 --> 00:00:37,145 - Uh, sure, Laura, let me, I'll talk a little bit about, uh, 19 00:00:37,245 --> 00:00:39,785 my professional background, just a little bit about, um, 20 00:00:39,865 --> 00:00:43,895 me personally, but I have been in, uh, healthcare finance 21 00:00:44,075 --> 00:00:46,335 for over 40 years, uh, with a, 22 00:00:46,495 --> 00:00:49,415 a long public accounting background at Ernst 23 00:00:49,415 --> 00:00:51,575 and Young, uh, when I left there. 24 00:00:51,875 --> 00:00:53,815 And then, uh, 20 years in 25 00:00:54,205 --> 00:00:56,495 what I would call medium-sized adult systems. 26 00:00:56,915 --> 00:00:59,895 Uh, I spent a little time in Colorado, was in the first, um, 27 00:01:00,385 --> 00:01:02,775 joint operating agreement out there when those were the big 28 00:01:02,775 --> 00:01:03,935 deal in the mid nineties. 29 00:01:04,315 --> 00:01:07,935 Um, uh, so journey with that organization for 10 years, 30 00:01:07,995 --> 00:01:09,815 and then a little bit of time in Michigan and, 31 00:01:10,115 --> 00:01:11,335 and now down in Ohio 32 00:01:11,515 --> 00:01:13,735 and kind of spending a lot of that time in the adult, 33 00:01:14,505 --> 00:01:15,535 adult hospital world. 34 00:01:15,555 --> 00:01:18,735 And about eight, a little over eight years ago, um, jumped, 35 00:01:19,355 --> 00:01:22,095 uh, into the pediatric scene at Dayton Children's. 36 00:01:22,275 --> 00:01:24,975 And it's been, uh, you know, again, I, I felt like for me 37 00:01:26,135 --> 00:01:30,185 that medium, smaller size organization is a really good fit 38 00:01:30,245 --> 00:01:32,305 for kind of my personality and, 39 00:01:32,305 --> 00:01:35,945 and my skillset, um, as opposed to the larger, 40 00:01:36,205 --> 00:01:37,385 larger organization. 41 00:01:37,525 --> 00:01:39,625 So that's kind of professionally, personally, 42 00:01:40,135 --> 00:01:44,305 just one thing nugget about me is that, um, um, you know, 43 00:01:44,405 --> 00:01:45,945 God willing, in about a year, I'll, 44 00:01:46,135 --> 00:01:48,345 I'll be ordained in the Catholic church as a deacon. 45 00:01:48,405 --> 00:01:50,985 So I've been on a, on a faith journey for a period of time 46 00:01:51,085 --> 00:01:53,825 and about ready to, uh, take the next step. 47 00:01:53,965 --> 00:01:55,785 So that's a little bit about me personally. 48 00:01:56,845 --> 00:01:59,545 - Oh, wow. Congratulations. That's a huge accomplishment. 49 00:01:59,565 --> 00:02:03,065 And certainly as you mentioned, something that, um, is 50 00:02:03,065 --> 00:02:06,025 so important and really a pillar of the community as well. 51 00:02:06,165 --> 00:02:09,145 Uh, I can imagine. Um, it's been, like you said, a journey, 52 00:02:09,205 --> 00:02:11,305 but, um, such a, a rewarding one too. 53 00:02:12,745 --> 00:02:16,005 - It hasn't, it hasn't been a great, uh, rewarding journey, 54 00:02:16,265 --> 00:02:17,325 um, all the way along. 55 00:02:17,345 --> 00:02:19,645 Got, uh, 16 other guys and journeying with, 56 00:02:19,665 --> 00:02:21,605 and it's been just a phenomenal experience. 57 00:02:22,345 --> 00:02:24,645 - Oh, that's amazing. Well, congratulations again, 58 00:02:24,705 --> 00:02:26,845 and definitely, um, a lot to look forward 59 00:02:26,845 --> 00:02:28,085 to in the next, this next year. 60 00:02:28,145 --> 00:02:32,285 And, you know, too, um, from your vantage point as CFO 61 00:02:32,285 --> 00:02:34,525 of Dayton Children's, what are some of the biggest issues 62 00:02:34,525 --> 00:02:36,085 that you're following in healthcare right now? 63 00:02:38,175 --> 00:02:39,425 - Well, there's, there's a couple. 64 00:02:39,425 --> 00:02:40,745 There's the ones that are unique 65 00:02:40,745 --> 00:02:42,145 to the, the, the kids' world. 66 00:02:42,145 --> 00:02:43,905 And the one I'm gonna talk about a little bit is 67 00:02:43,905 --> 00:02:44,945 pediatric mental health. 68 00:02:45,485 --> 00:02:48,785 Um, you know, pre covid we're starting to see more 69 00:02:48,785 --> 00:02:51,905 and more kids need, uh, behavioral health services, 70 00:02:52,725 --> 00:02:55,065 and Covid kind of really took it into, like, 71 00:02:55,295 --> 00:02:57,065 made it go orbital on us. 72 00:02:57,365 --> 00:03:01,085 Um, we've had a, we've seen an explosive need 73 00:03:01,225 --> 00:03:03,165 for mental health services for our kids. 74 00:03:03,425 --> 00:03:06,405 And, uh, I like to say that, that if you, 75 00:03:07,105 --> 00:03:08,725 if you know a kid in middle school, 76 00:03:09,385 --> 00:03:10,805 if you know five kids in middle school, 77 00:03:10,805 --> 00:03:12,405 you've probably known one kid who's put 78 00:03:12,525 --> 00:03:13,605 together a suicide pact. 79 00:03:13,865 --> 00:03:17,965 And, uh, our, our highest admitting diagnosis in 80 00:03:17,985 --> 00:03:21,365 2023 was suicide ideation at the hospital. 81 00:03:21,505 --> 00:03:22,565 And, and we're not unique 82 00:03:22,585 --> 00:03:24,005 to the other hospitals in the country, 83 00:03:24,015 --> 00:03:25,365 other children's hospitals in the country. 84 00:03:25,505 --> 00:03:29,525 So that one's a very big issue for us. 85 00:03:30,465 --> 00:03:33,885 And it's pretty underfunded in terms of, I mean, 86 00:03:34,265 --> 00:03:37,565 Ohio's doing a yeoman's job to try to put money into it, 87 00:03:37,635 --> 00:03:40,565 understanding the, the need and, and, 88 00:03:40,705 --> 00:03:41,925 and the need to fund it. 89 00:03:41,985 --> 00:03:43,925 But it's still largely an underfunded service. 90 00:03:44,065 --> 00:03:47,125 So when you think about my biggest growth opportunity over 91 00:03:47,125 --> 00:03:48,725 the next five years in a service 92 00:03:48,835 --> 00:03:52,005 that pays me a lot less than most of my other services do. 93 00:03:52,025 --> 00:03:56,125 So that's, that's a challenge for us uniquely with the, uh, 94 00:03:56,125 --> 00:03:57,445 of the children's side of things. 95 00:03:57,545 --> 00:04:00,365 And I think that we also track in, in general, 96 00:04:00,395 --> 00:04:01,925 like most hospitals do, 97 00:04:01,925 --> 00:04:06,325 the whole labor workforce challenges we have, um, just the, 98 00:04:06,705 --> 00:04:10,545 um, the, the work, um, the work, 99 00:04:11,105 --> 00:04:12,545 I don't know if I'd call it the work ethic. 100 00:04:12,605 --> 00:04:14,585 The work code of people today are different. 101 00:04:15,325 --> 00:04:16,305 Not saying that's right, wrong 102 00:04:16,305 --> 00:04:17,425 or different, they're just different. 103 00:04:17,485 --> 00:04:20,545 So trying to find that, that nice medium understanding 104 00:04:20,545 --> 00:04:21,585 that people aren't in it 105 00:04:21,585 --> 00:04:22,865 for the same reasons they were in it 106 00:04:22,865 --> 00:04:25,345 before, uh, the, the, um, 107 00:04:25,975 --> 00:04:29,745 that Gen Z is different than the baby boomers, et cetera. 108 00:04:29,845 --> 00:04:31,865 So you're just trying to find that balance to 109 00:04:32,205 --> 00:04:35,225 how do I engage everybody across the spectrum and, 110 00:04:35,405 --> 00:04:37,185 and also looking to see how do we, you know, 111 00:04:37,185 --> 00:04:38,905 if there's a shortage out there, how do we change 112 00:04:38,965 --> 00:04:39,985 how we do work so 113 00:04:39,985 --> 00:04:42,465 that we make sure we have the right people in the right 114 00:04:42,465 --> 00:04:43,465 place at the right time? 115 00:04:43,685 --> 00:04:45,425 So that's the second one. 116 00:04:45,425 --> 00:04:47,145 The third one kind, honestly, has been in the headlines. 117 00:04:47,445 --> 00:04:50,465 The whole cyber thing has been big, um, 118 00:04:51,535 --> 00:04:53,785 even pre covid we've been building, uh, 119 00:04:53,875 --> 00:04:57,825 cyber capabilities at, at our place, uh, in terms of trying 120 00:04:57,825 --> 00:05:00,225 to keep attacks out, ransomware, et cetera. 121 00:05:00,285 --> 00:05:02,785 And just, you know, you got this whole change healthcare 122 00:05:02,785 --> 00:05:04,745 that's impacting hundreds 123 00:05:04,745 --> 00:05:06,785 or thousands of hospitals across the country right now. 124 00:05:07,325 --> 00:05:10,185 And that's a challenge for us as well as, um, you know, 125 00:05:10,185 --> 00:05:12,825 big ransomware attack at, uh, Laurie's Children's. 126 00:05:12,825 --> 00:05:14,705 So in my own world, uh, one 127 00:05:14,705 --> 00:05:16,905 of our own children's hospitals being attacked, uh, 128 00:05:16,925 --> 00:05:20,385 in Chicago, and there's a lot of disruption, a lot of costs. 129 00:05:21,085 --> 00:05:22,825 We have a lot of preventive costs in place. 130 00:05:23,035 --> 00:05:24,145 We're only as good as the guy 131 00:05:24,145 --> 00:05:25,625 that figures out how to get through our systems. 132 00:05:25,685 --> 00:05:28,265 So the next person who gives away their credentials, right? 133 00:05:28,365 --> 00:05:30,905 So those are, to me, the, the three big issues. 134 00:05:31,045 --> 00:05:33,795 One that's generically healthcare labor, one 135 00:05:33,795 --> 00:05:35,875 that's uniquely different in, in the kids' world, 136 00:05:36,265 --> 00:05:37,275 pediatric mental health. 137 00:05:37,295 --> 00:05:38,515 And the other one's kind of u kind 138 00:05:38,515 --> 00:05:41,835 of ubiquitous across all companies is, is cyber issues. 139 00:05:41,935 --> 00:05:43,875 And we just happen to have a lot of information 140 00:05:43,905 --> 00:05:44,955 that people like to get. 141 00:05:45,295 --> 00:05:47,955 So those are kind of three biggest things I I see us 142 00:05:48,635 --> 00:05:49,835 tracking in, in 24. 143 00:05:49,895 --> 00:05:51,475 And, and obviously beyond that too. 144 00:05:53,085 --> 00:05:55,525 - Absolutely. I think all those aspects you mentioned are 145 00:05:55,985 --> 00:05:58,965 so fascinating and certainly, um, top of mind 146 00:05:59,025 --> 00:06:01,165 for many executives across the board today. 147 00:06:01,165 --> 00:06:03,005 And in particular, as you were talking 148 00:06:03,005 --> 00:06:06,525 through the cyber attack issues, I can imagine, you know, 149 00:06:06,905 --> 00:06:08,485 for years, like you said, it's been something 150 00:06:08,485 --> 00:06:09,605 that has loomed in, 151 00:06:09,605 --> 00:06:11,085 in some organizations that have been hit. 152 00:06:11,105 --> 00:06:13,925 But now with Change Healthcare, one of the largest 153 00:06:14,445 --> 00:06:16,565 companies, um, connected with Optum 154 00:06:16,565 --> 00:06:18,525 and United Health Group, uh, in the country 155 00:06:18,745 --> 00:06:20,845 and associated with healthcare in particular too. 156 00:06:21,025 --> 00:06:24,245 So, you know, in seeing that hit in, in the disruption from, 157 00:06:24,665 --> 00:06:29,605 um, from that particular, um, side of things, how do you, 158 00:06:29,925 --> 00:06:31,085 I guess, think about that? 159 00:06:31,265 --> 00:06:34,565 Um, I, I know you mentioned obviously being able to, um, 160 00:06:34,635 --> 00:06:38,085 have somewhat of a, um, ability to build capabilities 161 00:06:38,265 --> 00:06:42,165 and think through what kind of financial, um, responsibility 162 00:06:42,275 --> 00:06:45,205 that you have to, to put away, um, in 163 00:06:45,225 --> 00:06:48,005 and put parts of the, um, budget 164 00:06:48,145 --> 00:06:51,005 and hospital finances towards the cyber attack and, 165 00:06:51,005 --> 00:06:54,645 and planning for a potential recovery if something happens. 166 00:06:54,865 --> 00:06:57,445 But, um, from, you know, just kind 167 00:06:57,445 --> 00:06:59,285 of like looking at the way you're thinking about it today 168 00:06:59,285 --> 00:07:01,165 versus the way you thought about it five years ago. 169 00:07:01,345 --> 00:07:04,045 You know, what's kind of different? How have things evolved? 170 00:07:06,785 --> 00:07:08,985 - I think our education of our employees, uh, 171 00:07:09,565 --> 00:07:10,665 and have, has evolved. 172 00:07:10,825 --> 00:07:13,865 I always tell a funny story when we first started down this 173 00:07:14,015 --> 00:07:16,705 path of trying to test people like you 174 00:07:16,705 --> 00:07:18,065 send 'em a fake email, right? 175 00:07:18,245 --> 00:07:19,825 And you, and you see if they respond 176 00:07:19,845 --> 00:07:21,745 and then you use that as a training tool. 177 00:07:21,905 --> 00:07:23,865 A training platform to say, okay, here's 178 00:07:23,865 --> 00:07:25,265 what you should have noticed in this email 179 00:07:25,265 --> 00:07:26,825 that why you shouldn't have responded to it, right? 180 00:07:26,825 --> 00:07:29,345 So I'm teaching you to not respond to things 181 00:07:29,415 --> 00:07:30,785 that are, that are coming in. 182 00:07:31,405 --> 00:07:34,985 Um, the funny, the funny one was five years ago, 183 00:07:35,005 --> 00:07:37,705 we sent one out and said, oh, Christmas time is usual. 184 00:07:37,795 --> 00:07:39,105 We're going to, which isn't 185 00:07:39,105 --> 00:07:40,145 as usual 'cause we don't do this. 186 00:07:40,395 --> 00:07:42,705 We're gonna give you a free Turkey, so put all your info, 187 00:07:42,705 --> 00:07:44,465 click on this link and put all your information in. 188 00:07:45,005 --> 00:07:46,225 And of course, it was a fake thing, 189 00:07:46,485 --> 00:07:50,065 and somebody actually responded to our messages saying, 190 00:07:50,065 --> 00:07:51,265 well, you know, last place I worked 191 00:07:51,265 --> 00:07:53,185 to actually offer you a Turkey or a ham. 192 00:07:53,365 --> 00:07:54,545 I'm like, that guy's gonna be really 193 00:07:54,545 --> 00:07:55,905 disappointed when he finds out. 194 00:07:56,165 --> 00:07:58,585 We were just testing to see if he put his information in. 195 00:07:58,605 --> 00:08:00,225 But that's how we've evolved to, 196 00:08:00,225 --> 00:08:01,385 that's not an issue anymore. 197 00:08:01,795 --> 00:08:03,065 We're still, we're testing people 198 00:08:03,095 --> 00:08:04,145 with, you know, real things. 199 00:08:04,225 --> 00:08:06,945 A lot of times during, um, during the, uh, 200 00:08:07,165 --> 00:08:08,425 the January timeframe, 201 00:08:08,435 --> 00:08:10,785 we'll put stuff out there about W2 information 202 00:08:10,785 --> 00:08:12,025 because that's a real thing. 203 00:08:12,845 --> 00:08:16,465 And I remember even five years ago, my CEO saying, well, 204 00:08:16,465 --> 00:08:18,145 Chris, can you make it not seem so real? 205 00:08:18,365 --> 00:08:21,345 I'm like, well, you know, bad guys make it look real. 206 00:08:21,725 --> 00:08:23,985 We have to make our fake things look real 207 00:08:24,005 --> 00:08:25,945 so we can test and we can educate. 208 00:08:25,945 --> 00:08:27,505 We're not trying to hold anybody. 209 00:08:27,515 --> 00:08:28,665 We're not, it's not punitive. 210 00:08:28,695 --> 00:08:31,425 It's like, okay, we need to, we need to educate more here. 211 00:08:31,445 --> 00:08:33,625 We need to tell people what this is like, et cetera. 212 00:08:33,685 --> 00:08:36,625 So there's that piece that we've escalated our testing, 213 00:08:36,725 --> 00:08:37,945 but that's only so good. 214 00:08:37,945 --> 00:08:40,145 Then you've got 24 hour monitoring. 215 00:08:40,165 --> 00:08:42,225 If things are, things are starting to ping us, 216 00:08:42,225 --> 00:08:44,545 like what's our systems look like that says, 217 00:08:44,965 --> 00:08:47,465 here's some walls up here that we're looking and training. 218 00:08:47,685 --> 00:08:50,265 You know, you have to have software products that, that, 219 00:08:50,265 --> 00:08:52,265 that look at those things and try to keep things out. 220 00:08:52,345 --> 00:08:55,485 I mean, I guess we turn down thousands of emails a day 221 00:08:55,555 --> 00:08:59,765 that are phishing emails and some get through, and CEOs 222 00:08:59,765 --> 00:09:01,845 and CFOs and c-suite members are huge 223 00:09:01,915 --> 00:09:03,765 targets for all those things. 224 00:09:04,185 --> 00:09:07,845 Um, and my CEO's super savvy at all. 225 00:09:07,845 --> 00:09:10,765 This actually fell to one not too long ago, and it just, 226 00:09:10,765 --> 00:09:12,165 because it looked super real 227 00:09:13,105 --> 00:09:16,325 and, uh, it so it, it, it's, it's so, it's so easy. 228 00:09:16,605 --> 00:09:18,365 I mean, I worry about it all the time and 229 00:09:18,365 --> 00:09:19,685 because I get so many of these things, 230 00:09:19,885 --> 00:09:21,885 I know sometimes I don't respond when I should have 231 00:09:21,885 --> 00:09:23,525 because I, I think they're fake. 232 00:09:24,225 --> 00:09:26,685 And, um, so it's just, it, it's a disruptor. 233 00:09:26,945 --> 00:09:29,965 But we're, I mean, you never say you're in good shape 234 00:09:29,965 --> 00:09:32,205 because you know, as good as the, 235 00:09:32,385 --> 00:09:33,965 the guy tomorrow that does something. 236 00:09:34,025 --> 00:09:37,725 But a lot of times what we found is it's people freely 237 00:09:37,725 --> 00:09:40,005 giving up their, their, their credentials. 238 00:09:40,635 --> 00:09:44,205 That is what is what how people, the bad guys get in. 239 00:09:44,205 --> 00:09:46,485 And so it's just a matter of trying to, you're trying 240 00:09:46,485 --> 00:09:48,165 to train people for that, you know, 241 00:09:48,165 --> 00:09:51,325 now they're intercepting, you know, you have the, the, uh, 242 00:09:51,705 --> 00:09:54,205 the, you know, the, the authenticator thing that comes in 243 00:09:54,205 --> 00:09:56,445 and texts you and says, you know, put in this number. 244 00:09:56,515 --> 00:09:58,205 Well, they're faking those things now too. 245 00:09:58,345 --> 00:10:00,165 So now they've infiltrated that piece. 246 00:10:00,225 --> 00:10:02,725 So it's just constantly trying to stay ahead of 'em. 247 00:10:02,725 --> 00:10:05,045 And you end up having an infrastructure, you have a team 248 00:10:05,475 --> 00:10:08,165 that monitors the traffic, you got software tools, 249 00:10:08,265 --> 00:10:10,205 and now all of a sudden you have a caution in your system 250 00:10:10,345 --> 00:10:12,045 to try to do something you really, 251 00:10:12,115 --> 00:10:15,045 that adds zero patient care, uh, to 252 00:10:15,045 --> 00:10:16,325 what you're doing in your organization. 253 00:10:16,325 --> 00:10:17,325 It's just some way to try 254 00:10:17,325 --> 00:10:19,205 to keep the bad guys from getting all your stuff 255 00:10:19,205 --> 00:10:20,405 and locking down your systems. 256 00:10:20,545 --> 00:10:21,725 And so it's unfortunate. 257 00:10:22,225 --> 00:10:25,285 Uh, now it's the cost of business, um, uh, to do it. 258 00:10:25,285 --> 00:10:26,685 But that's how it's changed over. 259 00:10:27,405 --> 00:10:29,605 I mean, I would say five years ago we had very few 260 00:10:29,605 --> 00:10:30,805 of those tools, um, 261 00:10:31,025 --> 00:10:33,965 but that we've really escalated our training and education 262 00:10:34,065 --> 00:10:36,405 and, and the tools we had to try to monitor that stuff. 263 00:10:36,405 --> 00:10:37,485 And we continue to look at that 264 00:10:37,505 --> 00:10:40,525 and our guys are dialed into all the cyber networks out 265 00:10:40,525 --> 00:10:42,965 there, and they talk to the feds, you know, 266 00:10:43,165 --> 00:10:44,885 'cause the feds host different things as 267 00:10:44,885 --> 00:10:47,005 to what's going on in terms of the threat, 268 00:10:47,505 --> 00:10:48,805 uh, alerts that are out there. 269 00:10:48,945 --> 00:10:51,995 So they stay on top of that to try to do the best they can 270 00:10:51,995 --> 00:10:53,435 to keep us, keep us safe. 271 00:10:55,095 --> 00:10:57,655 - Absolutely. That's so helpful to hear and think through. 272 00:10:57,715 --> 00:11:00,175 And, you know, um, definitely is something 273 00:11:00,175 --> 00:11:01,775 that I can imagine, just like you said, 274 00:11:02,175 --> 00:11:03,335 continues to evolve and change. 275 00:11:03,435 --> 00:11:06,335 And so staying on top of it is a challenge. Mm-Hmm. 276 00:11:06,375 --> 00:11:07,735 , when you look ahead, 277 00:11:07,845 --> 00:11:10,455 what are you most excited about and what makes you nervous? 278 00:11:12,985 --> 00:11:15,035 - Well, I think there's some really cool things going on. 279 00:11:15,275 --> 00:11:19,875 Y you, so the cyber side, the, the, the digital things 280 00:11:19,875 --> 00:11:22,315 that we're, that we're communicating with our patients 281 00:11:22,335 --> 00:11:23,515 and families, et cetera. 282 00:11:23,515 --> 00:11:25,475 So for us, our, our, um, 283 00:11:25,565 --> 00:11:27,915 we're a little bit different in the pediatric world in 284 00:11:27,915 --> 00:11:30,475 that most of the people we communicate with are millennials, 285 00:11:30,735 --> 00:11:33,115 you know, 'cause they're in that 30 to 40 year range 286 00:11:33,215 --> 00:11:34,715 as the parent that we're dealing with. 287 00:11:34,825 --> 00:11:37,835 Whereas the adult hospitals have different, um, age groups 288 00:11:37,855 --> 00:11:39,195 and generations they're talking to. 289 00:11:39,255 --> 00:11:40,995 But we have a lot of people in that group. 290 00:11:41,345 --> 00:11:44,395 They, they like to be kind communicated 291 00:11:44,395 --> 00:11:45,555 with digitally, right? 292 00:11:45,555 --> 00:11:46,835 So they don't, they don't want a 293 00:11:46,835 --> 00:11:47,995 phone call, they don't want an email. 294 00:11:48,715 --> 00:11:49,995 I mean, they're, they're digital. 295 00:11:50,735 --> 00:11:52,395 Uh, a lot of times they're digital natives 296 00:11:52,515 --> 00:11:53,725 'cause that's, they grew up with it all. 297 00:11:53,725 --> 00:11:56,565 And so, but it's exciting there to start figuring out how 298 00:11:56,565 --> 00:12:00,285 to get away from paper processes and old things, et cetera, 299 00:12:00,285 --> 00:12:02,245 and move into that, that era. 300 00:12:02,345 --> 00:12:03,885 So that's, that's exciting. 301 00:12:03,885 --> 00:12:05,045 It's scary at the same time 302 00:12:05,045 --> 00:12:06,125 because there's a little bit 303 00:12:06,125 --> 00:12:08,405 of impersonal piece of that too, right? 304 00:12:08,405 --> 00:12:09,885 When you, when when you do that, 305 00:12:09,885 --> 00:12:12,445 you're disconnecting the personal touch into a, 306 00:12:12,805 --> 00:12:15,325 a digital touch, which has, it loses something, 307 00:12:15,745 --> 00:12:16,885 uh, from that perspective. 308 00:12:16,985 --> 00:12:19,325 But it's exciting because we can build those tools. 309 00:12:19,545 --> 00:12:20,965 We have it probably, 310 00:12:21,385 --> 00:12:22,765 and maybe a little bit easier on the 311 00:12:22,765 --> 00:12:23,885 pediatric side to do it. 312 00:12:24,045 --> 00:12:25,925 'cause most of our patients families 313 00:12:26,465 --> 00:12:29,285 and the people we communicate with are in that, in 314 00:12:29,285 --> 00:12:32,525 that small group versus the adults that have the, 315 00:12:32,945 --> 00:12:35,165 the seniors and the 30 year olds 316 00:12:35,165 --> 00:12:36,285 and everybody in between 317 00:12:36,475 --> 00:12:39,725 that all have different communication, uh, methods. 318 00:12:39,865 --> 00:12:42,005 That's not to say we don't, but by 319 00:12:42,005 --> 00:12:43,325 and large we have a large group of people 320 00:12:43,325 --> 00:12:45,325 that can be communicated with in one fashion. 321 00:12:45,465 --> 00:12:47,205 So I think that's exciting. 322 00:12:47,225 --> 00:12:50,085 The other piece that we're seeing in the pediatric front is 323 00:12:50,185 --> 00:12:52,125 the pediatricians are, 324 00:12:52,875 --> 00:12:56,165 have largely been independent in the pediatric world. 325 00:12:56,305 --> 00:12:58,205 Uh, usually in the pediatric world, 326 00:12:58,625 --> 00:13:00,645 the hospitals will employ the specialist 327 00:13:00,665 --> 00:13:02,445 and sub-specialists, but the pediatricians 328 00:13:02,445 --> 00:13:03,565 have tended to be independent. 329 00:13:03,565 --> 00:13:07,485 They're starting to, um, come into employment with us, 330 00:13:07,655 --> 00:13:10,125 which gives us a great opportunity to integrate all 331 00:13:10,125 --> 00:13:14,165 that information so that we can really tie in, um, you know, 332 00:13:14,165 --> 00:13:17,165 all your wealth checks and all those things into ed visits 333 00:13:17,545 --> 00:13:19,965 and, and costly healthcare and things like that. 334 00:13:20,065 --> 00:13:23,835 So there's, there's, um, to me that's exciting 335 00:13:23,835 --> 00:13:25,875 because that's, that's integration, that's integration 336 00:13:25,875 --> 00:13:28,875 of healthcare at, at kind of, its at, its at its best. 337 00:13:29,015 --> 00:13:32,275 And um, so those are, those are two I think 338 00:13:32,275 --> 00:13:33,555 that are, that are exciting. 339 00:13:33,555 --> 00:13:35,435 There's obviously costs 340 00:13:35,535 --> 00:13:37,475 and, you know, when you start employing physicians, 341 00:13:37,575 --> 00:13:39,275 do you lose money, et cetera, et cetera. 342 00:13:39,275 --> 00:13:40,835 So those are all your things you worry about. 343 00:13:40,895 --> 00:13:43,515 But see, if you look at it as this ability to really 344 00:13:44,115 --> 00:13:47,355 transform how we deliver care, uh, I find 345 00:13:47,355 --> 00:13:48,995 that really, really exciting. 346 00:13:49,095 --> 00:13:52,275 The other piece we've been working on from a clinical side 347 00:13:52,375 --> 00:13:54,195 and, and, uh, I got involved 348 00:13:54,395 --> 00:13:56,195 'cause we're looking at, you know, cost, how do we, 349 00:13:56,295 --> 00:13:58,835 how do we improve cost outcomes, et cetera, 350 00:13:59,175 --> 00:14:02,395 is just this whole notion of once a person comes in 351 00:14:02,395 --> 00:14:05,475 and admitted, are we managing their discharge? 352 00:14:05,695 --> 00:14:08,475 Are we discharging them when we, when we think we're ready 353 00:14:08,475 --> 00:14:10,315 to send 'em home, are we manage 'em up front 354 00:14:10,375 --> 00:14:12,155 and educating 'em, et cetera, et cetera, 355 00:14:12,525 --> 00:14:14,515 which yields a whole bunch of great outcomes. 356 00:14:14,835 --> 00:14:16,915 I mean, one, from the finance guy's perspective, 357 00:14:16,985 --> 00:14:19,755 it's probably better cost because I'm not gonna have all 358 00:14:19,755 --> 00:14:23,275 those variation in my patient pathways 359 00:14:23,275 --> 00:14:24,875 because we're gonna be talking 360 00:14:24,895 --> 00:14:26,555 to patients the day they come in the door 361 00:14:26,555 --> 00:14:27,675 when they should be going home. 362 00:14:27,675 --> 00:14:30,835 We're gonna be managing to an expected discharge date 363 00:14:31,025 --> 00:14:32,835 that may change, but at least from 364 00:14:33,115 --> 00:14:34,195 managing to a date we think about. 365 00:14:34,215 --> 00:14:35,595 So that helps manage costs. 366 00:14:35,895 --> 00:14:37,835 But I think from the patient communication, 367 00:14:37,905 --> 00:14:39,835 patient expectation perspective, 368 00:14:40,595 --> 00:14:44,435 I think has got tremendous upside to help them understand 369 00:14:44,455 --> 00:14:47,155 and be more transparent with them on how they, their care, 370 00:14:47,655 --> 00:14:49,955 uh, journeys through while they're at, at the hospital. 371 00:14:50,175 --> 00:14:51,605 So to me that's exciting. 372 00:14:51,665 --> 00:14:54,525 That's, that's, that's transforming how we deliver care. 373 00:14:55,065 --> 00:14:58,045 It isn't just the standard, you know, standard finance stuff 374 00:14:58,045 --> 00:15:00,525 of trying to, to do something 375 00:15:00,525 --> 00:15:02,565 for a little bit less money than we spent the year 376 00:15:02,565 --> 00:15:03,725 before, which we have to do too. 377 00:15:03,925 --> 00:15:05,845 I mean, we have to figure out all those pieces as well. 378 00:15:05,865 --> 00:15:07,125 But trying to transform it 379 00:15:07,125 --> 00:15:10,805 where you really get some different, uh, change to me is, 380 00:15:11,025 --> 00:15:12,245 is is exciting. 381 00:15:12,585 --> 00:15:17,125 And the final thing for us is we're starting to, uh, 382 00:15:17,265 --> 00:15:20,285 in the pediatric world, we've got some areas of town 383 00:15:20,395 --> 00:15:23,405 that are largely underserved with very little access to, 384 00:15:24,105 --> 00:15:27,965 you know, um, uh, primary care sorts of services. 385 00:15:28,065 --> 00:15:29,125 And so we're starting 386 00:15:29,185 --> 00:15:31,685 to venture out into those, those areas. 387 00:15:31,985 --> 00:15:34,645 We, uh, we take risk on a Medicaid contract 388 00:15:34,825 --> 00:15:39,685 and so we're able to reinvest those dollars into, um, 389 00:15:40,225 --> 00:15:42,965 you know, going out to, uh, you know, into these communities 390 00:15:42,965 --> 00:15:44,365 and bringing healthcare out to them. 391 00:15:44,425 --> 00:15:46,645 So it's more convenient for them to do, which should, 392 00:15:46,645 --> 00:15:48,525 should be transformative for them as well. 393 00:15:49,105 --> 00:15:51,205 Uh, 'cause all, they won't be always being 394 00:15:51,205 --> 00:15:52,405 seen in the emergency room. 395 00:15:52,465 --> 00:15:53,765 So have a lot of, a lot of kids 396 00:15:53,785 --> 00:15:55,405 who are seen in the emergency room simply 397 00:15:55,605 --> 00:15:56,925 'cause they don't have access to anything else. 398 00:15:57,855 --> 00:16:00,675 So that's, to me, that's exciting too, to try to change 399 00:16:00,855 --> 00:16:04,715 how we, how we take care of our, our, our community better. 400 00:16:08,245 --> 00:16:10,625 - That's amazing to hear. And definitely so important, 401 00:16:10,805 --> 00:16:13,505 as you said, just to, um, have that access to care 402 00:16:13,605 --> 00:16:15,865 and really cool to see some of those trends, whether it's 403 00:16:16,015 --> 00:16:17,665 with kind of the, the digital access 404 00:16:17,725 --> 00:16:21,305 and being able to connect easily in, in, in, in a way 405 00:16:21,305 --> 00:16:23,225 that is, um, convenient for patients. 406 00:16:23,225 --> 00:16:25,865 And then too, having the pediatric physicians now 407 00:16:25,865 --> 00:16:26,905 coming into employment. 408 00:16:27,425 --> 00:16:29,025 I think that's such an interesting trend. 409 00:16:29,165 --> 00:16:31,905 Uh, what do you think is driving them into the employment 410 00:16:31,905 --> 00:16:34,305 space and, um, versus being independent 411 00:16:34,305 --> 00:16:35,625 as they had been for so many years? 412 00:16:37,375 --> 00:16:38,905 - Well, it's interesting, but you know, 413 00:16:39,095 --> 00:16:40,745 it's some of us, the impact of covid. 414 00:16:41,045 --> 00:16:44,015 So even though we're, how many years are we past Covid, 415 00:16:44,225 --> 00:16:45,575 who's, who could say, right, who, 416 00:16:45,715 --> 00:16:48,095 who knows when covid actually ended, 417 00:16:48,675 --> 00:16:50,295 but as they came out of covid 418 00:16:50,515 --> 00:16:52,495 and some of the recovery dollars went away, 419 00:16:52,565 --> 00:16:54,655 they found some people had changed patterns. 420 00:16:54,715 --> 00:16:57,535 So, you know, when you have young kids 421 00:16:57,635 --> 00:17:00,175 and they get sick, you, you want them seen right away, 422 00:17:00,175 --> 00:17:01,815 but sometimes they get better in 72 hours. 423 00:17:02,325 --> 00:17:04,935 Well, during Covid, you actually found that out 424 00:17:05,055 --> 00:17:07,535 because you didn't go, you didn't go take him out. 425 00:17:07,835 --> 00:17:09,295 You just kind of wrote it out sometimes. 426 00:17:09,435 --> 00:17:11,975 So, so some things changed from that perspective. 427 00:17:11,995 --> 00:17:14,215 And then as a parent, maybe I thought, I don't need 428 00:17:14,215 --> 00:17:15,775 to take my kid to the doctor as quickly 429 00:17:16,195 --> 00:17:17,695 as I, as I did in the past. 430 00:17:17,695 --> 00:17:19,775 Right? That's one. All these are little pieces, 431 00:17:19,835 --> 00:17:21,175 but they all impacted their volume. 432 00:17:21,715 --> 00:17:24,095 Uh, people found alternative ways to do it. 433 00:17:24,095 --> 00:17:28,335 They did, they did, uh, virtual televisit, 434 00:17:28,875 --> 00:17:31,135 um, they went to urgent cares or, 435 00:17:31,235 --> 00:17:33,375 or we have a series of these, uh, 436 00:17:33,645 --> 00:17:35,335 pediatric minute clinics we've opened. 437 00:17:35,395 --> 00:17:36,735 So people started going to those. 438 00:17:36,915 --> 00:17:38,535 So they, they didn't go to the pediatrician, 439 00:17:38,715 --> 00:17:41,135 so you had another little piece of the business 440 00:17:41,135 --> 00:17:43,255 that went away, you know, from that perspective. 441 00:17:43,595 --> 00:17:45,975 And then their cost of running their business went way up 442 00:17:46,085 --> 00:17:50,165 because when inflation went high, uh, here 18 months ago, 443 00:17:50,485 --> 00:17:53,405 whenever it was, they had a, you know, an 8% cost 444 00:17:53,425 --> 00:17:55,285 of their labor workforce 445 00:17:55,465 --> 00:17:57,165 and the same labor challenges we have, 446 00:17:57,165 --> 00:17:58,405 but we're a large organization, 447 00:17:58,505 --> 00:18:00,405 we can figure a lot of those things out. 448 00:18:00,475 --> 00:18:03,325 They can't. And so they've, they've had, you know, 449 00:18:03,325 --> 00:18:07,445 they've had a loss of volume and an increase in cost. 450 00:18:08,385 --> 00:18:09,405 And I think, and they, 451 00:18:09,425 --> 00:18:13,485 and they have the same similar challenge like I talked about 452 00:18:13,485 --> 00:18:14,885 before with the workforce, is 453 00:18:14,885 --> 00:18:17,725 that people coming outta medical school don't necessarily 454 00:18:17,725 --> 00:18:18,765 want to go entrepreneurial 455 00:18:18,905 --> 00:18:20,445 and go run their own practice anymore. 456 00:18:20,555 --> 00:18:22,165 They kind of want to go be, 457 00:18:22,355 --> 00:18:24,085 they semi kind of want to just be employed. 458 00:18:24,435 --> 00:18:25,645 They don't want to have to run it, 459 00:18:25,845 --> 00:18:27,245 worry about running their own business. 460 00:18:27,265 --> 00:18:29,925 And so I think these guys have been in it for a long time. 461 00:18:30,635 --> 00:18:31,845 They can't recruit guys 462 00:18:31,845 --> 00:18:33,285 to come in and do what they used to do. 463 00:18:33,705 --> 00:18:35,885 You know, they, they, they have a, it's a different piece. 464 00:18:36,045 --> 00:18:37,645 I think that there's kind of a three, 465 00:18:37,935 --> 00:18:40,645 three three-pronged piece to that is I think there's loss 466 00:18:40,645 --> 00:18:42,165 of volume, there's higher costs, 467 00:18:42,185 --> 00:18:44,605 and I think it's hard for them to find replacement guys 468 00:18:44,785 --> 00:18:47,605 to come in and, and, and it's hard to fund them. 469 00:18:47,665 --> 00:18:49,845 If I got a little bit loss of volume 470 00:18:49,905 --> 00:18:52,125 and higher cost, I don't have as much money to try 471 00:18:52,125 --> 00:18:54,605 to subsidize a new guy coming into my practice. 472 00:18:54,665 --> 00:18:57,165 And so I think all those things put together is really hard, 473 00:18:57,745 --> 00:18:59,485 uh, for them to continue to manage through. 474 00:18:59,585 --> 00:19:01,085 So you seeing more of 'em come to the door 475 00:19:01,145 --> 00:19:02,965 and saying, you know, we've been working, 476 00:19:03,215 --> 00:19:04,525 we've been working with 'em for years. 477 00:19:05,125 --> 00:19:06,205 'cause they largely work with us. 478 00:19:06,315 --> 00:19:09,085 It's just they have been working with us as a independent, 479 00:19:09,225 --> 00:19:10,485 as an independent organization, 480 00:19:10,585 --> 00:19:13,165 but now that they're have a tighter relationship with us, 481 00:19:13,185 --> 00:19:16,485 we can incorporate them into our electronic medical record, 482 00:19:16,485 --> 00:19:17,285 which happens to be epic, 483 00:19:17,345 --> 00:19:18,565 but we can incorporate it in there. 484 00:19:18,565 --> 00:19:22,085 Now all a sudden you've got this full patient record, right? 485 00:19:22,145 --> 00:19:23,485 And so it's really got some great 486 00:19:23,805 --> 00:19:25,005 benefits from that perspective. 487 00:19:27,845 --> 00:19:29,765 - Absolutely. Well, thank you so much for, uh, going through 488 00:19:29,765 --> 00:19:31,165 that with us and going one big deeper. 489 00:19:31,505 --> 00:19:33,285 It is really just helpful and informative. 490 00:19:33,665 --> 00:19:35,805 Um, before we wrap up our conversation here, 491 00:19:35,855 --> 00:19:36,965 we've talked a lot about some 492 00:19:36,965 --> 00:19:38,565 of the ways healthcare is changing, whether it's 493 00:19:38,565 --> 00:19:41,885 through technology, um, obviously a lot of workforce changes 494 00:19:42,265 --> 00:19:44,725 and then certainly, you know, different, um, 495 00:19:45,325 --> 00:19:48,205 patterns from patients as well as what communities want 496 00:19:48,205 --> 00:19:49,325 and, and need from healthcare. 497 00:19:49,545 --> 00:19:52,245 So what do you think the most effective healthcare leaders 498 00:19:52,275 --> 00:19:54,045 will need to be successful over the next 499 00:19:54,065 --> 00:19:55,085 two to three years or so? 500 00:19:58,165 --> 00:20:00,565 - I, I think you get the approach to everything that, um, 501 00:20:01,625 --> 00:20:04,085 so first talk about the broader healthcare leader 502 00:20:04,085 --> 00:20:05,605 and a little bit about the finance guy, 503 00:20:05,605 --> 00:20:08,485 but I think you have to approach it 504 00:20:08,485 --> 00:20:11,565 that the way I did it isn't always the right way going 505 00:20:11,565 --> 00:20:13,925 forward and that we really have to think differently. 506 00:20:14,305 --> 00:20:15,645 And it's hard. It's really, 507 00:20:15,705 --> 00:20:17,245 and I'm not saying you're always stuck in the past, 508 00:20:17,245 --> 00:20:19,245 but it's just hard to make transformative change 509 00:20:19,425 --> 00:20:21,485 and really change what you're doing. 510 00:20:21,505 --> 00:20:23,045 And you really have to think about it. 511 00:20:23,045 --> 00:20:24,565 If workforce is gonna get tighter, 512 00:20:25,135 --> 00:20:26,365 costs are gonna be higher. 513 00:20:26,915 --> 00:20:29,045 It's just, and there's gonna be continued pressure on rates, 514 00:20:29,625 --> 00:20:31,365 uh, in terms of what, how we're paid. 515 00:20:31,525 --> 00:20:34,325 I think you just have to keep, um, you have 516 00:20:34,325 --> 00:20:36,125 to keep constantly looking at 517 00:20:36,145 --> 00:20:37,525 how you transform your business. 518 00:20:37,745 --> 00:20:41,405 And, and as a healthcare leader, she, one of the things we, 519 00:20:41,465 --> 00:20:45,485 we found with some of our, um, healthcare leaders is they, 520 00:20:46,745 --> 00:20:48,615 they think they know what the consumer wants, 521 00:20:49,655 --> 00:20:51,235 but they really need to listen to the consumer. 522 00:20:52,015 --> 00:20:54,025 Like in our world is that, that, that, 523 00:20:54,025 --> 00:20:56,625 because we have this millennial group, you have 524 00:20:56,625 --> 00:20:59,405 to understand what I call 'em, 525 00:20:59,405 --> 00:21:01,725 the Amazon prime generation, right? 526 00:21:02,065 --> 00:21:04,085 Oh, it's 10 o'clock tonight and I need something tomorrow. 527 00:21:04,085 --> 00:21:06,005 So I go online and I order it and I get it right? 528 00:21:06,755 --> 00:21:09,525 That want, they want healthcare the same way and, 529 00:21:09,665 --> 00:21:11,205 and we have to figure out 530 00:21:11,205 --> 00:21:13,605 how we can't deliver the same way Amazon Prime can, 531 00:21:13,625 --> 00:21:15,845 but we have to figure out how to deliver something 532 00:21:15,845 --> 00:21:18,725 that they want and meet them somewhere versus thinking 533 00:21:18,725 --> 00:21:20,525 that we've had people who said, 534 00:21:21,185 --> 00:21:23,005 we had some pediatricians in our community 535 00:21:23,005 --> 00:21:25,285 that thought consumerism was a disease 536 00:21:25,395 --> 00:21:26,485 that was gonna go away. 537 00:21:27,205 --> 00:21:30,165 and I, we can't wait till they come back to come in 538 00:21:30,165 --> 00:21:31,685 and visiting us when we want to be here. 539 00:21:31,685 --> 00:21:33,965 And it's like, well that's, that's, that's not gonna happen. 540 00:21:34,065 --> 00:21:36,325 So as a healthcare leader, you gotta understand like, 541 00:21:36,325 --> 00:21:37,845 what's the consumer, what's going on, 542 00:21:37,845 --> 00:21:40,365 and how do I meet them where they need to be so 543 00:21:40,365 --> 00:21:43,245 that they're, that, that I'm meeting their needs within 544 00:21:43,245 --> 00:21:45,645 obviously a reasonable, uh, um, 545 00:21:46,075 --> 00:21:47,885 cost perspective, et cetera, et cetera. 546 00:21:47,885 --> 00:21:50,805 But I think that that's a big piece on a broad basis. 547 00:21:51,345 --> 00:21:52,925 And as a finance guy, I always say, 548 00:21:52,985 --> 00:21:54,965 you gotta keep your finger on the revenue cycle 549 00:21:54,965 --> 00:21:57,795 because I, I would say I have a, 550 00:21:57,835 --> 00:21:59,515 I have a really good revenue cycle leader. 551 00:21:59,715 --> 00:22:01,435 I have a pretty good revenue cycle. 552 00:22:01,775 --> 00:22:04,315 But you know, we, if we don't stay focused on it, 553 00:22:04,315 --> 00:22:06,755 we wake up one day and we've lost a percent 554 00:22:06,755 --> 00:22:08,915 and a half of our revenue through a variety of things, 555 00:22:09,015 --> 00:22:12,075 the payers aren't looking to pay us more. 556 00:22:13,155 --> 00:22:14,575 And we have to kind of think that 557 00:22:14,795 --> 00:22:16,655 and say they're not looking to pay us more. 558 00:22:16,655 --> 00:22:18,935 So they're always changing subtle things like things. 559 00:22:18,935 --> 00:22:20,215 And if we don't stay on top of it, 560 00:22:20,445 --> 00:22:21,935 it's really easy to lose a percent. 561 00:22:22,195 --> 00:22:24,975 And that's a lot of money. Um, so he is just, 562 00:22:25,255 --> 00:22:27,535 I think the finance guy sometimes it's like, yeah, 563 00:22:27,535 --> 00:22:30,015 revenue cycles kind of ho-hum 'cause of the same thing, 564 00:22:30,035 --> 00:22:32,815 but it doesn't take long to lose a percent or two 565 00:22:32,815 --> 00:22:33,855 or 3% of that, 566 00:22:33,855 --> 00:22:36,375 and all of a sudden that's a big, that's a big margin. 567 00:22:36,375 --> 00:22:38,415 You're not getting paid for what you, what you're doing, 568 00:22:38,755 --> 00:22:39,935 uh, in the organization. 569 00:22:39,995 --> 00:22:41,735 So that's a, that's a big piece. 570 00:22:41,995 --> 00:22:44,535 Um, and I just think that that, 571 00:22:44,535 --> 00:22:47,015 the other thing I'd say on the finance side, you, you, you, 572 00:22:47,075 --> 00:22:50,465 you gotta be like the, you may not be the COO, 573 00:22:50,465 --> 00:22:52,025 but you gotta be like the COO, 574 00:22:52,045 --> 00:22:54,385 you gotta really understand what's going on so you can try 575 00:22:54,385 --> 00:22:55,745 to help make some of those changes. 576 00:22:55,845 --> 00:22:57,585 And a lot of CFOs have gone down that path. 577 00:22:57,765 --> 00:22:59,745 So I'm not trying to say they don't, 578 00:22:59,765 --> 00:23:02,425 but I think that you've gotta always think about the fact 579 00:23:02,425 --> 00:23:03,785 that it's not just financial. 580 00:23:04,005 --> 00:23:06,785 And I always say that sometimes I have 581 00:23:06,785 --> 00:23:09,025 to invest in something to get the return later. 582 00:23:09,165 --> 00:23:10,625 And you gotta really think about that. 583 00:23:10,685 --> 00:23:11,865 You gotta look at long term. 584 00:23:12,245 --> 00:23:14,225 Um, one of the things we've tried really hard 585 00:23:14,225 --> 00:23:17,825 to do is on the finding size, not get, you have 586 00:23:17,825 --> 00:23:19,025 to look at the monthly results, 587 00:23:19,085 --> 00:23:21,665 but you can't just be myopic on the monthly results. 588 00:23:21,725 --> 00:23:23,105 You gotta look long-term and say, 589 00:23:23,105 --> 00:23:24,465 are we going where we need to be going? 590 00:23:25,005 --> 00:23:27,345 And I'm looking at the long-term health of the organization, 591 00:23:27,525 --> 00:23:30,105 not what happened yesterday or today or tomorrow 592 00:23:30,205 --> 00:23:32,025 or next week or this month or whatever. 593 00:23:32,165 --> 00:23:34,145 So I think some of those pieces to say, 594 00:23:34,145 --> 00:23:35,545 how do I look at, look forward? 595 00:23:36,125 --> 00:23:38,745 How do I continue to work on transforming care and my, 596 00:23:38,745 --> 00:23:39,985 and looking at my consumers? 597 00:23:40,005 --> 00:23:41,865 And then just kind of keeping your fingers on 598 00:23:41,865 --> 00:23:44,185 that revenue cycle and making sure that you're constantly, 599 00:23:45,225 --> 00:23:46,885 uh, collecting everything, billing 600 00:23:46,905 --> 00:23:48,765 and collecting, coding, capturing, 601 00:23:49,245 --> 00:23:51,285 whatever you wanna call it, everything you can, I might 602 00:23:51,285 --> 00:23:53,445 as well get paid for everything I do in the organization. 603 00:23:53,705 --> 00:23:54,705 So, 604 00:23:55,395 --> 00:23:56,395 - Yeah. 605 00:23:56,395 --> 00:23:57,885 Yeah, I think all those are such a great point 606 00:23:57,985 --> 00:24:00,965 and definitely interesting, um, from the CFO perspective 607 00:24:00,985 --> 00:24:04,285 as you were talking about how to really get out of having 608 00:24:04,485 --> 00:24:08,405 that myopic finance, uh, focus and really think broadly 609 00:24:08,465 --> 00:24:09,885 and look broadly, think ahead 610 00:24:09,945 --> 00:24:11,525 and, um, look at, you know, 611 00:24:11,525 --> 00:24:13,165 where healthcare is transforming. 612 00:24:13,185 --> 00:24:14,485 And I think it goes back to so much of 613 00:24:14,485 --> 00:24:15,645 what we've talked about already, 614 00:24:15,645 --> 00:24:16,925 whether it's looking at workforce 615 00:24:17,065 --> 00:24:19,645 or where healthcare is taking place inside of the hospital 616 00:24:19,665 --> 00:24:20,805 or outside of the hospital and 617 00:24:20,805 --> 00:24:22,085 technology and all of these things. 618 00:24:22,905 --> 00:24:25,285 Um, I can imagine, you know, having that open mind 619 00:24:25,285 --> 00:24:28,405 and being able to, uh, transition along with healthcare, um, 620 00:24:28,705 --> 00:24:32,085 is not always easy, but definitely, uh, one way that, 621 00:24:32,085 --> 00:24:33,205 you know, you can really, um, 622 00:24:33,225 --> 00:24:34,485 put yourself in the best position 623 00:24:34,505 --> 00:24:35,845 to be successful in the future. 624 00:24:37,295 --> 00:24:40,065 - Yeah. Say, well, the, the, the challenges is, is, uh, 625 00:24:40,275 --> 00:24:42,305 we're all trained in the finance world. 626 00:24:42,395 --> 00:24:45,185 We're trained to our skillset a lot 627 00:24:45,185 --> 00:24:48,025 of times our personalities that we go into that profession, 628 00:24:48,075 --> 00:24:51,345 we're, we're trained and, and kind of formed into. 629 00:24:51,345 --> 00:24:52,905 That's how I think it's harder 630 00:24:52,925 --> 00:24:54,745 to think differently sometimes. 631 00:24:54,965 --> 00:24:56,105 That's is how we're trained to, 632 00:24:56,725 --> 00:24:58,025 and you have to have some of that. 633 00:24:58,425 --> 00:25:00,585 I can't let today get away from me either, 634 00:25:01,205 --> 00:25:03,185 but can't just be focused on today. 635 00:25:03,385 --> 00:25:05,865 I can't worry about how many fts I had today 636 00:25:05,865 --> 00:25:07,025 or whatever the case may be. 637 00:25:07,145 --> 00:25:09,265 I, I do, but I also gotta look ahead 638 00:25:09,265 --> 00:25:10,865 and say, am I moving in the right direction? 639 00:25:10,865 --> 00:25:12,625 Do I have the tools in place, uh, 640 00:25:13,005 --> 00:25:14,825 to help people do their their things? 641 00:25:14,965 --> 00:25:16,665 And maybe one of the last thing I'd say, 642 00:25:16,665 --> 00:25:18,625 because we're still, we'd have no idea how 643 00:25:18,625 --> 00:25:21,265 to figure this out, is the whole AI thing 644 00:25:21,365 --> 00:25:23,105 and even defining what AI means. 645 00:25:23,375 --> 00:25:26,225 Like what, what is ai? Is it machine learning? 646 00:25:26,325 --> 00:25:29,585 Is it truly, is it the chat GPT stuff? Is it broad? 647 00:25:29,745 --> 00:25:31,025 I mean, we're, we're still 648 00:25:31,025 --> 00:25:32,105 trying to get our hands around that. 649 00:25:32,335 --> 00:25:35,305 It's, um, but that's something that I even listed any 650 00:25:35,305 --> 00:25:38,065 of the things we talked about, which that's still out there 651 00:25:38,125 --> 00:25:41,065 as a big thing, but I don't, I couldn't tell you what I, 652 00:25:41,065 --> 00:25:42,705 what I even think about at this point in time. 653 00:25:42,825 --> 00:25:44,225 I think you gotta get your arms around it 654 00:25:44,225 --> 00:25:46,305 and define it first so you can figure out where you're, 655 00:25:46,555 --> 00:25:47,665 where you want to go with it. 656 00:25:48,625 --> 00:25:50,195 - Yeah, definitely. That's such a great point. 657 00:25:50,295 --> 00:25:52,395 So many of these conversations, AI comes up 658 00:25:52,415 --> 00:25:56,435 and, um, you know, definitely, um, in a space 659 00:25:56,435 --> 00:25:58,915 where it's still very much evolving and, 660 00:25:58,935 --> 00:26:02,315 and understanding exactly what, um, that means and, 661 00:26:02,315 --> 00:26:04,835 and what it entails for healthcare and health systems. 662 00:26:05,015 --> 00:26:06,595 So it'll just be interesting, uh, 663 00:26:06,615 --> 00:26:09,755 to see over the next few months here, um, where things go 664 00:26:09,775 --> 00:26:12,635 and, and how, um, health systems can really, uh, 665 00:26:12,635 --> 00:26:15,475 produce some of these, um, great use cases for it 666 00:26:15,495 --> 00:26:17,515 and then, um, continue to evolve. 667 00:26:18,685 --> 00:26:20,725 - Absolutely. - Well, Chris, thank you so much 668 00:26:20,725 --> 00:26:22,165 for joining us on the podcast today. 669 00:26:22,165 --> 00:26:23,845 This has been such a fascinating discussion. 670 00:26:23,925 --> 00:26:26,325 I wish we had two or three more hours here to talk about it, 671 00:26:26,465 --> 00:26:28,445 but, uh, you know, hopefully we'll be able 672 00:26:28,445 --> 00:26:30,405 to catch up again soon and looking forward as well 673 00:26:30,405 --> 00:26:32,965 to have you speaking at our fall events, um, 674 00:26:33,035 --> 00:26:35,445 here in Chicago, our Health IT Digital Health 675 00:26:35,445 --> 00:26:38,085 and Revenue Cycle event, as well as C-E-O-C-F-O Roundtable. 676 00:26:38,105 --> 00:26:40,045 So it'll be great to have you here in person. 677 00:26:41,445 --> 00:26:42,935 - Yeah, I'd like to meet you, Laura, when I, 678 00:26:42,935 --> 00:26:43,495 when I get there.