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Revolutionizing the Medical Supply Chain with Charlie Miceli's Insights · Taking The Supply Chain Pulse

• 0:05
  Speaker 1: Hello everybody, this is Crans from from St Onge, coming to you today with another episode of Taking the Pulse of the Healthcare Supply Chain.
• 0:14
  Speaker 1: Today we have a really interesting and special edition.
• 0:19
  Speaker 1: We're going to have a rematch of the 1988 showdown between the Catholics and the convicts.
• 0:26
  Speaker 1: Representing the Catholics of the University of Notre Dame in South Bend will be our guest.
• 0:32
  Speaker 1: Charlie Miceli of the University of Vermont Health Network and representing the convicts of the University of Miami and Coral Gables Florida will be me and Coral Gables Florida will be me.
• 0:47
  Speaker 1: So Charlie is a 2023 inductee into the National Healthcare Supply Chain Hall of Fame, the Bellwether League.
• 0:55
  Speaker 1: He's been at the University of Vermont Health Network for a long time.
• 1:00
  Speaker 1: I am a 2020 inductee into the Bellwether League, so this should be a real showdown between old friends and heavyweights as we delve into Charlie's career and Charlie's take on some of the things that are happening today in the health care supply chain.
• 1:16
  Speaker 1: Charlie, welcome, we're glad to have you with us and I'm so happy that you're a Hall of Famer because you've always been a Hall of Famer in my book.
• 1:24
  Speaker 1: Morning Fred.
• 1:28
  Speaker 1: Thank you, charlie.
• 1:29
  Speaker 1: Tell us about yourself.
• 1:30
  Speaker 1: You've got an interesting career.
• 1:31
  Speaker 1: Born in Chicago, raised in Chicago, moved.
• 1:34
  Speaker 1: I met you when you were in Boston, so tell us about how you got to where you are today and what your new role is going to be.
• 1:41
  Speaker 2: Yeah, actually your geography is incorrect.
• 1:44
  Speaker 2: I yeah you should have known this.
• 1:47
  Speaker 2: I was born in Oswego, new York oh wow, second largest city in North America on Lake Ontario, zip code E-I-E-I-O.
• 1:54
  Speaker 2: But I grew up in Oswego, went to University of Notre Dame for undergraduate, then moved to Chicago and worked in Chicago till 1996.
• 2:08
  Speaker 2: And I was fortunate.
• 2:09
  Speaker 2: I started at Northwestern Memorial Hospital in 1983, and then went to Loyola University Medical Center, then the University of Chicago on the University of Chicago side, as a director of procurement and then worked for Colonial Healthcare Supply which is now part of Cardinal.
• 2:30
  Speaker 2: Back in the day we used to compete against Medline, which was right up the way from us, up from where we were in Lake Zurich, illinois, and then came back to the University of Chicago Health Network and now it's called UC Medicine, and then moved to Boston is the first leader of purchasing for Partners Healthcare System, which is now called Mass General Brigham Went in consulting, where I work with you, fred, we both work for Tom Hughes at BD Healthcare Consulting and Services, which used to be Concepts in Healthcare.
• 3:09
  Speaker 2: And then for the last 15 years, six months, and then I came back to partners at Newton Wellesley Hospital, spent six years there and then came up with different roles and then came up here as the vice president of the supply chain.
• 3:26
  Speaker 2: For the last 15 years six months, I've also been fortunate to have led pharmacy, been the deputy CIO for the medical center, the CIO for our accountable care organization, and had two tours of duty as a chief CEO and a CFO for a clinical affiliate of ours in northern New York, in Ticonderoga, new York.
• 3:55
  Speaker 2: I did two tours of duty there, one in 2010, 2011, and then in 2014, and then came back and became the chief supply chain officer for the University of Vermont Health Network, and I've served in that capacity since 2015.
• 4:15
  Speaker 1: Wow, and you're only 42 years old.
• 4:16
  Speaker 2: That's pretty amazing, Charlie yeah right, right, and now I've just semi-retired.
• 4:22
  Speaker 2: I've just semi-retired.
• 4:39
  Speaker 2: I was fortunate.
• 4:39
  Speaker 2: I was able to work through a succession planning ever since 2015,.
• 4:46
  Speaker 2: 2016.
• 4:47
  Speaker 2: Supply chain officer.
• 4:48
  Speaker 2: Vice president of supply chain for the University of Vermont Health Network, ken Jensen.
• 4:54
  Speaker 2: Ken runs circles around me.
• 4:56
  Speaker 2: He has every designation from the logistics and supply chain outside of industry, outside of the healthcare industry.
• 5:06
  Speaker 2: The only thing I got on them is that I've worked in healthcare for 40 years, so I know where everything is.
• 5:13
  Speaker 2: But I'm introducing them to people like you Fred, council for Supply Chain Executives, uh, idn summit, uh, everybody uh, because I think you know having the network of, of, of the new folks and, uh, the folks like us, uh, that have been around the block.
• 5:36
  Speaker 2: I think it helps the new, the new folks coming in, and it helps us too, because you know, I I'm very proud of the way that I've been able to mentor folks over time, because I've been so fortunate and I mentioned that in the induction ceremony for the Bellwether League of all the people that helped me and gave me a chance, gave me a chance to fail and make mistakes, but then also had faith in me and let me continue to go.
• 6:05
  Speaker 2: So that's just been.
• 6:07
  Speaker 2: You know, something that's been a very positive in my career and I hope that a lot of other folks have that same opportunity.
• 6:16
  Speaker 1: Well, Charlie, one thing you forgot and I don't want you to tell us about it for 10 minutes, but you're a real renaissance man.
• 6:25
  Speaker 1: You're the Ayatollah of the health care supply chain rock and rolla, because you've got your band that you participate in and played at many important functions.
• 6:36
  Speaker 1: Tell us briefly about that.
• 6:39
  Speaker 2: Yeah, yeah, we established a local band called.
• 6:44
  Speaker 2: We first started out called McKenna Lee and the Eva Channel.
• 6:47
  Speaker 2: We used to play Eva Cassidy music, almost like a tribute band, and McKenna, who actually works in supply chain now is the senior project manager and has her MBA in supply chain, is our lead singer.
• 7:06
  Speaker 2: And then we've been able to augment with other folks across our health care network and a couple outsiders, and we've performed.
• 7:17
  Speaker 2: Our first away performance was at the Epic UGM, which is a big conclave that happens in September in Verona, wisconsin.
• 7:28
  Speaker 2: So our first public performance, our way performance, was in front of 7,000 people, so it was pretty good.
• 7:36
  Speaker 2: And then we've continued.
• 7:40
  Speaker 2: We donate our time.
• 7:40
  Speaker 2: We don't play for money.
• 7:41
  Speaker 2: We donate our time.
• 7:42
  Speaker 2: We don't play for money.
• 7:43
  Speaker 2: We take whatever we get and we've donated that suspense since the pandemic.
• 7:51
  Speaker 2: But we did do a video.
• 7:52
  Speaker 2: We wrote a song.
• 8:09
  Speaker 2: Mckenna wrote almost all of it and her partner wrote it and then we recorded it and it's been used by the patient safety movement, the World Health Organization as well as V you know different aspects.
• 8:25
  Speaker 2: We recorded it in August of 2020.
• 8:27
  Speaker 2: So we're pretty proud of that and hopefully we'll be playing a couple of times this year.
• 8:31
  Speaker 2: Before I hang up my.
• 8:33
  Speaker 2: I'm not hanging up my guitar, but I'm hanging up my supply chain spikes.
• 8:40
  Speaker 1: Well, charlie, the one thing that's always stood out about me is you've always been an early adapter of either applications or solutions, and I can think of two that I sort of associate you with.
• 8:55
  Speaker 1: One is in value analysis and the other one is the Resolink application.
• 9:01
  Speaker 1: As far as supply chain disruption warnings, is that just your nature to be curious and adapt things earlier, or do you just have the ability to immediately see the value of something?
• 9:18
  Speaker 1: I've always been impressed with how quick you get stuff.
• 9:21
  Speaker 2: Yeah, I think it's a couple of things and I kind of bring it up to my upbringing.
• 9:28
  Speaker 2: I came up in a blue collar town, um, and never really the big city I ever went to was syracuse, new york.
• 9:37
  Speaker 2: So when I went out to south bend and then went to Chicago on a couple of trips, you know, just saw the world opened up.
• 9:47
  Speaker 2: And but with that you know working person's ethic, work ethic, you know you never say never.
• 9:56
  Speaker 2: You put your head down and get stuff done but you're always keeping your eyes open to see how you can do better and help each other.
• 10:03
  Speaker 2: And that just came through my family and just the way we thought about things.
• 10:09
  Speaker 2: And I was an early adopter of computers when they first came out and some folks probably listening to this may not even know about it, but VisiCalc, lotus 1-2-3, the smart system that was back in the 80s, and when I grabbed onto that I saw the power that we could use and how fast you could move for analysis and decisions, whether we were selecting suppliers, whether we were looking at item masters, whether we were, you know, using barcodes.
• 10:46
  Speaker 2: You know, back in the day we were early adopters of barcodes for patient stickers, charge stickers, but the computers weren't fast enough and I had this one guy that worked in my group.
• 10:56
  Speaker 2: He could 10 key faster than the barcode and I used to bet money on it with folks to say that this one fella could key faster and the computer was an IBM XT.
• 11:09
  Speaker 2: But then when it went to the IBM AT the computer was faster than the 10 key guy.
• 11:15
  Speaker 2: So then I stopped doing it.
• 11:17
  Speaker 2: But we were one of the first ones to use the AS400.
• 11:21
  Speaker 2: So I always had visionary bosses that basically just let me go get loose and look at stuff and try to deploy.
• 11:29
  Speaker 2: So you know, tim Partridge gave me that chance, john Guida gave me that chance.
• 11:35
  Speaker 2: You know in the early career and you know to work and to use technology to help make decisions and support.
• 11:43
  Speaker 2: You know flash forward.
• 11:44
  Speaker 2: You know to work and to use technology to help make decisions and support.
• 11:46
  Speaker 2: You know flash forward.
• 11:48
  Speaker 2: You know when we made, when I came up to University of Vermont Health Network, we set up four tenants.
• 11:54
  Speaker 2: One was cost management, one supply chain which is basically no silos.
• 12:01
  Speaker 2: Third was have enhanced business processes.
• 12:06
  Speaker 2: But the most important thing, this was before meaningful use.
• 12:10
  Speaker 2: This was in 2008.
• 12:11
  Speaker 2: Meaningful informatics.
• 12:14
  Speaker 2: So we started building a platform on our informatics at the time.
• 12:21
  Speaker 2: Our ERP system was called MediClick at the time.
• 12:24
  Speaker 2: Now it's called Pink AI and it was a good system.
• 12:29
  Speaker 2: I've worked with SAP, with PeopleSoft, with Oracle, with Lawson, with Infor McKesson, you name it.
• 12:35
  Speaker 2: We were ADS System 20 back in the day, tom Pirelli's system Enterprise, and the system was a good system.
• 12:44
  Speaker 2: So we knew we had a good foundation and about three weeks in the, the chair of our value analysis committee, dr Rickey, who was a surgeon that ran value analysis, said hey, we'd like to have a voting system for blind voting to make selections.
• 13:08
  Speaker 2: And I said okay, and so we started looking around the market.
• 13:11
  Speaker 2: What was there?
• 13:11
  Speaker 2: And I had worked with this fellow, steve Kinsella, at BD Healthcare Consulting and Services.
• 13:17
  Speaker 2: He was our data guy and I had lost track of him.
• 13:20
  Speaker 2: You know just what he was doing.
• 13:22
  Speaker 2: We always, you know, we were friends, we kept in contact that way and he had started a company called the Data Leverage Group and had a system called VAMS, and this was in October of 2008.
• 13:34
  Speaker 2: This was when the financial meltdown was happening and but we went and we asked Steve hey, you know, can you design something for us?
• 13:43
  Speaker 2: And he had one client that was in Branson, missouri, and I remember that you know a lot of companies at that point in time we cutting any type of uh process or uh systems.
• 13:59
  Speaker 2: That didn't help you.
• 14:00
  Speaker 2: So they were his first customer, but they they canceled the contract.
• 14:05
  Speaker 2: So we were this, we were the second customer, but I always call us, we were the first one and our cfo, roger deshaies, who I, who was another one of my mentors, uh said yeah, yeah, go for it, this looks like a good thing.
• 14:18
  Speaker 2: And over the last, you know, almost 16 years, we've worked with the VAMS system and worked with Steve.
• 14:28
  Speaker 2: And what the magic there has been.
• 14:31
  Speaker 2: He listens and listens to things.
• 14:36
  Speaker 2: Like I asked him, I said when Atul Gawande's checklist manifesto came out I go we were talking on a Saturday I go, can you operationalize that and put that in the VAMS and the value analysis system?
• 14:48
  Speaker 2: He goes, yeah, so two weeks later we had the checklist and then, you know, we use it for project management, but we also use it to report impact on savings, whether it's unit price savings, cost avoidance, capex, opex, and we've done that.
• 15:08
  Speaker 2: So since we just did a show back for supply chain, we're good for about 10 million bucks a year.
• 15:17
  Speaker 2: So in the last, but since 2015, we've contributed about $100 million back to our company and we use that information.
• 15:32
  Speaker 2: We participate in the Gartner IDN benchmarking component and work with Eric Odafer and his team and you know very strenuous, very detailed process and we validated our performance in that respect.
• 15:52
  Speaker 2: So that system is core number one and if anybody else, you know you don't have to justify yourself, but you have to show your value.
• 16:03
  Speaker 2: You know we justified ourselves during the pandemic.
• 16:08
  Speaker 2: Supply chain did healthcare, supply chain did across the country, probably across the world, and so we have a seat at the table and sometimes at the high table.
• 16:18
  Speaker 2: But, with that said, another software system that helped us was ResLink and I think it was on a call with you, fred, with a connection with ResLink back in 2018, with Resolink back in 2018, subsequent to Hurricane Maria, we met and I think you guys were three minutes in and as soon as I saw what you were doing, I said stop.
• 16:54
  Speaker 2: It Did the Jerry Maguire, where you know you had me at resilience and so we asked for a term sheet.
• 16:56
  Speaker 2: So we've been using Resolink and I know Ed Hisak at Trinity we were right around the same time and that was our early warning system where our canary in the coal mine to help prepare for the injury to the healthcare supply chain or supply chains all around the world in 2020.
• 17:18
  Speaker 1: In fact, we call Let me jump in on you there, Charlie.
• 17:22
  Speaker 1: From an outside perspective, it looked to me like during COVID.
• 17:28
  Speaker 1: Your organization fared a lot better than others.
• 17:32
  Speaker 1: Is it because of something you did, or did you get lucky?
• 17:36
  Speaker 1: Or how come you made it through as well as you did?
• 17:41
  Speaker 2: All of the above but and I can't say we made it through as well as we did because we still had people that passed away from COVID in our state, as did over a million Americans lost their lives to this tragic event.
• 18:00
  Speaker 2: But what we did do, the most important thing is we made friends, we made alliances, and when I first started out in health care supply, everything was a handshake.
• 18:16
  Speaker 2: You trusted everybody and I think we went and I'm guilty of this too we chased the dollar so much and we lost the personal relationship with our suppliers and sometimes with our other colleagues in other healthcare institutions, and everything became a contract, everything became a KPI, everything became, you know, it was adversarial in the sense that it wasn't win-win or I call accommodate.
• 18:52
  Speaker 2: Accommodate is what it should be.
• 18:53
  Speaker 2: You know, we resolve what we need and we support the suppliers because they need to support us.
• 18:59
  Speaker 2: I think we push the suppliers too far and I knew that from when we used to have cost plus 12, that was a good deal.
• 19:07
  Speaker 2: When I first started for MedSearch distribution, I was one of the guys that made it go down to cost plus three, cost plus two, that made it go down to cost plus three, cost plus two, and then I went on the distributor side and saw what happened there and we made everything too tight.
• 19:26
  Speaker 2: So we turned into a grocery store which is very efficient and effective margin world.
• 19:31
  Speaker 2: But I think we did it the wrong way.
• 19:33
  Speaker 2: But never burn a bridge was one thing and always keep relationships going.
• 19:41
  Speaker 2: And you know, we work with people we trusted and who told us the truth.
• 19:47
  Speaker 2: We had some failures on supply stuff but we also had some big wins by working together with our state government, with Dartmouth, with our hospitals in two states, and then also, you know, I talked to Mark Faulkner and Lisa Scannell down at Mass, general Brigham Craig down at Memorial, sloan Kettering we made this network.
• 20:14
  Speaker 2: Amanda out at Stanford, we made this network and ResLink helped us put that together.
• 20:20
  Speaker 2: Smi helped us put that together and it was storytelling, but it was storytelling with experience and do this or don't do this.
• 20:33
  Speaker 2: That, I think, really helped us out.
• 20:36
  Speaker 2: And the software, whether it was your ERP system, whether it was, we have another system we use called TrueView Analytics, used to be called Neptune and it's an app that's used.
• 20:47
  Speaker 2: We used it for our we started in the EP lab and cardiac CRM and so our physicians could look at an iPhone or a Droid and see what our inventory was the technical specs of the implant devices, the cost structures that were from each supplier, and then the technical specs the size, the shock, if it was electric pulse, what that was.
• 21:16
  Speaker 2: And I gave the okay to build that and I didn't know how fast they were.
• 21:24
  Speaker 2: But I was in a grocery store, I was buying some Heddy Topper beer because this was back in 2016 and 2015, and I, dr Winget, came up to me.
• 21:36
  Speaker 2: He's in the grocery store and he goes check this out and he showed me the app.
• 21:39
  Speaker 2: So, flash forward, we won a Vizian Award for technology, for innovation, and then we were shortlisted with Procurement Leaders, which is a worldwide organization for technology.
• 21:55
  Speaker 2: So, you know, and it's helped us save money.
• 21:59
  Speaker 2: It's also helped our suppliers because they interact with the device and we've expanded that.
• 22:06
  Speaker 2: So and it works in consort with VAMS and it also works with our system with Pink AI, and then it also works with Epic.
• 22:17
  Speaker 2: We download data from Epic and throw that in.
• 22:20
  Speaker 2: We work with a number of other firms in doing that and TrueView Analytics has been one of our cornerstone systems that we use and that helped us during the pandemic too, because we were looking at costs.
• 22:33
  Speaker 2: We wanted to go as fast as we could to get back up and running once we kind of knew where we stood.
• 22:39
  Speaker 2: So May and June June was our target to get back up to 90% of capacity where we could do it safely and make sure we had the supply made sure we had the systems made sure we had the staff, make sure we had the logistics and our suppliers.
• 22:57
  Speaker 2: It worked out really good, but it was all with the handshake.
• 23:00
  Speaker 2: It was with the trust, because a contract doesn't mean any force majeure wipes out every contract thing that you ever had during a worldwide event like that and it really became down to trust and communication.
• 23:13
  Speaker 2: So I don't know if I answered your question, but that's that's interesting, charlie.
• 23:18
  Speaker 1: What you're saying is that you're using data and you're using all the technology that's out there, but really what really saved the day was going back to the basic human interaction and building relationships.
• 23:31
  Speaker 1: Yeah, that's cool.
• 23:32
  Speaker 2: Yeah, yeah, I went to two areas.
• 23:35
  Speaker 2: We went, we went old school, yeah.
• 23:37
  Speaker 1: Two areas we went old school.
• 23:39
  Speaker 1: Yeah Well, you brought up two areas in here, charlie, that I think probably bear a little more stretching out.
• 23:44
  Speaker 1: As an innovator, you've never been afraid to hire folks from outside of healthcare.
• 23:51
  Speaker 1: You talked about McKenna, your lead singer, and I know Ken came from.
• 23:59
  Speaker 1: Didn't Ken come from Green Mountain Coffee?
• 24:09
  Speaker 2: Yeah, cargill, us Navy.
• 24:10
  Speaker 2: He was a submariner missile commander officer, so the leadership and everything else was built in there.
• 24:13
  Speaker 2: And then we have attorneys too that came in into our group from.
• 24:16
  Speaker 2: One attorney was a assistant district attorney and then another attorney was the public defender, but it's the critical thinking skills that you want.
• 24:28
  Speaker 2: Another fellow that works in our group he's got his master's in molecular biology, but he's also an attorney and a patent attorney.
• 24:39
  Speaker 2: So you know, we have an attorney embedded in IT.
• 24:45
  Speaker 2: I would say that we're in the minority right now of healthcare supply chain organizations that have supply chain embedded in IT, which is one of your biggest spend areas, and so we've done that.
• 25:00
  Speaker 2: Sid Hamilton, who's actually a future Hall of Famer in the Bellwether League, was our first approach in that.
• 25:14
  Speaker 2: So when I was the deputy CIO, we brought Sid in and Sid sat in IT and Sid sat in IT and in fact we had a thing called where we put people up on the wall the faces of Fletcher Allen, and Sid went on the wall as a face of Fletcher Allen for his performance and his support, but it wasn't from supply chain, it was from IT.
• 25:34
  Speaker 2: So you know, and again, folks didn't have healthcare experience.
• 25:42
  Speaker 2: In fact, you know, if I had my brothers, I want people from the military who've served and supported our nation, because they understand, you know they work between X and Y and are really good.
• 26:00
  Speaker 2: But then there's other folks that they work within X and Y.
• 26:05
  Speaker 2: They know the mission but they can also work outside of the parameters there.
• 26:09
  Speaker 2: So two fellows that I've worked with Pat Jordan, who's an airborne ranger, he worked, I worked for Pat.
• 26:16
  Speaker 2: I worked with Pat at Mass General and then worked for him when he was COO at Newton-Wellesley Hospital.
• 26:22
  Speaker 2: He's currently the COO at Dartmouth Health.
• 26:27
  Speaker 2: And then Ken Peterson, who I served with at Loyola.
• 26:33
  Speaker 2: Ken had just got out of the Army, he taught at the Command Staff General College and we worked with each other.
• 26:42
  Speaker 2: We did after action reports every day, we did briefings.
• 26:49
  Speaker 2: So that discipline and the cadence of communication and using facts, ground truth is in our lexicon now in our organization.
• 27:00
  Speaker 2: I can say that I was probably the person that brought that here 16 years ago and it's in the lexicon of, as is AAR, and that was from working with Pat and working with Ken.
• 27:13
  Speaker 2: So I think you know people from manufacturing.
• 27:17
  Speaker 2: You know you got Brent, you know from Johnson, from Joe Joe Walsh.
• 27:22
  Speaker 2: You got all these folks that worked outside and now and now they're in our world and they bring that wealth of knowledge to us and makes us better.
• 27:31
  Speaker 2: Like I said earlier, the only reason I'm ahead of Ken is because I've been working.
• 27:37
  Speaker 2: I know, I know where everything is, so you know what's interesting about that, charlie, is.
• 27:45
  Speaker 1: I know many of the people you're talking about and and I think it gets down to a quality of person because, oh yeah, as many as many folks as there are like you that have built a dynamic team.
• 27:57
  Speaker 1: What those folks all share is they can get their egos out of the way, they're open to learning, they're expansive people, as opposed to other times where I've seen organizations bring in experts from outside healthcare who just don't get it, don't ever want to get it and think that healthcare is backwards and behind the times, ever want to get it and think that health care is backwards and behind the times is never going to move forward.
• 28:22
  Speaker 1: And those folks often exit the health care supply chain almost as quickly as they came in.
• 28:26
  Speaker 2: Yeah, I think the other thing too is working on, you know, having more female supply chain leaders.
• 28:34
  Speaker 2: So through the work of SMI, you know Jane Pleasance leading the way, our arrangement with women on their way, with Audrey McGuckin, with the McGuckin Group that's the best thing since sliced bread from my perspective.
• 28:51
  Speaker 2: Doing that, I've been fortunate.
• 28:53
  Speaker 2: Where I've been able to, you know I've been mentored and I want to, you know, pay it forward.
• 28:56
  Speaker 2: I've been able to.
• 28:56
  Speaker 2: You know, I've been mentored and I want to, you know, pay it forward.
• 28:59
  Speaker 2: So it's just wonderful to see, like somebody that used to work in my group, carmen Alvarez.
• 29:06
  Speaker 2: She started out on the receiving dock at the Mass General and has been in administration and has worked on diversity, equity and inclusion, has just worked on mindfulness and health.
• 29:33
  Speaker 2: We actually had Carmen come and talk to us about wellness and just to see somebody you know go from because that's where I started you know I started kicking boxes and, you know, not a bad thing to learn, because if you don go from the cause, that's where I started.
• 29:41
  Speaker 2: I, you know I started kicking boxes and, um, you know, not not a bad thing to learn, Cause if you don't do the work, you don't understand the physical part, but also the emotional part, and to see, and the human part, and to see somebody rise up like that Same thing.
• 29:53
  Speaker 2: You know, rachel Raines that's on my team is.
• 29:55
  Speaker 2: You know Rachel was the director of purchasing here back in the day.
• 29:59
  Speaker 2: You may have met her, fred, when you walked through Fletcher Allen in 2008.
• 30:09
  Speaker 2: And then Rachel left.
• 30:10
  Speaker 2: She was our first telecommuter, but she moved out to the left coast and during the pandemic she was my chief of staff.
• 30:14
  Speaker 2: She's an attorney and upon her return and through you know, she went through women on their way and also has moved from a manager is now the director of network contracting for us.
• 30:30
  Speaker 2: And then you have, you know, look at the folks that were just in the Bellwether League class of 2023.
• 30:36
  Speaker 2: You know, I'm at the bottom of that pile up there, you know, with Karen Conway and Mary Beth and Deb.
• 30:48
  Speaker 2: You know.
• 30:50
  Speaker 1: Charlie, be kind to yourself, buddy, you belong where you are.
• 30:54
  Speaker 2: No, I know, but just what they've done.
• 30:56
  Speaker 2: And you know, karen jumped off the working train right before.
• 31:01
  Speaker 2: I know but just what they've done.
• 31:01
  Speaker 2: And Karen jumped off the work and train right before I did like within a couple of weeks, but she did so much and is doing so much for the healthcare ecosystem.
• 31:10
  Speaker 1: Through her career, karen's going to be one of our guests and also I'm bringing a bunch of the young folks that you talk about in too, because I think one of the big things in healthcare is going is in healthcare supply chain is going to be attracting and keeping the future leaders.
• 31:29
  Speaker 2: Oh yeah, Future leaders.
• 31:31
  Speaker 1: Huge, yeah, but we're sort of coming near the end of our time.
• 31:36
  Speaker 1: I got two quick things to ask you, sort of coming near the end of our time.
• 31:41
  Speaker 1: I got two quick things to ask you.
• 31:41
  Speaker 1: Number one you're one of the few supply chain leaders that I know.
• 31:44
  Speaker 1: There was a guy named Dick Sim from the Health Alliance of Greater Cincinnati who became the president at York Hospital and York PA.
• 31:54
  Speaker 1: You're one of the few guys that I know that have actually been a CEO at some point.
• 31:59
  Speaker 1: So what did supply chain help you as far as being a CEO, and how did being a CEO perhaps change the way you looked?
• 32:16
  Speaker 2: at supply chain, I have to say, because when I served as CEO I volunteered to help an organization that was in difficulty.
• 32:25
  Speaker 2: So you know everything is we're brought up in supply chain is cost oriented and orientated and so you go in and you start in and you start looking at cost structures and but what you have to be careful with is two things.
• 32:44
  Speaker 2: Number one when you go into an organization you have to it's the people.
• 32:49
  Speaker 2: And in supply chain is very people centric in the sense that you get, you know, you can contract, you can purchase, find a desk and you can be really good at that.
• 33:04
  Speaker 2: But you have to understand that once a system or a service shows up it needs to be consumed by the organization and it's just not going to stand on the dock and work and help you.
• 33:16
  Speaker 2: You have to have folks that have relationships with the consumers of the services or the products.
• 33:22
  Speaker 2: So it's the people component and, knowing from the how the frontline is, especially when you're in anitel's character in Pulp Fiction, a cleaner but you have to be benevolent when you're in that and understand that it's the staff that are doing the work but it's also the community.
• 33:56
  Speaker 2: So when you're in a place that is an economic engine for a community.
• 34:02
  Speaker 2: You want to keep that place alive.
• 34:04
  Speaker 2: So supply chain helps you how to sustain.
• 34:07
  Speaker 2: But you also have to be careful depending on where you cut costs or how you cut costs, because when you work in a, say, a critical access hospital Because when you work in, say, a critical access hospital, some of your expenses cost you're in a cost plus with your Medicare.
• 34:25
  Speaker 2: So you have to be.
• 34:26
  Speaker 2: I listened to my colleagues and consultants and said, yeah, you want to keep this.
• 34:30
  Speaker 2: This part here is good, but you also want to make sure that you leverage economies of scale.
• 34:36
  Speaker 2: You leverage group purchasing organizations, you leverage your governmental agencies for help.
• 34:41
  Speaker 2: So it was eye-opening for me where you just can't come in like a consultant and just say here's the list, do it Because there's a person behind every penny or in front of every penny that you may work on and it's the what's the value of that spend that you may work on?
• 35:01
  Speaker 2: And it's what's the value of that spend and how does that help take care of a patient number one?
• 35:03
  Speaker 2: But then how does that help take care of the folks working there and then how does it take care of the community?
• 35:07
  Speaker 2: So I guess you know, just coming up in big organizations, I never worked at a small hospital before but when I went into consulting I'd only work.
• 35:18
  Speaker 2: You know Mass General, the Brigham University of Chicago, you know Loyola, you know 500,000 bed hospitals.
• 35:26
  Speaker 2: And then when we were in consulting we'd go work at a critical access hospital or a small, smaller system and try to save them, whether we were subcontracting for Hunter Group or you know, or doing it ourselves to make things better.
• 35:40
  Speaker 2: But that's what you learned.
• 35:43
  Speaker 2: You learned about the people and the organizations that gave me an advantage to go in and to listen and to turn around.
• 35:52
  Speaker 2: And we were able to turn around, in fact aligning with Hudson Headwaters, which is a Dr John Ruggie from my lens, saved healthcare in the Northern New York because he started Hudson Headwaters as a physician's organization to come in and take care of the population in a typically underserved area and has done a great job and is aligned with our health network and we made that relationship 10 to 12 years ago.
• 36:21
  Speaker 2: Underserved area and has done a great job and is aligned with our health network and we made that relationship, you know, 10 to 12 years ago versus a competitor, their colleague and a collaborator.
• 36:27
  Speaker 2: So that's what you learn.
• 36:30
  Speaker 2: I mean, the other thing is when you land, you want to, you have to be visible.
• 36:36
  Speaker 2: You have to meet with everybody.
• 36:38
  Speaker 2: They got to know your name.
• 36:39
  Speaker 2: You know, when you go into a smaller organization it's sometimes it's harder because people are so busy you don't get to see.
• 36:47
  Speaker 2: And then when you have, you have to understand your board of directors, which now we get to do in supply chain, which we didn't before.
• 36:56
  Speaker 2: So I don't know if I answered your question, but again, it's listening.
• 37:00
  Speaker 2: It's listening and honoring and respect.
• 37:03
  Speaker 2: You can't come in binary and just say you're in, you're out.
• 37:07
  Speaker 2: You have to think that way.
• 37:09
  Speaker 2: But then you have to humanize it and rationalize it to well.
• 37:15
  Speaker 2: I said you know the patient, the staff, the workforce.
• 37:20
  Speaker 2: You know who is it.
• 37:21
  Speaker 2: Dr Conroy I think Dr Conroy said this, I heard it in the discussion the other night at a supper is that you know what do you do when you come in Workforce, workforce, workforce, workforce, workforce, right, and you have to honor your staff and work and our CEO, our CEO not that our prior CEOs did that.
• 37:42
  Speaker 2: Dr Eppin is like that.
• 37:44
  Speaker 2: He went to every place, socialized with the folks town hall meetings, you know, probably people got tired of having meetings because you know when your organization's in trouble.
• 37:56
  Speaker 2: They got in trouble for a reason and it wasn't you know.
• 38:02
  Speaker 2: So you meet and tell.
• 38:04
  Speaker 2: You have to tell people the truth, yeah, and that's where the facts come in.
• 38:09
  Speaker 2: And to get the data and to show where the numbers are.
• 38:12
  Speaker 2: You know what's your day's cash on hand, what you know.
• 38:17
  Speaker 2: We're trained to do all that stuff in supply chain to figure out the financials and to report that back to everybody.
• 38:24
  Speaker 2: And you know a couple times had to tell folks, you know, 30 days out.
• 38:31
  Speaker 2: If we can't make a payroll 30 days out, I'm going to tell you as soon as I know.
• 38:36
  Speaker 2: And you know that's hard to do, but people respect you for it.
• 38:41
  Speaker 2: And you know because they got to take care of their families.
• 38:45
  Speaker 2: So that's all.
• 38:47
  Speaker 1: You know my I'll say this real quickly, then I'll have your final, final opportunity to say what's on your mind.
• 38:55
  Speaker 1: But I always thought that when we did the kind of supply chain consulting that we did, you'd walk into a place where senior leadership started out thinking that their people weren't doing a great job and we were there to correct it.
• 39:08
  Speaker 1: And I always walked in and I would say that 80% of the recommendations that I ended up making were stuff that the people that were working for him had been trying to tell these guys for years and they just weren't paying attention.
• 39:20
  Speaker 1: So I always thought that my job was to do what I could to protect the folks that were already there, and it worked out pretty well.
• 39:27
  Speaker 1: So, charlie, your last chance here, parting words.
• 39:31
  Speaker 1: You're moving on to greater things in life.
• 39:34
  Speaker 1: You've had a wonderful career.
• 39:36
  Speaker 1: What would you tell the healthcare supply chain that they need to know and take with them as your parting words?
• 39:44
  Speaker 2: All right, so have a succession plan and be a mentor.
• 39:51
  Speaker 2: Because you know, my most important thing that I've told the folks that have taken my job is saying that make sure you have a you working for you.
• 40:05
  Speaker 2: So I told Ken Jensen that I go make sure you have a you like this.
• 40:12
  Speaker 2: No, no, no, no, that's University of Miami, but let's make sure you have a Ken working for you, because having that strong leader as my second in command allowed me to do you're only as good as what?
• 40:32
  Speaker 2: Because you have to keep the trains running every day and take care of the patients and your customers, and that allows you to innovate.
• 40:37
  Speaker 2: Because you don't have the time to do it, even if you work, you know, 20 hours a day.
• 40:43
  Speaker 2: So that's the first thing you know listen, listen, don't hear, but listen, hear but listen.
• 40:59
  Speaker 2: And then, if you ever work with a consultant, the first thing you do is and I learned this from Steve Bunker, who was the president of Holmes Regional Medical Center down in Melbourne, florida that was my first flyaway consulting job and I walked Steve was the president and I walked into his office and he goes.
• 41:13
  Speaker 2: He goes, take off your watch and, uh, give it to me.
• 41:20
  Speaker 2: So I said okay.
• 41:21
  Speaker 2: So I gave it to him.
• 41:22
  Speaker 2: Then he took off his watch and gave it to me and he said never take off my watch and tell me what time it is.
• 41:33
  Speaker 2: Never take off my watch and tell me what time it is.
• 41:37
  Speaker 2: So, and that's what I learned is.
• 41:39
  Speaker 2: You know, make sure that when you have, when you bring in consultants, that they're resultants, not just taking your watch off and telling you what time it is.
• 41:48
  Speaker 2: We should you should know that and what.
• 41:52
  Speaker 2: When we engage with consultants, we give them the information.
• 41:55
  Speaker 2: In fact, we're working with Mark Van Someren's group, the LogicSource, now and it's a collaboration and it's not well.
• 42:04
  Speaker 2: They're going to come in and tell us we had a cage match between my expert in IT and their expert in IT.
• 42:11
  Speaker 2: It was awesome because you could see the lightning and the energy going with the discussions and I called it a tie.
• 42:18
  Speaker 2: I go well, we need to work together in our IT spend, but my guy is just as good as your guy.
• 42:24
  Speaker 2: So you know.
• 42:28
  Speaker 2: But in other areas and you know the last thing is that you're not the best in everything except Notre Dame and football.
• 42:35
  Speaker 2: But you have to concede sometimes to say you don't know everything and you learn.
• 42:44
  Speaker 2: You creatively.
• 42:45
  Speaker 2: Tom Peters used to say you creatively swipe.
• 42:48
  Speaker 2: So you take the best and put it into action and make friends across.
• 42:55
  Speaker 2: You know being every organization you can and make friends with folks and share information.
• 43:02
  Speaker 2: I mean you know that you can share.
• 43:05
  Speaker 2: That's not.
• 43:06
  Speaker 2: You know business confidential, but what are you doing?
• 43:09
  Speaker 2: And also, what happens when you fail how do you dig out of it?
• 43:13
  Speaker 2: That's resilience, so that's all I have to say about that.
• 43:18
  Speaker 2: And also, what happens when you fail how do you dig out of it?
• 43:21
  Speaker 2: That's resilience, so that's all I have to say about that.
• 43:24
  Speaker 1: I think that's you know.
• 43:25
  Speaker 1: Thanks for the question, though.
• 43:26
  Speaker 1: Well, charlie, I think that in this conversation, you've shown people why I invited you to be on the podcast.
• 43:32
  Speaker 1: You're one of the great characters in the healthcare supply chain podcast.
• 43:36
  Speaker 1: You're one of the great characters in the healthcare supply chain and you're one of the most thoughtful and visionary leaders, and it's been great to be a friend of yours for all these years, even though you did pick an absolutely crappy school to attend.
• 43:47
  Speaker 1: I can get past that, though, charlie, so thanks so much for being here.
• 43:53
  Speaker 1: We really appreciate it, and you know?
• 43:55
  Speaker 2: and what?
• 43:55
  Speaker 2: And what do you say, Fred?
• 43:57
  Speaker 2: You said that, uh, yeah, notre Dame.
• 43:59
  Speaker 2: Notre Dame's your second most favorite school and every other school's bet is number one.
• 44:03
  Speaker 2: Yeah, that was in health.
• 44:05
  Speaker 2: That was in healthcare purchasing news in 2008.
• 44:10
  Speaker 1: I got that from Kinky Friedman.
• 44:12
  Speaker 1: Uh once said the Germans are my second favorite people.
• 44:16
  Speaker 1: First is everybody else.
• 44:18
  Speaker 1: Yeah All right?
• 44:19
  Speaker 2: Well, take care Okay.
• 44:20
  Speaker 1: Charlie, thanks again, take care.
• 44:22
  Speaker 2: Bye-bye, bye.