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Becker’s Healthcare Podcast
Leading Intermountain Health Through Innovation and Change with Rob Allen
00:20:24
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- [00:01]
A
This is Laura Darda with the Beckers Healthcare podcast. Today I'm thrilled to be joined by CEO of Intermountain Health, Rob Allen. Rob, it's a pleasure to have you on the podcast today.
- [00:09]
B
It's a pleasure to be here. Thank you for the opportunity, Laura.
- [00:11]
A
Absolutely. And, you know, I'm excited to have you because I know there's so many things you're doing at Intermountain Health, and it's such an innovative health system and time in healthcare where there's lots of opportunities to grow and develop and really have a lot of things to think about. So I'm excited for our conversation today and really share what you're doing at Intermountain.
- [00:29]
B
Look forward to going where you'd like to go. So let's dive in.
- [00:32]
A
Perfect. Perfect. Well, to start, could you briefly introduce yourself, your role in the scope of Intermountain Health, what's currently commanding most of your time and attention today?
- [00:41]
B
Yeah. So, Rob Allen, I currently have the pleasure of serving as the President and CEO at Intermountain Health, an organization that is based in the western United States, headquartered in Salt Lake City, Utah. We serve across about six Western states, and we have 34 hospitals, nearly 70,000 caregivers. We have over 400 clinics. We have an insurance arm, Select Health, that we insure over 1.1 million lives. And just really focused on our mission of helping people live the healthiest lives possible. And what are we undertaking? Is that the question? Laura, let's make sure I move where you want to go here.
- [01:16]
A
Well, what was most of your attention paid today? What are kind of the top of mind things for you? Especially, as I know there's so much happening in the healthcare space, and truly, I know so many things that Intermountain's doing. The innovative new ideas that are brought up both internally as well as partnerships externally. So what's top of mind?
- [01:32]
B
Yeah, first and foremost, it's our caregivers every day and the people that they take care of. And right now, while we're speaking, we have all of our caregivers deployed, taking care of our communities. And that's important. That work needs to happen every day. It needs to move along. And we have remarkable people doing that work. I'm proud of them. And we want to make sure we're giving them due attention every day for what they need. But then we also have the vision at Intermountain is to be a model health system. And it was established when Intermountain was formed in 1975 when the church of Jesus Christ of Latter day Saints gifted 15 hospitals in Utah, Idaho and Wyoming to the community. And they did so with this single charge to be a model health system. And that has driven our governance under the board, our leadership of the organization and all of our caregivers for now, 51 years. Always thinking about what does a model look like? And it's not the model, it's a model. We look for other partners who also have like minds around serving community well. And so what takes energy and time for me is looking at what are the next steps we need to take towards that model of the future. How do we innovate, how do we evolve our services and how do we do it in a way that we can engage all of our caregivers so that it becomes part of their journey as they're here to do good, that we're able to enable them to do good through the work that we're doing and how we look to the future. Now there's lots of innovation happening, as you and I have already talked about a little bit on the side with AI and technology coming. And so we think a lot about how do we use these tools to improve our abilities to support our caregivers and to enhance the experience that our communities have with us.
- [03:13]
A
That's amazing to hear. And I think especially when you look at AI and technology and some of those tools, I mean, there can be some anxiety around incorporating them, some challenges, because folks may not want to change or, or see the technology as threatening in one way, shape or form. So how do you really make sure that your teams are in a great place to not only accept the technology, but then adopt it in a way that's going to be meaningful for the organization?
- [03:38]
B
Yeah, first I think you have to be able to talk about change in the context of why does it matter, why is it important and what will it mean to those we serve, but also to each caregiver? You know, anytime we individually face change, you at some point ask the question, what's in it for me? I mean, how is this going to actually be good for the things I'm trying to do? If, and we think a lot about our caregivers, why, why they got into healthcare, they wanted to serve, they wanted to do good, they wanted to bless lives and help people. And so when we look at this change, whether it's the AI tools, the technology, the general industry environment changing, how do we set a vision to the next place that helps them do that better? And what I love about the promise of the technology coming is, is that it will enhance Our ability to streamline the work process and particularly the administrative side. Let's take that burden off of our clinicians. Let's let them do what they got into medicine to do and find the joy in their journey again. And the environment we've been in has burdened them with too much of the administrative workflow. And we are excited about where this goes. In fact, at Intermountain, in order to help people through it, we have two very clearly stated objectives as an organization. Our strategic initiatives are simplification for our caregivers, our patients, our members in our community, and proactive care. How do we go upstream and keep people healthy? How do we, in the parlay of our mission statement, help people live the healthiest lives possible by being a partner before they get ill, before they have, you know, incident, disease, whatever that impacts them, so that we can avoid as much of that as possible. And on the simplification front, these tools really bring opportunity. We're seeing some of an impact already. Ambient dictation, a number of things there. There's more coming, I'm sure. And we've got to also be guarded and have guardrails in the process. We know that as well. And so if it's back office function, we want to run as hard as we can. If it's clinical patient touching, we want to make sure we're doing that hand in hand with our clinicians and making sure the right guardrails are there. But how do you simplify? You know, Einstein said, and if you're going to engage everybody in a process, if you're going to make it work for everybody, you got to simplify it. And so when we look at these tools, rather than have it be add ons, it is change, but it's changed towards something that will be better, more simple, hopefully easier to navigate as a caregiver, as a patient, et cetera. And when we anchor the work we're doing to one of those two things, simplification or proactive care. Our caregivers understand why we're doing it, and then they just need to know how will that impact towards that. And that's one of the things we really try and focus on in our ongoing dialogue with our teams. As we continue to have change coming
- [06:30]
A
our way, that makes a lot of sense because, as you know, the change doesn't seem like it's going to let up anytime soon. And I think to back up just one minute here in a year that was marked by a lot of rapid change, what are some of the recent decisions or pivots required that required the most leadership conviction from you, particularly when it comes to aligning people, resources or capabilities.
- [06:52]
B
There's been a lot of change. The list is long of different things we've done, but I think when you frame it that way is what took the most focus, the largest amount of resource, the largest impact for people, and the largest group that needed to be led through and guided through the change. Our EPIC launch last September clearly was the biggest undertaking we had in the last year. And it had been in the works for a couple of years before that. We had a long planning prep cycle where our teams were building and getting ready. But we had the largest single launch of EPIC in EPIC history last September on the 6th of September. And we had a part of our organization, Colorado, Montana, who joined Intermountain for the SCL merger about four years ago that were already on EPIC. But the rest of the system was on Cerner and a number of other smaller ones, by the way, that were in other places across the organization that we combined all into epic. So that took a tremendous amount of resource and time. Our caregivers did a beautiful job. Change is never easy and it came with its challenges. But I would say the launch went well. We're still through the. Still in the process, getting through the final polishing, and there were a number of areas that are still being built that we knew going in would come later. That's in process now, so still work to do on it. But that was the largest deployment of resource, the largest single change, I think, for all of our caregivers.
- [08:12]
A
And that's a huge undertaking. So I can appreciate everything that went into making that moment happen. And then now, you know, as you continue to iterate and get it into the place that you want it, I can imagine it just continues to become a better, better tool. But in that process, how did that EPIC implementation challenge your assumptions and what did it change about how you approach decision making, talent or organizational readiness?
- [08:36]
B
So there was a lot of planning around that on those very points. And our teams did a beautiful job really coming in and planning it. Probably the biggest area of challenge for me was the idea that we would do it all at once. The Big Bang Theory. We're just doing it. I was part of Intermountain years ago when we launched the Cerner product, which is the product that we transitioned from to epic. And the initial launch, it was scaled across the organization. The initial launch had much more challenge to it than we'd expected. We actually put a hold on the rest of the go lives and to work the bugs out of that. It took us, took us several years to work through the whole system and I was pretty anxious about launching a new ehr. I, you know, having lived through that scenario and so thinking we would do it everywhere and the risk of gosh, if it doesn't go good, we've got a massive challenge was something that I had to work through in my own mind. Why would we do it all at once? And it became apparent that number one, EPIC has done large installs, not quite this large, but they've done large installs successfully all at once. So there was a track record to say this can be done. And when we looked at the disruption of not doing it all at once, that was really the turning point for me. When I stepped back and said, do we want another three year journey of a transition? And you've got some people who are on it, some people who are off of it. You've got staff who actually work between facilities and so they'll go to one and they'll be on the new program, they'll go to another. Beyond the old program, the patient records weren't connected. Then it just became apparent that if it was feasible to do it all at once, it was much better to do it all at once. And so the planning focused more on how do we do that, how do we carry it through in one big move. And our teams did a beautiful job. Yeah, worked hard, planned out lots of scenario planning, lots of prep and design and just really proud of them.
- [10:22]
A
That's amazing to hear and kudos to you and your team for putting that all together and then being able to go through that. Go live. Now. When you think about some of the forces that are reshaping healthcare today, what do you believe leaders should be more decisive about? Especially when you think about balancing the speed risk as well as having the right teams in place.
- [10:41]
B
Yeah, I think as leaders there's so much coming at us and it can be overwhelming for anybody. Our caregivers be overwhelming for me at times. When you look at all the pieces that could be coming in order to see your way through the cloud, I think you've got to have a very clear focus on where are we going. So first off, why are you here? What is it that your purpose is as an organization, as an individual, as a leader, where are we going? And be really clear on that. Like I said, we have our two initiatives, simplification and proactive care, which is extremely beneficial. When all of these things come and you have people in essence lined up Saying, hey, I can do this for you. I can do that for you. I can do this for you. You have to say no to certain things. It may be a great idea, and in fact, you may want to come back and do it later. But right now, these are the things we're focused on, and we've got the two areas. We want all the work we're doing focused there so that our energies are targeted, our resources aren't chopped up. They're actually deployed in a successfully supportive way. And that's how we go about that. We need to get better at it, I'll tell you that. You know, it gets exciting to see the possibilities out there, and it sometimes takes real discipline to pause and not jump at the next thing while you're working down this path. But when we do that, we find much more success.
- [11:53]
A
That makes a lot of sense. And I can imagine, you know, there's people who are very fast and people who are a little more thoughtful at times. And so being able to balance that, you know, really makes a big difference in bringing everybody together, it seems like. Excellent. Well, I'm curious, too. Uncertainty has also become the norm in health care, whether you're looking at some of the policy changes, technology, all of the things we've been talking about today. So what leadership habit or mindset has been most critical in keeping your organization and your people moving forward, especially amid all this uncertainty?
- [12:28]
B
It's a great question, all this uncertainty. And I'm going to tell you a personal story in a moment. But When I became CEO, I met with all the past CEOs. There's five. I'm the fifth in Intermountains history. And they all live in the Salt Lake area, all the previous four, which is usually really good and sometimes a little challenging. And they're people I admire deeply. And I got together with three of them. It was Scott Parker, the inaugural Bill Nelson, and Charles Sorensen. I had lunch with them one day, and I said to them, I want to know not all the good stuff, because I actually know the good stuff. I know the history. I worked in Intermountain in some role under each of their leaderships. I admire each of them. And I said, I actually want to know the problems and how you dealt with them. And it was really interesting to go back and hear their problems, the journeys that they went through, the things that they really struggled with. And now, in hindsight, you go, of course it worked out great. Look, you made great decisions. You did awesome. And they told some of the stories of things they had to Change along the way. That in mind, I want to now go. My wife was diagnosed a little over 10 years ago, 10 to 12 years ago with Ms. And it was a shocking diagnosis for us. It's a diagnosis that apparently often for women comes younger than she was in our journey. But there was real risk with it. And I remember as she and I were trying to process this news, what does that mean? What could that mean? You have this period of you're just suddenly so unsteady on your feet, trying to sort that out. And she was obviously quite impacted by it and a bit distraught might be overstated, but she was quite worried about it. And she was talking to her mother and this was within the first couple of months of the diagnosis. And she said to her mother, you know, life is all of a sudden so uncertain. And her mother stopped and said, becky, it always has been. That statement and that perspective suddenly changed the journey for my wife in a dramatic way and it impacted my journey with her as well. But suddenly she could go back to life as she knew it when she realized I was living at a time when I thought everything was stable, that it wasn't changing, when in reality it's always been uncertain. You know, in our journey of life, we never, none of us know how long we're going to be here. None of us know what challenges lie ahead for sure, but you just deal with it when it comes. And I think that attitude and I look back at these CEOs that I had lunch with and I look at my journey and where we are today. Healthcare has always been a challenging field and we can talk about the speed of change and we can talk about the challenge of moving from one model to another. It's not new. The things we deal with are in ways unique to us in our generation. But this change is process in healthcare is not new at all. And when we get that perspective, I think we can pause and take a deep breath in the midst of it and say it is challenging today. It is fast paced, but actually there's a history behind us and in our organization. We have figured out how to do this now for 50 years. And so our job today is to figure out the next step, not to figure it all out. Leaders before us figured a lot of it out. We figure out what's in our era and leaders after us will figure out more of it as well. It's a different perspective to have, and I think it's an important one. It's always been uncertain in healthcare. There's always been change in healthcare. There's always been challenge in being able to do what we do. In our deep history, we merged with SEL Health. We have the Sisters of Charity of Leavenworth who landed in Leaven. Landed in Leavenworth, Kansas in 1858 with a few dollars in total to their names and went about to do their good and their ministries and went out. Several of our hospitals were started by these sisters as they traveled from Kansas to Colorado and to Montana to mining towns and to take care of people with little to no resource and figured out how to actually build hospitals, how to go get resource in the community. I mean, I don't know any era that's had more challenge than those sisters had in doing what they did. We can certainly tackle our challenges today. And their inspirations, I think in this process, and they should be. And we should look at the histories as ways to inspire us now to lead through what we're facing.
- [16:34]
A
Absolutely. You can really get that great perspective and looking back and understanding how monumental it was to even just move from one place to another back then. But then to set up a hospital and care for communities really puts that mission into perspective. Before we wrap up here, I have one more question. As technology becomes more embedded in daily operations, how are you ensuring that the digital investments you're making support rather than strain your workforce?
- [17:01]
B
Yeah, and I think this goes back to the simplification piece. There's also a piece here that's identity related, which is fascinating to me. And when I look back at the big change we talked about last September, it's the one area that I didn't think about before. We thought about so many different angles. When we were launching, we as leadership were out across the organization meeting with our teams every day, just talking about, how's it going? Do you have the resource you need? We wanted to support. Well, and one of my unit, they came up to the desk and they said, good morning. I'm here to talk about the epic change, see how things are going for you. And one lady looked up and said, you don't want to talk to me? And they said, actually, I think I may need to talk to you. Right. I mean, we were trying to understand what was going on. It was obvious that she was not in a good spot and she just broke into tears. And they waited and she came to herself. Her manager was there with her, put their hand on her shoulder and gave her a moment. She recomposed a little bit and then she said, I have been the expert on our ehr. And now he and she Pointed to a young man that was there on the unit, and now he knows more about the new system than I do. It was her identity. And I think in this process, we also have to recognize when change comes, there is a shift sometimes in people's identity, how they identify themselves in the ecosystem. And that was an area that we didn't pay enough attention to. And we need to stop and think about how do people view their role? And do they see themselves in a different way of doing their function? And can they define themselves in that new role as we go forward? I think that's really important in the work we do, is to help people get to that new space as well. And when you look at the investment of it, does it. When you help them through the transition, the change, do you get to a point where it's better? Is this easier to manage? Is it easier to do my job? Is it easier as a patient to get through it? And so when you look ahead and you're making these investments, what are you trying to impact and what is going to be different? Go back to that simplification for caregivers, for patients, for members, for community, what is different for any or all of that group? When you get it done, and if you can't define it and then if you ultimately don't achieve it, then it's a failed investment. So you need to be really clear on that. And the change process adds burden. But if we're changing the right ways, we should be simplifying it and making it easier. So people that have avenues for better success, whether it's my job, my identity, a patient, getting what I need to get out of the system, and if we have something that. And it's not how we measure it on a chart, if I go to you and you're a caregiver and I say, what's different for you now? And you can tell me how it's better, or if you're a patient and I do the same thing and you can tell me how it's better, then that was successful.
- [19:46]
A
I love it. Rob, thank you so much for joining us on the podcast today. This has been such an inspiring discussion. I really can tell your passion for what you do and the caregivers that work with you at Interbound is just incredible. So I appreciate your time and look forward to connecting with you again soon.
- [19:59]
B
My pleasure. Thank you for the opportunity to be here.
- [20:02]
A
It.