Scott Smiser [00:00:00]:

Emory Digital has a governance process, so our innovation governance fits into that. But it almost has an express lane because some of these opportunities that we’ve got to invest into an external partner or in a partner that wants to invest into Emory to co-develop something, there’s a very narrow window of time we can do that in from Healthcare.

Narrator [00:00:22]:

From Healthcare IT leaders, you’re listening to Leader to Leader with Ben Hilmes. Our guest today is Scott Smiser, Chief Innovation and Technology Officer at Emory Healthcare. Scott shares how his team is driving innovation through cloud migration, AI tools like ambient listening, and even Apple devices in clinical settings. He also talks about his people first approach to leadership and why growing others is at the heart of his work.

Ben Hilmes [00:00:48]:

Hey Scott, it’s great to see you again. It was great meeting you at Vive and I got to thinking, we just wrapped up, you know, the conference season I’ve went to. It seemed like every one of them, but curious to see do you have a particular set that you go to? How do you view the conference season? How do you use that in your role? It’s, it’s always interesting, I think, for people to get perspectives from leaders like you.

Scott Smiser [00:01:11]:

No, I agree it feels like it’s conference season when you come out of the holidays, but I was, I was able to make it at Vive. I wasn’t able to make it to hymns and other things, but a lot of times nowadays since they’re so compressed, you almost have to kind of pick and choose which ones you’re going to go to.

Ben Hilmes [00:01:26]:

So you’re at Emory Healthcare. And so before we kind of dive into more content, I’d love for you to tell me and the listeners a little bit more about Emory. A lot of people know who Emory is, huge name brand in the industry. But just a little bit about the footprint and what you got going on.

Scott Smiser [00:01:41]:

No, absolutely. So Emory Healthcare is based out of Atlanta, Georgia. We’re 11 hospitals, 320 clinic ambulatory locations across the metro Atlanta area. We’re expanding outside of Atlanta metro, about 7 1/2 billion in annualized revenue.

Ben Hilmes [00:01:58]:

Not a small footprint and certainly in a metro that I think in the top five in the US So a lot of lives to serve and some important work to do for sure. So you’ve been there just a little over two years and you recently had a title change. So the Chief Innovation and Technology officer. And are these kind of new? Is this new for you? And in our conversation at Vive, it felt like you’ve been doing this work for some time. So is this just A title catching up with your work, Sort of.

Scott Smiser [00:02:26]:

I mean, so I was always doing innovation. We can certainly talk about innovation if you want to as well, but I was already doing innovation. But what happened in January is the healthcare IT operation merged with the university IT operation. So now we’re one big division of Emory Digital. So that was part of the title change. But innovation was already part of my repertoire and my responsibilities at Emory.

Ben Hilmes [00:02:52]:

You know, it’s actually a trend I’m seeing in the AMCs where you’re starting to see the. I don’t know if it’s to manage cost, if it’s to better integrate across the. The macro enterprise or not, but starting to see a lot of those consolidations across health systems that are aligned with academic medical center. So interesting to see you guys kind of following suit there. You mentioned innovation. That can be a lot of things, right? And so I think in your world people may default to. Well, that means technology, but I’m not sure that’s the case. And so when you think about innovation, it can mean a lot of different things.

Ben Hilmes [00:03:28]:

I’d love to hear from you how you think about that and how you personally define it in your work there At Emory.

Scott Smiser [00:03:34]:

It’s twofold. I think it’s internal innovation. What I talk to my teams about is the way we deliver services and assets to the enterprise. I think we need to think smarter and think of ways that we can innovate the way we deliver those services. Innovation outside of that, obviously, you know, we’re wanting to find ways to do more for patients that we’re serving. Obviously with us being an academic medical center, we’re also in charge of research. So how do we leverage those capabilities to do something in a more compelling way? And, and I think a lot of people talk about innovation, but they don’t put a lot of guardrails or process around innovation, if you will.

Ben Hilmes [00:04:16]:

Do you guys kind of use the same governing structure to determine what gets the priority, what gets the investment? How do you think through that?

Scott Smiser [00:04:25]:

Yeah, fair question. So Emory Digital has a governance process. So our innovation governance fits into that. But it almost has an express lane because some of these opportunities that we’ve got to invest into an external partner or in a partner that wants to invest into Emory to co develop something. There’s a very narrow window of time we can do that in. So we’ve got to do a rapid cycle concept a lot of times with innovative products. So we’ve got a governance for innovation, but it is a top line rapid cycle. If it Looks like it’s going to go to scale.

Scott Smiser [00:05:00]:

It definitely folds into our overall digital process, but it kind of sits adjacent to, but it’s not separate from, if that makes sense.

Ben Hilmes [00:05:09]:

I’m going to go a little deeper here on this because it’s interesting how the narrative has been how do you innovate to cut cost or become more efficient. But we’re also seeing a growing number of innovations to drive top line. So grow the revenue line. How do you guys break down the two and are you seeing the same thing I am, which is more focusing on less around the efficiency cost cutting and more around the growth and revenue improvement?

Scott Smiser [00:05:37]:

You know, for us it’s both. I think we’re always looking at ways to work smarter with the resources we have. So if it’s driving cost or improving internal efficiency, we’ll do that. But a lot of the things that we’re trying to do from an innovation standpoint is to do that top line level growth. It really is a mixture of both that we’re going to continue to look at how do we operationalize the resources we’ve got in a more effective way. And you know, there’s things that we’re doing with like bot development and AI and other things that are making us more efficient that drive cost out of the operation. But then there’s also innovation things that we’re doing top level that are growing new levels of business, new lines of business, entirety in some cases.

Ben Hilmes [00:06:19]:

I’m actually excited about that because I, I think healthcare’s played defense too long. You know, how do you leverage talent like yourself and your teams to, to kind of pivot to being on offense more? You guys there at Emory have an innovation hub that you mentioned that’s doing some really amazing work. Can you kind of walk through what the vision is for that overall hub? And, and you guys do it in the Shark Tank style. So I’m anxious to hear more about that. I, I think that’s something listeners would love to hear about and potentially adopt.

Scott Smiser [00:06:50]:

Yeah, the Innovation hub is a partnership between Emory Digital and Emory Innovation and Operations. But we do do a Shark Tank style approach every year. So have is basically a request for ideas, concepts, etc, and we curate that list down to a finalist. Last year we, we had I think 10 in that finalist round. But it is truly a Shark Tank style pitch where they have a standard format. They need to follow that. They come before the executive team and say, hey Sharks, I’m looking for an investment for $200,000 and this is what we want to do. And then we as shark judges potentially don’t fund them through innovation.

Scott Smiser [00:07:32]:

But that’s a great idea that we need to work with them to go back and curate that a little more and then maybe they’ll come back the following year. But we do that as an annual exercise. Out of the 10 that were pitched, we. We fully funded five of the 10.

Ben Hilmes [00:07:45]:

Oh, wow. That was going to be my question. So that’s pretty good hit rate. I assume that. Do you put any parameters on that? Obviously you have a, you have a budget, but at the same time, moving forward, five initiatives is, Is a pretty big lift.

Scott Smiser [00:07:59]:

Yeah, it is. I mean, I’ve got to have resources within digital that can be focused on innovation. We’ve got a corporate director that’s over innovation out in operations that’s working with them. But we really, once we greenlight them and decide to fund them, we’re working with them on the business case, we’re working with them on the ROI analysis because, again, we want to be good stewards of what we’re investing in it. We want them to be successful. So when you start talking about, with some of the clinicians and researchers about ROI and different business aspects or nomenclature, they’re like, I know this is important, but I don’t know how to do ROI analysis. So we’re working with them from the start to make sure that they’re going to be successful. But I think more importantly, as we greenlight to scale some of these efforts, we want to take that pro forma and go back and say, did it deliver the results we expected?

Ben Hilmes [00:08:48]:

It’s hard to put dollars on, on something that doesn’t have a predictable outcome anymore. There’s not a lot of excess going around. So making sure you’re placing the right bets and the right things is pretty darn important. I’m curious, what’s the makeup of the. Of the sharks? I’d love to, love to know, kind of how you make that group up.

Scott Smiser [00:09:08]:

Yeah, so it’s operational executives and operational leaders. So I play a small part in that. So our innovation team gets it together. Myself, my boss, Dr. Erskine, who’s a cido for the enterprise, several different service line executives, and obviously operational executives. So the executive that runs all the community hospitals and the executive that runs all the university hospitals, they were both on the Shark Tank. So it’s probably about 12 people in the room. It’s not like the show Shark Tank where you only have four judges.

Scott Smiser [00:09:37]:

But, you know, we’re all asking questions that are valid to the pitch of what they’re looking for. But then more importantly, I think you know, helping support them. But you’ve got all the players at the table that could get behind that concept. Right. It’s not like that’s done in a vacuum where it’s like, who approved this project from the innovation cycle? We’ve got everybody at the table that’s got a potential foot in that.

Ben Hilmes [00:10:03]:

Right. So business lad it supported. I love that. I think we need to be doing more of that. So when we were in Nashville at Vive, you were saying healthcare needs to get out of being in the data center business. I know you’ve been pretty instrumental in pushing Emory to move to the cloud. Take us kind of behind the scenes there. The ecosystem of applications out there, an org year size, probably many thousands.

Ben Hilmes [00:10:30]:

How are you thinking about that ecosystem and where are you on that journey?

Scott Smiser [00:10:35]:

It’s interesting you bring that up because you’re not the first person that’s brought that statement up. I really feel like running data centers isn’t a core competency of a good healthcare system. Right. What really pivoted us into a move to the cloud was a couple of things. One, we were reaching capacity at our primary data center in Atlanta. So you’ve got to go around the whole capex structure around what does that look like? But then you’re constantly, from a business operations standpoint, I call it chasing the iron. Like I’m trying to stay ahead of what the business is going to need. So my engineering teams are constantly trying to say, okay, we’re a rack or two racks ahead of where the demand is or X petabytes of space ahead of where the demand is.

Scott Smiser [00:11:18]:

Where with the cloud, if we do it right, then we’re just dialing up that demand or conversely dialing back that demand as we need to. We’re in the process of dispositioning assets into the cloud now. This is a multi year endeavor. Right. It’s not going to happen overnight. And for a lot of the engineers on my team, they were like, why are we doing the cloud? And it was a lot of discussion around we’re managing virtual machines within a data center that we can walk across the street and badge into. And it’s that loss of, well, I won’t be able to walk across the street and badge into the data center, but we’re still managing nodes in the cloud. So what I’m looking forward to is a lot of app rationalization.

Scott Smiser [00:12:00]:

To your point, we’ve got a lot of applications in a portfolio. We did an exercise last year. We actually did a capability model assessment where we’re like heat mapping 14 different zones of capability, where we’re saying these systems fit in these quadrants and where is their duplicity, so that we’ve got four solutions that we don’t want to keep four solutions around that does the same thing. So it’s a combination of dispositioning assets off of on Prem services into the cloud and it’s also that rationalization of the app portfolio over time as well.

Ben Hilmes [00:12:34]:

Also a major component of this journey many are going through is to better position around security. I assume you drive some of the influence and investment around this. Around the topic of security. How is this helping that footprint for you?

Scott Smiser [00:12:50]:

I think anybody that’s trying to do a journey to the cloud, they’ve got to have our CISO and our security team. I mean, they have been from day one part of the discussion going to the cloud. When we stood up the circuits to go into the landing zones, they were part of the design of the landing zones from a security standpoint. So it’s without question that the security team and the security CISO needs to be at the table before you start any kind of design. In my opinion, going to the cloud.

Ben Hilmes [00:13:17]:

That’s right. Starting from the beginning at the table makes all the importance to build those layers of protection that are necessary, unfortunately necessary in today’s world. Small topic artificial intelligence. It’s the buzz everywhere. We saw it at vive, I saw it at hems, I saw it at all the conferences. You guys are doing a lot around ambient listening and other AI applications kind of leading through innovation. Talk to me about what you’re doing there and, and maybe a little bit about the readiness work that has to happen before you can take advantage of all of these AI tools. I mean, that’s, I think the thing that hits people in the face is, wow, there’s a fair amount of work I’ve got to do around data, data governance, et cetera, to even take advantage of all of the innovations that are coming out in the AI space.

Scott Smiser [00:14:04]:

The governance of just AI programs. We’re actually hiring a chief AI officer. If you think about it, you know, a couple years ago, artificial intelligence was just kind of conjecture out there. There wasn’t any real use case of it. So we really want to make sure we’ve got the governance, the use case down. When you talk about ambient listening, that is one of those projects that, you know, you do something for someone instead of something to them.

Ben Hilmes [00:14:33]:

Right.

Scott Smiser [00:14:33]:

The physicians that are on that program have point blank said you’ve Changed my life. Now I haven’t, my team hasn’t, but our team at Emory Digital has by deploying that solution just because it is changing that pajama time, that time after shift, the kids are in bed. Now I’m two and a half hours behind on documentation. I got a whole caseload tomorrow and they’ve got to wrap up documentation at 10 o’clock at night to keep up with it. So with ambient listening, I mean it’s crazy how the technology really distills a 15 or 20 minute session with a physician, a provider and a patient and it makes a note out of it. I mean it’s just crazy how it distills that into proper notes. So we’re really looking at how do we take that from just an ambulatory setting with physicians to an inpatient setting. How do we expose that kind of technology to the nurses where we’re looking at all kinds of different use cases of how AI and ambient listening in particular can be deployed to multiple stakeholder groups at the same time.

Scott Smiser [00:15:38]:

We’re using AI with Epic MyChart with inboxes where it’s actually using AI to auto respond or distill out the replies of thanks the physician or the caregiver doesn’t need, they can filter those messages out. So we’re using AI to really increase responsiveness to our patients that are trying to contact caregivers within MyChart.

Ben Hilmes [00:15:59]:

Really interested to see kind of what where you end up as you migrate from the physicians to the other providers and you start to think about that entire team of providers being on the similar kinds of tech capabilities that how that’ll improve efficiency and quality makes us to see the evolution of that. I’m glad you’re leading out in that space. So you’re a big fan of Apple versus some of the Windows based which most of us are on. I, I just hired a guy and he thought we were crazy that we don’t supply Apple devices and that we just need to get along with the program here. But you’ve been testing the use of Apple products in the clinical environment, which isn’t, isn’t mainstream yet. So I’m curious, kind of what drove that whole mindset and how is that going?

Scott Smiser [00:16:48]:

It’s going really well. I am an Apple fan. I’ve got my Emory Apple watch on. So when Dr. Erskine came to Emory a couple years ago, he asked me, he goes, what do you think of Apple? And I kind of joked, I’m like what do you mean? And I said, I’ve been An Apple avid user for 20 plus years as a consultant I would go into organizations using Apple products and I would immediately get met with that’s not allowed on our network. You can’t use that, you can’t do this. He’s an avid Apple user as well. But it really culminated with were working with Epic.

Scott Smiser [00:17:22]:

We were part of the brain trust that was doing Epic hyperspace for Mac. So Epic had a demand that they wanted to put their product as a Mac native application. And so we were in that small group of people and we had stood up our testing innovation lab in Atlanta. They had the code to the point where it was ready to be tested. We had the lab and the folks behind it. But we were the first health system to really roll at scale Epic locally on those MacBooks. And I can tell you the 1100 test pilot physicians that we ran that to with MacBook airs with them using Epic locally. I’ve been in situations where you’re rounding and literally they’ll see you coming and they hold their MacBook like to their chest.

Ben Hilmes [00:18:06]:

You’re going to take it away.

Scott Smiser [00:18:08]:

Yeah. And I’m like, why are you doing that? And they’re like, I was part of the pilot program. Please tell me you’re not taking this away. So what I know for sure is, you know, we’re doing some cool things with Apple. They’ve been a great partner of ours. We’re a big Epic shop obviously. You know, we even took that last summer and we thought, well, we had a chief nursing officer at one of our facilities say hey, can we do more with Apple? And I said, well, what do you mean? And she was like, well, could we do a whole nursing unit? I’m like, well, I don’t know, let’s explore that. So we actually have a whole nursing unit that’s all Apple.

Scott Smiser [00:18:38]:

There’s one Windows machine on there. It’s for the business continuity with Epic. And epic’s actually working with us to put something on an Apple device for business continuity. But we’ve got a whole nursing unit that’s nothing but Apple. And you know, between the pilot laptop users and the nursing unit, the way they feel about these devices like on the carts, you know, they don’t understand why they don’t have to plug the carts in as much because they’re running an iMac 24 inch with a silicone chip. It takes half the power that a Windows machine took. They don’t understand. They’re like, well, the carts, I don’t have to plug the cart in as much like, oh, that’s good, you can focus on our patients.

Scott Smiser [00:19:17]:

And I said, what else do you like about it? And they’re like, well, the font is real crisp, it’s bright, it’s easy on my eyes for 12 hours. So if I can give them a device that a, they like it, they feel good about interacting with it, they’re happy using it, that’s going to translate into patient care. It’s going to, it’s going to affect, you know, physician and provider burnout and joy of practice. So if those devices can give them some joy back in their practice of medicine for patients, you’ve hit a gold.

Ben Hilmes [00:19:46]:

Mine there because, I mean, one of the big challenges is now you’ve got people asking for more. That’s an exciting place to be, right, because they can see where they can utilize these capabilities in tech to improve the way they do their jobs. And I don’t know a provider that doesn’t want to be spending more time at the bedside with patients instead of interacting with technology and being frustrated and pajama time, all those things we talk about all the time. So that’s wonderful. Scott, one more question. And this is going to be around leadership. You and I have got a lot in common because you talk a lot about people that took chances on you throughout your career. And I’d love to hear how that’s kind of shaped your approach to leadership.

Ben Hilmes [00:20:30]:

What your mindset is around developing and.

Scott Smiser [00:20:33]:

Empowering your teams without question. I mean, I’ve been in the business 34 years. I started as a 19 year old kid, so you can do the math where I am on the clock. But I had an interest in computers early on. You know, at first I wanted to go to college and actually be an anesthesiologist. I worked at a hospital in the computer department because I knew how to. I could pull and patch cables and I can swap devices and help users. Right.

Scott Smiser [00:20:56]:

Obviously, I did not become an anesthesiologist. I stayed a technologist my career. But there were people throughout my career that, you know, probably saw something in me that I didn’t see in myself at the time. And what I try to do is with people that I’m curating. I think everybody needs to have a mantra. And my mantra for me in leadership is I grow people. Now sometimes that growth comes very willingly. People want to grow.

Scott Smiser [00:21:22]:

Sometimes they’re like, why are you giving me this project? Why are you asking me to do this? But if you see something in someone, give them a chance. You know, I think too often either A, they don’t see it in themselves or B, they’ve been told, oh, you can’t be good at that and you know, give them space to feel comfortable, to make a mistake. But I think my job as a leader is to surround myself with the smartest. I should be the one in the room with the least amount of answers. Right. To me, leadership is a privilege. It’s not a role, you know, it’s a privilege to be able to work alongside folks that, you know, they’re entrusting their career, they’re entrusting their livelihood with you. And you know, I always tried to lead very transparently but I think as leaders today, what I struggle with is trying to find that next generation behind me that you constantly have to find the next generation behind you to keep the momentum going.

Scott Smiser [00:22:16]:

But you know, that’s my view on leadership.

Ben Hilmes [00:22:19]:

I think you’re spot on is there’s a point in your career where, you know, you get out of the learning, earning, now I’m in the get back years, how am I making sure that when I leave there’s, you know, an opportunity for this thing to get better through the leadership you’ve developed. And I just love that mindset. So Scott, this has been wonderful. I really appreciate your time. The work you’re doing at Emory is industry leading. Looking forward to get on, on site there with you at some point.

Scott Smiser [00:22:47]:

Absolutely.

Ben Hilmes [00:22:48]:

Touring the holes, maybe seeing those Macs.

Scott Smiser [00:22:50]:

And, and they do exist, Ben, they do exist. I promise.

Ben Hilmes [00:22:53]:

I gotta see it, I gotta see it. But no, this has been wonderful. Thank you so much for, for joining the program and best of luck as you continue through your journey.

Scott Smiser [00:23:02]:

Thank you. Thanks Ben. Thanks for having me.

Ben Hilmes [00:23:06]:

Scott Smiser is doing forward-thinking work at Emory Healthcare. Here are a few takeaways from our conversation: One, Scott sees innovation as both internal and external. He’s working to improve both how Emory delivers services—and how it creates new value for patients and researchers. Two, Scott is leading a major cloud migration at Emory. This isn’t just about upgrading systems—it’s moving away from the outdated model of healthcare running its own data centers. 

Three, Emory is pushing the envelope with Apple products in clinical settings. Scott’s goal is to prioritize tools that healthcare workers actually enjoy using—and that support better patient care. So, what did you think? What were your big takeaways from this episode? I’d love to hear from you on our social media channels or drop me an email from our website at healthcareitleaders.com.

Narrator [00:23:56]:

Thanks for joining us. For Leader to Leader to learn more about how to fuel your own personal leadership journey through the healthcare industry, visit healthcareit leaders.com don’t forget to subscribe so you don’t miss any insights and we’ll see you on the next episode.