Episode 10 : Holiday Bonus. The Predictable Jerk:

Roberta Schwartz

EVP and Chief Innovation Officer at Houston Methodist Hospital

"In healthcare, we've been doing things the same way for a very long time. In fact, we were looking at some new vital sign technology and one of the nurses in the room said, “you know, we've been doing vital signs every four hours since doctors smoked in hospitals.” - Roberta Schwartz

SFTS_Holiday Special Becker's episode.mp3: Audio automatically transcribed by Sonix

SFTS_Holiday Special Becker's episode.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Molly McCarthy:
Welcome to a special holiday episode of the Smart Care Team Spotlight. I'm Molly McCarthy, and I hope you all are reveling in the joy of the holiday season with your friends and family. Today we have a treat for you! Another special crossover event with my friend Steve Lieber and his podcast Smart From the Start, also presented by care.ai. In this episode, host Steve Lieber interviews six health system leaders at the recent Becker's Health IT conference, delving into transformative technologies that are revolutionizing healthcare. Key topics include the vision for smart hospitals, the role of AI and ambient intelligence, and reimagining care delivery models, and the cost of maintaining the status quo. Gurmeet Sran from CommonSpirit Health envisions smart hospitals leveraging technology to enhance patient care, while Brian Sisk from Memorial Hermann discusses the challenge of balancing innovation with practical value for nurses and patients. Reed Smith from Ardent Health focuses on the potential of AI in addressing workforce challenges, and Nick Patel, formerly from Prisma Health, emphasizes the need for AI to drive insights and automation in healthcare, especially in managing chronic conditions. Bill Feaster, formerly from Children's Health of Orange County, calls for intelligent use of AI tools like generative AI to enhance predictive analytics, and Arz Raheem from Montefiore Health proposes ambient technology as a solution to physician burnout. Tune in and discover the transformative possibilities shaping the era of smart hospitals, AI and ambient intelligence can propel health care into the future, and it's already happening. Wishing you all a joyful holidays and a Happy New Year. Enjoy the show, and see you in 2024.

Intro/Outro:
Welcome to Smart From the Start, presented by care.ai, the smart care facility platform company and leader in AI and ambient intelligence for health care. Join Steve Lieber, former CEO of HIMS, as he interviews the brightest minds in the health providers space on truly transformative technologies that are modernizing healthcare.

Steve Lieber:
Hello, and welcome to Smart From the Start, I'm your host, Steve Lieber, and it's my pleasure to bring to you a series of conversations with some of the sharpest minds in health information technology. We'll discuss the smart directions healthcare companies and providers are pursuing to create smart care teams. While at the Becker's Health IT and Revenue Cycle Management Conference in Chicago, we had the opportunity to explore key topics on innovation. In this podcast series, we're giving you a sneak peek into the discussions we had with health system leaders at this event. The key questions we covered during the series are as follows: What is your vision for a smart hospital? How do you see AI and ambient Intelligence enabling you to reimagine your care delivery models? And what is the cost to hospitals of keeping the status quo? We hope you enjoy this abridged version of the insights shared at the conference. First, I want to share the insights. Doctor Gurmeet Sran, chief clinical Data Science officer at CommonSpirit Health, shared with us. Doctor Sran, what is your vision for a smart hospital?

Dr. Gurmeet Sran:
Well, thank you for that question. I think it's a very diverse question overall. You know, there's a lot of thoughts around how you can start to use technology, both either audio-visual AI, augmented intelligence, artificial intelligence to help support a more robust and more dynamic opportunity for patients to give better care. Part of it is really how do we actually start to enable the technology stack, so we can transform these hospitals to be able to become more well-equipped for better patient care? Part of that has a lot to do with how do you actually re-envision the way that the patient rooms should be actually managed, both in terms of the the layout of the room, as well as actually the technologies that you need to help enable this care. And then two, we often sort of forget about the fact that the operating rooms and the way that ours are managed nowadays. Often you have hybrid models of how the operating room needs to be managed. All that has to be sort of taken into consideration. The third part, which I think is actually a part of the word hospital itself, this idea of us having a containerized hospital where it's four walls, where physical patients are physically located there, that's becoming a more antiquated idea. Now, the hospital itself could actually be not only with a physical hospital that we know of today, but it could actually be partially, maybe in a nursing or a rehab facility. It could be the patient's home in some sense, actually, you know, now with mobile, mobile technology, people are beginning to think about mobile hospitals or mobile urgent care centers. So that whole sort of trajectory of it's not bounded by the four walls of the hospital anymore. We have to think about digital transformation and all these other care spaces. And a lot of that, as I'm sure you recognize, comes from using telephony and audio video technology to help enable us to help enable that vision to become a reality in the next decade or two.

Steve Lieber:
Doctor Sran, how do you see AI and ambient intelligence enabling you to reimagine your care delivery models?

Dr. Gurmeet Sran:
So sort of following on on the question that you just asked, uh, there's a huge opportunity here as it relates to the fact that we have a big workforce shortage, the fact that we're actually concerned that we aren't going to have enough nursing or physician staff to enable patient care in the next decade or two. The other part that has the opportunity around ambient intelligence is that how can you centralize the care to remote stations or remote command centers? So getting back to sort of on a per patient basis, as well as then thinking about a population basis on a per patient basis, how do you enable real-time analytics, real-time opportunities to intervene before a quality or a safety event happens, better sort of improve the patient experience, whether it's around sort of ensuring that the family members, the patients are given the information that they need, or at least their requests can be managed at that right time. Part of the idea behind ambient intelligence itself will also, as I mentioned, be around the fact that we don't have enough FTE labor. And so that ability and that power to scale that I think is going to be a super powerful opportunity that's going to actually become probably table stakes in the next decade or so. The others, uh, piece that I mentioned on the population side is now, if you actually have ambient technology working at the patient level, you can then also take that same technology that's built up and syndicate that out to command centers. So possibly allowing for more remote enabled care, remote-enabled care that's not just at your facility, but possibly even care at home care at actually other acute care sites as well. So all of that, um, will probably become a very big sort of opportunity of expansion, uh, to enable better patient care as they sort of move into this next decade.

Steve Lieber:
And for our last question, Doctor Sran, what is the cost to hospitals of keeping the status quo?

Dr. Gurmeet Sran:
Um, as we all know, the significant margin problems that all health systems in the nation face as it relates to both top line and bottom line opportunities, uh, the status quo is going to actually go and allow for dissolution of sort of health systems as we know it. If we don't think about how to reinvent the care models overall. So I'm not saying anything that probably anybody else has not said, but the fact is that we're seeing such a migration and shift in the definitions of where care can be managed, what it means to actually manage care not only from a medical perspective but a mental health perspective from a social determinants perspective. And so all of the way that we've been looking at, let's say, medicine being very medically focused and diagnosis focused, that envisionment of redefining what medical care is, is inevitably going to actually change the way that we have manage and care due care redesign over the course of the next couple of years. So. Put this answered very quickly. Status quo will lead to a, um, ultimate dissolution of, I think, the way that health systems practice if they don't go and they don't reinvigorate and rethink of where they want to go in the future.

Steve Lieber:
Now I want to invite you to listen in to a conversation we had with Brian Sisk, Senior Vice President and Chief Nursing Executive at Memorial Hermann. Brian, what is your vision for a smart hospital?

Brian Sisk:
You know, it's interesting because there's a lot of noise out there in the system right now. You know, we're just having this conversation around the show here. It's you know, it really is getting down to I think we have a lot of energy in this space, especially from front-line nurses all the way up through leaders. It really is getting down to those things that truly provide value to both of our nurses and to the patients, and that's an interesting place to be, right? It's it's because we all we see a lot of innovation that comes through, especially since Covid, right? All these new bells and whistles. But the adoption sometimes lags because it actually creates extra work on the front line or it's not valuable to the patient. And so it really is finding that sweet spot in between those two.

Steve Lieber:
For our next question, Brian, how do you see AI and ambient intelligence enabling you to reimagine your care delivery models?

Brian Sisk:
Yeah, so part of our nursing strategy is reimagine is actually one of the buckets. And we put a lot of energy into that with our front-line nurses, because they really want to be a part of reimagining their healthcare environment. And that really comes down to like everything from the number of times that patients have to press the call bell. Can we eliminate some of that? Can we be more proactive? Can AI help us in some of this ambient monitoring that's out there? Now identify the needs of the patients. We see a lot of things with falls and pressure injuries that I think this is a prime space that would be very beneficial to those that are actually delivering that care.

Steve Lieber:
And for our last question, what is the cost to hospitals of keeping the status quo?

Brian Sisk:
So I say this all the time. What we have now is a much smarter workforce. Um, you can't underestimate how dialed in that nurses docs are in the technology that is out there on the horizon. Some of it's true, some of it's not true. We realize that, right? But it really is, it's going to be a differentiator in these spaces. Because if I can work for an organization that has some of these tools and it makes my job easier, I will probably migrate that way or stay with that company. So I think that's going to have a huge implication. Um, as we kind of go down this pathway.

Steve Lieber:
In our conversation with doctor Nick Patel, founder and CEO of Stealth Consulting, we covered some of the same themes and picked up on some great ideas for innovation that you can also think about and apply at your health system. Doctor Patel, what is your vision for Smart Hospital?

Dr. Nick Patel:
Yeah, the future of Smart Hospital needs to be contiguous with not only just what happens on the acute space but also on the ambulatory space. A smart hospital should be able to know when someone is getting sick at home, alert the right people, and then bring that person seamlessly from the home into the acute bed, bypassing ERS and wait times there and directly into an acute bed to get that treatment quickest. And honestly, when that sort of thing happens, the treatment needs to start not only at the hospital but actually starts at the home through telemedicine, the EMS transport all the way to the acute space.

Steve Lieber:
Nick, how do you see AI and ambient intelligence enabling you to reimagine your care delivery models?

Dr. Nick Patel:
I've been practicing for 20 years and want to tell you health systems even now do a lot of manual tasks, and there are thousands and thousands of tasks that a person has to do for one patient visit, just from the checking-in process to the the the nursing intake to the provider to the checkout process. And then that's exponentially increased if you go to the good side. So what we can use AI is not only to get insights but to drive the patient to the right avenue of care, use automation to make sense of the large data sets from wearables and other chronic disease states coming in, and then make sure that person gets the right avenue of care and gets alerted proactively when they're going the wrong path. Let's not wait for someone to actually have high sugar that puts them in a DKA. Let's see. This person's sugar is actually been going up. Let's increase the treatment. Let's make sure that person talks to a pharmacist. Let's make sure it talks to a nutritionist all virtually. In order for that person to avert an organ damage from chronic kidney disease, blindness, heart disease, etc.. So it's all about using effective clean data to drive automation and get the insights from AI.

Steve Lieber:
And for a final question, Doctor Patel, what do you see as the cost to hospitals of keeping the status quo?

Dr. Nick Patel:
Most hospitals currently, are still working, like if they're in the 80s, even though we've had the high-tech act, the EHR come out. The cost is huge because the population has changed. If we don't change how we take care of our patients and move to more value-based care, more proactive care, more wellness care, then we're going to continue to have sicker and sicker patients in our hospitals, and our beds are going to continue to overflow. So the cost for a health system not to do anything and modernize and digitally transform is could be a threat for them to actually close, because there's no way that they can keep up with the cost of healthcare, the cost of inflation, the ever-growing population of our patients, the heart, and the fact that is continue to have a nursing shortage. So we have to do things in a different way. We have to modernize how we transform care. We need to make sure that we have patients, have proactive care and seamless care without having to see have a person see them. Uh, so it's all about that narrow margin of health systems have average health system has 2 to 3% margin. And if you modernize and transform your business to do things that require less people skill and more asynchronous skills and virtual care, you're going to improve access. You're going to actually bring in more commercial payers. The consumers are going to want to come to your health system. You're going to retain, and you're going to do better from a reimbursement perspective, because you're actually building much better quality to the patient.

Steve Lieber:
Reed Smith, chief consumer officer at Ardent Health Services, shares his experience from the lens of the consumer of health care. Reed, for our first question, what is your vision for a smart hospital?

Reed Smith:
The smart hospital is an interesting time. I think a lot of people probably, um, try to tie that back to technology specifically, and that is part of it. But I think a lot of it is how we educate and train our clinicians and the other people that operationalize, uh, you know, what we do on a daily basis. So when we think about smart hospitals, uh, it's not that it's not a virtual hospital or something to that effect, but how do we take that technology and actually leverage that against the people and the processes and even the education, uh, so we can better care for the communities that we serve.

Steve Lieber:
How do you see AI and ambient intelligence enabling you to reimagine your care delivery models?

Reed Smith:
Ai is interesting. I think it's hard to, you know, go to a conference or a webinar and, you know, this isn't on the agenda. So you take that and the ambient monitoring piece. And I think what we're doing is actually trying to solve real issues that we have in the hospital. So you take labor for example. There's not enough nurses. I've been doing this for 20 years. There's never been enough nurses. I'm not sure we'll ever have enough nurses. So how can you use these to actually enable, um, virtual clinicians, virtual nursing, things like that, where we can actually take some of the administrative burden off those people that are there in person and allow them to really maximize? We talked a lot about pricing at the height of your license. You know, how do we actually do that in a way that we're caring for the patient, actually bringing in their care team, their family members, things like that. So again, we could be more predictive. We can head off potential things like falls, for example, but then also care for them, uh, in a very systematic way that allows them to feel supported and hopefully goes home quicker. Uh, they heal faster, things like that.

Steve Lieber:
And for our last question, Reed, what do you see as the cost to hospitals of keeping the status quo? You know.

Reed Smith:
If we just keep doing what we're doing, we're probably going to keep getting what we're getting right, or however that analogy goes. And so, um, I don't think we can, you know, our chief medical officer, I've heard him say a few times now that he never wants to be called innovative. He's even doing what he's doing. He says we have to. Right. So I don't think we can keep doing what we're doing. Um, I think that's. Really, we run the risk of being irrelevant at some point. Um, I think hospitals will always they'll always be a need in that higher acuity. But how do we actually use all these technologies, these new processes, to really become more consumer-centric? And that's whether they're in the home and the evolving side of care, or they're in our hospitals or otherwise. So if we stay where we are, you know, we run the risk of being out of business, quite honestly.

Steve Lieber:
Doctor Bill Feaster, former Health Information Officer at Children's Hospital of Orange County, kicks off the questions with a candid approach that got right into the opportunities we have. So Doctor Feaster, for our first question, what is your vision for a smart hospital?

Dr. Bill Feaster:
Well, I would say the way we operate our hospitals right now is sort of the furthest thing from being smart, and that basically we do things the same way we did them. When I started my practice in 1981, we staff in the same way, and often that staffing is regulated by the state. Uh, we, uh, have processes that are all pretty much the same. We've, uh, inserted electronic medical records into our care since then, but we haven't really been able to use them in any sort of intelligent way. So I think the whole industry is ripe for, uh, completely redoing what we do now and trying to add some intelligence in it. So instead of just operating, can we operate intelligently in the future?

Steve Lieber:
Our next question is how do you see AI and ambient intelligence enabling you to reimagine your care delivery models?

Dr. Bill Feaster:
Well, um, we've been applying intelligence to our care of patients for some time now. Uh, we started our data science journey about five years ago, doing predictive analytics and applying it back to healthcare. But in the last year, there has just been a quantum leap in intelligence capabilities through the use of Generative AI, the ChatGPT of the world, and the other AI tools, of which some are now really focusing on healthcare. So the application of those tools in the right way, the correct way to healthcare that both preserves privacy but also gives true intelligence, I think is going to be a game changer moving forward.

Steve Lieber:
And for our last question, Doctor Feaster, what do you see as the cost to hospitals of keeping the status quo?

Dr. Bill Feaster:
Uh, well, the cost of hospitals right now with our current status quo is unacceptable. Uh, we can't function much longer because our costs are all increasing. Our providers are sort of getting swamped by costs in their practices. Uh, everything is not, you know, it's not a sustainable solution. Nobody wants to pay what we're going to need to charge to keep doing things the way we're doing them now. So, uh, I don't think healthcare has a choice but to transform and try to figure out ways to not only staff smarter, but use staff or smartly. Like, for example, physicians, uh, currently are kind of the top of the food chain, and I appreciate that being a physician. But at the same time, with the advance of mid-level practitioners, if we can get intelligent tools in their hands to try to decrease the divide in knowledge between the two groups, we're going to be able to let the mid-level practitioners just have more and more responsibility over care and try to balance out, uh, some of our other shortages.

Steve Lieber:
Finally, we wrapped up the sessions with Arz Raheem, Senior Director at the Digital Transformation Office at Montefiore Health System, who focused his responses on ways we can transform healthcare today. Arz, what is your vision for a smart hospital?

Arz Raheem:
My vision for a smart hospital is to incorporate new technologies. I mean, we're at the back of conference today. I've been speaking to a lot of different people talking about generative AI, talking about AI, ambient technology, uh, you know, RTLS things that have been around for a while as well. So my vision is to incorporate all of that and to look at pain points within the health system that we have. So my role is I oversee digital transformation, and it's a good space to be in because we're outside of IT, but we sit very, very closely with the faculty practice group. We listen to the clinicians, to the physicians, to our operations staff, and and we try and understand the pain points that they have, uh, in their workflows, both operational and clinical, and try and address that with the right technology. And sometimes technology is not even the answer, but we want to make sure that we we address that with the right technology by listening to the folks that are actually undergoing the actual problems.

Steve Lieber:
For our next question, how do you see AI and ambient intelligence enabling you to reimagine your care delivery model?

Arz Raheem:
I think it's a really exciting, the space to be in with digital transformation and ambient technology. Um, you know, I've been talking to Care.ai and we've been working with some other organizations that do ambient technology and, uh, you know, have the technology to listen in to a conversation with a provider and a patient. So that kind of technology is a win win, not only for the patient, because I think it's a patient satisfier. Um, and I'll go into that in a second, but it's also something that can really reduce, uh, physician burnout. Uh, we are desperately trying to address physician burnout. What we have is we have a situation where, uh, pajama time and our hospital is through the roof. We have folks who are switching on Netflix at the end of the day and catching up with their notes and doing all their charting. When ambient technology has the ability to listen into the conversation, to create, uh, you do the charting for you do the medical note for you, and it requires minutes, if that, for a physician to quickly look at what the what's been suggested, check it, post it, and it saves a lot of time. It's an opportunity to see more patients as well. And obviously it reduces, uh, pajama time and physician burnout as well. So I think that's what excites me about, uh, ambient technology today in healthcare.

Steve Lieber:
And for our last question hours, what is the cost to hospitals of keeping the status quo?

Arz Raheem:
That's an interesting one. Uh, cost to hospitals is really. It's a trade-off. Do you want to stand still and hope that where we are is sufficient, or do you want to explore new technology? Do you want to look at generative AI? It's a really tough question to answer because healthcare has historically moved very, very slowly. I used to work in finance before. It was very, very fast-paced, but healthcare is a little bit slow, and healthcare, uh, is comfortable, I think, with being a little bit slow. But I think things like generative AI, it's, uh ChatGPT. It's not even a year old. And everyone in this conference is talking about it, talking about conversational AI. So I think you can either take a risk and jump on that bandwagon. But you have to be very, very careful about making sure that you select the right technology for your hospital, for your patient demographic. Otherwise, you lose that patient demographic. Not all this technology is the right technology for your particular patient demographic, so you have to make sure that you have the right, uh, strategy if you like. And I think the strategy has to be a change in culture, of a culture of innovation versus a culture of maintenance and preservation that we've had for so long.

Steve Lieber:
Well, folks, that's a wrap. We hope you enjoyed the insights from these health system leaders on today's podcast. We are always in search for insights from the brightest minds in healthcare that could help us move healthcare forward at the speed of tech. A big thanks to all of those that participated and a thank you for joining me today. Until next time.

Intro/Outro:
Thanks for listening to Smart From the Start. For best practices in AI, in ambient intelligence, and ways your organization can help lead the era of smart hospitals. Visit us at Smart hospital.i and for information on the leading smart care facility platform, visit care.i.

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care.ai is the artificial intelligence company redefining how care is delivered with its Smart Care Facility Platform and Always-aware Ambient Intelligent Sensors. care.ai’s solutions transform physical spaces into self-aware smart care environments to autonomously enhance and optimize clinical and operational workflows, delivering a transformative approach to virtual care models, including Virtual Nursing.