This Week Health

Dr. Sean Kelly with Well Health stops by to discuss patient communication in the clinician workflow on our next #interviewinaction from #chime21fall. Great conversation, hope you enjoy.

Transcript
Bill Russell:

Today in health, it interviews from the chime

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conference in San Diego.

Bill Russell:

My name is bill Russell.

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I'm a former CIO for a 16 hospital system and creator of this week in health.

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It a channel dedicated to keeping health it staff current and engaged.

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Just a quick reminder.

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I wouldn't be dropping interviews over the next couple of days and into

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next week from the chime conference.

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And then I'm going to have some more interviews from the next conference I

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want to be going to, and then eventually I'll get back to Florida and to the studio

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where we'll start looking at the news.

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Once again.

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Hope you enjoy this interview.

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Alright, here we are from the chime floor with Dr.

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Sean Kelly with, uh, with well health, uh, congratulations.

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Where, where Dr.

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So where do you practice

Sean Kelly:

at Beth Israel?

Sean Kelly:

Deaconess and Boston.

Sean Kelly:

Massachusetts.

Sean Kelly:

Oh, up in Boston.

Bill Russell:

Just came back from Boston.

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Where you at the health conference?

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Yes, it was.

Bill Russell:

How was

Sean Kelly:

it?

Sean Kelly:

It was good.

Sean Kelly:

It was really good for connections in industry, strategic partnerships,

Sean Kelly:

direction of the industry.

Sean Kelly:

It's less about meeting with provider side people at that.

Sean Kelly:

It was my, it, it

Sean Kelly:

was

Bill Russell:

really well put on though.

Bill Russell:

I mean, they, they, they do a, they do a great job with the conference

Bill Russell:

and I, I love the artwork too.

Sean Kelly:

Yeah.

Sean Kelly:

And it, it was, I think it was fun.

Sean Kelly:

I mean, uh, to me, you seeing the innovation is really interesting

Sean Kelly:

and some of the mix of the big companies and the little companies

Sean Kelly:

and everything in between and how that could be, you know, strategically

Sean Kelly:

cobbled together or stitched together.

Bill Russell:

Yeah.

Bill Russell:

Some of the conversations I was talking to a startup and, uh, there was two people.

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I'm like, so tell me about your company.

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It's like, it's us two and the three other people back in a coffee shop.

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Right.

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Here's my garage.

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And they were showcasing their product and I'm like, well, what are you here for us?

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Like, let's get funded.

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Yeah.

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Essentially.

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We've, we've got a product we're showing it.

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We've got some, they actually had some clients.

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I was like, that's an impressive start.

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I'm sure they're going to get some, some traction there.

Bill Russell:

So, uh, recently with well

Sean Kelly:

health.

Sean Kelly:

Yeah.

Sean Kelly:

I just joined well health as the chief medical officer and as a

Sean Kelly:

practicing emergency physician.

Sean Kelly:

Uh, really enjoy trying to bridge the gap between the real world with

Sean Kelly:

consumer grade technology and the world of healthcare that we've all grown

Sean Kelly:

up in and trying to usher that in, in ways that make sense for all of us.

Sean Kelly:

All right.

Sean Kelly:

So

Bill Russell:

you're going to educate me on wealth because I

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just had Michelle Stansberry on the show is Houston Methodist.

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And she talks about well health and she was very, uh, uh, she was excited about

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the results that they were able to get.

Bill Russell:

So give us an idea of what.

Sean Kelly:

Uh, last mile of communications to patients, uh, it

Sean Kelly:

catches any signal you want to send them, whether it's coming from your EHR, red

Sean Kelly:

sketch or the numerous other third-party vendors, do billing forms, management,

Sean Kelly:

manual messaging, pretty much anything where you're trying to communicate

Sean Kelly:

with a patient in the ecosystem.

Sean Kelly:

Well, health can grab all that, pull it together and send it to you as

Sean Kelly:

a patient in a form that you want.

Sean Kelly:

It can be voice email, but the large predominance is, guess what?

Sean Kelly:

To your phone or your

Bill Russell:

other platform?

Bill Russell:

Well, that's the thing she was saying.

Bill Russell:

She said, you know, the, the portal is nice and we get the, you know, this

Bill Russell:

much activity on the portal, but we found that texting is a better forum

Bill Russell:

to, to interact because people are used to do that on an ongoing basis.

Sean Kelly:

Yeah.

Sean Kelly:

The trick is you have to go to where the patient wants to be and sending

Sean Kelly:

them to a separate place, whether it's an app, a portal, a third-party

Sean Kelly:

thing, your own hospital website can be problematic because there could be

Sean Kelly:

an authentication there's friction.

Sean Kelly:

Yeah.

Sean Kelly:

There's user issues and then coordinating a use case for gosh

Sean Kelly:

forbid you have to do three different things at three different places.

Sean Kelly:

If that can all be put together into a text with AI and chatbots automated, and

Sean Kelly:

it all just works and you can complete those transactions, you know, confirm an

Sean Kelly:

appointment, schedule appointment, or more valuable clinically relevant use cases

Sean Kelly:

around pharmacy, around, you know, meds around post discharge, pre discharge.

Sean Kelly:

Just think of the multitudinous use cases out about . Yup.

Sean Kelly:

Yup.

Sean Kelly:

The, the amazing thing is build the atomic elements are all there.

Sean Kelly:

And the funny thing for me, from my perspective, as many hospitals

Sean Kelly:

actually already owned the technology and it might be at the patient access

Sean Kelly:

level or the, you know, the, the call center level and someone in a silo is

Sean Kelly:

doing something with the technology.

Sean Kelly:

And at that very hospital, I talked to a CMIO.

Sean Kelly:

Those are most of my friends and see.

Sean Kelly:

And they're telling me about a problem that they're trying to solve manually

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throwing bodies at the problem, cold calling patients, trying to

Sean Kelly:

get them to sign up for a portal.

Sean Kelly:

They have the technology in their own hospital, and now we're just, and these

Sean Kelly:

are fun conversations for me, cause I'm just like, well, I'm gonna introduce

Sean Kelly:

you to the technology you already own.

Sean Kelly:

And you're going to tell me about that use case and we're actually gonna start

Sean Kelly:

solving it, you know, right now today

Bill Russell:

it's interesting because automation is a

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conversation that came up a lot.

Bill Russell:

At the, uh, at the health conference.

Bill Russell:

And I assume it's going to come up here at the chime conference as well.

Bill Russell:

And part of that is just, we're looking at a significant nursing shortage.

Bill Russell:

We're actually going through vaccine mandates right now.

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And we're seeing a natural reduction, um, in an already strained workforce.

Bill Russell:

So that, that automation level, I assume is the, is the power of this.

Bill Russell:

Is that pretty accurate?

Bill Russell:

Absolutely.

Sean Kelly:

That's one of many, you know, it's, it's loyalty and

Sean Kelly:

it's it's patient engagement.

Sean Kelly:

It's usability, but absolutely automate.

Sean Kelly:

Allows everyone on the healthcare side to operate at the top of their license.

Sean Kelly:

You want doctors doing doctor things, a nurse is doing not nursing things.

Sean Kelly:

And even, you know, front end staff doing things that are the most valuable humans

Sean Kelly:

should be doing, not doing things that can be automated and taken off the table.

Sean Kelly:

And, you know, instead of the scale of someone following up

Sean Kelly:

on a patient and getting through 10 or 12 calls, you can do.

Sean Kelly:

80% empirically 80% are taken care of through automation, 20% kick

Sean Kelly:

up the higher level use cases are then dealt with by human beings

Sean Kelly:

who can do that higher order stuff.

Sean Kelly:

And then even more interesting as you, as you move along a month or two later,

Sean Kelly:

you can analyze what's bumping out to the humans and then add that into the

Sean Kelly:

automation and refine it more and more.

Bill Russell:

I think what my, the audience would want to hear

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is how hard is this to stand up?

Bill Russell:

So we have a lot of projects.

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We're bringing a lot of new stuff in.

Bill Russell:

Is this a, uh, a real heavy.

Bill Russell:

It's not like I can hear the operational lift in the background, but from a

Bill Russell:

technology perspective, it doesn't sound like that heavy, but Lyft.

Sean Kelly:

Yeah.

Sean Kelly:

Luckily it's not, it's already baked into the Cerner

Sean Kelly:

HealtheIntent platform to Meditech.

Sean Kelly:

It integrates really well with epic and then a lot of other third-party vendors.

Sean Kelly:

And the beauty of it is the genius of it is it knows exactly where

Sean Kelly:

it should live in the ecosystem.

Sean Kelly:

Not trying to be the brains of anything.

Sean Kelly:

It's not the, you know, the content curation or development in the

Sean Kelly:

background is very plugged in.

Sean Kelly:

You don't have to custom code everything.

Sean Kelly:

It just links into those.

Sean Kelly:

There's an integration.

Sean Kelly:

But once you're integrated into the major ecosystem partners,

Bill Russell:

then your operations team kicks in and they, they look

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at all the various touch points and say, could this be better?

Bill Russell:

Anything other than tax?

Bill Russell:

I assume you can deliver.

Bill Russell:

Yeah.

Bill Russell:

Um,

Sean Kelly:

pretty much on anything you have VR, you can do email and, um,

Sean Kelly:

you know, a lot of places use it for links to, to enable telehealth visits

Sean Kelly:

through COVID and beyond a lot of specialized COVID use cases that really.

Sean Kelly:

Give those out for free and, um, got people using it.

Sean Kelly:

And you know that, of course, as we've talked about, a lot of the

Sean Kelly:

tele-health is now here to stay.

Sean Kelly:

And so those use cases have stuck and other mission critical use cases out

Bill Russell:

there.

Bill Russell:

So, so why continue to practice just out of curiosity?

Sean Kelly:

Cause oh, for me.

Sean Kelly:

Oh, I, my passion is, is, you know, kind of living on both sides of the fence.

Sean Kelly:

It keeps me honest, both ways, right?

Sean Kelly:

The express you're meeting your own.

Sean Kelly:

I mean, you, you have to, you have to, you have to know what you're trying

Sean Kelly:

to do from the industry side to know what the world of medicine is like, and

Sean Kelly:

healthcare is messy, but it's gratifying.

Sean Kelly:

So seeing patients now is still fun and gratifying.

Bill Russell:

It's interesting because that is CIO panel.

Bill Russell:

Uh, all these CEO's who used to be doctors who became CIO and three of

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them essentially took a different approach to continuing to practice.

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One, continued to practice.

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Cause they're like, look, I that's my credible.

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Another essentially said, look, I can't in good conscience, continue to practice.

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Cause I can't keep up on all these skills that are required and,

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and medicine is rapidly changing.

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Uh, and then the other one said, I, I do, I went to telehealth visits

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on a, uh, I think like two, two or three days a month, essentially.

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It's like, it's the least I could possibly do.

Bill Russell:

And you know, I'm seeing, seeing certain kinds of patients triaging stuff.

Bill Russell:

So it's.

Bill Russell:

No it's stuff, I guess you've learned in your first year

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of med school kind of stuff.

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So, yeah.

Bill Russell:

Um, so it's, it always fascinates me.

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Why people either choose to continue to practice or whatnot.

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What do you think is top of mind?

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I asked you this question before, what do you think is top of mind here?

Bill Russell:

That the thing I'm saying, I think it's this labor thing is the thing I'm hearing

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over and over again is I just, I just lost a handful of my staff from it.

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I'm worried about my it staff being that's now working remote,

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getting plucked away from me.

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And obviously the, you know, the, some of the nurse shortages and whatnot, they're

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getting tasked with that kind of stuff.

Bill Russell:

That's what I think is the top of mind right now.

Sean Kelly:

Yeah.

Sean Kelly:

We can chat about that for a second.

Sean Kelly:

And I think, you know, burnout is a big issue and staffing issues and, you

Sean Kelly:

know, it's been there for a long time, got a lot worse during the pandemic,

Sean Kelly:

but, you know, from someone who works on the front lines has done a lot of work.

Sean Kelly:

That can be difficult work.

Sean Kelly:

It's, it's less about the, the amount of work you're doing, but the type of.

Sean Kelly:

And so if you're doing work, that's what you actually want to do.

Sean Kelly:

And patient care, direct patient care can be really hard work, but if it's

Sean Kelly:

directly impactful to the patient and you feel like you're using your skill

Sean Kelly:

set in an efficient manner and spending your time doing the things that you

Sean Kelly:

were trained to do, and it's having an outcome, even if it's a difficult outcome

Sean Kelly:

someone's coming in, you know, sick and dying from COVID and intubate them,

Sean Kelly:

prone them and send them to the ICU.

Sean Kelly:

But that's not where I get burnt out, where the burnout comes from as if

Sean Kelly:

despite all that stuff we're dealing with and, you know, putting on PPE,

Sean Kelly:

donning and doffing that, and all the procedural changes and all that.

Sean Kelly:

If then I get blocked out of the EHR or I, you know, I can't,

Sean Kelly:

I can't message each other.

Sean Kelly:

You know, if there are all these artificial barriers and frustrating

Sean Kelly:

clerical or regulatory or compliance work or litigious stuff, that's frustrating.

Sean Kelly:

And that's not what you said.

Sean Kelly:

For and more and more in the us healthcare system, that just the

Sean Kelly:

burden of that keeps increasing.

Sean Kelly:

And even some of the tools we know we use like, like EHR is, are

Sean Kelly:

very good at passing the burden of documentation onto the front end user.

Sean Kelly:

And, you know, nothing happens until it's documented to happen.

Sean Kelly:

Things like that turn into a lot of extra work.

Sean Kelly:

And

Bill Russell:

it's interesting.

Bill Russell:

This is going a little long, but I love when I get, get to speak with the

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doctor, because one of the, one of the things we tend to do in health, And

Bill Russell:

um, critical eye towards us is we get excited about like, oh, I think this

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is going to solve interoperability.

Bill Russell:

If I I've heard that, like half dozen times since I came into healthcare,

Bill Russell:

like I think we've got, um, one of the things I hear is ambient listening

Bill Russell:

and, and voice those kinds of things.

Bill Russell:

It helps, but it, I have, have you worked a lot with various tools?

Sean Kelly:

I have not.

Sean Kelly:

I have not worked with that.

Sean Kelly:

Especially recently.

Sean Kelly:

We experimented with like Google, Google glass a long time ago at our hospital.

Sean Kelly:

And.

Sean Kelly:

I will say this.

Sean Kelly:

I think it's really important to work from the use cases backwards.

Sean Kelly:

Right?

Sean Kelly:

Don't try to push sexy technology into healthcare because it's a

Sean Kelly:

great technology looking for a home.

Sean Kelly:

You really got to think about the use case first, look at the atomic

Sean Kelly:

elements of that use case and figure out how they're best addressed.

Sean Kelly:

And sometimes it's it's technology that's already commercially

Sean Kelly:

available in different industry.

Sean Kelly:

We're just not using it in.

Sean Kelly:

For whatever reason and, you know, fear of HIPAA, HIPAA violations, or

Sean Kelly:

for some other artificial reason.

Sean Kelly:

And, you know, maybe we should be using a proven technology in healthcare.

Sean Kelly:

That's from other industries.

Sean Kelly:

Sometimes we have to start from scratch, but regardless I'm a big fan of starting

Sean Kelly:

with what are we actually trying to do and not replicating bad workflows

Sean Kelly:

or bad practice or voodoo that we've been doing for 20 years, just because

Sean Kelly:

that's the way we've been doing.

Sean Kelly:

But really think about what should we be doing here?

Sean Kelly:

And, you know, we should be getting doctors and nurses to your point,

Sean Kelly:

focusing on the patient, caring for the patient and allowing all that repetitive

Sean Kelly:

documentation and order entry and all these other things that are clerical

Sean Kelly:

somehow happen and be offloaded.

Sean Kelly:

And whether that's using AI or, you know, other processes

Sean Kelly:

and technologies, it's fine.

Sean Kelly:

But we gotta be crystal clear about the use case first.

Sean Kelly:

Right.

Sean Kelly:

And just.

Sean Kelly:

And that's the disruptive part and start from that and kind

Sean Kelly:

of pull the technology into it.

Bill Russell:

And by the way, Sean, thank you for your time.

Bill Russell:

Talking

Sean Kelly:

with you as always.

Bill Russell:

Don't forget to check back as we have more of these interviews

Bill Russell:

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Bill Russell:

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