julio
Jun 26, 2026 15:56
· 34:50
· English
· Whisper Turbo
· 3 דוברים
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Speaker 2 (julio)
sounds good um well i think
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i've been in the health systems for over 25
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years all of my career has been all but health
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care and i've worked in all aspects of the health
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care from the clinics to the medical
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centers to big hospital systems and
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now i'm in the pair with united healthcare
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So really encompassing every facet of
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healthcare.
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And I started just
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dealing with membership,
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how to enroll members,
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what was memorable about,
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and what doctor they belong to.
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And from there,
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I started going up into more database experience,
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doing a little bit of programming.
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making sure that I understood how
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to structure data.
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So if you work with databases,
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you have to learn to structure the data accordingly so that
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you can not only deliver the data,
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but...
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You know what they say,
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garbage in,
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garbage out.
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So you got to make sure that the data is done correctly
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when you put it into the system.
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You know,
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so all those things I had to manage and review and
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take care of as well.
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And then from there,
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I started going up.
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I became a supervisor of a unit,
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just the same database people.
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And then I moved on to managing
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a system.
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But the way I entered into management,
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it was an experience.
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So I was working as a consultant.
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And then I got a call from UCLA
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Medical Center.
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Because they were having some issues with their system where they had
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not processed membership or processed claims.
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And they were behind for six months.
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And so when I went in there,
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I'm like, wait,
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what kind of problems?
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I mean, UCLA has the best system.
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I mean,
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they are known for their health care worldwide.
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Well,
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this particular unit.
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I say we're like 10 years behind when it came to systems.
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They were doing work using Microsoft Access
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to process things.
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But I was a Microsoft Access
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programmer and had developed actual applications in
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Access.
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So when I went in there,
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The first thing,
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and I think this is a lot of the mistakes a lot of people,
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they just go and start typing in,
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start working in and trying to fix the problem.
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And what I ended up doing is I started
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meeting with the leadership.
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What were the issues that they were having?
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what was the process because i needed to understand what the process
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was before it was broken so that i could understand how or
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what to fix or even as i was fixing trying to improve
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the process and not just fix it but if i had a chance to improve the process
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as i was going to look at the issue i was going to do that
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and then leadership
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understands the big picture how things should be running but
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i went and started meeting with some of the actual users because
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they were the ones they're going to tell me exactly what the problems
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they were having uh how it broke and all that
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so at the end it took me about
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Four months for me to be able to take care of the
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issue and actually got up to start processing membership and
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paying their claims.
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And it took another two months for them to catch up to be on par.
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But then I mentioned that,
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okay,
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we got the process working.
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I did some small upgrades to the process,
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but I said right away we cannot have Microsoft Access.
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for handling this type of data because it's not a it does not handle
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security correctly it does not live up to the standards of california or
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the federal government so in the meantime to speed that up
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we moved everything to sql database and then from
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there i started talking to leadership about what was
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the big
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uh future ahead right what was it that they wanted to do
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i understood that part of their plans they wanted to acquire
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seven different
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surgical centers as part of it and i said okay we need to
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think bigger how are we going to grow and as part of
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this unit how are we going to integrate
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with the whole ucla hospital as well which is already
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doing things and how are we going to handle the
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or the patients and all the data that is sent from the hospital so
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that we can become one.
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So I told them to look into
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some of the electronic health records
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systems.
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So we started evaluating different systems.
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And we landed with one,
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which I thought it was,
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at the time,
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one of the best systems that we had for this particular unit.
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As we were in the process already of installing,
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we were 50 % installing this system when
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UCLA Hospital decided to change their core
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system into a system called EPIC.
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That was the big rising system that was used by Kaiser
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and some of the other big hospitals.
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So I said...
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We need to stop.
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And of course,
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leadership looks at you.
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What do you mean we need to stop?
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I said,
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if the hospital is changing their core
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system, we need to reevaluate if
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this is still the correct system.
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In other words,
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I am not afraid to be able to come up and bring in
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risks to people instead of just saying,
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oh, we are too,
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this is too late and let's just continue.
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having to have a major expense already,
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and then having to switch,
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which costs a lot more because now you have already transitioned off your data.
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So we stopped.
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We re -evaluated.
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I met with some of the UCLA medical hospital
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people,
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and we made the decision to transition to the same system that
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they were going to adopt.
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And so it took us longer.
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We were already behind because now we had to undo what we did.
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and catch up with the new
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implementation of the system.
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But we were,
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I think we went with our own implementation eight
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months after UCLA Hospital went with theirs,
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which eight months really wasn't that bad considering the amount of work that we
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had to do.
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But I believe that...
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this not only improve you know this the whole overall
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system because now we can communicate you know with
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one another but i believe we reduce the costs
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right even though um you
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know it could have been possibly that we could have gone well with the
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qnex implemented work for a while but if we wanted
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to grow with
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surgical centers,
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UCLA hospital was not going to put them in this
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QNX.
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It was probably going to implement them.
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So I was looking into that future as well as to what is that they wanted
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to do and implementing a system that was
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going to help them overall.
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Through that process,
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I grew, I was managing the IT
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infrastructure there for UCLA.
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And then an opportunity came working
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for Cedars -Sinai,
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which is another major.
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So UCLA at the time was the number one hospital in
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the U .S.
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Cedars -Sinai was the number two.
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I went to work for Cedars -Sinai and I did the same implementation for them
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because at the time they were using
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a vendor to use all of their systems and
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I was able to bring in that system in -house using EPIC again
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to transform that and be able to accommodate
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to the same thing as the medical center was using overall through
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the system.
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That took me to Optum,
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which I am currently,
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well, actually it was Change Healthcare at the time.
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Change Healthcare wanted to improve their
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processes because all of their information,
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all their systems were being done at a data center
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and they wanted to move their items to the cloud.
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And I really didn't have much experience
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working in the cloud at the time.
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I love the challenges.
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I love to be able to learn and even if it's something new and
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I have no problem rolling my sleeves and get to work and
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trying to understand that which is what I've always done probably
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because I've been an analyst.
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the database and a business.
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So I've done the work.
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And to me,
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at this level now,
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I still believe that it is important for me to understand what's
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happening so that I can guide the people correctly.
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Change Healthcare eventually was bought out by
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Optum.
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And it was great to know that they
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interviewed me and they kept me in the position because
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of the work that I have been doing and transforming that to a cloud.
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And then I was able to remain up to now and
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still doing that kind of work.
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Now transforming the systems to do
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more of AI.
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i think the biggest thing that has helped me throughout my career
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is the ability to engage with the people that
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are running the business see i think in it many
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times they are so focused on the system and
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web programming that they forget who
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we are serving and that's the patient ultimately
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you know it's the patient it's about the patient and that patient
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if it's not happy with how the treatment and how which
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also of course includes the the caretakers but
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if the caretakers are not even looking like if i were to be looking
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at my computer all the time to try to take the notes and not pay attention
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to you you feel disengaged this doctor
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this nurse is not paying attention to me so my job
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to ask questions again is how am I going to facilitate that
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transition because I want also the same thing for the doctor or nurses
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or the caretakers specifically for Libertana who are doing home
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health services right which is
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A difficult part because these patients already
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are not at their best.
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And you want to be able to have empathy as well
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and love for these patients
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to take care of.
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And the least thing you want is an IT system to not conform with
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the care that you're already providing.
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We need to make sure that these
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people who are providing the services
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are still focusing on the patient and not frustrated because the system cannot
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do something.
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for example,
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about a time where I understand that you have a focus on
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the mission of the company.
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So tell me about the time that you have to improve a process
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where speed and compliance and
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operational needs were like intense.
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How did you decide what to do
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fast and what to pay more attention
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and more control?
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I would say the company that right away came to mind was Cedars -Sinai.
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They are about quick pace.
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Let's get it done.
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Let's move.
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Let's get this implemented.
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Anything that you rush is not
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going to work at the end.
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So my question that I always bring up to leaders is what do you
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prefer?
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To meet a deadline or to
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meet compliance?
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Huge difference,
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right?
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We can all meet a deadline and then say,
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well, we'll have all these upgrades and live with upgrades for
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three years just to try to fix the system because it was rushed
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out.
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So I believe that there is a happy medium
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to work with it.
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And I think that as long as the leaders understand,
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as well as the people implementing the system,
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they understand about the deadlines and what it takes.
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I think they're both equally important.
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It's not one more than the other,
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because you have to make sure that we meet the compliance.
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At the same time,
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we cannot have a project that's going to last five years.
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to roll out because by the time you roll it out,
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there's something new and you missed the boat.
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So I think part of the issue is the lack of communication
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or understanding with the leaders or the IT
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Speaker 1 (julio)
people implementing the systems that causes
14:42
S…
Speaker 1 (julio)
a lot of the frictions.
14:43
S…
Speaker 1 (julio)
But I do believe that there is a compromise to be made for both
14:47
S…
Speaker 1 (julio)
where it's okay to have an upgrade.
14:51
S…
Speaker 1 (julio)
But what is the best upgrade to move to the end or
14:55
S…
Speaker 1 (julio)
later?
14:56
S…
Speaker 1 (julio)
And what is the most important part of the project that we can implement?
15:00
S…
Speaker 1 (julio)
And now, I think safety
15:04
S…
Speaker 1 (julio)
and all the other things,
15:06
S…
Speaker 1 (julio)
especially nowadays,
15:07
S…
Speaker 1 (julio)
the security of the data,
15:08
S…
Speaker 1 (julio)
which we hear all the time,
15:11
S…
Speaker 1 (julio)
people hacking into systems because they were not secure enough.
15:15
S…
Speaker 2 (julio)
And how did you...
15:19
S…
Speaker 2 (julio)
Can you tell me that
15:23
S…
Speaker 2 (julio)
approach in a real example?
15:25
S…
Speaker 2 (julio)
And what was the final outcome of that?
15:29
S…
Speaker 1 (julio)
So the original...
15:34
S…
Speaker 1 (julio)
that they had given us at cedars was for us to implement
15:38
S…
Speaker 1 (julio)
this in 14 months a whole system that was externally
15:42
S…
Speaker 1 (julio)
um i said that it was not um
15:47
S…
Speaker 1 (julio)
possible to bring this in 14 months because of the
15:51
S…
Speaker 1 (julio)
amount of changes that we needed to do not only understanding
15:55
S…
Speaker 1 (julio)
that we were going to bring three different vendors systems
15:59
S…
Speaker 1 (julio)
into one and still
16:02
S…
Speaker 1 (julio)
make the system so that it could talk to the existing Cedar Sinai system.
16:07
S…
Speaker 1 (julio)
And again,
16:08
S…
Speaker 1 (julio)
so it was about having the conversations,
16:10
S…
Speaker 1 (julio)
understanding,
16:11
S…
Speaker 1 (julio)
helping with the budgets,
16:14
S…
Speaker 1 (julio)
the amount of people that we needed to bring in.
16:16
S…
Speaker 1 (julio)
Overall,
16:18
S…
Speaker 1 (julio)
I think it took us about two and a half years.
16:23
S…
Speaker 1 (julio)
to bring in the system completely and um but
16:27
S…
Speaker 1 (julio)
you know we reduced the amount of upgrades uh and
16:31
S…
Speaker 1 (julio)
we were functional at the same time so it took
16:35
S…
Speaker 1 (julio)
us a little bit longer but we did it right uh we started doing implementations
16:40
S…
Speaker 1 (julio)
and we kept um
16:43
S…
Speaker 1 (julio)
updates to the leadership so that they understood that the project
16:47
S…
Speaker 1 (julio)
was moving so we broke down the project with different quarterly
16:51
S…
Speaker 1 (julio)
updates and in some cases monthly updates weekly updates depending
16:56
S…
Speaker 1 (julio)
on who needed to know what but they understood the
17:00
S…
Speaker 1 (julio)
amount of the task that they wanted to do but
17:04
S…
Speaker 1 (julio)
it took us about two years and a half to implement
17:09
S…
Speaker 1 (julio)
but again
17:11
S…
Speaker 1 (julio)
I believe that they randomly came with less than 14
17:15
S…
Speaker 1 (julio)
months.
17:15
S…
Speaker 1 (julio)
And sometimes that's what happens,
17:17
S…
Speaker 1 (julio)
is that people just think of,
17:19
S…
Speaker 1 (julio)
let's get this done without realizing the complexity of what needs to be done.
17:24
S…
Speaker 1 (julio)
And every case is different.
17:27
S…
Speaker 1 (julio)
Maybe someone can tell you 14 months and you can bring it in
17:31
S…
Speaker 1 (julio)
eight months.
17:32
S…
Speaker 1 (julio)
But again,
17:33
S…
Speaker 1 (julio)
it's about having those conversations,
17:35
S…
Speaker 1 (julio)
not only with the leadership that's making the decisions,
17:38
S…
Speaker 1 (julio)
the budget,
17:38
S…
Speaker 1 (julio)
the finance.
17:40
S…
Speaker 1 (julio)
but the IT people also,
17:42
S…
Speaker 1 (julio)
because we need the people to do the work.
17:45
S…
Speaker 1 (julio)
But in this particular case,
17:46
S…
Speaker 1 (julio)
it took us two years and a half for us to complete the whole
17:50
S…
Speaker 1 (julio)
project.
17:51
S…
Speaker 1 (julio)
Okay.
17:52
S…
Speaker 2 (julio)
Well,
17:55
S…
Speaker 2 (julio)
can you tell me from your words,
17:57
S…
Speaker 2 (julio)
how do you think that the difference between working
18:01
S…
Speaker 2 (julio)
in IT and in system information
18:06
S…
Speaker 2 (julio)
is?
18:10
S…
Speaker 1 (julio)
I studied three years of engineering and I was working
18:15
S…
Speaker 1 (julio)
on shuttle engines and whatnot.
18:17
S…
Speaker 1 (julio)
I ended up switching to business management.
18:22
S…
Speaker 1 (julio)
And I think that even though at the
18:26
S…
Speaker 1 (julio)
time I did it because I was panicking because a lot of engineering companies were
18:30
S…
Speaker 1 (julio)
in California,
18:30
S…
Speaker 1 (julio)
I think it was the best thing because I understood how to talk
18:34
S…
Speaker 1 (julio)
to people.
18:36
S…
Speaker 1 (julio)
It's not only about the system.
18:38
S…
Speaker 1 (julio)
And I think that's one of the biggest frustrations that happens between doctors and
18:42
S…
Speaker 1 (julio)
IT.
18:42
S…
Speaker 1 (julio)
Doctors want things done.
18:45
S…
Speaker 1 (julio)
And they are very forceful about how they
18:49
S…
Speaker 1 (julio)
want certain things done.
18:51
S…
Speaker 1 (julio)
IT is,
18:53
S…
Speaker 1 (julio)
that's not going to work.
18:55
S…
Speaker 1 (julio)
Let me program it.
18:56
S…
Speaker 1 (julio)
This is how the system works.
18:57
S…
Speaker 1 (julio)
Again,
18:58
S…
Speaker 1 (julio)
I think it's communication.
19:00
S…
Speaker 1 (julio)
If anything,
19:01
S…
Speaker 1 (julio)
I have learned.
19:02
S…
Speaker 1 (julio)
It's not that the doctor is wrong or the
19:06
S…
Speaker 1 (julio)
IT is wrong.
19:08
S…
Speaker 1 (julio)
It's the communication and the lack of understanding for how to
19:12
S…
Speaker 1 (julio)
come to agreements.
19:13
S…
Speaker 1 (julio)
I'll give you another example.
19:15
S…
Speaker 1 (julio)
Even when I came to Optum,
19:17
S…
Speaker 1 (julio)
one of the biggest things I noticed is that they had projects
19:22
S…
Speaker 1 (julio)
that they were lasting months to complete.
19:26
S…
Speaker 1 (julio)
And after they were almost ready to complete...
19:30
S…
Speaker 1 (julio)
There was a change.
19:31
S…
Speaker 1 (julio)
No, we want you to do this and we want you to do that.
19:34
S…
Speaker 1 (julio)
And I said,
19:35
S…
Speaker 1 (julio)
why are people changing their minds at the very end?
19:40
S…
Speaker 1 (julio)
But I understood that there were no specifications written
19:44
S…
Speaker 1 (julio)
anywhere.
19:45
S…
Speaker 1 (julio)
People were just doing the type of work.
19:48
S…
Speaker 1 (julio)
And I think that is so important.
19:49
S…
Speaker 1 (julio)
Part of the process is understanding what is it that
19:53
S…
Speaker 1 (julio)
the client,
19:55
S…
Speaker 1 (julio)
we call them clients here,
19:57
S…
Speaker 1 (julio)
you know,
19:58
S…
Speaker 1 (julio)
the people that we support.
20:00
S…
Speaker 1 (julio)
client, what is it that they want?
20:01
S…
Speaker 1 (julio)
Because sometimes what they want and what they need are two different things.
20:05
S…
Speaker 1 (julio)
So even coming up with something like,
20:08
S…
Speaker 1 (julio)
let's talk about specifications.
20:09
S…
Speaker 1 (julio)
What is it?
20:10
S…
Speaker 1 (julio)
Let's have the conversations.
20:12
S…
Speaker 1 (julio)
And those conversations may seem that may take
20:16
S…
Speaker 1 (julio)
maybe a week or two,
20:17
S…
Speaker 1 (julio)
but it can save you months worth of time
20:21
S…
Speaker 1 (julio)
when you're building something.
20:24
S…
Speaker 2 (julio)
And how do you align when,
20:27
S…
Speaker 2 (julio)
like,
20:28
S…
Speaker 2 (julio)
when,
20:29
S…
Speaker 2 (julio)
as you mentioned,
20:30
S…
Speaker 2 (julio)
right, you work across billing and claims and
20:34
S…
Speaker 2 (julio)
clinical and finance team.
20:36
S…
Speaker 2 (julio)
And tell me about a change that,
20:38
S…
Speaker 2 (julio)
like a moment that...
20:40
S…
Speaker 2 (julio)
the definition of success of all of those areas was different.
20:45
S…
Speaker 2 (julio)
How did you get the alignment and
20:49
S…
Speaker 2 (julio)
what made you sure that they adopt this new
20:53
S…
Speaker 2 (julio)
process?
20:54
S…
Speaker 1 (julio)
So there's two things.
20:57
S…
Speaker 1 (julio)
One is that at the
21:01
S…
Speaker 1 (julio)
end of the day,
21:01
S…
Speaker 1 (julio)
I have to make sure that the policies,
21:06
S…
Speaker 1 (julio)
the
21:10
S…
Speaker 1 (julio)
values,
21:10
S…
Speaker 1 (julio)
the mission of the company are being taken care of.
21:15
S…
Speaker 1 (julio)
And that is going to be a lot more important on whether I
21:19
S…
Speaker 1 (julio)
believe what we are doing is going to work or not,
21:22
S…
Speaker 1 (julio)
right?
21:23
S…
Speaker 1 (julio)
So there is a point,
21:24
S…
Speaker 1 (julio)
and this is one of the things that I have also learned throughout my years,
21:28
S…
Speaker 1 (julio)
that there's a point that we have to learn to agree to disagree.
21:32
S…
Speaker 1 (julio)
It's just...
21:34
S…
Speaker 1 (julio)
Getting the mission done,
21:36
S…
Speaker 1 (julio)
getting the work done,
21:37
S…
Speaker 1 (julio)
right? So I may not necessarily agree with everything that someone
21:41
S…
Speaker 1 (julio)
is telling me I need to do or how we need to go about this.
21:45
S…
Speaker 1 (julio)
And after I have provided the information and they still want
21:49
S…
Speaker 1 (julio)
to go with that,
21:50
S…
Speaker 3 (julio)
you know,
21:52
S…
Speaker 1 (julio)
they are leading for a reason and they probably know more than I do.
21:57
S…
Speaker 1 (julio)
in other areas and I at one point have to learn
22:01
S…
Speaker 1 (julio)
to say okay let's get that done let's get it work because at least I feel good
22:05
S…
Speaker 1 (julio)
that I have already provided my feedback right accordingly so
22:09
S…
Speaker 1 (julio)
this is not about me it's about the company always about
22:13
S…
Speaker 1 (julio)
the company not about me so it's never personal the other
22:17
S…
Speaker 1 (julio)
is how do we implement things
22:21
S…
Speaker 1 (julio)
even again from leadership
22:26
S…
Speaker 1 (julio)
How do we implement processes so that there's buying so
22:30
S…
Speaker 1 (julio)
that people accept it?
22:32
S…
Speaker 1 (julio)
Because not everybody is willing to accept changes.
22:34
S…
Speaker 1 (julio)
Not everybody likes to make changes,
22:37
S…
Speaker 1 (julio)
but sometimes changes are here and there's nothing about it.
22:40
S…
Speaker 1 (julio)
How are you going to sell these things?
22:43
S…
Speaker 1 (julio)
If you don't get the people involved throughout the process,
22:47
S…
Speaker 1 (julio)
they will resist you.
22:49
S…
Speaker 1 (julio)
If you get them engaged throughout the whole process,
22:52
S…
Speaker 1 (julio)
meaning...
22:53
S…
Speaker 1 (julio)
provide demos,
22:54
S…
Speaker 1 (julio)
provide information,
22:56
S…
Speaker 1 (julio)
provide newsletters,
22:58
S…
Speaker 1 (julio)
get them involved,
22:59
S…
Speaker 1 (julio)
seek their feedback.
23:02
S…
Speaker 1 (julio)
I mean,
23:03
S…
Speaker 1 (julio)
this is how the people are going to be using the system anyway.
23:05
S…
Speaker 1 (julio)
So even here,
23:07
S…
Speaker 1 (julio)
one of the things that we always do before we start
23:11
S…
Speaker 1 (julio)
any project, we create.
23:14
S…
Speaker 1 (julio)
team meetings where we first discuss it internally
23:18
S…
Speaker 1 (julio)
and then we open it up and we create town halls
23:22
S…
Speaker 1 (julio)
where people can provide us well we would provide information and then
23:27
S…
Speaker 1 (julio)
we ask them for questions feedbacks about
23:31
S…
Speaker 1 (julio)
what they think and a lot of the fear
23:36
S…
Speaker 1 (julio)
is misconceptions about
23:38
S…
Speaker 1 (julio)
Oh, but if I do this,
23:40
S…
Speaker 1 (julio)
I'm going to lose my job.
23:41
S…
Speaker 1 (julio)
AI is exactly doing that right now.
23:43
S…
Speaker 1 (julio)
People are fearful of AI because they think they're going to lose their job when,
23:48
S…
Speaker 1 (julio)
in fact,
23:48
S…
Speaker 1 (julio)
AI can help you do a better job.
23:52
S…
Speaker 1 (julio)
But if you don't talk about it,
23:54
S…
Speaker 1 (julio)
yes,
23:55
S…
Speaker 1 (julio)
you're going to be fearful,
23:56
S…
Speaker 1 (julio)
and then you're going to not want to implement something that can
24:00
S…
Speaker 1 (julio)
save you more time for you to be able to be less stressed.
24:04
S…
Speaker 2 (julio)
And how do you metric that all the resources you share and everything,
24:08
S…
Speaker 2 (julio)
it's finally implemented?
24:10
S…
Speaker 1 (julio)
It's
24:15
S…
Speaker 1 (julio)
a matter of making sure that per the specifications and
24:19
S…
Speaker 1 (julio)
we have timelines.
24:20
S…
Speaker 1 (julio)
And one of the things that I work on is called Scrum.
24:24
S…
Speaker 1 (julio)
And what I,
24:27
S…
Speaker 1 (julio)
Scrum,
24:27
S…
Speaker 1 (julio)
sorry, Scrum,
24:29
S…
Speaker 1 (julio)
what we do is every day,
24:32
S…
Speaker 1 (julio)
15 minutes early in the morning,
24:34
S…
Speaker 1 (julio)
let's talk about what are the issues.
24:38
S…
Speaker 1 (julio)
How can we resolve them?
24:40
S…
Speaker 1 (julio)
And always share the wins.
24:43
S…
Speaker 1 (julio)
Because if we only shared about issues or things
24:48
S…
Speaker 2 (julio)
that we can resolve,
24:49
S…
Speaker 1 (julio)
right?
24:49
S…
Speaker 1 (julio)
You have,
24:51
S…
Speaker 1 (julio)
I always end up with the wins.
24:53
S…
Speaker 1 (julio)
Because that's what stays with here.
24:55
S…
Speaker 1 (julio)
The wins,
24:56
S…
Speaker 3 (julio)
you know.
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