This Week Health

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August 4, 2022: Today on This Week Health, a special highlight reel episode of Townhall this week combines different hosts, guests and topics that really illustrate what this channel is all about: community. We’ve clipped together some of our favorite moments from the past 6 months, though it was hard to choose just a few. In this episode we feature the following hosts, guests and topics:

  1. Lee Milligan, CIO for Asante and Mark Stockwell, Director of ITS Enterprise Services at Asante - Framework, Discovery, and Launch of a Successful Data Governance Program
  2. Reid Stephan, VP and CIO at St. Lukes and Todd Dunn, Vice President of Innovation at Atrium Health -  Empathy Married with Curiosity are the Two Foundational Principles of Great Innovation
  3. Jake Lancaster, Chief Medical Information Officer at Baptist Memorial Health Care and Matthew Sakumoto, Virtualist & Clinical Informatics Physician Champion at Sutter Health - Virtual Primary Care Creates Hybrid Care Coordination For Patients
  4. Brett Oliver, Family physician and Chief Medical Information Officer at Baptist Health and Andy Truscott, Global Health Technology Lead for Accenture - A Physician And A Technologist Ask How To Make Health IT Projects Less Burdensome For Clinicians
  5. Lee Milligan, CIO for Asante and Allison Graffis, Manager of Clinical Informatics Training at Asante - A One Hour Call Results In 104 Hours A Year Saved For One Clinician
  6. Jake Lancaster, Chief Medical Information Officer at Baptist Memorial Health Care and Peter Hong, Clinical Informatics Fellow and Pediatric Hospitalist fellow at Boston Children's - How Can Health Systems And Centers Carry App Maintenance?
  7. Brett Oliver, Family Physician and Chief Medical Information Officer at Baptist Health and Aaron Miri, SVP, Chief Digital & Information Officer at Baptist Health Jacksonville - How Has COVID And The Use Of Telehealth Affected The Relationship Between Health IT And Clinicians?
  8. Reid Stephan, VP and CIO at St. Lukes and Carrie Liken, Head of Industry for Healthcare at Yext - Data Interoperability Will Be Important In 2022, How Can Organizations Prepare?

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Transcript

This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Today on This Week Health.

Because of cOVID 19 and we could not see folks in person, even those that were reluctant, suddenly got to experience consumer-based telemedicine or telehealth solutions and say, oh, this really is effortless.

It hurt, because everybody started saying telehealth and telemedicine. Which confused the whole organization and the whole industry as to what is actually telehealth and telemedicine.

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Welcome to This Week Health Community. This is TownHall a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels designed to amplify great thinking to propel healthcare forward. We want to thank our show sponsors Olive, Rubrik, Trellix, Medigate and F5 in partnership with Sirius Healthcare for investing in our mission to develop the next generation of health leaders. Now 📍 onto our show.

Today on this week, health I'm on vacation. Hanging out with my family for a few days. I still wanted to provide some new content to you. So we kicked off this week health community, our newest podcast with a show called town hall earlier this year. This is an interview by health. It leaders. And practitioners of practitioners.

And today I give you a little highlight reel. Town hall is now one of my favorite podcasts. We have seven great guest hosts, and we are in the process of adding two more to that list just from conversations I've had in the last two days. So far we have re Stephen CIO for St.

Luke's out of Boise, Idaho. We have chief Lancaster CIO of Baptist Memorial in Tennessee. Brett Oliver, CMIO Baptist in Kentucky. Craig Richard CIO Intermountain. Lee Milligan CIO for Asante, actually he just left. Asante is going to a new role when he's ready to announce it. I will let you know where he's going.

Mark Weisman, CIO for title health and sushi principal at Starbridge advisors. These are our phenomenal guess hosts. I'm really excited that they have decided to be a part of this. And in today's clips, you are only gonna hear from four of them. As some of them recently joined us as hosts. So we're gonna showcase them later on in the year, probably in the next highlight show.

So, all right. That's enough setup. Let's just get to it in the first clip, we have a great interview. Lee Milligan interviewed mark Stockwell. Who's also with Asante and they talk about data governance and specifically the framework for setting up and launching great data governance.

So here you go. Our 📍 first clip.

I want to pivot a little bit to your work in data governance. I kind of glossed over this with a single sentence, but you did stand up and create arguably one of the best data governance programs that I know of. And of course I'm very biased because I have got a chance to partner with you and, be part of it. But the reality is a lot of this work was non technical.

It was procedural and policy driven and accountability driven across the organization, not just EHR databases. Can you talk a little bit about when you first came on board, what the framework was that we put in place for you to initially do investigation and discovery and to research that, and then kind of what you ultimately were able to put in place here at Asante.

you're a part of this since the beginning. We did have a first attempt at data governance and largely s temming from the fact that we were going to start to ingest additional information from outside the system.

We were going to start to share more data outside the system, and we really had concerns about how certain are we of the quality of the information we're going to share the data we were going to share. that prompted us to think about governance as a structure we needed to have in place in order to ensure we could deliver quality data and manage the receipt of quality data.

So our first attempt was largely academic and we learned from that experience, as you were part of that original team, but then following that when you and I got together to talk further, how would we do this again? I think one of the smartest things we did was to spend some time really researching and understanding what we wanted to get out of data governance.

It's a big domain. If you were to go out and look at the internet search on data governance, you'll find any number of models with any number of elements that are supporting data governance. But at the end of the day, when we did our research and spend some quality time doing that research and talking to people, talking to other healthcare systems, other governance organizations outside of healthcare we came to the conclusion that really we needed to focus on just a few things without the size of the system we have.

We really only needed to focus on a few things and we identified these as our pillars. And they really around us around accountability for data assets across the enterprise. The proper use of our data assets within and outside of the enterprise quality. The core elements of quality for data and lastly movement, right?

Because there's a risk both in and outbound with data coming in 📍 and out of the system.

Yeah, you're gonna hear more from Lee later on in the show. Our next clip though is Reid Stephan, who is the as I said, VP CIO for St. Luke's health. And in this clip, he interviews Todd Dunn, the vice president of innovation for atrium health. And I like this for a lot of reasons. One is. When I talked to Reid about doing this, he said, yeah.

So, I'm very busy, got a lot going on. Why should I do this? And I said, each of us should invest time in our network. And if you do this, it gives you an opportunity to interview people from your network, people,

you know, and you just wanna ask, 'em a few more questions. And in the process you get to give back to the community.

And recently I was talking to Reid and he was like, you know what? I am so glad you asked me to do this. This has been phenomenal. I've had great conversations and you're gonna hear one right here. In this Reid and Todd end up talking about foundational principles in innovation.

So here you go. Reid, Stephan and 📍 Todd Dunn

You and I, as we've talked over the years, you often advocate that culture is the essential element of innovation. What advice would you offer someone who is trying to create a culture of innovation at their workplace?

I often say that empathy is the heartbeat of healthcare. And I also think it is, when married with curiosity, the two foundational principles of great innovation. So I think you have to create a servant leadership mindset in your organization where your leaders truly care about the people who they serve as their boss or manager.

And I think that that is not an adjective. That is a verb. What does it look like? Does it look like taking time and understanding people because that creates a safe space for people to do the second thing really well. And that's to be curious, and in my opinion, curiosity is embodied in the shape of a question.

Really engaging people in active dialogues that tells them that. Their voice is really appreciated, the question really sparks everything.

And I would say that the behavior expectation that I think is necessary in the leadership ranks is every time. in a Meeting have the leader ask about the consumer if the consumer is the nursing team and and in turn, sit and listen and encourage the team to ask a lot of questions.

We do question bursts. We do assumption bursts. We do some of these activities, but I think those are it Reid. Because if you don't have those, all the tools and the language and the methods are just kind of window dressing. And the curiosity thing just changes the world. But if you don't allow people to safely be curious, because you're empathetic towards what they're struggling with, you're going to have a hard time being a great 📍 innovation company.

Fantastic. Here's another great insight. We have Jake Lancaster again, CMIO for Baptist Memorial outta Tennessee. And in this interview, he talks to Matthew Sakamoto, virtual and clinical informaticist. And physician champion at Sutter health. Again, I love this cross pollination that's happening and the conversation, little known fact about Jake Lancaster, he has done podcasts before.

So he is a natural to step in and start doing this hosting and this conversation, they talk about hybrid care coordination through virtual primary healthcare and how to create that environment and that coordination that works for the provider and for the patient. So here you go, Jake Lancaster.

And Matthew 📍 Sakamoto.

Everybody knows that the beginning of the pandemic telemedicine really exploded.

It was obviously here before then, but exploded in a,, huge way during the pandemic. But virtual primary care is a little bit different than just your average telemedicine visit for maybe an acute problem, like urgent care tell us what you mean by virtual primary care?

Yeah, for sure. And I make a specific point to say virtual primary care and virtual care, not specifically telehealth cause I, that, to me, most people, when they hear telehealth, they tend to think of a video visit, maybe a telephone call. The virtual primary care part in the same way that primary care spans the care continuum.

Virtual care as well. So I always include in that, like that asynchronous messaging, so texting kind of things that are through a patient portal. Cause I think that really does that's part of the glue that keeps it together. So for me, virtual primary care, it's the same it's, I have patients I provide their, for their chronic care needs as well as kind of any urgent stuff that comes up and all the care coordination that happens.

That's the main thing is like it's a lot of that care coordination piece. And by virtualizing that, that one, let's you look across your panel a little bit easier. And then two, and I think this is the biggest piece, is it really helps turn the primary care team, not just on the primary care physician, but actually the whole primary care teams.

I work with the nurse practitioner a nurse that help manage this panel. And by virtualizing, a lot of the care they can jump in and help and things can happen in parallel and you don't have to stack up eight to 25 visits in a day.

Yeah. Sure. And do you see all of your patients 100% virtual or do you have any in-person visits as well?

We have a virtual first, but a hybrid model. So 80% of the time I'm doing either video visits, phone calls or messaging with the patients. I have a reserved day in clinic for patients in my region that I can see in person. And there are things that you don't have to be done, vaccines need to be delivered in person, certain physical exam things.

And even patients that don't necessarily a physical exam, but are pretty complex. I'll have them come in and we'll talk. So I don't think we lose that personal touch at all. And having that hybrid ability is helpful. And the other nice thing is that we can take care of a lot of the easy med refill, med reconciliation things before the visit, even days before the visits or the time spent in person in the clinic is really high yield time.

📍 📍 We'll get back to our show in just a minute, we have a couple of webinars coming up and I don't like webinars. I think they are oversaturated at this point. And I think a lot of them are not all that good. And so that's why I think I'm the perfect person to put together webinars for you. I make sure that we have great topics.

I validate them with CIOs. I make sure we have great guests and I make sure. We actually plan ahead and we actually spend time together before the actual webinar. So it's not just spur of the moment stuff, but we make sure we identify the things that we should talk about in those webinars. And we even collect questions from you ahead of the webinar so that we can make sure to talk about the things that you want to talk about.

So let me tell you a little bit about the two webinars we have coming up. There's a global survey. That we talked about on the today show a thousand cybersecurity professionals found that 30% plan to change professions within two or more years, and cybersecurity threats are growing. And, you know, quite frankly, we need to make sure that we recruit, retain and optimize our staff so that they can be our frontline.

And so the first webinar we're doing is how's your frontline recruit. Retain and optimize your cybersecurity team. And we're gonna talk to experts from Christiana care and Seattle children's and Seuss about their thoughts on this exit of security professionals and what you can do to stay ahead of that.

You can join us August 11th. At, 1:00 PM Eastern time and you can register right on our homepage this week, health.com on the top right hand side, you're gonna have the two upcoming webinars. You go ahead and click on those again. That is August 11th at 1:00 PM Eastern time. The next one, we're going to talk about ransomware, but I've seen a lot of different ransomware, webinars.

I love this one. The topic we came up with is Don. Pay the ransom and rubric is bringing together some great leaders from Thomas Jefferson university in St. Luke's university health system and and rubric themselves. And we're gonna discuss solutions around protecting all of your healthcare data, especially as you're moving to the cloud.

And specifically, we're also gonna talk about epic. Backup in Azure. And what rubric gets doing around that, that webinar is going to be on Thursday, August 18th at 1:00 PM. You can register for both of them. Just go to our homepage this week, health.com upper right hand corner. You're gonna see both of the graphics for those click on the one you wanna attend, fill out the form. And we will see you then now back to our show. 📍

📍 In, in our next clip, we have Dr. Brett Oliver, CMIO Baptist health outta Kentucky, and he interviews Andy Truscott, global health technology lead at Accenture. And Brett has been a phenomenal friend of the show and really appreciate him coming on the show multiple times. He is doing work in DC.

He's doing, I mean, he's doing so much stuff. I really appreciate him putting some time aside for this. And he has captured some great conversations and this one, they talk about how to make health. It projects less burdensome on the clinicians. So here you go. Brett Oliver and Andy Truscott 📍 with Accenture.

If someone comes to me with a new algorithm and says, Brett, I think this could really help in the care of your pneumonia patients or your diabetic patients.

The amount of due diligence I have to do because of the investment of time and resources to get that live in our system and using the patients is tremendous. There has to be a way that we can, I don't even know what the correct term is platformatied. I just made one up right there where I can have a platform that I've already vetted.

I vet once. I vet annually, whatever it might be, I'm connected there and I can plug Andy's new diabetic algorithm in there. Try it out for three months. See where my patients land and if the data holds true for them. I'm just curious to your thoughts on just sort of this platform approach. And if there's other solutions to that from a technical perspective to get around it?

Somebody knowing the argument between, is it AI or is it complex processing.

Fair enough. That's fair. Yeah.

So I, I kind of ask you the question. What would you trust?

I would trust something that I could try. Let's say it's with it let's say Andy Truscott's got a brand new platform. Your company. And I connected to that. I've vetted it. My relationship is with you and your company. That's where the trust comes in. And then you have a basic level of vetting that you do with any company that comes with their machine learning, what algorithm, their AI, whatever it might be.

And I still want to do my own vetting, but from a technical perspective, I don't have a new project. You do. You figured that out. And so my vetting from a clinical perspective can actually be done, whether it's in the background or alive in production with my own patients. Does that make sense?

Oh, I understand what you're saying, but why would you want to vet something with production patients when you're trying to provide them the best care you can? This is still untrusted. You haven't proven it yet.

Yeah. I guess what I'm saying, I would run it on production patients, but in the background, it wouldn't be.

Enough time to run things in parallel.

Correct. It's certainly better than doing a six to nine month project only to find out this isn't working. I would like to have three months where I could easily connect there really wasn't a much of an IT project. Determine that yeah, this is great, or this is not great because it's with my own data. Does that make sense?

I understand that point. The major question in my mind is actually providers who are able to run these things in parallel. Okay. Because there is a time overhead from doing it. And that always causes me concern because we don't providers have more than nothing to do that day without experimenting with the stuff that like. Something, something we're doing, we are doing right now is we're one of the platforms we have inside Accenture, our health and human insights indicators and models we actually embedded inside it. So when you're cutting and slicing patient data, it shows you a diabetes score. And a diabetes risk score, right. Whether or not your ask is just sitting there in the corner and you can choose to pay attention just like you would any other clincial decision support. And I think that's probably the good approach for getting adoption of some of these new quote unquote AI type algorithms is actually there are existing clinical decision support channels out there.

Okay. There are existing ways by which we can display risk information around patients for on whatever dimension. I don't know. And we are trying to develop new ones as well around, especially things like social determinants of health, but also around other clinical risk, et cetera, as new models come out.

So augmenting that, but making it more accessible and there's some great examples around the world in that kind of risk data is made more 📍 accessible.

If

Fantastic. I said I would get back to Lee Milligan and here he is again with another clip. And the thing I like about this Lee was the CIO for Asante health and he chose to go on a little different path. He chose to interview the people from within his organization. And to highlight the great work that they were doing and give them a little exposure to the outside world.

And also to be honest with you, it was a great mentoring opportunity for him in the discussions I've had with him. He really appreciated that opportunity. So in this interview Dr. Milligan talks to Allison Graphis manager, clinical informatics and training at Asante. And it's really an interesting clip here, cuz.

talk about a one hour call results in a hundred, four hours a year saved from one clinician's time. So, again, excellent insights. Here you go. Dr. Milligan and Allison Gruss. Here 📍 you go.

One of your staff recently spent one hour with one provider and it was a positive impact. Can you talk about that a bit?

Yeah. So one of my staff members reached out and we have what's called signal reports in Epic. So it's a way to look at how productive and efficient providers are using Epic. So this one staff member looked at it, studied, it, found a couple of areas and was able to get a one hour of dedicated time with this clinician.

So this clinician was not seeing patients at the time, but just had a meeting scheduled in our office. So she went down there, met with her and we were able to save 28 minutes per day for this provider just on three different basic areas. I did follow up with this person as well. And she now has a second meeting set up with this provider to look at her notes, to see how we can improve her timing on her notes. So it's a huge success. And I think if we can get engagement, it's just amazing what we can do to help ease some of the burden.

I'm a nerd. I took those minutes say per day times by the number of potential days, you're working a year, come up with 104 hours a year, save from a single hour of your staff's time in front of a clinician. That is 📍 so cool.

All right. We're back to Jake Lancaster, CMIO Baptist, Memorial healthcare. And in this clip, he interviews Peter Hong clinical fellow clinical informatics and pediatrics at Boston children's hospital. And what they end up talking about is how can health systems and centers carry app maintenance. This is no small task and it's something that more and more health systems are doing and trying to figure out.

So here you go. Jake Lancaster and Peter. 📍

You alluded to this earlier, when you were talking about how apps were maybe previously developed in individual departments. But in my experience at another academic center, had a similar issue where there was some independent app development that would occur and we'd have these legacy apps and then the physician or whoever made the app would leave the organization. And then all of a sudden you had to pick up this code that nobody knew about and tried to maintain it over time. How has your group looking at making sure that they can maintain and keep up with, these apps once they're out there?

Yeah. Oh man. Gosh, if we had the answer to that I think we would be all set. We wouldn't need to look outside for any vendor softwares. I think we had a similar experience of that and I'm sure we're very much not alone.

In some of our applications being written by specialists with really deep domain knowledge and certain things that necessarily weren't a easily fundable skillset. And I think somewhat, fortunately I think a lot of people are working in this space and a lot of the different vendors and companies globally.

So sometimes we have fortunately been in a situation where something starts to not work so much. And we're at the point where it's harder and harder to keep putting patchwork onto an application when everything else around it is evolving rapidly. And at some point with advocacy efforts or more research and I think publicity around the importance of you know some of the different functionality and the electronic health record, particularly in pediatric needs. Different vendors are catching up and able to provide some of that software. So we don't necessarily need to then go to redesign those applications from the ground up. And there seem to be ways that we can more seamlessly integrate that either from a vendor or a company that works very closely with some of the vendors that we 📍 work with.

love that insight. So. We're back to Brett Oliver, Brett Oliver. Sometimes what goes on in this show kind of surprises me because again, I've handed over some of the control to these guest hosts and I trust them and they're doing a great job. And Brett Oliver reached out to Aaron, Mary. So Aaron marries the chief digital and information officer at Baptist health outta Jacksonville.

And they ended up having a conversation. And the reason this surprised me. I did hour long interviews with Aaron at least twice in the last two years. And he agreed to come on with Brett and have a conversation. The thing I love about this is you're gonna get a completely different lens.

You're gonna get questions that come from a CMIO's perspective and from Brett's perspective, and it's gonna be a much. Different conversation than say I would have with Aaron, Mary. And this is what I love about this show. So in this clip they talked about how has COVID and the use of telehealth affected the relationship between health it and the clinicians.

So here you go. Aaron, Mary and Dr. Brett 📍 Oliver.

Do you find that the clinicians experience was good. And in the end, that's going to be a positive to what you were speaking of the trust factor. Like, Do you think COVID has helped that or hurt it? Or dependent upon your organization?

So I think it's all the above. Be very honest with you. I think it's helped in that it brought awareness to the importance that telehealth and telemedicine can be to an organization, both from a sustainability perspective, as well as clinical caregiving A lot of physicians particularly had reservations before COVID about the efficacy of telemedicine. Completely understandable mindset of, let me just be safe and sorry. because I do believe clinicians go into this business because they truly want to help people.

So to the degree of it, with that, now relaxed for lack of a better term because of situational issues. right.. COVID 19 and we could not see folks in person, even those that were reluctant, suddenly got to experience consumer-based telemedicine or telehealth solutions and say, oh, this really is effortless.

I think it helped in that situation.

than what it may have been in:

So that's how it hurt. And then I would say depending on organization, which is if you had the finances to dabble and try different solutions, you're in a much better position, but a lot of FQHCs or hospitals with basically no margin had to wing it. Right.. I'm not entirely sure you know what you look like now, if you never had the ability to sort of double down and say, I'm going to go in all in on this one task regardless of good or bad and make it work for my workflows because that's where it really hits the road. . That's where it really happens is where is it in the course of care?

Yeah I see that a lot in the affiliated independent practices that we have throughout 📍 our state.

I know you're getting tired of hearing it, but I just love that. And we have come to our final clip and here you go, reach Stephan again from St. Luke's outta Boise, Idaho. And in this clip, he's talking to Carrie lichen, head of industry and healthcare at. Yext, Y E XT company, interesting company to look at.

ity and why it's important in:predictions for healthcare in:

What are the ways that you predict that that importance is going to manifest itself. And what can organizations do to be ready for that and to kind of proactively take the steps they need.

Great question. What We saw over the last two years throughout the pandemic, there is this realization that a lot of different technologies didn't talk to one another.

What we're going to start seeing over the next year, there will be these new ways that organizations are going to be able to tap into the availability of data, to more robustly understand the patient's experience within healthcare. The second part of your question though, is how can organizations prepare?

One is I think organization. And individuals need to have an open mind. Historically, what I see is that organizations have been very risk averse and very security minded for very good cause, but very risk preventing so the second recommendation I have is organizations need to push back.

So what we found is that there are very large organizations, software platforms, electronic medical records, whatever we want to call it within healthcare organizations right now who are really embedded and they've built walls around their platform.

If healthcare organizations can start collectively pushing back to try to open up those walls that's really the only way that these larger organizations are going to have to acquiesce, there's so much rich information that is being held behind a wall that without a collective campaign to try to break down those walls. I don't think that interoperability will really be that 📍 successful.

All right. That's it for our highlights of the town hall show. If If you are thinking to yourself, you know what bill should consider me as a host, shoot me a note bill at this week.

health.com. Love to hear from you, and we can discuss that. See if it makes sense.

The more people we add to the community, the stronger the discussion gets. And we just we thrive on that and we appreciate the dynamic of hearing the discussion and amplifying the best thinking so that everybody can benefit, especially healthcare.

I really love this show. I love hearing from people on the front lines. I love hearing from these leaders and we want to thank our hosts who continue to support the community by developing this great content. We also want to thank our show sponsors, olive rubric trellis. Mitigate and F five in partnership with serious healthcare for investing in our mission to develop the next generation of health leaders.

If you wanna support the show, let someone know about our shows. They all start with this week health and you can find them wherever you listen to podcasts. There's keynote town hall 📍 and newsroom. Check them out today. And thanks for listening. That's all for now. 📍

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