Better Implementation: Northwest Specialty Hospital CEO's Strategy On Innovation

Phil Sobol: 

Welcome to the CereCore Podcast where we focus on the intersection of healthcare and IT from practical conversations to strategic thought leadership. Let's unpack the decisions, challenges, and journey of those whose purpose it is to deliver technology that improves healthcare in their communities. Today we're pleased to welcome to the CereCore Podcast, Rick Rasmussen, chief Executive Officer of Northwest Specialty Hospital. Rick has been with Northwest Specialty Hospital for more than a decade, serving first as CFO and now CEO, since 2014. With a strong background in accounting and finance, Rick brings a disciplined yet growth-minded perspective to leading one of the region's most innovative specialty hospitals. Under his leadership, Northwest Specialty has grown its clinical offerings, embraced technology modernization, and built a culture that blends high quality care with business agility. Rick, welcome to the CereCore Podcast. 

Rick Rasmussen: 

Thanks, Philip. I'm excited to be here today. Thank you for the invitation. 

Phil Sobol: 

Oh, you're quite welcome, and we're excited to hear from you. Certainly having been both a CFO and A CEO, we'd love to learn just a little bit more about that journey, and ultimately what drew you into healthcare leadership. 

Rick Rasmussen: 

Yeah, I feel that I started here at the hospital 15 years ago as the CFO, having served a finance positions at other corporations prior to this. And I was on the job for two years, and the CEO decided that he needed to move on and so I did both the CFO and CEO job for like nine months. I would do the CEO job during the day and the CFO job at night. And I'm like, I might be able to do this. And so, as they were doing a national search, I threw my hat in and I was lucky enough to get the position. I feel that being a CFO is a really good background though. I think understanding the numbers and understand the financials and being able to do that. And so at Northwest we grew at that time, when I started here, we had about 90 employees. We were doing about 5,000 surgeries a year. We are now currently, as of today, we just opened up two more ORs two weeks ago. We are at over 950 employees, we're going to see over 400,000 people this year. 

Phil Sobol: 

Incredible. 

Rick Rasmussen: 

We just built our 13th and 14th ORs, and just what our goal and what our North Star at Northwest is community. I was born and raised here, lived in this community my whole life. We're in Northern Idaho, but we're right by Spokane, Washington, so we actually get patients from all over. We do medical tourism. We've had people this year from 34 different states, even had somebody from Dubai come over. We do a lot of medical tourism. But our North Star's community, our community's been very good to us. I want to help as many people in our community as possible. We've added not only the ORs, we've added 26 different clinics and imaging services in my 15 years, but we also want to employ as many people in our community. So, good paying jobs. 

And everybody comes in here as somebody's brother, cousin, sister. I have certain rules, a five and 10 rule, that if our staff's within a, somebody within five feet, I ask them to stay off their phones, let's get a warm smile. Healthcare is the only thing that somebody's not feeling good. If you go into a grocery store or go to a restaurant, you're probably... Half the place might be feeling good and having a good day. Everybody who comes here other than maybe a wellness visit is not feeling well. Something's going on, needs a surgery. So I just try to really, with culture, try to help our team realize that everybody coming in here is somebody's cousin, a relative, neighbor, and let's be kind and compassionate. 

When I started here as CFO, I was able to see a lot of stuff going on, and when I got the CEO job, I let go six doctors and nine managers in my first six months, that did not have the same, what I felt, patient-first mentality. I don't allow computers in the exam room. I want the doctor to, mid-levels, to listen with their eyes and their ears. I don't need them to be on their computer and typing [inaudible 00:04:48]. 

Phil Sobol: 

Right. 

Rick Rasmussen: 

I think there's a relationship that's being built there. And so that's why EMR is so vital to us. But it's just something that we have really tried to give back to our community. We're involved with a lot of stuff because they've been so good to us, and allowed us to grow, and that has played the part. We're also, the second half, is we're typically, we're a physician-owned hospital, one of only 300 in the country. And we're probably 60, 80% less expensive, that if college tuition and healthcare costs keep going at the same rate from when I went to when my daughters went to college to when my granddaughter will eventually go, it's going to be unattainable. It's the same thing with healthcare. 

So we're typically 60, 80% less expensive and it resonates with people. That's why they travel from all over the country to have surgery here because of the price, but then they come out and find out it's a great quality. We have phenomenal food, we have non-white walls. We do this stuff to make people feel at home. Our front desk staff that when you're met here has folks that came from the food industry where I've been out to eat with somebody, and one came from a tanning salon, one was at a golf course. You can't teach people to be nice. I could teach you how to register, I can't teach you to be nice. And so that's really what we've tried to do, is get people, hire local people, get them good-paying jobs, allow them to help their other community members, and it's just something that's allowed us to grow over these 15 years that I've been here. 

Phil Sobol: 

Yeah, no, that's fantastic. I appreciate that, Rick. And certainly, you've been in that community your entire life and just the dedication that you've shown to not only continue to elevate and deliver those high quality services, but then grow and really reinforce the fact that healthcare is a personal business. And I think you said it so well, when folks are walking in the door, they're not walking in at their best, they're walking in, they're not well. It's both the health issue but then also the mental issue and also the uncertainty and having that staff treat them like people, like family. And I just can't say enough for what you guys have done and certainly I think the community has responded well. Heck, you've even, if you go out, you guys have received award after award after award for those as well, which is always nice recognition. 

Rick Rasmussen: 

And we know that and we're really proud of that, but we know we're only as good as that next patient. 

Phil Sobol: 

Absolutely. 

Rick Rasmussen: 

You can't just say, "Oh, we became a five-star hospital. We're the only one within 500 miles of us in Washington and Montana and Idaho." But we're only as good as that next patient. So we remind them. 

Phil Sobol: 

That's right. 

Rick Rasmussen: 

It's a very proud thing, but we've got to always keep on our toes. 

Phil Sobol: 

That's right. Well, you sound a little bit like a football coach there, right? We're in football season, right. It's always the next game. 

Rick Rasmussen: 

I played college football and yeah, I refereed football. 

Phil Sobol: 

That's right. 

Rick Rasmussen: 

I bring a lot of that into my leadership style. 

Phil Sobol: 

No, that's excellent. Well, we've been working together a little bit on an implementation for a new EHR. You know, and you mentioned that earlier on. From your perspective, what role does IT and an EHR play in driving both patient outcomes and the financial stability of the organization? 

Rick Rasmussen: 

We think it's a huge and vital role. We went out, and what we've done with our IT team is, from the very start... My brother's a doctor down in Texas, and we talked about this a lot. And our team, the majority of our leaders in IT, were all clinical first. Our IT manager was a nurse in an ER. Our head of this implementation was an RN in our pre-op PACU. We have folks that were LPNs, we have another RN that was in inpatient. So they were clinical first, went back, we helped pay for the IT training. And so now when they're talking to our team and talking to people on the floor, nothing against lifelong IT professionals, but when somebody can go in an IT and say, "It's taking me 16 keystrokes and punches to get this ordered." And he clinical person is saying, "I don't have time for 16 keystrokes and all these things. What can we do to work together to make templates or to make things work together?" 

So it's been a great partnership that way where they could bring that in there and now they're clinical talking to clinical. And be it templates or we badge-in, badge-out when you're on a computer, there's things that we can do that really elevate. It is such a vital part of the care too. So if those reports are wrong, we don't have the imaging and we don't have the labs coming through, you could have misdiagnosis, you could have... Or care for the patients that are here, and there's a life behind that. That is somebody's mom, that is somebody's brother, that is somebody. And so having that in there, it's got to be the full tight end part of the program because we will have second class care, and that's not what our community and what our patients deserve. 

And so not having a strong EMR, not having the ability to use it at its full. There's people that I know that go in there, and I was an accountant for a long time, and there's people that use Excel and they use one 100th of what Excel can do for them. [inaudible 00:10:58]. 

Phil Sobol: 

Yes. 

Rick Rasmussen: 

It's like, there's probably so many things that our staff... And that's why partnerships with organizations like yours and others, it's so vital. Let's utilize to the max so that we can then give the best care, and we just see it as a completely tied in, as a full partnership that one can't happen without the other. 

It's one of those also that you need it to be there. It's kind of like the scrubs in your locker room and the rugs at the front desk. I don't know how they get there, I don't know who puts the rugs or how the scrubs get there, but they're there. IT is the same way, when they come in the morning and the first patient and we're checking them for surgery, duh, duh. The EMR needs to be up and working, we need reliability. Not sure who's behind there and doing the backups and doing all the work there, but it needs to be reliable. No news is good news, it needs to be up and running. And that's from, for us, it's all in the partnerships and the setup and doing things right up front, and the organization has been so vital for us and that part of that, and so we're proud to be a partner with you guys. 

Phil Sobol: 

Well, thank you very much for those kind words. You've often talked about balancing business discipline with clinical excellence. I'd love to just get your take and perspective on how do you keep those two in harmony? 

Rick Rasmussen: 

There's a couple things here for me on this one. Number one, I have a rock on my desk right here and it says the word trust. And it all has to be trust. We have to trust that our patients are trusting us. We got to trust them that they're preparing themselves before surgeries, or coming in here and they're being honest with us. We got to have trust. And then the second one is communication. We have to have strong communication. And EMR is communication. The care, we could have a patient that comes in here, comes into one of our urgent cares, they've been injured on the job, they meet the front desk person, they get registered in there and then they go in, they meet the urgent care RN and the urgent care doctor. And they say, "You need an MRI." 

So now they're transferred down to get an MRI. They meet our tech and then they say, "You need surgery." So they go to our pre-surgical clinic, and all that information is being carried from each department. Then they come in the day of surgery, they check in, we verify what they need, they go to the OR, then they come out to recovery, then they go out down to inpatient and then they get a bill. I mean, it could be 20 encounters with our team and 500 entries into an EMR system, but that's not reliable. And so that communication is so vital, having that consistency and a system that works well. 

And I think the last one for us is, to get that harmony, you need to know the why. What is the why? Explaining to people, just not, just do it because we really work on what is the why? Why is it set up like that? Why was Expanse... Or whatever system you're on. And then it's like people want to buy-in. They will trust it. You communicate, you give them the why, you train them, you're there to support them, and then we're able to do that. And so I think that's the balance for us. I think that is making sure we have that. 

Phil Sobol: 

The why and the trust, it just, you're absolutely spot on. And it sounds so simple, but it's amazing how many times people don't get there. And they don't think about it. And when you ask them the why question, they kind of scratch their heads. So I love that that's a cornerstone of the leadership there for sure. I was at kind of an industry think tank conference a few weeks back, and again, it came up that workforce and staffing remain top challenges across healthcare. I think you mentioned earlier on that you're one of the largest, if not the largest, employer in the region. And that's very, very important to you all. How is Northwest Specialty approaching recruitment retention, kind of building that employee culture of care? 

Rick Rasmussen: 

Well, I see one of the books behind you there, that Good to Great. I'm a big believer in that, and it's finding the right people on the bus. You're going to switch seats sometimes, but it's getting the right people, and it does start with culture and then it's backing it up. So I'm the first one that meets every new employee. I go to orientation every two weeks and I meet the employees and I talk to them about our culture and then I live our culture, and I round every week. I round every day in the hospital in the main campus and then we go out to our satellite. We have 12 satellite buildings now. And I go every day, one day different a week. So I see different people and I go out there. 

And right now, we currently have zero travelers. We have hospitals in Spokane that have 200 travelers. Our local one at one time had 300 travel. We have zero. [inaudible 00:16:16] people who are not the highest paid, we have strong benefits and competitive pay, but it's culture. And then backing it up. Seeing that when things in... So there's a couple standards that I built in that I've just grown up. And number one, it's family first. We go out and, first day of school, we start our OR slate, we start the clinic slate so the families could be there for the kids standing on the front floor with the lunchbox. I don't know if they still have them, but when I was a kid I'd stand there with my lunchbox and [inaudible 00:16:51]. 

Phil Sobol: 

Absolutely. 

Rick Rasmussen: 

And that's a big thing. When somebody comes up and says, "Oh, my son or daughter has a play I need to be at." Or, "They're having an assembly at school." Or, "We have a football game after school." It's family first. You go to that. You're not going to say later on, "Boy, I wish I would've worked more." No, you're going to say, "I wish I spent time with family." And that resonates. We do a lot of events. We do an annual pig roast where we'll have 1200, 1300 people and their families and junk castles and junk tanks for the doctors, you get back at the surgeons. And we have ice cream machines and snow cone machines, and it's just a great way. We do it as a fundraiser for a veteran organization and a youth group here in town. 

I may or may not be Santa Claus for a kids' event that we have in December. We'll have 400 kids, they drive through our parking lot, it's the North Pole, and they check in and first station they get a gingerbread house, and then they get cookies and hot chocolate, people dressed up. And then they get to meet Santa and he has a president and he knows their name, and they're like, "Santa, he's real. He knows my name." And we go through that. And it's those little things. We do an event... We don't celebrate like Rad Tech Day and RN Day, we celebrate hospital week because we feel healthcare is a team sport, we celebrate everybody. We can't be doing it alone. 

Phil Sobol: 

That's great. 

Rick Rasmussen: 

So we love our rad techs, love our nurses, love our scrub techs, everybody, but for us, it is done out there and celebrating our whole team. That takes everybody. And the last one is that I manage, and we manage, and our team manage, we manage out of fear... Or excuse me, out of love and not fear. It's one of those things that walk in there and you need to see four more patients and you're in a fear and you don't want to come to work. We manage out of love where we go to them and say, "How can we help you? We really, for us to be financially solid, we need to see X amount per day. What are the barriers? Is it..." 

This is a huge example. We went and started looking at our clinics. Our urgent care was on paper charts in our clinics and we were on four different EMRs and they didn't speak to each other and we had all these issues. And it was a big hindrance, and so it was an opportunity our staff said, "Boy, we'd love to be in one system." Our finance team said, "We'd love to drop one bill." We went out there, and so we managed out of love and listened to them and they trust us and we trust them. And they said, "We need to look at a new EMR system." And now we're out there. 

We're not able to do everything they asked for, but we listened to them and they know that they have a voice. And we're right in the middle, I told you, a remodel. We just added... We went to the team and said, "What would you do different? We're going to have one [inaudible 00:19:45]." And they said, "Well, your countertops are too low. We need to be able to stand here and work." There's things that we go to them all the time with. We manage out of love, not fear. It's not going out there and forcing these people into things and being there to be that, "You got to do, you got to do." That's just not our style. And if that is, there are other hospitals you can go work at, I tell them all the time. 

So ours is going to be family first, trust, and communicate, and manage out of love, not fear. It works for us, it may not work for everybody. But our staff's here, we have a very low turnover rate. We're able to bring folks like I said. We have 20 open positions right now. 20, in a hospital of 950 people. 

Phil Sobol: 

That's incredible. 

Rick Rasmussen: 

It's unheard of. 

Phil Sobol: 

Yes it is. No, that's spectacular. Well you've mentioned the EMR project ,and certainly technology change can be overwhelming for an organization and for staff. What lessons have you learned about leading teams through large IT implementations, new technology implementations like an EHR program? 

Rick Rasmussen: 

In my finance world, I actually took a year off of an accounting manager job and implemented a financial package suite that had payroll, and had all that. So I kind of got to see being on the other side of things and working with consultants. And I mean, I think what I learned again in a [inaudible 00:21:21] trade, is we, in my mind, gone through because I've been on that side, I've been on multiple other ones, was that you got to really vet-out vendors, you got to find what I call, again sports analogy, varsity-level players. We need to have good support. I mean, your organization has been so phenomenal to work with. And the folks that you've sent out here, I wrote some handwritten notes to a couple of them just because they've gone above and beyond, and I think they were younger and I'm older, and I don't know if they've seen a handwritten note, but they thought it was pretty cool I think. So it was one of those. 

Phil Sobol: 

Always. 

Rick Rasmussen: 

But I just think that going in there and vetting-out and making sure that we're on the same page, because I feel like our team, we're on, and I told you about how we built clinical and they went out. And then we found your organization and we got varsity-level players there. And we met with our vendor and quite frankly, I don't know if we had full varsity, we mixed in a few JV and maybe a couple of freshmen-level, and it's really kind of has hindered our getting to the finish line. 

And so I think as you look at that, you need to stack hands, you need to communicate. Again, just like I talked about with our team, there's trust in communication and team stepping up and raising your hand and saying, "I don't know if we're quite here, there, here's what we need." And not be afraid. There was some at first were like, "Well, they didn't want to go tell Rick that we're behind and all that." I'm like, "Rick needs to know." 

Phil Sobol: 

Exactly. 

Rick Rasmussen: 

I'm not a fly off the handle, go scream and holler. I mean, I just need to know because then we could plan and organize. And so I think being on the same page, I think making sure you have not always just believing salesmen, but that [inaudible 00:23:14] getting to the teams and the folks that are going to implement and understanding what they have for capability, what they have that they could send out. 

It's definitely stuff that I would highly recommend as you're looking to that. That if you're going to help the whole implementation go better, that if everybody's on that same page, and you're talking and communicating and trusting one another, you're going to get to the finish line, and it's going to be implemented well. But in our world, the reward is here because you just needed to have, but the risk is up here. If you're not doing it right or if it's not working or your bills don't drop or somebody's labs are not in the system, it's just too much risk. So I would make sure you have varsity-level players from all the vendor, the consultants and your team. 

Phil Sobol: 

Yeah, no, I think that's spot on. And I think that's absolutely critical. And you've talked a little bit about our partnership, and I'm sure you've got other partnerships as well. What is it that you as a CEO, what are maybe some of the top criteria that are just absolute musts for you when you look at partnering with a firm? 

Rick Rasmussen: 

So for us as we vetted-out, because we looked at three or four different consulting firms and we looked at vendors, we went through the same process, went through an RFP, we looked at it. And we actually talked to each organization about what kind of support, what kind of experience are you going to be sending? Can they be boots-on-the-ground? How much can be done, when? Just kind of like what does that support look like? Is it an email support or is it when we're going to testing or we're going to go live week, can they be here on the ground? Can you get somebody from Boston to come to Coeur d'Alene, Idaho in February when it's snowing? You know what I mean? So there's things that are just... We really vet that out and we look at is there a point-person? 

For me, I need to know that if things aren't going well, can I call one person? I don't need dysfunctional quarter arms where there's 10 people and they're all pointing. There's times that if things start going off the rail, you need to have that point-person. And you guys had that. When we went in there, they said, "If you have an issue, you go to Grace, you go to Brooke." And we know we're going to get an answer. They may not be the one that fixes it or helps us to the point, but they know who to get to. And that is so vital because you spend all this time in different channels, and I think that is very... When we went out and we were trying to choose who we were going to go with, it was, what kind of support you were going to bid, who is that support going to bid, how often are we going to get that support? 

And then the contingency plan. What if something goes wrong? What if it's derailed? What if it has to expand? Are you able to be flexible with us? And that was really key to me. And you guys checked all the boxes. And even gone above and beyond. I write very few handwritten notes, and I was very proud to do that because it really meant a lot because they truly did. They were here. And I went over, we have a little war room and we have all these computer. We setup a whole area for our training center and testing and all that. And it was eight o'clock at night, and the Meditech folks were long gone, and CereCore folks are right with arm-in-arm with our team, working on trying to get the build and everything. 

And it's just you don't... Because you could have left at five, checked out, that's what the contract says, but it's, do you own your job? Do they own their job? 

Phil Sobol: 

That's right. 

Rick Rasmussen: 

I really feel your team owns their job and wants us to succeed. It's not just another... They've been invested with our team, they get to know our team. And they own their job, and they want us to succeed. It's not just checking a box and here we are again and we're implementing number 982 and this is what... You see them where they're invested and you see their passion. And that was huge to me. So that's why I recognize. 

Phil Sobol: 

Well, I can tell you that those handwritten notes meant an awful lot to those team members. And you're right, handwritten notes are few and far between anymore. But again, I think it's personal, and certainly our team members here at CereCore do truly care about your organization, and really supporting that mission. Is there anything that you would want to share directly with our team about the work that we have done together or really even how we can continue supporting your organization going forward? 

Rick Rasmussen: 

I think you've done it. Your team is very, very highly competent, and they're open. I love that, as things, if there is issues or problem, it's not kept behind the scenes and not talked about. They raise their hand and say, "Hey, here's an opportunity." Or... We don't know, this is not what we do every day. We've implemented, the last time we implemented this, was 12 years ago. So we've not had... We only have two people of our team that were here then. And I was brand new and I was in the CFO. So you go in there and so you guys are the experts and then you're helping us to hold the vendor accountable, and you're helping us... So I would say keep doing that, keep open to that. Be communicative, have trust that we do want to hear what's going on because it could save so much. 

You've saved us thousands of hours. We go down... And our vendor master item list was not ready. And so they're like, "This is going to be because it's used so many places. You need it in the OR, you need it for your billing, you need..." And they're like, "Let's spend more time up here and let's wait another week so that it's in there right." Because once you have it, that's what you have. Or I mean, you can make small changes, but that was a CereCore person coming and saying, "We need to do better here so that we don't have issues down the road." And if they would've kept themselves, we would've not had that opportunity to fix it and do it. 

And that's why it's so vital for us to have that partnership. I truly feel it's a partnership. And so that's been great. The level of people you've sent here are phenomenal. And it's one of those, like I said before, and I probably drilled it in the ground, but you own your job and you helping. You want us to succeed. And that is so awesome. Yeah, it's really powerful to use. 

Phil Sobol: 

Well, I greatly appreciate that, Rick. So you have done a lot over your tenure there for the system. Looking ahead, what opportunities or innovations are you most excited about for Northwest Specialty? 

Rick Rasmussen: 

Well, I'm really excited. So we have seven spine surgeons, 25 orthopedic surgeons. We do a lot of robotics here. There are three hospitals that have three Globus robots, New York, NYU, the Mayo Clinic and Northwest Specialty Hospital. So we're really big into... And I see that expanding. And I think AI is going to be a big player in healthcare coming up. And we do it now with our AI scribes. We use a tool that, instead of having a scribe in there over there typing, because I told you I don't like the doctors to be typing, we go in with an AI tool, the note's done, they walked out of the room, the AI can talk back and will say, "Hey, did you ask about their colonoscopy?" I mean it's been... They learn. So I'm excited about AI there. 

I think AI is going to be in radiology. I think radiologists that read MRIs and CTs, I think they're going to be seeing AI. Some of our competitors are using AI robots for discharging. They will bring Rosie the robot into the room and they'll have them give them their discharge summaries. We're not as set on that, because I think there's some still customer service and personal touch. But as you see those type of things, I think you're going to see more and more around that, and innovation, and where it's done right. I mean, I think billing and coding can have some innovation around there. So I think there's opportunities there. Medical tourism, I told you we've been on the cutting-edge of. I've been on NPR talking about it, and my two daughters aren't big fans because they listen to NPR and they don't want to hear their dad talking on NPR. But I've talked about medical tourism, I've talked about the cost savings. And becoming a consumer, that you need an MRI. 

We have a hospital in Montana that their MRI is $4,200. Ours is 700. And it's the same machine. They're both Hitachi, same exact [inaudible 00:32:31]. So I went to school, played college football in University of Montana, this friend of mine calls up, and says, "What are your price on an MRI?" And I said, "$700." He bused over 10 people from this town, did 10 MRIs on a Saturday. They saved $35,000 for the same MRI. And it's the same machine. It was going to be the same read in the same layer. So I think becoming more... If you have kids, and mine are finally closed off of payroll here, but car insurance was one of the last ones, that when they wanted to go find a car insurance, they went online, they found, here's what I need, one million, three, whatever, the different deductibles and all that. Then they had 10 choices, and then they make their choice. And I think healthcare would be the same way. 

Your doctor says you need an MRI. A lot of what's going on now is that the doctor will say, "Well, I set you up an MRI down at Memorial Hospital," and you go and you do it. You don't know if they're the high price. You don't know if that's an option. You just follow. And so I think becoming more cost-wise, again, just consumers where you're looking at the cost, you're looking at the quality. Someday my goal would be to have a tool that you go and you type in, "I need an MRI with contrast." And it shows you eight choices within 35 miles. And then it gives you a quality score and it shows you the price. And then you're able to be a consumer. And I think that will help with the healthcare costs like we talked about before. 

Phil Sobol: 

[inaudible 00:34:04]. 

Rick Rasmussen: 

So those get me excited, helping people pay less. And then helping them get better. We're huge, huge on wellness and getting ahead and coming in for your mam, because you find things earlier, the better off. Come in for your colonoscopies, come in for your mammo. We just started mammo, my wife went through something where her exam showed something in there, and then it was 38 days before she got back in for the follow-up. And she went WebMD crazy and started going out there telling my daughters you need to have grandkids, and things are going... And then everything thankfully was good when it got to the end. But we have a... So we set up mammo. You get in within two weeks of when you check in. 

And if there is something found, we have a 48-hour rule, you're back in within 48 hours. And you're able to do that because of the different things and the AI and the other tools to get them back in there. And it's just something that that's going to help people out. 

Phil Sobol: 

Indeed. 

Rick Rasmussen: 

You catch something earlier on, it's going to help them, it's going to help their family, it's going to help extend lives. And that's what I like when I hear that and somebody says, "That made a difference. I got in, I got out. It was an early Stage I." And it really, really makes me excited to help people out, because these are my neighbors. These are people that I grew up with. And it's pretty exciting to be able to help them out. 

Phil Sobol: 

Well, you have structured the organization to make healthcare personal. And at the end of the day, that's what matters and what's important. 

Rick Rasmussen: 

I like that. That is what we're doing. Yeah, that's good. 

Phil Sobol: 

Agreed. Well, so we talked a little bit about where you guys are located. And you've lived there in Northern Idaho your whole life. So just for fun, what might be some tidbit of information to people that have never been to that part of the country? What's it like living and working there? What might be surprising that people wouldn't know? 

Rick Rasmussen: 

I've traveled a lot, and been elsewhere. My daughter went to Stanford, spent some time there. My other daughter went to Colorado State, got her master's there. And so I've traveled a lot, brother in tech. We have four seasons here, it's nice to have snow in the winter and sun in... I live on a lake and we have no humidity and no bugs. And I've been to Tennessee and that humidity and I get off the plane and chiggers do not sound like fun. And there's things that- 

Phil Sobol: 

They're not. 

Rick Rasmussen: 

We don't have bugs and humidity, but we got year-round activity. So in the winter, there's five ski hills within an hour of Coeur d'Alene, there are sledding and cross-country skiing, and the activity snowmobiling. And then during the summer, there's probably 10 lakes within an hour of us, and boating and kayaking. And then there's rivers and fly-fishing and there's all sorts of bigger... You could go sturgeon fishing, and there's rafting trips. 

And then we have a big bike trail that's 18 miles downhill, and it's an old train. They took the train track out and you could rent bikes or ride your own, it was one of the best rides you've ever been on. You're in the mountains, and you just go out and that is what we do every fall. My wife's birthday's in the fall, and she loves them. Pick the family, and then there's some natural hot springs. And so we do that. And so we have low crime rate, don't have any professional sports, so you have to live through Seattle and other things that are close, but it's a great place to live. 

We have phenomenal people here. And once you've been here and you've seen our... We have mountains. And a lot of people live here. We've had a lot of folks move our area. We've grown in the last five years, almost 25% growth. We were recognized in Wall Street Journal for one of the highest large growth. And it is something that once you've been in Coeur d'Alene [inaudible 00:38:27], you'll want to stay. We have a lot of golf courses. We have the only floating green golf course, it's a different length every day. 

One of my best friends is the guy who owns the place. So it's one of those that it's pretty cool to be here. And our town used to be really known for logging and mining, and now we've changed that to tourism and healthcare. We're a top-five employer. And again, the medical tourism and people come from the whole area to come here. And it's very rewarding. And I think you would [inaudible 00:39:02] North Idaho if you ever visited. 

Phil Sobol: 

Oh, that's amazing. Honestly, that's one of the... You talked about being on NPR, and now I think the Chamber of Commerce is going to have to get their hooks into you. And that was probably one of the best advertisements. 

Rick Rasmussen: 

I'm actually the chairman of the board of the Chamber of Commerce. 

Phil Sobol: 

There you go. See, there's a reason. There's a reason why. Yeah, that floating green golf course is on my bucket list. Although, I'm not sure my game would be adequate, but that's okay. 

Rick Rasmussen: 

Oh, it's resort golfing, you'll like it. Yeah, no, I'm not a golfer- 

Phil Sobol: 

I'm sure it is. 

Rick Rasmussen: 

They make... Yeah, you would enjoy it. 

Phil Sobol: 

No, that's great. Well, Rick, we always just like to wrap these up with just a call for any final words of wisdom that you have out there for our listening audience. 

Rick Rasmussen: 

I think one thing I do, and probably a lot of folks do this, but I prioritize everything. So I ask for people the why, I give them the why, or ask their why. But the other thing too is I do everything on a 10 X, 5 X, 1 X priority list. So when I give an assignment or ask somebody to do something, I let them know, is this a 10 X, is this a 5 X or a 1 X? So that they're not spending all their time doing the 1 X's because they're easy and they could do them. But this is what needs to get done. Like that item master, we said, "Materials manager, this is a 10 X. You put your head down and do this." And because I think it helps, as being somebody on the other side, I've learned more from bad managers than I have from good managers. 

And sometimes they lack the direction and prioritization. I come back and I'm like, "Here's this great spreadsheet," and this and that. And they're like, "Well, I didn't really need that. I could have had that in a couple months. I needed you to do this." And I'm like, "Well, why don't you say that?" So when I end a meeting, when I do an assignment, we do something, "Is it a 10 X? Is it a 5 X or is it a 1 X?" And our team has really taken to it. They like it because they know then what to prioritize for themselves. When they come to me and they know I don't read outside the preview pane on an email. So I get emails that say, "10 X. We're short of this," or whatever. I mean, they put it right in there for me. And so it's something that I really feel that it's simple, but it's something that I really think is helpful to folks just to help on prioritization. 

Phil Sobol: 

No, I think that's excellent. Well, Rick, again, thank you for your time today, for your insights, and more importantly, thank you for your partnership. So it's greatly appreciated and we look forward to still being alongside you throughout this journey, and helping you and your team achieve the mission that you're working towards so diligently. 

Rick Rasmussen: 

Yeah, we're not getting to the finish line over that goal line without CereCore. So we're really, we're happy with the partnership, love the team, and you're a vital partner to get us all across that goal line. 

Phil Sobol: 

Yep. Wonderful. Well, Rick, thank you so much. Greatly appreciate you joining us on the podcast today. 

Rick Rasmussen: 

Thank you. Yep. Appreciate the opportunity. 

Phil Sobol: 

Thanks for listening to the CereCore Podcast. We hope you enjoyed this conversation. Follow us on your favorite podcast platform for more episodes, connect with us on LinkedIn. Visit our US website at cerecore.net. And for those abroad, visit cerecoreinternational.net. Learn more about our services and find resources. At CereCore, we are healthcare operators at heart, and know the difference that the right IT partner can make in delivering quality patient care 24/7. Let's help make IT better. Here's to the journey.