Episode 12: Visionary Voices with Jim Bilsky

Larry Kaiser:
Hello, and welcome to this episode of Visionary Voices. Today, we’re joined by an old friend of mine, Jim Bilsky, Vice President of Enterprise IT Operations at Baptist Jacksonville.

Larry Kaiser:
For those that don’t know, Baptist Health serves families throughout the Northeast Florida region, with more than 200 primary care and specialty physician practices, children’s specialty clinics, home health care, behavioral health, occupational health, rehab services, urgent care, and I’m sure a lot more.

Jim is a seasoned technology executive known for driving enterprise-wide innovation and leading large, high-performing teams. He has very deep experience building integrated platforms, shaping strategy, and guiding major programs. He’s been recognized for his ability to deliver clarity, growth, and results, and is overall a great guy.

So, Jim, thanks for joining the podcast today.

Jim Bilsky:
Well, thank you, Larry, for having me. Appreciate it. We go back a long way, so I appreciate those compliments.

Larry Kaiser:
Yeah, we do. As I was getting ready for today’s conversation, I was thinking a little bit, and you are one of the first people I met 21 years ago when I got into healthcare IT, when we worked at Keane together.

Larry Kaiser:
So, we go back…

Jim Bilsky:
Back a lot of memories… a lot of memories and a long, long time ago. Probably a lot more hair then too, as well. So certainly an interesting journey and history along the path.

Larry Kaiser:
For sure. I always say whenever I’m looking back, I can’t believe I’ve been in healthcare IT for 21 years now. I look back at our time at Keane, and I still run into many people throughout the industry. It’s interesting to see the different avenues people went. You did the same because when I met you, you were in sales, and you transitioned into your current role. So I’m sure that’s an interesting journey for you. I’m not sure if you want to give our listeners any insight into that journey a little bit.

Jim Bilsky:
Yeah, absolutely. Definitely an interesting career journey, without a doubt. I think it goes along with healthcare as well, right? Healthcare is not static. It’s very dynamic, lots of changes, and I saw that in my own personal career over the years. From when I first started on the software development side and leading the development of applications, to the acquisition of our organization by Keane, where you and I met with another friend of ours, and taking a role on the sales side and leading a sales organization.

Then journeying over to Baptist, where I started my career here on the provider side doing different things. I think along the way, you learn something unique and beneficial as a building block to everything. From building applications, you learn something. Selling them and listening to prospective customers asking questions and what their needs are. Then being on the provider side, and now me asking the vendors questions. I somewhat know how it goes and how it flows.

We certainly learn from that journey across, so it’s definitely been creative, interesting, and very eye-opening as I’ve been able to see all different sides of building software, building systems, selling them, implementing those, and now leading the group from an enterprise operations perspective and how we can bring that all together. Because ultimately, it’s all about the patient and how we provide those services needed for our clinical team members and all the team members that support them across the board each and every day.

So it’s definitely an interesting and fun path.

Larry Kaiser:
And I’m sure the experience of being on the vendor side and in sales has helped you in a way because all the questions that provider organizations used to ask you, in turn, you’re probably asking them the same questions now.

Jim Bilsky:
Yeah, absolutely.

The most fun I have is when I look at contracts because I know what we can and can’t do.

“Oh, we can’t do that?” Yes, you can. Here’s why. Here’s what you can do.

“Oh, that’s a revenue recognition problem. That’s not a contractual problem. That’s a you problem.”

Having been presented with those challenges and questions certainly helps because as we build relationships with our various vendors, you can meet them in the middle and help bridge the gaps and understand where they’re coming from as much as where we need to go from a business perspective of running the health system. We can help bridge that gap and provide suggestions because I certainly have a bank of suggestions that you and I and others created over the years.

You kind of go through that mental Rolodex of, “Oh, that’s answer 23. We could do it this way. How about this?”

It’s all about asking better questions and presenting options so that we can get over things and through hurdles. It’s definitely been a great journey being on both sides. It helps a lot from the sense that I can see it from all angles and gives me that dynamic and 360 view of things.

Larry Kaiser:
Yeah, and we’ve spoken to many leaders in healthcare between our first season and now into our second season of this podcast, and we get to hear a lot of very interesting perspectives. You’re our first guest who came from a sales side of that, so I appreciate the insight that you can bring there. And of course, I would be remiss in saying that we jumped into your journey and completely skipped over our usual first segment of Bandwidth Banter, which is perfectly fine because we’re a podcast and we like to be conversational. Usually we take a few seconds and talk about random stuff and icebreakers to help our listeners learn about our guests on a more personal level. I think it makes it a more enjoyable listening experience when you get to know the person you’re talking to and they can share a little bit about themselves.

Going back in our history, we used to have all sorts of very interesting and in-depth conversations about music with another former friend of ours. So what’s the last concert you saw?

Jim Bilsky:
Oh wow. The last concert I saw…

That’s a great question. Probably goes back a ways. Actually Def Leppard. I was gonna go see them last year in Orlando, but wasn’t able to go see them most recently. But it probably goes back to Def Leppard years ago.

Larry Kaiser:
I have seen them, and they are very enjoyable. The one thing I’ve always noticed about Def Leppard is they literally have the same exact stage setup from the 80s.

Jim Bilsky:
The elevated guitar stands for the guys to stand on.

Larry Kaiser:
And Joe Elliott likes to do his thing, and the guitarist still doesn’t wear a shirt. I’ve always noticed that. All these years later, he must be 70 years old and still doesn’t wear a shirt when he’s on the guitar.

Jim Bilsky:
He must be doing something right. They’re living.

Larry Kaiser:
Must be doing something right, but they are enjoyable.

Jim Bilsky:
Yeah, they definitely are enjoyable.

I guess the other item would probably be Nashville at ViVE.

Jim Bilsky:
Was likewise.

Jim Bilsky:
What’s that? Black Crowes?

Larry Kaiser:
Black Crowes?

Jim Bilsky:
Yes, yes.

I’m not considering that a concert since it was inside, but yeah, close enough.

Larry Kaiser:
As the sponsor of that event, it was a fun show.

Chris and Rich Robinson are two very, very nice guys. I spent a little time with them backstage prior to that. They put on a great set. I enjoyed it quite a bit.

Jim Bilsky:
Yeah, it was definitely an enjoyable evening. So I guess I’ll have to refine my answer. That was the last concert, but going back prior to that was Def Leppard.

Larry Kaiser:
Alright, well, as long as you can say an industry event is where you saw a concert at, I guess that’s okay. Alright, so we’ve had a little fun and reminiscing here, but let’s dive into the meat of the conversation.

Optimum Healthcare IT is based in Jacksonville Beach. Baptist Jacksonville is our hometown hospital. As a resident in the area, I see all of the growth that’s been going on with Baptist Jacksonville. You guys have been going through some significant growth over the past several years. You’re currently building a new four-story emergency and patient tower. That growth is expanding care for children and adults here in Northeast Florida. I’m sure as that building is getting constructed and other M&A activity is going on, it’s a big part of your day-to-day and long-term strategy.

Can you share with us what the organizational growth looks like within the IT department?

Jim Bilsky:
Yeah, for sure.

Probably pretty easy to answer. It’s pretty flat, right? Just like every other organization, we’re challenged across the board on resources and staffing and everything else. One of the things we’ve worked on significantly over the last several years to overcome some of those challenges is standardization. We viciously standardized so that the technology footprint we deploy is the same everywhere where possible to support everything going on in those locations. That gives us a foundation that is very familiar, and then we can train our team to be comfortable with that tech stack, and they know it’s repeatable everywhere else. That’s definitely one of the healthcare challenges. Probably nothing unlike you’ve heard from every other customer or interaction with folks like me.

Do more. Go fast. One of the ways is to reduce variability so it’s not a unique snowflake in every instance.

Larry Kaiser:
Yeah, so obviously I’m sure the use of AI comes into play there quite a bit. AI and automation as you’re standardizing things across the board.

Jim Bilsky:
Yeah, we’re definitely looking at AIOps as a vector to help improve service and delivery. Standardization, templates, gold images wherever possible, and then automate everything to death. If it can be automated, we’re certainly looking at how we automate that so it’s easier across the board. Not only from a deployment perspective when we first open a location and bring the tech into the building, but also afterwards and how we support it. If it’s different, how do we remediate and fix it as fast as possible? Having those standards, that gold image, that automation is critical across the board. It doesn’t have to be these huge endeavors. Everyone tends to think of the big AI initiative as this huge revolutionary item, but if you start small, you can win across the board by taking out a lot of smaller components and achieving a whole lot quickly.

Larry Kaiser:
That makes sense. So from a roadmap or best practices perspective, when it comes to deploying new hardware, onboarding new FTEs, or onboarding consultants in some cases, what does that look like for you? Obviously, with new hospitals popping up and ambulatory clinics opening, how do you approach that?

Jim Bilsky:
We built and worked hard on standardized footprints. We know in a primary care location of X size and scale what we’re going to deploy, so it’s really a mechanical process. We know the construction footprint, we know what’s going to be in there, and we have a standard template that we order and deploy to those locations. They can be brought online pretty quickly from that perspective. It’s not reinventing and reassessing every time.

It’s, “Here’s the standard. Here’s what we’re going to deploy. Here’s how it’s going to look.”

We’re able to scale that way. As you know, Jacksonville and the geography is one of the challenges we have. Baptist Health runs from Nassau County to St. Johns County. We have a footprint down in Daytona, over in Tallahassee, over in Clay County, and there are many miles in between. How do we support those things remotely and quickly, knowing it’s a standardized footprint? We’re looking to further improve that standardization to pull out variations wherever possible.

Larry Kaiser:
And you guys have been live on Epic for what, close to four or five years now?

Jim Bilsky:
It’ll be four years this coming August 26, if I remember correctly.

Larry Kaiser:
So I’m sure once you were on a single EHR, that made this endeavor of growth much easier when it comes to automation and repeatability across the board versus having two or three systems.

Jim Bilsky:
Yeah, it certainly comes into play, but there’s still opportunity even in a variable-based environment. Your network doesn’t really care what kind of traffic it’s passing. So you can definitely standardize on hardware, config, and endpoints. But yes, we definitely leveraged the standardization approach with our Epic deployment to further drive that going forward.

Larry Kaiser:
Healthcare is an ever-evolving industry, and one could argue that every day new technology is popping up. From an IT perspective, how do you balance keeping the ship moving forward with all the applications and technologies you already have in place while also staying leading-edge or bleeding-edge with adopting new technologies and tools that improve care?

Jim Bilsky:
That’s a great question because it’s a difficult balance. From an operational perspective, the ideal state is “fix it and set it.” If it’s not changing, it’s predictable. If it’s predictable, you know everything going on.

But healthcare is exactly opposite. It’s changing every day.

We definitely drive for consistency in operations.

I think it starts with an awesome team. I have a great group of leaders underneath me that help drive the day-to-day and respond to our clinicians’ and patients’ needs pretty quickly.

It’s tech, so it is gonna break.

Anyone who says it’s not is lying.

It’s gonna break. It breaks every day in some areas.

It’s all about how do you respond.

How do you respond to “wow, that’s not working,” or the Rover iPhone device that became bricked for some odd reason?

A great group of leaders drives all those things.

Through that, we also look at what we can learn from the patient experience and clinician experience that we can innovate on and improve.

Take something out of the process. Remove a step or two just to make life easier.

We look at that all the time.

Whether it’s AI and automation, AIOps behind the scenes where we diagnose a problem before it ever hits the user, or private 5G in a location, disaster recovery capabilities, resiliency.

All those things we look at all the time trying to drive forward.

How do we use drones? Is there a way to use a drone for different mechanisms?

I’m really blessed with a great CDIO, Aaron Miri, who supports us in our initiatives and helps drive innovation.

Then we try and fail fast.

If it’s not gonna work, that’s okay. You learn and move on.

Throw it to the side, tweak it, figure out how to make it better, and then go again.

It’s very iterative, very quick. What works? What doesn’t? Then you move on.

Larry Kaiser:
I’ve seen numbers that the average healthcare system has somewhere between 70 to 100 applications. I’ve seen some organizations have well over a thousand.

On average, how many new technologies or applications do you think the organization attempts to implement in a given year?

Jim Bilsky:
We’re probably over 400 to 500 different applications in the enterprise.

We’re definitely on an app rationalization initiative over time. It’s not something that’s one and done.

We standardize on platforms.

Epic from an EMR perspective is the benchmark.

If it can be done there, why are we not using that? Let’s go there first.

It goes back to the opening conversation — how do we remove variability?

If it’s all in Epic, that eliminates interfaces and integration points that could fail.

If I eliminate those data points that could fail, I can have better predictability, usability, and user experience.

We still bring in point solutions though.

Whether it’s RFID, contact center, or other core technologies, we certainly look at those.

But we definitely want to leverage existing relationships and software solutions wherever possible.

Larry Kaiser:
Platforming is an interesting conversation.

We hosted a roundtable event earlier this year with CHIME, and one of the conversations we had with panelists was platforming.

Everybody is identifying what platforms work for them or what their core platforms are.

It used to be back in the day that you had best-of-breed systems, and people kind of went away from that.

Now you have your EMR platform, ERP platform, potentially a service desk platform, and people are saying, “These are our three platforms, and anything else we do needs to see if it happens there first before we bring in another solution.”

Application rationalization is probably the biggest buzzword in the industry these days because everybody needs to do it.

Budgets are tight.

Eliminating unnecessary applications and iterating off your platforms makes a lot of sense.

Larry Kaiser:
With all the growth that Baptist Jacksonville has gone through in the last five to eight years, is there a specific “this is our biggest success story” that you could share?

Jim Bilsky:
That’s an interesting and difficult question because we do so many things supporting the organization and health system.

Obviously our success with Epic and our Honor Roll Gold Stars achievement in such a short period of time is huge.

I think we as an IT division and organization all contribute to that success.

It goes from how we support the clinician workflow and documentation to how we patch and stay current in the operating system to meet all those requirements.

I think that’s a huge one.

Being three-and-a-half-plus years into Epic and our achievements there have been stellar from my perspective.

If we dive deeper and look at individual accomplishments, our service level on the service desk has improved.

Our team members have faster response, easier means to get help, and we’re more proactive across the organization.

All of those are small items, but they add up to a lot.

It’s a tough question because I joke with the team that no one ever calls me to say, “Hey, my Wi-Fi experience was great today.”

No one’s calling to say, “That phone call I made just was awesome.”

A lot of what the team does is behind the scenes, and we only hear about it when it breaks.

So we learn that early on.

We do a lot of rounding. We listen to clinicians. We observe.

We try and find things we can improve upon.

All of that contributes to success.

If no one calls, that’s probably a really good day.

But no one calling doesn’t mean it’s all good, which is why we go out there.

Clinicians don’t have the luxury of getting on the phone and calling. There’s a patient at the other end in the emergency room or OR.

We have to be visible and out in the field to make sure what we believe is occurring is actually occurring.

So we do a lot of that as well.

Larry Kaiser:
I’m gonna say that’s probably one of the best answers I’ve gotten for a question like that.

I think an interesting piece to add to that would be the feedback from your patients.

As a resident who uses Baptist South, my daughter was born there, I’ve been in the ER there, my wife has, my daughter has gone to Wolfson’s ER there.

The level of care is phenomenal.

I’ve never once been there when there was a software outage, network outage, or anything.

Kudos to your team because I’ve always had a great experience at the hospital.

Jim Bilsky:
Yeah, for sure.

It’s tough. There are thousands and thousands of moving pieces and things that happen.

Jacksonville’s growing. Lots of road construction and housing construction.

One misplaced backhoe and we have problems.

Certainly redundancy and connectivity are things we worry about all the time and monitor.

But again, we don’t want to rely on no one calling to say everything’s good.

We have to be out there observing and being present.

As our CEO says, we’re a people organization. We’re not a tech company.

Everything at the end of the day is a clinician and a patient.

We try and mirror that as well.

We’re visible. We’re out there.

And when things aren’t right, we want to own it and fix it.

Larry Kaiser:
Usually I like to finish these conversations and ask if you have recommendations or advice to give, but I would just say listen to what you just said.

You’re a people-first organization, and everything you just said from an IT perspective is a blueprint on seeing how well you’re doing as an organization and making sure everything, as Steve Jobs used to say, “just works.”

I appreciate that.

I know Baptist Jacksonville is a massive health system with a huge footprint, and I know it takes a lot to keep it running.

I won’t even ask what recommendations you have.

I’ll just say if you need recommendation or advice from Jim, listen to his last answer because that right there is a blueprint.

So, awesome.

Jim Bilsky:
Yeah, it’s interesting you mentioned Steve Jobs because it’s definitely a different perspective.

If you take it from the consumer backwards rather than from the tech forward, I think you’d be much better served.

Look at the experience.

It doesn’t have to be technically beautiful to an engineer’s eyes.

As long as the clinician, patient, or provider thinks it’s great, then that’s the reality.

Take it from the end-user perspective and work backwards, not from the tech stack forward.

Larry Kaiser:
That right there is excellent advice.

Well listeners, that concludes our discussion today on Visionary Voices.

I want to again thank my guest, Jim Bilsky, for joining us to share his insight.

And to our listeners, thanks for tuning in to this episode of Visionary Voices, powered by Optimum Healthcare IT.

And remember, the future of healthcare starts with your vision.

We’ll catch you next time.