There is a fundamental problem in healthcare, and Saad Chaudhry wants to solve it. “While we are in the business of lengthening your existence, the industry at large also continues to quietly rob you of it in small — and sometimes, not-so-small — increments,” he wrote in a recent piece.
But it doesn’t have to be this way. Leaders have an opportunity to help turn the tide and “give back time,” whether it’s providing a safe and simple way for patients to schedule appointments and pay bills, or creating a “digital workplace” for employees. During a recent podcast interview with Kate Gamble, Managing Editor and Director of Social Media, Chaudry talked about why the concept of giving back time is so important to him and how it has “seeped into” his strategy at Luminis Health, where he was recently promoted to Chief Digital and Information Officer, and why he believes there is no ‘digital front door’ — just a digital door.
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- The concept of giving back is certainly not new, especially in healthcare. “Every day since Meaningful Use saw the first ray of sunshine, all of us have been talking about how it takes so much time to document.”
- Mortality is still a difficult concept for people to process and discuss, said Chaudhry, particularly in a business setting. Reversing that trend is a critical step in giving back time.
- “Stop getting into the complexity of looking at things from a vendor perspective, from a cloud transition perspective, from this digital perspective versus technology perspective, and just distill it.”
- Although healthcare is designed to give back time, “we steal time from you in small and sometimes not-so-small increments in an ongoing way.”
- Doing so, however, won’t necessarily be easy, especially for users. “If we have to make our technology landscape more complex, if I need to custom develop something because what I’m about to implement just doesn’t give time back, then I’ll do it.”
Q&A with Saad Chaudhry, Chief Digital & Information Officer, Luminis Health, Part 1
Gamble: Hi Saad, great to speak with you. You wrote a piece for LinkedIn a little while back about giving back time. Can you talk about this concept and why it resonates with you?
Chaudhry: Sure. The tricky thing about that entire idea is that the phrasing. To ‘give back time’ is not a new concept. Because every day since Meaningful Use saw the first ray of sunshine, all of us have been talking about how it takes so much time to document. Our physicians are saying we lose pajama time. Our nurses are saying we have to document after our rounds because it’s not exactly that easy to do it during the rounds, there’s too many clicks, there’s too much writing, all that stuff.
The idea of time being a factor has been around in the nomenclature for so long. I’ve tried to distill the idea of what it means, the factor of time in healthcare at large, to something very basic that I myself in my personal life have been obsessed with.
We talk about complexities in every industry, but especially in healthcare. We talk about sub-sub complexities in healthcare technology like cybersecurity and digital transformation. We talk about how technology is going to transform healthcare businesses into digital businesses which is absolutely true. And it’s different than just installing software and data centers and everything that’s been done for decades and decades.
At the core of it all is human beings who are living out their mortal lives not knowing how long each life is. It’s kind of funny to talk about it. I laugh when I say it because it’s an unexpected thing to mention in a business setting — ‘hey, just so you know, none of us know how much we have left.’
Gamble: It’s true. Nobody wants to say it, but it’s true.
Chaudhry: When I say it, I try hard not to smile; that’s hard for me. But I can’t help it because it seems like an absurd thing to bring up. It’s almost as if somebody in a board stood up and said, ‘go my favorite NFL team!’ People would say, ‘What? Are you having like a stroke? What are you talking about?’ That’s the reaction I might expect if I happened to raise my hand and say, ‘Hey, just in case you guys weren’t aware, if we’re lucky — really lucky, if we have the right skin color, we’re born on the right side of an imaginary line that someone drew on an old map hundreds of years ago and live in the right zip code, we have 80 years to live. That’s 700,000 hours. And by the way, we’ve spent two hours right now in this boardroom talking about stuff that is circular.
When I say that out loud — and I have — people laugh. They laugh because they can identify with it. Who can’t? What living thing cannot identify with mortality? And so, what I’ve tried to do is make it less absurd because it shouldn’t be. It is, I think, a governing principle of everything in life — why shouldn’t it be a governing principle of healthcare technology? The lives of every being is governed by the exact same thing, which is the fact that you’re going to cease to exist someday.
The “Manifesto of time”
That’s the manifesto. The manifesto of time says that we need something that can apply to everybody. Stop getting into the complexity of looking at things from a vendor perspective, from a cloud transition perspective, from this digital perspective versus technology perspective, and just distill it. It’s a dichotomy if you think about it — we’re spending countless hours in a business that’s meant to give back hours. Every time you seek healthcare, you’re not seeking healthcare because of any other reason except trying to get the most out of your existence allowance — the 700,000 hours you have, if you’re lucky. That’s your existence allowance, on average. Some people have more, some have less.
But every time you do anything in healthcare — for example, let’s say you’re sick and you go to urgent care or you have a telehealth meeting or you ask someone to write a prescription. What you’re saying is, ‘please let me get my existence allowance.’ That’s what you’re actually doing. When you distill it all the way down to mortality, that’s it.
“We’re in the business of time”
However, isn’t it weird that in doing so, in saying ‘please help me get my existence allowance,’ you are wasting your existence allowance most of the time. What if you didn’t have a cold? What if you have something more serious? Do you have any idea how much of your existence allowance you’re wasting before you actually get treated for it? Between insurance calls, consultations, and tests — and don’t even get me started on the holds on the phone lines and the scheduling of all of these things. That blew my mind.
What if we distilled it down to say, ‘we’re in the business of time.’ We’re not in the business of fancy words and terminology; we’re only in the business of time. If you need something done with your existence allowance, you come to us. That’s our business. If every healthcare organization in the world had that on their billboards, do you think they would be able to get away with having people spend hours and days just to schedule an appointment?
“It always has an impact”
Gamble: No. Not at all.
Chaudhry: That’s essentially what we do. We say that we give you time, but we steal time from you in small and sometimes not-so-small increments in an ongoing way. The reason I’m obsessed with this is because 12 years ago, my dad, a perfectly healthy person who was genetically predisposed to health diseases, did at the age of 50. Not only was he a physician; my grandparents were physicians too. He had a heart attack, and the events after the heart attack led to his demise within a week. I never got to say goodbye to him in person; that had an impact on me. Losing a parent is never easy. It doesn’t matter how old you are and how old your parent is, it’s always hard, and it always has an impact. It was no different me and my siblings.
For me, I became obsessed with the philosophy of time and life. I started reading all the stoic philosophers that all of us know, and I started applying it in my personal life. To the point where I started saying, for example, I don’t know if I want to cut my grass. Because nobody ever on their death bed has ever said, ‘I wish I had done more chores when I was alive.’ I guarantee you my father, in the conscious moments he had left, cared nothing about car leases, home mortgages, or cutting the grass. He was probably thinking, ‘how is my family going to cope without me? Because they weren’t expecting me to die yet.’
Looking “through a different lens”
Chaudhry: I have a 3-year-old and I think about what would happen if I got hit by a bus tomorrow. How will she feel? Will she be sad? Will she go quiet? Will she have any delay in her development? This is the stuff we think about as humans. We don’t think about all these other things we waste time on in our daily lives. This is my personal obsession that has seeped into now my career obsession.
When I think about what my family went through, do you think I would have cared how many Gold Stars our Epic shop had when he was admitted? Do you think I would have cared that they had a chief digital and information officer and they had a digital strategy? Do you think I would have cared that their nurses are rounding on mobile versus computers and that it’s very efficient for them? I wouldn’t have cared about a single one of those things, and I’m a CIO.
I started looking at everything through a different lens. We’re dealing with mortality. We’re dealing with existence allowance. We’re in the business of time and we’re thieves because we’re stealing time. How do I fix that? Because I personally believe that if I can attack things from that angle, everything else will fall into place. The Gold Stars will come. The Most Wired awards will come. The Stage 7 Certifications will come. All the things we talk about at every conference will automatically happen if we just approach it with that angle.
“I want to be responsible”
And so, I took this upon myself. I realized that I need to take accountability; I can’t just get on a soapbox and talk about it. The accountability that I’m taking is if we have to make our technology landscape more complex, if I need to custom develop something because what I’m about to implement just doesn’t give time back, then I’ll do it. And that can create a headache on my side; I have to create a budgetary row item for that, which in today’s world is very hard. I have to maintain some level of complexity, which upsets the VPs and the directors that report up to me, but that’s on me. And if I do badly, I have it on my performance evaluations.
I’ve actually said that I want the CFOs performance evals on my evals. I want to be responsible for the chief physician executive having a better frontline medical system on the ambulatory side. I want to be responsible for meeting the bottom line from our finance perspective.
How am I going to do that? By attacking the one thing that’s common everywhere, whether you’re in finance, patient care, or anywhere, and that’s time. My boss told me she believed in me and is willing to taking the risk.
“We can’t go wrong if we’re giving back time”
Right now, we have these massive projects happening that are true digital transformation projects where’re we’re changing the jobs of people, not just technology. As a result, everything people do after the first cup of coffee in the morning is going to change, from the nurse to the physician. We’re losing people over it, but that’s okay, because we’re hiring people as well that are excited about this.
And the two sponsors of this initiative, which is across our 10,000-person organization, are me and our CEO. If you count the vice president layer, all the way to our CEO, that’s about 40 for our organization. Every one of those 40 people, including me, will not get our bonus at the end of the fiscal year if it doesn’t go well. The CFO, the chief physician executive, the CMIOs, the CMIOs, and the CEO.
Why? Because I believe we cannot go wrong if we’re giving back time. We just won’t go wrong. You can’t find me a single human that says I am willing to give up minutes, seconds, hours, and days of my life for this. Nobody wants to. We just don’t think about it actively, but nobody wants to live less.
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