What does it take to build a health organization that will still be running on a strong digital and AI foundation in five years, ten years, or twenty? In this closing conversation, John Henderson, Vice President and Chief Information and Digital Officer at Rady Children's Health, takes the long view. Drawing on his work leading the digital integration of CHOC into Rady Children's Health, launching private generative AI platforms to support clinical and administrative work, and building an AI-ready data infrastructure that reaches beyond the EHR, John shares what it actually takes to align your organization around a multi-year digital vision.
John Henderson, VP and CIO, Rady Children's Health
Janae Sharp, Founder, The Sharp Index
00:00:00 Intro: Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't as we focus on the innovations that deliver. Join Megan Antonelli, Jenny Sharp and Shahid Shah for a weekly no BS deep dive on what's really making an impact in healthcare.
00:00:29 Janae Sharp: I'm really excited to sit down with you today and to talk about your work. And you have a lot a strong history with working at Children's Health and Rady's children. I wanted to start. So you've built your career across some of the largest health systems in the country, with leadership roles at Texas Children's now leading it at Rady Children's Health. And before we get into this longer view, I want to ask how you think about the role of a CIO and chief digital officer today, and how that role has changed as digital and AI have moved to the center of organizations. So let's start there. Let's level set.
00:01:13 John Henderson: Let's jump right in. All right. Yeah. Um, great to be here with you. You know, I think the, the biggest change, um, has really been historically the focus has been run the business, run the infrastructure. You do a little bit of enablement, but you keep things going, keep things running. Um, and I think today that digital means a lot. Uh, it means really everything as it relates to data. It means everything related to how you engage your patients, patient families and the workforce. And it means the two words that everyone either loves or cringes when they hear AI.
00:01:58 Janae Sharp: Uh, they might do both.
00:02:00 John Henderson: You're right. That was probably both. Um, and so that's really the biggest difference, uh, in what the expectation is. We're supposed to know all of those things. We are supposed to be able to enable the organization with AI, gen AI digital. You're supposed to do all of those things. But I think the other element of that is there's just an expectation that we are a real partner with operations, and we are able to align what their needs are with these technologies to drive better outcomes for their service lines for our patients, patient families. I think that's the biggest difference that we're doing both. We're transforming, we're modernizing, but we're also keeping everything going.
00:02:48 Janae Sharp: Right. And I think that's it sounds so simple when you say it, but it's a huge job. And without it, you kind of fall apart. I think about this yesterday I didn't have internet, so things just didn't happen, right? But also, you're talking about anticipating people's needs. You need to just not just keep things going, but also move forward. I want to talk a little bit about what differentiates a great job doing that and just having it on paper, because a lot of systems might have a digital strategy on paper, they might have found someone to give that to them or have these ideals. But there are leadership changes. There are changes, changes in, you know, who who's working there, the size of everything. You know, you've worked through mergers, through all this stuff. What how do you approach that digital vision that can survive so much change, not just with technology innovation, but also with people and everything. And what have you learned about getting aligned? So it's not just something you say you're going to do.
00:03:51 John Henderson: Right, right. So think there's a few things that are really critical. Um, the Technology is important. Love the technology. Um, so you gotta have, you have to have the capabilities. No doubt about that. But I think the other two things that are important is understanding why we're doing what we're doing. Operations is aligned with what the expectations are. What are we trying to solve? Uh, if you think about improving access in digital, we need to have a more efficient way for our patients to get access to appointments, whether it's primary care, whether it's specialty care. And if you align, okay, we need to do this, then we get into, okay, well, what needs to change in order for us to enable capabilities? Is it just the tech or do we also need to maybe limit how many visit types we offer? So if someone needs to self-service, find whatever appointment works for them by location, they're not going to see a drop down of one hundred different visit types to select from, right? Um, so you have, there's a lot of process optimization and redesign that also goes into it. And having everyone grounded in this is a people process and technology program of work, and not just the technology program to implement. That's important. And the last piece, the dreaded G word governance. Having an executive governance group that is helping drive and prioritize what we do now, what do we do next and what is going to come later? Because that sequencing sometimes it's hard because we want to do it all. Uh, but the challenge that I think people face is you can't always do it all. Or if you try to do it all at the same time, then you don't really do anything really well. So having that governance group to say, okay, here's what we need to do first, and we're going to build upon it to get to that future desired state. And I think that's what for me is important and critical to, to, to be able to execute and do it well.
00:05:56 Janae Sharp: Right. I think too, that that's really relatable, like making an appointment online. Like I don't want all the options. I just want them to anticipate what I need and for it to be fast and easy.
00:06:08 John Henderson: Preferably one hundred percent, one hundred percent. I think the other thing I didn't mention is that people process and technology piece. The physicians who are going to see the patients, they got to be in that in the loop with this as well, because they may have to adjust their schedule. What's available for Self-scheduling? Because if you get into specialties, there are some criteria that they want to understand to make sure that you're going to see the right position for the right thing at the right time. So.
00:06:43 Janae Sharp: Right. Nobody wants to go to a specialty. They don't need to go to like, or maybe you do. And that's, that's, that's not what you're talking we're talking about today. I want to talk a little bit about governance and, and what that actually looks like when we're talking. You've done significant work with integration with mergers consolidation. When we talk about digital and data versus governance, what does it actually take? What does that actually look like to bring it together? And our audience is pretty technical too. So you can really say like, you know what your top of mind is, what, what you think is important. And then I'm going to ask you another question after you answer about this.
00:07:24 John Henderson: So really what it practically looks like, particularly if you're bringing, trying to bring two organizations together, because everyone already has governance groups that are in flight in various stages and various levels of maturity. Um, but you have to, you want to leverage that. Uh, you don't want to just throw it all out. You want to leverage it and then be able to create that overarching governance with representation of the clinical areas you need physician representation, patient safety quality is critical because we're here to deliver the best in the highest quality care. You got to have that. And then revenue side is important. And then some of the other operational, you know, nursing. Having those leaders really guide what is most important. What kind of insights do we need that we don't have today? And then once we understand what those needs are, then that governance group can really then drive what I call the governance groups, which are the, the, the senior leaders in the organization that are the kind of domain experts you need those individuals because they really help you understand what the different workflow challenges are going to be. What's the questions that they have to answer to run the day to day operations of their clinical unit, uh, their administrative area? They help you really understand that. So you're building this massive data lake, uh, architecture and platform. Um, that's really going to serve the audience as they intend, not the way you want them to receive it, but based upon what their needs are. Uh, and so I think that's, that's a, that's a key part of the governance that has to be in place. The IT team, I'm there to facilitate. But the, the most important part is the engagement from those leaders. Because once we have that, then it's easier for us to build out that platform and to start to enable and, and start to create a scenario where we identify operations folks that actually want to create visualizations off of those platforms. The hardest thing to do when you're creating these platforms is to get out of the business of being the primary dashboard creator. And it's.
00:09:46 Janae Sharp: Hard. People I love, we love a dashboard.
00:09:49 John Henderson: Yes. And and getting people, having it in a way in which operations and analysts outside of it can actually do it. And it's not such a complicated endeavor in a huge time commitment and drain on them to do it. That's the that's the part that has to be solved. And that's the approach that we're that we're taking. Um, so we have those creators. So even though we still build some, we don't want, we're building what I call what you call me citizen developers, where they're able to create their own visual visualizations. Or as my director of analytics, Caroline Parker says, they're based creators because she always has great names for things.
00:10:31 Janae Sharp: I like that, like they're, they're creators. They don't want to do everything. They don't want all of it. When we're looking at consolidation before we move on, I want to talk more about those creators. But before that, I wanted to go back and think when we're talking about this wave of consolidation, like how will this shape care in the next decade? Will we have more people in the workforce creating stuff? Will we have more, you know, top down what what's your what you can predict? And, you know, we will hold you to this. Well.
00:11:08 John Henderson: All right. I'm on the record. So I think if we're doing it right, um, and doing it well. The old way of the creators, you'll still have some of that because there's going to, there's always a real need to understand how we're improving and looking at that visually to say, hey, we've done these interventions. We're trying to improve care delivery and quality. Let's look at this in a timeline and understand the interventions. And are we seeing the outcomes? So you're always going to need that. But I think because things are moving so fast with AI and really AI platforms that the future state is going to be more about those platforms connected to your data platform. Mhm. And you really using that as your analysis tool and your creation tool. So there's going to be so much democratization of access and creation using those tools. That's what I see the future state being not so much, you know, the traditional way of I built this platform and here is my, my click for you. Here's my tableau, here's my power BI. Those tools are important and I've leveraged them.
00:12:28 Janae Sharp: But yeah, we love you guys. We love all the people. You know.
00:12:34 John Henderson: I don't know that that's going to be the way at least I at least for me, if that's still the primary way in which we're doing visualizations and creating insights, and I have failed in what we're trying to get to.
00:12:51 Janae Sharp: Right? Although we love Dataviz, we love the Excel World Championships. We need more people to be involved and it to be more fun. We need to amp that up.
00:13:03 John Henderson: As for what you want.
00:13:05 Janae Sharp: Right?
00:13:05 John Henderson: Prompt it out and it's going to create that visualization for you. And if you need to refine it, then you can refine it.
00:13:11 Janae Sharp: Right?
00:13:12 John Henderson: You're going to tell you're going to prompt it again and say, I need a different longitudinal view with, uh, with the, with, with the scatter graph. And because that's the, that's the best way for me to present the information and it's going to do it right.
00:13:27 Janae Sharp: Imagine having your own private data scientist available all the time for what you need. I love it. Let's talk a little bit about how you've developed that, because you've been driving this launch of private generative AI platforms, um, to support administrative and clinical work. Is that correct? Yes.
00:13:46 John Henderson: That's correct.
00:13:48 Break: You're listening to digital health talks. When we return, we'll continue our discussion on how technology is revolutionizing healthcare delivery. Stay with us to hear more insights on creating sustainable, patient centered digital health solutions.
00:14:06 Janae Sharp: Let's talk about that. Why did you choose that private platform path rather than just the vendor, you know, relying on one person? And how does that make it decision making possible? Are people really doing this?
00:14:21 John Henderson: Well, yeah. So this is how we looked at it. And I'm you'll hear me reference my director, Caroline Fager because she really came in to the.
00:14:30 Janae Sharp: I know she's here.
00:14:31 John Henderson: I hope so.
00:14:33 Janae Sharp: This is her test if she's listening. Right.
00:14:35 John Henderson: Yeah, yeah. Because, you know, she came in a couple of years ago and basically said, hey, here's what you guys have been doing. um, based on everything I've heard from everyone, we need to do this differently. Um, and so we went about this plan of creating a data platform that could serve, uh, our operations, but also we have research data scientists in the research group. They have very particular needs. And then we have data scientists that are also, uh, I'll say hospital operations focused on building their own models, integrating them into the EHR. They have different, slightly different needs than the research data sets. Yeah. And then, and so what we had before couldn't serve all three of those use cases and audiences. So she said, hey, here's what we're going to need to be able to serve all audiences effectively. And well, that's scalable. And we went about going that path. Then, you know, as part of that, that's when, you know, AI really just in the marketplace and across the world became this Hot thing, even though it's been around for a long time.
00:15:44 Janae Sharp: It's hot right now.
00:15:46 John Henderson: And it's super, super hot. Super hot, uh, sunburst hot. But you know, she said we started talking about, okay, well, what are we willing to go? And so we said, okay, if we go down the path, we can't really leverage the commercial versions of these tools because, um, security, we can't have, uh, our phi and pi being trained out in the public domain. Um, that's, that's just a non-starter. So we landed on okay. Well, if we do private instance, um, can we really build this out in a way that allows us to continue to take advantage of the capabilities that come with the commercially available options, although it's probably not a one to one, will that be enough to sustain and allow us to create differentiation and to continue to build products against it, to serve clinical and administrative? And the answer kept coming back. Yes. So we said, okay, that's what we're going to do. So in the midst of creating this new data platform, we also said, okay, we can do that. And we're also going to start down the path with our own product. And that's how we came to the decision. It had to be secure. Um, we had to feel like the capabilities were going to allow us to add to it and build things internally, um, while still taking advantage of the native capabilities. And secondly, we wanted to make sure that we're not limited to one, we want to be able to access multiple models. And so that was also important. And all those answers kept saying, yes, that's, that's the way that's how we have to do this. And that's the path we've been on.
00:17:18 Janae Sharp: Yeah. That's the way to keep everybody's data secure and also develop new ways of doing things. How has that changed your decision making and your organization? Have you seen any anything people should look out for? What's going great? What's the.
00:17:35 John Henderson: So adoption is, is, has to be a part of the process. So because of where we are with our integration, we still have a little bit more work to go over the next eighteen months to complete all the integration activities. So it's not available to the entire health system yet. Um, we have, you know, we still have to connect and integrate our networks. That's coming over the summer. Once we're able to do that, then we can begin to give the broader audience of our workforce access to it. But so far, the group that's have been using it, it's been it's been a knowledge base. And so we're getting really good traction there. Um, we have a couple of products we built, um, our marketing group, uh, they do a lot of analyzing content that gets created by individuals in the organization. And of course, you know, marketing has our brand assets. They want everything to really be crisp and following those guidelines. And it can be difficult because they'll produce more and better ones. And how do you know and how do you keep track of it? So they have a lot of spend a lot of time, uh, reviewing content for individuals and organization. So as they were sharing that, we said, okay, we think we can incorporate this into what we call RC chat. Uh, and so we just released that and basically what it does. Um, you can submit, upload your files, whether it's, you know, whatever the, the version or type is, uh, and whether it's a physician profile, whether it's a presentation you're giving at a conference, and you load it and it will go and find and compare our marketing, uh, brand guidelines and tell you whether or not you need to make any adjustments.
00:19:18 Janae Sharp: Uh, the marketers that health systems are thrilled right now.
00:19:22 John Henderson: And so, uh, I mean, it's, it's, we just released that, um, but we're super excited about it. I, I used it, um, just yesterday, um, for, uh, for presentation. I'm creating for something, uh, next month and yeah. So I didn't have to send it to marketing to do it. It just.
00:19:39 Janae Sharp: Did it. They could just look at it. I can't imagine, I really can't imagine just getting a deck. And it works like that. But like, let's think about that because I like that you're meeting actual needs of the organization and, and helping things be better for everyone involved. Um, you mentioned stuff about EHR and that. Let's talk a little bit more about that because you've spoken about, spoken about moving past the EHR as your center of gravity. I listened to it and talking about building an AI data foundation underneath it. And for leaders who are still thinking of the EHR as the center of the universe and for the HR vendors on here, we're not saying you aren't, but what does that look like in practice? Like what? You know, you have this, you have this timeline. You have the eighteen months. What does that mean though?
00:20:39 John Henderson: Right. So our HR we're we're we're unifying on epic. Love epic. Yeah. And they have tremendous capabilities. So it's not it's not not throwing shade on them, but but the philosophy and approach to creating that infrastructure that you can build and leverage AI and on top of has to be agnostic from, from my lens. And so what it looks like for us is we have a legacy of another EHR vendor that was prevalent, and we have a lot of that data. It's important. We're going to need to keep that. But as we unify on epic over the next eighteen months, um, we start to pipe in that data into the platform. So that's where the integration of the data and assets from both legacy organizations come together. And that's where the power and the magic can begin to happen because you have that combination in wealth of data across. So as we bring that over, the intent and goal is before we get to that unified EHR platform, we'll already have all of that data in. We'll start to enable meeting with operations collectively. We'll be in the middle of implementing this EHR unification. So we'll already have sessions where we'll have some insights into what are they missing today? What are they? What are they going to need? What questions we need to answer. So we'll be able to glean some of those insights and start building some products against this newly integrated data platform. So it's not only just some visualizations that are going to be important for us to track and monitor performance, but it's also going to be some of those products. So as the data is what we call it, that just launched for a folks on our census, uh, uh, types of data elements. We're going to build that out even more over the coming months. Uh, the rest of this calendar year. So it becomes more robust. And as that data rolls in, it just incorporates. And so by the time we get to that go live and unification of one EHR platform, we're going to exit with this wealth of insights that is going to be driven by this private album that we have, uh, invested in. And yeah, I'm super excited about it. And it means post go live, we'll leverage the inline reporting of epic is important for the folks who are in it day in and day out. But for those who are having to analyze and forecast and look at things more holistically, what do we need to do in the next ninety days? It's going to give us capabilities that we didn't have in a, in a, in a, in a, in a speed at a speed that we weren't able to produce previously. And so that's what I really mean by moving past, uh, the EHR as the center of the universe. This combination of data and these AI tools becomes how everything happens, right? Even though you have these things underneath it and these inputs that are coming from these core critical systems, that becomes the foundation and the core infrastructure for everything else.
00:23:53 Janae Sharp: Yes. Yeah. And then you're not held hostage by your legacy data. You're letting it add to your organization and contribute to a better, a better system. What are the things when people are talking about this? What's the hardest part and what do people not talk about enough? You don't have to. You don't have to call yourself out totally. But, you know, I think sometimes we only want to hear the good thing, but like, what are the conversations that are being missed?
00:24:22 John Henderson: Um, the, the hard part is getting the data platform and the data organized and cleaned for use. You can't really leverage AI and really take advantage of it if you don't have a good organized data structure and platform. Obviously, you know, with LLMs, you can search unstructured data.
00:24:46 Janae Sharp: Yeah.
00:24:47 John Henderson: That's important. But you have to if you don't have it, then it's real. It takes its effort. It takes a long time to get that clean. So that's hard. Um, changing to a new data platform architecture is hard because what you had before, you have to make a decision. AM I going to recreate all of the insights that I had before? And we didn't do that. And that hurt.
00:25:09 Janae Sharp: Um, yeah.
00:25:10 John Henderson: It hurts some of our customers. Um, and then because of that, um, it damaged, uh, you know, um, what we had been doing, uh, previously by serving them. And so we have to perform service recovery. Um, even, even though, you know, we felt, we communicated, um, that's what was happening. It didn't all. We didn't do a good enough job. Uh, I'll say continue to have that conversation and making sure they understood that. Uh, so that's right. But once you get that piece done, then you can do all these other incredible things faster, more effective, and you can get to the really funny, cool stuff.
00:25:49 Janae Sharp: I love that. And, and I think too, when I was looking at your work, like getting to the good stuff is nice. I also like that you in your work always bring up how important it is to improve the patient and employee satisfaction at the same time, and not trade one for the other. And I thank you for that story of like, sometimes when you change things, things get lost and then you have to, you have to fix it. So how are you using tools to uplift your clinician and staff experience? And how do you know when you've arrived instead of them just like being nice to your face.
00:26:28 John Henderson: Right? Right. So, you know, Ambien has really shifted and has really made a huge impact. So that's been a big. Win for us with our physicians. Um, we can't roll it out fast enough. Um, and they're gonna, and, and, you know, we survey and we say, tell us what you think. And they're telling us, um, they'll tell you, they'll stop you in the hallway and tell you. So they're giving you feedback. So we have to have that close. We can't just rely on, well, here's what the metrics and the, uh, the data is showing how well you're using it. You also have to get that feedback from them. The qualitative feedback to say is the, is the data matching their actual experience that you always have to do those two things. So that's, that's how we approach it and, and do that. Um, you know, we're looking at care guidelines, introducing that into the mix too with the DNI platform. Um, and we're taking advantage of some of the epic things, uh, the chart summarization, we released that in both inpatient and outpatient so far that's receiving good success and feedback from physicians. But we did it small. We want to make sure they see it's valuable. And once we feel like we have a good cohort that says yes, then we'll scale it out. And there's so much more that we'll do in that, in that manner. But we don't want to just do it big bang. We want to do it small and say, tell us if this is really helpful. And when they say yes, then we can scale it out and roll it out.
00:27:52 Janae Sharp: I like that you want the qualitative data. You want to make sure you're actually meeting people's needs. I think it's easy to forget those things. And I think it's also easy for health systems to just think about their current budget cycle and lose sight of where you want to be in a decade. So when would you say and how do you do this? Like, how do you take the long view to justify decisions or to explain what they are about? AI investments or data infrastructure? Like, is it easy to show the value?
00:28:25 John Henderson: It's not always easy to show the value. Um, but what you have, you have to tell the story of what this is going to do. We have to have a platform. You need data. Everyone needs this information. So how are we going to make it available to you. And here's what it's going to take for us to do that. Um and if you can focus on use cases that you've already talked to the customer about, that's that are pain points and understand that there's an, an efficiency, uh, that can be gained. Then you build that story and say, here's the value we're going to be able to deliver. Secondly, and lastly, it's a no, we're coming up on time is, yeah, you have to be creative with your budget. Um, and sometimes you have to make some trade offs and say, okay, I'm not going to do some of these other things that I have been doing. I need to shift that investment to this, uh, this domain. I need to ship it to, to AI and data because that is what is going to really catapult us. And so you have to do some of those things as well.
00:29:24 Janae Sharp: I like that. Like you have to be you have to be creative. And to close us out. I have one question. I want to hear what's good right now. What's something that's happening that you're proud of? We need to end on a good note. And we always ask people, you know, five good things, like, what's our good thing right now? What's something you're that's keeping you working?
00:29:45 John Henderson: Uh, so I'm because I just what I do, I'm, I'm gonna give you two, not just one. Um.
00:29:52 Janae Sharp: We'll accept it. We'll allow it.
00:29:54 John Henderson: This, the acceleration of what we're doing with our chat is super exciting. And I am so excited to build more, um, and introduce some of those capabilities to the broader Rady Children's Health organization. So I'm super excited about that, uh, over the summer and to be able to get there, uh, I think it's going to really shift how we operate fundamentally, uh, in a way that's going to just be transformational for us. Uh, and I'll say the other thing is it's the people. So we're in this military integration, uh, and building and, uh, this technology organization has been, uh, really, really fun. It's been challenging. Um, but we're creating a team that is going to really drive the organization forward, uh, and getting to know, uh, everyone has been, uh, really, really exciting and fun. And hopefully, you know, they're getting to know me. Uh, and we're going to come out with this, you know, it'll make us a much stronger and more disciplined, focused technology organization. So I'm excited about that.
00:31:00 Janae Sharp: I love that. So I always have to do one technology thing and one person thing. So that was a great, a great way to close out our day. And I want to thank you for, for your work and for sharing some of those insights.
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