This Week Health 5 Years


November 22: Today on the Community channel, it’s an Interview in Action live from CHIME’s Fall Forum with Terri Couts, SVP and CIO at The Guthrie Clinic. Terri talks with Bill about clinician burnout and how she is leveraging technology to address the problem. How has she implemented Artisight within her organization and how much time is it saving nurses per patient? How did she get clinical buy-in? What was her path from nursing to becoming a CIO?

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Welcome to this week Health Community. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this Week Health, A set of channels dedicated to keeping health IT staff current and engaged. Today we have an interview in action from the 2023 fall conferences of CHIME in San Antonio and HLTH in Las Vegas, and we want to thank our show sponsors who are. In our mission to develop the next generation of health leaders and they are Olive, Rubrik, Trellix, Medigate, and F5. Check them out at this and here we go.

Another interview in action from the Chime fall forum, and we're here with Terry Coots with the Guthrie Clinic. Yes. It's great to see you again.

Yeah, you as well.

Actually, before we get going, the Guthrie Clinic, tell us a little bit.

So the Guthrie Clinic is an integrated health system in the southern and northern tier of New York and pa we have about 36 multi-specialty clinics in that region.

Southern New York, Northern Pennsylvania.

So Southern New York, Northern Pennsylvania. Yes.

Okay, so that's like above Scranton?

Yes, correct.

Okay. So is that mostly rural area?

Very much rural. Okay. The nearest Starbucks to me is like an hour, if that gives you any kind of clue.

Where's the headquarter?

So the headquarters is Sara Pennsylvania, which is literally right on the border of New York mpa.

It's probably a beautiful place every time we look for lakes and stuff, it's.

So the finger lakes are in our region and the five lakes that are up there in

upstate York.


Great place to live. And so you are the CIO there? That's correct. So what's top of mind at the Guthrie Clinic?

So, top of mind is addressing our workforce challenges, trying to use technology to enable care. Think a little differently about, the use of that technology. No longer the days where we're gonna have endless amounts of nursing staff or even radiology staff.

Some, challenges around physicians. So how do we do care differently because we can't just apply people to.

That's a very common theme that keeps coming up of how are we going to enable new levels of efficiency, allow people to practice at the top of their license.

Address some of the financial pressures that are happening. What are some of the things that you're, you're doing in that area?

So we are an epic shop, so we're all always epic first. So how do we can use Epic to solve problems? But we've tagged on a couple different platforms. One of 'em is called sick Bay.

It's by medical informatics and it takes all of your biometric data. Ventilators cardiac monitors and dwellings and centralizes that those wave forms and the history of those wave forms in a central location and then we're using on site. And so I know you've had several conversations with Andrew and Stephanie Lar about art site, and we're using that to help be the visual in the room for maximizing our staff.

Around not just nursing, but air coordination, respiratory therapy pharmacy management with with education and trying to maximize those platforms so that we can scale it to meet the patient where they are. So if they're at cor, which is about a hundred miles from our main campus they can still get the same level of care that they would get our, our higher community hospital.

And Sarah,

so Artisight for those who are like tuning in late to the show we have done a couple shows, talk to Stephanie about that. Artificial sight cameras in the room, but cameras tied to artificial intelligence and it's looking for. Things that you train it to look for. Right, So falls and rooms that need to be cleaned and that kind of stuff.

And I've heard actually what's great about it is a platform so I can hear people going, Hey, we're gonna use it over here. We're gonna, We're gonna put it in our supply closets to keep an inventory. What are some of the areas that specifically that you are looking at it for?

So, our, first pilot was around telesitting really to get those individuals that were in the room back to patient care, being able to maximize that at scale.

But we're now moving into virtual nursing particularly in our ICU's. We have about 50% of our nurses are under three. years Experience in our icu. So we don't have the ability to have that kind of intuition. Like when a nurse looks at a sick patient, they kind of know the patient's sick.

And so having that mentorship in that area and then we're gonna move that into our MedSurg And what we really would like to do is not just have that visual where they ping into the room and have that conversation But to look for things that help take the burden out of their daily work.

So if you think about incentive spirometry, it's something that we have to do for patients. We have to go in, we have to remind them every hour. Well, why can't the camera and the speaker remind the patient to do their incentive spirometer? And then can the camera then learn that they've actually lifted it and not remind them because it's already been done and not have that disruption And then finally, since they've done it, document that in the EMR for us. And so that's an ability to kind of use that. It's a simple case, but that's one thing that they have to do.

every hour How much work did you just take off the nurse in that case?

I mean, if you think of a nurse that has 12 hour shift and, maybe they spend 15 minutes, going into the room, talking to the patient, engaging them, and then going out and documenting hopefully that it was.

That's, you probably anywhere between 15 to, 45 minutes out of just one patient that they have for that shift So we're, really looking at all of those little things and co-developing with ArtiSight to kind of make that happen.

It's interesting having been a cio, I know that you can dream up that as the cio.

I'm also a nurse by background, so it helps

that. Helpful. That's where I was gonna go. I'm like, okay. So how did you get the, clinical buy-in? How did you get them in the room to say, Hey, this is something we should talk about, and then what was their process to say, oh, okay, I could I see what this is gonna do?

Yeah, so we've actually started right to the floor nurses. So, um, really we think in order for this to be successful, we have to do it right the first time and have that trust. So when we started with tele sitting, we're kind of risk adverse. We don't wanna harm the patient, and so we will, what if everything to death?

What if, what if, what if Finally we ripped off the bandaid and we said, let's just do this, and then we can step back to where we had people in the room. If, If it was, you know, not gonna work out. We'll know really quickly. Within three days they ask for more. And so I think it was just getting that quick win, that value add.

And now we're having work group sessions when we're developing these workflows, know, what's appropriate for the bedside nurse and what's appropriate for the virtual nurse, how can the technology enable that and maybe take out both of them and, do some automation and designing those work. every scenario, you know, helping cold transports or discharge patients, those kinds of things, it's about the efficiency around them.

📍 📍 All right. We'll get back to our show in just a minute. We have a webinar coming up on December 7th, and I'm looking forward to that webinar. It is on how to modernize the data platform within healthcare, the modern data platform within healthcare. And I'm really looking forward to the conversation. We just recorded five pre episodes for that. And so they're gonna air on Tuesday and Thursdays leading up to the episode. And we have great conversation about the different aspects, different use cases around the modern data platform and how agility becomes so key and data quality and all those things. So great conversation. Looking forward to that. Wednesday, December 7th at one o'clock. Love to have you join us. We're gonna have health system leaders from Memorial Care and others. CDW is going to have some of their experts on this show as well. So check that out. You can go to our website, top right hand corner. You'll see the upcoming webinars. Love to have you be a part of it. If you have a question coming into it, one of the things we do is we collect the questions in the signup form because we want to make sure that we incorporate that into the discussion. So hope to see you there. Now, back to the show.

📍 📍

It's interesting cuz we've done 20 interviews now and the, foundation of financial Challenges has caused everybody to, I, I think, focus on efficiency the foundation. Unrest amongst the clinicians, burnout, those kind of things has caused them to focus on that. And then obviously cybersecurity.

I'm not gonna take you into cybersecurity direction, but from a nurse standpoint, what are they looking for from you as a cio? What are they looking for from technology in order to. I, Stephanie says it all the time, return the joy, yeah. To the practice of medicine.

It's, it's to reduce all the friction.

And it can be with nursing and not, but just not nursing. I mean, there's so many things where we try to solve problems with tools that we know that we're comfortable with, and we're just always doing the same thing with never getting any different outcomes and just having somebody ask the question well.

What if we can do this, and I'll give a very simple example. Just this week I was having an email conversation with a provider who wants to put printers in every exam room so they can print out their EBS or ABS and they can help the patients schedule their follow up appointment in the room for privacy.

That's great that they're trying to address privacy, but we're adding print services paper. Going away from the technology that we have. And why can't we talk to the patient in the room and have them schedule it on their, we call it e got three, but on my chart it takes away the paper. They have it, they don't, it doesn't get lost.

We don't have to add additional costs with printers. And it's really just challenging them to think a little differently. So that the problem that they're trying to solve is, I'm on board. It's just how they're approaching it with the tools that they, know they don't reach outside of that box.

The thing I like about how you're talking about this is, It provides hope, right? So we just came through the pandemic and a lot of clinicians are looking at it going, man, I, I can't go through that again. And now we're hitting recession and there's some, reductions and whatnot. And what you're saying is, Hey, there's a different way to do this we're gonna bring some technology and some tools into place.

We're gonna sit around as a group and say, Hey, here are the capabilities. Here's how we used to do things, but we can do things differently now. And I think that hope provides I, it provides hope. Yeah. That, Hey, we can do this differently. It's not gonna be the same as it was yesterday. and hopefully if you're practicing different, you can attract some talent to

your area as well.

Yeah, absolutely. I mean, one of our key initiatives around using aride and, sit Bay is to really retain our nurses, to keep them happier. Um, And we've actually factored in some of the cost savings around the unproductive time that we have when we train new nurses. You bring 'em. You can't get rid of the traveler cuz you have the train that new nurse on the workflow.

So you have all that unproductive time. But then also the sign-on bonuses and some of the other things that go over, you know, there's, a huge cost savings that we can retain and just to help them do the job that they want to do, which is patient care.

So tell me a little bit about Sick Bay, cuz I'm not, I'm not

familiar with it.

It's a medical informatics product. And it is a software platform. It's an FDA approved software platform almost like a medical device. It takes. Any, streaming waiting form that you want to stream in a central location and will connect it regardless of vendors. So, for example, we have five hospitals across our region.

We have three different cardiac monitor vendors. We take all that data, we centralize it, now we have essential telling. So we can maximize the efficiencies of, of that staff and have standard alarm management, all of those things that come up with good clinical care. They also do

ventilator data. And it doesn't matter if if they was set up to be interfaced, they just put a little do on the back of it and it's all a sudden it's connected. So it's, It's helped us with things like ICU and some of the other things. If you would buy likes product that's ICUs, it's like $20,000 a bed and it's unattainable for.

Some like ours. And so we've been able to scale it pretty quickly and be able to use it for many different use cases.

So n it is it the traditional path that I've heard? It's like we did the ehr, I sort of got involved and then that's how you

Yes, yes. I'm a, a pediatric partners by background. Was looking for a change that was on call all the time and somebody said, you need to get into this epic thing.

It's gonna be big. We were implementing it. And so I interviewed for role. Had no idea what I was interviewing for when I left the interview. Still had no idea, but I got the role and I just love to solve problems. And I think that that's what we do. Yeah. Um, Is we're trying to take technology. It's not just about the implementation, but are we addressing the issues?

What is the problem we're trying to solve in order to.

Right. Absolutely. Well, thank you Terry. It's great to catch up. Appreciate it.

Another great interview. I wanna thank everybody who spent time with us at the conferences. I love hearing from people on the front lines and it is Phenomen. That they have taken the time to share their wisdom and experience with the community, which is greatly appreciated. We also want to thank our channel sponsors one more time, who invest in our mission to develop the next generation of health leaders. They are Olive, Rubrik, trx, Mitigate, and F5. Thanks for listening. That's all for now.

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