Q. Thank you for joining the podcast, Sophy. It’s great to have you here.​ Likewise. I’m Rohit Mahajan, managing partner and CEO of BigRio and Damo Consulting, and the host of the Big Unlock podcast. As you know, it was started by Paddy a long time ago. We’re honored to continue this podcast. We’re now in the 150s episodes, so it has come a long way. Sophie, could you please introduce yourself?

Sophy:  Thank you. My name is Sophy Lu. I am currently the Senior Vice President of Digital Integration and Business Relations at Northwell Health. Previously, I’ve held multiple executive roles at Northwell, including System CIO, and I’ve been with Northwell for approximately 15 years. I grew up in the application space. Prior to that, I was trained as a chemical engineer. I enjoy continuous learning, integration, connecting people, and solving problems by bringing common to chaos. I live in Brooklyn, happily married with two grown kids. I have four Labradors and two Norwegian cats.

Q. That’s awesome. So, how does a chemical engineer like you, Sophy, wind up in one of the largest healthcare systems in the country? Please tell us a bit about your journey and about Northwell as well.

Sophy: Absolutely. I often say it’s a mix of luck, timing, and a lot of hard work, along with the networks you’re exposed to. Initially, I wanted to be a kindergarten teacher, but my love for science and math led me to chemical engineering. I worked in that field for about seven years after graduation, focusing on process and industrial design for chemical plants. This role took me across Europe and Indonesia.​

During that time, I was drawn to sustainability, working on clean energy projects. About 20 years ago, I was involved in expanding liquefied natural gas and combined natural gas. While these concepts are well-established today, back then, scaling them in the transportation and energy industries was quite ambitious.​

As the engineering sector shifted more towards the central United States, I wanted to stay close to my family here. I explored other opportunities, sending out numerous resumes at job fairs. A consulting company noticed my background and brought me on board to work on technology integration and implementation, leveraging my industrial gas experience.​

This consulting role involved extensive project management, business integration, and participation in mergers and acquisitions. Notably, I worked with St. Vincent’s Hospital, which expanded from a single institution to about seven or eight. Unfortunately, it eventually faced bankruptcy. This experience provided deep insights into management during financial crises and organizational turnarounds.​

This was my first exposure to healthcare—a sector dedicated to care and wellness but often challenged by reimbursement issues and technological limitations. After St. Vincent’s closure, I was recruited by Northwell Health to work in their application space. I joined during the inception of their revenue cycle implementation, marking the beginning of their patient journey and EHR initiatives. Since then, I’ve been with Northwell and have never looked back.​

Q. Oh yeah, yeah. So you spent many years at Northwell and that’s a fabulous, you know, segue from your industrial engineering and engineering background into healthcare. You know, and you got a glimpse up close of a, of an institution that, that went through that phase as well of M& A and, you know, turn around.

So Sophy, tell us about your new role. I understand that you have a new role here at Northwell and that you are looking at, uh, some very different initiatives. So how’s that coming along and, and. What can you share with the audience? 

Sophy: Yes. So as we started the digital transformation journey at Northwell, laying out the foundation of simplifying the ecosystem and selecting strategic functions that we wanted to implement relative to sort of the cloud foundation, the data platform and evolving our EHR for the entire organization, there was a need that we looked into that we wanted to focus on for digital transformation integration and business relations. And what does that mean? If you look at the heart of where technology and a seat at the table, along with operations and clinical care and patient experience has married, the new discipline of digital relationship management really is trying to make sure that we are bridging operations to technology to patient at the center.

Right. And some of those objectives, no matter whether you’re looking at an adoption of technology that you just are implementing, like an EHR or your new emerges and acquisitions of how are you going to integrate the business  looking at building out a new facility? And what are you thinking about relative to innovative workflows and engagement and experience for, for the patient and the families, right?

And so you look to bridge in that relationship, strategic alignment, you want to make sure that the stakeholders are engaged in the decision making and the journey. And you want to facilitate effective communications because everybody doesn’t always speak the same language at the same time. It is what’s important to me and what’s relative to my role at that time, right?

You want to get synergy across that and you promote the continuous improvement and selection of what works best to meet the mission and the vision of whatever that initiative that you’re working on. Always focusing on process improvement.  Efficiencies and helping out the users, whether the users persona is the clinician or the operations or, of course, the patient and the family as they’re going through the continuum and last, at least you want to ensure you’re translating all that into something that is executable, um, have a translation, understanding that the implementation is not technology only right that are addressing the problem you’re trying to solve, you’re addressing the vision that you have sort of enabled across the institution, and then you want to measure and look at how you’re doing in that implementation real  often and repeat. Basically, uh, there is constant tweaking and recalibrating because that changes life changes and roles change.

Q. Yeah, of course. And you mentioned Sophy previously, before we started the podcast, about change management and cultural alignment, right? Would you illustrate that with an example from your new role? What works, how does it work, and what works best? You also mentioned something interesting about measuring it—any such measures you actually use in the business enterprise?

Sophy: Yeah, I’ll use a couple of examples. Right now, our main focus is preparing for our EHR implementation. As part of this readiness, while we ensure best practices and enterprise standards in our processes, we also prioritize operational engagement. We work closely with operations to understand their needs, ensuring workflows complement and meet their requirements.

We focus on operational input regarding readiness and translating that understanding across departments. Another key aspect of cultural success is our partnership with perioperative teams. Since our organization has grown through mergers and acquisitions, we don’t have a standardized system across our 21 institutions. This presents challenges, especially in OR throughput.

Think about OR throughput—not just scheduling surgeries, but also coordinating surgeons, care teams, room logistics, pre-op, and post-op processes. We collaborated with operations to understand these challenges and explored technology solutions to optimize data and improve real-time decision-making. This turned out to be a great success. We now have significant measurable outcomes in optimizing OR scheduling and real-time adjustments.

Planning on paper is easy, but managing the complexity of multiple ORs, surgeons, and a triple-digit workforce in real-time is challenging. We successfully balanced workloads, improving clinician and patient experiences while optimizing throughput. While efficiency was a key outcome, we also increased volume and revenue. Most importantly, we brought joy back to clinicians and improved patient scheduling.

Q. That’s a great example, Sophy. Thank you for sharing that. You mentioned that Northwell has grown significantly through mergers and acquisitions, now comprising 21 organizations. Given your involvement in this process, could you tell us more about Northwell’s approach to M&As?

Sophy: Absolutely. Northwell Health is the largest healthcare provider in New York State and one of the largest employers, with nearly 90,000 employees. We have 21 hospitals—11 of which are Magnet-designated—and almost 1,000 outpatient facilities. Our workforce includes about 12,000 physicians and over 19,000 nurses. We continue to grow while investing in community education, research, and outreach.

One of our CEO’s key visions is intentional growth. We don’t expand randomly; we grow in a way that ensures integrated, continuous care for the communities we serve. This approach also applies to our M&A strategy. We prioritize synergies, ensuring that mergers align with our mission and values. We focus on contiguous growth, enhancing referral networks, and leveraging our size and capabilities to improve healthcare access and quality.

Most recently, we’ve been working on a major merger with a health system about a third of our size. While it’s not yet approved, it would be one of our largest acquisitions.

Q. That’s awesome. So, Sophy, you mentioned earlier in our conversation that there is no standard playbook for M&As and that success comes from finding complementary technology strategies. Could you share your thoughts on how mergers and acquisitions are approached at Northwell and what makes for some success stories? 

Sophy:  Yeah. I hear this a lot from our partners and customers—Northwell’s approach to mergers and acquisitions isn’t a forced takeover. It’s a very collaborative, synergetic process.

The key to our approach is thoughtfulness—whether it’s a partnership or an M&A, we prioritize cultural and value alignment. If those two things are in place, everything else becomes much easier. When you have similar mindsets and ethics, you’re already aligned on what you’re trying to achieve.

From there, we move into the business aspects. Every M&A is different because it depends on the type of deal, the initial objectives, and the long-term goals. Ultimately, the goal is to optimize and integrate the best of both worlds while learning from each other.

Our playbook starts with integrating people first—creating a sense of unity, where we operate as one team with one purpose. Next, we align on strategic initiatives, assess key risks, and map out long-term goals. We ask: What are your priorities? What challenges need to be addressed? How can we help each other move forward? These discussions help us build a roadmap for business integration.

From there, technology plays a critical role in accelerating and supporting these objectives. If there’s a low-complexity, high-impact opportunity that addresses a pressing challenge, we double down on it. That way, we can create immediate value while laying the foundation for future innovation and growth.

At the same time, risk mitigation is a top priority. We need to ensure that our infrastructure is solid—cybersecurity, resiliency, regulatory compliance—these are non-negotiables. They form the foundation that allows us to focus on investments that drive meaningful impact for both organizations.

Q: That’s great to know. And that leads us to the innovation and AI aspect of things. Sophy, no podcast would be complete without touching on artificial intelligence, augmented intelligence—any type of intelligence in today’s conversations! Looking into the future, especially regarding EHR adoption and the broader integration of AI in business, what are some things you see coming our way, and what might you be working on?

Sophy: Yeah, I want to emphasize again—and maybe it’s my bias now—that any successful AI initiative should always start with defining the problem you’re trying to solve and involving the operators in that process. We can easily get caught up in the tech itself, especially with the fast pace of innovation, and try to find sponsors and problems to fit the tools.

For AI to be successful and scalable, you really need to start with the operators in mind. And by operators, I mean the people who will be using it day to day. AI isn’t just about generative or machine learning; there’s a broad spectrum of AI that includes RPA and other technologies that we can leverage. But to truly scale it in clinical, administrative, or experience spaces, you have to go to the source.

When I talk about AI, I always remind people that AI has been around for decades. In the last five years, generative AI has taken center stage and is often viewed as the “magic” solution for everything. But we should remember that AI is much broader than just generative AI.

At Northwell, we’ve been exploring AI across multiple areas, including imaging and precision medicine, for years, and we’re now diving into generative AI. We’ve had an internal AI hub in place for about five years, focused on security and data protection, which are our most important assets. This hub allows our workforce to securely access generative AI and leverage it for a variety of use cases, all while protecting sensitive information.

We’ve also put in place a governance structure to better understand the needs of our team, identify high-value use cases, and drive innovation. One of the areas we’ve already made an impact is in administrative tasks, like using generative AI to search for information, saving time when employees need to sift through policies and documents. These small efficiencies can add up significantly across a large organization.

Q: That’s amazing! Giving time back to 90,000 people adds up to a huge impact. There are so many use cases that people don’t even realize. They might not be flashy, but they solve real problems that make a big difference in people’s daily work. As we come toward the end of the podcast, Sophy, I’d like to touch on something you mentioned before we started—the celebration of International Women’s Month.

Sophy: Oh, yes! Thank you, Rohan, for reminding me. I’d love to wrap up today by recognizing and celebrating International Women’s Month. Some people focus on just a day, but I say we should make it a whole month! It’s important to recognize the incredible women and all the support behind the agendas advocating for women. Let’s make sure we support each other, raise the bar together, and make a real impact in the world.

Lastly, thank you all for the work you do, and remember: self-care is just as important. It’s okay to take a compliment and take care of yourself, so you can give your best every day.

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com   

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

 Q. Hi Soumya, welcome to the Big Unlock Podcast. It is a pleasure to have you here. Thank you very much, Rohit. Appreciate it that you are able to spare time for this. So Soumya, we would like to start with some quick introductions. So I’m Rohit Mahajan, I’m the CEO and Managing Partner at BigView and Demo Consulting.

We’ve been doing this podcast for a while, so it’s pretty popular with our listeners. So I’m sure they’re looking forward to understanding your thought process and, and what advice you have for them. So could you please start with your introduction as well?

Soumya: Thanks Rohit. Very nice to meet you again. I am Dr. Soumya Viswanathan. And I’m the Chief Physician Executive at BayCare Health System in Tampa, Florida.

That’s amazing. So what motivated you, Soumya, into this direction? That is my, one of my questions. And second is, what are the differences that you find between the two, let’s say, geographies or the roles that you had here previously in Massachusetts and now what you’re doing over there?

Soumya: Absolutely. So I heavy hitter on the clinical side. You know, I love clinical. My patients love me the typical clinician, but I started getting roles and opportunities to take on projects on the management side or so called the leadership side. When I took the projects on, I felt very comfortable. Then I was doing them and I started getting more projects because as you deliver on the outcomes and the results for each of the projects, people say, Oh, she’s done this.

So let’s give her more. So it ended up being that I was, uh, first I raised my hand for projects and then I just started getting them and I had some really good mentors. And the mentors trusted me, which is also important. So I circled back to them and said, you know, I like doing this, but I’m not sure do I want to give up clinical or not.

So that was the time when I decided to do MBA and MHCM just to make sure that I do want to go down this path of leadership. And it turned out that I started liking it a lot. I liked it as much as I liked clinical. So it came to a point where I couldn’t do both equally well if I spent 100 percent of my time on both of them.

So it’s 200 percent of my time. So I had to carve out and figure out which direction I wanted to go in. And finally, once I did my MHCM, I realized I really like leadership and I want to give it my best. Put my best foot forward and give it my best shot and see how well I do. And that’s what led me to taking on leadership role.

And Baycare has been pivotal because the health system is on a tremendous growth mode. We are expanding like crazy. So what also helped us in that journey is a lot of the health systems in Northeast North. I should say all the northern states through COVID  they allow their people to work remotely. And as you may have seen in the news, a lot of people gravitated or they move migrated down to southern states for warm weather.

And they could work remotely. So the fastest growing cities ended up being, at that time it was Austin, Texas and Tampa, Florida. So, the population here has grown so much that the system, and BayCare is the largest health system in the West Central Florida. So, and it is rated as one of the best in quality outcomes, patient safety, people provide clinically excellent care.

So, it became imperative that, you know, we are on a growth mode, we need to support the population that has migrated here. And I jokingly say, when people move down and move, migrate to other areas, they don’t bring their doctors with them. So we had to support, you know, we need more doctors here. That’s what helped me make the decision to make this my, my stop where I can contribute to leadership team and administration.

Big differences that I see is at least in Bay Care, I should say that, you know, Bay Care has traditionally come together as a health system with the acquisition of community hospitals. And then we set up a medical group. to move forward in expansion of the medical group. So there hasn’t been a lot of focus on academics, which is heavy in Massachusetts, as you know.

So for me, that was a big difference is okay. We need to support, we need to support our physician pipeline for the next generation with a pipeline for recruitment. So what we have done now is moving forward. I’m doing a huge. focus on building the academic mission for Bay Care Health System. We have not delved into academics, and right now we are on the run for being one of the fastest growing GME programs in the country, almost, with 650 residents who will be graduating by 2029, which means in three years we went from 24 residents to, we’ll be looking at 500 plus residents who are approved by ACGME next year, in the next year.

So it’s a very exciting time for us. I want to say academics is one big piece culturally or from a practice pattern perspective. Massachusetts and Northeast is heavily steeped in value based care and, um, the fee for service mentality is still a little bit present in some of the southern states. So we’re moving towards value and taking on more risk.

So that’s a difference I do see that the risk taking capability of physicians is definitely ramped up significantly over the past few years and at least in the region where I am.

That’s pretty cool. And, and I was noticing, uh, Soumya that, uh, you recently celebrated your 10th anniversary and, uh,

Sowmya: One of our hospitals, one, one of our 16 hospitals. So it’s St. Joseph South celebrated our 10th anniversary. And, uh, that’s one of the newer facilities we had built, which has been really, growth has been tremendous in that region, but Baycare by itself is 25 years old. As a health system.

That’s cool. And also curious, Soumya, that you are the chief physician.

Executive. Executive. What does that mean as in relation to, let’s say, a chief information officer, chief medical information officer, or a CTO? So what kind of roles do you play and where is the overlap or where is the synergy with your other?  Colleagues.

Sowmya: Yeah. So from the chief physician executive role has been evolving through many health systems where traditionally the chief medical officers would lead certain aspects of the health system such as quality, patient safety, you know, dealing with physician enterprise only in the form of peer review and clinical care.

The chief physician executive officer pretty much bridges a little bit more than that So what it does is it it requires us to have a little bit more input into operations A little bit more input into looking at financials and cost accounting and gap, you know So it’s kind of a well rounded Cmo role where you pull into tap into all the other aspects that are required for a health system To be very successful, I want to say.

So we form a very close relationship with every other aspect of our health system. Whether it’s the technology officer, informatics officer, CMIO, or the chief financial officer, the COO, we form a very close dyadic partnership with almost everybody in the organization. The CMIO and the CIO, so we do have an informatics officer and we do have chief medical informatics officer.

Work very closely with them because now that there is so much of enhancement and technology input into almost everything we do, especially for doctors to  raising the electronic health record and everything, you know, we cannot do without that kind of partnership. 

That’s awesome. That was my segway. I was going to ask you that you mentioned new care delivery models and also, you know, about patient engagement and technology now.

So how does it all come together for you? Some of your what are some of your digital, you know, initiatives? that you are, you are, you know, thinking about or you’re happy about that you have implemented? What are some of the things in the future that you’re looking for?

Sowmya: We have quite a few things, you know, electronic health record optimization obviously is one of the key areas we want to continue to focus on.

We have Cerner as our EMR, so we definitely want to make sure there is always room for improvement and how the clinicians are taking on the EMR. positives and the pros and cons within an electronic health record. So optimizing that flow. The second piece that we are working actively on is tele visits and tele health in general.

Tele health and remote patient monitoring is a big focus for us just because I already mentioned the population has grown and the access to care has been amplified several folds. So we need more visits. to be delivered to this community. The third one is AI innovation in all forms. So artificial intelligence, which is the buzzword these days and data driven, you know, a lot of data driven platforms that we strive to make sure that when we make changes that impact any workflow, that it’s backed up and validated by data.

So data driven platforms are very near and dear to us. The other most important one, I think, is the patient engagement. Bayfield is very focused on providing the right care at the right time in the right place. So we follow that mission to the T, where we want to make sure that patients Providers. So physicians allied health professionals as well as nurses are all taken care off in a similar manner.

So patients should have ease of access to care. So all that becomes very critical for us. And so patient engagement tools is another big portion that we’re looking at. And of course, you know, interoperability and cyber security come hand in hand with everything that we just discussed.

Yeah, yeah. So, Swami, you touched on a lot of things. Could you help us understand more in detail or with any examples that you might have of any digital health initiatives that you found, you know, success in the past with, you know, or that you’re moving in the direction of?

Sowmya: So, in terms of just the tools of engagement, we have engaged. So, we do a lot of  We have done a lot of pilots.

We have done a lot of phased approaches to engaging in digital health platforms.  So let me just share a few of them without mentioning specific names. So for example, we have engaged in a telehealth platform that improves the care coordination of patients. So we are working with a platform right now that actually engages patients.

And then they also have the care management or the care coordination support on the back end. So with the tools first, we risk stratify the patients on who is high risk for certain diseases and disease conditions. And then we have the care coordination team actually work with us on identifying the disease conditions.

So there is a patient engagement. There is a chronic disease management component to it. And then there is the engaging the patient through the care coordination team that we have. And then looking at, you know, how the outcomes measure out. So that is one we are actively working on. Then we also have like rehab potential, right?

So when a patient has acute hospitalization and they are discharged to home, for example, let’s say they have a heart attack, post heart attack. Oftentimes, the past would be that cardiac rehab has to, the patient has to come in. To the hospital to have the rehab done. Now we are looking at platforms that actually will engage with the patient at home so they are able to do rehab at home without having to drive around and having to take that long distance trial time for commute to come in and have the rehab option available to them.

The other piece that we are working on is early detection. So, early detection is critical. The speed to detecting certain conditions can actually change the outcome of that patient’s condition. So, how quickly do we identify a stroke in a patient? And is it a stroke mimic or is it a real stroke? We are working with a company that allows us for Accurate and early stroke detection.

That’s one of them We also have a couple of others where we have an eicu  platform Where it’s an electronic icu because we need to monitor the icu in patients, but we cannot have that many intensivists rounding 24 seven. So we have an electronic methodology to identify that. We’re looking at platforms that look at sepsis bundles, you know, so there is a whole host of conditions that they’re looking at, which are digitally oriented, that allows us to look at them.

You said what has gone well and what hasn’t, I will share with you that some of the exciting ones are. The radiology ones, the radiology digital analytics, because the radiology ones help to identify the accuracy is outstanding. It’s like they have done studies on how many AI driven platforms can actually identify incidental findings  versus a radiologist reading it or, you know, how many radiologists do you need to read X number of films? And so we are looking at platforms that look at incidental findings in the lungs, as well as lesions on the heart through echocardiogram.  So there’s a whole host of digital platforms that allow us to do this. One thing that we have to watch out for is the fatigue that can set alarm fatigue. So sometimes you have these platforms and it’s pinging away nonstop because it depends on how you set the platform. If you say that you need to alarm me when this happens and you have the metrics not correct, it will be blowing out of control and the alarm fatigue sets in amongst the end user.

So I want to say that we have had our mixed bag where we tested a few and we had to give up on a few and some of them we are many of them we are moving forward with.

That’s great to know Soumya. So is there a way that you think about innovation in certain areas and how about working with startups? Any thoughts or suggestions around those?

Sowmya: We are very open to the areas of focus are definitely driven by, like I said, the three pronged approach. You know, is this going to help our patients? Is this going to help our physicians in any way? Is this going to help our nursing team in any way? We are working with technology tool that’s actually looking at You probably have heard of this, the doctor’s dictations.

Yeah, it used to be transcription in the past. And now we are looking at a dictation modality that allows them to just have a conversation with a patient  and not have to worry about the dictation. And there is AI methodology that works on it. We have looked at a similar, we are working with another company that’s doing a similar modality for nurse driven, nurse voice is being recognized, that a nurse can walk into a patient’s room and have a conversation and not have to worry about, have I captured everything that the patient told me? So, you know, every aspect of clinical care is being looked at very closely to see, does it make sense for us to invest in this or not?

In terms of, you know, so we definitely look at the feasibility of. The patient, the physicians, the nursing, and if it helps improve the way we deliver care, we look at it more closely. The second thing that we do look at, you know, obviously there is going to be all kinds of macroeconomics that jumps into all this with, you know, funding and what is the cost and all that, but we, we weigh it very carefully.

As far as startups go, the one thing that Baycare is very open to is if there are programs that are going to deliver on improving care and help our trio team, as I mentioned, and they are willing to co develop a product with us. We are willing to look at it. So Baycare is not just going to say, well, I’m going to open up my purse strings and just, you know, invest in all this technology because there is so much out there.

So we want to make it appropriate, available for our team. But at the same time, if people are willing to co develop, we are willing to look into it. That’s fantastic approach.

Yeah, so as we’re getting close to the end of the podcast and this session here, Soumya, I would like to touch upon the subject of chat GPT, Gen AI, and all the new things which are coming our way in terms of agentic AI.

So any thoughts there or anything that you are, you know, kind of. Heading in the direction of.

Sowmya: I think it’s very fascinating. I’m waiting to see what the next generation of even chat GPT and Jenny do  because it’s mind blowing how data can be aggregated. Data can be utilized and how it can effectively help us.

But we also have to be cognizant that, you know, there is always, there could be a downside that we have to watch out for. And unless. It is fine tuned to the point where we feel comfortable, you know, all of us in the digital world feel comfortable that there is no harm, no threat that’s coming out of this.

I think we should forge ahead and move forward because that is the next generation that’s going to come our way, whether we like it or not. And, uh, it’s going to be in every industry, you know, healthcare has traditionally been. I want to say probably at the bottom of the totem pole trying to adapt and adopt technology because we always felt as a doctor, we always felt, well, technology can never overtake doctors and take care of patients, but.

When we started understanding how technology can help us drive better patient care, the adoption became easier. So we have to get to that stage where the chat GPTs of the world have to help us drive better patient care and better outcomes for our patients. Then I think the comfort level will set in.

Rohit: Absolutely. So on that beautiful note, Soumya, thank you so much for this interaction. Really enjoyed it. And, uh, if you would like to add anything, I really appreciate this opportunity. And, uh, so, so much appreciate your time too today.

We hope you enjoyed this podcast. Subscribe to our podcast series at www.thebigunlock.com and write to us at info@thebigunlock.com   

Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.

 Q. Welcome to the Big Unlock podcast, Mark. As you might be aware, Paddy used to do these, and I’m continuing after that. We’re up to the 150 to 160 range in terms of the number of episodes now. So it’s going pretty well. I’ll do a quick intro for myself, then I’ll ask you to introduce yourself as well. I’m Rohit Mahajan, the Managing Partner and CEO at Damo Consulting and BigRio. Mark, please go ahead and introduce yourself to the audience. 

Mark: Yeah, thank you. I’ve been on once before, probably about three years ago with Paddy. It was a great time, so I appreciate you guys having me back. I’m Mark Weisman. I am the Chief Information Officer and Chief Medical Information Officer at Tidal Health. We’re on the eastern shore of Maryland. We are a two, soon-to-be-three-hospital system, and we take care of a large chunk of the eastern shore. It’s a great place to be. Ocean City, Maryland, is probably the most familiar area in this region. Thanks for having me on. I look forward to talking, particularly about digital engagement, which is one of the areas I’d love to bring forth to our organization and help our patients and clinicians interact.

Q. That’s awesome, Mark. So could you please share with us how you got started? What attracted you to the healthcare industry segment and your role? How has it changed over the years? Please share the story. 

Mark: Yeah, sure. So I started as a doctor. Uh, if you go back to, to, to that beginning, and actually I started as a paramedic and a firefighter.

That was how, okay. When I was much younger and much stronger, I was involved with volunteer fire and rescue, and really loved it. I really loved the medical side of it and then went on to medical school and at some point got involved in in primary care and getting into data and analytics and quality measures.

It’s really where I got my start. I started moving over once I saw how dirty the data was and how much. I got more into the informatics side and eventually led to my role as a CMIO and then the CIO. I love being the CIO and the CMIO. I get to use my medical knowledge and bring the technology knowledge and say, All right, how do we make the technology better?

blend into the background for the clinicians and for the patients as much as possible so that let the people interact. That’s what we want. We want those interactions. We want people who are spending time on the harder level things, let machines do easy, repetitive, boring things so that, that the clinicians can really focus on the, on the important stuff and the patients as well. That’s how I got my start. It was really around data analytics and then more used the technology. 

Q. That is so interesting that you have both perspectives and you’re able to wear both hats in the same organization and add so much value to patient care. So, Mark, what do you think about—like you said—dirty data? That is something that caught my attention. How do you get from dirty data to clean data?

Mark: Yeah, good luck. But mostly, I think the most effective way has been getting operational leaders to look at the data. Until they can touch and feel, see it, and go, “Oh, that particular data point is wrong because we don’t do it that way. We do this other thing on the floor,” and then they realize the measurement is just totally wrong.

Without that operational engagement, I can’t know everything about how every different unit does it differently. And neither can Epic, Cerner, Meditech, or whichever. The data will always be dirty in healthcare until the operational leaders sit down, look at their data, engage with it, use it to make operational decisions, and then challenge it. They need to say, “This just doesn’t feel right. There’s no way our time to seeing the patients is that wrong.”

Well, because of the workflow, it’s not capturing something. And until you do the workflow the way the designers made the program to capture it, the data will be dirty. So healthcare is loaded with dirty data—it’s just the nature of the beast.

Q. Yeah, and I quite agree with you. This is a very interesting perspective. You said that operational people need to look at it. How do you do that at an enterprise scale, Mark, both from the people perspective and the technology perspective? If you can give us some insights into that. 

Mark: Yeah, our HR department authorized me to use tasers because it’s really effective on operational leaders. It’s the only thing that gets them to look at their data.

It is a challenge. One of the things we use is Epic, and the Epic Slicer Dicer is their self-service analytics tool. It’s really easy to use. Now, people are terrified of it at first. They’re intimidated. But once you get them to sit down and play with it a little bit, a portion—maybe 5, 10 percent—of the operational leaders will say, “Okay, I can use this tool and I can explore the data, start to ask questions, and then sit with an analyst and say, ‘Show me where this came from.'”

Then we start to realize, “Oh, how we’re capturing it—that little flow sheet row isn’t doing what we thought it should do.” The only way it works is if the senior leaders ask for data. If they ask data-driven questions, their directors and managers will go out and try to look at the data.

Otherwise, they do what they do today and don’t make data-driven decisions. It has to come from the top, with interested people who are willing to explore and experiment with data, and then you’ll start to see the ball move slowly. It’s a journey. There’s nothing quick about this.

Q: Absolutely. And what are your thoughts, Mark, on data governance? How did you put a structure to it, even though you mentioned Epic? How do you put a structure on the data governance piece?

Mark: I don’t want to mislead anyone into thinking that I’ve mastered this by any means. Let’s be realistic here. Yes, we’ve been trying for years to put in place the basics of data governance, particularly operational data governance.

I happen to have an excellent partner in finance. Her name’s Kathy, and she’s wonderful because she’s very data-driven and knows the value of data governance and how the “wild west” happens with people showing data that’s not finance-approved—particularly in finance. It’s all about the data, the numbers, and they’re data-driven. They deal with numbers all day. She’s really been a strong proponent for pushing it forward, and I partner with her.

We’re trying to get definitions for the major projects going on in the organization today. What are you measuring? How do you know if the project is successful? That’s where we start. We ask, “Okay, you’ve got this in your head about what makes it successful, but what’s the definition of that?” And we’re starting to collect these definitions. It’s just one of those things where you just get started—that’s the key piece. Start somewhere.

We then started to figure out how we’re collecting that information. It’s taking too long, so we need data stewards who are closer to the data. The world will start to develop, and it will begin to snowball. We’re still pretty raw at this, but I can see it starting. At least we’re making baby steps.

For so long, we’ve just said anyone who wants data gets data and can present it however they want. We’ve occasionally been bitten by that, and we’re finding that putting some structure in place and finding the champions—those who are passionate about it—is where it starts.

Our population health team is also very good, so we’ve started with some initiatives with them. There are other areas in the organization that aren’t as good, so I’m not starting there. I’ll go back and prove how this works in certain silos, and then we’ll work back.

Q: And Mark, we were talking before about some new Epic tools that are very easy to use and simple in terms of standing them up for patient engagement. Would you like to share some of those experiences?

Mark: There’s a new tool that’s out. Again, we’re an Epic shop, and so anytime I start to play with a new tool, I like to talk about it—especially if my colleagues get interested in these things. This new tool is called MyChartBuilder.

What it enables us to do is build a very simple one-page microsite. It’s a very static page—it might have a link or a phone number in it for people to take action. For instance, we have a new rheumatologist who just joined our organization. Well, maybe people who have rheumatologic diseases would want to know about that. Rheumatology is severely underserved in our area, as in most areas. So we’re lucky to have a new one.

I can now put in MyChart a link that says we have a new rheumatologist, but only present it to those where it makes sense using the medical knowledge we have in Epic. I can say, “Look, knowing that this doctor only sees people over 18, don’t show it to a 17-year-old. Show it to those who are eligible to see this kind of doctor.”

It’s that kind of tool where we can start to use this vast repository of data we have and actually use it to bring good education to patients. I should be showing diabetic education to diabetics, not those with some other disease. And so now we can do that.

What’s nice is that we can do this in IT. We took some of the templates to marketing and branding and said, “Look, I know your logo, we need to use it. This is what it’s going to look like,” and we take that. So when we’re building our microsite, it’s just these templates that the branding center gives us—colors we use. But once that’s set up, now IT can spin up a page in a matter of 20 minutes.

It’s a drag-and-drop website designer. I don’t know if anyone’s ever built a Wix website or one of those, but it’s that simple. These are drag-and-drop and repetitive templates you can reuse. And all of a sudden, you’ve got quick and easy tools to deploy that patients are now engaging with. You get analytics on that using Slicer Dicer—you can see patients are clicking on it when you set it up this way, they’re not clicking on it when you did it another way.

It’s wonderful to see patients engage with some of the tools that were early. This has been out for probably six months now, and we just picked it up in the last month or so. We’re starting to put these in place, and we’re just experimenting with a handful of them. But I can see this being really valuable in terms of things like lung cancer screening. We’ll just put that in front of those who qualify for the screening and not put the information in front of those who don’t. Stuff like that is going to be really powerful.

Q: That’s good to know. So, which are some of the other areas of either patient care or technology at the intersection, Mark, that you’re super excited about? Are there any new digital initiatives that you’re thinking about or seeing coming down the pipeline?

Mark: I think most CIOs are now focusing on virtual nursing and how to scale that. Most of us have done the pilots now. It’s a good thing. The nurses do seem to be responding well to it.

The technology’s in the room. They’re not bothered by it—the “big brother’s watching me” thing. No, it’s here. These are tools that are here to help you. And then the AI we can start to bring in.

Now that we have cameras and microphones going into the rooms, we can bring AI to detect when a patient’s moving out of bed. Right now, we have humans staring at screens, like little Hollywood Square screens—18 screens that they’re just staring at, saying, “Okay, is this patient moving?” It’s a very repetitive, boring job. Computers do that well.

Let’s let the computer do that work and then set off an alert. Let someone know this patient has moved out of a threshold of what we said was safe, and bring the human into the loop to correct the situation or go to the bedside.

This kind of technology is possible now because we’re really investing in virtual nursing. And, oh, by the way, there’s this AI that’s going to come with it, which I’m looking forward to working with these AI models and starting to deploy. So, I think virtual nursing, and all the benefits that come from that, is a great area that most CIOs are now starting to play in.

Q: So, any other aspects of Epic or any other tools that you’re using, Mark, in your health system that are driven by new technologies, like generative AI? Any thoughts on that?

Mark: We all talk about generative AI and some of the use cases—some are panning out, some maybe not so much. But what we’ve been discussing in our organization is the education needed about large language models—how they work, where they can be good, and where they may not be great. We also need to be careful because they could lead a doctor astray.

We have some doctors who are very seasoned and experienced, and I think they’re wonderful candidates to use a large language model because they’ll know when it’s wrong. Then, we have some new trainees who are willing and eager to use AI, but I’m not sure we trust them yet to know enough about medicine to spot potential issues. It takes intuition and experience to know when something doesn’t feel right.

So, the sweet spot for using AI seems to be with doctors who are willing, eager, and engaged to use it—but usually not the most seasoned physicians. My junior physicians are ready to try it, but they might not be quite ready yet. We’re watching and learning as we go, but we’re definitely exposing them to it and teaching them about it.

I think that’s essential for where we are now. As we start putting microphones in the exam rooms and recording conversations with patients, we can input that data into large language models to help with things like differential diagnosis or determining the next best cost-effective test to order. That’s coming—but not quite yet. I could take a transcript today, copy and paste it into a Microsoft Copilot (that’s what we have available), and ask questions about the data. That’s interesting, and in the future, it’ll happen automatically.

I could ask the large language model to develop a Python program for me, but I’m not that good at it myself. I don’t have the subject matter expertise to know if what it’s producing will launch a rocket or serve me breakfast. So, you should have some domain expertise when you’re working with a large language model. It doesn’t replace that, not yet.

Q: That’s true. Which other areas of interest, Mark, on the innovation side? How do you innovate in a health system like yours? How do you encourage innovation with physicians, nurses, or other staff? How do you bring in third-party startups into your ecosystem? Any thoughts on that or advice for fostering innovation?

Mark: It’s challenging. I’d consider us an academic community hospital system. We have residents, medical students, and fellows, but we’re not typically working with biotech startups. If we’re bringing in new tech, it’s because we think it solves a problem, and we see value in it. Sometimes, it’s from a startup, and there’s definitely room for that.

I surveyed my IT team—CIOs, I encourage you to do this. Ask your teams, “How many failures are you allowed to have this year?” Some will say zero (and those are my network guys!). I love them, but yes, correct. There should be zero failures on the network. But there should also be areas where we’re okay with experimenting—even in a network. What if we try something new, like a software-defined wide-area network instead of traditional MPLS? What if we try it in a small clinic? There won’t be any major fallout if it fails, but we get some experience.

Risk tolerance varies across teams. Most IT people are on the conservative side, favoring no failures, because they see a failure as a waste of time and money. But I try to push the team to say, “Let’s try this. It might not work, and I’ve had failures working with startups, but that’s okay.” One tool we tried didn’t work for us, but it will be successful someday. We had invested time and energy into it, but finance wasn’t comfortable with it. We moved on, and that’s the job of a CIO—taking losses and moving forward.

Advice: For other CIOs, assess your team’s risk tolerance. If your team says, “We can’t fail,” you’ll have trouble being innovative. On the other hand, if you have people willing to try, innovating while handling daily operations is hard. You must carve out time, protect it, and give it a safe space. In a community health setting, even with an academic background, it’s still tough to get daily operations to accept new pilots.

Q: I understand. So, Mark, as we’re coming towards the end of this podcast, what do you see in the next 1-3 years for your healthcare setting?

Mark: I see movement toward the cloud, and it should accelerate. Our data center has some weaknesses that would be expensive to fix. If I were to build another data center, AWS or Azure might do it better than we could, actually. So, we’re exploring that. I think we’re middle of the pack in this regard, but there are cutting-edge examples like Dr. Shafiq Robinson, who has gone all-in on AWS and done great things with Epic, or Sentara with all-Azure. Our teams are starting to get on board mentally—they see the benefits of cloud adoption, though it’s a new skill set for us.

That’s exciting. The computing power we gain will let us use data in new ways. And if we wanted to use our own large language model, I don’t know if we will in three years, but we should at least be positioning ourselves to participate in the game. Otherwise, we’ll be left behind.

Q: That makes sense. Thank you, Mark. This was wonderful. I really appreciate your thoughts, advice, and suggestions. We’ll have another session.

Mark: It’s always great to be on the show. I enjoyed the conversation—it was easy-flowing, and time flew by. If you ever need me back, just let me know. People can reach me on LinkedIn, that’s the best way.

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Disclaimer: This Q&A has been derived from the podcast transcript and has been edited for readability and clarity.