From Teen CNA to Healthcare CIO: Sheri Strobel's Technology Revolution at Chapters

Welcome back to another episode here on the hard hustle podcast. Our next guest, I love this line that she mentioned when we first spoke. She says, "We're not just using technology to collect data. We're actually using it to give caregivers back their evenings so they can spend more time with their families and helping after helping yours. Sorry, Sherry. Welcome. in between both of those. So, uh asking a lot of questions, seeking to understand, respecting others is really what helps uh guide me and help along the way. So, and you talked about your career. You end up um joining, if I'm not mistaken, chapters in February 2020, like really right before the pandemic, right before the world shifts, right underneath our feet. What did that moment teach about them, but we're not them. So having to partner, having to try to really listen, seek to understand what it is that we can embed in their workflows to make their lives better, that's what our goal initiatives. A and one of the things that you talk about just allowing them to have that pajama time back and allowing them to uh we talked a little earlier as well doing the things they love more and the things that could be automated and and um you know repetitive tasks we can give it to became real big, Instagram real big, but now we have this new word AI, new technology AI. What was your first thoughts about AI when when it actually implemented and what is your thoughts now seeing AI and some of the things that it's doing and not just in the um beyond the front layer frontline care but also on the back end of operations and revenue cycle and things like that. I think everyone has a different take over their comfort level, their familiarity with it. When it becomes real and you actually can get a solution that can scale, "When the Sethoscope came out, did it replace the doctor?" No, but it was a tool for the doctor to use to provide better care for patients. That's what ANI means to me. I um I love it. I I think there is we're still in a space where a lot of people still have their guards up. Um, and it's because they haven't got their hands in it yet. I think a lot of people that when they get their hands dirty and realize like, oh my god, this is actually really, really good. and just at the surface level like a co-pilot or a chat GPT that they really see how this is a value to them. Um kind of to what you just mentioned that you heard something about the AI space. So I don't because that's exactly what it is and there's so many there's so many different tools even on the back end like we're talking about what's happening at the caregiver level. Do you have anything that you can talk about um in the back end that people are very surprised could be utilized for? Well, one I want to quick comment back on what you did for showing the person their brand. What you did is you made it real for them. You showed them how it can help improve their life and made it a reality. That's what I think is going to be the most important area. So, when months, you know, it may be a brand new tool that's a fraction of the price commodity-wise, and it's even more improved to be more accurate and better. So, you got to stay close to it, give it time, and work with it. If the Heart and Hustle podcast has ever sparked any idea or made you think differently, do us a favor. Make sure to guys share this, post it on LinkedIn, or even text that nonprofit friend that you just have. Whatever works. This is what keeps the conversation going and allows us to just grow this community together. That's what's going to really help you guys continue to increase the number of locations, the number of places that you guys are going to be um in because of the technology that you guys are building now. So I'm excited to see where you guys continue to move. Um Sherry, but if we can kind of talk about the end of life care, it's something that every family will face. And I love that you're in a different seat cuz I do speak to a lot of those that may either be at the CEO level and maybe have a lot of experience here, but someone like yourself that is in the CIO, that is technology, that is more in the IT realm, how do you want people to think that's going to try to make anything happen through a little bit of innovation and a little bit of just thinking outside the box. So you you're in a sweet spot. I think I know you talking about, you know, I think what's your space? You're a geek in two things or whatever it was. It's a good thing to have, right? It's a good thing to be actually. I I love that. I just love the excitement that you bring um to this this field that a lot of people kind of cringe when they hear you're not going to get the chance to solve, you know. So, please uh yeah, look me up. I'd love to hear how uh I can help you and probably more importantly, how you can help your team help others along the way. We don't always have the answers, right? But we do have the ability to listen and be empathetic and support. I love it. Well, Shar, are you ready to get in the hot seat? I got a blind question for you. Are you ready? Thank you. Pleasure to be here. What a line. You know, when we think about caregivers and I love that you you you did kind of bring that up on just the technology aspect. I feel so many people have lost um the passion for what they do because of all this admin and repetitive task that is needed to be done on the back end. But you you've you've understood that and you're trying to give back that work life balance. Um so kudo kudos to you on that. But can you talk about the organization? What's the organization that you represent and and and your role in this organization? Sure. Absolutely. I'll give you a little bit of background. I'm Sher Strobble. I'm the chief information officer at Chapter's Health System. We're one of the largest nonprofit hospice endof life care organizations in our country. We currently are caring for over 6,000 patients a day across six plus states uh mostly in people's homes. So uh we do also have in inpatient hospice units which run very similar to a critical care unit in a hospital type setting. Uh my job is to develop our team, develop our systems and really enable our technology to support our caregivers across all of the different uh lines of business. we have and at the bedside as you've kind of referred to it as well too there we're looking at ways we can do this that will provide the compassionate heart of hospice that's what we're all in this business for my organization and not have the technology get in the way of providing that good compassionate care and this wasn't just something that you woke up and decided I'm going to do because you actually had a pretty nice uh career you know you go from that teenage nursing assistant to a CPA to CIO of one of the largest end of life care systems in the country as you mentioned. Um so definitely not a straight line. What tied it all together though? Like what first drew you to healthcare as a teenager? So um real brief short story um one of our neighborhood families. I was their babysitter as a very young teen and she happened to be an LPN at a continuous care retirement community that uh took care of the elderly, had an Alzheimer unit and after working with her and her kids for a few years helping when she was at work, she recommended me when I was 16 to be a certified nursing assistant get a job there as well. So, she inspired me to uh go into the healthcare realm. I give her a lot of credit and uh have been in that healthcare realm ever since. When I was a certified nursing assistant, I really realized the uh end of life care was such an impactful area for people, for their families. Um there was a woman I met there, one of the patients, last name was Pullman, and uh Louise Pullman uh was probably from the Pullman train uh company. You may have heard of it in school and growing up, Pullman Cars. And it always was very uh influential to me and impactful to realize the woman who was at final stages of Alzheimer's, you know, the story, the life that she must have led along the way and realizing that these are people with real stories that are living their last couple of years with unfortunately tough diseases to work through. But their story, giving them compassion, giving them the quality and the dignity of life they deserve and wanting to hear their stories, you know, was always something that just inspired me along the way as well. I love that. I love that. Life be lifening. You we have these plans and people just pour into us and really start to spark a little some interest that we've never even knew we had. Um I can imagine you didn't think you were going to be in this healthcare space, right? Like what did you want to be before? I said I would the school my undergrad was in accounting, right? I graduated. and it went off and I I worked in accounting for quite a few years. I ended up implementing uh a payroll HR system for them. Really got the technology bug in me. I learned how to write queries which was at the time I was just tickled bank over thrilled to see the power of what that could do to help from an accounting perspective. Uh then uh I got a phone call and they were looking for someone to lead up a area of applications for a senior living company. And I thought at the time, what does senior living need technology for? This seems really crazy. Well, it uh it turned into be one of the greatest 20 years of my career uh working for that organization. And it really brought me back to realizing how technology can help the seniors, help the elderly, help those in memory care. kind of brought me full circle, you know, and once I realized the power of all of that and still using my accounting finance background, you know, to make sure the investments we're making are going to be good ones for the organization, you know, and be able to relate to the finance team, relate to the others and relate to the nurses. That's what kind of helped me, I think, draw me back in. It's so good. Yeah, it's it's so good when you're able to really do the things that you love and mix those with other things that you love and that's really what you you loved something and you found another place that you love and how do you merge those two together and really you have that dual background in the finance and and the tech. How do you think that kind of shaped your leadership? probably it makes me a double geek right on both sides of it's been hard though you know it's I have learned that I am not a programmer you know I didn't grow up with a computer science degree or a networking degree so working with those folks in IT I gained a lot of respect asked a lot of questions you know seeking to understand right and be able to partner together but realizing I'm not the network expert I am not the I'm not a nurse I am not a doctor or physician kind of been in that resilience and leadership? I mean, going through something where you start this new job and all of a sudden you're like, "Wait a minute. Did I just get into this? What What is next? Like, am I do I have a job?" Like, what was your thoughts on that? Oh, you're summing it up very well, right? Like so many of us at the time, right? What's going to happen? Is this going to be over in a few weeks? Is this like the flu or, you know, we didn't really know in February? I moved myself 500 miles south from the Tennessee area down to Tampa, Florida. Our plans at the time were to kind of commute. I previously had a job in both Milwaukee and in Nashville, Tennessee. So, I thought, well, instead of going back and forth from Nashville to Tennessee, I'll go from, cuz my family at the time was living in Tennessee, I'll go from Tennessee to Tampa. It'll still work out. Let our son graduate high school in a year and then uh relocate the family. AI right and you've also said AI can't just be a hype it has to deliver that real impact for caregivers really important that we do how are you rolling that out at chapters or if you guys are even rolling it out I think you may may mention some pilot projects or something yep there's some areas around it that we're getting into so physician notes the physician tends to do more of a longer narrative note. We're we are using agentic AI tools there that are describing that note not just dictation but it is actually summarizing it more clinical terms bringing in diagnosis codes taking out maybe some of the conversation over last night's football game or right or can I pet your dog and it's turning the the note into what it needs to be appropriate for that. Where we need to go though is to make sure that AI does belong at the bedside when it helps that human be more human. that is sustainable, right? That's secure in healthcare. You know, we just can't implement anything over the way we've got to be respecting people's data, their privacy, where all else is going, right? And that it still can be simple to use and it's accurate. Those are the areas that my mind goes around of how is this new technology going to actually work and can we actually afford it right in our area of health care that postaccute care nonaccute care space our funding is so very different and our margins are so different that it's a dream it's a pipeline you can see it you can get excited over the potential trying to help build that trust with others you know especially when I'm talking with our CFO or we need to be able to fund these things we need to be able to invest in them and they're probably going to fail. More are going to fail than succeed, but we'll learn from it and we'll get better along the way. That's different, right, than other people's take on what they can afford in their organization, what they can bring know if you're familiar with Gary Vee but um Gary Vee says you know when he started his career he had someone following him with a camera um just filming his everyday and people thought that was crazy but now there's so many people that have a camera guy that follow them around every single day and he said that's exactly what's happening to the AI space. We'll have so much AI jobs out there, new jobs that are around AI and the people that understand those jobs will get the jobs ideally. You know, it's not that we're replacing jobs, but we're coming we're becoming more efficient. I love AI in the space of and I was just doing this with my team. They were really in shock. Like I created these AI and automations on the back end that you drop something in one folder and it would produce something in the other folder and they're both looking at me like, "Oh, this is great." But it was it was also buying them back time. Not only is it buying me back time, but allows them to do more of the things that they love, right? You don't have to now do all these different we talk about the caregivers and you're asking me for examples of where it it improved on the back end is where you wanted to go with the the question. Mhm. Yeah. Um, looking at workflows, I think I'm going to weave it into that that part of it. The workflow piece is what has to be incorporated. And if you can find a way to make a part of that workflow that's happening naturally today improve and improve that person, improve the care they're giving. That's where I think it's going to be catching on the the uh the notes, getting the data in the EMR, right? That's a part of the care plan for somebody and to make sure that others can help take care of them. Seriously, we appreciate you. You talk about months, but I ask you um how about the next 5 years? What's exciting about the next 5 years of healthcare technology, especially in this not just AI? AI may be the technology we're all talking about, but what does it look like for you next 5 years? What what is exciting? What excites me is if we can really help change the mindset over end of life and a better end of life care that we can provide. I know I'm not answering the question around technology, but technology is going to be an enabler for it. It's really going to allow our humans to be reducing the stress we all have in healthcare. Reduce the hours that is being spent pajama time at night at weekends answering calls throughout the day. answering calls. Reactive technology is going to get it so that differently about it about hospice and the end of life, the mindset of hospice of so many people that I talk to when I share the line of work of healthcare that I'm Their initial reaction is, "Oh, I'm so sorry. That must be a really hard job." And it is a hard job, right? Healthcare is a hard job. Jobs these days are hard everywhere you go. What I really want people to do is have a better understanding that we can make your end of life be what you want it to be. It's still living and it's life. And we're going to give you the best health care, the best care overall. And I think getting the people to realize that, you know, uh maybe Jimmy Carver might have helped. He was on hospice for quite a long time. And you don't go to hospice to die. You go to hospital hospice to hospice and end of life. But you're just so excited to just keep throwing this and I love it. Um before we start wrapping up, where can people find you? Maybe on LinkedIn, but also the organization. They want to know more information. Yep. Chapter's health system is a is becoming a larger health system. We are growing when I mentioned that six plus states. So you may not have known us in your community because we're often community branded like a lifepath hospice or capital caring or others. So being a larger complex health care system, easy to look up chaptersalth.org and check us out and learn maybe perhaps near you. We do have a uniquely community branded name as I'm on LinkedIn. My contact information is out there. Please feel free to connect along the way and uh I love talking about your goals, your dreams, what you're struggling with. We all realize, right, I know some of these questions you're like, "What? I've already had the hot seat question multiple times here." No, this is the the blind question to end this all off for us. When you look back at your journey from the nursing assistant to the CIO, what's the one choice you think you made that changed everything for you? Even it didn't feel like it at that time. willing to do something someone said you weren't qualified for. So, um being told no that you know uh you don't have enough years of experience, you're too young at the time. And I my that was what comes back to my initial reaction. Uh and uh the manager at the time told the recruiter that she's too young. Now I look back and be like, but I stayed with this uh manager, been a relationship, Well, sure enough, a month into it, right? The whole world kind of became upside down and things changed. Uh resiliency, absolutely. I'm the new kid joining a team. Everyone's now remote. Building those relationships all remote is so different, right? And uh you roll up your sleeves, you start listening, respecting, and you try to accelerate, you know, what you can do to help. But being that new person, you know, I didn't come with that 20 years of experience to really provide value. It was it was difficult. I think I learned a lot in the speed course. Fortunately, have one of the best teams, one of the best leaders that I came to this organization to work with to help me out along the way and uh pull me in. But boy, was it a whirlwind. Um I hear you. If it would have been one month later, probably would not be in this place today. But I'm really glad it worked out and I'm glad the team gave me that patience and uh still welcomed me along the way. The new kid. I love that. And we talk about technology, right? Like how cool was it that we were all able to go instantly virtually. Um tellahalth which was something that people were fighting and thought it would never work. Tellah health became a huge thing. Everyone switched overnight to tellahalth. Um but just yeah, you're in the space of of So for the physician, it's working out pretty well getting an agentic AI scribe note and we're very excited about it. But our EMR for the nurses, social workers, chaplain, and the other caregivers, they have discrete fields. They don't just have a note. So finding a way where we can get that summary of the conversation safely and securely that the patients are understanding what's being recorded and it's there to help everyone along the way and they're comfortable with it. They're giving permission, but then finding a way for all to go back in the discrete fields, right, back in that EMR so the nurse can have the eye contact with the patient and have a discussion with the family, not staring at the computer and typing it in for each field. That's I think the part that will really sink and make AI work at the bedside. You being a a you mentioned a technology geek, right? Being in this space for 20 years, we've seen innovation happen and very fast. I mean, at one point we had a what's called a iPod and now it doesn't even exist. Um, we got into social media almost 20 years ago, right? Facebook in and do. So for me, those areas of when I saw AI, my mind just become so open and excited over where it could go. And I think that seeking to understand and waiting, trying to find small wins. How do you find a win for someone? And you're going to explain to them that this may take over your workflow. This may take over the things you're doing. For some people, it's thrilling cuz I'm so overworked. Other people, you know, now you're getting a bit personal and now I'm getting scared and leery. So, building that trust for me, and that's where I think a lot of our challenges that we've had in healthcare. Is it going to be safe and secure? Is it going to take over my job? Are the robots, you know, going to be now taking over the world? What's it going to look like? Uh I think I heard in one webinar that I was listening to fairly early on, uh that AI will not replace caregivers or doctors, right? But a doctor or caregiver that uses AI will replace one that does not. That I think is what resonated probably the most to me to try to help communicate and get others to understand. It's a tool. Um, and then another great colleague of mine shared, things. Go here, go here. It's done for you all at at a click. So, I what I think though is that um it's we're expecting our teams to adopt this. Why do you think that why do you believe leaders need to use AI themselves before even having their teams adopt it? Folks are looking us as leaders and wanting to emulate, right? when they see us embracing change, embracing technology to help us, not replace us, but to help us and do our jobs better, it encourages I think it inspires them to want to do their job better and find an easier way. And so for me, if we're not if we think it's we're too good to have to use co-pilot to check our emails and revise it for us or it's not needed for me, but I want you guys for it to find ways. How is that setting an example? So, and and it's a really it's a tool for all. It would have been crazy to think today, right? That excels only for the accountants. It's not for anyone else. I think getting that analogy out there might help folks too along the way. Um, embrace that's just my own thoughts. So, and no, I love it. It's different for everybody, right? It's a tool. So, how can we use these tools? The only way we're going to be able to use them better and get that innovation out of them is by using them and learning, How do we bring those both of those things together is where it's really going to take off and help us. So, I'm not quite sure if I answer that question. I think it got carried away thinking about your experience with uh No, I love it. AI is such a fun topic, isn't it? It gets your mind going in so many other areas and and I think the things we're struggling with today, we need to share those areas we're struggling, you know, and be honest. It is not a perfect tool, right? How often do you even just ask Siri to do something or you'll say Sherry and Siri kicks in, you know, along the way? It isn't perfect. Humans aren't perfect either. Um but that's why I think with the humans and the technology together we'll find the areas where that tool is going to be useful for us right and how do we make that tool better and just look at all the new versions that are coming out the different tools that are being built even today as something if I'm looking at for a caregiver isn't going to be scalable to help all 1,000 because the dollar amount of the investment for that is just going to be overwhelming um within time because things are changing so fast another 12 those digital workers are going to be able to look at the chart, answer phone calls if we need to, route the phone calls where they need to go, do more predictive work for our patients, our caregivers, and their families. And when we can become more predictive, change the mindset of end of life care, reduce that stress for our caregivers to let people want to come into this line of health care, it'll give back and really change, I think, the patient experience along the way. And that's what I'm excited about. So, it's that technology being the enabler. Gosh only knows in 5 years what that technology is going to look like, but I definitely want to be a part of it. I want my team leaders to be a part of it and the whole team to be a part of it. My next question, I think you just answered it, was really um what would the next generation of caregivers inherit, you know, because of the groundwork you're laying now, and I think you just you just made sense of it all. You know, it's it's adding those things that are going to allow people to really probably come back into this work field. Pandemic obviously took a lot of people out because of exactly what we're talking about. They didn't have enough pajama time. They were doing things they did not go to school for. Like when we go to school for something, it's because we truly love it. Um, and when you put things on our plate that we don't love, it becomes not fun anymore. It it doesn't become peaceful, purposeful. Um, live better, to live the life that you want to live. Helping change that mindset. And we're going to do it through my tool, my toolbox is is technology and enabling our caregivers to do it better. Everyone that we work with at our organization has a different tool that they're using to do that. For me, being able to change that mindset would be wonderful. Give you one little quick example if you still have time. I was on vacation recently in Scotland and we were up in the Highlands and we were doing a walk just outside of our hotel and I ran into a hospice house. I was shocked. I'm like in Scotland. We got to go in. My family is very much used to uh when we go on vacation, we visit one of our locations throughout. My previous organization had locations in almost every state. So there was usually a chance to visit a a caregiving setting and very used to that. And we stopped in and speaking with the women that were there, you know, around the world in a completely different healthc care system of England, right? Very different. We had the same challenges. We had the same aspirations and the same hospice heart. and listening to them and I'm like what is the you know I asked them I think that question what's the one thing you'd like to change and that's people's opinions of what hospice healthcare can do what they can do for your loved ones and how we help the family and get that mindset that it's open to talk about it's hard talking about death and if we can get a a better sense of talking about how you want to live your life what does that look like and make it an easier conversation so we know technology challenges are technology challenges and leading teams to uh work through it these days with limited budgets, right? ever flowing list of requests and backlogs and things like that and trying to prioritize and just try to build relationships, you know, it is not easy. And if you don't build a relationship, you're not going to get the trust, good relationship with him for decades along the way and I'm so glad I didn't take no for an answer or it's not going to work for you. So sometimes the timing not might not be right, might not be the right organization, but if it's something that you believe in, lean in to whatever that looks like to make it happen at the right place because it's uh there's going to be something out there that's meant to be. So yeah, and sometimes hearing that it's like it's so easy to take that in the wrong context and be like, what do you mean? But sometimes that's just almost um confirmation that we need to move on sometimes, you know, because I've had those experiences plenty of times. And you know, I've been I've been in leadership since I was 19 years old. I was running my first store at 19 years old with a staff of like seven and you know, the store making manager. Yeah, a general manager. Yeah, I was a general manager. And you know, I did that for seven, eight years at Subway. And um I I don't know if you ever seen the show undercover boss, but I had a lot of great opportunities through it. I even as I was working at Subway, I had my own restaurant working. So I was working 6:00 to 4 and then I would work 5 to 2 in the morning and I was doing that for some time. And then when life was lighting, I decided to close my cafe because I was doing so well with Subway. So I remember going to the new CEO. She was HR for about 25 years. And um she's I said, "Hey, I I want to do more. like technology and when I talk about technology and the hospice is something or even end of life, it's a conversation people don't have or don't want to have. But we'll all need it someday, right? How does technology actually help you change that conversation? Oh, that's a good tough question along the way. Yeah, I'm putting I'm putting you on I'm putting you on the spot here. Putting you on there, right? So, a lot of the areas of technology that we have been implementing have been focused probably on the areas around the bedside because for us, you know, the bedside, I think I may have shared is it's in someone's living room usually, right? There may not be Wi-Fi. There may be a lot of background noise, dogs barking. Um, people coming and going. It may be intimidating for some folks as to what's happening. They're already at a very challenging time in their family's life dealing with loved ones in hospice or advanced illness care. And for us to be introducing some of those things is um may work, may not work. So we've started on more of the other areas, the probably the more traditional ones, the back office areas of technology. We've done a lot of work with trying to automate, get better analytics to provide better care, try to reduce things along the way. How we do it though at the bedside, you know, we've got some new pilots going on and we're working through those, but it hasn't been easy. It hasn't been easy to build that trust with people that we're trying to help them do their jobs better. How do we reduce those clicks, right? Not create more of where we started the conversation, that pajama time where they're working in the evenings updating their charts, you know, when they should be spending it with their family and relaxing or reading a good book. Those are how we've been trying to to work through those challenges, work through the trust, work through the buy in. And then it makes it really difficult because we aren't those frontline caregivers. We're helping trying, piloting, learn from it. We're they're not all going to work, right? And that's that's about it. I think people are very surprised when they start to tap into the space of I and I bring this up often, but I was speaking to a leader and um she was trying to create she was paying someone to create her tone and brand. And I was like, well, you know, you can use chat DPT and create your own brand and tone and all these different things. And her response to me was like, "No, Ephra, I'm not going to use it. Oh, I'm so against it." And so many people tried. It's like social media. She brought it back to social media. Everyone's on social media, right? So, I pulled up chat GPT and I'm showing her like, look, I can take this and I ask her questions and I'm prompting because it's all about prompting, right? Good data. Uh Kenan would say, my my co-partner would say that um uh trash in, trash out. But if you actually put in some good information, you're going to get some good stuff back that really surprises you. So, for 5 minutes, I'm just showing her. Five minutes later, she's sharing her screen and she's using it. And then a week later, she emails me and she says, "Ephrain, thank you so much. like I think I may be overusing this and I'm like there's no way you're over overusing it. And I think it's just people are scared. People are scared and it's just life. People don't like to get uncomfortable. And I think this is a place that we have to really get uncomfortable with and see the value within um this tool as you mentioned so I love that you're really laying this groundwork for the next generation of healthcare leaders and and you know, and helping them become more efficient at their job, but also love again what they've what they do. Um, so that that's pretty cool. But you believe it or not, like there's still like my mom, I said, "Mom, do you use chat DPT?" And she's like, "What the hell is that?" And I'm like, "You don't know about it?" And then, you know, I don't even know if she's using AI her job. And even my mother-in-law, I'm like, "What are you guys doing AI wise?" And she's kind of in the um I guess the nursing side. Uh not at home care, but I guess the the hospice where they're in a center, right? What would you call that? I'm not an impatient unit or is she in a hospice house type of a She's a hospice house, more of a hospice house. And they're not using technology. And I'm like, what? Like why not? So there there's people that are really adapting a little slower, but I'm happy that you guys are ahead of the game. what our loved ones want and we can improve their life you know throughout out with wherever stage they're at. That's just going to drive that passion. It's going to drive improvements in our society all the way around. I know it may sound a little lofty here along the way, but it does get exciting to think about how we can kind of change the culture, right, and change the mindset for folks to to improve it. A tough situation. I love that you're so passionate that even in another country, you're going to go experience what hospice looks like because you can imagine you bring all these ideas and these visions back to your own organization. How do we be better? How do we compete? That is that's how you know you love what you do, right? Like it's it's not even work for you. It's not about the paycheck. It's about the purpose and the passion. Um and I love that. And we really didn't get to talk a lot like because you're in the your seat, but I've heard some amazing things that are happening um such as VR, right? people. I heard one story that someone wanted to skydive and they say, "Well, I mean, you're in a space where you really cannot skydive. You're 80ome years old. You know, you're you have these things going on internally." And his response was, "George Bush did it." And he's like, "Yeah, well, you know, he didn't have what you have." But what they did is put him in a VR and allowed him to experience that. Um, I had another lady share how um there was a gentleman, he wanted to shoot a bear before he passed away. And she's like, "We have to work towards that." and and it was um morphine, right? And the kids were like, "No, I don't want it to happen." But she was like, "Let like, you know, we'll give you dosages. You can take with a button. I'm guessing that you can just take as much as you want." And weeks later, he was able to go shoot a bear. And then he didn't get a bear shot that day. But then I think like two weeks later, he shot he went with his other child, didn't get a bear. The next child weeks later, they got a bear. And then weeks later, he passed away. but he passed away doing what he wanted to do. And that's what hospice and that's what these organizations when we talk about um just doing whatever it takes to allow people to live their end of life happy doing the things that we love and they thought were never possible again. There's technology to do and there's people that care like Sherry I cannot be continued to be contained in these boxes, these four walls, right? Um you've asked me to go to this location. I've I've done what I needed to do. You asked me to go help this person. I've done that. And um she says, "Well, I waited 25 years for my opportunity. Ephrain, you have to wait for yours." And I'm I'm I'm young. I'm like, "What? You think I'm going to wait 25 years in this box?" And that was what I needed. I I asked God to give me a sign if this is where I need to stay. And then he gave me a clear sign and I walked away. And I tell you what, I'm happy that I did. So, you know, at the moment, of course, I was a little upset that she said that to me. Now, I look back and I'm like, "Thank you that she said that to me, right?" Because I would still been at Subway probably inside some boxes, just maybe not one. I had probably multiple stores. So, I love that you took that and you, as you mentioned, you didn't take no for an answer. You kept going on the things that you love and that you cared for. So, Sherry, I appreciate your time. You have been amazing. Um, I I know that we're going to do this again. I know that next time we talk, we're going to see so much growth in the innovation and the AI space because you guys are already kind of ahead of the game when I speak to other leaders. But, um, if you guys are still watching, make sure that you guys do like, subscribe, comment, find Sherry. She's always willing to answer those questions. And if you want her to just visit your hospice location, she's down to do that as well, right? Sherry's down to go make those visits when she's in town. Guys, thank you guys so much for watching. This is Ephrain with Sherry. We'll catch you guys on the next episode. Thank you. Take care.

Key moments

• 2:15 – What “hitting rock bottom” looked like for Dr. Mitchell
• 8:30 – The communication gaps she discovered as a patient
• 15:45 – Building the first clinic with SMS-first engagement
• 23:10 – How automated texting reduced no-shows by 34%
• 31:00 – Scaling to 43,000 patients: what broke and what held
• 38:20 – Advice for leaders in mission-driven organizations