Camille Baxter:
Hello and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter, and today we are speaking with Brian Doerr, senior Vice President of Information Technology and Security and Privacy Officer at Community Hospital Corporation. In his role, Brian is responsible for the implementation and development of all IT security and privacy related programs for CHC and CHC hospital clients. Brian has an extensive background in technology services and hospital cost management.
Previously Brian worked as senior vice president of technology services at Argyle Solutions and director of business intelligence for Duke University Health Systems. Before we dive in, we'd like to thank the sponsor of this episode Community Hospital Corporation, otherwise known as CHC. Since its inception in 1996, CHC remains a not-for-profit organization whose sole mission is to help hospitals improve performance and remain community operated and governed. Based in Plano, Texas, CHC provides community hospitals with the resources and experience they need to improve the quality of treatment outcomes, patient satisfaction, and financial performance. Today we are talking to Brian about how technology can be an important business strategy for hospitals and how to transform IT with limited resources. Brian, thanks for being here today.
Brian Doerr:
Good morning, Camille, and thank you so much. I am always super excited to talk with you about healthcare and technology and transformation.
Camille Baxter:
I know you've done this a lot and I'm really looking forward to getting into our conversation and learning more. Can you tell us a little bit about your time at CHC and talk a little bit about your healthcare journey?
Brian Doerr:
Sure, sure, sure. So I've been at CHC almost 15 years. Before that I was with a small company, Argyle for a little bit, before that with Triad Hospitals and did business intelligence there as well as at Duke University. So I came to healthcare through I would say the revenue cycle, analytics, and technology management perspective. Initially when I came to CHC, I walked in the door as the first IT executive they had ever had, and so many people came to my office and asked me what I did and I said, you know what? We're going to figure that out together, which is really kind of the start of what I did at CHC and really kind of the focus of what I do at hospitals all the time. It's all about how do we work together to figure out what's best for that community and the patients that they serve.
Camille Baxter:
One of the things I found really interesting in looking at your background was your masters, which was in human dimensions of organizations, and I thought that has to bring a really interesting perspective to IT. Can you talk a little bit about the unique perspective that that provides you in your day-to-day work?
Brian Doerr:
Sure. It's a fantastic program and I was honored to be a part of their, I think it was their fourth class cohort and at the University of Texas. And interestingly, I went into it, I was looking around at different types of programs and there was a lot of MBAs, MHAs and all of those types of things out there. But when I looked at those I thought, I understand technology, I know enough about finance to be dangerous, but I don't want to be a CFO. But what I really felt was missing in a lot of the work that I did was how do I deal with people and bring people along on a journey of change? Because what we look at today in healthcare is all about change. So I went into it with that mindset of how do I fix people, right, to bring them along on my technology journey?
And interestingly enough, the first meeting that we had was a dinner with all of our professors and I said that to one of my professors and he chuckled and I thought, well, he's English, maybe he's just chuckling at the silly American. But about half of his class that semester, I realized that what he was chuckling about was that it really kind of flipped the script and it wasn't about how do I fix those people that I'm working with. It's really about how do I change myself, my perspective and really come to them in a way that allows them to be successful and come along with me on this journey. How do I bring them along on this journey rather than drag them along on my journey? So I utilized everything that I learned in HDO every single day in how I deal with my colleagues here at CHC, how we deal with our hospitals and how do we figure out how to help people be more successful in serving those communities.
Camille Baxter:
Thank you for sharing that. It's such a unique perspective and technology really is about behavior change. It's getting people to change and to do things differently or to add new behaviors. So in looking at that, I could only imagine that that must have been such a powerful addition to your perspective and how you approach what you do.
Brian Doerr:
Yes, definitely. It was kind of a huge game changer and now we talk a lot about mindset and you hear about it enough and I'll sure we'll get into it, you'll hear me mention it because a lot of it is about being flexible and having a flexible mindset and not something fixed. And understanding why we're doing what we do and are we doing it for the right reasons or are we stuck in something because it's just the way we've always done it and being open to be flexible and change. And it's a hard thing for people to understand, but it's, I will say ultimately freeing when you start to say, okay, I don't have to do it, and I'm not stuck and holding onto something just because it's what I know. I learned something new and realized, wow, there's better things and better ways and different ideas about how to do things.
Camille Baxter:
Yeah, I'll bet. Let's bring that to the community hospital perspective. Can you talk a little bit about how community hospitals can take an enterprise approach to IT and tell us a little bit more about that
Brian Doerr:
So when I talk about enterprise IT, it really is about breaking down those preexisting barriers between IT and other departments, creating organizational related plans that are collaborative. Right. And ultimately it's all about doing that and enabling technology that betters our patient care process. Right. It's how do we use technology to do that? What I will say on the flip side, it's kind of like getting rid of, I call it, I used this term a long time ago, people that are older might understand it, getting rid of a mentality of Radio Shack IT. The old school IT department in many cases is so busy fixing PCs and changing this little part and plugging this in and making sure somebody has a mouse and it's changing that and radically changing the mindset of those IT individuals to say, that's not why I'm here. It's not about this individual piece of hardware.
It's about how do I build a process that allows us to transform IT. Right. It takes a lot of collaboration with a lot of other people and IT people sometimes aren't so good at that. They like to build what they build and have what we call tadda moments where they show it and everybody loves it, but that's not what works. What works is working with people in the weeds, figuring out all of these really difficult problems and getting everybody into that IT enterprise, IT mindset so that they can all reap the benefits of improved IT functionality. That's really what it's about.
Camille Baxter:
It's really bringing all the voices together and including them. And I love your reference to Radio Shack technology and moving away from that and the ta-da moments because I've experienced that in other organizations, but it really sounds like what you do is bring people together so that they understand and that their voices can be a part of the progress in technology.
Brian Doerr:
Totally. And that is really hard because we all want to, like IT folks, we want to go and say, I found something that's going to transform and change your life, and we love that big like bang, look at that new technology. That's not what it's about. If you look at all the technology you have in your hands, you'll notice that it's very iterative. There is transformational technology, but a lot of times it's little changes along a path that get you down to where you want to go. It's about a road and it's a path and it's a process. It's not about a destination of bang, here it is. I've built what everybody wants and we're done. And it's not just about me, it's got to be about embracing other people's ideas because we may think we have a lot of good ideas, but I guarantee you if you get diverse opinions from a number of different constituencies and stakeholders, you'll find that there are ideas you never would've come up with. Never.
Camille Baxter:
What are the most common areas that rural and community hospitals should begin when looking to transform their IT solutions?
Brian Doerr:
Interestingly, when I think about what rural hospitals should focus on, I will tell you again, IT transformation doesn't really start with IT. It's really about evaluating where a hospital is, what their current goals and objectives are. Right. So a lot of times we go in the back room and we build a bunch of stuff and we come out and it's like, oh, but we're down this path and you're over here, so we've got to get away from that. And then once we understand that, then it's really looking at, okay, what technology investments can we operationalize that will supercharge those hospitals goals? A lot of times what we do when we go into a rural or community setting is to have an exercise where we sit down and we reimagine the IT platform and we kind of take all of the barriers that we see and all the frustrations and problems.
If we were going to imagine what this is about and how we deliver technology to a community, we all of a sudden see that it's not actually about the technology, it's about how it feels when people use it. So what do people need? What are the services, the products, the offerings, all of that. Right. And then we start to look at that IT, that infrastructure, the desktop systems, the legacy systems. And sometimes when we get to the end of that exercise, it could be just augmenting their current IT infrastructure and processes and systems and tools, and sometimes it's about building an entire IT transformation roadmap. Right. It's how do we put that point out in the future and really get them to what we call the hospital of the future. And that may take some time. It's not something that happens overnight, but we all know where we're driving when we get to the end of that process.
Camille Baxter:
So with that, Brian, how should hospitals with limited resources prioritize their IT investment needs?
Brian Doerr:
So when I think about that, I would tell you that I think facilities need to start with a top-down approach. Okay. When I say top-down approach, it's kind of interesting, I had this conversation with a lot of executive teams, but it starts with get your IT leader out of the basement, out of an outbuilding, a different place than the rest of the executive team and make them a full member of the executive team because that will help you get rid of those ta-da moments. Right. When they feel empowered to bring solutions to the business problems and are engaged at the beginning of the conversation when you're planning and thinking about what your objectives and growth plans are, they can have the most impact at the least cost, which is critical obviously for a lot of rural and community hospitals. Then once they have that and they know those ideas, then they can work with your steering committee or the executive team, however your governance set up is structured and align those tactical programs with that IT strategy. Right. And then they can execute on it and everybody agrees with it.
They know about it and it's all aligned. Right. It's not IT working down some path and everybody's just frustrated because IT's doing this to me. IT's doing it with everybody. And I think that's a tremendous important thing. We see a lot of old school IT departments still. IT's really still focused on system management and replacing mice and PCs, implementing tools. Sometimes they're actually implementing tools that their buddy or someone asked them to or a department bought that they didn't even have any input on. And all that does is drive increased cost, increased complexity and additional cybersecurity concerns, honestly, because you have a much more complex environment. So we want the focus to be very strategic and not tactical, not reactionary. That never, never positions an organization for success.
Camille Baxter:
You talked about the importance of the top-down plan, so can you talk about IT transformation roadmaps and what are those and how can hospitals use that to improve performance?
Brian Doerr:
So IT roadmaps, it's going to sound funny. So once you have done that first piece, right, and you have kind of the governance and executive buy-in and the team together, then you actually flip the script and you start bottom up. So you go, hmm well, that's kind of interesting, but the reason you do that is so now I know where we're going. The first thing I need to do, if I have the picture of my finished house, I take that picture. That's my strategy. I want to get there. How am I going to get there? Well, I got to start at the bottom. I got to start with a solid foundation. Right. So a lot of times what we're doing when we do that is we build a roadmap that takes a facility along that journey that says, okay, here's what our destination, here's our strategy, here's our vision, and here's what we want to do to deliver better care to our community.
But now do we have a roadmap that gets us there? So we start literally with the outside world. We start with connectivity to the inbound. Do we have the infrastructure on the network side, the firewall side, the security side to build a solid foundation that we can build everything on top of? Then we started looking at all of our systems and our network internally, and while we're doing that, we look at it and say, are the things that we're doing at every step that we're doing today, are there the things that we need for tomorrow? Or do we need to bring up something new? Do we need to look at something? And again, try not to do that in the back room, do it in front of everybody. Get messy with your team and say, here's three options that we're looking at. This one's really valuable, this one's less valuable, but here's the cost of this one versus that one.
So everybody can be involved in that. And then once we create that roadmap, then it's really like how do we hold ourselves accountable to everybody else and that we're delivering on it? So bringing quarterly updates, making sure that we're measuring. We've seen so many projects where people have brought in systems and you asked them, and they can't even tell you what the value of that system was. But man, when they saw the demo and the dashboard and all the little analytics, it sounded great. And again, having that strategy, having a roadmap, knowing where you're going, and then literally walking down the road, it also gives you the ability for some flexibility.
So we all know things change in healthcare on a day-to-day basis. So I may have a roadmap that is a year, two years long, and if I'm giving quarterly updates on that roadmap, then at that quarterly meeting I can say, Hey, here's where we're at. Here's what we've done. Here's what we're planning to do. And the team can come together and say, we've got some business challenges here. Oh, we have this opportunity over here. Can we redirect? And again, it's keeping us all getting down that path, getting down that road and going the same direction. And so we don't have any traffic jams and we don't have anybody going the wrong way.
Camille Baxter:
Can you talk us through an example from a community hospital you've worked with that has seen success transforming their IT solutions using an enterprise approach?
Brian Doerr:
So we have a facility, Freestone Medical Center. It's 35 bed facility in Fairfield, Texas. And they were really, when we walked in the door shackled with a whole bunch of expensive onsite infrastructure, it was all housed inside their building. They had a small internet connection, but most of their technology was all sitting onsite. And they have a very, very small team both to manage it and secure it. So upgrading that infrastructure was going to be a monumental task and a monumental cost if they used all of the same types of technologies. Right. And they had a real vision organizationally when we went in that IT really wasn't aware of, of we want to open some new service lines. We want to open some new clinics, fantastic services for the community. Right. But when we walk in and say, you really need to upgrade this infrastructure. It's going to pull all of the capital resources from those projects and move them into, let's just keep the things running that we have running.
So we worked with their CEO, John Yeary. He's a fantastic visionary and his team, his IT team, and we laid out that roadmap. We said, here's where we want to be. We want to be able to upgrade and have the infrastructure that supports the growth that we're planning, but also doesn't hinder us from getting to that growth in the next five years. So we laid out that roadmap and started down the path. Now, I will tell you, when we started going down and evaluating the different tools and technologies that were related to that, it means change. It just means change. So that's where my HDO experience came in and we said, look, I get that there's change. Let's bring people along on this journey. We could do it. I always tell people, we could implement technology in 30 days and we could watch people crumble around you.
So we've literally set out a plan and we said, okay, let's do this over the course of a year, year and a half, and bring people along on that process. It's not always easy. People aren't always comfortable, but give them and be honest with them about the fact that this change is coming and it's going to be hard. Right. And it wasn't just infrastructure, it wasn't just the tools that they used. Some of it was very intrusive technologies, like their radiology systems, things like that. But looking at those in a new light and saying, maybe those don't have to be onsite at our hospital, allowed us to free ourselves from all of that capital requirement and say, okay, now we can take the capital requirement and reduce it by 90, 95% and use that capital for those growth projects that we have while embedding a brand-new infrastructure.
So it took us about a little over a year to get it done, and honestly, the outcome has been fantastic. Their IT director is a raving fan of ours. Now, I will tell you at the beginning, he was concerned too. He's like, this moves my cheese. I'm used to looking at all these blinking lights and making sure that they're blinking the right way, and he doesn't do any of that now, but now he's a partner with the business, and so his life is different, but he feels so much more empowered to have an impact on people's lives. And that's what we all want to do.
Camille Baxter:
I think that's such a valuable approach that you take is bringing people along and addressing technology and technology development as a change process, and it sounds like that makes all the difference in the world. Any final thoughts on this topic, Brian, before we close out today?
Brian Doerr:
The only thing I would say is, I mean, I hope people get something valuable out of this conversation, and for executives out there, maybe they might get a little perspective that IT isn't always that group that's coming in and just saying, I need more, I need more, especially with the cybersecurity environment that we live within, and that maybe they can look at IT as another valuable partner at the table that can help them solve the challenges and literally set them up for growth and success. That's my objective. That's my hope out of this.
Camille Baxter:
Brian, thank you so much for your time today. This was a great conversation. I'm now a raving fan too. Thanks for being here today.
Brian Doerr:
My pleasure. Thank you for having me, Camille.
Camille Baxter:
This has been a sponsored episode of Healthcare Insider, created in collaboration with Community Hospital Corporation. For more information about CHC, please visit communityhospitalcorp.com. I'm your host, Camille Baxter. Look for more episodes of Healthcare Insider under the multimedia tab at modernhealthcare.com or subscribe to your preferred pod catcher. Thanks for listening.
