<div class="tagline">Full transcript</div>
[00:00:00] Liat: I'm your host, Liat, and today we have Dr. Zafar Chaudry, Senior Vice President, Chief Digital and Information Officer at Seattle Children's. His goal is to enable clinicians with the best technology to deliver safe and excellent care to patients. Dr. Chaudry, it's great to have you with us today.
[00:00:14] Zafar: Thank you for having me.
[00:00:15] Liat: We're gonna have to start with a big congratulations. You recently won the Seattle Healthcare, O R B I E Award, Becker's Top CIOs to Know, Top 100 Influential Tech Leaders in the UK public sector and more.
[00:00:27] Zafar: Thank you. Yeah, I'm humbled. It's all down to my team really. As I say, my team has done a great job of keeping me employed.
[00:00:35] Liat: But I'm sure you lead with very nice example as well. So tell us briefly about your journey in healthcare, how you got to where you are today, and then we'll dive into the questions.
[00:00:43] Zafar: Yeah, so I've been in healthcare IT almost coming on 35 years. I started as a physician, my specialty internal medicine, but I defected quite early in my medical career to the dark side. This was the era of green screens and lots of key strokes, and they needed clinical people to learn about IT. And I volunteered. And over a period of time I didn't look back. So I've traveled all over the world. I've worked all over the world as a healthcare CIO and seen all kinds of versions of healthcare. And what's really interesting to me is people tell me every, everywhere I go, healthcare is different. But actually it's paid differently, but the challenges are still the same. And I've certainly learned that across the, across my journey, and also had the opportunity to meet people from multiple cultures and backgrounds and now I'm here in Seattle.
[00:01:37] Liat: Amazing. What does your role entail today at Seattle Children's?
[00:01:40] Zafar: The healthcare IT group at Seattle Children's is a team of about 500 people. We do everything from core technology, infrastructure, digital health, clinical information systems, business applications. It's the full spectrum of soup to nuts of IT services in effect.
[00:02:02] And we're servicing Seattle Children's, which is 46 sites across Washington, Alaska, Montana, and Idaho.
[00:02:10] Liat: You've implemented Epic in the middle of the pandemic. What are some other examples of things you're working on today at Seattle Children's when it comes to the digital patient experience?
[00:02:18] Zafar: So I think the pandemic accelerated digital transformation at a pace never seen before. Traditionally physicians and nurses and allied health professionals. Are reluctant to change, right? Change is always hard no matter what organization you're in and I would put myself in the same boat when I was a physician. I was just as bad when it came to adopting new things, new techniques, new business processes. The pandemic has certainly accelerated that. And so yes, we were in the middle of putting in electronic medical record. Didn't know a pandemic was gonna happen, but it did. The other thing that accelerated though, was patient facing applications. So having a digital front door was key. We had to build that. But what we also learned in the pandemic is that patients don't always have access to the right technology. There is an equity issue. People don't have access. The latest laptop, not every family can buy five MacBook Pros or iPhones, and not every family has good internet connect in their homes. So as part of this digital transformation, moving to a strong presence in telehealth, telemedicine, and building a digital front door application, we also built programs to loan devices to those patients, parents, caregivers who didn't have the right access. The devices also had built in internet capability.
[00:03:48] Because we had to be able to facilitate those telemedicine visits, so that wasn't something we were banking on. Trying to loan out devices then hoping they'll actually come back or, be gone forever is a challenge for a health system. At Children's, because we deal with kids, equity, diversity and inclusion is a strong focus for our organization as part of the transformation.
[00:04:11] Liat: That's amazing. I never heard of that. And at a previous chime forum you mentioned the equity to have access, so it shouldn't be taken for granted.
[00:04:20] Zafar: No, I think we are lucky, right? Because we have decent jobs. We work in tech, right? We have access to devices. It, it baffles me that somebody might not have an internet connection. That's great, right? Because I'm so used to having a great internet connection because I can afford to pay for it. Exactly. But in, in our organization, 53% of patients are on Medicaid. And that means that they're paid through a government program, their healthcare, and that means they're probably low income.
[00:04:52] Liat: How's it going with the loaning program?
[00:04:56] Zafar: Yeah, it's been successful. Of course. There's always a limitation to how many devices you have and how many you can loan out. , we are now learning from our first version of that program and revamping it into sort of version. You always evolve, right? You always learn and evolve. That's being agile, and so we wish we could do more to help the patient population. But of course there's limitations on funding and equipment availability. Supply chain hasn't been great as well, right during this pandemic era. So that's also had challenges and having people to then administer a program is something we've had to spin up. But it's important that people understand that having too much technology, is still, this is still a people. I always tell my team that, we are in the business of patients. We're not in the business of it, right? And so whatever plans and programs and tools we come up with, we have to make sure that it's available to all.
[00:05:58] Otherwise, it's not of value. know, Not everybody's carrying the latest version of iOS in their pocket or. In their pocket, right? If you're a low income individual, you are probably buying the pay as you go services for phones. You probably have got the free Android phone that some vendor gave you as part of your contract, and that's not gonna be the latest and greatest version, right?
[00:06:21] And so I think it's important that whatever technology solutions hospitals build, they must take into consideration the accessibility of said application and then how that is actually delivered to the patient, and if the patient is unable to consume, then find ways to help them consume. So the other thing we've done in addition to loaning out devices is we did put kiosks at our clinics around the four states where you could drive in and still be able to use the telemedicine function if you didn't have a device or we didn't have a device to loan you.
[00:07:01] Liat: Wow. I love that. Labor shortage, burnout, service support costs, all these terms. What do they bring to mind? How do you handle these in today's world?
[00:07:11] Zafar: So I think that's the point of discussion for most leaders in my shoes. Staff recruitment and retention is a problem. It's even worse in Seattle. I am competing with technology companies that are literally across the street from my building.
[00:07:26] That is difficult, but I think we have an advantage. One. In healthcare, most organizations are mission driven, so when you're working for us, you are really working to help kids. With their care and hope, care and cure for kids. So the mission helps retain staff. In addition, we have done a lot of work in equity measurements across our pay scales, so we've made sure that there is no discrepancy between men and women.
[00:08:01] When it comes to being paid for the same job, we've looked at job descriptions, we've reviewed those, we've compared those to the market. We've made market adjustments to retain people, and we've done well. We've only got an 8% turnover. In health it, it's Seattle Children's. That's really low.
[00:08:19] That is very low. So we've done that. We've created employee. We have an employee welfare group within the team called Your Voice. They receive funding from me to do fun events, to keep people engaged, to listen to people. I do frequent town halls and all hand sessions with the teams where they get to anonymously grill me on questions and things that I'm thinking about that's usually well received.
[00:08:49] I do updates every Friday to my team where I talk about life. I think one of the most important things for a leader is to humanize themselves with their staff. You know when you have a big title, people tend to be afraid of having a conversation with you if they work for you because they look at the title and they see some level of power that scares them off.
[00:09:16] And what I've tried to do in the pandemic, and it's been difficult for me cuz that's probably, I'm probably the biggest introvert you'll ever meet. So you might say that talking to me. But yes I'm quite comfortable. Hiding on the sofa and watching sci-fi and not talking to anybody. But that's really how I grew up and how I am.
[00:09:33] But at work, you have to humanize yourself with your teams, and I've learned that through the pandemic by telling people your own challenges during a pandemic. Being locked up at home for months on end wasn't great for anybody. One of my biggest concerns for my team has always been their mental.
[00:09:50] Are they all doing okay, So we, I spend Friday talking about what I've learn, what I've really struggled with that week. What challenges I've had from a family perspective, from a, who's been affected by Covid and my family perspective, what I'm looking forward to, what I've watched on tv and what I've learnt from that.
[00:10:13] And, prior to pandemic, I was unable to cook. I taught myself to cook. I shared those recipes with the team. People are still alive after trying my recipes, which is good news for me, . So I've really tried to humanize the conversation and I've encouraged teams to reach out for just a chat.
[00:10:33] whether it's with me, or their direct leaders, and it doesn't have to be about work. I've actively encouraged people around the fact that the most important thing in life is family. A job is great, and serving a mission is also amazing. But at the same time, if you don't take care of your family, if you don't take care of your own mental health, if you don't take care of your own kids, you will struggle at work.
[00:11:00] Because those things will be in the back of your head, right? At the end of the day, no matter what field you're in or what profession you're in, that's your real life. That's how you're going to spend the next hopefully 70, 80 years of your life and not I'm collecting a paycheck, or I have a really big title, right?
[00:11:19] Titles come and go. And the title's valid for the time you're sitting in that seat. But the reality is who are you as a person and who are you going home to? And who you're going home to. Yeah. And I've tried to do that and I think that's been well received as a conversation. Cause then people get to know that, you're not the almighty evil person sitting in the chair who's giving them lots of work to do and everybody's all afraid.
[00:11:43] I think you have to humanize it. Yes. The most important thing. Question I always say to people every day you wake up and go to work, are you having. If you're not having fun, I tell people, step away from the laptop. Do something else. Because you can always come back and catch up your work.
[00:12:02] But if all you're doing is burying yourself in the laptop, reading email after email, cuz let's be honest, we'll get hundreds of emails a day. It's crazy. And so that really can make you, I. get hundreds of emails that if I look at my inbox and say, Oh my God, I have all these emails. Oh, how am I gonna make this work?
[00:12:19] Am I going to fall apart? Yes, I probably will. And the body gets into stress. Exactly. So you have to decompress. And a lot of times decompression works well if you're able to talk to someone and maybe someone that doesn't know anything about you because then they can't judge you. Exactly. Are you having fun?
[00:12:40] I'm always having fun, right? I say to people, This is the easiest job in the world. And they're like how do you say that? And I say because every day I wake up and I know I'm helping kids get better. What more can I want from life? Every time I walk through the hospital and I see really sick kids it's heartbreaking.
[00:12:58] But then I also see kids that are getting better and they're smiling. One of the, one of the best things I've learned in my career is, A child is the most resilient person you will ever meet. The 11 year old kid who is suffering from leukemia who may not live. For the next, but maybe, may pass away in the next six months is still the happiest person you actually meet.
[00:13:22] They face their pain better than anybody else can. So when I look at those kids, I draw strength from that to say, How can I actually tell you that I'm stressed? Exactly. I'm fine. I'm healthy. I'm having this conversation with you. Yes. The person that should be stressed is the person who's suffering from leukemia.
[00:13:41] Yes. Or the family that is affected because they may lose their child. That is the pain. Not, Oh, Zaha has 300 emails to cancer today. That's, And I may be one of them. and you may be one of them. So it, it's pretty relevant. So I tend to say that's what gets me out of bed every.
[00:13:59] Liat: As someone who's made such a big impact on the industry like yourself, what you learned from that experience that other CIOs can draw from?
[00:14:06] Zafar: So a lot of people ask me the question of what grounds me, right? What was that pivotal moment in my life that, that really changed how I thought, And I'll take you back to the time when I first became a cio. It's a proud part of your life to grow in your career. To become a leader, to lead a team of people.
[00:14:28] The very first CIO job I had, I was summoned by a patient. Patient was 14 years old, and the patient said to me, I want to speak to you. So you know, I was all new and excited. And look at me with my big title. Went to see this 14 year old patient and the 14 year old patient told me that I had really ruined their life.
[00:14:53] And I just sat down, took a seat and said, Can you explain what I've done? Cause I'm looking at this, I'm all proud of myself. Look at me, I'm in charge. And this 14 year old kid is telling me I have done something massively wrong to impact his life. And he told me his story. So he was suffering from cancer and he had six months left.
[00:15:14] And as I was sitting there and listening to this story, he said to me that the reason why you've impacted my life is because the wifi, the internet connection here at my bedside is terrible, and it's terrible. And I want to tell you that my father is a pilot and he flies all over the world and he can't be with.
[00:15:41] All the time while I'm here in the hospital and I might not leave and without a great internet connection, I'm unable to speak to him on Skype. I can't see him. I can't talk to him. It breaks the voice, the sound breaks up, the video breaks up, and do you know that I may not see him again if I don't make it?
[00:16:04] And that was the very first time in my life I realized. It doesn't matter who you are, and it doesn't matter what your title is, and it doesn't matter how much money someone pays you. What matters most importantly is are you doing the right work that helps people? And that conversation broke my heart.
[00:16:28] What was the point of me having this big title and this really simple thing? That we hadn't focused on and hadn't fixed. And I could tell you that the same day that was fixed. And then I spent the next six months or so chatting with this person about the improved experience and unfortunately did pass away, but the.
[00:16:54] That was what I learned was why I do this job, not for the big title, the big salary the kudos people are gonna, want to talk to you. I think it's most important that everybody's probably facing a humbling moment in their career, and it's what you learn from that. So we are in the service industry.
[00:17:14] The customer is right. I believe that for me, the customer is the patient. The customer is the doctor, nurse, allied health professional. So whatever I can do to make their lives easy is how I would define success in my career. Not, yeah, it's great to be recognized for it, but that's not important because, one day when I'm retired sitting at home thinking about did I do a good job in my life, that's what I want to think about.
[00:17:42] I got paid a lot of money and look at me. And I think you, everybody gets that moment in their life where something happens that helps them redefine. And I'm glad that happened to me early in my career, otherwise I still probably would have a chip on my shoulder. Ego is a proper Right.
[00:17:58] You're only human. We are human. And certainly the pandemic has taught us that it takes but a few minutes to be. Yeah, I could. I could have the best role, the best finances, all the awards, Big American Express Black Card. But the reality is, if I'm gonna go, I'm gonna go and nobody's gonna be able to stop that.
[00:18:22] And I think people need to take a breath. And remember that post pandemic, that we're only human. We're very fragile. We need to be kind. We need to treat each other with respect and dignity, and we should always help each other. The end of the day, you meet interesting people. I've met you. You're an interesting person.
[00:18:45] I've learned about the fact that you're halfway across the world. I never would've guessed that. . I probably have hundreds of questions about where you live, what it's like, and that would be a different conversation. But do you see what I mean? You can learn so much from each other, want to be able to help but I think it does help me do my job better because I have a clinical back.
[00:19:08] and therefore I understand I've been on both sides of the fence. So I understand when a patient is telling me what we may have done wrong. And I also understand what a clinician is telling me that we may have done wrong. And so I drive, My digital strategy isn't driven by, my 35 years in healthcare.
[00:19:28] My digital strategy is driven by conversations. We have a patient advisory group. That we meet with every month. And we ask them what do they need to make their experience from a technology perspective better. And the analogy I'll leave you with is the average 11 year old knows more about technology than I do.
[00:19:50] That's true. They really do. Cause they're native, right? They grew up, yeah. Tech savvy. When I look at kids and how they're using their fingers on their tablets and phones and I'm like, I can't even keep up .
[00:20:02] Liat: I wonder what the future CIO will be dealing with. How do you envision a hallway conversation between two healthcare CIOs in 10 years from now?
[00:20:11] Zafar: I think what worries me the most about the future is the loss or lack of communication that we see with the next generation. So the Gen Z being more digital. In the way they grow up is they're taking it to the extreme. Everything has to be done on social media. Everything has to be done on texting or iMessaging or WhatsApping, Facebook messaging.
[00:20:38] That worries me. I think the art, whether or not you are introverted or extroverted, the art of communication is what we are as humans. And so it, it does worry me that you could be sitting on a sofa and the person next to you instead of talking to you will actually send you a text , or is just glu to their phone and outlook looking up or just glu to their phone.
[00:21:01] And that, that even when you go out for a meal. Families and couples sitting for a meal and they're not talking, they're texting, they're on their screen. I think the art of the communication piece needs to be focused on. My worry for the next generation of CIO is, will he?
[00:21:21] She, they be able to have that level of communication. And sometimes conversations are tough. Sometimes you have to have difficult conversations, and I don't see that with the younger generation of folks. They're. Struggle to have any form of conversation. Never mind a difficult conversation. So I think as people train up to be the next generation of CIOs, I hope that their programs, their educational versus work journey.
[00:21:54] Actually includes more focus on communication skills, people skills, and it's become a bit harder with this virtual world. Here I am having a conversation with you in two dimensions. If we were having it in 3d, there would be. A different level of communication. I think body language is something that you learn over time to read, whether you are making a presentation or having a discussion in a big meeting, that's important.
[00:22:25] And I hope we, we don't completely stay a hundred percent virtual. We come to a hybrid environment. People interaction is great, but that's not something that's always taught to technologists, as I'm sure you appreciate,
[00:22:38] Liat: If you had 100 million to spend on health tech and no red tape involved, how would you spend it?
[00:22:45] Zafar: I still think that money would be invested in medical equipment and devices that were connected, that actually impacted patient. You're going to get more value from buying. Buying a surgical robot, training a surgeon to do a new technology with that surgical robot. Reducing patient bedtime, reducing patient recovery time, and having better outcomes.
[00:23:20] That's really where the value is because what business are we in, right? In healthcare you, first of all, we don't want you to come into a hospital. We want you to remain. If you come in, we want you to leave and never come back and be healed. The other area I would spend some of that money would be on technologies that support stronger primary care.
[00:23:46] One of the biggest challenges in the US healthcare system is a lack of access to primary care, which means people tend to get super sick and then end up in the emergency room. I would like to build technologies. I would invest in technologies that looked at chronic diseases, diabetes, hypertension, asthma, and make sure.
[00:24:07] Those kids and even adults are taken care of before they trigger an event that brings them to the hospital better diet. So the other thing I would invest in is tools around social determinants of health, right? People don't eat well. That also impacts their health. People don't sleep enough. That impacts their health.
[00:24:32] Physical and mental. So I would also use a chunk of that money on tools for mental health,
[00:24:38] Liat: a new generation of CIOs. What is the last thing you'd like to leave them with?
[00:24:43] Zafar: A piece of advice. I would say don't forget, don't ever forget why you're doing your job. Who are you serving? So spend time with patients.
[00:24:54] Spend time with caregivers. Spend time with parents. It is not a technology role, even though you will be enabling all lots of, Don't get me wrong, I like flashy lights in a data center as much as the next person, but that's not gonna be the driver as to why I do this role. And that should be the focus of all CIOs coming into this profession is, why do you do this?
[00:25:19] What gets you out of bed every day? And if that changes in your career, then you need to seriously think. What that means for you, cuz you're not gonna work in health it for the big payoff. You're gonna work in health it cuz you know why you're doing it. If you are really a technologist who wants a bigger payoff, then you're gonna be working in a technology company or building your own startup.
[00:25:40] And that could be a startup in health, right? But the reality is that's what's gonna get you ipo not working for a not-for-profit, mission based organization That's, A driver, it's very different, right? So I would say think about the people that you serve and in your journey as a cio, don't forget about family, Don't forget about your mental health.
[00:26:05] Those are all the things that will keep you grounded to be more successful. Technology is just something we do, right? I don't think if you work in health it, you wake up thinking about the next shiny box. Hopefully you. It's still exciting to see something new built out. If a new software tool comes on board and you get a briefing about it, it's exciting to learn about it.
[00:26:29] But I don't think that is going to define your success, right? You can put any technology in and I could turn a box on today, but that doesn't mean it's actually going to sustain, right? Or it's actually going to get. It's using simple tools like Microsoft Office, we all use it, right?
[00:26:49] But we only use about 10% of its features, right? But we pay a hundred percent of its cost, right? So you talk, you walk up to the average person and you say, Hey, you were working on Microsoft Word. Did you do a mail merge today? And people look at me like, What? What's that? I haven't have done. So that's what you've gotta think about, right?
[00:27:12] Everything you put in, what is the adoption, utilization, and sustainability of that technology? It's exciting. It's like buying a new car, right? Everybody wants to buy a car full of technology. 17 screens staring at you. But how many times have you used all the feature? That you actually paid money for seldom.
[00:27:36] Very infrequently. It extremely. It's saying, Oh, I've gotta have wireless charging in my car. It's a must have. I have wireless charging in my car. I bar use it. Used it. I've used it. Cause my phone is always full. It's that . But it was a big point I had to have. And healthcare it.
[00:27:54] Yeah, healthcare, it's no different. As a technologist, you go and see a new demo, I could come to your company and you could show me a demo of something amazing, I'm sure, and I might say, Oh my God, if we had that would be great. But what I've really gotta understand is, does that technology have a use case that is going to bring value?
[00:28:16] And can I then sustain it in years 2, 3, 4, 5, and beyond, right? Otherwise, we'll buy it. This is why healthcare organizations have hundreds and thousands of applications, right? We currently have 789 applications, and I scratch my head sometimes to say, Yeah, what's the utilization of said 789 applications?
[00:28:41] Cause certainly in my day, I probably use the same five things. And have been for the last five years of being here. Why have we bought so many of those things? It's like buying a really expensive laptop and then realizing I just wanna surf the web. Exactly.
[00:28:58] Liat: And healthcare organizations should come to realize that.
[00:29:02] Zafar: Yeah, absolutely.
[00:29:04] Liat: Wow, this has been so amazing. I loved hearing your thoughts. Do you have anyone in mind as a trailblazer in the industry making an impact that you would nominate as a future guest?
[00:29:16] Zafar: I would definitely nominate my good friend and colleague, Aaron Mary. He's the Chief digital officer and CIO at Baptist Health in Florida, and I would certainly nominate him as a visionary colleague that I've known him for many years.
[00:29:31] Close. Yeah. Absolutely.
[00:29:32] Liat: Thank you so very much for your time and it was such a pleasure and I hope to see you again very soon and hopefully in person.
[00:29:40] Zafar: Yes, thank you. It's been a pleasure talking to you and thanks for taking the time to spend some time with me and yeah, I absolutely hope to see you in three dimensions at some point.
[00:29:48] Liat: For sure.