Latest / Becker’s Healthcare Digital Health + Health IT / Chuck Podesta, Chief Information Officer at Renown Health

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Chuck Podesta, Chief Information Officer at Renown Health · Becker’s Healthcare Digital Health + Health IT

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This is Laura Dierda with the Becker's Health
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Care podcast.
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I'm thrilled today to be joined by Chuck
1:44
Podesta, chief information officer at Renown Health. Chuck,
1:47
it's a pleasure to have you on the
1:48
podcast today.
1:50
Thank you. Thank you very much. I'm, happy
1:52
to be here.
1:54
Now I know we've got a lot to
1:55
talk about. There's so much happening in health
1:57
care and technology right now and really, you
1:59
know, cool things you're doing at Renown as
2:01
well. But before we dive into our discussion,
2:03
can you tell us a little bit more
2:04
about yourself and your background?
2:07
Sure. Yeah. So I've been here at Renown
2:10
Health for about 3 years now. Started actually,
2:12
I just had my anniversary 3 years in
2:14
July.
2:15
But I've been a CIO now for almost
2:17
30 years
2:18
and,
2:20
and almost 40 a little over 40 years
2:22
in health care, IT,
2:24
in my career, and I used to introduce
2:26
myself and say that just makes me old,
2:28
but somebody stopped me one day and said,
2:30
no. That makes you wise.
2:32
So I'm gonna go with wisdom over age,
2:35
in my introduction from now on. So,
2:38
but the last, I would say, 15 years
2:40
have been in academic medicine, and now at
2:42
Renown Health, for 3 years. We're an integrated
2:44
delivery system
2:46
in, Northern Nevada. Also have a, we have
2:49
2 acute care centers along with, children's hospital,
2:52
all the ambulatory
2:53
clinics that you would imagine that would be
2:55
part of an integrated delivery
2:58
network. We also have a very tight affiliation
3:00
with University of Nevada Reno,
3:02
School of Medicine. So,
3:04
we are rapidly, you know, moving
3:07
academic affiliation,
3:09
you know, with,
3:10
residency programs and and,
3:13
certainly,
3:14
focused on research activities, clinical trials, and things
3:17
like that. So I'm excited about that since
3:19
I I do have a background
3:21
in academic medicine. And, you know, we are
3:24
this is good timing for this because we
3:25
actually are embarked on a a multiyear strategic
3:28
planning effort, and we're actually getting towards the
3:31
end of that, coming down to the actual
3:34
initiatives that will start in 2025.
3:36
So
3:37
happy to talk about those.
3:40
That's fantastic. Well, we can dive right in.
3:42
What are some of the big opportunities and
3:44
headwinds that you have your eye on right
3:46
now? What's top of mind for you, especially
3:47
as you mentioned, some of that strategic planning
3:51
for the future?
3:53
Yeah. I think it you know, it's a
3:54
it definitely is a growth strategy,
3:57
that that we're embarked on in serving our
3:59
our community here in Northern Nevada. And if
4:02
you know anything about, the Reno area, it
4:04
is from a a population
4:07
perspective.
4:08
We have an influx of people from,
4:11
a lot of different states, but, particularly
4:13
California right now.
4:14
So,
4:16
every time I drive around, I see new
4:17
housing units going up,
4:19
and, it's really,
4:21
the population is expanding. So we have to
4:24
expand with that and make sure that we're
4:26
we have facilities available in in the various
4:28
areas of Northern Nevada that serve our patients,
4:32
and community. We also have a a large
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rural population as you can imagine,
4:37
with a lot of critical access hospitals,
4:39
that we,
4:41
work closely with as well. So that needs
4:43
to be part of the strategy. I think
4:45
in in just to name a few areas
4:47
we're focused on, I think this will mirror
4:50
a lot of what's happening with health care,
4:52
you know, across the
4:54
United States
4:55
right now is,
4:57
so in areas of virtual care,
4:59
you know, which a lot of that started
5:01
with COVID
5:02
and kind of petered out a little bit,
5:04
post post COVID. Although, I don't know if
5:07
I can say post COVID because,
5:09
COVID's here to stay.
5:10
But things like, you know, telehealth, telemedicine,
5:13
hospital home,
5:15
virtual nursing, all those things come under kind
5:17
of a virtual care
5:19
umbrella.
5:20
And as organizations,
5:23
move
5:24
more towards a a value based care
5:27
model versus
5:28
fee for service. These types of
5:31
technologies and initiatives come into play, and that's,
5:34
no different here. But now we also I
5:36
I should have mentioned, we also have,
5:39
an insurance company, Hometown Health.
5:41
So we are in the
5:43
payer space as well, and we do have
5:46
value based care models for some of our
5:48
patients. So we have to look at these
5:51
type of virtual care strategies to help in
5:53
that area. But also from a rural care
5:55
perspective, when you think of telehealth and telemedicine
5:58
expanding out into those areas, it certainly makes
6:00
a lot of sense. So
6:02
I know that's something that's being discussed, you
6:05
know, across the country. A lot of,
6:07
organization already moved in that direction. We're going
6:09
there as well. And I would say the
6:11
next thing is data analytics.
6:14
We hear that
6:16
across all of health care.
6:18
That will be the engine, I think, that
6:20
drives everything. You've gotta have quality data
6:23
to do a lot of different things, you
6:25
know, when it comes to
6:27
looking at personalized medicine,
6:30
certainly disease outbreaks. We learned that from our
6:32
COVID experience.
6:34
Operational efficiencies within the organization
6:37
itself, patient experience,
6:39
and safety.
6:40
You know, data analytics plays a huge role,
6:44
in all of those areas. And, of course,
6:46
with
6:47
the buzzwords now with AI and ML,
6:50
without
6:51
a solid data analytics program,
6:54
you can't really venture into the AI ML
6:57
space without it.
6:59
So that's big. Interoperability,
7:01
again, again, the government's got involved in that
7:03
as well and and requiring a lot of
7:05
interoperability
7:05
between systems.
7:07
Lots of challenges there.
7:09
But from a coordination of care aspect, you
7:12
you really need to be able to move
7:13
information
7:14
in and out of your electronic health records
7:16
in a seamless fashion
7:18
to a variety of other systems,
7:20
both within your organization, but outside of your
7:22
organization as well.
7:24
I mentioned briefly AI machine learning. That's,
7:27
without question,
7:28
probably the biggest thing that's going to impact
7:31
health care in the next 5 years
7:34
around.
7:36
Right now, it's you know, a lot of
7:37
it's focused on administrative processes, which is great,
7:41
saving people time, productivity, things like that.
7:44
But we're also getting into diagnostics and treatment
7:47
plans and things like that, going forward.
7:50
Research will also be big in the space.
7:52
Wearable tech, which,
7:54
has been around for for quite a while,
7:57
but it's getting,
7:59
I think a little more play post COVID
8:01
as well as part of the tide of
8:02
virtual care, hospital or home. Also, the technology,
8:05
I think, has caught up a bit.
8:07
Better technology, better wearables.
8:10
I think the focus,
8:12
for us and and and others from what
8:14
I'm hearing is is that continuous monitoring of
8:17
chronic diseases will be big. If you think
8:19
about, you know, chronic diseases like,
8:22
like diabetes,
8:23
COPD,
8:25
congestive heart failure,
8:27
things like that, those are the highest cost
8:30
diseases that states that are out there.
8:32
And so continuous monitoring of those, I think,
8:35
gives us a
8:36
window into what's happening to those patients, but
8:39
also allows us to intervene
8:40
in lower cost settings,
8:42
for them and hopefully drive the cost down.
8:44
So that will be,
8:46
I think you'll see wearable tech kick off
8:48
more than it has.
8:50
And then certainly cybersecurity,
8:53
you know, that's we every time we turn
8:55
around, we just had a,
8:57
the issue with Change Healthcare. That was the
8:59
biggest thing,
9:00
I would think in the past year, but
9:02
also variety of other ransomware
9:04
attacks that have taken place. I think one
9:07
of the technologies that you're gonna hear more
9:08
about is blockchain.
9:10
It's been around for quite a while,
9:13
and used in, like, claims processing
9:16
and some other types of applications. But I
9:19
think, securing patient data, it's it's gonna have
9:21
a role just
9:23
based on the way it's architected. And I
9:25
know a lot of companies are starting to
9:26
look at that, and I think that that
9:28
will play a role for us. And in
9:30
cloud computing, you've gotta have a strategy around
9:32
that
9:33
as well,
9:35
just to be able to be scalable in
9:37
your technology as you're implementing,
9:39
the different applications.
9:41
But, you know, there's risks associated with that,
9:45
as well as we all know,
9:47
with the, you know, the various cloud type
9:50
systems that have gone down,
9:52
and, you know, with the change health care
9:55
issue and,
9:57
merger and acquisitions
9:58
in in the industry,
10:00
it's very difficult to have
10:03
backup plans. And so,
10:05
you need to have,
10:07
you know, some sort of business continuity
10:09
tied to, that cloud computing. So,
10:12
lots of challenges,
10:14
I can touch on,
10:16
you know, the data security
10:18
and and privacy's,
10:20
on everybody's mind.
10:22
Right now,
10:23
I talked about interoperability
10:25
and just, there's just so many diverse systems
10:27
out there and moving data around. Again, that's
10:29
a data security issue as well.
10:32
Regulatory compliance, I think that just will increase
10:35
and become more complex,
10:38
as we go forward, especially with AI and
10:40
ML.
10:42
That that will add cost certainly to an
10:45
organization,
10:46
especially to IT.
10:48
The implementation costs as well, I think are
10:49
gonna be a challenge to a lot of
10:51
these new technologies.
10:52
When you think about cybersecurity,
10:55
I'm seeing some statistics around, you know, the
10:57
average
10:59
budget for cyber is 4 to 6 percent
11:01
of the total IT spend in an organization.
11:04
That's going up to a 7 7 to
11:07
10% spend.
11:09
So,
11:10
you know, does your IT budget go up
11:12
to account for that, or do you have
11:13
to make cuts in other areas?
11:16
So that's gonna be interesting.
11:18
And also the impact on smaller providers,
11:21
they can't afford
11:22
a lot of these technologies. So, you know,
11:24
what are we gonna do in in those
11:26
spaces as well, and how can we help?
11:29
Training challenges, you know, the user adoption of
11:31
these new technologies, I think, are is gonna
11:34
be
11:35
interesting. And how do we train,
11:37
especially our clinician clinicians to use these technologies
11:43
in in a patient care settings.
11:46
Data management and the quality of that data,
11:48
that's key. As I said, that's gonna drive,
11:52
especially the AI and ML
11:54
aspects of of what we do.
11:58
Just AI if we just touch on AI
12:00
and ML just a bit too. You know,
12:02
you're hearing a lot about
12:05
security around that as well, but also
12:08
the ethical use of of that technology
12:12
and things like algorithm bias. And and, so
12:14
those are the things we're gonna have to
12:16
be really
12:17
careful and watch over,
12:19
as you implement those types of technologies as
12:21
well.
12:22
And then we've got a bunch of legacy
12:24
systems sitting out there.
12:26
We gotta figure out what to do with
12:27
those. A lot of them fit. A lot
12:28
of them don't.
12:29
Again, costs associated with doing that. So,
12:32
I would say that, you know, from my
12:34
standpoint, when we look at the initiatives here,
12:36
right now, and I think across the country
12:38
that,
12:39
probably gives you a pretty good summary of
12:42
where we're heading, but also, you know, some
12:44
of the challenges involved in it. So I'll
12:46
stop there for a minute.
12:48
Yeah. Yeah. No. That was a fascinating overview.
12:50
Think especially you mentioning just so many different
12:53
areas, whether
12:54
it's virtual care and looking at how, you
12:56
know, that strategy will continue to evolve as,
12:59
value based care becomes more prominent and then
13:02
talking through artificial intelligence, machine learning, and data
13:06
analytics infrastructure that health systems need. I know
13:09
a lot of organizations across the country are
13:11
in various stages of trying to figure out
13:13
what makes the most sense for them, what
13:15
investments are are gonna be primary. And,
13:18
the most important is they're evolving their organizations,
13:21
to really incorporate those tools in a meaningful
13:24
way. And then the security piece of it
13:26
too. Yeah. I think it's just so fascinating,
13:29
to try to pin down, you know, how
13:31
you can
13:33
continue to build out and create these systems,
13:36
that are also then secure and the partnerships
13:38
that are going to be most beneficial while
13:41
also
13:42
understanding the risks,
13:43
that are are clearly out there no matter
13:45
who your partner is or,
13:47
how, you know,
13:49
secure it seems at the moment. So I
13:50
think it's just been fascinating to hear you
13:52
talk about some of those different areas,
13:55
in really highlighting
13:56
what's top of mind for you.
13:58
So that's been really interesting to hear. When
14:01
you think about just, you know, that continued
14:03
growth, talking about wanting to grow both in
14:06
the urban as well as rural setting,
14:08
and then obviously add value to Renown overall,
14:12
How do you think about that? What's really,
14:14
how do those things play together? And then
14:16
I I know every helped your dollar is
14:18
precious. So how do you,
14:20
make sure that as you're growing and making
14:22
the right IT investments, you can really show
14:25
that return?
14:27
Yeah. So I it's a great question. I
14:28
mean, you have to be careful because, you
14:30
know, you depending on the size of the
14:32
organization, you know, you
14:35
you can only do so much. Right?
14:38
You from a financing standpoint, depending on what
14:41
your, you know, your bottom line is, what
14:44
you look like s and p, if you're
14:46
gonna do debt financing, and what your capital
14:49
spends can be. And and, of course, you
14:50
have your, you know, your keep the lights
14:52
on types of spend.
14:54
Every year, you've got to keep your medical
14:56
equipment up, new medical equipment coming in certainly
14:59
in the IT space around networks and infrastructure.
15:02
So you've got all these other costs that
15:04
you have to make sure that you account
15:06
for before you can do the growth strategies.
15:08
So you really gotta focus in on,
15:11
you know, what what can you what, you
15:13
know, what do you wanna be when you
15:14
grow up, but also what what can you
15:17
be and what you can't be, right, you
15:19
know, based on
15:21
where you are from a financial perspective. So
15:23
you gotta take that all that into account,
15:25
and and we're doing that that here as
15:27
well. But you can there's some medication
15:29
strategies around some of this that
15:32
can help you make the right investments,
15:35
going forward
15:36
and not try to be all things to
15:38
everybody.
15:40
And and one of them is is around
15:42
if you think about the IT, some of
15:43
these,
15:44
technologies I talked about is is to really
15:47
have a pilot mentality
15:49
on everything that you do. So, you know,
15:51
don't go all in and
15:53
and and really look at the size of
15:55
your organization. You know? Most of health care
15:57
is not Mayo and Cleveland Clinic and and
16:00
Stanford's of the world. Right? Most of health
16:02
care is is renowned and smaller. And so
16:05
you have to be very careful. You know,
16:07
you hear the term chasing, you know, shiny
16:09
bright objects all the time. And I I
16:12
think CIOs,
16:13
a lot of ways, fall into that trap,
16:15
especially younger CIOs trying to build up their
16:18
their careers and resumes and and
16:22
and
16:23
and and going for that, you know, kind
16:25
of bleeding edge next best thing.
16:28
And you gotta be very careful about that
16:30
because you can make a break, an organization,
16:33
by making the wrong decision on some of
16:36
these newer technologies. So I I urge a
16:39
lot of CIOs. I do a lot of
16:40
mentoring,
16:41
that, you know, be very careful about chasing
16:44
those shiny bright objects to build your resume
16:46
on the backs of the of the organization
16:49
that you work for
16:51
and really focus on doing the right thing
16:53
for the organization. And that will build your
16:54
career, not the shiny bright objects. So
16:57
the piloting,
16:58
and the and the strategy we have here
17:00
at Renown is really to see what the
17:02
mayos of the world are doing in the
17:04
Stanford. I want them to be chasing those
17:07
objects.
17:08
I want them to be innovative and doing
17:10
all that work, And then I wanna stay
17:12
close to what they're doing and and
17:14
see and and see what works
17:16
and what and more importantly, what doesn't work
17:18
so I don't fall into that trap. And
17:20
then pilot the things that that do work,
17:23
or look like they work. And and that's
17:25
what we're doing here. We're not afraid of,
17:28
some of the newer technologies. We're doing some
17:30
things in ambient
17:31
listening with our providers that's,
17:34
that has a lot of promise rolling that
17:36
out right now on,
17:39
around clinical content and and productivity for our
17:42
our providers and and also,
17:45
some virtual nursing,
17:46
piloting that we have. But, again, these are
17:48
not,
17:49
companies
17:50
that
17:52
are,
17:53
just on the market. They've been working with
17:55
other organizations,
17:56
so we're following that lead. That's okay,
18:00
to do.
18:01
As a CIO, you don't need to be
18:03
on that that leading edge,
18:06
unless you do work for,
18:07
Aimeo or a Cleveland Clinic or those types
18:10
of organizations.
18:11
So
18:12
so, again, following others,
18:14
focus on data quality and security in everything
18:16
that you do. Right? So whatever these pilots
18:19
are, whether this new technology is, you've gotta
18:22
have a data quality program around that,
18:24
and you've gotta have a security program around
18:26
that as well.
18:27
You also have to be able to train.
18:29
Right? You've got all these, for example, using
18:31
a you've got physicians using,
18:33
ambient
18:34
listening technology with their patients. How do you
18:36
train for that? How do you train IT
18:38
to support it? What kind of staff do
18:40
you need? So your workforce evaluation
18:42
involved in that is super important. And then
18:45
the continuous monitoring and evaluation, you know, auditing
18:48
your programs,
18:50
monitoring your programs,
18:52
things that are working continue, things that are
18:54
not stop
18:55
before they do get too expensive, and just
18:58
the evaluation, the constant evaluation of that going
19:00
forward. So I think if you put those
19:02
kind of mitigation
19:04
strategies together around all the you know, whether
19:07
it's virtual care, whether data analytics, whether it's
19:09
interoperability,
19:10
AI, you know, wearable tech. We talked about
19:12
all these things, cyber.
19:14
If you add in, you know, the piloting,
19:17
focus on data quality and security, train, train,
19:19
train, train,
19:20
continuous monitoring evaluation of every single one of
19:23
those,
19:24
then you have a, you know, a high
19:26
likelihood of success,
19:28
in those areas.
19:30
If you don't put those mitigation strategies in
19:32
place,
19:34
then there's a lot of risk involved with
19:35
a lot of these newer technologies that are
19:37
coming out, and you could end up in
19:39
a situation of, you know, spending
19:42
money that, you know, you don't have in
19:44
an organization on things
19:46
that don't actually work.
19:48
So so that's that's super important.
19:51
That makes a lot of sense. You know,
19:53
it's great advice. I think with our last
19:55
minute or 2 here, I was wondering if
19:56
you could talk about where you see some
19:58
of the best opportunities to grow in the
20:00
future. What's,
20:01
do you see as being really the space
20:03
where,
20:04
leaders, CIOs, and other health care executives should
20:06
lean in?
20:08
Mhmm. I I think the biggest the biggest
20:11
thing, and we we've already talked about it,
20:12
is AI,
20:14
AIML
20:15
and everything that goes with it, whether you're
20:16
talking about
20:18
ambient technologies and the things that are kind
20:20
of offshoots from that,
20:22
along with the, you know, certainly the data
20:24
analytics play that goes with that. Because if
20:26
you think about it in the next 5
20:28
years,
20:29
you know, you think about 5 years ago,
20:31
what we were doing with AIML even maybe
20:34
3 years ago,
20:36
and and where what we've done just in
20:38
the past couple of years and and where
20:40
that whole technology is going. And I know
20:42
there's there's certainly a lot of challenges with
20:45
it. We talked about the the ethical aspects
20:47
of it, safety,
20:50
algorithm bias, and things like that that all
20:52
need to be worked out. And there's a
20:54
lot of organizations, you know, IEEE and some
20:56
others that are and even government organizations that
20:59
are focusing on that. So
21:01
I'm hopeful,
21:02
that we, you know, put
21:05
a fence around this thing so that we
21:06
we're using it in the right way.
21:08
But when you think about it, gosh, it
21:11
it has the biggest,
21:12
impact, I think. You know, when you think
21:14
about personalized medicine, right,
21:16
and AI and ML impact on personalized medicine,
21:19
predictive analytics
21:21
and helping clinicians do the right thing for
21:23
for their patients,
21:25
a huge impact in that area as well.
21:27
And you can't forget about research.
21:30
AI and ML will play in accelerating research
21:34
and getting, you know, pharmaceuticals,
21:36
you know, to the market faster,
21:38
getting different types of procedures and care
21:40
to the market faster back into health care
21:43
in a translational way that can be used
21:46
a lot faster than,
21:48
you know, when you think about the timelines
21:50
for research from
21:51
beginning basic research to be able to use
21:54
whatever comes out of that is like 13
21:55
to 15 years same with drugs
21:58
and imagine shortening that down to 3 or
22:01
4 or 5 years what the impact of
22:03
that is gonna be to health care,
22:06
you know, across
22:07
the across the United States. So to me
22:10
that that is where
22:12
the focus,
22:14
needs to be. And, again, all these other
22:16
things I've talked about
22:18
aren't of less importance, but
22:21
need to, you know, be shored up so
22:23
that we can focus on,
22:25
some of these other, you know, bigger technologies.
22:27
And, again,
22:29
again, when we think about AIML too, it's
22:31
around cybersecurity.
22:32
I think it'll have a big impact in
22:34
that area, both good and bad because the
22:36
bad actors will use it as well.
22:38
And then,
22:39
you know, we'll have to respond using these
22:41
tools as well.
22:42
And so that that'll be interesting to see
22:44
how that plays out, but yeah, but that's
22:47
why I think it's going.
22:49
That's fascinating to hear. Chuck, thank you so
22:51
much for joining us on the podcast today.
22:53
This has been a really interesting discussion, and
22:55
I look forward to connecting with you again
22:56
soon.
22:58
Absolutely. Thank you. And, I I appreciate it.