Perspectives from a CEO (ft. Craig Kinyon)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now, your host, Ed Marx.

Thanks for joining Digital Voices. Great to have you again. And one of my favorite conversations to have are those with actual chief executive officers of health systems because They have a very unique point of view. And so, Craig, I want to welcome you to Digital Voices.

Thank you. Great to be here.

And Craig, the reason that we got connected, one of the reasons is not only are you the CEO of Reed Health, but your CIO is a good friend of mine. So he's one of the best that's out there. And he's like, you have to meet my CEO because he's awesome and, you know, a great advocate of all things digital.

Pleasure working with him. He's quite a bundle of energy.

And then I also noticed in the research I was doing that you're a former CFO. So you went from being a CFO to a CEO.

Yes, I have.

I've been, uh, that's pretty—

I've been for 28 years, the first 13 as CFO.

Yeah, that's great. We're going to dive a little bit into that. So that's basically how we first met. But Craig, our first question always Is what's on your playlist? What kind of music do you like to listen to?

Oh, the important stuff. Definitely '70s rock. That would include things like Lynyrd Skynyrd, Blue Oyster Cult, which is a band from where I grew up at, Led Zeppelin, Boston, Eagles, anything in and around that.

Yeah, nice. Have you seen any of them in concert? And if so, which one was your favorite?

I would love to have seen several of them, but I have seen Blue Oyster Cult Cult, uh, in more than one setting. So, uh, that was a really good one. And Rush was also— should be on the list, and I've seen Rush once as well.

But, uh, yeah, I've seen some of them. I've never seen Blue Oyster Cult, but one of my all-time favorite songs, of course, is Don't Fear the Reaper.

Yeah, and a lot of early stuff too that's really good.

That'd be, you know, an interesting song to play as, uh, when during budget time.

Yes.

You know, when CFO comes in.

Perfect.

Craig, what about sort of a life message or mantra? Do you have words that you live by or sort of guide you?

Well, you know, it's, for me, I guess what I would say is when I'm looking at a problem or a new situation, I'm always looking at it and wondering what the process is and then why is it done this way? So I find my mind immediately goes to troubleshooting. And looking at things differently. So I guess I'm always just built and wired that way. That would be probably just a little bit about how I'm set up.

Yeah, no, that— and it makes a lot of sense because obviously we have very complex challenges in healthcare, and having this sort of mindset makes, makes a lot of sense. Can you share with us your story a little bit? You can go however deep you want on the personal and professional side. Obviously I gave away a little bit already on the CFO, but Tell us, like, you know, where did you grow up and then how did you end up becoming a CEO?

I'm a native of Long Island, New York, so I lived there until I went away to college. I went to Grove City College in Grove City, Pennsylvania. I have really a split life. I have a lot of family in small rural America and living in New York, so I saw life in New York and life out of New York. So for me, traveling outside of Long Island was not a big step. You know, it wasn't a big step. And then, so I would say then I went to Steele. I was with Steele for a year and a half. My first introduction to hospitals was at Montefiore in 1983. Then I was the staff accountant, first job there, and then accounting supervisor, and then became the director of accounting when I went to Lafayette Home Hospital in '85. Then I became the CFO when I went to Fayette Memorial in 1990. I was there for 5 years, and I came to Reed in 1995 as Reed's first CFO. Much smaller organization, uh, our home of 100 years down the street from where we're at right now, and one property across the street with 1,100 employees, and just a bundle of great opportunities. And then in 2008, when my boss retired as CEO, I took over as CEO in 2008. So I've been CEO since that time, now 15 years as CEO, and I'm the 3rd CEO in about 65 years at Reed.

Wow, that's, that's an amazing legacy. That, that says a lot for the culture of Reed, you know, that That's the case.

Yeah, culture is a good word because that was really what attracted me.

So what, what is it like to be a CEO after being a CFO for so long, right? Because as a CFO, your mindset may have been— and I know I'm going to be stereotypical here— but very, right, hyper-focused appropriately on sort of the finances and keeping checks and balances and making sure we had revenue and, you know, expenses, everything was measured. And then you go to become a CEO, which can be a little bit more visionary and maybe pushing a little bit. Do you find yourself— like, how did you make that transition? Do you find yourself sort of pulled back on the finance side or more on the vision side?

Definitely on the vision side. It started as a reluctant idea with me. I really want to do this. who really wanted this type of job. And then it sort of grew on me a little bit overnight, so to speak. And then I said, you know, I think I'm interested and put my hat in the ring. Of course, they did look at internal and external candidates. And when I got it, I was the CEO, then I was still the interim CFO because I hadn't yet backfilled my position. I am an accountant by training. I'm a CPA. So still in this brain is calculator in the mind of an accountant that looks at life also in that perimeter. So whenever I would hear things as a CEO, my immediate brain kicks in. If there's financial issues involved to do the analytics on those, which when you've been looking at things long enough, it's just kind of an automatic visual process. And that's just the way I looked at it. So for me, transitioning to other things that were outside the realm of CFO was a little more of a challenge. So stepping out of my comfort zone, of course, I was doing a lot more public speaking, a lot more leadership-type roles that, you know, you're the sole person being focused on, and a lot of managing my board and working with my committees of the board. So I was the person to really bring the information to them, make sure it was made clear. And that's a challenge when you have a board that has a life and several other things outside of healthcare. You have to bring it back to them in terms they can understand.

Yeah, that's something to explore on another podcast sometimes. I don't think people realize that board dynamic that a CEO has to contend with. And it's good, right? When you've got this great board and they're very supportive and they give you a lot of ideas and across industry and a lot of great stuff. And at the same time, it consumes a lot of your time. And so I always admire watching, you know, I serve on the board of a couple health systems, and I just admire watching CEOs sort of navigate that relationship. But I don't think the average person, you know, knows how intense that time can be. So that's pretty cool. What's the most challenging aspect? So you became a CEO for many years now. What's the most challenging aspect of being a CEO?

For me, it was really managing the growth. Growth was a big challenge coming in. So I'd been in the organization 13 years at that point, but Reed was on the vortex of becoming a much larger regional organization, transforming from a community organization. So as I mentioned earlier, we had 1,100 employees and now we have 3,300. Back when I came here, we had our home campus and one property across the street. Now we have 68 buildings. We're in 8 counties, 6 of those Indiana, 2 in Ohio, and 3,300 employees. So it has been a story of just growth, growth, growth, filling in a niche between Indianapolis, Dayton, and Cincinnati.

So let's talk a little bit about digital. So, you know, the big buzzword right now is digital transformation. Speaking of boards, right, the boards Kind of, they read something on the airplane, digital transformation, they come back and they say, what are we doing with digital transformation? What are we doing with AI? You know, that sort of thing. So how do you view digital at Reed Health?

To me, digital is us keeping pace with the rest of society because for many years it seemed healthcare was on the outside looking into where other industries were progressing with computers. I think we're the The territory that nobody dared step into. So, I always felt that healthcare was several years behind banking and retail and you name it, just really out of the mainstream. But now, seeing more and more attention to understanding how healthcare models can be improved and how they can be digitized, we're seeing a lot more attention and have been seeing that for the last several years. The turning point for us most recently was Epic. And having a very powerful tool now that would give us a lot of opportunity to do things that we couldn't do before, and now leveraging that and the technologies that have been updated in that particular module of Epic. So that transformation to digital for me is all about how do we reduce our labor footprint and bring a different level of service and connectivity to the families we're serving. And that has been a wonderful opportunity and challenge, but one that is long overdue in giving people more access to healthcare besides just coming in and sitting in a waiting room chair and waiting to be called. So that information coming to me, for instance, now if I got a lab test and walked back in my office, it'd be about 15 minutes before the result came in. On my phone, and I would see it probably before my doctor did, because as soon as it's processed in our computer and the lab does the results, it's on my phone. And I thought, wow, that has really shown how far we have come in the ability to bring data and information to individuals. So if we can do that, there's so much more opportunity to still bring to the bedside and to the homes.

Yeah, that's awesome. How do you go about developing that strategy? So what's the process like from a CEO point of view when you think about digital strategy or whatever, or just strategy in general? What's the process that you undertake?

Well, oddly enough, I sometimes look at myself as an outsider. I don't look at myself as the CEO. I look at myself as, okay, if I'm a family member or I'm a patient, What are the types of things I see that we're doing that I really like? What are the types of things that I wish we were doing better? And I test those out from time to time with my family, my friends, to say, you know, what do you think about this? What do you think about that? Occasionally get into some conversations, which really reinforces the fact that we had a big journey to travel. We had a big gap to fill in being more mainstream with what are accustomed to, especially since the advent of the internet. We were much, much behind where others were joining in on the internet. So the ability to move our organization forward, to me, was taking us— taking a step outside of the organization to try and see us from an outsider's perspective and try and improve that image, that picture, and that access to healthcare.

Yeah, I like that approach. So you're putting yourself in the customer, the consumer, the patient, their family sort of seat and taking that point of view and bringing that back. I like that a lot. What are one or two things that you're most proud of regarding Reed Health? So it might be digital, but it might not be. So whatever it is, what is it for you?

Sure. I think the first one was when I first arrived, we were using an antiquated system. It was end of life. The hardware's end of life. We had programmers that had access to the code, and the only fly in the ointment was that the hardware was end of life, and we had 2 controllers and 1 hard drive left, and after that, we'd be out of business. Oddly enough, my boss, who was a super techie— just to put that in context, he loved gadgets. My first Christmas with him, he got us US Robotics Palm Pilots. That dates me quite a bit. But he gave those to us and expected us to use them. As techie as he was, he was not aware of the backdrop in the system, what you couldn't see, what was going on in the processing in the computer room, that we were really in trouble. So we immediately had to jump into action and get an information strategic plan, which I led, and that got us into the next phase of mainstream systems. So that was a big jump. So that was probably number one. Number 2 was the building of the new Reed. It came down to the fact that we had a building campus of 100 years with 5 different generations of buildings attached together. And when it came time to expand, because we're really growing, the expansion was problematic because any building you touched, you had to invoke the then-current building codes. So any major renovation would dramatically change your ability to transform it in the way you probably initially thought. It made essentially the buildings untouchable. In other words, for the amount of money and time you put into them to expand or renovate them, you would not get back the benefit of a true transformation or a change in workflow that would be good money spent. So that spawned me looking at 5 different options for my boss. At that time, I was a CFO, and one of those options was a greenfield site. And my conclusion back to him, and I did this through data, was showing that the only transformation that made sense was not to do a rebuild of our current building on the same campus, but to go to a greenfield site. The greenfield site sounded really good, but we had no Greenfield site in mind. As luck would have it, we did have some land that opened up just a mile and a quarter north of us. It was initially 66 acres. We bought those, and we bought another 33 after that. So we have our campus here right now of 99 acres. We've been on this campus now since 2008. We have continued to grow on this campus as we have grown into the other 7 counties we serve. So I feel very good about that because it completely transformed our organization from more of a community hospital to a regional hospital. And with that came higher levels of service and things that were giving our community access to healthcare that changed outcomes, advanced stroke care, life-changing access to cardiology work. Including interventional cardiology. We put modems into the ambulances that served our area that were attached to EKGs. So no matter where they were, we could see immediately in the ED, in our emergency department, that the patient was having a heart attack. So while the patient was getting ready to be transported in, we were already calling the heart team into action, and the patient would glide through the emergency room right to the cath lab where the interventional cardiologist is standing there waiting to take them. So the door-to-door times, as we call them, could not have gotten any better, and that changes lives and outcomes for individuals. So I feel good about that because when you can do good work and you know it manifests into better care, that makes everybody feel better.

Yeah, those are great examples. And that's another thing I don't know that everyone realizes because I think you always assume that A physical plant's a physical plant and everything's modern, but especially with hospitals that have been around for over 100 years, you know, it takes a— it adds a layer of complexity that others don't have to deal with. But it's cool that you were able to come up with a greenfield facility, physical plant, and continue to serve your region. What about digital tech? So I know you mentioned already you just did a major implementation of electronic health records. And you've got the portal capability you gave example of. Is there another area of where you're headed or like to get to in terms of Reed and its use of digital technology?

Sure. I think many of us right now are doing remote computer access for video visits. Those have now become much more mainstream in the post-pandemic era. They were by necessity during the pandemic. I think we had 5 different solutions trying to get those to work well. But the connection of that video conferencing with patient and Epic has really proven to be a game changer. I also like the ability to have the technology that pushes information 24/7 from the patient to the provider or vice versa. So it's not anymore connected to a phone call to gain access. during working hours of a practice or of a hospital to get information. Having that in the palm of your hand has really become the expectation of all of us. What I do in banking, what I do in recreation, what I do in connecting to my family, and now what I do in connecting to my healthcare system and my provider is all in my hand. So I feel that we finally have gotten into the mainstream. We're in center stage now.

Right.

And that's very satisfying.

That's cool. Yeah, I mean, as I'm listening to you, Greg, I'm always like, hey, I'd be very happy to live in your community, in your region, you know, knowing that there's progressive healthcare there and a sort of cutting-edge CEO and CIO. And speaking of which, a lot of our listeners are chief digital officers and chief information officers, so the opportunity to interact, have this dialogue with you Yeah, is, is cool. And they always ask about what's, what's the best way for a CIO to serve a CEO. So what are the things that you look for? Like when you recruited, like I said, you got one of the world's best there with Muhammad. When you recruited him, what are the sort of some of the attributes you look for and how can a CIO best serve, you know, a CEO?

With our investment in Epic, clearly that was our number one objective. Finding somebody that had experience and the ability to take our Epic investment to the next level and the level beyond that. So in talking with Mohammed, obviously he's, he's just a fantastic human being with a tremendous amount of energy and drive and a very strong passion for patients and healthcare. So he had all of the base requisites you'd want in anybody driving any part of your system, more or less IT. But he also had a passion for advancing this organization, and he saw where we're at and he saw where we could be. And I let him run loose. I gave him room to run and did what he did best.

No, that's great. Yeah, he's definitely one of the best, and you guys are really blessed to have him. Let's talk about— we'll shift now to leadership and what's the most enjoyable aspect of your job. Obviously you like it, you've been there a long time, and Like you said, only the 3rd CEO in 60-some years.

Yeah. Well, you know, in leadership, you're involved in so many different things, which is good because you have a chance to listen to conversations that maybe you didn't have in other roles. You have the chance to put a perspective and a voice out in, whether it's an internal board or a committee member, or going out in the community and talking to other people community board settings and educate them more or give them more information about things you're doing. And I always felt that people seem to be very attentive to things related to healthcare. So when you're talking about changes in healthcare and that conversation came up and I'm sharing, people are tuned in because obviously it's all personal to everyone as it relates to your health and the health of your family. So when you're dealing with such an intimate personal part of our lives, I find that healthcare advances is what everybody is very interested in hearing more about because they want the health systems to progress. They want to have better information in their systems they're working with. They want to reduce communication gaps and voids and so forth. So they're engaged. They're very supportive, cheering us on. And it's hard for them to vision where we're going next. But we know this is going to continue to change over and over and over and get better and better and better.

What's the hardest decision you've had to make as a CEO?

Hardest decision probably is trying to deal with the payer structures we have. The payer structures are in conflict with healthcare. That's probably all over. And for all 50 states, people don't like to pay for healthcare. And it's probably one of the most misunderstood issues. The underpayments of Medicare and Medicaid are funded by people that have commercial insurance. That is deliberate by design by the federal government, has been in place since I came in in 1983, the advent of DRGs with fixed payments. So, So that has forced what's called cost shifting. So trying to explain to the community, and then first and foremost to the board of laypeople that aren't insiders in healthcare, why hospital costs are so high. Well, when you're losing 8% on costs, not charges, but 8% on costs on Medicare and Medicaid, there's nowhere to make it up except on the employer-based health plans. And that's just how this country has decided they would fund healthcare is on the back of employers. And that's a model that's becoming more challenging because today we have 11,000 people per day becoming 65, generally moving out of the workforce, going into Medicare, but we don't have 11,000 coming into the workforce. So the workforce is becoming a much smaller, smaller group, and the post-retirement group is coming a much larger, larger group that is at a time in their life where they're going to become very high consumers of healthcare. So we have the perfect storm or mismatch of a population with high needs and a smaller population that's expected to serve them. So this is where the real leverage of where technology comes in. How can technology help to bridge that gap, reduce that void? So that's where the excitement is.

Yeah, yeah, that's definitely a conundrum that we all deal with, that's for sure. How do you recharge your batteries and remain fresh? So obviously, as a CEO, and as great as Reed Health is, it's a— there's a lot of pressures, a lot of stressors. So what do you do to sort of relax and recharge?

Sure. Well, you know, it's not a lot of time to relax. I have 4 adult daughters. I have 7 granddaughters, and they're not far from us in Indianapolis. So There's always something going on with 7 granddaughters. So we spend a lot of time on weekends traveling to Indianapolis, obviously keeping in touch on FaceTime and so forth, and are very involved in what they're doing and supporting them. So I really enjoy being around them and just have a great time with them. And even though they're at the younger ages they are, I'm just so marveled at how advanced they are. And I think about— me when I was their age and what I was doing, and I'm seeing what they're doing at their age. My one granddaughter, 18 months, was able to navigate through a visual on an iPhone and only got stuck when the screen would go to sleep and she got locked out from the code. And I thought, we are not ready for this next generation. This next generation coming up is going to be so far ahead of anything we've seen before. I'm just sitting at the edge of my chair waiting to see how that unfolds.

Yeah, no, that's great. And man, I can't imagine the celebration that's going to happen in your extended family when you have the first grandson with all the daughters and granddaughters. The odds are definitely with you for the next baby that comes along, I think.

When that happens, Ed, you'll know it because the earth will truly shake.

Yeah, I had one of my sisters has 4 boys, you know, and they were— they kept trying after the second one.

Oh, the next one will be a boy, the next one will be a boy.

They finally, finally stopped. Um, and then I think all of them since then, uh, I think there's finally a girl coming, but they had the same thing but in reverse, you know, all these grandsons. Uh, but I think they just recently granddaughter. So we talked about a lot of things. It was super interesting, you know, from a CEO perspective about Digital, um, and of course a little bit of music. Can't forget, uh, the concerts. But you talk about digital and leadership in general. Is there something we missed, Greg, or something you want to double down on? I'll give you the last word.

You know, um, I had some good mentors in my life, uh, going through high school. Uh, a man who wanted to teach, he was an executive at Citibank, and he connected with me when I was in high school to do night classes for accounting too and kept in touch with him during college and so forth. And so he's not my parent. So you have this person who has adult knowledge and experience in a field in which you're headed into in finance and a lot of very supportive sorts of things. Not to be complacent. He said that over and over, don't be complacent.

Yeah.

to think and stretch and ask why and so forth. And I endeared those words because I always felt that if I'm not the one pushing, who will be the person pushing? You have to keep pushing. We can't be satisfied with what we have today. What we have today is great. Quick celebration. Now where else are we going to go? And we have to keep moving forward. So that's how I'm wired. I'm not complacent. If I see something, I want to make it better.

Yeah.

And I also had a lot of opportunities with computers at early, early age and have always been marveled on computers. And that's when I came into healthcare. My first job, there was no computers, no bed— there was nothing. You had a calculator and you had a computer that did billing, admitting, discharge, transfer, and payroll, and printed checks for your accounts payable. There was nothing. It was all paper. And I was just marveling over this entire industry that dealt with human lives and science that was completely 100% paper-based on the medical record. It's been absolutely endearing and satisfying to see this progression going back over the course of my career, to see where we are right now with Epic. And to me, this is the fulfillment of where we needed to go in healthcare. So that's my quick and maybe Exaggerated responses to your question.

No, no, that's great. And I really appreciate it. I know the audience does too, just hearing your perspective as CEO and such a champion of technology and digital. And it's great too that you had a mentor and you still are impacted because I'm always telling people, go get them. If you don't have a mentor, you really need to for the reasons you just cited. So Thanks again for being our guest. You're doing great things out there. Muhammad speaks so highly of you and of course Reed Health. And like I said, I would wanna move out there 'cause knowing there's a progressive organization to take care of our health in the community. So thank you again for being our guest.

Thank you, Ed. You're always welcome to visit anytime you like.

I need to do that. So that wraps up Digital Voices. Thanks for spending time with us.

Thank you for listening to Digital Voices podcast, With Ed Marx. If you enjoyed this episode, subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.