Blockchains, Apps, eHealth, Innovating to Save Lives… All in a Day's Work for the Postmodern CIO, Edward Marx/The Cleveland Clinic

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Living a Life in Full is the conversation you always wanted to have with that person who gave an amazing TED Talk, or the author of one of your favorite books, or that inspirational Olympian you always wanted to know more about. It's graduate level conversations with those making a difference in the world and in the lives of others. This show brings you new ideas and approaches so that you can live a life in full. I'm your host, Dr. Chris Stout and I hope you enjoy this episode. This is episode sponsor ATI foundation welcome to another episode of Living a Life in full. I'm Dr. Chris Stout, your host and today's episode is brought to you by the ATI Foundation. ATI Physical Therapy's philanthropic efforts extend their commitment to quality care outside clinic walls by giving back to communities. They touch the lives of thousands of people each year through their ATI Foundation. The ATI foundation is an independent, 501 charitable organization that gives help and hope to children with physical impairments. Since 2003, the foundation has raised over $4 million to assist children with physical impairments in our communities. Often the beneficiary families have mounting debt and are overcome by financial and physical obstacles. Through the work of the clinical and corporate team members, they raise funds to purchase medical equipment, pay medical bills, remodel families homes to accommodate their child's special needs. But more importantly, they give families hope by offering a better quality of life for their child. To learn more about the foundation and ATI, please visit atipt.com welcome to another episode of Living a Life in Full. I'm your host, Dr. Chris Stout, and I'm very excited to have Edward Marks on the show today. Ed, if you don't already know, this is somewhat of the new CIO for the Cleveland Clinic. And congrats on that, Ed. He is a Colorado State University alum with a Bachelor of Science and Psychology and a Master of Science in Design, Merchandising and Consumer Sciences. He's an accomplished guy who I really think has been there and done that. He's a fellow of both the College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society and He's on the college's faculty for their CIO boot campus. For eight years he was the governor appointed chairman of the Texas Health Services Authority, providing leadership over health information exchange for Texas, which I can imagine is no small task. I did not anything at that scale, but some similar stuff with Illinois. So I want to pick your brain about what Texas was like. The College of Healthcare Information Management Executives and the Healthcare Information and Management System society named him CIO of the Year in 2013, which is quite the accomplishment. And Ed, in kind of a cool way, I think, is widely considered one of the top 10 disruptive forces in healthcare. I also consider Ed to be a force of nature because in addition to all this, as if that wasn't enough, Ed serves in professional organizations and on various corporate boards such as some of these companies. You may have heard of hewlett Packard, Cisco, AT&T Microsoft. He's also been an advisor on a number of academic boards. Texas Christian University in Fort Worth, University of Texas at Dallas, and where most of my high school went, Southern Methodist University. He also served 15 years in the Army Reserve as both a combat medic and a combat engineer officer. He's very active in his family life. He's a member of Team USA and the duathlon. And Ed, I got to tell you, I love your scenes from an early morning run, by the way. That so I just love those. He's also a climber. He's published his autobiography which is available on Amazon. It's entitled Extraordinary Tales from a Rather Ordinary Guy, which unfortunately I think is very mistitled as the audience will soon learn from our our conversation. So welcome to the show, Ed.

Thank you, Chris. It's an honor to be part of it.

I'm so happy to have you on. So first off, I have to ask, how do you transition from psychology and design to being a CIO and CIO of the year in medical technology? What was that path like?

Yeah, you know, looking back, certainly I would never have predicted that I would be in technology, but certainly healthcare. I knew when I was a 16 year old janitor at Peterson Air Force Base in Colorado Springs, I was working in their outpatient facility, which was also in a 24 hour ed. And I don't know how to explain it other than I just knew I belonged in healthcare. So I was this janitor and I would clean up at the end of the day, sweep floors, mop floors, empty garbage cans, those sort of things. But there was something about the environment that really drew me and the people that I ran into. Whether they were nurses or physicians or other people working in healthcare, there was just the sense, like, wow, this was my destiny. But I had no idea how it would manifest itself. So a couple years later, as I was preparing to graduate, I knew I would be going to college, which was sort of a mandate, an unfunded mandate by my parents. And so I had to figure out, wow, how can I afford this? And so the Army Reserve offered me a small scholarship and of course, a monthly stipend to join and help pay for my school. And so, being somewhat of a patriot, following my dad's footsteps in the Army, I jumped at the chance. And once I took some tests and was able to pretty much decide on whatever specialty I wanted to partake in, I chose becoming a combat medic. So while I went through that training and served as a combat medic in the Army Reserve, it just reinforced sort of this calling or drawing towards health care. And so I just continued to keep that in the back of my mind, continued to pursue that. And as life went on and my education continued, and I had some choices to make about staying in the city that we lived in and just trying to get a job. So now this point, I had my master's degree. I had become an officer in the Army Reserve. But we wanted to stay in this community of Fort Collins, Colorado, which is where Colorado State University is located. And so we had already sort of set some roots down. And so I was really thinking hard about my career and trying to get my first real job. And so I was naturally, again, drawn towards the health system that was in our town. And so I took a job as a anesthesia tech working inside the operating room. And once again, it just reinforced that healthcare was where I was supposed to be.

Felt like home.

Yeah. And I didn't know exactly again, how, you know, was I going to go to school and continue school and become a PA or a nurse or a physician or. And, you know, by this time, we had our first child. And so the realities of life and making a living were very, very real. And the thought about going back to school, wasn't that really in the realm of possibilities? So, as an anesthesia tech, I was really exposed to different aspects of healthcare, and I was exposed to other people that worked there. And so eventually I got my first salary job after serving the OR for a while in a couple of different roles. But my first salary job was as a physician relations coordinator. And I think that the hiring managers that were in the Office of Strategy figured if I could work and get along with physicians. Well, as I did in the or that I could certainly work in physician relations. And so that's just opened up this other door and really my first professional position salaried and really started me going down this road of healthcare. And again I was still trying to figure out was it going to be strategy, was it physician relations, you know. But I was very young, open, certainly had a lot of different avenues that I could go. But what ended up happening is the IT department had a very large project underway where physicians were able to dial in. So this is back in the day of the 2400 bod modem and physicians so like the early to mid-90s and physicians could very progressive, could dial into this mainframe clinical system and see patients records remotely so they no longer had to be in the hospital. So it was really a great lifestyle enhancer for them. But the problem was with it at the time they weren't the best communicators and they had about a 5% adoption rate. So they asked me, knowing that I had good relations with physicians and I worked in physician relations if I would help them. And I learned about the product and I was like very wowed by the capabilities of this product and help them to sort of evangelize this product. And soon we had about 95% physician adoption. And I began to see just the power of technology and what it meant to the physician from a lifestyle point of view, but also a patient care point of view. Being able to more quickly respond to patients need no matter where they were, as long as they were close to obviously back in those days, a computer. So what happened next? So it's a long answer to your question, but I'm going to bring it around full circle. Here is our second child was born. So our daughter was born. And I won't get into the details, but it was not good. It was a lot of trauma with our daughter getting her out of the womb. And our daughter just did not want to become part of this world. And so it took a lot for the clinicians to get her out. And every time they almost had her out, her vitals went down to zero, her heart rate, both of her life, you know, life signs were down to zero. So they had to get her out obviously because now mom's life was apparel. So they, they managed to get her out and she was born floppy and was very traumatic. But they did revive her. So they revived her, but she had three life threatening situations going on. So they talked to us about life flighting her down about an hour away to Denver Children's Hospital where they had the appropriate level of nursery compared to what they had in Fort Collins. But there was a lot of risk involved. And also it meant a separation between her mom, who is now hospitalized as well, and the baby. And then again, the risks just of the lifeline. But the alternative was to keep her in a lower level nursery close to mom and myself. But then she wouldn't necessarily have the appropriate level of care. So it dawned on me in that moment, and that was the precise moment that I knew what my calling was. It was healthcare technology. Because I realized that same capability that I had been helping it evangelize. We could give that same capability or tool set to the physicians at the Children's Hospital in Denver so they could dial in to the mainframe that we had in Fort Collins and help take care of my daughter so we wouldn't have to fly her out, she could stay with us. And it seemed to be the lowest risk, highest probability of success. So indeed, that's what transpired. We sent tech down to Denver Children's. The doctors, the neonatologists were able to dial in, consult in real time with our pediatrician. And the good news is my daughter had a complete recovery. She in fact graduated from College at age 18. And again, it was at that precise moment that I knew without a doubt that my purpose, my career purpose, was to be able to help leverage technology to enable superior business and clinical outcomes. And I'd experienced it firsthand on the clinical side, and I just knew that my next job absolutely would be in technology. So sure enough, I started looking for new positions and the first one that opened up was also in Colorado. But that's when I became a director level person, but actually in it. So that's what set my career in motion to the point of becoming a CIO of the Cleveland Clinic.

The professional as well as the personal. It sounds really kind of like the harbinger of, you know, the basics of telehealth. I mean, back with what you experienced with your, your wife and daughter.

So, yeah, and when I look back at the use cases of telehealth, that's exactly what it was. But that was 24 years ago.

Wow. Well, and you know, in some ways it's like things are so advanced, and in other ways, things haven't advanced as much as you would have thought they would have. You know, I mean, there's still faxes and, you know, beepers and whatnot. So it's just, it's, it's kind of crazy. So I Just love that story, Ed. I really had no idea. So thank you. Thank you for sharing that. So the traumatic, scary kind of circumstances is the birth of your daughter and the curiosity and kind of growing up in the hospital since age 16 as a janitor and that sort of a thing from there today people call you and literally I've read this, I'll probably put it in the show notes that you are an it rock star. So how does tell us the trajectory, tell us the trail, because I know you've kind of been in a variety of different. You've been in Tech, Texas, you've been in New York, you're now at Cleveland Clinic in Ohio, you've been in Colorado. Tell us the this story, the trajectory of how someone comes from, you know, over the course of this 20ish or so years to be an it rock star.

Well, I think, well, first I have to give any sort of credit to my teams, and that's really the answer to the question as well. I've been so fortunate to work with some pretty amazing people. And so when I think back about, you know, and I'm very concerned about, as I answer this question about what I call false humility. So I'm going to do my best to avoid that. One thing I can do well is put together teams. And so I've been very blessed with some great teams and great individuals. And sometimes it just takes a leader who has some passion to then unleash other people's passions and then remove any roadblocks but get out of their way. And when I look back to, you know, whether it was University hospitals where I first became a CIO 15 years ago, or what we were able to do as a team in Texas Health or New York and now Cleveland, I just think about the team and then the ability to form a team, go through the storming that sometimes required, but ultimately is to let people operate in their gifting. And so I think that's just naturally what happened. I ended up as a CIO before my time. You know, I was at University hospitals. I was in my mid-30s. We had a new CEO come in, he fired the CIO and they started a national search. And they did the typical national search. You know, someone with 20, 30 years of experience and progressive healthcare organizations, academic research, all those sorts of things. And I watched these candidates come through and I knew that, yes, they were much more qualified on paper, but off the paper, I thought, you know, I have the same level of passion, maybe more as they do. And I've got this passion for customer service. And I've got this customer. I mean, this passion for leveraging technology to just make transformational change. And while I can't claim the 20 years of experience or having worked in multibillion dollar organizations before, my gosh, I can. I'll make up for it. I'll form the right teams and I'll work hard and won't rely on past success and just make things happen. So our CEO who's still there, actually, University Hospitals, name is Tom Zenti. This is University Hospitals in Cleveland, Ohio. I went to his office one day, and of course, he knew me because I was sort of the interim CIO while we did this recruitment process. And I just said, Mr. Zenti, you can stop the CIO search. And he stared at me, and he's about six and a half feet tall, and he's looking down at me. I'm about five, eight. And I think he was waiting for me to break a sweat or get nervous or something, but I just. He's like, what are you talking about, Mark? And I just said, look, I can do this. Give me the job. And he just stared me down again. And what seemed like a minute later, he cracked a smile and he said, okay, I'll give you six months. And so I was like, oh, my gosh, what a thrill. And at the same time, I was scared to death.

And I used good news, bad news. Yeah, yeah.

But sometimes you can use fear as the appropriate catalyst to make sure that you take your job seriously, that you do the right things, that you work hard. And so that's what I did. And I immediately started working on forming a team. We called ourselves the Whiz Kids, because the Whiz Kids were the gentlemen who came from the military just after World War II, and they really got the American automotive industry up and running. But they didn't really ever work in automotive, but they had some other skills. And we were like the same. We were all these former military officers, and we're like, come on, we can utilize the same things we learned in the military and leverage them and try and do something great here. And so we worked hard, and it was just the right team. Going back to the team. It was the right mix of talents and skills and experience. And so where we were weak, we brought in people to help strengthen us. And so ultimately, we just made things happen thanks to the team. And then the collaboration, of course, with the rest of the organization. And so that same sort of mindset and that same sort of pattern I just replicated when I went to Texas Health. So I was recruited to Texas Health and Dallas Fort Worth area. And I took that same mindset with me. It's like, I can't do it on my own. Oh, my gosh, if it's up to me, we'll be okay, but we're not going to do anything, you know, good, you know, special. So got to form the right team. So, you know, it was nice. There was already a good team there. We added a couple people here and there just to strengthen things up. And again, my job was just to unleash people's passions, remove roadblocks, and let them do the good things that were in their heart and minds. And that's what they did. So, again, we won a lot of awards. What's called the Davies Award for best use of technology and healthcare. We won some other awards, best places to work, those sorts of things. But I can't take any credit myself. It was really just the ability to form this team, and the team made things happen. So when people say, quote, unquote, rockstar healthcare, it or what have you, I, you know, I don't spend too much time on that. But I just think about how if you think about a rock band, it's never about, you know, just one person. It's really the entire band. It's the rhythm section, it's the drummers, it's the basis, it's the backup singers, it's all the stuff that goes on behind the scenes. So I take that as a compliment, but I quickly to deflect because I know it was never about one person but the team or the band.

Yeah, well, I think I appreciate that. And you know, I think you are a. A modest fellow as, even as evidenced by the title of your book. But, you know, it just makes me think of like you're also able to sort of architect or bring together, you know, a wonderful ensemble. And in that context, you know, letting people play to their skills and being able, like you said, you know, to get through the roadblocks or make it, you know, make their. The work that they need to do, that they have the talent and skill set in, you know, is really the tip of the hat to you in terms of your leadership. And I think your book, you know, really focuses on leadership. I mean, it's, you know, autobiographical kind of a thing too. But you've. In the book, you develop kind of basically 14 principles around leadership. Can you tell us a little bit more about the concept behind that as well as your book?

Yeah, what, what happened was I never set out to write a book. But I would do a fair amount of speaking and I would tell stories because people can resonate with stories. I think people get pretty bored looking at PowerPoints full of words, so. And then, you know, I don't want to tell someone else's story because you could read someone else's story. So I would just tell personal stories about my struggles, about challenges that I've overcome or things I might still be struggling with. And it just resonated. It made a connection with people. And so they were like, write a book, write a book, write a book. So eventually I was approached by a publisher and was able to come to this point in my life where I could set aside some time and write. And I tried to think about, okay, what enabled these, what we call extraordinary tales. What were the things, if I could share with anyone, what sort of things make these extraordinary tales happen? And so when I thought about it, I really boiled it down to these 14 principles that are pretty general and that have to be a special person to possess any of these. And again, that's why the title of the book is what it is. And talking about being just an ordinary person is that anyone, if you grasp these principles and sort of focus on them, you can make. Make things happen. And. And, you know, just like the first one is about risk, boldly, people are so afraid of taking any sort of personal or professional risk. And it's kind of the cliche of no risk, no reward. You've got to take risk. If you want to experience extraordinary things personally or professionally, you have to take a risk. And so I just talk about, and I share stories about some of the risks that I've taken in life. But you can just pick any one of those principles. And it's the same sort of thing where it's like, wow, if you want to do anything extraordinary, again, workplace or personal life, you gotta, you know, grab onto some of these sort of principles. Certainly this is not an exhaustive list, but These are the 14 that really worked for me. And so I just try to encourage people by telling them stories that, hey, if I can do it, and I have a very, very humble beginnings, if I can do it, then certainly anyone can.

That's great. So I've also read some of the things that you've. You've written about in terms of your conceptualizations of, like, the origination of, you know, chief information officers. And I think you refer to them as like, you know, kind of the. The difference between a 1.0 and a 2.0 and a 3.0 or the. The postmodern CIO? Can you share your thoughts with the audience about what, how, what that means and how you conceptualize those variations and kind of where are we today?

Sure. And I imagine it's the same in every profession, not just technology. But that happens to be obviously the one that I'm most familiar with and operate within. The basic premise is if you don't evolve, you're not going to succeed. And so we saw that happening. If you look back in the history of technology, which isn't a very long one, but you had what used to be called data processing, and there was probably a lot of people who refused to go into the sort of the first or second generation of it, and they were stuck in data processing and didn't really see the potential of technology to really transform quality of care. And whether we talk about from the business side or for me, my main heartbeat is the clinical side, but they didn't see it happening, or they saw it but didn't want to change and they just sort of went away and their careers probably just fizzled out and, you know, or they went on to a different career. And then we saw the emergence of the cio. And I don't have precise years for this. This is just sort of guesses looking back on history. But, you know, in the 90s, you saw the emergence of the CIO, maybe the early 90s, you know, moving out of data processing to CIO 1.0, and it was good. They saw themselves a little bit more relevant, a little bit more strategic towards the end of that era, maybe heading up to the 2000s and the whole Y2K situation, you know, maybe sitting at the corporate table for the first time, maybe no longer reporting to a cfo, but really starting to report to a CEO or COO or someone in a more strategic position than your traditional cfo, and again starting to see how you could leverage technology, how you could really impact care. And of course, technology was evolving as well. And you kind of went to this 2.0. And I suspect most CIOs in healthcare today are, are in the 1.0 to 2.0 range. And what I'm really trying to get people to think about is the fact that if we don't move to the 3.0, we will be disintermediated, we will no longer exist as a profession, and that might be okay too. So what I'm talking about there is that given the consumerism of healthcare, you don't need an IT shop anymore. Given how easy it is to do it from a business point of view or clinical point of view. You don't really need this huge corporate IT function. And if you try to insist on that model from the 90s, I think you're going to get disintermediated. I think your organization is going to pass you by. And when I look at some organizations, I see that happening, and I don't mean that on a critical basis, but being part of the faculty for chime, as I think you mentioned in the boot camps that we run, I get to see hundreds every year, hundreds of different IT leaders come through from different organizations. And we talk a lot about this. And I get to see what's going on in their organizations. And then I just get a general feel from conferences and in my peer group and that we haven't moved quickly enough, I think, to this 3.0, which is very strategic reporting the CEO. Typically it doesn't have to be that way, but typically it does in really helping to lead change. No longer reactive, but very proactive. Understanding the technology that's not even here yet and how we might apply it to our business and clinical side of the house. Understanding the clinical side of the house. Understanding the business side, understanding technology. We're in such a unique place and it can be frustrating for me and some others when we see our profession not evolving as quickly as it should because we have the best position to really understand the entire ecosystem, 360 degrees. And so we need to be very proactive and really helping to carry and lead the message, hope for it, and how it can impact quality. And again, the business side, as opposed to just sitting back and taking orders and just waiting and just reacting. We should be hand in hand with our other caregivers, as we call them at the Cleveland Clinic. We should be hand in hand with everyone again, from the business cycle continuum to the clinical cycle, working together, looking out on the horizon. What are the new technologies? How can we do things differently? And so that's what I talk about.

It becomes much more of a contributory, collaborative kind of integration with other C Suite colleagues, it sounds like. And I want to pick your brain about the disintermediation part. I mean, I'm sure there's varieties of this and varieties of distributions and in advances and slower places and things like that. But do you see that as sort of like a hybridization of having your own internal shop, so to speak, than with, you know, using certain vendors for certain products or something? I mean, it's sort of like, you know, no one's going to build their own X ray machine, no one's going to build their own mri. But it still seems like a lot of healthcare systems have this philosophy with, I'm still going to build my own, you know, IT platform or my own own, you know, whatever. What, what are your thoughts about that?

Yeah, I think it's going to come down to the culture of an organization at the clinic. We're pretty innovative organization and I could never see ourselves being dependent on the vendor community. But there's other organizations that might not be as innovative, which is fine too. It's not a bad thing. But it's just important that you know where you stand, where you are, where you stand. And so you might just work with whatever the vendors come up with in terms of innovation. And that's not a bad thing either. I think a lot of organizations struggle with this whole question and it's okay. And there are, there is a great, a fine gray area to work in and that's partnering with vendors to do innovative things. We've done that many, many times. We do it at the Cleveland Clinic, we did it at Texas Health. And that's a really strong way of, you know, leveraging the assets of some of these larger organizations.

Is it the organization becomes sort of like the incubator or the hothouse for collaboratively developing a new tech with benefit to the health system, but by virtue of the collaboration with the vendor?

Yeah, absolutely. Really important to work together because oftentimes the vendors, they obviously don't have a place to really test. They have R and D labs and things of that nature, but they don't have a real world place where they can try things out in a safe way. And so through this sort of collaborative partnerships, you know, you have the ability to. Everyone wins. The patient wins number one, the caregivers win number two. But both the vendor and the institution, the healthcare institution win because they're able to, you know, accelerate the pace of innovation, acceleration of new developments that help our patients. So it's a win win. So I'm a big believer in partnering with vendors. I'm not necessarily going back to, you know, the heart of your question, a believer in doing everything yourself. I don't think that's, that's a good way of doing things, but it's somewhere in between. And again, it depends on the culture of the organization.

Sure, sure. And the activities and things as well too. I mean, I could see larger healthcare systems being very different than smaller clinic based kinds of operations or outpatient surgery centers. Or things like that. So, all right, here's my biggest question and conundrum. I mean I'm sort of a hobbyist in the, you know, the healthcare, medical tech area. And what is the difference, if there is any between M health, telehealth, I health, D health, alphabetical, fill in the blank health, you know, kind of a thing? Are they just sort of synonyms for one another or do they actually have distinguishable differences between them? Or what are your thoughts about all the, you know, the Alphabet soup of whatever kind of health and tech is the latest sizzle?

I think it's two things. It's one, it's pure marketing and another is it's a way of developing a common language so everyone sort of understands. So right now the big thing is digital. Well, so I asked myself, I wrestled. It's funny you asked this question because I finally came to terms with it like right after Thanksgiving. I was like, what is digital? Because I would talk about digital health and you know, I could give you a fluffy answer, but at the end of the day it's nothing. And it's the same with mobile health. Remember E commerce, we don't talk about bank or E commerce anymore. And it's the same with mobile, even mobile. You know, I remember at Texas Health I, along with chief marketing officer, we were responsible for the mobile M health plan, the mobile plan and we had these beautiful drawings. And that's because, you know, mobile was sort of new. You know, the iPhone had only been out a couple years and just more mobile options. And so it just meant about the transition of taking things from, from the computer, a desktop into you know, everywhere, anytime type of environment. But it was the natural extension of technology. And I see the same thing with quote unquote digital, you know, where now we've got the consumerization, we've got more cloud based things being accepted. So this in the concept of taking everything that's sort of manual and just digitizing it and sharing it. And when I broke it down again, it's nothing but the continuous maturation, evolution, if you will, of technology. So there's nothing special about it. So I'm, yeah, you know, I'm, I'm. I almost wrote a post but it might be too much right now to be go this far out. But basically digital is dead because there's no, there's really no such thing.

Yeah, I thank you. I will sleep better tonight. It's been one of those itches that I just cannot scratch kind of a thing. So I, and I makes me feel A little bit better, too. I have to say that you were kind of, you know, wrestling and struggling with that as well, too. And I do encourage you to write that piece. I think that was. Would be a fun, fun read. So I want to go a little deeper into some of the general medical and healthcare it kinds of things. And just recently, you know, I track a lot of this stuff and curate a lot of it on LinkedIn. But one of the surveys I came across, it said something along the lines of 83% of physicians have experienced a cyber attack, a cyber attack in their practices. And in doing my background around you, I found also that you had been quoted as saying that health record security breaches are not a matter of if, but rather than when. Can you say a little bit more about that?

Yeah. You know, let me start off by saying this. I thought I was being pretty bold. One time, I was in a room full of five other CIOs who are from companies larger than my company, and I thought I was being bold by saying, look, I went to my board. This was when I was at Texas Health. I went to my board. And this also in New York City, I went to the board and I said, it's not a matter of if, it's a matter of when. And so I thought again that that was a pretty bold statement. And my peer group, they actually sort of smiled at me and they said, ed, that's nothing. You know, what we tell our boards, we tell them we've probably been breached and we don't know it.

Yep.

And I think they're right. You know, you have to take that sort of stance because you don't want to have this blind spot that you've got it figured out, because as we've seen from the media, all the reports and these are the ones that we just know about, you know, whether it's Scotland Yard, the CIA, other big companies, even security companies themselves, no one's immune. And you, you would go broke if all you did was spend money on security. So you have to make sure you're you. You know, you fulfill the promise. What I talk about is we made an implicit promise to our patients that we will give them the highest quality of care and we will protect their data. And so we're going to do everything we can. And so there's definitely an implicit promise and a balance that we make to do the right thing by our patients and do everything that's reasonable in terms of security. So what I always talk about is resiliency. So I think the key to cybersecurity is resiliency. And I break that down two pieces. The first is, how quickly do we know we've been breached? And the second is how quickly do we mitigate that breach? Because, like, we're talking about, it's probably going to happen or has happened. So how quickly do you identify it and how quickly do you repair it? So that's. That's the best defense. Because like I was saying, there's no way you can defend against it completely. You wouldn't exist as a company.

Right. The expectation that you're never going to have a flat tire, so you don't have a jack and a spare. Right?

Yeah, yeah, yeah. We talk about it like a doctor can never tell you. So you and I are both into fitness and many of your listeners as well, a doctor, you would not believe a physician if they told you, oh, don't worry, don't worry, Chris. You just keep seeing me get your annual checkups, you know, eat right and do workout and you'll never get sick. No, we know that's not true. Something is going to happen because that's life. And unfortunately, the realities of life is the same with cyber security. Something's going to happen now. You got to take the right precautions. You know, you got to eat right, you got to exercise, you got to get your checkups, all those sorts of things. You got to do the right thing, and that's. That's what we do with good security or cyber security plan. But if something does happen, how quickly do you know? So if you get your angel checkups, or if you get your annual pap smear, you get your mammograms, you get your prostate check, all those sorts of things. You're helping to ensure that, hey, maybe if you are getting something, you're going to know about it pretty quickly, and then you can take action or mitigate that. And it's exactly the same with cybersecurity. So routine, you know, you do the right things. The routine checks, the penetration tests. Oh, you know, everything. That's. That's right. Make sure you have the right layers of security. Operate with what I believe to be best practice. However, you also have the best practice ability to know if you have been breached and how to fix it right away. So I just use that medical analogy because that's something obviously in our field that our executives and other caregivers can understand when we use their own terminology to explain our defenses and our philosophies.

I like that. I like that. I mean, again, back to the Story and speaking a person's language. Do you think there's any. I don't know if this is too far afield or too tangential, but of like blockchain applications to protecting EMRs or whatever you know, kinds of security issues there might be.

The blockchain sounds like a great promise for the future and to help with security. And we're starting to see early examples. But I've not personally done anything yet with blockchain. I'm kind of watching from the sidelines to see how people incorporate that. So I know a couple of healthcare organizations that are doing some early endeavors with blockchain and I'm certainly anxious to see how it works out. So by definition, if we could work, make it work, if everyone agreed to a certain standard and that we all developed our PHRs and personal health records and the ability and electronic health records ability to exchange that information with blockchain type technology, I do think it will enhance security. That said, I think there will always be a way for someone to develop any, you know, any counter, you know, antidote to security to, you know, take advantage of some sort of weakness in the chain, in the system. But I do think it does present a great opportunity for us to increase our ability for security.

Yeah, I'm so curious to see what will come. I mean, I totally agree with you. I think I was at South By a couple of years ago and I heard, I'm a big fan but boy of Eric Topol and went to one of his talks and he talked about which, you know, in two years is, you know, is like decades in tech and medical. But he talked about what he referred to as homeless medical data and the disconnects. And it just sort of made me think about my, my mother, you know, of thinking that, you know, well, she's got this one guy she sees for this and this other gal she sees for that and none of them ever talk to one another, even though there's, you know, proper consents and all this stuff, because none of them, you know, share, you know, a lingua franca of a medical record of, you know, based upon my mom kind of a thing. So I think it'll be interesting to kind of see what the evolutions of, you know, the keys to the blockchain, so to speak. If you own yours and I own mine, my mom owns hers. And then the access to know that there may be that homelessness of those data, you know, can find a spot, you know, to camp out at and then it can be accessible. And my big fantasy is then, you know, things like, you know, predictive analytics and big data to be able to take a look, with her permission at whatever data that resides in there and you know, to say, hey, maybe we should tweak the dose of this, or maybe we should, you know, augment, you know, this med with that med, or swap out these, or maybe we should add this diagnostic, you know, to an annual checkup with her, that sort of a thing. So that's kind of my, my sci fi fantasy about where those things might go. So anyway, so I got, I've got a couple of quotes. I'm gonna, I want to dive deep with you. You also once said, my philosophy is that there's no such thing as an IT project. And I just, I thought that was so. I love your provocative comments. I just think that's so cool. So can you unpack what you were thinking or what you meant by that?

Yeah, no such thing as an IT project. So I always think of, you know, it's the same thing with the plans. People say, what is your, you know, top four strategies or top four goals? And I said, I don't have any because I'll point them back. I'll say, let's look at our organization strategy because that's my strategy. So I don't think in a maturable IT organization that you would have a separate plan, that you would have separate objectives because they would all be baked in. They'd be part of the fabric of the organization. I suspect again, based on anecdotal evidence and some qualitative measurements that, you know, maybe only 10% of healthcare organizations, it is at that level, kind of that 3O level, if you will, where they, they don't have a strategy because it's literally baked in to the fabric of the organization. I suspect another 50%, 40, 50% have a separate plan, an IT plan. And then the bottom 40% don't have a plan at all. It's not part of the organization and they just don't have a plan. It's still, it's still, it still surprises me because again, you know, I speak with a lot of leaders and emerging leaders because of these boot camps and things that, that they just don't have a plan plan. So it's really surprising. So going now to the IT project, so a lot of people will talk about, well, we have an IT project and I'm never, I'm not. We don't have an IT pro. What's an IT project? I'm like, well, we have a, a major initiative part of our health system that IT is a big part of and we're helping to enable. But it's not an IT project. We don't have an IT project. So even when we did core technology, like I remember going back to University Hospital, we had a major partnership with Cisco and as a result we were able to become the first healthcare organization in the country at the time to go voice over IP 100%.

Wow.

And so we implemented. But it was part of this communication transformation for the organization. It wasn't an IT project about, hey, everyone's going to get soft phones on their laptops and we're going to get this quote unquote medical grade network and we're going to become enhanced, you know, our ability to be mobile or, you know, tie together video with data with voice. We didn't talk about IT like that, but we talked about this communication transformation for the organization. Because if you talk about as IT project, I think you lose the collaborative effort that you require for success. So people see that, oh, that's an IT thing. And you don't want it to be like that. You want to be led or co led with caregivers who are at the front lines. And so we always talk about, let's not have an IT leader of this particular initiative. Let's find someone in the business or in the clinical business who will lead this effort because the, because it just hurts the probability of success if it's seen as an IT project. And not only that, from a internal marketing point of view, it's a lot easier to get funding for some big capital projects if they're associated with the clinical side and not it.

Yeah, that's good. That's, I think that's excellent advice. That's very, I think it's very timely and just, I really like the, you know, the, the baked in, you know, wording or the, the synthetic aspect that these really aren't, you know, separate kinds of things. I think that's, I think that's brilliant. So in a recent article I also came across, I just love these kinds of titles. It was entitled Pathologists Face Their Deep Blue Moment. Computer Beats Human Experts in Detecting Metastatic Cancer. And gosh, probably about six weeks, two months ago, I gave a talk at a tech conference and I was talking about kind of historically, I think it was just, at least just last year, 2016, that we saw in New England Journal of Medicine and we saw in JAMA that they actually talked about machine learning and predictive analytics and things like that. And, and even one of the articles, I forget which one was which kind of talked about, you know, the Turing Test. And as someone is, you know, is. Is a machine as good as a person? And it seemed like just within a few months when the other article came out, it was like, you know, that wasn't even a question. The issue was that, you know, in, like, radiology and stuff that, you know, very, you know, sophisticated, sophisticated, complex kinds of reads that, you know, machines are doing a bit better job than a human. So it wasn't an issue of, oh, is this machine as good as a human? It was like, wow, you know, the. This trumps a human, you know, left and right, which is kind of what this article was about in terms of detecting metastatic cancer. So my question then is like, thinking about those kinds of things, like, what's your crystal ball say, like, in terms of the impact of these combo packs of big data and predictive analytics and deep learning or machine learning or whatever to medicine and to the kind of work and opportunities that you see.

Yeah, it's very provocative. And I actually look at some of your materials when it comes to some of the predictions that you've been able to make. And by the way, I appreciate the fact that you freely admit about those

that didn't, didn't do such a hot job for 16, I think, or 17

years. You're just ahead of your time.

Yeah, thank you.

I think it's going to be pretty transformative in disruptive. And I think the sooner we grab hold of it and own it and run with it and partner and collaborate with it, I think the better off our organizations and healthcare in general and outcomes and those sorts of things. So I would be afraid to, you know, if I were part of an organization that just said no. Kind of like the data processing managers of the 80s that said, no, no, no, you know, nothing's going to change or I can do it better than something automated. So I think what would be really the best outcome is for us to see the evidence, which a lot of it is out there already, embrace it, and then how do we augment it with that personal touch that's still needed and part of the healing process and that personal insight that maybe eventually, Chris, we'll get there with machine learning. But I think there's still something to the expertise, that emotional intelligence, that hope that a clinician can inspire in their patient to help them overcome that a machine can't. So I think it's still a partnership. I don't think you're doing away with the clinician. But we should embrace it and see what the right mix is, because do you know what I'm talking about? It's like a machine coldly telling you that you have such and such an outcome. Well, you're going to give up. But I hear stories all the time, so I volunteer all the time in a clinical environment. And one of the most common stories I hear, and I happen to volunteer right now at a cancer hospital, and I'm telling you, I hear the same story every week. I probably talk with 10, 15 patients every week, so maybe one or two of them will say what I'm about to tell you. They said, I came here, usually from a far distance, from another state. I came here and I felt pretty hopeless. And the doc looked me over, looked at my information. He said, oh, don't worry about it, we got you. Whereas other doc, other clinicians from some other organization told them, you know, this is it. So they've come to us for second opinion. And the doctor tells them, we got. We're gonna, we're doing this with you. We're fighting this with you. We. I've seen this before and we had good outcome. So you can never replace that, that human touch. So I think it's a combination. Imagine now that clinician with that data, with that human touch. I think we're going to see our outcomes vastly improve. Improve more than it would just with the clinician, but improve more than just would with artificial intelligence and machine learning. It's really the combination of the two. Because again, a machine is cold, can never give you that hope, can never inspire you. These patients were inspired. And I think that's part of one reason that they got healed up is because they got inspired.

They had the humanity as well as the clinical and the technical and the scientific. So good. Yeah, that's. I love the way you frame that. So still keep the crystal ball out. Are there any unicorns out there? Does that come across anything that you see in the boot camps and the different visibilities that you have? I mean, I saw you recently, I think it was not necessarily that this would be a unicorn, but I think it was. I forget if it was Facebook or LinkedIn or something. You posted something that like about these 3D diagnostics and things in medical training where people could like, look at, you know, a ventricle and a heart and, you know, wrote it just, you know, was. Looked like something Philip K. Dick would have written or something, but was in actuality. So do you think there's any, you know, Ubers out there? Any, any medical healthcare unicorns that you've seen?

Yeah, I, I'm certainly not a futurist, but I know people who are and that's who I love to work with, inform teams. Going back to the original premise, but that's one of the reasons I, I wanted to serve at the clinic, was to get back into the teaching and research atmosphere as well as the provider, because it provides a very unique. Collaborate, a very unique recipe for great collaboration and which then can lead to some superior innovation. I think a really good example, and you're referring to it, I don't think we've seen the end of it yet is what we've done with HoloLens. But there's other products out there as well. But, you know, we're redoing the way, you know, the medical classroom, the training classroom has been the same for 100 years. You know, the professor, the physician stands up front, students teaches certain things. They go dissect and cadavers and they look at the human body and learn. It's been that same way for 100 years. And so we're finally disrupting that. So we're opening this new medical campus and it's doing a couple things. One, it's going to, you know, as much, and this is in partnership with Case Western Medical School. So in our, our own medical school that we have. So I don't want to take, I don't want to make it sound like it's old Cleveland Clinic, but it's really a partnership with Case. And so our researchers and educators, you know, they're figuring out better ways of training the next, the next generation of physicians who, you know, grew up as digital natives, if you will. And it just sort of disrupting the way the classroom is, is organized today. And not only that, but what's cool. I just did a tour of this new medical campus. So they're about, I don't know, 50% complete. So the shell is complete. So we were walking inside, it was pretty empty, but we were looking at the different floors and how things were organized. And for the first time ever, you know, you have this one medical campus under one roof. But you have the College of Medicine, so traditional physicians. Then you have a college of Dentistry, you have the College of Nursing, and then the other ancillaries also integrated under one roof. Just like you practice.

Brilliant.

Why train differently? So I think through that there's going to be a lot of aha moments and I think we're going to see some new things. We haven't even Thought about, I do believe there's great hope in AI. I do believe the great hope in precision medicine. I see a day where, you know, but I, before I get, I'll continue on that path. But I just think that that whole integrated campus, the new way of thinking, the new technology to teach, I think is really going to open up some new things that you and I haven't even heard of yet or thought of. But I do think in terms of what we do know now that we're really early stages in with AI and machine learning and predictive analytics leading to precision medicine. I can't tell you the exact stories because of confidentiality, but some amazing, amazing early results that we're having that literally save people's lives and change people's lives for the better. It's just amazing the results that we're seeing. And it's not just us, there's others as well. So I think those are going to get evangelized, they're going to become bigger, they're going to become mainstream. So everyone has that same sort of experience. But I think where we're headed, which would be the ultimate as far as my, you know, vision is, which is probably only a two year horizon, is this whole concept of precision medicine and then, and then the drugs, right, you're, you're, and I don't have the statistic perfect, but it's something like, you know, 50% of the drugs that, that are prescribed aren't really going to necessarily be all that helpful, but it's a best guess, best based on the evidence we do have. But imagine if, based on your DNA and based on your previous history and your family history and all that data coming together, that we know that we can create this drug in real time in our 3D printer that's going to have 90% efficacy instead of 50%. And the more we do that and the more we track the results, the more we share the results and mine those results that 90% might get to 95 and 96 and 97. So I think AI and machine learning and leading to precision medicine, leading to this sort of ability to create your own medicine based on your exact situation. I think that's a big hope for us.

Yeah, I think likewise. I, I can't wait. I think the whole pharmacogenomic kind of thing just is so, so promising and with, you know, much better, the big data sets and stuff, being able to be thrown at that and see what, you know, what comes up. So I want to, this is, this has been, you know, I've. I could spend three hours just diving deep into the tech and whatnot. But I think part of your humanity speaks through this. I mean, even just in what we were talking about, the human aspect of being augmented by maybe better diagnostics or better tech. But I want to shift gears a little bit more so to the personal side. And I know that you also are involved in some humanitarian efforts, Seats of Hope, and some work with. In Tanzania as well. Can you share what your projects are with that and what you've done?

Yeah, I just believe. You know, I'm just so thankful. I. I grew up with parents who survived the Holocaust. You know, my dad is a concentration camp escapee.

Wow.

My mom was not put in a concentration camp, but her family was bombed. And my grandfather, who I've never met, you know, was in the German army and died on the Russian front six weeks before the end of the war. But she was bombed constantly and never finished her education until she was in her 50s in United States and got her GED, that sort of thing. So I grew up with very humble roots. And, you know, we grew up. We're fairly. I mean, we had everything. We had love, and that's the main thing. But when you look back, you know, and you become more affluent, looking back and you're in the United States and not in German rural or Bavaria Germany, you realize, wow, we were sort of poor and we were on food stamps when we came to United States, and we wore the same clothes every day. And so. And then just to begin, you know, this land of United States we're so privileged to be a part of, I just became a very thankful person. I was like, wow, I'm so thankful for the. You know, I can have a different change of clothes every day now that my parents lived through the war, that I could even be created, that I have this beautiful family that I had this opportunity to be a college flunky. You know, I was a flunky at a 1.6 GPA my freshman year. And I still. Someone gave me a second chance. Oh, my gosh. And I went on to graduate and went on to graduate school or, you know, I had trouble, you know, when I was underage with the law, getting in trouble a few times. I was just kind of a bad kid in some ways, but people still believed in me and gave me chances. And so I'm just so thankful. So I just think it's not a right or a privilege, but it's almost like an obligation that we have to give back and whatever we Can. So, you know, so wherever we go, like, we do climb. I've taken a pause in climbing mountains, but for a while there, we're doing one of the seven summits each year, so one of the highest peaks in the world. And we're like, look, we're pretty wealthy people. You know, it's physicians and other executives. And it's like, we're going to these countries where $100 to us is nothing, but to them, that's, oh, that's definitely a year's wage. And so let's bless them. Let's just do something. Let's not just be a typical tourist, go climb Kilimanjaro and come down, but let's do something extraordinary. So that's just one of the tales where we said, okay, you know, for $10,000, which again, dropping the bucket, you know, for, I think there were 17 of us, let's create this medical clinic and this rural community of 10,000 Maasai villagers that have never seen a clinician in their life. They've never seen a band aid in their life, They've never seen an aspirin in their life. It's like, it's easy. It's $10,000. We'll work with the government. And so these things are self sustaining. And so without going into the big story of that particular clinic, you know, but I just do want to say that it's self sustaining, those sorts of things. It has a full time physician, nurse, Africans that are in there, still operates today, and does a lot of pretty cool things for that village. But it's like, we have to give back. And so friends of ours who are missionaries in Mexico, they just started this whole concept of, hey, come to Mexico. Yeah, have a great vacation. You know, there are great beaches and great things. But hey, once you spend half your time helping teach English as a second language language, once you spend half your time in this restaurant that's staffed by people learning how to operate a restaurant and how to be chefs and give back and hey, help these people who just need a. They don't want a handout. They just want a hand to help them gain some skills. So it's like, all right, so every year we go to Mexico for vacation. We do enjoy the beach and other things that people enjoy, but we also spend half our time in the orphanages or with these people that just want not a handout but, but a hand, you know, to learn a new skill or something. So it's just a philosophy our family carries. So every, every time we can, you Know, we always try, and, you know, it's not perfect. I don't want to create the wrong impression to anyone listening. But wherever we can, we're like always, you know, talking about giving. Let me just tell you one really quick story because it came up a couple weeks ago. We were, you know, I was in Cleveland and we had a big it town hall. And the theme of the town hall that one of my directors had dreamed up was giving. And so whenever we were talking about it, we always talked about giving. And it was very emotional because people shared some cool stories. But, you know, one thing we used to do in Cleveland is every other week, we used to do a food truck and we used to go to a homeless shelter and we'd coordinate with them. And we do hot meals and we do some, you know, we give. Give things to people trying to help them and then if they want it. And I won't get, I won't get evangelistic on you, but if they wanted to, you know, we would pray for people. And, you know, and this, this. It was just getting cold. And this one gentleman said, hey, I want a new coat. And so I'm praying with this other person. I'm like, she's praying, oh, you know, let this person have a new coat, like tonight. And I'm like thinking, are you crazy? You know, this person's not going to get a new coat tonight. So why are you praying this? And I have such little faith, even though I was trying to be very faithful. And we finished praying and I walked away. I turned and walked away, and I took about five or six steps and I turned around to go the other direction, and there was that man with the biggest smile you've ever seen in your life with a brand new coat on.

Wow.

And I'm thinking, okay, wow, okay, this is blowing me away. But what had happened is as we were praying, another person from our group was walking by, and she heard this woman that was with say that prayer that I just told to you. And she's like, oh, I just bought my husband a new coat for the winter. And it's here in the van, which is right next to where we were praying on the side of the street. She opens the door, gives the guy the coat. I turn around and, you know, I didn't learn that whole story until a little while later. But that's why giving is so important. It's listening and looking for opportunities and then giving. And when you do that, you get these amazing stories and you. And it's definitely a feel good thing to you. It's like, you know what? You're not being selfish. You are giving to others. You're acknowledging that there's other people out there who may not be as fortunate as you, and you can do things to help them. And it could be a simple as a prayer. It could be as simple as a coat. It doesn't have to be opening up a medical clinic. It doesn't, you know, it could be just feeding someone or, you know, there's all sorts of things. So anyways, it's a very long answer, but you just, you know, where I come from, I just have to give.

I love that. I think that's, that's so true. I think you're so authentic to that, too, Ed. I mean, it's sort of like, you know, it also just points out, I mean, kind of the, the meta of your point is that it's, it's easy. You know, it's, it doesn't have to be difficult. You know, there's certain kinds of things and the, you know, the proverbial helping one person at a time or one patient at a time or one starfish at a time or, you know, whatever, you know, is impactful. So I have to say, too, there's, there's some, there's a weird thing about climbing and stuff because I, I started my nonprofit by virtue of an inspiration that I had from a guy that I met when I was climbing Kilimanjaro. And our CEO at ati, Dylan D. Bates, and a senior vice president, Matt Smith, are starting. I'll put this in the show notes too, a thing called Climb for Kids. And they're going to be going, I think it's in March to climb Kilimanjaro. And they're making it, you know, quite the fundraiser for that as well, too. So, I mean, there's, you know, those kinds of needs and the kinds of things where you, you know, in my head, I always kind of felt like I want to transition into triathlons and duathlons and a second. But I always felt like, you know, my workouts and my training tended to be kind of, you know, alone. And, you know, you get up like I know you do. You get up. You, you know, it's the middle of the night or in the early morning or whatever, and it's, you know, you're going for a run by yourself and you see some cool things or whatever, but, you know, it's sort of a solitary kind of thing. And, and I don't really, I'm not, I Don't really have, like, workout buddies or something like that. So my schedule, you know, in situations, never really lend themselves, but. And I specifically felt like when I'd go on climbs, I mean, you'd be on a team with an expedition, which is very much collaborative and cooperative. But I always felt like, you know, kind of tagging fundraisers with climbs made them more communal and made them more outside of just, you know, me, me, me, me, me kind of a thing. So I. I think it's. There's some intoxication around climbing that I think you and I and others experience and feel. But it's. You know, there's a heartfelt aspect to it, too, to see the kinds of benefits that it can have, you know, for others, while someone takes on a physical challenge. So. So I tip my hat to you for that. So, speaking of physical challenges, you know, the climbing and whatnot. Tell us about. We've got just a few minutes left. I don't want to, you know, take all of your day, but tell us about your racing. You're. You are part of Team usa. You're a duathlete. Tell us about how you got into that and what that's all about.

Yeah, it was just a dream come true. So I got. I was always athletic, not necessarily the best, but I was always, you know, definitely middle of the pack, but enjoyed good competition, being part of good teams. But the way I got into triathlon is our oldest son was. I was like an overbearing dad. I think, you know, our first born was a son, and he was 2, 3 years old. I was, like, throwing footballs with him. I was kicking soccer balls. I was doing ice skating. I was like, I just so thrilled to have this boy, you know, not that you couldn't with a girl as well, and I did that with my daughter. But I was just so thrilled doing all these different things and. But my son was a perfectionist, and I overdid it. And so by the time he was five or six, like, if he wasn't perfect at something, he didn't really want to do it. And he sort of was rebelling. And I was like, oh, I'm such a bad dad. I forced my son into these things, and now he doesn't want to do them. So we let. We let loose a little bit, and my son gained a lot of weight, you know, and. And then here's my wife, you know, she's fit, and I'm fairly fit. And in our son, we're like, oh, my gosh, we know about childhood Obesity and what happens, you know, secondary effects and leading, you know, he's going to have trouble as an adult. All these different things. We're like, oh, we're so terrible. So then we got him into like taekwondo and some other sports. And then the kids made back to soccer and kids made fun of him because, you know, he was overweight and, you know, self esteem, you know, it's just hard now. He's like 11 or 12. We're like thinking, oh, we're so, you know, we're failures of parents. What do we do? Yeah. And someone said, hey, and you know, have you ever thought about like a triathlon or a race? Because everyone cheers, they wait around for the last person, they cheer. And it was like, well, we're pretty desperate. So we did this like a duathlon. It was like a run, bike run. And I just told my son, I said, look, you don't have to run the whole thing or bike the whole thing, but we're gonna finish. And our goal is just to be last. If we're last, we're good. But we finished. And so, sure enough, you know, he was crying and it was hard for him, but we walked a lot and we finished and we were last. And sure enough, people stuck around and they were cheering. There was no one making fun of you, you know. So the next year we trained a little bit more and he did it. And this time he didn't cry anymore. And I said, look, the goal here is we can finish last, but. But we can't walk. And he did it. So he accomplished it. And then the next year was, hey, this time we're not going to be last. And we weren't last. And so by time, the fourth year rolled around, he was first place in his age group.

Wow.

His. His body started to change, partially because he was becoming a teenager, but partially because he started training and then he owned it. Then he liked it. It was no longer being forced and he liked the fact that people would cheer. And now he was first place. And eventually, you know, he's faster than me. And then we started doing triathlons and Half Ironman together. And so it became this family thing, but that was how we got into it. So anyways, I just kept up with it over the years as a way of staying in shape and, you know, having sort of a goal to keep you motivated and keep you going. And. And one year I did okay in a local race, which like a regional qualifier for the national championship. So I get this email and it's like, hey, you you're invited to the National Championships, which I now think is open to anyone. But a few years ago, you had to qualify, make this qualification. So I was like, well, there's no way I'm going, because I'm going to be that person that's last place that, you know, just is there so that the first place people can, you know, look really fast running by them or whatever.

I was like, that's what I. That's my job.

Yeah, right. And I was like, plus my body fat compared to them, and they got better bikes and. And then I thought to myself, no, that's. That's a failure attitude. I mean, I'll never get invited again. I might as well go and make the most of it. So I did a little. I upped my training a little bit. But I showed up and I was very insecure, and I was like, dang, I've got, you know, 19% body fat. They've got nine. They've got a $9,000 bike. Mine's $4,000. You know, I did all this competitive comparison. I pretty much lost the race before I started. And I was like, no, that's not who I am. You know, I don't teach these things. I don't. That's not my life. That's not my dad's legacy, you know, So I was like, no, I'm gonna go out there and, you know, then I got an attitude, like, in a good way. I was like, I'm gonna beat the crap out of some of these. I gotta do something. You know, I'm not gonna be the loser. And so I went out there and I performed beyond my training, and I got the last spot on the team. And then I went to the World Championships and to where? Team usa. You know, given my background and being first generation American, you know, they had these parades and I was like, crying.

I bet.

Yeah, representing our country. And. And so then I got the bug. It's like, dang, I don't want to lose out on this. I'm gonna. Next year. I'm gonna make the team easily. I'm not gonna be the last person to make the team. And so I've been on it, and I've had some rough times because I had a knee injury last year, but I've been on a team for four years now, and this past. In 2017. So this year, it's a long story, and I won't go into detail, but suffice it to say, I was highly encouraged by my physical training team. I had knee surgery in late 2016, my 2017 physical trainers, they highly encouraged me and motivated me. So to cover any prospects of not making the team, I tried out. They have three different levels of Team usa, You know, they're all distance, you know, like sprint, Olympic, and sort of this Ironman version. And yeah, so I tried out for all three. Just hedging my bets and I became the first athlete. Actually one of my friends did it with me. So we became the first athletes to ever make all three teams in the same year. Because you, if you're a sprinter, you're not necessarily.

Yeah, yeah, yeah. It's like running the, the, the 400 and the marathon. I mean, those are big different skill sets.

Yeah. So we both decided, heck, we're gonna go to all three world championships, so. So that's the big. So anyways, that's how I got into it. But I learned a lot from that. You know, about self talk about motivation, about believing in yourself, about your team. You know, even though it's individual on the bike and running, it's really your team. It's your wife, it's your kids, it's your employer, it's. It's your friends, it's your tri athlete group that you belong to. It's really a team effort to get you there. It's my physical therapist, it's my doctor, my surgeon. So I learned a lot of life lessons through it. So I. It's something that keeps me motivated and something I'll probably try again for at least another year.

That's awesome. That's great. Well, I just. Thank you. Thank you for sharing that story. That, that is so cool. I had. I didn't know the, the, the triple crown there. That's pretty amazing. So, last couple of questions and I'll let you can get on with things. What's. What's next? Like you just now said you're going to be, you know, continuing to do the, the competitions. Any in particular kinds of challenges or adventures or anything on your, your calendar for 2018.

I think 2018 is really about just getting past my surgery and recovery. Obviously I made the teams after my surgery, so I'm feeling pretty good. So I want to get back to be top 100 in the world. So that's the big one. So in 2014, at age 49, I was a top 100, sort of the long distance or iron man of Duaspons, top 100 in the world. And I want to get back there again. So my wife's helping me a lot with my diet. I'll have another trainer, a coach starting up in a. In about a month. So I'll have a couple national championships along the way, you know, for the 2019 teams. But I have world championships in Denmark and the big one though is the long distance one in September in Switzerland. So I definitely want to be top 100 in the world. So it means a lot of good diet. Diet, you know, good eating, good nutrition, good training and just, you know, hoping that the body holds up and, you know, and my employer has been great. Cleveland Clinic, they're going to actually, on my Team USA uniform, we're going to have the Cleveland Clinic logo.

Brilliant.

Yeah. So it's going to be pretty awesome. So that's the big one. I'd love to get back into climbing another of the Seven Summits, but I don't know if that's in my future or not. So we'll just kind of wait and see.

Gotcha. Well, keep as much as you feel comfortable post them on the socials because I just love to, you know, keep track of your adventures and learn from you with those. I think that would be fantastic. So speaking of that, my just. My last question is what's the best way for people to reach out and be in touch or to track your work or the kinds of things that you're up to, be it humanitarian or athletic or tech and medicine?

Yeah, I think there's. There's probably two primary ways, but LinkedIn probably covers all of them. So LinkedIn is really good. And then the other one is my blog. So I do blog regularly under CIO called CIO Unplugged. And it's under the kind of roof of his talk H I S t a l k.com and so I post there typically twice a month. I've done that think for about 10 years now. So there's a lot of quite a bit of content out there. And so I'll talk a lot about different philosophies and things. I.

Excellent.

I've reduced my Facebook to mostly just friends and colleagues. I used to be much more open.

But you're taking a little break from it too right now, right?

Yeah, I've slowed down quite a bit. It's sometimes you have to be very careful. Right. And Chris, you know this really well with social media and, and people will perhaps take things out of context or, you know, not have your best interest in mind.

Right.

So I'm like, you know, Facebook, I'm really going to reduce and, and just keep a pretty tight circle around that as opposed to what I used to do. But LinkedIn is really good because you'll see the his talk posts on there as well as any other, you know, important thing on. And I'm also on Twitter. It's all professional type things.

Well, we'll get all those in the show notes too, so people can, you know, keep up with you with your content. And blogging twice a month also is impressive. You're an endurance athlete in a variety of ways, my friend.

I don't think people realize.

No, it's hard.

Yeah, it takes a lot of effort.

Well, Ed, I just want to close. And again, thank you for your, your precious time today. You do have so many things going on. I really appreciate you making the time for it and helping, helping to broaden the audience's appreciation of the kinds of work that, that you're doing, that you've done, the kinds of things that you've been able to accomplish. I hope people highly recommend your book and reach out and learn some of the leadership principles because I really think you are, I said it earlier, I'll say it again to emphasize that you are so authentic with who you are and how you handle yourself in the variety of domains that you live your life in. You're very much an inspiration to me as a thought leader and as an athlete and as a friend. So it's just a big thrill to be able to have you on the show today. Thank you so much.

Well, Chris, thanks for having me. And as I said, I appreciate what you're doing in the community and encouraging people to live a full life and not to sit on the sidelines with, you know, and you lead that way by personal example and then also by bringing together other like minded people in these sort of forums. I think you're doing a lot to help spread the message of how important it is to have a full life. So thanks for all that you do.

I really appreciate that, dad. Thanks so much, Ed. Take care.

All right, take care. Bye bye.

Living a Life in Full is a production of Stout Media, a subsidiary of Gordian Knot, llc. Assistant Gracie Wong Music Dan o' Brien Sam Rude Graphics Larry Newberry Executive producer and host Dr. Chris Stout to learn more, stop by our website alifeinfull.org for show notes and please recommend us to your friends and leave us a review on itunes. Thanks.