Welcome to The Edge of Healthcare, your premier destination for insightful discussions and actionable insights. In each episode, we dive deep into conversations with industry leaders, exploring the dynamic landscape of healthcare. From overcoming hurdles to embracing breakthroughs, join us as we discover firsthand the strategies and experiences of healthcare trailblazers. Whether it’s payer and health system leaders or innovative solutions, we’re here to empower you with knowledge that drives real change in the industry. Don’t just listen—be part of the transformation.

About This Episode

Embracing a balanced approach to leadership, informed by curiosity and empathy, is essential for driving positive change in healthcare.

In this episode, Tina Joros, Vice President of Policy and Innovation at Veradigm, shares her journey from law to healthcare technology, highlighting the industry’s rapid evolution. Tina emphasizes the importance of lifelong learning and maintaining work-life balance, especially in remote work settings. From opening up to third-party developers to serving various stakeholders, Veradigm’s platform evolution demonstrates its commitment to innovation and collaboration. Leadership in healthcare, Tina underscores, requires advocating for stakeholders, embracing change, and listening to diverse perspectives. She stresses the need for balance in decision-making, offering baseline services while catering to different budget needs. Mentors like Siddhartha Mukherjee and Micky Tripathi have influenced her, emphasizing the value of knowledge and curiosity. Tina encourages continuous learning and concludes with a reminder of the symphony of learning and leadership, urging listeners to tune in, embrace balance, and seek knowledge to navigate the complexities of healthcare effectively.

Tune in and learn why effective leadership in healthcare entails advocating for stakeholders, embracing change, and listening to diverse perspectives!

Read the transcript below and subscribe to The Edge of Healthcare on YouTube.

Martin Cody: Welcome to the Edge of Healthcare, where the pulse of innovation meets the heartbeat of leadership. I’m Martin Cody, your guide through riveting conversations with the trailblazers of healthcare. Tune in to gain exclusive access to strategies, experiences, and groundbreaking solutions from influential payer and health system leaders. This isn’t just a podcast, it’s your VIP ticket to the minds shaping the future of healthcare right now. Buckle up, subscribe, and get ready to ride to the edge of healthcare, where lessons from leaders are ready for you to use today.

Martin Cody: Hello again, everyone, and welcome to another episode of The Edge of Healthcare: Lessons from Leaders to Use Today. I am thrilled to have our next guest join us, because she has been in healthcare a long time and comes from a diverse background, and she is going to give you some tips of wisdom that I promise you will be beneficial. Ladies and gentlemen, welcome Tina Joros from Veradigm. Tina, how are you?

Tina Joros: It’s been great. Thank you so much, Martin, for having me on.

Martin Cody: You are very welcome. And I’ll let the crowd applause die down a little bit because a very important guest. So, and we’ll put some background applause in, so it makes more sense. But I wanted to, you and I have known each other professionally for a number of years; our paths have crossed through various intersections of the industry. But before we get into what you’re doing today, I want to go back and say, tell me about Tina Joros. Where did you grow up, and then where did you go to college? And give us some background.

Tina Joros: Sure. So, I grew up in Indiana, and when I was going to college, my parents said, “You can go to school anywhere you want to go in the great state of Indiana.” So, I ended up at Indiana University Bloomington. I got a business degree, and then stayed there for law school. So, I’ve got seven years in Bloomington, and I love it very much; a place near and dear to my heart. But in Indiana, my goal was to be inside counsel, corporate counsel for a big company and ideally specialize in human resources, making the workplace the best place to be.

Martin Cody: How did you decide to get into law? That is not usually a decision that one just wakes up and says, I’m going to be an attorney.

Tina Joros: I’ve always wanted to be an attorney. I love reading, I love analyzing, there’s a lot of aspects of being a contractual attorney and an in-house attorney that I love. I’m not a litigator. I don’t like conflict in that sense. I like preventing conflict. I like being very transparent and clear about contracts and rules and things that impact your daily life. But it wasn’t a hard decision for me.

Martin Cody: So, it wasn’t anything like mom was an attorney or dad was an attorney. You just woke up or really went to it naturally, because of the love of reading and analyzing and preventing conflict and thought I could do something in the legal space.

Tina Joros: So, I had my business degree from Indiana, and I knew I wanted to work for a big company, but I wanted to impact it at a different level. I wanted to be able to impact policy for a group of people. So, the law was a good fit.

Martin Cody: Interesting. And then so you, did you ever work for a law practice?

Tina Joros: I did. I worked for practices in Indiana, mostly doing employment law related to unions. There’s a lot of unions in the state of Indiana on the employer side. And then I moved down to Florida and started working for a securities fraud defense firm. I was part of the group that was helping the victims of the Bernie Madoff scheme try to recover $0.10 on the dollar, which was heartbreaking. But I’m licensed in Indiana and Florida, and so I worked at a private law firm until I got my bar results and was a licensed attorney. And then I started applying for companies and Eclipsys in 2002, was one of the companies that I applied for, and I did not have a health technology background at all. I just knew I wanted to work for a company, I wanted to be in-house, and when I interviewed for the job, the goal was, okay, how much longer do I need to do this private practice billing in six-minute increments and all the things that go along with that? How much longer do I have to do this before I can be really ready for an in-house job? And the good news for me was that even at that time, in 2002, industry was moving so fast. So, remember, this is before high tech, meaningful use cure everything. Eclipsys was a software company, and like any other software company, all we were trying to do was raise features and functionality out to our customers. Who could get this out fastest? And hospitals at that time were buying their very first EHR. So, we were busy. We were busy, really developing software, acquiring companies for all the different parts and pieces of specialty and expertise that we needed. So, there’s a lot of M&A activity, and there was a lot of client contracting because people were buying their first EHR, and there was a lot of implementation and services that went along with buying the software. So, I was really busy, and I was really lucky to start in that environment where it was fast paced. I had no idea that pace would never slow down over 20 years like none. But from an attorney’s standpoint, from a legal standpoint, watching the industry move from one that was not regulated was just software, was just a product to a heavily regulated, really structured environment that we have today with USCDI, data elements being required, and interoperability rules that require us to be speaking the same language, it’s been a fascinating journey. And like I said, the one thing nobody could have told me was that it would never slow down. It would keep going year after year; new things, new hurdles to overcome, new regulations to work with. And that’s really been fascinating from my standpoint. So, I love it.

Martin Cody: And I think that brings up an important point. If someone is listening and currently in their first or second or third year in the healthcare industry, I think it’s a good thing and potentially a bad thing; that perpetual high velocity rate of change. For those of us that are, I don’t know if it’s thrill seeking or adrenaline junkies or anything like that comes to mind, but you’re right, it is constantly evolving. So, would you say that if you don’t like change, that maybe healthcare might not be for you? Or there could be a special, you know, area within healthcare that would be more gratifying?

Tina Joros: I would, I think you have to have that desire to remain curious. You have to have that lifetime learning attitude, because even right now, no one’s going to escape this year without hearing about artificial intelligence. We’re all learning this together. There’s always something to do. We talk about physician burnout a lot in this industry, but no one talks about burnout at the level of the vendor, the company, the developer. I’ve seen in my time here, a lot of software developers that care very much about this industry, who’ve invested tons of training in understanding clinical workflows and the nuances of the algorithms we’re using in our software. And they burn out, too, and they just walk away from healthcare and say, It’s too much. I’m done. I’m moving. I’ve seen people move to the finance industry, to the oil industry, banking, anything but healthcare. And so, you have to really go in with eyes wide open, knowing that you’re about to embark on a journey where you’re going to learn skills that are going to be superseded by new information very quickly. You have to keep learning.

Martin Cody: Perspective, and it’s interesting you never, ever hear about the the health of the healthcare worker or the developer or the engineer or those sorts of folks. You do hear about it on the clinical side because you see, rightfully so and importantly, a movement now that especially folks with Alzheimer’s, dementia, their caregivers, that’s exhausting work. So now there is finally all sorts of different modalities and groups and businesses that are helping care for the caregiver. But on the development side and the engineering side, it is a relentless pace, 24 over seven. So that’s an interesting perspective. And I’m glad you shed a light on it, because there are some work life balance that is absolutely necessary.

Tina Joros: I think, I want to add one more thing, because when you’re new, you’re starting out, you don’t always look at the benefits package that a company is offering. But for example, we’ve increased the benefits for mental health, we’ve increased vacation time to unlimited PTO so people can take those breaks when they can and when they need them to try to have that quality of life that helps you stay delivering at this pace. So, I think the benefits package that your company offers to you makes a difference, and you need to really look at that closely and make sure that they’re giving you tools to take care of yourself, both mentally and physically, while you’re out there doing the work for them.

Martin Cody: Agreed. So maybe the beanbag lounge chair and the break room is not necessarily the end all be all that it once was. There needs to be a little bit more substance in the path.

Tina Joros: That’s pretty nice, but it’s going to be different for everybody. What people use to wind down or de-stress is going to be different for everybody. I know a lot of people that sitting in that beanbag and playing a video game is going to be exactly what they want to do. For me, I go outside and take walk and say, “Okay, let’s regroup, let’s breathe, and walk.” But you’ve got to take care of yourself in order to maintain this pace in this industry.

Martin Cody: And I think that’s the importance of that has probably accelerated in the last four years because of the pandemic. And now you have a significant chunk of the workforce, both in healthcare and in every other industry. Working remotely, so the foosball table, the ping pong table, the cocktail mixer, what have you on Fridays, those are essentially gone. So, the workforce is learning a new manner of productivity and efficiency and helping the company scale. So those intangible attributes that you talk about with regards to the benefits package are even more important today.

Tina Joros: So, I’ve been working remote since 2008. So, I like to say I was doing it before it was cool, got a lot of experience under my belt, but the pandemic was very different. It was more isolating than I’ve ever felt, so my outlet was going to conferences and events, seeing people like you, being able to collaborate in person with people and talk through things. We don’t see nearly as much travel post-pandemic as we did before, even for internal meetings. So, people really are on their own. And again, we just encourage everyone to find their own way to deal with that stress and try to provide the tools and the resources and the recognition and things that keep people going.

Martin Cody: Agreed. And getting outside, getting some vitamin D, even a five-minute meditation break, all of that stuff can make it tremendous difference to the mental health. The Eclipsys, it’s a name I hadn’t heard in a long time, it was a great technology software company, graduated from there, and then did you decide very quickly, “Okay. I definitely want to be more involved in healthcare than I do with law?”

Tina Joros: No. So, remember I told you my dream was to be in human resources, and I thought that’s where I could make a really big difference in people’s lives. But that was a little naive. I didn’t realize that when you’re the attorney in human resources, you are doing reorganizations, layoffs, Warn Act, you’re looking at discrimination claims. I fired a lot of people, and boy, that’s really hard to do for a long time. So, I got my dream, and I was like, “Oh wow, that’s all I thought it would be.” So, I tell people early in their career a lot, it is okay to get what you want and not like it. It’s okay. You still want to have that dream; you still want to have that North Star. But if you get there and it is not exactly what you thought it would be and what you’ve built up in your mind, it’s okay to reevaluate and go, “Okay, I’m gonna look for a pivot.” I got really lucky. I’m so grateful for the opportunities I’ve had at this company because I was assigned to work with our software development team, so for two years we were reorganizing. We had done a ton of acquisition. We had people offices everywhere. We were consolidating, we were reorganizing, and I was working really closely with the leadership team for software development. And so, I learned a lot about software development. I helped the teams move from waterfall software development to agile. I helped run a couple of developer challenges for new APIs that we were rolling out internally to help our different systems talk to each other. And so, in 2009, 2010, when our customers started saying, “Hey, we think we want to open up this platform to other third-party development,” I was in a really good place to understand the technology side of that and think about the real risks and mitigating the risks associated with doing something like opening up your platform. So, remember, at that time everybody was siloed. Nobody, if you worked with a third party, it was via a strategic partnership, and you had very specific terms in place. You got this data; you got that data. Some vendors were going direct to databases, which carries its own risks with it in terms of trying to that maintained and up to date. But our customers were saying, “We need more,” right? “We need faster innovation. We need you to open up this platform, have APIs that others can learn.” So, the board decided that we wanted to open up our platform in the most conservative way possible. And appointing an attorney to do that is is one way to do that. I got the opportunity, and just did a crash course on application programming interfaces, all sorts of technology, things that I needed to learn in order to understand how this would actually work and built the program. So that’s how I ended up on the business side. And I spent 13 years there running our developer program and a number of other products for the company. Over time, it would be all scripts and then paradigm in terms of regulatory compliance, reporting, all sorts of things, e-prescribing, lab and radiology, connections, just a wide range of solutions.

Martin Cody: It’s an interesting perspective and an interesting time because that was a huge transition and a corporate shift away from normal business workings of everyday corporate software company. So, you said the customers are asking to open up the platform. What was the hope of the customers and also the internal leadership, by opening up the platform that would allow you to do what?

Tina Joros: At the time, strategic partnerships take a lot of betting. They take a lot of internal. You’re going to choose one vendor to do one thing. You’re going to go all in. You might embed that in the software. You might price and package it separately. What the customers wanted to do was have a little more freedom and flexibility over the vendors that they chose and have a path for them to get connected that wasn’t so onerous. Initially, we were still having groups sign a separate contract. We negotiated lightly, but we were trying to get to standard terms and conditions. You could just click through. And I forget what year, I think it was 2000, somewhere in between 2012 and 2014 is when we got to a click-through agreement that was like, take it or leave it. Like, we now have all of these terms refined. We have a very fast on-ramp. If you decide this morning that you want to connect with our software, by the afternoon you can be developing. It took us a little time to get there, but it allowed our customers to choose third parties they wanted, and they had very different reasons for choosing the software that they wanted. They didn’t want one vendor, they wanted options.

Martin Cody: So now, and I’m trying to get educated, I think it’s a great idea. Click-through agreements have just become almost standard. I don’t think anybody reads them, self-included. But if you, so you had, were building a development platform where unfinished products and developers could come in and continue development on your platform, and also fully baked products could come in and be available. So, customers had a menu, if you will, or table of contents, index what have you, to say, “Okay, I definitely want this for prescribing, I definitely want this,” and they could choose a la carte?

Tina Joros: So, we had a couple of different flavors of companies that came to us. Sometimes our customers were already working with the vendor and just wanted it to be integrated. So, you have a standalone solution that just needs some integration. In other cases, companies were startups, and they might have been working in stealth mode, they might have been working through an incubator and they wanted to connect to their first EHR. We worked with a lot of companies that way. Connect with your first EHR, show how the integration would work, and then use that to go out and build a customer base. So, we worked with a number of different companies like that. Sometimes early on it was really device vendors. So in the 2010-to-12-time frame, it was Hillrom, it was ECGs, it was Spirometers, it was things that doctors were using, and these were jotting down numbers on a pad and then taking it over to the computer and inputting it, which had all sorts of the same problems that e-prescribing did when you did it manually with messy handwriting, putting in the numbers wrong, etc. So early on it was really, low-hanging fruit was devices. Just make sure the things you’re already doing are coming over automatically into the system. And then we started moving into a lot of patient engagement. So, everybody wanted to find different ways to communicate with patients and different ways to get the intake forms into the systems. Sometimes we had technology that provided this function, sometimes we provided basic functionality, and then the third party might come in and provide a premium, something or other. And it was opposite. Our solution was heavy in premium and a lot of stuff, and sometimes people just wanted something streamlined. Clients had lots of options to mix and match, and for a while it was a very, it was a very robust program.

Martin Cody: Sounds fascinating, and I think super intelligent because it allows you to be able to offer your customer base the best of everything without having to develop it in-house, which takes years of iteration cycles and and is hundreds of thousands, if not millions of dollars, and bring it’s almost like inclusivity for software technology from that standpoint.

Tina Joros: Right. And it also served one other main purpose. At the time, in the 2010-ish time frame, we were starting to have to comply with meaningful use, and we had a ton of development to be regulatory compliant. When we looked at roadmaps, our entire workforce was going to be spent building to regulatory. We had no ability to really do some of the fun, creative stuff, and so program allowed developers to build the fun stuff on so that our customers could get both the basic meaningful use compliance and also some of the features that they were looking for without us having to invest in tons of additional workforce to build all of that out. Plus, it allowed us to use the expertise of the third parties, really to build out the best solution for a specific purpose. Best of breed, and I think it was successful.

Martin Cody: Very much so.

Tina Joros: It’s easy now.

Martin Cody: Which leads me to two questions, because it was a very elegant, sophisticated labor arbitrage, it also allowed you to get to market faster on a variety of products. What would you say was your number one takeaway that you would want to share with someone who potentially is considering opening up their platform, Judy Faulkner, to other individuals and companies that could actually then benefit the community or healthcare patient as a whole? What would be your number one bit of advice?

Tina Joros: Well, Epic has opened up their platform, they’ve got a good robust program as well. There’s the technical integration and then there’s the business side terms. And both of them have to really work for a developer in order for them to want to invest in integrating with your solution. So, the technology, I’m not going to say the technology is the easy part. Most, everything you want to do can be done from a technical standpoint. The question is, how are you going to give access to that? How much are you going to charge? I think those are some of the more interesting issues when it comes to developer ecosystems, because anything’s possible at a certain price. But what can you do that’s going to bring a lot of value? That’s why you’ll see if you look at our program today, we actually have moved over the years to different tiers because developers need different things at different times. When they’re first starting out, they may not have any live customers. You want that to be a very low cost of entry, so it’s not prohibitive from them to start developing and thinking about what’s possible. Then once you’ve got a customer that’s got 50, 100, 200 customers, they need something very different. They’re much more hands-on. You’ve got support cases coming in. There’s a higher cost for staying at level. So, I think we had to modify the pricing structure and the services provided over the years as everybody grew to really make sure we were aligning value with cost. And I think some of the business challenges in this space are even more interesting than the technical one.

Martin Cody: I can see that. So, let’s talk about the business side of things. Educate the listener and viewer on Veradigm, because I have some vague familiarity with Allscripts. Full disclosure: most folks may or may not know that I worked for the company in 2006 to 2009 or so via an acquisition. You talked about a rapid pace of acquisitions back in the early 2000s; I was part of one. And then it has transitioned considerably, shifted away from some technology to other technologies. So, give us a high-level overview of Veradigm, the name, origin, and the mission statement today.

Tina Joros: Yeah. The thing I love about Veradigm today is we’re serving a number of different stakeholders in the industry. So, we certainly have providers that have clinical financial solutions, patient engagement solutions, etc. That is what you would typically think of as the old Allscripts, right? That provider base and selling the EHR into that space. But Veradigm as a company also has a couple of other facets. We have solutions for payers. We’ve got claims management. We also have a number of different payer solutions in our portfolio to help them get charts, information for adjudication, for audits or things like that, for gaps in care, for all sorts of things. We work with a number of different payers in the industry on that sense. We also have a life sciences business where we’re helping with clinical trials, we’re helping with research, we’re helping advance the entire ecosystem from that perspective as well, using all of this rich data that we have and also combining it with the data from other vendors in the in the marketplace. What I think is so awesome today is that a lot of the companies that we compete against in one arm, we collaborate with in another sense. So it is, it’s a very interesting place, there’s a lot of coopetition happening, and I have a ton of respect for all the groups that are here trying to make a difference in healthcare. We all have that same altruistic goal of really improving the experience for patients, for providers, for everyone in the healthcare ecosystem. And there are many times people don’t realize that we are working together to go to market with a solution or to combine the best things that we each do, and I think that’s really exciting. So Veradigm today really serves a number of different players, providers, payers in life sciences. So, we have a pretty broad set of stakeholders and customers.

Martin Cody: I like that you mentioned, first of all, that’s an incredibly dynamic, rich portfolio. And I think if anybody is interested in trying to find a place with a healthcare company, that would allow them a terrific opportunity in a variety of areas to certainly seek out and be curious. So, congratulations to the leadership group. You mentioned the altruistic goal of trying to make healthcare better for everybody. And we’ve been in healthcare a long time. And I hear a common phrase that healthcare is always 50 years behind the private sector. Why is that?

Tina Joros: I’ve looked into this a lot over the years. I don’t know, I think it has something to do with the Hippocratic Oath. First, do no harm. As clinicians, a lot of the doctors that we work with, they want to make sure that the technology that they’re using is not going to do harm. It’s going to be better than what they have right now, which means that you have fewer early adopters, especially in the ambulatory space. If some things working well, do we have to touch it? We have few early adopters. So that innovation bell curve of adoption, I think pushed out a little bit until we can prove this is working, it’s not doing any harm. Okay, this makes sense for everybody. I think the ONC, their rulemaking has been pretty exceptional over the last few years, and they’re forcing everybody a little closer towards that front end of the adoption curve. And there’s a cost to that too, right? People are, we’re not sure how this all work out because there hasn’t been time to let some of it settle in. But we’re headed in the right direction. But I think it just takes some time.

Martin Cody: I also think a lot of it has to do with leadership. And you mentioned the Hippocratic Oath, and I think that’s good; we apply that on the clinical side. But I bet you there’s a bunch of providers that are looking out there saying, “Yeah, do no harm to us too. Stop putting the burden of things on the provider because the provider community is so burnt out.” And I think there’s, it’s a long conversation that we can potentially have at a different time because leadership is so important in healthcare and the Veradigm folks made a decision to move to an open platform aspect, to bring in all stakeholders to help elevate the entire organization, to be able to deliver more value to your customers. That’s a leadership decision. Probably not an easy decision because it was very unconventional at the time. So, as you look at leaders, what are some of the attributes that Tina admires in leadership and believes these are must-haves for an effective leader?

Tina Joros: I think in this industry, you’ve got to be open to change. You’ve got to be open to at least understanding the pros and cons of trying new technology, moving into a new direction. And you’ve got to be vocal. You’ve got to advocate for what your providers, your patients, need. Same thing with the vendors; you have to have that voice. So, for example, we participate in the EHRA, an association of 29 different EHRAs, to provide public comments and have dialogue about some of the rules that are coming out. I think it’s important to be good participants in this program by being vocal about the real impact of the rules coming out, what needs clarification, what’s really difficult to achieve even on the best day, just because of the time for development or the complexity of what they’re asking. So, I think leaders have to be both great advocates for their stakeholders and also vocal. You can’t be quiet. You can’t just sit and accept what’s happening and just keep up with everything. I think everybody needs to be really active in this industry in order to drive it forward in a way that’s going to make sense and be good for patients and everyone else.

Martin Cody: And take a, and we probably could have put some nuance behind the leadership question because there’s provider leaders, there’s technology leaders. But specifically on the business side, CEO or presidents of division: on a scale of 1 to 10, how important is the listening skill?

Tina Joros: I would give it a ten. Nobody can know every nuance of this industry. You’ve got to have a diverse team that’s got different skill sets, seeing things from different perspectives. So, we’re talking about diversity, not just racial, gender, but also neurodiversity and also different perspectives from an economic standpoint to understand how the things we’re doing impact patients and providers at different levels. So, for example, we have a lot of rural healthcare providers. I was looking at the US, the latest US census and about 20% of Americans live in a rural ZIP code, and I matched that up with our Veradigm EHR data, and lo and behold, 21% of our customers also reside in a rural zip code. And I was like, we are America. That is awesome. We have stakeholders that have different challenges. We’ve got inner-city urban providers. We’ve got providers in large cities or suburbs of large cities. And we also have rural providers that are in a very different place in terms of providing care for their patients. We have to listen to all of these different types of voices, and we have to take into account the different perspectives that they have in order to build products that are going to be fit for purpose when they need to use them.

Martin Cody: Yeah. And I think there’s a delicate balance there too, because first of all, I completely agree: It’s really just data. And the more data you can acquire from different unique data sources, the better the overall product or service or offering is going to be. And especially when, you’re right, the rural clinician and caregiver has a totally different need requirement than, say, someone at a big teaching institution in a major city. Their voices have to be heard somehow. The other challenge that you have to balance that with, obviously, is you’re a publicly traded company, so you’ve got responsibilities to shareholders; you have responsibilities in that in the business community as well. Because sometimes it may make sense for the clinical side of things, but it may not make economic sense. It might be something that isn’t going to return the ROI that we had hoped it would, but boy, is it going to be very valuable. So, I think from a leadership standpoint, that balance never goes away as an incredibly complex. How often do you see that fold out in decision-making?

Tina Joros: What I’ve done in the past with my different products and teams, in order to try to balance that, is provide baseline services or software that meets the criteria that says, “This allows you to comply; these are the basics of what you need,” and then a more premium offering that some groups might have the appetite for they might have the budget for that allows them to do a little bit more. I think that strikes the right balance when you can meet people where they are and with what they need at a cost that’s fair. So, I think it’s the same thing that we did with the developer program, like how value versus the service provided and finding that balance. And I don’t think there’s a one-size-fits-all. So, continuing to offer options I think is important. It’s harder to maintain. And from a business standpoint, it’s much harder to sell a bunch of options, but it allows everyone to customize a little bit better so that they can do what they need to do. The other thing we have to recognize is that all of these providers are running a business as well. They’ve got budget cycles. We have provided information at the right time so that they can plan for it and budget for it as well. Nobody likes to be hit with an expense that they have to do that hasn’t been planned for. I don’t like that in my personal life; nobody appreciates that. So, we’ve got to make sure we’re providing information at the right time so that they can plan that out in their own budgets and think about what they’re going to do to cover costs, etc.

Martin Cody: I like it, and you have a tremendous wealth of knowledge and experience. If you were going to go back in time, because obviously this has been acquired through the years and all the iterations and experiences of the work process, some things working and some things failing, picking yourself up and dusting yourself off and go, “Oh, I did not get the outcome I thought I would get right there.” So, if you were to give young Tina, who’s embarking on a legal career at any advice, what would you tell her based upon what you know today?

Tina Joros: Yeah, I actually give the same advice to everyone that my dad gave me when I was in school. And he said, the job that you’ll do doesn’t exist today. It doesn’t exist. Prepare. Just be a good or learn how to deliver. Do the basics well. You don’t have to know what you’re going to do, but if you have a good skill set and you can deliver on what you say you’re going to do, and you can think critically and analytically, then you can move into those positions as they come up. And he’s been right every single job I’ve taken, apart from associate general counsel when I first started. Everything after that over 21 years has been a job that did not exist when I was in law school, and that nobody knew we would need until the regulations came out or the market demanded this type of infrastructure. For example, today I’m working with the team that’s building our AI Center of Excellence. That didn’t exist before. We need an AI Center of Excellence because not only are we trying to infuse artificial intelligence into every area of our business, but we’ve got obligations to be transparent about how we do that and the new HTI1 rules about decision, support, interventions, we have to provide data around how these algorithms are built, how their models are trained. This isn’t a problem we had to solve for five years ago, but it is today.

Martin Cody: So other than your dad, who are some of the leaders that have mentored might be too strong, but where you’ve taken bits of advice and wisdom and have shaped and influenced your career path and or personal path?

Tina Joros: I get insights from everywhere. I really love reading. So, from a clinical standpoint, I think Siddhartha Mukherjee is a fantastic clinician and author. I don’t know if you’ve read any of his books, but, oh, they’re big beautiful and wonderful. And if I’m going to recommend a book that kind of shapes how we think about medicine and technology and what we’re going to do to treat patients in the future, the Emperor of All Maladies is a book called A Biography of Cancer, and it goes back to the first known cancer detection and all the different things we did to treat that along the way; the technology that was used and available at the time, the outcomes, the clinical trials. It’s really a story of how we treat disease and people, and how our own environment is contributing to some of the challenges we’re facing today. I love it so much, and it’s a fantastic read. So, I don’t know. There’s a lot of people influencing this. I think Micky Tripathi at the ONC is fantastic and from a leadership perspective, see him bringing in Fire and interoperability and USCDI core data elements and just this really mature, thoughtful way of building an ecosystem that can communicate with each other and then expanding the use cases. For example, I’m on the TEFCA Transitional Council, and we’re not just looking at use cases that are about treatment payment operations. There’s also public health reporting, use cases, emergency use cases for the CDC. There’s all sorts of ways we can use this baseline ecosystem at some point. And I think it’s been really great to see him lead the charge there and enact some things. He’s difficult to keep up with. I think things are moving in a great direction and so happy to have somebody like him leading the charge.

Martin Cody: So, I especially applaud and endorse and share the passion for reading. And I also think that hearkens back to what you said earlier about curiosity. So, if you have that curiosity, expose yourself to authors. If you find an author you like, read everything that they’ve produced. And then if they recommend someone, which they usually do on the back flap of their books, go find that individual, but you’ll attain much more knowledge, experience, wisdom, curiosity. By the way, if you can hear the ambulances and everything behind me, there’s just the symphony of the City of Chicago these days. It is beautiful. Okay, I want to move on to one other topic. What excites you the most about Veradigm today?

Tina Joros: Right now, we have an interim CEO. And so right now we’re in a transition phase. And I’m really looking forward to having a permanent CEO kind of starting the next chapter. I think I’ve been through ten CEOs at this point. Three major name changes. But we’re here, right? I think that there’s another chapter coming up for us, and I’m really excited about it, because there’s some incredibly passionate people and we’re thinking about things like artificial intelligence and some of the things that are going to be next level in this industry, and I love that. So, there’s a lot to look forward to from my perspective. But right now, we are waiting to get some finalization on that role and who will be leading us through that next chapter.

Martin Cody: Super cool. And that’s exciting too, because this is another example of you just embracing change and getting excited and geeked out about it, because there’s something on the other side of that isn’t going to be more rewarding. And to your point earlier, there’s probably going to be some positions that didn’t exist 12 months ago that need to be fulfilled. Awesome. All right, last segment. I know it’s your favorite one, the one you’ve been anticipating the most.

Tina Joros: Hang on, let me have some coffee.

Martin Cody: Word association. I’m going to just mention a few things, a term or a phrase, and you tell me the first thing that pops into your mind. So, I’ll give you an easy one. Chicago Cubs.

Tina Joros: Ooh! Hot dogs.

Martin Cody: Very good. Acceptable answers were also greatest baseball team ever, best experience in these sorts of things.

Tina Joros: I’d also throw Pearl Jam in there because they had a really great documentary called, I think it’s called Let’s Play Two. Yeah. Do you watch that? It was really good.

Martin Cody: I haven’t seen it in totality, but yeah, an old Ernie Banks quote.

Tina Joros: It’s good. It’s really good. I love Wrigley Field. I grew up going to Wrigley Field from northern Indiana, so there’s a lot of things. But I didn’t eat meat for about ten years. And smelling hot dogs at Wrigley Field changed all of that for me.

Martin Cody: There may be some in the audience that would say, “That’s not meat,” and that’s a whole different discussion for another time. All right, let’s talk about a term or just tell me the first thing that pops in your mind. You said this earlier: inclusivity.

Tina Joros: I think inclusivity includes so many broad categories. We think racial, we think ethnic, we think gender. But inclusivity involves neurodiversity. It involves economic diversity. It involves diversity from so many different standpoints. And when I create teams, I like to look and make sure that we’re approaching things from different perspectives, that we think differently about solutions. And I think good teams are going to have all of those aspects represented.

Martin Cody: I totally agree. Okay. An old word, want to, I’m curious if there’s any mental scarring. Meaningful use.

Tina Joros: Busy. Meaningful use is a blur. A meaningful use one was a blur. We were just so busy building things out. But it was.

Martin Cody: Yeah. You want to talk about fast paced? Getting those requirements out the door was insane. All right, last one. Glass ceilings.

Tina Joros: Shatter. Just shatter them. I think a lot of limitations exist in our minds. There are real limitations out there to the different things that we can do, but an individual’s will and their desire to affect change, I think, can overcome a lot of that.

Martin Cody: Agreed. And I will spare you any more. So, you are done with word association. But I do appreciate your perspective on everything that we talked about. And one of my goals is I’d like to see more women in leadership positions at very high levels because I think the voice that they have is unique to what you talked about earlier. Let’s not just all hear from the same type of voice that we’ve been hearing for 30 or 40 years, and based upon what we’ve heard today, I would not be surprised in the near future if in fact, CEO didn’t follow your name.

Tina Joros: I would love that. But like a lot of women, I balance out my other obligations. And so, for right now, raising really competent, caring teenagers is a priority as well.

Martin Cody: That’s also a fulltime job.

Tina Joros: I’d love that opportunity someday. But again, I think what I’ve realized being a woman in business is that you can do anything you want, but you can’t do everything you want. So, you need to be very thoughtful about how you pick and choose where you spend your time and what you can contribute to. And I feel really good about what I’m contributing to right now at Veridian with what we’re building, TEFCA, and with artificial intelligence and some of the policy, things that we’re trying to make moves towards. So, I like where I’m at, but there’s a future where I get to allocate a little more time to those things.

Martin Cody: I look forward to seeing that happen. I want to thank you so much. It’s always good to catch up with you. And I know there’s a ton of wisdom that people can use towards their both their career path today, but also their personal path with regards to philosophy, curiosity, reading, mental balance, making certain you’re doing what’s right for you. But the door is open to do just about anything you want. So, appreciate you sharing that wisdom. It’s going to mean a lot to a lot of people.

Tina Joros: Thank you so much, Martin. I really appreciate your podcast and connect with me on LinkedIn if you’d like to have a chat. I’m always open to connecting with people who are passionate about health technology.

Martin Cody: Awesome. Thank you so much and I look forward to seeing you soon probably at a trade show.

Tina Joros: Definitely at a trade show. That’s our thing, right? Okay.

Martin Cody: You got it. All right. Be well.

Tina Joros: Thank you.

Martin Cody: Thanks for diving into the edge of healthcare with us today. I hope these insights will fuel your journey in healthcare leadership. For more details, show notes, and ways to stay plugged into the conversation, head over to MadaketHealth.com. Until next time, stay ahead of the curve with the Edge of Healthcare, where lessons from leaders are always within reach. Take care of yourselves and keep pushing the boundaries of healthcare innovation.

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