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Clarify Your Health IT Plan

Myth Busting Cybersecurity and Plans for a Big Texas Merger

Craig Richardville

Bill Russell:                   00:01                Welcome to This Week in Healthcare where we discuss the news information, and emerging thought with leaders from across the healthcare industry. Today we ask the question What do executives need to know before they pull the trigger on mergers.

Bill Russell:                   00:13                Plus we bust some of the cyber security myths that are out there. This is episode number 40. This gets brought to you by how clerics how systems are ruining the cloud agility efficiency and new capabilities. Work with a trusted partner that has been moving health systems the fastest 2010 visit Elthorne Cellcom to schedule your free consultation. My name is Bill Russell recovery CIO writer and advisor with the previously mentioned health. Lyrics before I get to a guest I want to thank everyone especially my guests who made the show a success. We set a goal before we started the year to get 500 weekly dominance of the show in the first year and so that was that was our big goal and this past week we clip’s thousand downloads for the week. We want to thank you for making us part of your week and we hope that you will continue to share the podcast in the YouTube channel with your peers. Today’s guest is new to the show. Gosh you’re probably like the fourth Chayyim CIO of the year that we’ve had on here. A highly decorated industry veteran Craig Richardville joins us from North Carolina. Good morning Craig welcome to the show.

C Richardville:               01:18                Good morning Bill. Thanks for having me.

Bill Russell:                   01:20                You know I assume you’re in North Carolina but every time I check social media you seem to be in it. And like other countries or other locations are you in North Carolina today.

C Richardville:               01:29                Today I am even though I had you had New York in my background. So I think when you’re when you’re a child you know that the world is so large but as you get older you realize it’s very flat and you could really make yourself very mobile in any place than Egypt.

Bill Russell:                   01:44                Yeah I think one of the person I saw you were you in Asia doing some things in Asia.

C Richardville:               01:49                I was I did some work in Thailand. I was a very large health care system a healthcare system that was that part of the system was more of a community service system of the 20th year but a single facility hospital with an that are it. Then they also had a private facility which has 350 beds. Here to enhance the reach of those that had more of a cash payment system.

Bill Russell:                   02:13                So it’s health care. So health care is pretty dramatically different. I mean Thailand’s pretty I mean if you’ve been to Bangkok it’s a pretty advanced city. I mean it is a pretty dramatically different a pretty similar to what we have here.

C Richardville:               02:27                It’s interesting you know when we’re going into I have some assumptions of what I was going to run into and some of those assumptions are wrong the way I would say it is that when you look at the U.S. healthcare system as on that digital technology ways it’s much more advanced than what I observe. However when you look at outcomes we look at margins we looked at all of the measurable pieces that we all fire to the actual we’re leading in many if not most all of those cases.

Bill Russell:                   02:56                Wow. That’s interesting. Well I’m going to do that for people who don’t know you do a quick flyby of your accomplishments and who you are. If they want to know more you have a website. We have KHRAIS Richardville dot com.

C Richardville:               03:10                Yes I do like this. Yeah which has a ton of stuff on there. You’ve done advocacy work in the nation’s capital.

Bill Russell:                   03:18                We’ve already mentioned in 2015 John Eagle Jr. CIO of the Year by Time your 2017 Leadership Award for Charlotte CIO. Most recently North Carolinas HealthCare System which is now interim health for those who don’t know roughly. I mean that’s roughly about a billion dollar system is roughly right.

C Richardville:               03:42                How you measure it. Somewhere around 6 billion in terms of the owned assets that we look at to manage assets is right around 11 billion.

Bill Russell:                   03:51                Okay. And the geography is today is Caroline has been obviously the name change sort of denotes that it’s moving outside of North and South Carolina I would assume.

C Richardville:               04:00                I think that’s the end of the age range for my when I was there we had three hospitals when I left we had 42 all in North and South Carolina.

C Richardville:               04:09                So clearly you will work to do while you are there. So 14 years in a row most wire designation which is awesome. You’re a fellow at the American College of Healthcare executives fellow at healthcare him’s chairman of Premier member technology improvement committee.

Bill Russell:                   04:28                You’re on several board University of North Carolina Charlotte Foundation board member of Care Connect or member of Carolina shared services. So not only were you able to be the CEO of a rapidly growing health care system but you found time to give back and be a part of a lot of these things are going on in the community which was which is exceptional. So you know one of the things we like to do with our guests is start with a pretty open ended question. Once you know which one thing or what are some things that you’re working out today that you’re really excited about.

C Richardville:               05:02                Well there’s probably two things on that. First and foremost I have three boys and two of them are getting married within the next year. I want to move along and Southern but so from that standpoint I like any anywhere that’s really on top of mind for me. But secondly professionally what I’ve been doing for the last 6 7 months is really going out and looking at different companies different companies of different sizes different companies that actually deliver across multiple industries and looking to see a handful of really golden nugget companies that I would really be interested to be part of working with and or when I was an associate I would really appreciate if people free those kinds of nuggets to me.

Bill Russell:                   05:43                Yeah. You know one of the things I’ve thought about is we could do a whole show on CEOs in transition. I mean your story my story and a handful of others that I’ve had conversations with I know that a friend of mine just became a co CEO a former CEO here. So there weren’t just Emeco CEO of a pretty fascinating tech startup and doing some really cool big data stuff in healthcare. And I think there’s a lot of different directions CEOs have ended up going. They can go in that startup preme from from Stanford went to a startup. This gentleman from Merlina went to a startup. So you know the startup route you go back into the CIO route. You know I started a consulting practice going back out. What other directions do you think CEOs end up going at this point do you have any thoughts on that.

C Richardville:               06:42                Yeah you know I think it’s it’s a very interesting piece to be. I mean the role that we’ve had the other fires as well Don of us especially in healthcare and what we’ve been able to do a lot of things in a very short period of time where we look at some of the other industries where there’s retail or banking others that they’ve done some things over a couple of decades to their. We’ve done things you know anywhere between 6 and 10 in some cases 12 years. And I think we really advanced the system so we look at a CIO look at the industries most industries are the only technology centric. The CIO role can actually go all the way across. So I like it when people are saying the CIO is the CEO or the CIO within Oracle healthcare and the CIO within retail or banking.

C Richardville:               07:28                I think there’s so much that we can deliver that to other industries or other companies. One thing I’ll say the most that I think for all of us that have been successful in this role. The biggest thing that I have been proud of and I’m sure you yourself and others is really just that they’re all little people and having the ability to learn and to deal with multiple people at different levels across the organization. You don’t come in with the mindset of technology person you come in with the mindset of a business person to solve problems. And because of that you know you get all the other senior executives able to bring them around so they can be part of that decision making process or part of their circle.

Bill Russell:                   08:05                Yeah. We’ve learned that when somebody goes hey are you going to do this. Are you going to do that EMR migration are you going to bring all those things and our first question is you know usually what problem are you trying to solve. Tell me what you know. And then and then yeah then it’s a matter of rallying people it’s really it’s now leadership in a People role much more than attack technology at this point.

C Richardville:               08:27                Yeah for me you know sometimes that answer is it’s not. I’m going to do it. We’re going to do it. Yeah. It’s all about autism. We’re all in this together right away.

Bill Russell:                   08:35                The objective is Yeah absolutely. It’s our show breaks down into two segments in the news and in sound bites where I ask you a series of questions we’ll start with in the news.

C Richardville:               08:45                I think the big story this week and we try not to cover every one of these that’s talked about but this one’s pretty big comes from the usual Chronicle. It’s the Memorial Hermann to merge with Balash gotten white creating the largest health system in Texas and we know that in Texas they like to have the largest things and this is now a pretty significant.

Bill Russell:                   09:06                While they were they were significant health systems in themselves bringing them together makes some preventive. So let me read a couple things from this.

C Richardville:               09:14                Two of the biggest hospital chains Texas announced plans Monday for a merger that would create a mega system stretching from Dallas to Austin to used in treating patients in more than 30 counties and employing more than 73000 people across the state. Memorial Hermann Health System Yushan biggest nonprofit hospital chain and Baelish gotten White Health the largest and Dallas have signed a letter of intent to begin negotiations with the goal of having a definitive agreement in place by next spring. And then it has the usual stuff growing national trend.

Bill Russell:                   09:46                Like minded systems economies of scale to address growing consumer trend within health care. The article actually gets a look a little a little more interesting down at the bottom. And that is you know the cost of health care is the number one issue in America whether it’s in D.C. or us in taxes. One of the people was quoted as saying saying so taking cost out of a system will be an important part of the journey as we come together. Actually this was the CEO I believe of Morino Herman. So they actually just come straight out and say taking costs out will be an important part which is actually kind of unusual for these kinds of announcements especially this early in the process. Officials said that most of the cost savings would come from a sharing of expertise collaboration and technology as is usually the case. It’s not clear whether the merger will lead to job cuts. That two systems combined have nearly 5000 current job openings so with 5000 job openings there might not be a need is what they’re essentially saying. Actually I find it interesting usually when mergers come out there’s there’s no talk of any any reductions at least for you know a good period of time to have one of the CEOs come out and start talking about reductions as early as pretty interesting. Have you seen or what have you. Have you ever. Have you ever done a merger.

Bill Russell:                   11:16                Have you ever done a merger that hasn’t led to some aspect of. Sharing or job job you know attrition in the process.

C Richardville:               11:27                Yeah well I mean we look at the cost of healthcare. You look at your healthcare provider you’re somewhere between 45 and 5 of all of our expenses are Labor. So I’m that point is just as reasonable as the worthy doing it as a an objective or either murder or an acquisition or is going to be some impact to your labor bottom line. But you know it depends on how you handling it. So to me the most important part is try not to affect. So the fact that they have 5000 probably budgeted job openings means they could put several thousand jobs restructure the work the process the workload and impact that person will still be able to achieve their budgeted expectations of reductions. So given that Baylor and Scott in the light of recently Bombolas Memorial certainly is a very well recognized and respected organization I believe with both of them coming together with the assets assets they will have the opportunity to you know to make a difference and I think part of that will be to lower the cost of that that the expense structure that thing that happens without those. What are you going to do with those savings and those savings can be reinvested back into the company do other things that go toward bonuses. You know to administrator of physicians and others or let them go back to the patients or combination of all three. That’s where there are opportunities to grow it is ending what the outcomes look like.

C Richardville:               12:50                One is going to be one of the Pops to better the patient experience or the patient.

C Richardville:               12:56                Yeah. And actually has the story goes on towards the bottom they cover so many health care economists disagree on the notion of hospital mergers leads that are more efficient care for patients. Vivian Ho healthier fresher from Rice’s Baker Institute of Public Policy said she worries the proposed merger could have the opposite effect. She pointed to research showing increasing health care costs and they have four or five other corroborating kind of statements around that it hasn’t meant to better outcomes for more costs in the communities they serve. Why do you think such mergers haven’t led to either better outcomes or lower costs in the community. Is it. No. Is it because we’re not taking those savings and passing them on to the community. As it is it less competition in those markets. I mean what do you think. What do you think.

C Richardville:               13:59                I think that those are very valid point statements. The concern is when you have somebody of this size coming then they get you in the most mess with the out of the deal. What is the deal that is being done. What are the realistic after expectations in many cases they may overcommit number below or even know that delivery might be better than what the previous Barma was commit acts you don’t achieve it it looks like it’s a failure.

C Richardville:               14:27                So for me it’s really kind of fun to find the right balance of that with the level of delivery and making sure that the community and the patients and the providers all as well as some of them.

C Richardville:               14:39                When we look at change management having been through several mergers acquisitions partnerships loss management agreements over the last few decades it’s really all about establishing the right expectations then realizing those expectations in many cases. And your goal is to overachieve. Once you’ve already committed to so long as you go into it.

C Richardville:               15:00                I think with that was the understanding what you want to try to get out of that is sure that it’s measurable. Sure we could track it that and the other part is we’re in a very ever changing environ. So we start to shift and move things from volume to value. There are some experiment where today when they make this announcement years five years later we’ll be right. It’s not of the environment the same environment that would be all the combined aspects and may impact what those results would be and how some people may have been a lot worse. They could’ve been a lot better. So it may just had measure margin ensuring that you’re doing the right things or what the ballot or in these cases you know there are community based of that standpoint. What they want to do is measure the benefits back to the community.

C Richardville:               15:44                And those are the measures that multiple different ways that change managements of these two. I think that’s probably one of the underlying assumptions that people don’t take seriously what they should as the change Madgwick the absence of want to have a more efficient system more effective system that means the going to change and in many cases as you know Bill these people are going to have to change. People are really hard to change. You’ve got two organizations highly respected highly decorated coming together both going to have best practices but the reality is there’s going to be one best practice. So it’s not going to be multiple. So as you start to bring Internet service lines together different areas together we’re all going to have to reassess what the next best practices are would be that would be either of the two that they’ve been practicing but actually there’s a forward out of a state of the possible world affording it together.

C Richardville:               16:35                I think that the utopia Robert so here’s the good news.

C Richardville:               16:40                Good news is that Matt Chambers has been. He’s got the merit badge on him and because the bill has on why merger or something. He was present for so he said before which means I’ll have an appreciation for the complexity of war change management and all the things that you’re talking about. I know that Memorial Hermann was doing a search for CIO earlier this year so it’s not really clear to me whether they ever fill that position. So let’s I’m going to shift this towards health care I.T. now and just focus in on that and bringing back some free consulting. Not that he’s asked for it but we’ll give it to him anyway. What do you say. What do you Matthijs to do now. They haven’t even gotten to a definitive agreement yet. What do you think Maddi’s to do over the next six months or so to try the best outcome for the merger. From you know for both organizations.

C Richardville:               17:37                Well this is the most important piece of a relationship I to really understand its organization what a combined organization might look like more than Apollo. You see it all across expensive or sometimes they have a lot of them together but they don’t make it at the start to peel back the onion. They start seeing that there are things that maybe they had expected or unexpected things or to show either organization. And we try to bring it together to offload problem. The answer from that is whatever those things are are back we see some that are successful some that have gone on and you know for a couple of years several years before making a decision. I think this is the most important pieces to truly be a very open transparent and there’s a due diligence phase where all each organization is really exposing themselves to each other.

C Richardville:               18:27                That is the opportunity to make sure that early understand what you’re getting into so that hopefully in the spring comes out you have to find a lot of agreement and objectives of one of the powerful and a realistic expectation of the achievable goals for those agents. So these next six months or so I think are going to be wonderful that everybody is open transparent as well be and are forgotten about what they really know what you’re getting into. Just like any marriage you know you husband the wife for any other relationship you’ve got to really understand the other party coming into the water.

Bill Russell:                   19:02                So is there a common mistake that the IOC make in human activity do you think.

C Richardville:               19:08                Yeah. Do you know.

C Richardville:               19:09                I I can’t say that as it’s always a mistake but I think there is an assumption that running on a single system or a single set of systems is the best way that you know so whether you’re talking about amount what you’re talking about you know corporate areas with the air systems or etc. I think there is a national embassy to save for all of on the same one it’s going to be better and more effective more efficient. I think what happens is both systems in this case or in any other case have made huge investments in audio over the years. And so just to throw away that investment and merge together that’s a big cultural issue. It’s a big financial issue. I think you’ve got to really understand which of the parties that meet together for the organization together. See things like communications systems of e-mail systems cetera.

C Richardville:               19:59                Some of you are seeing all that coming together right off the bat that we as a as a strong player are do what they want to use what you want to be able to operate like one system. We look at things that are these systems. To me that’s probably something to the US are bringing together with the SES target somehow that’s out of the work that we did that unclear systems well those are very sensitive systems. It there’s a lot of problem out of ownership of what they want and it put them all on the same system may and may not be the right thing to do at that.

C Richardville:               20:31                I do think as time evolves. It does become the right time once you start to appreciate that investment has the to reinvest reinvest operating at the dollar they have to be that right up front. I think you’re probably going to waste the dollars are yet to be realised in terms of other returns. And it’s not a priority at this time because it brings those of us service leaders together. Well those are people that are extremely right. They are optimistic they have a lot of characteristics that are going to be you know that they have the best practice in those areas to take some time to work through and shortage of that type of issue. And I think those are things that probably lag a little bit farther down the road. But to me it’s just discount to reiterate is really that yes the one system in which it does that may actually cause more problems with change management education and things of that nature and in many cases because we’re so immature in our market where with our systems some like the baby some of leader. This is what they do. They made this happen. Others are mad at that name. This is something that really emotion tends to 21 which is not just yeah a lot of emotion.

Bill Russell:                   21:45                It’s interesting that that does end up being one of the first questions that gets asked by everybody who gets asked by the media gets asked by clinicians like are we going to the system are we you know and the answer to that question is you know we’re still working on a definitive agreement. What’s the definitive agreements in place and we’ve you know we’ve we’re working towards merger. We’re still that could be on to make a decision.

C Richardville:               22:10                We’re not going to be able to make that decision until our clinicians are sitting in the room with their clinicians talking about all aspects of medical care and what are desired outcomes are in and determining you know what’s the best system and what what drives the best thing. So if it’s usually not for another 12 months after the merger unless it’s a balanced case I mean if it’s a merger of this size to equal sort of coming together that’s that’s a different animal than say you know large healthsystem acquiring a small whatever practice. That’s a that’s probably a different conversation. But even then it’s not the kind of thing while you’re doing initiation that’s that easy to answer whether it can be the best.

C Richardville:               22:55                So that you know today’s world and the future of the delivery of healthcare in our operability become such a key council that you know that the other providers in your market are not going to have the same core information systems that you have. In many cases and from that standpoint you gotta start proving your ability are in science you’re out communicating back or other providers is going to add that in your ACL or other types of association that you’re rating. You’re going to and they have to have that are being integrated back for multiple different vendors. Yes.

Bill Russell:                   23:32                Yeah. You Mashele Mashele figured out now I’m going to move us to the next story and we’re actually not even going to cover the next story we’re just going to use it as a backdrop for conversation. So healthcare as a whole section on security and one of their stories they have is 10 stubborn cybersecurity myths busted and they have some things listed there that are pretty interesting but it got me to thinking it would be interesting to talk to another CIO about you know what they think are some cybersecurity myths that are out there and why there are myths. So here’s the challenge. Well I’d like to do is go back and forth on some of the myths that we use in cybersecurity. Mess we’ve seen in healthcare that are out there and just sort of battled back and forth. And just to give you an idea of you know start us off.

Bill Russell:                   24:25                I was in a I was in a meeting with our internal auditor and we we were sort of presenting our security posture and they were sort of commenting on it and a former NSA person was sitting there and she looked she looked at me and she said she was OK I’m here. I’m going to give you one thing that you need to do and that’s going to change how you do all of your security. She said assume they are already in your network. And as we start talking about it I think the myth is that you can keep them out. And she said assume they’re in your network and they might even be in with proper credentials. And she goes so now how do you design your security. And I thought wow that really does change things. Instead of that exterior being the end all be all.

Bill Russell:                   25:18                Now you have to look at a more comprehensive security posture where you’re looking at people’s activities on the wire and saying it does that activity match what they’ve been doing for the last six months and if it doesn’t that becomes a red flag. So you’re looking at behavior on the wire you’re looking at actual creation of data you’re looking at a lot of different things than just you know do we have. Do we have the wall built up and do we have policies in place. There’s you know sometimes with the walls built up as well as you can and your policies in place as well as you can. They’re still on the wire and you have to start looking for that activity. So I think that’s you know for me that was one of the biggest myths that was busted for me which is you know assume they’re on the wire and assume that you can’t keep them out. Yes. So what’s a myth that you’ve run across.

C Richardville:               26:11                Well you know interesting like for example in this article it’s health your I.T. news and you know for me when you look at you know cyber security and the whole aspects around that this is not a health care issue. This is a toll all industry issue. Everybody’s in it together. So the fact that we advocate on behalf of the health care services and retail.

C Richardville:               26:33                And this is one of the things like for example the CIO that you mentioned that he wanted to take that out of the church.

C Richardville:               26:42                And yet over 700 people participate. So what people are interested about many things together cross all the industries now were proud to have been part of that. When we look at cyber and next week that’s actually as our as our next event is we have one that reports about cyber. So you’re going to have major banks and you’re going to major retailers with major energy and major health care systems in town etc. all participating on the cyber East.

C Richardville:               27:09                So it’s really not the health care I.T. type thing. It is a massive business so we look at not even the CIO dot com but these are the business aspects Wall Street Journal New York Times you know the types of information that needs to be exposed to as do the board members and the senior executives.

C Richardville:               27:27                This is a business issue of having the cyber security. The one thing we don’t have the luxury of that we had in the end you know from a physical security attack. I don’t have the but you know antimissile systems are around my disability right. So the government protects us in certain aspects but we look at the Internet and the way this serve to be a global network. The United States can’t put a border around it and provide those protections.

C Richardville:               27:50                So we’re kind of all in it right now on our out.

C Richardville:               27:52                So to me I think it would be a very nice way to move forward is to actually have multiple across industry CIO leadership getting together to start to look at how do we fight and protect our assets our data from cyber attacks as a unified industry as opposed to the different sectors of the I can see that as one of the message that we probably believe is that we need to do this ourselves.

Bill Russell:                   28:20                And as you’re pointing out we all have the problem. I remember hearing a gentleman speaking and he said it actually was sort of this and the government alone that he just you know her cybersecurity essentially these countries these countries that are stealing the data and in this case are use China as an example because this is the equivalent of China parking aircraft carriers off the East Coast and West Coast. And just you know attacking on a daily basis he said you know the federal government needs to step in here he goes because almost none of that state a nation attack on your individual your individual organization because those nation attacks those nation state attacks on your hospital or on your on your organization are and you know unlimited funding unlimited time unlimited unlimited resources. So you know. So how do you think we’re going to partner with how you partnered with say the FBI the with the federal government. Have you seen them sort of take a role in this.

C Richardville:               29:28                You know I’ve advocated by a lot of lives for most of their cyber was one of them.

C Richardville:               29:34                And so I represented China which is a fantastic organization that you know represent a mere part of those discussions that are going to the federal government is they really will say if you want us to help put some borders around we’re probably set you back about 10 years. Given the different restrictions and the different things that they have in place there and the expertise that they don’t so I really think it’s across all industry.

C Richardville:               29:58                That’s why like for example next week at the trials will be all this yellows across multiple industries is any you know probably about 40 to 50 different major companies that are owned based here in Charlotte will all be coming together to talk about cyber and things that are doing where we’re going.

C Richardville:               30:18                When you say do it yourself you’re 100 percent correct. I think that’s a misnomer that some of us you know may have had in the past. You know I started doing cloud computing oh you know maybe about 10 12 years ago me things off premise moving things out knowing that I did not want to be a data center centered company nor a service but that was going to be more of a utility scale what I’d do with an innovation that actually make a difference and one of the questions that came up was how are you going to have our Asian data our most precious data you know off campus somewhere else being store. You know my response to the board at that time was you know you can’t expect me with the budget and the investment that you’re making today. Do you have a better perimeter for protection and detection when it does come in as somebody who does this as part of their core business.

C Richardville:               31:09                So actually by moving it off site or moving it up to the cloud in many cases you have a higher level of security and protection by doing it that way. And then it becomes more of a service you’ve still got to have some people on the streets of the street in your shop. Are a lot of those services the 724 Marjorie all those types of pieces need to really be helped by somebody who does it as a core component of their business. And we do it as you know Campbell most like a insurance policy for business. It just doesn’t have the amount of investment others can do you know. And they in this year space.

Bill Russell:                   31:45                Yeah. And I think this that is one of the mess right. So cloud is not secure. Well you know St. Cloud is not secure is like saying healthcare I.T. is not secure. Well it depends on which when you’re talking about but you know Microsoft’s cloud Google’s cloud Amazon’s cloud boxes cloud salespersons cloud you know if they get breached that’s their core business and they will have a significant hit on their revenue. Their shareholders earn their share price. I mean so you have to know that they’re spending a ton of time in a ton of money on security and probably far more than any individual health care system is spending on security so I agree with you I think that’s one of the messes that cloud does not secure. There are many clouds that are much more secure than what we have. Here’s another myth I’m going to throw at you which is cyber security technology technology problem.

Bill Russell:                   32:38                I don’t you know cyber security has a component that’s technology. But you know at the end of the day it’s you know 70 percent of all breaches are caused by individuals either you know clicking on something doing something reusing their password all over the Internet having it hacked that way. I know that and I shared this before and that you know there’s a CIO I know went to our say I believe and said you know we want to do an audit. We want to see if you can get some of our physician credentials on the black market and it only took him about 48 hours to come back with some actual credentials of acting physicians that they could log into their Sitrick environment get into their EMR and start viewing patients and when they did the research on why that was because those doctors used those same credentials that they used to get into the EMR they use them for their banking system. Because you know have to remember 20 things. So it remains they were remains a people challenge more than anything. How do you get. You know this kind of right now 70000 some employees with more armament. How are you going to get 70000 people to act in a way that’s not going to jeopardize your security position or security posture and that still remains the biggest problem with security anyway.

C Richardville:               34:06                Yeah I think part of that is with that as we look at in some cases I think there’s also an understanding or at least the feeling that in many cases consumers are a little bit numb to the zappers security number one they don’t understand it. We’re number two we’ve probably all been breached. You know a handful of this in the last over years or there’s a target breach of the Facebook I mean you name it I’ve got several different you know monitoring services free of charge on me because I’ve been breached so many times they offer that out there and so when that does happen to take advantage of it getting back to the core question about the company.

C Richardville:               34:40                I think it is a people problem but a technology solution and by the solution standpoint. You know it is the people that are doing this. The wounded go through it we all the the education we all do the fake phishing.

C Richardville:               34:51                We all know we did all those things and we look at it the way you tell the Department of that division I’m coming at you next month. You know it’s a bust. You had to see marginal improvement. People are still clicking on those phishing attacks and jumping into you know places that there really should be jumping into. I think it’s for us. You know it’s still looking tenuous to try to manage monitor or detect and when it does occur because you’re right. Every system every system has been breached. If he had not been briefed he just felt no right to ask the. Are they the underline that you have been breached. So once that does happen it’s like the question that somebody posed. You want to just assume they’re already in your spot. You have to contain it. You have to get it so it doesn’t spread.

C Richardville:               35:35                Then you have to remove it. You have to figure out how they went and try to plug all again because it’s an ever changing world. You know when it comes to the expertise coming in on these attacks your thing I’ll say is we look at today’s Internet occupation it’s about 4 billion. I think they’re estimating it to be 6 billion in the next five years so there’s going to be a 50 percent growth of the potential number of victims for cyber attacks. So you talking about the cyber criminals. You know they’re just guys salivating like my number of potential attacks will go up by 50 percent of victims over the next five years. That’s a huge growth. That still isn’t even the total population. So from that standpoint I think they see it as a policy getting bigger. That’s right I think as an individual company or an individual industry there’s only so much that we can do.

C Richardville:               36:27                I think to step it up a notch to do things that are all industry like we’re trying to do here in Charlotte if you get bumped that up the other major cities and have those cities on the other I think you will see over a period of time possibly everybody working together on this because to me you know this is not an opponent of any type is this you don’t wish this upon you know you are your worst competitor. This is not something they play with. We all want to play in a very safe environment and have everybody’s data be protected. You were there yourself salty competitor across the street or some entries so as for all of us to come together and that’s going to be I think with the leadership the boards the CEOs come together start to leak things and so we look at some of the mergers that’s probably you know one of the advantages that goes undetected is a leisurely and look at the merger we are about the beginning. The one thing that will say is those are two very large organizations and now will be able to share best practices among each other about how to better protect you know the assets of the data that all those to keep on behalf of their patients. And so they will end up having at the end of the day a much better detection in place than what they really have in each individual organization.

Bill Russell:                   37:37                Yeah well I’m going to move along. This is this is the part where you’re going to end up doing the majority of the talking I’m going to sound my section I’m going to toss out five different questions. Short answers 1 to 3 minute answers if you will longer I’m not going to stop you. But generally one to three minute answers on these things. We are focusing on innovation. The first time I met you was at a Dreamforce event and I think we were the only two healthcare CEOs at the event and we missed it on a table talking to people about how healthcare could benefit from around and and you know I think it was pretty forward thinking back then. And I was kind of surprised to even see any other health care CEOs. I think there’s more. I think Dreamforce is actually going on this week or more. Yeah I think it’s going on this week. There’s probably more health care CEOs there now than there were before so. All right. So five questions. One the three main answers. Let’s start. Question everyone what industries do you look to for inspiration for innovation within healthcare.

C Richardville:               38:42                Greg glycine my answers may be all. I think there’s a lot of nuggets that they gained from all threes so we look at the energy sector.

C Richardville:               38:50                There’s things that they do to try to limit the use of energy. And so from that standpoint we’re trying to limit the use of health care. So those are both two very precious resources. So I think will learn from them. Retail obviously and how to brand how to get things out there baking services all that stuff kind range things into patients hands or consumers hands putting things in your pocket. I think all those different industries are all things that we can learn from. We never get within healthcare had to or very rarely had to focus much on the humor aspect of delivery. People came to us because their doctors told them to come to us or people with those Daccord because they were a part of our plans that they were in network or out of network. You’d have had a network. I don’t have any network.

C Richardville:               39:38                You know the jail shop I can go to wherever I walk. And I think now that we were getting Mutulu although I lead at a slower pace than expectations in terms of you know consumer directed and high deductible plans. People do have choices to go in and out of network for the best value of their dollar that the only way out of their wallet. So from that standpoint I think there’s all the other sectors got to learn from now that there’s a specific one that would be all of them I do believe they all have advantages where they you know move ahead. And that’s where I think when it looks like it’s just a shadow Association you know when we started coming together half a dozen years ago or so more formally what we realized was 80 to 85 percent of all the work that we do was to say that there’s a there’s very few that actually the things that we perform as a CIO that actually was different in a day versus a energy sector versus the healthcare sector. So what we found that went out that quote unquote special that we always thought it was really great to be able to share things back and forth and use them the techniques that they used and bring that out to the healthcare industry.

Bill Russell:                   40:46                So that’s great advice so if you’re healthcare I keep her knowledge relationships outside the industry and you know you might might learn some things and they might say she thinks it’s great to have those relationships. Second a second question what one core technologies do you think need to be in place for health systems to become really a digital business or digital platform for business.

C Richardville:               41:11                I think what you have to do is you really have to empower the patient patients last Masoom Ahmedi use are interchangeable because to me it is interchangeable. The Asian actually has made a commitment on the organization. But the next time next week they are a consumer again making toys. So to me got to be able to put the information to make decisions in their hands. You know when most of us do you know transfer money to our children or somebody else I need to build our own and we make the payments that way. We want to purchase something. You’re sitting there in your car driving along and as you see there you know we need X people out on that we buy that piece of thing. We want healthcare. We just become a havinga just logic when we deliver that. You think it’s going to grow and that’s where I think you see some alignment with banking or banking at big banks that we have hospitals they need at branches and get urgent care centers and in practice and then we have you know urgent care centers they have he asked machines you see a lot of things that are happening that way.

C Richardville:               42:18                Now I think it’s mostly in your pocket. So for me I think the number one thing is to be able to go to the patient where they want to be at versus that have the patient.

C Richardville:               42:30                That’s going back to 10 years ago we all got into telemedicine every hour. Now that I read recently kind of continues to show the amount of savings that is occurring not only in terms of that actual cost per that is it but also that with the repeated recurring afterwards I read something this past week that talked about if somebody had a virtual visit versus a visit with a primary care physician there is less likelihood that that patient will show back up again for any kind of health care service within the next three weeks. But if you go to the primary care they’re going to want to follow up as is. So from that standpoint you know seeing the costs going up when you start doing it the old fashioned way and the new way having it in your pocket you kind of want it done here she needs to reach you. Most of us typically have our own pockets at all times.

Bill Russell:                   43:16                Anywhere you can access that information real time metrics skills. Third question so I’m luck. I’ll narrow it down to three areas three areas like your thoughts on innovation possibilities for each. So let’s start with the clinician experience. So what are some opportunities for innovation in that in the way in.

C Richardville:               43:42                Yeah I think there’s two things. I think one is nation generated data that the page and the word you know that him or submit your online or submit via you know the Web the information at their galleries of modern somebodies idols. You know let them take the violin. Almost on that’s it’s Ill let them do the things that they needed and have that information be imported back into you know the for either of them. So I think wouldn’t that work. What about the patient. You know most of us if you look at banking again you know the road Jackson that after you went to the bank to get cash. Well now all that stuff happens to me.

C Richardville:               44:20                So let me do the work I do those working those teller activities myself and I want to do it myself. So let me do that work for you and I think on the other side you hear a lot of the interaction with EMR and one some people measure satisfaction as a very highly correlated with the amount of looks that they have to use on their on their mouse. Well the voice technology has certainly advanced use the voice to interact with the system just like you use it for a lot of the today. Yeah I saw you can pay bills you know using the voice schedule on images in the voice second read back to back you may view an exam room talking to a patient and you want to see their most recent results. Let your voice be the input into the system to allow it to navigate for music and bring that information out versus turning your back on the patient. Looking up here looking down here when things back up I think the voice will alleviate some of the frustration that people have. Other providers have interacted with the.

Bill Russell:                   45:17                So it is second area innovation possibilities around the consumer patient hybrid listeners to separate but since you brought them together as consumer patient experience what’s I mean this is probably the most talked about area was once some of your thoughts on innovation possibilities for consumer patients.

C Richardville:               45:38                Yeah and this this will be innovative for healthcare get out there for other industries and you start to see that come out recently Walgreens announced a couple of months ago a marketplace.

C Richardville:               45:47                I mean you really have going to have to bring out cost quality the open be transparent don’t fight that don’t keep it inclose don’t keep it as a protection for you within your healthcare system if you’re not proud of your review of your policy arm then fix it. Fix that problem. But I think as a consumer and you know next time I want to make that decision I want to see all the possibility just like when I purchase a product or service or go to a hotel I can’t pay any hotel in that city. I can see what the cost is for that night. I can see what the quality reviews are you know for that hotel. I can read comments that people made about it. I can look to see if I have any other kind of points or things that I’ve earned to allow me discounts or other benefits before I make that decision.

C Richardville:               46:33                When you look at health care you typically go in line with most if not all that information. So I think the marketplace is going to be a big piece for consumers. I think the health care system as is hey we’re very high quality. We have reasonable costs. I’m a great value. I’m going to go out there with a key online open TransFair with other providers and we look at that especially at telehealth that services those borders around the state. Those are going to be very soon disrupted broken out. You’ll be able to see providers Ross you know multiple states and so from that standpoint I’m in California the byproduct in California I can buy it anywhere in the United States never be delivered. And that’s going to same things can happen with health care. You’re going to have that openness that transparency but we made these decisions and it’s going to be a demand from the system I mean from the consumer they need to be able to make well informed decisions. And I think destined to be a driver for us in that marketplace.

Bill Russell:                   47:32                All right well let’s shift to the Foursquare. First question is how do you engage the consumer patient when identifying innovative innovation opportunity. So I know that some health systems have patient panels that they bring in and some that will include patients in their innovation sort of identifying the opportunities and tracking the progress of different especially mobile technologies and those kind of things. How do you how do you engage the consumer patient in your innovation opportunities.

C Richardville:               48:11                Yeah I think those are all great ways of doing it. The one thing that you don’t want to do is you don’t want to think something that hasn’t been tested yet and beyond that the proof of concept to bring that out to the market to be exposed is that although you know that will not be the representation so for me with the reptile is like a dimmer switch you can get the idea you turned on.

C Richardville:               48:33                You start to get feedback you keep on doing it keep turning it up but you can they get dimmer switch and once you’re ready to roll up it all the way out. So that’s not an issue the issue is how to get from the current starting point to high. And I think in the article yet asked way because whatever the innovator today for you tomorrow somebody else can imagine you got the on to the next. So once you get something there you get it rolling you’ve got to be thinking three to five years ahead of what I want to be delivering. Then when the health care system or the physician market or whatever you know whatever area that you’re working in is right to take advantage of it. You’ve already moved on to something else. It’s up to them to change their processes to take advantage of it to modify the people to be able to take advantage of it and to bring all that together. So from a technology perspective you’ve got to be know services and that’s the way you look at your market. You look at your healthcare system. It’s going to be up to them to accelerate and bring that up. We look at whether the consumer you can get one shot. You know what you can’t mess up the apple somebody they can move on to an actual fighter. And that’s that really got to be careful before you get to the office. You’ve got to be.

Bill Russell:                   49:41                Yes I know. Last question if you could eventually be with one of these innovation partners. The last question is what do you look for in a vendor partner that is bringing innovation into your health system. Are there certain characteristics you’re looking for. You know what are you looking for from them.

C Richardville:               49:59                I think to me probably first and foremost it’s it’s kind of having a shared vision a shared culture you know people that have the same type of relationship that you want to have together.

C Richardville:               50:09                So from that standpoint you know bringing people in the work both within the organization I think is extremely important and equally important to me as Sherriffs Well this is an all upside for them and you know just downside for you if it doesn’t work. This is a share that we both in a and together are going to make it together. Now something that I’m here to be a test that for years you can go take it somewhere else. I want to be our whatever that is I want to be part of our solution to make it so that it’s actually an advantage to our health care system.

C Richardville:               50:38                Let me help you be part of something else. We look at things of that nature. You know sometimes people go back and they look at how they can know almost like or take advantage of those relationships. I don’t like to see it that way because it’s to your advantage that that partner is successful. So it’s not squeezing everything out of them. Put all the risk upon their back. They don’t make it too bad. Another one tomorrow. I think this is something that we do due diligence that you’re going to be working together when you have these kind of stumbling blocks that aren’t a good alter order what we want to get a outclasses that you are going to be lots of Mathale will change and modify opt into that whatever you’re looking to me as be a good fit.

C Richardville:               51:18                And that could be a shared respite.

Bill Russell:                   51:20                Absolutely. Well Craig thanks for coming on the show. Is there a good way for people to follow you on social media or other things.

C Richardville:               51:27                Yeah sure. I mean I actually think Rehder together is the I think I’m the only one in the world that actually has that net. So from that standpoint you know we look at Craig ritual that com or any of my social media whether it’s on the Dan or whether you’re looking at Twitter or anything of that nature laden and the virtual that is the best way to take a look at me and this is some of the things that we’re doing and I’m totally okay with to engage in open discussions anybody has any questions Kamis thoughts. I just want to kind of brainstorm us stuff like in this case with you. This is so enjoyable and that the information that you bring back to all of us is fantastic so I certainly want to applaud you for what you’ve done over the past year. Certainly you’ll be able to double your goal as we all do things of that nature.

C Richardville:               52:18                So congratulations on that. But certainly if anybody has any questions thoughts that’s network it’s at the semi or at least that no regrettable that damn you know like or that contact me and be more than happy to get back to you and that’s the one thing that I will say I’ve never ignored nor the message I’m alive. I have always replied back and the reply might not be the answer you’re looking for but I’ve always replied that so please feel free to reach out via and having Vinicio and having reached out to see Io’s that’s no small task with the number of people and cations you have to deal with everyday.

Bill Russell:                   52:54                So awesome. You can follow me on Twitter at patient zero the Healthworks website for my writing. Don’t forget the show’s Twitter this week.

C Richardville:               53:02                HIIT. Check out the website this week and I’ll let you dot com and the videos this week and highlight com slash video will take you to our YouTube channel. Please come back every Friday for more news information and commentary from industry influencers.

C Richardville:               53:17                That’s all for now.


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