December 10, 2025 • 41 mins
Imagine a hospital corridor lined with open doors and a chorus of hotel bells, each ring a patient hoping to be found. That’s the picture Julie Dearinger Smith paints from real stories of downtime, the moments when networks collapse, call systems fail, and teams fight to deliver safe care without the tools they rely on. Julie brings two decades in clinical informatics atop years at the bedside, and she turns that experience into a simple but radical premise: resilience is a clinical operations discipline, not just a cybersecurity task.
We dig into Leadership by Design, Julie’s practical framework that maps growth from novice to expert using observable skills. No more vague advice like “show initiative.” Instead, leaders get a clear coaching plan, and team members get a transparent path to advancement. This clarity becomes critical during outages, when pattern recognition, prioritization, and calm execution can prevent harm. Julie shares the mindset shift that separates “testing to pass” from “testing to break,” and why that difference defines proficient practitioners in health tech.
From there, we get tactical. Julie explains how Contingency Health Solutions approaches downtime with tools designed to run when the internet doesn’t. Bell Assist gives patients a cellular-based call capability with location awareness and prioritization, while a lightweight bed management module restores throughput and room turnover visibility when EHRs and intercoms are offline. We cover everyday value too, including meeting CMS requirements for communication in ED overflow spaces without expensive infrastructure. Along the way, we surface hidden dependencies in radiology, pharmacy, and supply chain, and outline how to run serious tabletop exercises that prepare clinical leaders for the worst-case scenario.
If you care about patient safety, informatics, nursing leadership, or hospital operations, this conversation offers a blueprint you can act on today. Subscribe for more practical health tech stories, share this episode with a colleague who owns downtime planning, and leave a review with your biggest resiliency question—we’ll tackle it next.
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Episode Transcript
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SPEAKER_01 (00:02):
Welcome to another episode of This Week in Health
Tech.
Again, it's another Friday andthree o'clock on a Friday
afternoon.
That's when we record ourpodcast.
And I have an amazing guestjoining me today, Julie
Derringer Smith from ContingencyHealth Solutions.
Thanks for joining me, Julie.
SPEAKER_00 (00:20):
Thank you for having me.
SPEAKER_01 (00:22):
Yeah, really, I'm really happy for you to join me.
I know we have been talkingabout meeting up for a podcast
episode, and it's been anadventure, but we have finally
done it.
And we are recording it.
And so yeah, no, welcome.
Please, I think it would be goodto get a little bit of
background about yourself andalso a little bit about
(00:43):
contingency health solutions tostart with.
SPEAKER_00 (00:46):
Yeah.
So I hope that and I believethat if you speak with team
members that I've worked with inthe past, that they'll tell you
that I'm a big believer inwork-life balance.
So I'm going to start with mymost important role that I have,
uh, which is wife and mom.
And uh I'm GG to three beautifulbrands that I have.
And so that's the most importantjob that I have out of all of
(01:09):
them.
But um, but professionally, uhI've been in healthcare for more
than 25 years.
It's hard to believe that.
I spent 10 years by the at thebedside as a registered nurse.
Um, did some overlap bedside andclinical informatics, but for
the last 20 years, I've been inclinical informatics and IT
leadership.
Um, and really um that's thosetwo experiences have always they
(01:35):
it always impacts the way Iapproach really any project that
we look at.
Um, and I've really I've workedacross the the healthcare
ecosystem.
So I've worked in the hospitalsum and then more broadly with
health tech partners or vendors,um, and then back in hospitals.
Uh when I worked for vendors foran EHR company and I led the
(01:56):
clinical um clinical projectmanager team, and that was
great.
Learned so much and met greatpeople.
Um, and all of that experiencereally has helped me to um find
contingency health solutions.
Um, and so it's a company uhthat really was born out of
passion.
(02:17):
And I'll I'm gonna talk about Igot two great passions when it
comes to work uh professionally.
Um, one is leadership.
Uh I love leadership.
I love being able to um helpdevelop team members.
So recently uh released a book.
It's called Leadership byDesign, uh a framework for team
member development.
(02:37):
So, how do you help that teammember become what they want to
be, where they want to go?
And then the other is uhoperational resiliency in the
face of disaster, whether it'snatural disaster or uh cyber
attacks, when we don't have ourprimary systems, how do we keep
our patients safe?
How do we give them the bestcare we can when we don't have
(02:59):
the technology that we've cometo rely on?
And I'm really excited to talkabout both today.
SPEAKER_01 (03:04):
That's awesome.
And let's go into your bookfirst, uh, Leadership by Design.
And, you know, so this issomething I'm I'm I'm really
interested in.
I don't know how much time Ihave to kind of put into you
know thinking about myleadership skills and whatnot.
I I I read a lot of books and II try and learn from that.
(03:28):
Right, it's a lot of biographiesand mostly nonfiction books, but
so maybe this should be on mylist now.
Uh I'll definitely add that andread it and and hopefully gain
something out of it, but or I'lldefinitely gain something out of
it.
I know you, so it should beshould be good.
(03:48):
But what is uh like what led youto devote time to that?
I mean, which is great, youknow.
I mean, bringing up your teammembers and making sure that
they go on and succeed and andthat definitely not only helps
them, but obviously helpseverybody that they come in
contact with.
But is there any stories aroundthat that led you to kind of
(04:10):
have so much passion around theleadership?
SPEAKER_00 (04:13):
Uh you know, I've been in leadership, uh I was in
leadership multiple years,multiple positions, multiple,
multiple companies.
Um and I found this framework.
I was actually taking um acourse for some continuing
education, and they were talkingabout this specific model that I
(04:36):
mentioned and we can go into,but it it clicked for me.
So I've been in leadership, I'vetaken a step back from
leadership, kind of taking abreak.
And then when I went back intoleadership again, um, I had I I
had a even more passion for it.
I think because I had been aleader in the past uh for
leading a team, um it helped mefeel more confident in that.
(04:58):
So then I could go on and kindof focus on how do I get them to
where they want to be.
And I think about when I was aleader, when I first became a
manager and finally got my feetunderneath me, I was always that
person that looked around andsaid, okay, now they're a senior
manager.
What do I have to do to be asenior manager?
(05:18):
You know, what do I have to doto take the next step?
And even before I was a leader,when I was um a nurse, actually
when I started out as a CNA orand a nurse, then a nurse, um,
you know, I would go, okay, youhave a level one, you have a
level two.
What are those skill sets?
What do I have to do to getthere?
And so um that's always thequestion.
(05:39):
And the answer was very, veryvague.
And I I don't blame any leaderfor for giving me those answers,
but it was usually, well, youknow, um it you've been here a
while, you step up, you showsome initiative, right?
It was always uh, you know,there's not one thing you have
to do.
And um, then I became a leader,and of course I had team members
(06:03):
asking me, well, okay, well,what do I need to do to get to
level two?
What do I need to?
And it may not be levels.
I want to point that out becausesome people might go, oh, well,
we don't have a ladder likethat.
It may not be levels, it may beyou start out as an application
analyst, and then you go to asystems analyst, and then if
you're good there, you go to youknow, something else.
So it could be differentpositions, but really, what is
(06:25):
the pathway to get that teammember where they want to be?
And as I was taking somecourses, um, the Dreyfus um
model of skills acquisition cameup.
I it sounds boring, I know.
I I learned about it in nursingschool and bachelor's for
nursing when I went back for mymaster's, and um it never really
(06:46):
clicked.
But once it clicked, it justmade so much sense, and and we
can get into that.
That this is exactly what Ineed.
And this framework that you canbuild, and in this framework, it
works for any industry.
You could be a recruiter and youcould use it, you could be in
banking and you can use it, youcould be anywhere because you
(07:08):
you develop that framework, andI walk through how to do that,
and it will show your teammembers exactly where they are
on that matrix.
What do they need to do to getto this point?
They can see that.
There's also a flip side tothat.
If you have a team member thathas been in their job for a very
long time and they feel likethey need a promotion because of
(07:30):
the length of time in thatposition, um, it it gives you
the ability to have a reallyproductive conversation with
that employee.
So instead of going, or Ishouldn't say team member, I
usually don't use the wordemployee, but if if you work
with that team member and youcan very clearly show them where
they're underperforming, andthat gives you the ability to
(07:53):
target how do I need to, how doI need to help you to get you
where you need to be?
So it has um really a lot ofvalue across the board.
SPEAKER_01 (08:03):
Oh, that's really good information in terms of
improving yourself, andespecially if that is some kind
of logic-based, you know, thatsome kind of logic that you can
actually learn and follow togrow as a leader.
I mean, absolutely.
So yeah, I'll I'll check it out.
(08:23):
And related to that, I mean, youknow, especially being a leader
in uncertain times.
Um, so let's talk about thatpiece, you know, in terms of
when systems are down and inhealth system, more and more
every day.
We hear about this in the newsall the time, and unfortunately,
it's because of cyber threatsand everything is online.
(08:47):
We need to be online, we usetechnology non-stop.
And so I would like to hear, youknow, if you have some stories
of how the contingency healthsolution came about and you know
the the background of it andthen why it does it exist?
What does it solve?
SPEAKER_00 (09:04):
Yeah, I'll tell you the story of how it was born.
Uh, it was kind of like my book.
I'm not an author, it was bornout of passion, and so was
contingency.
Um, so I have been reallypreoccupied with operational
preparedness for several years.
Um, in healthcare, we all knowthat healthcare is one of the
most targeted industries when itcomes to cyber attacks for a
(09:25):
number of reasons.
And those attacks and and theimpact of those have continued
to rise over the years.
And I thought to myself, youknow, it seems like we're just
not ready.
When it happens, we we seem tobe struggling to find the best
way to care for our patients andto keep going.
We do the best we can.
(09:46):
Um, every hospital, I mean,patients are patient value,
patient safety is at their core.
So everyone does the best theycan.
Um, but I want to plan ahead oftime so that we're ready.
You know, my my dream is that ifit happens in 10 years from now,
that a COO or a CEO can say,yes, our primary systems are
(10:10):
down, um, but we've alreadyprepared for this.
And that's that's a bigstatement to really say that and
mean it and have your teammembers um understand that too,
because that is that ispreparing intentionally and
leading the way.
So about a year and a half ago,um, there was a health system,
rather large health system thatwas hit and several of their
(10:30):
hospitals, uh, many, many oftheir hospitals were down.
And um I've spoken actually withsome of the patients in the
hospital that have been hostthat have been patients, some
parents of patients.
I've spoken with several uhnurses that have cared through
this.
I personally have not um workedthrough that, thankfully.
Um, but I do connect andinterview and talk a lot to
(10:52):
people who have, including CNOsand other healthcare, CIOs,
other healthcare professionals.
And the story that really mademe take action, Vic, um, was it
shocked me.
So I've never worked in a healthsystem that could lose their
call light.
Really depends on the call lightsystem that you have.
(11:12):
Some of them are server-based,internet-based.
And they had lost their internetand they'd lost their nurse call
system, which shocked me.
Um and a lot of nurses may knowthis because they may have seen
it in the past.
But um, so what they did, andand kudos to them for doing, you
know, taking action and um youknow, doing their best to take
(11:33):
care of patients.
They went out and they boughtbells for the patients to ring,
like hotel check-in bells.
Um, I've heard that.
I've heard other hospitals saythe the little hand, you know,
handheld bells.
Um, but I started picturing thisand imagining what this was like
because um the nurses are arescared their patients aren't as
safe as they could be, um, andthey're worried for their own
(11:55):
license as well.
Um, rightfully so.
But if you imagine this picturewhere they give every patient a
hotel check-in bell to ring.
Now we can't close the patient'sdoors because if we close their
doors, we can't hear theirbells, right?
Um, also, it's not ringing thebell once and the nurse comes to
(12:15):
your room.
Now we're playing Marco Polo.
SPEAKER_01 (12:19):
Right.
SPEAKER_00 (12:19):
Right.
The patient continues to ringtheir bell until the nurse shows
up because you know she'swalking up and down the hallway
trying to find the patient'sroom that's that has the bell
ringing.
And so finally the nurse is ableto identify which room that is.
But the nurse doesn't know whichwhich bell is a priority.
She doesn't know which patientmaybe is a fall risk, and and
(12:42):
this is the person, this is theroom that the bell is coming
from.
So she's got to search for it.
And this is happening, whichjust terrifies me.
I just I shouldn't say terrifyhorrified.
It's really the way I felt.
This horrified me because thenyou also think about that moment
in time that the patient and thenurses, especially the nurses,
are going through because theyare doing something they may
(13:05):
never have done.
Uh, I'm a seasoned nurse, Iremember the days of paper.
Um, but a lot of the nurses thatwe have on the floor do not.
And in fact, talking to a CNO acouple of weeks ago, she said,
it seems to be kind of a bit ofa Gen X joke online.
She said, But I literally hadyoung nurses that could not read
(13:25):
cursive.
Wow.
Yeah.
And they don't have electronicmars.
They're writing orders, they're,you know, and and not only that,
but you think about an ordergets written down in the
emergency room.
They get admitted.
Maybe the patient goes to thefloor, then to the ICU.
Now lab doesn't even know wherethe patient is.
And there's so many stories.
(13:45):
I want to, I really want tocollect those stories so that
they're heard and so thatthey're not forgotten.
And that's maybe an upcomingproject.
But that is what moved me isthat we have to plan for this.
We have to be ready for exactlythat, and then we're going to
expand that.
So that's where contingencyhealth solutions was born.
(14:07):
It was born out of a passion andknowable need that we need to
pick keep our patients safeduring those times.
SPEAKER_01 (14:15):
Those are powerful stories.
They are.
I mean, though, that's you canactually imagine.
As you were speaking, I was Iwas I was trying to like I can
actually imagine what that floorlooked like and the bells
ringing everywhere.
Not a good situation.
But when there is a downtime,it's definitely not a good
(14:37):
situation.
So I mean, what's the, you know,how many hospitals are actively
thinking about this andpreparing for these situations?
I would be curious to know inyour conversations, you know, as
you come across these leaders atconferences or or meetings.
Um, yeah, like what what whatdoes that look like?
SPEAKER_00 (15:00):
Yeah, so it's really interesting.
Um, so I've had two speakingengagements at a couple of
conferences over the last fewmonths, um, different
conferences, all healthcarerelated, um, different parts of
the country.
Um, and I'm seeing an increasewhen I ask who is starting to
plan for operational resiliency,who is starting to plan for that
(15:22):
and talk about it.
And I've I've started to getmaybe 40%, maybe 50, 40, 50% of
the hospitals start to raisetheir hands.
But when I start asking moreabout it, which is much more, I
should say, much more than itused to be.
It used to be like, oh, I don'tknow, you know, IT plans for
that.
Um, but when I start asking,it's typically the IT teams that
(15:42):
are saying, okay, operationallyguys, how are you going to do
this?
You know, we're going to bebusy.
And so I often say when anybodyasks um operations, well, what
happens when all your systemsare gone?
And they're like, oh, well, wecall IT, right?
Which I understand.
Right.
And and let me say, IT is verywell aware.
They are very focused.
(16:03):
Your CIOs, they know your um,you know, CISOs, chief security
officers, that they they knowthat they've got to focus on
this.
I think that overall umhealthcare is with it's it's a
target.
But when we get there, right,we're that's all about
prevention, right?
Um, when we get there, when itwhen it happens, when somebody
(16:25):
opens up an email and clicks ona link they think is going to
show them their grandkids, andnow our entire system's down.
IT is busy.
IT is working to keep us safe,to make sure nothing or nothing
else gets encrypted, to figureout the best way to bring those
back up, what's impacted, what'snot.
So IT is not going to be up onthe floor talking to you about
(16:48):
how to care for your patient.
Um, and so that's really theconversations that need to have
happen now.
That that intentional preparingfor the worst case scenario,
because anything less than theworst case scenario, that means
you've already planned for it.
But it's very, very important.
And it's it's there's so manyparts and pieces to it.
(17:11):
It's hard to wrap your brainaround.
Um, you know, and and it's it'stime to really prepare now, not
when it happens.
SPEAKER_01 (17:20):
And I don't think many people, I mean, everyone
who, you know, who goes to thehospital can kind of imagine the
front lines in terms of yes, youknow, there's a nurse who comes
and takes care of me, andthere's a doctor who comes and
talks to me after many hours ofwaiting, but regardless, um I
don't think many peopleunderstand the back end piece of
(17:42):
it.
You know, like there's so muchgoing on behind the scenes.
I mean, a lot of my friends,they still may or may not
understand what we do.
You know, it's like, oh, what doyou mean?
Like there's integration behindthe scenes, like you know,
there's hundreds of systems thattalk to each other constantly,
right?
Like they it's very hard topicture all of that.
So I think like you were saying,you know, it's it's not just
(18:06):
always the clinic, the front endpiece of it, but yeah, you need
to prepare in terms of when allthese back end systems are down,
not available, what happens?
And and maybe that's what it is.
Everything goes into prevention,but how much goes into the
actual when it is downtime,unscheduled, or usually, you
(18:27):
know, this is more theunscheduled piece of it.
Yeah, like that's a preparingfor that piece.
I don't I don't hear a whole lotof those conversations.
I I definitely prevention.
And you know, from an ITstandpoint, yes, we we are our
teams are part of hey, if thingsgo down, let's have a dry run of
(18:49):
bringing up everything at ourbackup site, you know, the
disaster recovery drills and allthat.
But other than that, what is theother, you know, like the actual
on the floors and all that?
That's what you are talkingabout here.
SPEAKER_00 (19:03):
That's right.
I I I could give you exampleafter example.
So for instance, um, radiology.
Do you have radiologists?
Does the hospital haveradiologists across the country
that read for them?
Which, you know, I remember whenthat was a new thing, but now
it's very common.
Well, well, when you're down,you have to have a radiologist
(19:26):
in the department, possibly atthe modality.
So where is that radiologistgoing to come from?
Um, if I bring in people whodon't have a who don't have
tasks to do, such as, you know,maybe I my my coders don't have
anything to code becauseeverything is on paper, and now
they're gonna be runners so thatthey can take orders to the lab
(19:46):
and and so on and so forth.
Well, how are you gonna pay themum differential for the
different shifts?
Because they don't typically getthat.
And so how are you gonna keeptrack of that?
That's you know, anotherexample.
There's a ton of examples.
Um Pharmacy.
Well, we're gonna have to stockup our staff up on pharmacy on
pharmacists because now all ofour medication dispensing
(20:07):
machines can't keep inventorybecause they're down.
Right.
So there's just so many piecesand parts.
Um, I really part of the theconversation, part of my um
speaking engagement was actuallyabout this topic.
And um I really encourageeveryone um to take back and and
say, hey, from a leadershipperspective, we need to have a
(20:29):
very intense tabletop exercise.
Usually the hospitals have hadtabletop exercises when it comes
to the disaster of the ITdepartment and standing that up.
But I'm talking about, okay, youknow, let's talk about to our
nurse leaders.
Um, let's assume that your IVpumps that are integrated are
not going to work.
Do you have enough dial of flowsto use?
(20:51):
So it's even, you know, talkingabout the supply chain.
Um, and you know, you may nothave a it's another example.
I could go on and on, Vic.
No, it's good.
You know, I want to, I need toorder, I need to order supplies.
Normally, what do we do?
I'm not in supply chain.
I can't speak to the details ofthat, but typically you order
(21:11):
all of that online.
Oh, well, then fax is something.
Well, our faxes are down.
Um, so how are we going to orderthe supplies that we need?
So there's so much to thinkabout, and that downtime looks
different for um for everyhealthcare system, every
hospital.
Even within an ecosystem, ahealth system, a large health
(21:32):
system, each individualhospital's downtime is going to
look different.
So, for instance, one may havetheir phones working and their
faxes may be working.
Well, another hospital down theroad, all of that might be
server-based.
So no phones, no faxes.
Uh, I was recently, actually,um, very recently, I think
(21:53):
yesterday, talking to directorsof informatics.
Um, I had about four differenthospitals that I was talking to
uh in different health systems,and we were talking about
downtime that happened thatwasn't related to cyber uh
events, um, related to otherthings, some some infrastructure
and some some things like that.
So, what does that look like?
(22:13):
And then have we planned for allof it?
Again, if you plan for theworst, hope for the best, you'll
be prepared.
SPEAKER_01 (22:22):
Man, I I am learning a lot.
Like I I know our listeners willdefinitely appreciate all the
real world stories and andthings that you need to think
about.
How many hospitals or healthsystems actually have a
department allocated to this?
Is there is there anyoneactually designated to to do
(22:43):
this?
SPEAKER_00 (22:44):
I've met one.
SPEAKER_01 (22:45):
Okay.
SPEAKER_00 (22:46):
Um and uh and it was an unusual set of circumstances
that created that position fordirector of operational
resiliency.
I don't know that that's nextthat's the official title.
Um spoke with her.
She had previously been a CNOwho had lived through it.
And um we're gonna keep incontact because you know, again,
love to bring all these storiestogether.
(23:08):
But um and I I've talked to themabout and the people I'm talking
to and interviewing and findingout more from, you know, I'm
letting them know what we'reworking on at contingency.
How can we help?
Um, I spoke about that thathorror of the nurse, you know,
giving all the patients bells toring.
(23:28):
Um so your your healthcare oryour hospital, I'm sorry, your
your nurse call system may notgo down, but you may lose your
intercom.
So again, you may lose parts ofit, you may lose the whole
thing.
So what what I started with atContingency Health Solutions and
got a great team, um, not only ateam internally, but also a care
(23:50):
advisory board, which isclinicians across the country uh
that help as well for review anddesign.
Uh, but what we started with wasBell Assist.
And so what Bell Assist is, isit's it is a patient
communication tool.
So the patient can say, Yes, Ineed help.
You'll know where the patientis.
Um, and I'm sure one of yourquestions is, how are you going
(24:12):
to be up if all the othersystems are down?
SPEAKER_01 (24:15):
Right.
SPEAKER_00 (24:16):
So um we do approach every design with the assumption
that the um the health system,the hospital's internet is down
for 30 days or more.
So if the internet's down, planon everything to be down.
And if it's more than that,okay, we we've planned for that.
If it's less than that, thenwe've already done we're
covered.
And so a patient is able to scana code with their own smart
(24:42):
device, um, whatever smartdevice that is, that's actually
connected to a network, like acellular network or satellite
network, and they immediatelyinstantly have that
communication tool in theirhand.
Um, we can mark some of thefeatures I'm really thrilled
with is like we can even mark apatient as a fall risk so we can
(25:03):
help us prioritize when thosecall lights go off.
Um, we can say a room doesn'thave a device, so we can round
on that room more frequently andhave another plan for that room.
Um, and so there's also somecommunication back and forth.
Um, it actually ties in with umour bed management system.
Uh so you're you might have yourcall system, but you may not
(25:26):
have your bed management systemif all your systems are down.
Um, so again, cellular networks,hot spots, we talk with
hospitals about um how toaccomplish having these
applications available.
They are um a low integration.
So um right now, what when weinitially start, there is no
PHI, there is no integration, sothen it's easier to stand up.
(25:46):
Um, we are talking to a fewhealth systems now to get our
foundational clients.
I'm very excited about that,still looking for more.
Um, and then we'll we'll getinto the integration.
But there'll always be a lightintegration, right?
In healthcare technology, um, weare very proud of our real
intense integration, and weshould be.
(26:07):
It is amazing what we have doneover the decades.
And everything, every time ahospital brings a new
application or a new vendor in,the question is okay, how are we
going to integrate this?
How are we gonna be a make thisa part of a bigger ecosystem so
that everything can talk to eachother and be together?
And but that really tightintegration also means that when
you lose one, you might losethem all.
(26:28):
So um, so we'll be lightlyconnected with the information
we we have.
Um, again, you can use theseseparately or you can use them
together.
So maybe your intercom goesdown, but you would like to have
a know why the patient needssome help.
You can optimize your work, yourum workforce because you can you
can say, Well, I need a supplyor I need my room clean.
(26:50):
Maybe I spilled something, mytrash is full.
And those can go to the peoplewho need to know.
And I don't necessarily need tosend a nurse into the room for
those things.
Um, part of uh the way ourapplications work together is
also for throughput.
So, from a nursing perspective,a hospital perspective,
throughput really slows downwhen you don't have all of that
integrated system.
(27:10):
And so this lets you know whichbeds are full, which ones are
not.
Um, as soon as a patient isdischarged, housekeeping knows
immediately, okay, this is wherewe need to go.
Uh we can see how long it takesus to turn those rooms over.
So they really help in their ownway separately, but then they
work together as well.
So those are our first twoapplications.
(27:32):
I'm so, so thrilled to say thatthey're ready.
They're ready to use.
And we have some everyday usecases, Vic.
Maybe we can go into that if wehave time.
Um, but then also what we'reworking on now is the
registration piece so that whenwe're integrated, then we can
register patients into thatroom.
Scheduling, we want to know whoour patients are two weeks from
tomorrow so that we can callthem and say, hey, we've
(27:53):
prepared for this.
We are still gonna see you,we're still gonna be doing your
surgery.
Please come into the clinic.
We have what we need to care foryou so we can have that patient
communication, individualpatient communication if we need
to.
And then that'll also help ourhospitals, if they do go down,
um, you know, for whateverreason, it'll help them recover
because it takes a long time tomanually read, you know,
(28:15):
manually admit all of thosepatients in.
And that's really our next step.
But let me tell you where I wantto go and where the vision
started before I pulled back alittle bit.
Clinical decision support.
I want us to have a way to havethat automated clinical decision
support, even when our primarysystems are down.
(28:36):
Every hospital, you say, Whatare you doing during downtime?
And they'll say, We go to paper.
Paper is the most unsafe way tocare for patients, and I want to
change that.
SPEAKER_01 (28:46):
That's so is your suite of applications going to
like what's the approach there?
Are you just going to go byservice departments?
Like, hey, is the next thinghave an application for
radiology and then pharmacy andthe supply chain?
Is that, you know, like, hey,here's all your backup systems
(29:07):
when everything is not working,right?
Like the main main systems arenot working.
SPEAKER_00 (29:12):
Um, I I we are definitely open to where we need
to go.
We have a lot on our plate froma roadmap development
standpoint.
Um, you know, again, first two,first two applications, great.
Um, then we'll start withintegration.
Um, and I want to make sure thatwe've got a way.
I'm thinking about the patient.
That's that's my first focus,right?
Um, what do I need to careliterally at the bedside for
(29:35):
that patient?
Um, and for me, that is orderentry, clinical decision
support, allergy checking,interaction checking.
It's also medicationadministration because that
keeps the patient safe when wehave all of that in one place.
I'm sure we'll get dodocumentation, but to your
point, there's there's so muchto do.
(29:57):
So we're gonna focus here first.
Um, and we just we want to helphealth systems, and that's what
we're gonna do.
SPEAKER_01 (30:06):
I mean, everything you're talking about makes sense
because all those systems thatyou're mentioning, like our team
comes across that every day,right?
As we manage integration for allthe health, you know, m for many
health systems.
And yeah, like we do everythingwe can to make sure it's running
and we monitor it proactivelyusing our our AI monitoring now.
(30:31):
So it it all makes sense, youknow, in your efforts.
So it's like, hey, if all theprimary systems are down, here's
what we what we can do as acontingency plan and make sure
that the patient is being takencare of, which is all it's all
about at the end of the day.
Um yeah, I know, which is andsince I brought up AI, is there,
(30:52):
I mean, is that can AI help herein any way um in your solutions,
you think, in the future aswell?
SPEAKER_00 (31:00):
Well, a hundred percent.
So there's there's you talkabout AI, and there's two pieces
to that.
There's the preparedness piece.
Um, you know, AI won't replacedowntime planning, but it can
enhance it if used correctly.
We won't go into all the theright ways to use um AI.
SPEAKER_01 (31:19):
Um but that's a whole other episode, yeah.
SPEAKER_00 (31:22):
That's a whole other episode.
Um, but yes, I do think thatthere's a place for that.
Um, you know, a lot of ourclinicians now across the
country and for the last fiveplus years um have started
relying on ambient AI.
I I believe that they will havea piece for that.
Um, being able to pull outimportant pieces of the chart,
(31:43):
that's not you know, specific tomy applications.
I think that from a healthcareperspective and how clinicians
can use it, I think that that'sone of the great ways that um AI
can be used.
So there's a lot of thosethings.
Um and being able to, there's alot from AI.
I again, AI, man, like we couldtalk for an hour, right, about
(32:04):
AI.
But um, I do think there's aplace for it as long as it's
used responsibly in the rightway.
Um I did, I'm gonna segue if youdon't mind.
Yeah.
Um, I did want to mention theeveryday use case for uh Bell
Assist, which is our patientcommunication system.
(32:25):
I think this is really importantand a lot of hospitals aren't
aware.
And so that's why I want to makesure that we talk about it.
Um, I did have a hospital reachout to me because CMS um in July
of this year.
So we're past this already.
In July of this year, part oftheir um their conditions for
participation for the emergencyroom says that all of your
(32:45):
overflow spaces, every patienthas to have a communication
system.
And we there's always overflow,you know, hallway beds.
Yeah, you you go into a holiday.
SPEAKER_01 (32:54):
You see the photos in the news and yeah, or social
media, look at look where I am.
Yeah, okay, yeah.
SPEAKER_00 (33:00):
Yeah, I was in the emergency room, unfortunately,
um, last month, maybe it was themonth before.
And you know, I I didn't noticethem at the time.
I dude looking back, but therewas these were freestanding EDs
just a mile from my house.
And there's patients in thehallway, but they don't have a
call system.
And so CMS has said that's arequirement.
So that is definitely aneveryday use case where if they
(33:21):
scan a code, patients have acall system right in their hand.
Um, and it's that easy.
And again, no inventory, notnone of that to worry about.
Um, it's easy to stand up, it'snot a lot of infrastructure, um,
doesn't have to have anyintegration.
So that's an everyday use case Ido want to bring up because I
think it's important a lot ofhospitals um aren't aware of
that.
Um, and and converted, you know,any converted clinical space
(33:44):
that doesn't have call lights.
So it's not, it's not just oursolutions are not just a
generator for when your primarysystems are down, right?
Just like a generator, right?
Oh, everything goes down, wehave a generator.
That's really what this is isthe background is oh now we have
a generator, we can keep going.
Um, but there is everyday usecases for it as well.
SPEAKER_01 (34:03):
Yeah, might as well use it.
It's there, you don't have towait until everything is down.
So no, I I really appreciate allyour insights, you know, talking
about how to actually maneuveraround the downtime operations
and making sure patients aretaken care of.
So as we kind of start closingthis, um, you know, I just want
(34:26):
to go kind of back a little bitto the leadership part and you
know, anything because we haveall you know, our listeners, I
think many might be inmanagement, but many are not.
So I mean, maybe for both, youknow, for for everybody.
Like, what is you know, any lastadvice that you would give, you
know, for somebody um who islooking to kind of grow into
(34:50):
their career and just just beinga better leader, you know, is it
for me, I would say personally,for me, if I'm I'm a better
leader, if I'm cultivating theright relationships, right, with
my team members and and with ourclients.
So, yeah, I mean, if you want togive us some final thoughts
about the um the leadership andthen maybe a little bit about
you know how people can findyour your upcoming book and how
(35:14):
to reach out to you.
SPEAKER_00 (35:15):
Yeah, absolutely.
So um the thing I would say thatfor team members and leaders is
to have the conversation aboutwhere the team member wants to
go.
Um, first time I offered anybodyan assistant manager position,
they said, Yeah, I don't think Iwant to be even in leadership
because they had been inleadership before.
And it didn't occur to me.
(35:36):
I'm always the person again, asI said, I think in the
beginning, I always wear how doI get to the next place?
How do I how do my manager howto become a senior manager?
Right.
Um and so I would say make surethat you're helping to guide the
team member where they want tobe.
And for team members, talk toyour leaders about where you
want to go.
They they may not know.
(35:56):
Um, I I spoke with a CIOrecently, and he wants to move
into a CFO position.
I wouldn't have thought aboutthat.
And and so, and that's you know,a different level, but think
about you know having thatconversation and then talking
about okay, what needs to happento get there.
As far as this matrix that Ispoke about and what the book is
(36:19):
about, from a leaderperspective, I think it'll make
a lot of sense when you read it.
There are a couple of reallyeye-opener for me.
Um, we go through novice toexpert.
This is what a novice lookslike.
This is how you lead a novice,this is how you can identify a
novice, um, what makes somebodya novice.
We go to an advanced beginner,we go through competent,
(36:42):
proficient expert.
And so we talk about each ofthose levels.
And the the biggest exclamationmark for me was when I um
started working at a position Iand I'd been doing informatics
for a long time.
They said, Hey, here you go.
We we we coded this piece, and Ilooked at it and I looked at it,
(37:03):
I said I said, it's it itdoesn't, it needs more.
Great job, it needs more.
So they said, Okay, so they theytook it away, they brought it
back.
I looked at it, I said, Great,we're on the right path.
We're missing a couple ofpieces.
This is what I found, and itneeds more work.
And they worked on it, theybrought it back, and they're
like, Okay.
(37:24):
And I said, All right, and Isaid, please don't break it.
That, and I'll tell you why thatwas so profound to me, is
because as a clinicalinformaticist, um, and somebody
very experienced, you you knowit's a it's mantra, right?
You don't test something to seeif it works, you test it to see
if you can break it.
That is a proficient skill.
(37:47):
That is not a novice or anadvanced beginner or even a
competent.
That is a proficient skill.
And so that was kind of aneye-opener of oh, they didn't
understand that.
Now I teach my team that now.
So as you see what that means,it also has helped me to develop
team members into that type ofunderstanding and thought
(38:09):
process, even before they'retrying to become proficient.
We start from the beginning.
And so some of those rules.
So going back to as a teammember, you can read the book,
you can look at this and talk toyour um leaders about how would
we how would we fill this out sothat I know where I am, because
this is where I want to go.
(38:30):
And as a leader, you can beproactive to think about your
team, the skills, the hardskills, the soft skills will
walk you through it.
It's a it's a I have been toldan easy read.
I hope so.
Um, and it's not a long book,it's 80 pages, but it gets you
what you need.
It's packed full of information,so it's a very fast read.
Yes, it's it's it's not a longbook.
(38:51):
Um, I don't think you'll bebored through it, but it'll help
you to be able to map out allyour team members so that you
can see exactly where everyoneis.
And because we have this and itworks so well, when I have
somebody that's now mapping andperforming at a level two, I can
give them and offer them thatpromotion because I know they're
(39:14):
already doing the job.
I don't promote somebody into arole and say, Whoa, I hope that
they can do everything I'm gonnaask them to do.
Um, so it really sets them upfor success.
And it also, from a HRperspective, gives you a really
great um way to discuss why thisteam member needs a promotion.
It's because what they'realready doing is that level of
(39:37):
work.
I don't know if I answered yourquestion, but I'll talk for two
hours if you if you let me.
SPEAKER_01 (39:45):
No, I'm loving, I'm I'm learning so much as we
continue to go.
And and where where can everyonefind your book?
SPEAKER_00 (39:52):
Thank you.
Um, yes, so uh the print book isalready available to order on
Amazon.
I should have the Kindle versionon Amazon very soon.
It's also on Lulu Books.
Um, and so if you'd like it, goout there and take a look, take
a look at it.
Um, you know, I I hope you loveit.
Give me your feedback.
Um, you can reach me at Julie atcontingencyhealth solutions.com.
(40:16):
Happy to take any questionsabout the book, about
contingency planning, um,anything that I can help with.
Love to hear from people.
SPEAKER_01 (40:25):
Yeah, thanks again for for joining me on this
beautiful Friday afternoon andwish you a very amazing happy
Thanksgiving.
SPEAKER_00 (40:32):
Yeah, happy Thanksgiving.
Um, so somebody uh saidsomething to me a couple of days
ago that just really stuck withme.
And I I really want to pass italong.
And it's they said, What if theonly thing you had tomorrow was
what you thank God for today?
It was something.
And so with Thanksgiving comingup, and you know, we were really
(40:56):
mindful and thankful onThanksgiving, we should be
mindful and thankful every day.
Um, just think about that.
Think about being thankful forthe things that you want to have
in your life tomorrow.
I thought it was an importantmessage.
SPEAKER_01 (41:08):
That's a beautiful message as we close this out.
And thank you again forlistening to This Week in Hell
Tech.
And Julie and I wish you all avery happy Thanksgiving.
SPEAKER_00 (41:18):
Happy Thanksgiving.
Welcome to another episode of This Week in Health
Tech.
Again, it's another Friday andthree o'clock on a Friday
afternoon.
That's when we record ourpodcast.
And I have an amazing guestjoining me today, Julie
Derringer Smith from ContingencyHealth Solutions.
Thanks for joining me, Julie.
SPEAKER_00 (00:20):
Thank you for having me.
SPEAKER_01 (00:22):
Yeah, really, I'm really happy for you to join me.
I know we have been talkingabout meeting up for a podcast
episode, and it's been anadventure, but we have finally
done it.
And we are recording it.
And so yeah, no, welcome.
Please, I think it would be goodto get a little bit of
background about yourself andalso a little bit about
(00:43):
contingency health solutions tostart with.
SPEAKER_00 (00:46):
Yeah.
So I hope that and I believethat if you speak with team
members that I've worked with inthe past, that they'll tell you
that I'm a big believer inwork-life balance.
So I'm going to start with mymost important role that I have,
uh, which is wife and mom.
And uh I'm GG to three beautifulbrands that I have.
And so that's the most importantjob that I have out of all of
(01:09):
them.
But um, but professionally, uhI've been in healthcare for more
than 25 years.
It's hard to believe that.
I spent 10 years by the at thebedside as a registered nurse.
Um, did some overlap bedside andclinical informatics, but for
the last 20 years, I've been inclinical informatics and IT
leadership.
Um, and really um that's thosetwo experiences have always they
(01:35):
it always impacts the way Iapproach really any project that
we look at.
Um, and I've really I've workedacross the the healthcare
ecosystem.
So I've worked in the hospitalsum and then more broadly with
health tech partners or vendors,um, and then back in hospitals.
Uh when I worked for vendors foran EHR company and I led the
(01:56):
clinical um clinical projectmanager team, and that was
great.
Learned so much and met greatpeople.
Um, and all of that experiencereally has helped me to um find
contingency health solutions.
Um, and so it's a company uhthat really was born out of
passion.
(02:17):
And I'll I'm gonna talk about Igot two great passions when it
comes to work uh professionally.
Um, one is leadership.
Uh I love leadership.
I love being able to um helpdevelop team members.
So recently uh released a book.
It's called Leadership byDesign, uh a framework for team
member development.
(02:37):
So, how do you help that teammember become what they want to
be, where they want to go?
And then the other is uhoperational resiliency in the
face of disaster, whether it'snatural disaster or uh cyber
attacks, when we don't have ourprimary systems, how do we keep
our patients safe?
How do we give them the bestcare we can when we don't have
(02:59):
the technology that we've cometo rely on?
And I'm really excited to talkabout both today.
SPEAKER_01 (03:04):
That's awesome.
And let's go into your bookfirst, uh, Leadership by Design.
And, you know, so this issomething I'm I'm I'm really
interested in.
I don't know how much time Ihave to kind of put into you
know thinking about myleadership skills and whatnot.
I I I read a lot of books and II try and learn from that.
(03:28):
Right, it's a lot of biographiesand mostly nonfiction books, but
so maybe this should be on mylist now.
Uh I'll definitely add that andread it and and hopefully gain
something out of it, but or I'lldefinitely gain something out of
it.
I know you, so it should beshould be good.
(03:48):
But what is uh like what led youto devote time to that?
I mean, which is great, youknow.
I mean, bringing up your teammembers and making sure that
they go on and succeed and andthat definitely not only helps
them, but obviously helpseverybody that they come in
contact with.
But is there any stories aroundthat that led you to kind of
(04:10):
have so much passion around theleadership?
SPEAKER_00 (04:13):
Uh you know, I've been in leadership, uh I was in
leadership multiple years,multiple positions, multiple,
multiple companies.
Um and I found this framework.
I was actually taking um acourse for some continuing
education, and they were talkingabout this specific model that I
(04:36):
mentioned and we can go into,but it it clicked for me.
So I've been in leadership, I'vetaken a step back from
leadership, kind of taking abreak.
And then when I went back intoleadership again, um, I had I I
had a even more passion for it.
I think because I had been aleader in the past uh for
leading a team, um it helped mefeel more confident in that.
(04:58):
So then I could go on and kindof focus on how do I get them to
where they want to be.
And I think about when I was aleader, when I first became a
manager and finally got my feetunderneath me, I was always that
person that looked around andsaid, okay, now they're a senior
manager.
What do I have to do to be asenior manager?
(05:18):
You know, what do I have to doto take the next step?
And even before I was a leader,when I was um a nurse, actually
when I started out as a CNA orand a nurse, then a nurse, um,
you know, I would go, okay, youhave a level one, you have a
level two.
What are those skill sets?
What do I have to do to getthere?
And so um that's always thequestion.
(05:39):
And the answer was very, veryvague.
And I I don't blame any leaderfor for giving me those answers,
but it was usually, well, youknow, um it you've been here a
while, you step up, you showsome initiative, right?
It was always uh, you know,there's not one thing you have
to do.
And um, then I became a leader,and of course I had team members
(06:03):
asking me, well, okay, well,what do I need to do to get to
level two?
What do I need to?
And it may not be levels.
I want to point that out becausesome people might go, oh, well,
we don't have a ladder likethat.
It may not be levels, it may beyou start out as an application
analyst, and then you go to asystems analyst, and then if
you're good there, you go to youknow, something else.
So it could be differentpositions, but really, what is
(06:25):
the pathway to get that teammember where they want to be?
And as I was taking somecourses, um, the Dreyfus um
model of skills acquisition cameup.
I it sounds boring, I know.
I I learned about it in nursingschool and bachelor's for
nursing when I went back for mymaster's, and um it never really
(06:46):
clicked.
But once it clicked, it justmade so much sense, and and we
can get into that.
That this is exactly what Ineed.
And this framework that you canbuild, and in this framework, it
works for any industry.
You could be a recruiter and youcould use it, you could be in
banking and you can use it, youcould be anywhere because you
(07:08):
you develop that framework, andI walk through how to do that,
and it will show your teammembers exactly where they are
on that matrix.
What do they need to do to getto this point?
They can see that.
There's also a flip side tothat.
If you have a team member thathas been in their job for a very
long time and they feel likethey need a promotion because of
(07:30):
the length of time in thatposition, um, it it gives you
the ability to have a reallyproductive conversation with
that employee.
So instead of going, or Ishouldn't say team member, I
usually don't use the wordemployee, but if if you work
with that team member and youcan very clearly show them where
they're underperforming, andthat gives you the ability to
(07:53):
target how do I need to, how doI need to help you to get you
where you need to be?
So it has um really a lot ofvalue across the board.
SPEAKER_01 (08:03):
Oh, that's really good information in terms of
improving yourself, andespecially if that is some kind
of logic-based, you know, thatsome kind of logic that you can
actually learn and follow togrow as a leader.
I mean, absolutely.
So yeah, I'll I'll check it out.
(08:23):
And related to that, I mean, youknow, especially being a leader
in uncertain times.
Um, so let's talk about thatpiece, you know, in terms of
when systems are down and inhealth system, more and more
every day.
We hear about this in the newsall the time, and unfortunately,
it's because of cyber threatsand everything is online.
(08:47):
We need to be online, we usetechnology non-stop.
And so I would like to hear, youknow, if you have some stories
of how the contingency healthsolution came about and you know
the the background of it andthen why it does it exist?
What does it solve?
SPEAKER_00 (09:04):
Yeah, I'll tell you the story of how it was born.
Uh, it was kind of like my book.
I'm not an author, it was bornout of passion, and so was
contingency.
Um, so I have been reallypreoccupied with operational
preparedness for several years.
Um, in healthcare, we all knowthat healthcare is one of the
most targeted industries when itcomes to cyber attacks for a
(09:25):
number of reasons.
And those attacks and and theimpact of those have continued
to rise over the years.
And I thought to myself, youknow, it seems like we're just
not ready.
When it happens, we we seem tobe struggling to find the best
way to care for our patients andto keep going.
We do the best we can.
(09:46):
Um, every hospital, I mean,patients are patient value,
patient safety is at their core.
So everyone does the best theycan.
Um, but I want to plan ahead oftime so that we're ready.
You know, my my dream is that ifit happens in 10 years from now,
that a COO or a CEO can say,yes, our primary systems are
(10:10):
down, um, but we've alreadyprepared for this.
And that's that's a bigstatement to really say that and
mean it and have your teammembers um understand that too,
because that is that ispreparing intentionally and
leading the way.
So about a year and a half ago,um, there was a health system,
rather large health system thatwas hit and several of their
(10:30):
hospitals, uh, many, many oftheir hospitals were down.
And um I've spoken actually withsome of the patients in the
hospital that have been hostthat have been patients, some
parents of patients.
I've spoken with several uhnurses that have cared through
this.
I personally have not um workedthrough that, thankfully.
Um, but I do connect andinterview and talk a lot to
(10:52):
people who have, including CNOsand other healthcare, CIOs,
other healthcare professionals.
And the story that really mademe take action, Vic, um, was it
shocked me.
So I've never worked in a healthsystem that could lose their
call light.
Really depends on the call lightsystem that you have.
(11:12):
Some of them are server-based,internet-based.
And they had lost their internetand they'd lost their nurse call
system, which shocked me.
Um and a lot of nurses may knowthis because they may have seen
it in the past.
But um, so what they did, andand kudos to them for doing, you
know, taking action and um youknow, doing their best to take
(11:33):
care of patients.
They went out and they boughtbells for the patients to ring,
like hotel check-in bells.
Um, I've heard that.
I've heard other hospitals saythe the little hand, you know,
handheld bells.
Um, but I started picturing thisand imagining what this was like
because um the nurses are arescared their patients aren't as
safe as they could be, um, andthey're worried for their own
(11:55):
license as well.
Um, rightfully so.
But if you imagine this picturewhere they give every patient a
hotel check-in bell to ring.
Now we can't close the patient'sdoors because if we close their
doors, we can't hear theirbells, right?
Um, also, it's not ringing thebell once and the nurse comes to
(12:15):
your room.
Now we're playing Marco Polo.
SPEAKER_01 (12:19):
Right.
SPEAKER_00 (12:19):
Right.
The patient continues to ringtheir bell until the nurse shows
up because you know she'swalking up and down the hallway
trying to find the patient'sroom that's that has the bell
ringing.
And so finally the nurse is ableto identify which room that is.
But the nurse doesn't know whichwhich bell is a priority.
She doesn't know which patientmaybe is a fall risk, and and
(12:42):
this is the person, this is theroom that the bell is coming
from.
So she's got to search for it.
And this is happening, whichjust terrifies me.
I just I shouldn't say terrifyhorrified.
It's really the way I felt.
This horrified me because thenyou also think about that moment
in time that the patient and thenurses, especially the nurses,
are going through because theyare doing something they may
(13:05):
never have done.
Uh, I'm a seasoned nurse, Iremember the days of paper.
Um, but a lot of the nurses thatwe have on the floor do not.
And in fact, talking to a CNO acouple of weeks ago, she said,
it seems to be kind of a bit ofa Gen X joke online.
She said, But I literally hadyoung nurses that could not read
(13:25):
cursive.
Wow.
Yeah.
And they don't have electronicmars.
They're writing orders, they're,you know, and and not only that,
but you think about an ordergets written down in the
emergency room.
They get admitted.
Maybe the patient goes to thefloor, then to the ICU.
Now lab doesn't even know wherethe patient is.
And there's so many stories.
(13:45):
I want to, I really want tocollect those stories so that
they're heard and so thatthey're not forgotten.
And that's maybe an upcomingproject.
But that is what moved me isthat we have to plan for this.
We have to be ready for exactlythat, and then we're going to
expand that.
So that's where contingencyhealth solutions was born.
(14:07):
It was born out of a passion andknowable need that we need to
pick keep our patients safeduring those times.
SPEAKER_01 (14:15):
Those are powerful stories.
They are.
I mean, though, that's you canactually imagine.
As you were speaking, I was Iwas I was trying to like I can
actually imagine what that floorlooked like and the bells
ringing everywhere.
Not a good situation.
But when there is a downtime,it's definitely not a good
(14:37):
situation.
So I mean, what's the, you know,how many hospitals are actively
thinking about this andpreparing for these situations?
I would be curious to know inyour conversations, you know, as
you come across these leaders atconferences or or meetings.
Um, yeah, like what what whatdoes that look like?
SPEAKER_00 (15:00):
Yeah, so it's really interesting.
Um, so I've had two speakingengagements at a couple of
conferences over the last fewmonths, um, different
conferences, all healthcarerelated, um, different parts of
the country.
Um, and I'm seeing an increasewhen I ask who is starting to
plan for operational resiliency,who is starting to plan for that
(15:22):
and talk about it.
And I've I've started to getmaybe 40%, maybe 50, 40, 50% of
the hospitals start to raisetheir hands.
But when I start asking moreabout it, which is much more, I
should say, much more than itused to be.
It used to be like, oh, I don'tknow, you know, IT plans for
that.
Um, but when I start asking,it's typically the IT teams that
(15:42):
are saying, okay, operationallyguys, how are you going to do
this?
You know, we're going to bebusy.
And so I often say when anybodyasks um operations, well, what
happens when all your systemsare gone?
And they're like, oh, well, wecall IT, right?
Which I understand.
Right.
And and let me say, IT is verywell aware.
They are very focused.
(16:03):
Your CIOs, they know your um,you know, CISOs, chief security
officers, that they they knowthat they've got to focus on
this.
I think that overall umhealthcare is with it's it's a
target.
But when we get there, right,we're that's all about
prevention, right?
Um, when we get there, when itwhen it happens, when somebody
(16:25):
opens up an email and clicks ona link they think is going to
show them their grandkids, andnow our entire system's down.
IT is busy.
IT is working to keep us safe,to make sure nothing or nothing
else gets encrypted, to figureout the best way to bring those
back up, what's impacted, what'snot.
So IT is not going to be up onthe floor talking to you about
(16:48):
how to care for your patient.
Um, and so that's really theconversations that need to have
happen now.
That that intentional preparingfor the worst case scenario,
because anything less than theworst case scenario, that means
you've already planned for it.
But it's very, very important.
And it's it's there's so manyparts and pieces to it.
(17:11):
It's hard to wrap your brainaround.
Um, you know, and and it's it'stime to really prepare now, not
when it happens.
SPEAKER_01 (17:20):
And I don't think many people, I mean, everyone
who, you know, who goes to thehospital can kind of imagine the
front lines in terms of yes, youknow, there's a nurse who comes
and takes care of me, andthere's a doctor who comes and
talks to me after many hours ofwaiting, but regardless, um I
don't think many peopleunderstand the back end piece of
(17:42):
it.
You know, like there's so muchgoing on behind the scenes.
I mean, a lot of my friends,they still may or may not
understand what we do.
You know, it's like, oh, what doyou mean?
Like there's integration behindthe scenes, like you know,
there's hundreds of systems thattalk to each other constantly,
right?
Like they it's very hard topicture all of that.
So I think like you were saying,you know, it's it's not just
(18:06):
always the clinic, the front endpiece of it, but yeah, you need
to prepare in terms of when allthese back end systems are down,
not available, what happens?
And and maybe that's what it is.
Everything goes into prevention,but how much goes into the
actual when it is downtime,unscheduled, or usually, you
(18:27):
know, this is more theunscheduled piece of it.
Yeah, like that's a preparingfor that piece.
I don't I don't hear a whole lotof those conversations.
I I definitely prevention.
And you know, from an ITstandpoint, yes, we we are our
teams are part of hey, if thingsgo down, let's have a dry run of
(18:49):
bringing up everything at ourbackup site, you know, the
disaster recovery drills and allthat.
But other than that, what is theother, you know, like the actual
on the floors and all that?
That's what you are talkingabout here.
SPEAKER_00 (19:03):
That's right.
I I I could give you exampleafter example.
So for instance, um, radiology.
Do you have radiologists?
Does the hospital haveradiologists across the country
that read for them?
Which, you know, I remember whenthat was a new thing, but now
it's very common.
Well, well, when you're down,you have to have a radiologist
(19:26):
in the department, possibly atthe modality.
So where is that radiologistgoing to come from?
Um, if I bring in people whodon't have a who don't have
tasks to do, such as, you know,maybe I my my coders don't have
anything to code becauseeverything is on paper, and now
they're gonna be runners so thatthey can take orders to the lab
(19:46):
and and so on and so forth.
Well, how are you gonna pay themum differential for the
different shifts?
Because they don't typically getthat.
And so how are you gonna keeptrack of that?
That's you know, anotherexample.
There's a ton of examples.
Um Pharmacy.
Well, we're gonna have to stockup our staff up on pharmacy on
pharmacists because now all ofour medication dispensing
(20:07):
machines can't keep inventorybecause they're down.
Right.
So there's just so many piecesand parts.
Um, I really part of the theconversation, part of my um
speaking engagement was actuallyabout this topic.
And um I really encourageeveryone um to take back and and
say, hey, from a leadershipperspective, we need to have a
(20:29):
very intense tabletop exercise.
Usually the hospitals have hadtabletop exercises when it comes
to the disaster of the ITdepartment and standing that up.
But I'm talking about, okay, youknow, let's talk about to our
nurse leaders.
Um, let's assume that your IVpumps that are integrated are
not going to work.
Do you have enough dial of flowsto use?
(20:51):
So it's even, you know, talkingabout the supply chain.
Um, and you know, you may nothave a it's another example.
I could go on and on, Vic.
No, it's good.
You know, I want to, I need toorder, I need to order supplies.
Normally, what do we do?
I'm not in supply chain.
I can't speak to the details ofthat, but typically you order
(21:11):
all of that online.
Oh, well, then fax is something.
Well, our faxes are down.
Um, so how are we going to orderthe supplies that we need?
So there's so much to thinkabout, and that downtime looks
different for um for everyhealthcare system, every
hospital.
Even within an ecosystem, ahealth system, a large health
(21:32):
system, each individualhospital's downtime is going to
look different.
So, for instance, one may havetheir phones working and their
faxes may be working.
Well, another hospital down theroad, all of that might be
server-based.
So no phones, no faxes.
Uh, I was recently, actually,um, very recently, I think
(21:53):
yesterday, talking to directorsof informatics.
Um, I had about four differenthospitals that I was talking to
uh in different health systems,and we were talking about
downtime that happened thatwasn't related to cyber uh
events, um, related to otherthings, some some infrastructure
and some some things like that.
So, what does that look like?
(22:13):
And then have we planned for allof it?
Again, if you plan for theworst, hope for the best, you'll
be prepared.
SPEAKER_01 (22:22):
Man, I I am learning a lot.
Like I I know our listeners willdefinitely appreciate all the
real world stories and andthings that you need to think
about.
How many hospitals or healthsystems actually have a
department allocated to this?
Is there is there anyoneactually designated to to do
(22:43):
this?
SPEAKER_00 (22:44):
I've met one.
SPEAKER_01 (22:45):
Okay.
SPEAKER_00 (22:46):
Um and uh and it was an unusual set of circumstances
that created that position fordirector of operational
resiliency.
I don't know that that's nextthat's the official title.
Um spoke with her.
She had previously been a CNOwho had lived through it.
And um we're gonna keep incontact because you know, again,
love to bring all these storiestogether.
(23:08):
But um and I I've talked to themabout and the people I'm talking
to and interviewing and findingout more from, you know, I'm
letting them know what we'reworking on at contingency.
How can we help?
Um, I spoke about that thathorror of the nurse, you know,
giving all the patients bells toring.
(23:28):
Um so your your healthcare oryour hospital, I'm sorry, your
your nurse call system may notgo down, but you may lose your
intercom.
So again, you may lose parts ofit, you may lose the whole
thing.
So what what I started with atContingency Health Solutions and
got a great team, um, not only ateam internally, but also a care
(23:50):
advisory board, which isclinicians across the country uh
that help as well for review anddesign.
Uh, but what we started with wasBell Assist.
And so what Bell Assist is, isit's it is a patient
communication tool.
So the patient can say, Yes, Ineed help.
You'll know where the patientis.
Um, and I'm sure one of yourquestions is, how are you going
(24:12):
to be up if all the othersystems are down?
SPEAKER_01 (24:15):
Right.
SPEAKER_00 (24:16):
So um we do approach every design with the assumption
that the um the health system,the hospital's internet is down
for 30 days or more.
So if the internet's down, planon everything to be down.
And if it's more than that,okay, we we've planned for that.
If it's less than that, thenwe've already done we're
covered.
And so a patient is able to scana code with their own smart
(24:42):
device, um, whatever smartdevice that is, that's actually
connected to a network, like acellular network or satellite
network, and they immediatelyinstantly have that
communication tool in theirhand.
Um, we can mark some of thefeatures I'm really thrilled
with is like we can even mark apatient as a fall risk so we can
(25:03):
help us prioritize when thosecall lights go off.
Um, we can say a room doesn'thave a device, so we can round
on that room more frequently andhave another plan for that room.
Um, and so there's also somecommunication back and forth.
Um, it actually ties in with umour bed management system.
Uh so you're you might have yourcall system, but you may not
(25:26):
have your bed management systemif all your systems are down.
Um, so again, cellular networks,hot spots, we talk with
hospitals about um how toaccomplish having these
applications available.
They are um a low integration.
So um right now, what when weinitially start, there is no
PHI, there is no integration, sothen it's easier to stand up.
(25:46):
Um, we are talking to a fewhealth systems now to get our
foundational clients.
I'm very excited about that,still looking for more.
Um, and then we'll we'll getinto the integration.
But there'll always be a lightintegration, right?
In healthcare technology, um, weare very proud of our real
intense integration, and weshould be.
(26:07):
It is amazing what we have doneover the decades.
And everything, every time ahospital brings a new
application or a new vendor in,the question is okay, how are we
going to integrate this?
How are we gonna be a make thisa part of a bigger ecosystem so
that everything can talk to eachother and be together?
And but that really tightintegration also means that when
you lose one, you might losethem all.
(26:28):
So um, so we'll be lightlyconnected with the information
we we have.
Um, again, you can use theseseparately or you can use them
together.
So maybe your intercom goesdown, but you would like to have
a know why the patient needssome help.
You can optimize your work, yourum workforce because you can you
can say, Well, I need a supplyor I need my room clean.
(26:50):
Maybe I spilled something, mytrash is full.
And those can go to the peoplewho need to know.
And I don't necessarily need tosend a nurse into the room for
those things.
Um, part of uh the way ourapplications work together is
also for throughput.
So, from a nursing perspective,a hospital perspective,
throughput really slows downwhen you don't have all of that
integrated system.
(27:10):
And so this lets you know whichbeds are full, which ones are
not.
Um, as soon as a patient isdischarged, housekeeping knows
immediately, okay, this is wherewe need to go.
Uh we can see how long it takesus to turn those rooms over.
So they really help in their ownway separately, but then they
work together as well.
So those are our first twoapplications.
(27:32):
I'm so, so thrilled to say thatthey're ready.
They're ready to use.
And we have some everyday usecases, Vic.
Maybe we can go into that if wehave time.
Um, but then also what we'reworking on now is the
registration piece so that whenwe're integrated, then we can
register patients into thatroom.
Scheduling, we want to know whoour patients are two weeks from
tomorrow so that we can callthem and say, hey, we've
(27:53):
prepared for this.
We are still gonna see you,we're still gonna be doing your
surgery.
Please come into the clinic.
We have what we need to care foryou so we can have that patient
communication, individualpatient communication if we need
to.
And then that'll also help ourhospitals, if they do go down,
um, you know, for whateverreason, it'll help them recover
because it takes a long time tomanually read, you know,
(28:15):
manually admit all of thosepatients in.
And that's really our next step.
But let me tell you where I wantto go and where the vision
started before I pulled back alittle bit.
Clinical decision support.
I want us to have a way to havethat automated clinical decision
support, even when our primarysystems are down.
(28:36):
Every hospital, you say, Whatare you doing during downtime?
And they'll say, We go to paper.
Paper is the most unsafe way tocare for patients, and I want to
change that.
SPEAKER_01 (28:46):
That's so is your suite of applications going to
like what's the approach there?
Are you just going to go byservice departments?
Like, hey, is the next thinghave an application for
radiology and then pharmacy andthe supply chain?
Is that, you know, like, hey,here's all your backup systems
(29:07):
when everything is not working,right?
Like the main main systems arenot working.
SPEAKER_00 (29:12):
Um, I I we are definitely open to where we need
to go.
We have a lot on our plate froma roadmap development
standpoint.
Um, you know, again, first two,first two applications, great.
Um, then we'll start withintegration.
Um, and I want to make sure thatwe've got a way.
I'm thinking about the patient.
That's that's my first focus,right?
Um, what do I need to careliterally at the bedside for
(29:35):
that patient?
Um, and for me, that is orderentry, clinical decision
support, allergy checking,interaction checking.
It's also medicationadministration because that
keeps the patient safe when wehave all of that in one place.
I'm sure we'll get dodocumentation, but to your
point, there's there's so muchto do.
(29:57):
So we're gonna focus here first.
Um, and we just we want to helphealth systems, and that's what
we're gonna do.
SPEAKER_01 (30:06):
I mean, everything you're talking about makes sense
because all those systems thatyou're mentioning, like our team
comes across that every day,right?
As we manage integration for allthe health, you know, m for many
health systems.
And yeah, like we do everythingwe can to make sure it's running
and we monitor it proactivelyusing our our AI monitoring now.
(30:31):
So it it all makes sense, youknow, in your efforts.
So it's like, hey, if all theprimary systems are down, here's
what we what we can do as acontingency plan and make sure
that the patient is being takencare of, which is all it's all
about at the end of the day.
Um yeah, I know, which is andsince I brought up AI, is there,
(30:52):
I mean, is that can AI help herein any way um in your solutions,
you think, in the future aswell?
SPEAKER_00 (31:00):
Well, a hundred percent.
So there's there's you talkabout AI, and there's two pieces
to that.
There's the preparedness piece.
Um, you know, AI won't replacedowntime planning, but it can
enhance it if used correctly.
We won't go into all the theright ways to use um AI.
SPEAKER_01 (31:19):
Um but that's a whole other episode, yeah.
SPEAKER_00 (31:22):
That's a whole other episode.
Um, but yes, I do think thatthere's a place for that.
Um, you know, a lot of ourclinicians now across the
country and for the last fiveplus years um have started
relying on ambient AI.
I I believe that they will havea piece for that.
Um, being able to pull outimportant pieces of the chart,
(31:43):
that's not you know, specific tomy applications.
I think that from a healthcareperspective and how clinicians
can use it, I think that that'sone of the great ways that um AI
can be used.
So there's a lot of thosethings.
Um and being able to, there's alot from AI.
I again, AI, man, like we couldtalk for an hour, right, about
(32:04):
AI.
But um, I do think there's aplace for it as long as it's
used responsibly in the rightway.
Um I did, I'm gonna segue if youdon't mind.
Yeah.
Um, I did want to mention theeveryday use case for uh Bell
Assist, which is our patientcommunication system.
(32:25):
I think this is really importantand a lot of hospitals aren't
aware.
And so that's why I want to makesure that we talk about it.
Um, I did have a hospital reachout to me because CMS um in July
of this year.
So we're past this already.
In July of this year, part oftheir um their conditions for
participation for the emergencyroom says that all of your
(32:45):
overflow spaces, every patienthas to have a communication
system.
And we there's always overflow,you know, hallway beds.
Yeah, you you go into a holiday.
SPEAKER_01 (32:54):
You see the photos in the news and yeah, or social
media, look at look where I am.
Yeah, okay, yeah.
SPEAKER_00 (33:00):
Yeah, I was in the emergency room, unfortunately,
um, last month, maybe it was themonth before.
And you know, I I didn't noticethem at the time.
I dude looking back, but therewas these were freestanding EDs
just a mile from my house.
And there's patients in thehallway, but they don't have a
call system.
And so CMS has said that's arequirement.
So that is definitely aneveryday use case where if they
(33:21):
scan a code, patients have acall system right in their hand.
Um, and it's that easy.
And again, no inventory, notnone of that to worry about.
Um, it's easy to stand up, it'snot a lot of infrastructure, um,
doesn't have to have anyintegration.
So that's an everyday use case Ido want to bring up because I
think it's important a lot ofhospitals um aren't aware of
that.
Um, and and converted, you know,any converted clinical space
(33:44):
that doesn't have call lights.
So it's not, it's not just oursolutions are not just a
generator for when your primarysystems are down, right?
Just like a generator, right?
Oh, everything goes down, wehave a generator.
That's really what this is isthe background is oh now we have
a generator, we can keep going.
Um, but there is everyday usecases for it as well.
SPEAKER_01 (34:03):
Yeah, might as well use it.
It's there, you don't have towait until everything is down.
So no, I I really appreciate allyour insights, you know, talking
about how to actually maneuveraround the downtime operations
and making sure patients aretaken care of.
So as we kind of start closingthis, um, you know, I just want
(34:26):
to go kind of back a little bitto the leadership part and you
know, anything because we haveall you know, our listeners, I
think many might be inmanagement, but many are not.
So I mean, maybe for both, youknow, for for everybody.
Like, what is you know, any lastadvice that you would give, you
know, for somebody um who islooking to kind of grow into
(34:50):
their career and just just beinga better leader, you know, is it
for me, I would say personally,for me, if I'm I'm a better
leader, if I'm cultivating theright relationships, right, with
my team members and and with ourclients.
So, yeah, I mean, if you want togive us some final thoughts
about the um the leadership andthen maybe a little bit about
you know how people can findyour your upcoming book and how
(35:14):
to reach out to you.
SPEAKER_00 (35:15):
Yeah, absolutely.
So um the thing I would say thatfor team members and leaders is
to have the conversation aboutwhere the team member wants to
go.
Um, first time I offered anybodyan assistant manager position,
they said, Yeah, I don't think Iwant to be even in leadership
because they had been inleadership before.
And it didn't occur to me.
(35:36):
I'm always the person again, asI said, I think in the
beginning, I always wear how doI get to the next place?
How do I how do my manager howto become a senior manager?
Right.
Um and so I would say make surethat you're helping to guide the
team member where they want tobe.
And for team members, talk toyour leaders about where you
want to go.
They they may not know.
(35:56):
Um, I I spoke with a CIOrecently, and he wants to move
into a CFO position.
I wouldn't have thought aboutthat.
And and so, and that's you know,a different level, but think
about you know having thatconversation and then talking
about okay, what needs to happento get there.
As far as this matrix that Ispoke about and what the book is
(36:19):
about, from a leaderperspective, I think it'll make
a lot of sense when you read it.
There are a couple of reallyeye-opener for me.
Um, we go through novice toexpert.
This is what a novice lookslike.
This is how you lead a novice,this is how you can identify a
novice, um, what makes somebodya novice.
We go to an advanced beginner,we go through competent,
(36:42):
proficient expert.
And so we talk about each ofthose levels.
And the the biggest exclamationmark for me was when I um
started working at a position Iand I'd been doing informatics
for a long time.
They said, Hey, here you go.
We we we coded this piece, and Ilooked at it and I looked at it,
(37:03):
I said I said, it's it itdoesn't, it needs more.
Great job, it needs more.
So they said, Okay, so they theytook it away, they brought it
back.
I looked at it, I said, Great,we're on the right path.
We're missing a couple ofpieces.
This is what I found, and itneeds more work.
And they worked on it, theybrought it back, and they're
like, Okay.
(37:24):
And I said, All right, and Isaid, please don't break it.
That, and I'll tell you why thatwas so profound to me, is
because as a clinicalinformaticist, um, and somebody
very experienced, you you knowit's a it's mantra, right?
You don't test something to seeif it works, you test it to see
if you can break it.
That is a proficient skill.
(37:47):
That is not a novice or anadvanced beginner or even a
competent.
That is a proficient skill.
And so that was kind of aneye-opener of oh, they didn't
understand that.
Now I teach my team that now.
So as you see what that means,it also has helped me to develop
team members into that type ofunderstanding and thought
(38:09):
process, even before they'retrying to become proficient.
We start from the beginning.
And so some of those rules.
So going back to as a teammember, you can read the book,
you can look at this and talk toyour um leaders about how would
we how would we fill this out sothat I know where I am, because
this is where I want to go.
(38:30):
And as a leader, you can beproactive to think about your
team, the skills, the hardskills, the soft skills will
walk you through it.
It's a it's a I have been toldan easy read.
I hope so.
Um, and it's not a long book,it's 80 pages, but it gets you
what you need.
It's packed full of information,so it's a very fast read.
Yes, it's it's it's not a longbook.
(38:51):
Um, I don't think you'll bebored through it, but it'll help
you to be able to map out allyour team members so that you
can see exactly where everyoneis.
And because we have this and itworks so well, when I have
somebody that's now mapping andperforming at a level two, I can
give them and offer them thatpromotion because I know they're
(39:14):
already doing the job.
I don't promote somebody into arole and say, Whoa, I hope that
they can do everything I'm gonnaask them to do.
Um, so it really sets them upfor success.
And it also, from a HRperspective, gives you a really
great um way to discuss why thisteam member needs a promotion.
It's because what they'realready doing is that level of
(39:37):
work.
I don't know if I answered yourquestion, but I'll talk for two
hours if you if you let me.
SPEAKER_01 (39:45):
No, I'm loving, I'm I'm learning so much as we
continue to go.
And and where where can everyonefind your book?
SPEAKER_00 (39:52):
Thank you.
Um, yes, so uh the print book isalready available to order on
Amazon.
I should have the Kindle versionon Amazon very soon.
It's also on Lulu Books.
Um, and so if you'd like it, goout there and take a look, take
a look at it.
Um, you know, I I hope you loveit.
Give me your feedback.
Um, you can reach me at Julie atcontingencyhealth solutions.com.
(40:16):
Happy to take any questionsabout the book, about
contingency planning, um,anything that I can help with.
Love to hear from people.
SPEAKER_01 (40:25):
Yeah, thanks again for for joining me on this
beautiful Friday afternoon andwish you a very amazing happy
Thanksgiving.
SPEAKER_00 (40:32):
Yeah, happy Thanksgiving.
Um, so somebody uh saidsomething to me a couple of days
ago that just really stuck withme.
And I I really want to pass italong.
And it's they said, What if theonly thing you had tomorrow was
what you thank God for today?
It was something.
And so with Thanksgiving comingup, and you know, we were really
(40:56):
mindful and thankful onThanksgiving, we should be
mindful and thankful every day.
Um, just think about that.
Think about being thankful forthe things that you want to have
in your life tomorrow.
I thought it was an importantmessage.
SPEAKER_01 (41:08):
That's a beautiful message as we close this out.
And thank you again forlistening to This Week in Hell
Tech.
And Julie and I wish you all avery happy Thanksgiving.
SPEAKER_00 (41:18):
Happy Thanksgiving.
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