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Ed Gaudet:
Welcome to Risk Never Sleeps, where we meet and get to know the people delivering patient care and protecting patient safety. I'm your host, Ed Gaudet.
Ed Gaudet:
Welcome to the Risk Never Sleeps podcast. I'm your host, Ed Gaudet, and today I'm welcomed by Aaron Miri of Baptist Health Jacksonville. Did I get that right?
Aaron Miri:
You got it right, yeah.
Ed Gaudet:
And you are the chief digital officer and information officer.
Aaron Miri:
It's a bunch of alphabets in there.
Ed Gaudet:
It's a lot going on there, man.
Aaron Miri:
Digital information officer, that's right, for Baptist Health, you got it.
Ed Gaudet:
All right, man. I used to do my alphabet with cereal in the morning so I could probably find enough letters to.
Aaron Miri:
We always run out of vowels, that we kind of create words. You always run out of vowels like, man, never enough of them.
Ed Gaudet:
Exactly. So tell us what's going on at Baptist Jacksonville. So there's a lot going on, right?
Aaron Miri:
A lot. And so Florida. Let's take Florida as a macro example.
Ed Gaudet:
Yeah, how's that?
Aaron Miri:
About a thousand people a day moving to Florida, just under 100 people a day, moving to northern Florida. So our region is booming in growth. To put that in perspective for you, at the height of when I was in Austin prior to COVID, they were about 85 and 90 people a day moving to Austin. So we're on a pace and a clip that is either as good, if not better, than Austin, Texas. Now, why, right? Favorable taxes, favorable climate? Quite simply, it's affordable still. They rank Jacksonville as the second-best city to live in outside of Tampa in Florida because of affordability, you're on the beach. It's sunny, like 300 days out of the year. I mean, you have family here, you know this, Ed. It's.
Ed Gaudet:
Absolutely.
Aaron Miri:
Beautiful year-round here. So everybody is like, why am I living in the cold, dead of winter of wherever, when I could just live in a sun and pay a fraction of taxes? So what's happening here is robust growth, robust demographic change of your workforce coming into market, robust demographic change of your patients happening, all good things, and a health system that is a very successful one, largest, independent, locally governed health system in all of northern Florida that is growing rapidly. But when you grow, you start stretching your processes to the max. So we're in a process right now of really revamping our operations, how we become more efficient, more effective to make sure we do a really good job of patient care, which we do, but to make sure that we weed out any inefficiencies and that we're the best possible product in the market. It's the old business adage. To be good at business, be good at business. So it's kind of where we're at.
Ed Gaudet:
That's right. And how does transformation fit into all that?
Aaron Miri:
Yeah, so transformation is part and parcel, is part of doing good business. And what boards of directors have realized, and this is why even my role, when my predecessor retired, they said, we really want a chief digital officer, we don't just want a CIO. It's how do I drive top-line growth from digital beyond just efficiency and EBITDA? Usually, IT was, like, all right, just make me more efficient, build me a better way to crack the walnut. Now, it's, help me engage with the walnut farmers so I get more walnuts to crack, right? Help me engage more with the people that are coming in a way that's smarter and more robust. So my job is as much about PNL and growing share than it is also about being more efficient and putting a new EMR or new back office systems and all the things you normally do as a CIO. It's about that digital engagement. So working closely with our operators, with our marketing team, with our business leaders on how do you get more patients here that have neurological symptoms or more cardiovascular symptoms or more orthopedic symptoms, or, gosh, they want to deliver a baby and they want to start planning in a year. So how do we get in front of them now so that when they do a baby, they want to deliver a Baptist? It's all those pieces fit together.
Ed Gaudet:
Yeah, you had me at EBITDA.
Aaron Miri:
You must be a CEO, Ed.
Ed Gaudet:
Because I can pronounce it now.
Aaron Miri:
Yeah.
Ed Gaudet:
It took me a while, 30 some years.
Aaron Miri:
Right.
Ed Gaudet:
So tell our listeners how you got into healthcare.
Aaron Miri:
All right. So my mom was a nurse, growing up, so I was around it my whole life growing up. Now, I was that weird kid who fell in love with tinker toys, ... tinker toys and light brights and then eventually migrated to word processors, when they became, they got off the computers and they were Tandy word processors and then had the orange screen, if you recall that. So I would write a lot of stuff on there typing and taught myself at that time. And then eventually the early languages of C and Pascal and COBOL.
Ed Gaudet:
Pascal.
Aaron Miri:
And all these things, yeah. And really just sort of self-taught. And then when classes became available, they started doing computer classes about the time I entered high school, right, this is mid-nineties now, early ninety's, and I fell in love and I was like this is cool, man, I can actually make this thing do what I tell it to do and it's kind of like a power trip when you're a programmer like ha-ha, watch me do this to the mouse, right? So you get really involved with these things. So I got to college and at first I was pre-med. Then I said, everybody dies. You switch at about ten times and I was convinced I was going to be an astronaut one day, that's not going to happen. So then I was like, let me go into electrical engineering. But I realized that it wasn't electrical engineering, I really want to do computer engineering. And that became a degree at that point because it was EE with a CS minor or CS major, and then you could go CSC or C, And so I decided to flip altogether and go to CSC route. And so I fell in love with computers and it happened that I was a developer at Comcast at the time. We were, that's cable systems. We were acquired by Time Warner, I became a free agent, I'm leaving for Microsoft. Like I accepted the job to be part of the team that would eventually help rebuild the kernel for Windows XP to eventually become Windows seven. Didn't know at the time it was their security team, that's what they told me. And so I was like, yeah, let's do it. So I was moving to Seattle and then I get a phone call from Methodist Health System in Dallas, Texas, this is circa 2003, 2004 saying, hey, we're doing this thing called digitizing medical records, want to come help us? I'm like, what is that? That sounds interesting. And being me, right? I always choose the path of, like, the weirdest thing possible. And I'm like, that sounds interesting and weird, let's go do that. I can always go work for Bill Gates later on. That's how I ended up in healthcare. And I fell in love with it, and it ended up being a Rubik's Cube of impossible sorts to fix, and I love situations like that. And for me it's fun and I really find intangible joy helping people. And that's what you get to do in my role, is you get to bring technology solutions to help people. I mean, that's the best thing possible.
Ed Gaudet:
It truly is a unique industry, unlike any other. I entered in healthcare within Imprivata, actually, so that was my first experience in healthcare. And what a wonderful industry. And everyone tells you it's different, but you really don't appreciate the difference and uniqueness of it until you're in it and you realize that first and foremost, the relationships you develop with people are unlike others because the shared mission of healthcare that everyone's a patient, everyone knows patients, everyone has family that's in and out of hospitals. So like I can tell my mother, when she was alive I could tell her, what I did and she got it. And then when she would visit the hospital, she'd say, my son created that. You see that thing you're clicking on? That's my son's. I'm like, Ma, no, that's the keyboard, Mom, it's, I didn't create that.
Aaron Miri:
... keyword ... Podcast, right? No.
Ed Gaudet:
That's right. But occasionally she get it right. She'd see the badges, like, yeah, I was part of that. It was so interesting. And I love some of the innovations you're driving as well at the health system. So you want to talk more about that? I saw some recent news clips on some of the innovations. Do you want to talk a little bit about?
Aaron Miri:
Yeah. So what's cool about this? One of the reasons I came here was the desire. From your frontline staff all the way to the board of directors, what to do more with digital. Kind of, like I was telling you about a little bit ago, and really engage this community in a way it wants to be engaged. I mean, that's great lip service until you get in it, right? But I felt really confident that, okay, eyes wide open, I've been here now 18 months. This seems to be an organization that really, really wants to be a leading edge. And it is, so now being here for a year and a half through and through, it absolutely is. And so some of the things that I've been able to do, number one, we rolled out our own low code platform to allow for our nurses and doctors to write their own software. They no longer have to rely on me to do anything. They can write their own stuff and they've already built five apps, they're about to launch their sixth one this week of stuff they would have just built in Excel or Microsoft Access database because that's all they had at the time. But I gave them a drag-and-drop the low code platform and boom, they're creating their own solutions, a push to Baptist devices. Cool, all right. Second thing that we're doing, again, hospitals and healthcare in Florida are doing that. Second thing we're doing, we're the first health system in all of Florida to bring MOXI robots here to deploy side by side with the caregivers, MOXI. And it does all the utility things, right? Get your clean linen, get your food, get blood, all these things, all the stuff that you would have nurse running between floor to pharmacy and back. Now, this robot goes, not unlike if you go to Las Vegas, you see little robots with food trucks carting back and forth to your room, same thing. But it works and it's effective, and it's sterile, and it's made for healthcare environment. So we're doing these things programmatically. Analytics, another dimension we're doing and we're doing high in AI, one of the founding members of Truvada, in terms of a consortium of hospitals that get together to put our data together. We do things at Baptist that I was trying to push the envelope with at UT Austin, but because it's a state institution, you have state regulations for the right reasons. But here I'm able to go faster with a group that's hungry, with a team of people that's brilliant with a part of the country that wants it. So what that materializes to, are these news stories you're alluding to, in national news, I'm now seeing a Baptist in like Iowa showing what we did here at Jacksonville. I'm like, how did my friends at Iowa see this? So it's all because of the people and because of the leadership here. And so I was blessed to make the right decision a year and a half ago and sign the contract, and I'm glad I did. But the reality is this organization's always been that way. And they just needed a digital officer or someone to be the spark behind the innovation, so that's what we're at.
Ed Gaudet:
That's great. And a synonym for the word MOXI is courage, which is one of our values. And obviously, you had to take steps to make those changes and have the courage to move those projects forward and those initiatives forward. And so because of that, I've got something I wanted to share with you today.
Aaron Miri:
Yeah, let's see it.
Ed Gaudet:
... here. And so we honor you, sir, for all the work you do and, you notice I'm undressing.
Aaron Miri:
What are you doing? What are you doing, Ed?
Ed Gaudet:
You know it's going to get weird.
Aaron Miri:
Oh, Ed, risk never sleeps, that's for sure.
Ed Gaudet:
I'm going to take this off here. I'm going to share with you a little bit of something I don't think could see it yet, but. So here we go. Hold on for one second. Move this mic out of the way here. We made a little T-shirt here, the MOXI.
Aaron Miri:
Awesome!
Ed Gaudet:
The MOXI with your logo.
Aaron Miri:
That's cool!
Ed Gaudet:
You'll see. Isn't that great?
Aaron Miri:
That's cool. I got to get some of those.
Ed Gaudet:
Oh, we're going to send you one. We're going to send you one.
Aaron Miri:
I love that. My team will eat that up. That's fantastic.
Ed Gaudet:
Great. Well, you're going to have to get me your wish list of sizes and we'll go ahead and.
Aaron Miri:
Get some MOXI socks. We'll get the whole line going.
Ed Gaudet:
Isn't it great, though, to ...
Aaron Miri:
See a whole product segment here for all your VCs, the whole product line coming out of Censinet.
Ed Gaudet:
All that you do, my friend. So I wanted to share that with you.
Aaron Miri:
Thank you.
Ed Gaudet:
That was not my idea, but I said I would do it, so.
Aaron Miri:
I have a feeling, who on your team recommended that? And I appreciate that.
Ed Gaudet:
Fantastic. Yeah. So I think that innovation is fantastic and I'm sure you've sort of, what is your appetite on Chat GPT? You've been looking at it.
Aaron Miri:
Absolutely.
Ed Gaudet:
What's your take?
Aaron Miri:
I think it's a game-changer. I think that this is where Web3 wanted to go. I think that this was the promise of massive data stores and faster compute. I think this is the promise of the eventual interface of natural language processing into an interface like a Chat GPT, there's a few other ones, right? Nvidia has a decent platform, others, Chat GPT just happen to get the most press time and they get $10 billion infusion of dollars from Microsoft, no problem.
Ed Gaudet:
... Helps. Doesn't hurt.
Aaron Miri:
Microsoft can do that, right? That's great. Here's a check. I wish I could, but I think in healthcare, the promise is this. We right now cannot create physicians and nurses unless they create, graduate them fast enough, right? We cannot find them fast enough. It just takes years as you want them to take years to become proficient at their job. So you got to start really young to recruit them a decade later. That's a long tail. If I can shrink the amount of linkage time and time to get to value for that new grad by enabling them with an assistant like a Chat GPT to accelerate their acceleration to knowledge and new knowledge.
Ed Gaudet:
That's interesting how.
Aaron Miri:
Fast I can now take that ten-year graduate air quotes to become a four-year graduate with just as much knowledge, if not better, with that phone or friend. Kind of like you see, like cartoons, a good angel and the bad angel kind of like that. So you have Chat GPT and you're guessing here on this side, so what if you had that? So there's a whole lot here I see. Or a medical education around patient education and as well as the ability for hospital administrators to eventually simplify the amount of back-office staff you need to do coding, you need to do prior off doing all these things that cost tens of millions of dollars a year, streamline it, help make those agents more efficient and more effective, right? We can't create those folks.
Ed Gaudet:
And I love that. If you think about the history of knowledge, right? So sort of the first version of that, the first application in a big way was Google. Google search engine all of a sudden made us used to say, Google makes me smarter, right? Or lazier as well. And then the next generation, if you will, leverage Google Plus YouTube. So my kids all use they want to learn something, they're on their .... with YouTube. They pick up YouTube and they go, oh, I want to learn how to do this, they watch a YouTube, and all of a sudden they're experts, and your ChatGPTs is that next generation now where you apply all of that exponentially. And it'll be interesting to see how people apply. But I think you're right. It's going to be that it's almost like that equivalent to the building blocks of coding, right? Before you had to write lines of code, then it was object-oriented program than it was low code. And so it's that same type of evolution, but now our knowledge and how we apply knowledge.
Aaron Miri:
I saw a really interesting, I think it was Forbes contributor article that had somebody like extrapolating what ChatGPT could be. And I thought the best analogy was, you know, how we all love and hated Clippy, back with Windows 95? What have you had, a really smart Clippy, I was like, oh, that's a really interesting way of thinking about it.
Ed Gaudet:
That's good. A useful clip ...
Aaron Miri:
I was like, I can still use me some clippy. There's the need for that. That's cool.
Ed Gaudet:
That's so great. It's so great. All right, let's get a little personal. Last couple of years' been really hard on a lot of people. What are you most proud of this past year? Personally and professionally?
Aaron Miri:
Personally, I would say that we moved in the middle of a pandemic, which, again, I love Austin. I will always love Austin. I go back to Austin as much as I can, but moving in the middle of a pandemic is hard, particularly when you have young kids. It's even harder when you moving across the country where there's really no family over here. And it was a leap of faith. And so seeing them successful, seeing my, both my daughters, straight-A students, they both had a blip in their grades the first month we were here. You can imagine the stress of it, but they're fine now, successful. My wife teaching, all the things personally, my personal life it worked, right? And I'm grateful for that, and I'm grateful for the support and for my family support to make that happen, and friends, right, to make sure that my community ecosystem of people came with me to really help make that. So I, that the personal success of that. Professional success, I would honestly say, is what we've been able to do here at Baptist in, like I said, 15 to 16 months that I hear all the time. This would never have happened before, and I'm like, well, it's the same people, it's just a different spark, but it's the same folks. Not like I got rid of 500 or 800 people. Now, these are the same staff. I added a few position players, but I didn't do anything major. Folks were just hungry for it. So I would say professionally is seeing the success of Baptist Health, seeing us in the news, doing things. An EMR swap is never sexy, but it's important and it's hard to do, and do it right and do it well. And we did that well, right? We opened up two hospitals over the course of the year, so it's been a year of change. I navigated two hurricanes, those things aren't easy, right? On top of all the other things you're dealing with, you're dealing with that. And it's important. It's important to get it right, it's important to anchor yourself and all those things. You know, I'm about a year into my PhD program personally, and so that's been interesting doing that also in the middle of pandemic, so.
Ed Gaudet:
I did not know that.
Aaron Miri:
Yes! I had to drop some knowledge on you or drop me shot ... knowledge. It's one of those things that ... You take the time for what's important both professionally and personally, and you make the time for what you want to do, and you surround yourself with the people that you want to emulate and you want to be around. And so when you do that and you have a true north and my north is helping people and being a family man, then you come out the other side and this perspective right?
Ed Gaudet:
Now, that's great. Outside of healthcare, what are you passionate about? What would you be doing if you weren't doing this?
Aaron Miri:
Nothing, Ed, everything but.
Ed Gaudet:
Come on!
Aaron Miri:
Nothing. Nothing. No, I would say honestly.
Ed Gaudet:
I'd be dancing in a casino. I would have seen that.
Aaron Miri:
Sure, I would be, if I'm winning. I would say that, I'm actually a big believer in human psychology and sociology. I love to study the reason for why it makes people think. And I would love one day nothing more than just obsessed with that dimensions of people and persona and management theory. I geek out on that stuff, and it's probably why I became a senior executive, because senior executives have so many problems that I love to dissect and digest. I'm kidding.
Ed Gaudet:
I say that, so true.
Aaron Miri:
Fictitious. But now the reality is I love people, I love making people tick, I love working with folks, I love growing people. I love seeing them succeed, I love showcasing managers in front of our board of directors, like, look at this superstar who you're going to see a lot more of in a decade, watch that.
Ed Gaudet:
Awesome. It's an awesome.
Aaron Miri:
It's the coolest feeling in the world to make somebody bigger than what they are and believe in them and then watch them blossom, I guess I knew it ...
Ed Gaudet:
It's so great when you see people like that years later and you go like, yep, that person worked on my team, and that's right. And they come back to you like they call you for advice still and they're, still reach out to you. Isn't that fantastic? To me, that's what makes us really worth it. So what would you tell your 20-year-old self, that was like last week? So that's why, that's why I stumbled a little bit there. I'm like, wait a minute, isn't he 21 right now?
Aaron Miri:
No, I'm. 25, Ed. Let's get it right, man.
Ed Gaudet:
You look great ...
Aaron Miri:
What would I tell my 20-year-old self? Don't put too much worry into what other people think about you.
Ed Gaudet:
That's a great one.
Aaron Miri:
Do the right thing all the time and everything else works out. Just do right by other people, don't be a jerk, do right by others and keep your head on straight and don't worry about other people. Don't, just keep going so.
Ed Gaudet:
Isn't that.
Aaron Miri:
In you're, in your twenties, you worry so much about what other people think about you, only to get your forties and fifties and realize no one was ever thinking about you to begin with.
Ed Gaudet:
Nobody. And it didn't matter. Like, that's right.
Aaron Miri:
Didn't matter.
Ed Gaudet:
You're so, yeah, that's so great. Yeah. Unfortunately, I didn't have that worry. I, unfortunately, I had no filter either so.
Aaron Miri:
Well. You also admirably served our country and earned the right to .... I don't want to hear that.
Ed Gaudet:
No, thank you, sir. I appreciate that. And I appreciate you and all you do because this is the Risk Never Sleeps podcast. I have to ask you this question. Let's try to keep it clean too. What's the riskiest thing you've ever done, huh?
Aaron Miri:
Oh, and riskiest thing I've ever done. All right. So fun story for you.
Ed Gaudet:
Okay.
Aaron Miri:
This was early on to being a manager. So usually in data science, again, go to data center side before there was cloud, before all these things, you were hosting all these things on big mainframes, right? So you had a bunch of big mainframes.
Ed Gaudet:
This isn't sounding too risky here.
Aaron Miri:
Well, no. Okay. Trust me. Just trust me, that's right. And so we were testing to make sure that there was a clean, a home-run power supply for every single chassis that we had in the data center, right? So you pull the floor panels, you make sure it's plugged in, you make sure both sides is A side and B side, usually for old SAN arrays. But one of them was an old HP SAN array that we really didn't have any idea. Was it truly powered off the same receptacle or not? And we were trying to trace the power lines out. We're like, really can't tell in the back if it's really going to two different PDUs or not. And so I looked at my manager actually, he was a team that was a manager, and I said, hey, just pull the other one out. And if it goes dark, he was like, but Aaron, this is the SAN array for our financial system. So I'm like, how hard can it be? Just unplug it? And if it's dual run, then it will go down. If it's not dual run, we'll know and we'll, we'll be in trouble. We'll know, we'll.
Ed Gaudet:
...
Aaron Miri:
Go home. I'm like, go big or go home, do it. They unplugged it, sure enough, so this is what happens when you have a SAN array. All the lights on the front of the array light up and they start blinking at you, but they don't turn off. It's basically a way for to alert you that one leg went down. So I would say that's the risky known, eyes wide open, risk assumed and accepted thing I have done.
Ed Gaudet:
Wow. Never jumped out of a plane?
Aaron Miri:
Well, I've done that, too. But that's personal.
Ed Gaudet:
You ever bungee jump? Come on. These are riskier than that pulling that wire.
Aaron Miri:
Well, you know me. Yes to all those things. I was trying to keep this work-related, but yes, I've done all those.
Ed Gaudet:
This is risky thing you've ever done in your life. It could be work-related.
Aaron Miri:
I guess jumping out of a plane would equate to one.
Ed Gaudet:
That's pretty risky.
Aaron Miri:
It's pretty fun, though.
Ed Gaudet:
Pretty fun.
Aaron Miri:
Pretty fun.
Ed Gaudet:
All right. Well, anything else you'd like to leave with our listeners?
Aaron Miri:
No, I would say that right now in healthcare, specifically, cyber risk and third-party risk is one of the most important things for a CIO or CTO to get in front of, your board of directors if they're not already asking you about this, will be asking you about this. And is the number one threat vector that foreign adversaries are getting in is via a third-party risk. There's nothing you can do to assume good intent on any of your vendors, but as long as you trust but verify, have a really good plan, check those BAs and make sure that you're putting everything in front of your board of directors and I mean everything, then you will be okay because it will happen to you. It's just a matter of if and not when.
Ed Gaudet:
That's a great way to end this podcast. That's awesome. Thank you very much. And.
Aaron Miri:
You're welcome.
Ed Gaudet:
Thanks, everyone, for listening. I'm Ed Gaudet. I'm the host of Risk Never Sleeps Podcast. And if you are on the front lines of healthcare, protecting patient safety, we salute you and stay vigilant because Risk Never Sleeps.
Ed Gaudet:
Thanks for listening to Risk Never Sleeps. For the show notes, resources, and more information and how to transform the protection of patient safety, visit us at Censinet.com. That's C E N S I N E T.com. I'm your host, Ed Gaudet, and until next time, stay vigilant because Risk Never Sleeps.
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