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TownHall: Creative Rural Healthcare Solutions with Sue Schade and Brian Sterud

Bill Russell: [00:00:00] Today on Town Hall

Brian Sterud: In my opinion and, it can be unpopular. There has to be regulation. Yeah. But it has to be at the right level too, so that we don't Inhibit benefits that we could gain from it. Right,

Bill Russell: My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health.

Where we are dedicated to transforming healthcare, one connection at a time. Our town hall show is designed to bring insights from practitioners and leaders. on the front lines of healthcare. .

Alright, let's jump right into today's episode.

Sue Schade: Hello, I'm Sue Schade, principal at Starbridge Advisors and one of the hosts for the Town Hall Show at this week, health. Today my guest is Brian Sterud, VP Information Technology, CIO and CISO at Faith Regional Health Services in Nebraska. Brian has been in this role for 13 years. I'm looking forward to catching up with Brian today to hear what he and his team and Faith Regional have been focusing on.

So welcome Brian.

Brian Sterud: Yeah. Thanks. It's a

Sue Schade: pleasure to be here. This [00:01:00] should be fun. Let's start by having you briefly introduce yourself and tell us about Faith Regional.

Brian Sterud: I've been in this role for 13 years at Faith Regional. We're located in northeast Nebraska. We cover a pretty, pretty wide geography as it relates to this part of the country and being very rural.

So, I have a multi-specialty physician practice as well with about a hundred providers in addition to the hospital and have responsibility for all of the above. And some of the challenges we'll talk about they go along with it, we'll talk about in the next couple questions.

But really great organization. We do a lot of things that aren't done in cities our size. We have a heart program, a cancer program, so really proud of what we're able to do.

Sue Schade: Great. Well, let's talk about some of the challenges being a rural health system. Let's just start there.

And share what some of the things are that you face as a rural health system that may be a, you know, a big city health system or a big regional health system doesn't face.

Brian Sterud: Yeah, I, a lot of it comes down to, there's a couple different things. And I think maybe we'll talk about workforce a little bit later.

But as it relates [00:02:00] to the rural nature of how we're dispersed, there's a lot of things that we do to accommodate for that. we have patients that could drive up to, Two and a half, maybe three hours to see us. And so, to the extent that we can leverage telehealth, that's very important to us.

That's something that we've been doing for a long time. And that can help in those scenarios. We also have some other ways that we accommodate those things. So we do, and I forget the number. It's a crazy number of, outreach clinics that we do. So our Cardiology program alone I think it's, I shouldn't even say the number.

It's dozens of sites that they go to. So in those circumstances, they go out to a community they're able to partner with a local hospital in many cases and do an outreach clinic. And we have I guess said dozens and dozens of those in order to help serve our patients. So those are, some of the challenges.

There's obviously our team is covering a lot of ground when there are it issues at some of those places. There's about 10 [00:03:00] locations outside of Norfolk where we have permanent clinics.

Sue Schade: So do you have your IT support staff who are in Norfolk there and go out to these other locations that are at some distance or do you have staff based there?

Brian Sterud: Everybody's based here. And we send folks out when they need to be. some of it pre-scheduled. We have affiliate hospital that we provided it services for the last four or five years. There's no ownership. It's just an IT agreement and that is on certain intervals, we will proactively go there.

The rest of the locations are as needed outside of, we proactively round on them. And that's this really pretty simple block and tackle stuff, but I mean, it has dramatically reduced the number of tickets that come in as emergencies. They feel more connected with the organization.

'cause some of these clinics are quite always away from us. And so I think that's really been beneficial.

Sue Schade: So proactively rounding can be beneficial regardless of location. So that's good to hear that [00:04:00] makes a difference for you. So tell me about some of the current priorities that you and your team are working on.

Brian Sterud: maybe completing is the wrong word, but we're getting closer to finalizing an it plan. Obviously that involves all kinds of things. One of the most prominent being, artificial intelligence type of initiative. So we had a very specific session about artificial intelligence and in, and innovation.

And so I kind of lumped those all together just because, some people see different automation processes, they'll lump that in with artificial intelligence, it really isn't. But one way or another, if there's innovation that needs to happen, that's all on a list that we're working through to prioritize.

And I think what I've really tried my best to do is I would like to understand and entertain the problems that we have, and then find ways to solve them. I think lots of people right now are running around with a solution looking for a problem, and especially in artificial [00:05:00] intelligence, things are kind of really, happening fast. And so our goals are to look at what our business problems are and then allow us some opportunity to find a way to solve those problems.

Sue Schade: Great. That seems like a sound approach. Are there any particular projects in that area that you wanna highlight?

Brian Sterud: We're doing things like, just like almost anybody else, like with ambient listening and those sorts of things. Those are certainly becoming very quickly table stakes, I think, for everybody. Mm-hmm. Mm-hmm. and then as it relates to some, budgetary, expense cutting and that sort of thing, I'm involved in a lot of conversations about where there may need be, opportunity across the entire organization and where we may be able to help use technology to help solve that problem and help reduce expenses, whether it's labor or whether it's other sorts of things. So, working through all that right now.

Sue Schade: Okay, great. Great. So you have both the CIO and the CISO role, which maybe is more common for a smaller health system like yours, but how do you [00:06:00] handle holding both of those roles?

Brian Sterud: Yeah, I think the first thing, is that I have a director that works for me. Her name is Emily Crone and she's fantastic.

Without somebody as strong as her, that would be challenging and would require more intervention on my part.

So that's the first reason I say I can do it because she's great. So she

Sue Schade: kinda like a deputy or dealing with operational stuff for you?

Brian Sterud: Yeah. I mean, if we think about what happens on a day-to-day operational it, so she's not called a deputy. she surfaces things to me that require my attention, but otherwise she's handling a lot of day-to-day operations that way.

Okay. So it would be very similar to that type of role in a larger organization. Okay. And then because of that, I can try to split my time. I definitely, the percentage of time that I spend thinking about cybersecurity is obviously a lot more than it was 10 years ago.

Sue Schade: Yeah.

Brian Sterud: I think that's common for everybody.

Yeah. But I try to then fulfill that role and and pay attention to where we have risk. I [00:07:00] work closely with our risk manager and then. Strategically utilizing consulting firms that can help us. I'd be remiss if I didn't mention that, because in order to wear two hats like this, there has to be some reliance in that sense as well.

Sue Schade: So we had a chance to talk early May, and I heard some about your workforce challenges and the fact that you have a college partnership program that you've developed workforce challenges specific to location, a rural setting. So tell us about that and what those challenges are and how you're addressing them.

Brian Sterud: Yeah. We're really excited about it. Really proud of that partnership. And so just to start in a rural area recruiting talent is extremely hard. I think it's hard for actually in an urban area right now too. Yeah. So it's can be very difficult. For us

a lot of times it is either, discovering somebody that grew up in the area, moved away, now they have kids and they wanna be back home. [00:08:00] Those are fantastic. We love those. And then aside from that, it's the ability to then internally develop and develop our talent that we have. So we've done a couple different things with that.

We have our, our field support positions that we have done, created a kind of a junior system analyst or a bridge between that role and that next opportunity. And I think that's gonna help us out. And to try to bring up folks that come into our entry level positions and grow into larger roles that's something

that's been a change for us, and that hopefully produces good results. And then as it relates to the partnership, so at, it's with Wayne State College and so there was a group that came together to look at workforce issues in northeast Nebraska. It involved our state senator at the time, he wasn't, he is now.

And just looking at what can we do to build workforce. And it's actually across other, it's not just it. But a really visionary group that said, tell us what you want. And so myself and some other IT leaders [00:09:00] in the region sar down and had some meetings. And to be honest, these are meetings that people have lots of times and but I would say that actions aren't always swift or happen at all This

thing came together and there was so much priority placed on it. Pretty much everything that we recommended needs to happen was done and built into the program. And the program was started, I mean, very quickly in relative terms and how those things can be turned around. So where we are part of what that program does, then it takes the students through the curriculum in three years and then in the fourth year they're working quote unquote full-time. I think it's like 30 hours as an internship. And they're placed at local businesses. So Wayne, Nebraska is about 30 miles away from us. It's a smaller town, but they actually then built an apartment complex in Norfolk where I'm at. And in that fourth year, you live in this apartment complex and you work for one of these companies.

So. [00:10:00] It takes a while, as you might imagine. And so they only enroll as a freshman. So that takes, those four years to get a first class. The first class was a year ago. Had a great intern there and had a, great experience, and we've hired graduates now, which is the idea, right?

I mean, the idea is that you can get them exposed to our organizations, to the community. Obviously hire them and at least create relationships with people that could benefit downstream later too. So, been excited about it. We've been very involved in it. We have internship opportunities outside of IT as well.

So we've had HR, marketing, finance so that's been a really great relationship with the school.

Sue Schade: Excellent. Well, we all know that pipeline's critical. And we have to really look ahead and be patient, right? They've gotta get through their training program first, or school before they can intern for you.

So do you have interns already that have been through that program or is it too new?

Brian Sterud: yeah, they've been through the program and we've hired as a full-time full-time employee, one that just completed it. [00:11:00] Great. And we've got folks slated to come in. Next year, we give a little bit of gap in the summer as far as coverage obviously, but

Sue Schade: Sure.

Brian Sterud: Yeah.

Sue Schade: Great. And do you require people to be on site live in the area, or are you able to hire people from other states to work remotely?

Brian Sterud: that can be a challenge. we're typically hybrid, so we allow so many days per month. Where they can do remote some of the payroll laws that can get kind of difficult depending on states could be tough to deal with, so.

We allow at certain levels remote within the state of Nebraska. So that helps us a little bit. Outside of that, you have to get a little bit more creative, but typically we're state of Nebraska. Fully remote we do actually restrict that even within the state.

Only if you're at a certain level of position within our IT organization just because we want to build that culture and we want to have the connectivity when once you're at a particular level, then, there's more opportunity that way.

Sue Schade: I'm gonna pivot. Let's [00:12:00] talk about regulatory challenges.

I know you're on the CHIME policy steering committee. What are some of the regulatory challenges that you are all looking at right now and how are you handling them at Faith Regional?

Brian Sterud: Yeah, so I'm very thankful to be on the committee and to serve on that committee. It allows me to be way more informed than I would be if I was not on it.

So, I think that's something people maybe don't think about. I learn and hear of things fairly early on and that allows me to maybe there may not be actions that are taken at that point, but at least it's on your mind. Yeah. And you start to think about what could happen. So that's a

Sue Schade: pitch for

being on the

committee and being involved.

Yeah.

Brian Sterud: Okay. That'd be great. Yep. Get involved, be on the committee, know what's going on. I'll be the first person too, to tell you that I don't like reading contracts and I don't like reading regulations.

Sue Schade: I'm with you totally, Brian.

Brian Sterud: Yeah, they make me fall asleep.

Sue Schade: Yeah.

Brian Sterud: However. that has to be a muscle that you exercise, so to speak.

Yeah. And [00:13:00] also say being on that committee allows me to kind of exercise that skill that I'm weak at. And become way better at it and know what to look for. So, what are we looking at with changes? So obviously there's lots of things right now I'm, watching a lot of things that, that aren't IT related.

What's gonna happen with reimbursements. What's gonna happen with state directed payments? We're very interested in that one. Yeah. Because the state of Nebraska is kind of, in the middle of that conversation.

Sue Schade: Yeah.

Brian Sterud: And so those things can change our reimbursements, and therefore our revenue very dramatically. And depending on which way they go, can change things for us very quickly. Also interested to understand where AI is gonna end up, I think there was a previous administration had, had, begun some conversations about how that would be regulated. That's been rescinded and there's, and so it remains to be seen where that will go.

I

Sue Schade: think that's my opinion, very concerning that regulation on AI would be pulled back.

Brian Sterud: Yes. The problem [00:14:00] that needs to be solved, that relates to AI and healthcare and regulatory, is we need to not stifle innovation. Right. But we need to not have dangerous things occur either.

In my opinion it can be unpopular. There has to be regulation. Yeah. And then, but it has to be at the right level too, so that we don't. Inhibit benefits that we could gain from it. Right,

Sue Schade: right. Bear with you. So I know we're running up on time here. Is there anything else that you wanna highlight before we close that we haven't gotten to?

Brian Sterud: That's a really great question. The one soapbox that I didn't get on that. Okay. That I know folks is your chance Yeah. That I know folks would've expected. Me to say was when we talk about the, I'm super pro-education, so going back to that program that we built, right.

I find that it's. And I don't think a whole lot of people disagree with this but education plus experience is so important in IT. Mm-hmm. And so that's why we were so adamant about the way we wanted that program structured [00:15:00] because we were seeing too many kids. I suppose I can call them kids that were walking outta college with no experience and a degree that somebody told them was gonna make them X amount of dollars.

And in IT, and probably lots of other places, but it for sure, you're not prepared to actually really do a lot of things with just a degree. Yes. I'm also super pro education. It's just that you have to have both. So you gotta get that experience and then get the degree to reinforce the things that you're learning.

I don't believe in having one or the other. It has to be both. And so that's kind of how that program came to be.

Sue Schade: Got it. Got it. Great. Well, that's a great note to end on in terms of our workforce development going forward. So thank you so much for taking time today. I think this has been very

enlightening, and look forward to talking to you soon.

Brian Sterud: Appreciate it. Thank you very much, Sue.

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