Episode 1: Visionary Voices with Northeast Georgia Health System

Larry Kaiser: Hello, everyone, and welcome to Visionary Voices, Optimum Healthcare IT’s conversational thought leadership podcast that hosts digital and technology healthcare leaders to discuss innovation and transformation. I’m your host, Larry Kaiser, Chief Marketing Officer at Optimum Healthcare IT. In this episode, we are thrilled to welcome two visionary leaders from Northeast Georgia Health System: Chris Paravate, CIO, and Stuart Samples, CTO. Together, they’ll share insights into NGHS’s Cloud-First journey. In 2024, NGHS earned the prestigious Level 10 Most Wired designation, the only healthcare organization in Georgia to achieve this recognition for technology innovation. Curtis Hendrick, Senior Vice President of Cloud Services with Optimum Healthcare IT, will be guiding today’s discussion. Chris and Stuart, welcome to the show.

Stuart Samples: Thanks.

Larry Kaiser: So we’re going to get things started today with what we like to call Bandwidth Banter. It’s our fun take on icebreakers for IT professionals. So, have a little fun first, and give a little opportunity for our listeners to learn about you as individuals. Chris, I’ll start with you. And this question can get people riled up sometimes; it can be a little controversial. Is healthcare one word or two words?

Chris Paravate: I’m going with one word. Of course, I’m not exactly the literary giant, so you might want to check that. Words that combine it, or Outlook told me to combine it. I don’t know. Why do you ask me these questions, Larry? They’re so complex, I mean, can we… You know, hypervisors or storage strategy, something a little easier.

Larry Kaiser: Complex, but it’s fun!

Stuart Samples: I love a good noun-adjective compound word question right off the bat. Thanks for that. Yeah, healthcare is both technically right. It can be healthcare, no space, or health space care. The difference for us is we are in healthcare, so it just never stops. Whatever it is, we get it done.

Larry Kaiser: Alright, that seems fair. So then, a follow-up, Stuart. If you were watching TV today, would you watch Friends or The Office?

Stuart Samples: Oh, The Office, for sure! You know, probably less about characters, more about themes. One of my favorites was, the business school to operate the toaster, Google that one, if you’re not familiar. And then Office Parkour. So, you know, we gotta keep it fun.

Larry Kaiser: That episode is fantastic. Chris, what about you, Friends or The Office?

Chris Paravate: I like Friends. You know, so I’m thinking the Beach Farm might be something interesting. Now, see if you know that reference, then you know the answer.

Larry Kaiser: BB.

Curtis Hendrick: Yes, Battlestar Galactica, though.

Larry Kaiser: One-hundred percent. And you know, Curtis and I have this back and forth quite often because we’re both fans of the show. But Curtis, I know what answer you’re going to give.

Curtis Hendrick: Oh yeah, it’s definitely The Office. And definitely Scott’s Tots. You will not find an episode more cringeworthy or awkward on any type of sitcom. So, most certainly The Office.

Larry Kaiser: Yeah, I’ve seen every episode, even the really bad ones at the end, with Ricky Gervais when he was leading The Office. But I think my favorite time is when Michael Scott leaves and you have Jim Carrey, Will Ferrell, and all the different comedians that came in those episodes were just classic. So, alright guys, well, thanks for playing along like I said, that’s just our icebreakers to kind of loosen things up a little bit here. So now, I’m gonna pass the mic over to Curtis, who is ready to lead this really interesting conversation.

Curtis Hendrick: Thanks, Larry. Appreciate it, Stuart, Chris. Again, thanks for joining us here today, and I know we got a chance to chat a bit on stage at Advise recently talking about some of these topics. But I think before we get into that, I kind of want to hear just from each of you, maybe starting with you, Chris, how did you end up in your role at NGHS, how’d you end up in healthcare? It’s kind of a strange place that we all ended up in. Just love to hear everyone’s journey in terms of how they got here.

Chris Paravate: So, I have a running joke with our CEO Carol that I’m completely unqualified for the role because I don’t have a formal degree in any technology. I have a degree in manufacturing logistics. And for those of you who are old enough to remember modems, I was the production line planner for several Hayes modems here in Norcross, Georgia, right out of school. And I hated it. It was miserable. In fact, I have a minor in accounting. And I thought, you know, I could go get my CPA, Hated accounting as well. So, I fell into a technology post-sales implementation role and I loved it. Taught myself C++. I was a master on a VAX. I think we had 2 TB of storage at that time, which was like twice the size of my office now. It was incredible. Wrote my own interface engine, didn’t call it interface engines at that time, and just naturally enjoyed it. But mostly I enjoyed the passion of connecting with customers in healthcare, in a health system. Frankly, it’s like a city of customers, and they all have different needs, but they’re all interdependent. So when I joined Children’s Healthcare of Atlanta, as really my first healthcare gig, I really got to learn so much about healthcare. I would dress out in a bunny suit and go into the OR, and do preference cards, and I would spend time in a pharmacy in the lab and understand how they interact. And then just took off from there. I just always had a passion for how technology can impact the lives of our employees, our providers, and ultimately our patients. And that’s something that keeps me up late at night, and gets me up early in the morning.

Curtis Hendrick: So, did you, or did you not, configure token ring networks with BNC connectors?

Chris Paravate: There was no token ring.

Curtis Hendrick: Okay. I was just curious. Maybe.

Curtis Hendrick: Alright. Okay. Fine.

Chris Paravate: If anything. I’m not even sure, Curtis, you were alive.

Curtis Hendrick: Fair enough, fair enough, all right. Thank you for answering that very controversial question. Stuart, how about you?

Stuart Samples: Yeah, so interesting journey as well. I actually have a degree in biology. And when I graduated from university, I ended up at a biotechnology company. It was wildly sophisticated, and I kind of fell in love with the technology side of the business. But never, never left the human health side. So I have been all over the place, done all kinds of interesting things, but have always had a passion for people, and when I had the opportunity to come to NGHS, it really felt like a homecoming for me. Because I had been working in technology for a number of years. In various different leadership roles and technical roles. But to come here and work as a CTO and to help Chris with this transformation, it’s really just been fantastic. So for me, it’s a fun journey and just learning every single day.

Curtis Hendrick: That’s the consistent theme throughout probably all of our careers, right? We have to learn every day to keep up with this stuff. So what keeps you guys passionate about the roles that you have and the impact that you’re making?

Chris Paravate: You know, on the technical side, it’s, you know, I kind of joke that I have some mad batch skills, right? I mean, give me some C++, put me on a green screen with a monitor that’s three feet deep. And you know, that’s a homecoming, right? But technology is always changing, right? And so you’re constantly evolving and growing and looking at how to apply that technology in your environment. What’s neat about healthcare is that you can directly touch every patient in your community. In fact, I tell my staff that you will impact more patients’ lives than any one provider will in a lifetime of medical care. I mean, that’s incredible. Right? And these people you know, when we are taking care of patients, we’re not only taking care of their medical issues, we’re dealing with a lot more, a lot more complex situation, family issues, socioeconomic issues. And so I really need those clinicians to be in the moment to be able to demonstrate the most compassionate and most complete care. And I think technology helps us to enable that and you know it. What we worked on last year is funny. We had just come from a Senior Staff meeting, and someone said, “Oh, my gosh! You know, when you deployed some resources to help build out this unit for one of our hospitals.” “It’s really helping us right now, because we have a hundred patients holding in the emergency room, and we would have had 120 holding in the emergency room.” and I don’t even remember that project, right? Cause it just, it’s going so fast, so it’s a great place to be. It also can be a bit daunting. Because that learning curve is intimidating. And you know, you come from ViVE and you come from other activities. And you’re like, “Oh, my gosh! All these things I need to do, and all these, how does this fit together? And how do I fund it? And how do I resource it? And how do I champion that?” And that actually can be fun as well, right? Because, you’re not. What you did last year is not what you’ll do this year, and it’ll be different the following.

Curtis Hendrick: Yeah, that’s awesome, Stuart. What about you? What keeps you passionate about what you’re doing?

Stuart Samples: Thanks so much I really appreciate the question. For me, it’s the evolution that Chris mentioned—looking at the turning point we’re in with the intersection of data, intelligence, artificial intelligence, machine learning, cybersecurity. All of those elements are a constant drive within this industry, not only to improve patient outcomes but also to make things a bit easier for our providers. It’s a tough, tough business. When people come in with those needs that Chris mentioned, it doesn’t stop. So if we can take some burden off our providers, make their lives easier, and result in better clinical outcomes, I think there’s a huge opportunity to really dig in, make smart investments and make smart changes to how we do things from a technology perspective to solve those problems. So I love the challenge.

Curtis Hendrick: Awesome. Well, thanks, guys, I think I mean, on that note, why don’t we dive a little bit into the conversation we’re having previously about the journey that you guys are on and the kind of undertaking this cloud-first strategy that you guys have. And when you guys are undertaking there. So just to kind of set the stage, Chris, maybe you want to share a little bit about what’s going on at NGHS and what kind of journey you guys are undertaking.

Chris Paravate: So, you know, I’ve been in the CIO role for 10 years. And in that 10 years, one of the things that we’ve really focused on is a thoughtful architecture of our technical platforms and in our application delivery platforms. We only have one EMR, right? And not every health system can say that. We only have one of a lot of things, and that’s really fortunate. When people talk about app rationalization, well, we do that every day, every year, all the time, and even in our acquisition strategy, we don’t take on additional applications. We sunset those. And so that deliberate planning also moves into our cloud journey. Now. So about 8, 9 months ago, maybe longer, I have to go back and look at the timeline. But we started looking at what’s the end of life for some of our core systems? What is our end of life around storage? And then we move backward in that timeline and said, Okay, what is our future technology tech platform strategy? And really started to evaluate the cloud. And two particular reasons for that. One is and probably they fit together is cyber resiliency and business continuance. So You know, 10 years ago people would think about disaster recovery as “I had a disaster, and what essential things do I need in order to continue to do operations?” Sure I can register, but I don’t need eligibility. I can place orders. I can do those things, but you know what I don’t need to—I don’t need to place supply orders. Because that’s— we’re not going to do that in disaster. It’s a short period of time. We’re not going to bill. We’re not gonna, you know, do collections. Those are not essential services. And we focused on that. In today’s world, we’re a digital company. We’re digital from end to end, from our patient experience, from the time in which a patient is looking to engage with us, through end-of-life decisions. It’s all on a digital platform, and so disaster recovery or business continuance takes on a very different definition. And so you take those two things converging—this digital world that we now live in—and you add the cyber risks that are present. It really— really speaks to having a more— a more contemporary strategy than what we implemented. And so we closely evaluated, you know: Where’s the industry in the cloud? What’s going on in healthcare in the cloud? Also, what’s our architecture? Because that’s a big part of it, right? It can’t just lift and shift. And if I’m moving legacy systems to cloud, that’s… that’s, it’s almost like I’m paying twice for that. So all these things kind of fit together- in a timing and a sequence for us. Makes an incredible amount of sense. We have a beautiful data center. It’s well powered. It’s well cooled. Stuart’s team is well staffed. It’s not about that. It’s not about, “Oh, I want to get out of the data center business.” I could do the data center business in this region of the country. It’s not incredibly costly. We have a great doctor site, hardened colo site that’s very cost effective. Again, it’s not about that. It’s about what is our cyber resilience posture? How do we make that more effective? And how do we move from a disaster recovery plan to a business continuity plan? And that’s— at, you know, at the highest level—that’s the overall strategy of the “why.” And as we were talking through that as a senior team, you know, sometimes the senior team—a lot of senior teams—will go, “That’s really technical, and we trust you, you know, let’s get to the numbers.” And it’s like, “Yeah, wait a second. First of all, don’t trust me. No.” Because your entire system is running on a digital platform, and for which you need to know that that’s the best decision for the organization—not just trust the CIO to lead you through a technical platform change.

Curtis Hendrick: Yeah, I think, like, the hyper-dependency on technology that healthcare organizations, I don’t even know that everybody understands the extent at which they’re dependent on technology, and what doesn’t work, and how that just brings the business to a screeching halt. Right? I mean, it’s absolutely remarkable. And we’ve done a great job of deploying technology to help operate business, and we have to make sure it works, right? So, I know Chris said a lot of that. Anything you’d add in terms of kind of what’s going on with you guys’ strategy and what’s happening there?

Stuart Samples: Yeah, sure, I think for us, it’s also agility, right? We’re growing. Our population is increasing. Certainly, we’re expanding our business to meet our customers’ needs. So we’ve got to be super agile. And on-premise data center infrastructure—it’s not quite as easy to dial up performance and— speed and capability on those rapid demands as we can do in the cloud. There’s a lot of value in that, especially within a secure and protected infrastructure. So we’re really excited to be able to provide that capability back to our patients and to our business. You know, as we kind of look at that dynamic strategy to grow, having stable, reliable, secure platforms. to your point, it’s table stakes. It’s not— optional. We have to make sure these platforms run and operate, and that they’re always secure, and that they can always fail over in the event of some weird, strange incident or disaster. That’s just reality in our business. So you know, that always-on 24 by 7, 365 is the core of our business because we care for humans. You know, as we kind of move towards that hybrid multi-cloud infrastructure— we’re gonna leverage the best-in-class technologies, working with our architects and engineers and the team at Optimum, to really improve how we run and operate as we transform to cloud. It’s—to Chris’s point—it’s not just a lift and shift. We are genuinely looking at every single application and making sure that we make the best decision for our patients. One by one.

Curtis Hendrick: Yeah, I mean, that’s one thing I’ll commend you guys on as well, too, is, you know, the plan that you laid out, and the timing that you gave it, gave the opportunity to not just rush a migration. It really was, you know, a thoughtful consideration of the different components of your environment. Which I think is gonna pay dividends long-term as you guys realize the strategy. So— no, I know, I mean, I hear from a lot of CIOs and CTOs you know about. I know that there’s some value in the cloud. I know that this is things that organizations are doing, and that these are good things organizations are doing. But they’re kind of, you know- they’ve got a million priorities, and they’re struggling to kind of figure out, “Okay, how do I go from the way I’m operating today to kind of this agile, elastic cloud-first type of environment?”

And you know, you guys aren’t done by any means in terms of your entire journey. But you guys are certainly well on your journey. I think you guys have made a lot of great progress.

What’s some advice you would give to a peer in the industry if they were to ask- you know, “What kind of mistakes do I want to look out for? What kind of things should I be doing right now to make sure that I can be successful on this journey of the right foundation and ultimately achieve?” You know the value we’re trying to get.

Chris Paravate: I guess, you know, I’ll start with that is, you know, our technology, our applications partners are gonna give us end of life on chipsets. I don’t want to talk about end of life of chipsets. It’s in the next 24 months, right? I need to know that way out in advance. I can’t show up to our Finance Board Committee with a multi-million dollar ask in a 12 month window. I just can’t do it. I mean, we got too much stuff going on.

So you know, most healthcare organizations have a 3-year capital investment, maybe a 5-year 7-year capital investment plan. So, you know, if we weren’t talking about the cloud, what I would be doing is I would be earmarking that budget in 2 years out or 3 years out for- 20 million or a 30 million dollar investment in core infrastructure. Right? And so really, all the only thing I’ve done is made a decision on a technology platform that we’re gonna ride on. And you know, I kind of joked about, you know, early on in my career, working with modems and deck systems. The systems are gone right, and guess what? Your core infrastructure will be gone.

It’s just not… We’re evolving and that technology is moving. So how do you decide where is the right point for your organization to be there? And what are the motives? If you believe you’re gonna save a bunch of money moving to the cloud… well, you might save some money. But, I wouldn’t go to the board with, “Hey? I’m gonna save you a bunch of money.” Am I going to? Instead of making it a Capex, I’m gonna make it an OPEX expense.

And how do you bridge that gap? Well, I had a conversation 2 years ago with my CFO about what does that mean? How do we plan for it? How do we make it sure that it’s in our strategic financial roadmap that you’re going to have this operating lift? How does that offset your depreciation? How are you planning that out? So the discussions are often not the you know, to make that kind of leap. It’s the early discussions you have to inform each of your peers. My CFO is my peer about- How do, how do we plan for that? Because it’s coming?

And then, it’s timing for us. The timing is, it’s not rushed. It’s purposeful, it’s deliberate. It’s on a roadmap. Now. While I say that, I also want to move quickly. Right? I don’t want to drag an 8-month project out to a 24-month project. I want to see, you know real results. I want to see us demonstrate business continuance across environments across regions. You know, I want to see that because we also have a board that’s looking at risk.

And much like many health systems, and the number one risk, I believe, for every health system there may be some more immediate risk is cyber and so this is a cyber resilience strategy. Not that you, you know- I think every health system now in the country recognizes they’re gonna have some type of cyber issue. This is part of a business continuance in response to a cyber issue that we would anticipate that we would that we are planning for. And this is how we continue to support that operation.

Curtis Hendrick: That’s excellent. Stuart, what about you? What advice do you have for a CTO peer asking for guidance?

Stuart Samples: Great question. The advice I’d give to another CTO would really be about deeply understanding their application space. It’s easy to claim a handle on the number of applications you manage, but do you really know how those applications are being used? Are they current? Do they have SaaS capabilities? Are they cloud compliant, or will they hamstring you when you start trying to move, manage, or migrate them? Understanding your application landscape is crucial and should be done early to make discussions with the board much easier when you need funding. It’s also about structuring your program and project management to be ready for these changes—it’s not just projects and apps; it’s an organizational change requiring training, education, and adjustments in roles and responsibilities. Lastly, selecting the right partner is critical; this journey is a marathon, not a sprint, and you need a partner that can adjust the pace as needed and stand by you throughout the process.

Curtis Hendrick: The speed of change in technology is immense, even within a three-year plan, and staying updated with industry movements is crucial. It sounds like you both have a well-thought-out strategy and are making significant progress on your digital transformation journey.

Let’s finish with this- Assuming we’re two years into the future and you’ve achieved most of what’s on your current roadmap, what impact do you expect this transformation to have? What changes or benefits should be realized?

Chris Paravate: From a top-level perspective, one of the key outcomes would be achieving a more predictable and consistent spending pattern in our technology infrastructure, avoiding major capital expenditure spikes. We’d also expect to be more nimble, leveraging long-term partnerships with key technology providers like our EMR and ERP systems. Some technologies may come and go, but the core will enable us to rapidly respond to and strategically align with business needs. If we don’t build capability today in our core infrastructure, we risk merely reacting to business demands rather than anticipating and leading them. This transformation is as much about scaling and skill as it is about harnessing technology in a deliberate, sequenced approach with clear outcomes.

Stuart Samples: And to add, the transformation should result in an infrastructure that’s secure, rationalized, efficient, powerful, and agile. We aim to deliver modern applications with ease of use to our end-users, ensuring all platforms are stable and capable of supporting continuous growth and the high-quality care our community expects. Ultimately, this journey is about setting a foundation that allows us to take care of our community better, leveraging technology to meet their needs proactively.

Curtis Hendrick: I appreciate your insights today, Chris and Stuart. It’s clear that your focus isn’t just on technology for technology’s sake but on how it serves your broader mission in healthcare. Thank you both for sharing your journey and strategies. It’s been enlightening.

Larry Kaiser: Thanks, Curtis. And thank you, Chris and Stuart, for this deep dive into your cloud journey and the strategic thinking behind your technology decisions. It’s clear that Northeast Georgia Health System is on a fascinating path. To our listeners, thanks for tuning into Visionary Voices, where we explore the future of healthcare through the insights of today’s technology leaders. Remember, the future starts with your vision. Join us next time for more insights on Visionary Voices.