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Welcome to This Week Health. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare, one connection at a time.

Now, onto our interview

your role.

Cause we saw the foreshadowing of value based contracting and more of the government programs and realized even as a 10 person group we didn't have the resources to. figure out how we were going to manage that and joined the local health system. At that same time, they were looking for a medical director for their insurance plan.

Trying to figure out how to take care of people on a larger scale using that knowledge and since I've been at Piedmont We joined Piedmont in I've been fortunate enough to help oversee their employee health plan from a medical supervision standpoint well as looking at their population health and recently have been the chair of their clinical governance council, which is made up of primary care from across the system And we help try to drive quality and safety for our primary care network for the Clinically Integrated Network.

So just to give people an idea of the scale, so

Piedmont number of associates in that plan?

Okay.

I think it's a lot of the same year over year with just incremental progress. It's easy to get disheartened when you I just left an interoperability talk. And I was like, yeah, we're still talking about interoperability.

Interoperability, really?

Yeah, it was actually a really good talk.

But there's going to be a lot of AI. And I think the trick is going to be figuring out like what is actual real AI and what is just like the buzzword AI, just like. buzzword interoperability has become. In fact, , one of the quotes upstairs was when a word becomes the solution to everything, it means it's lost all of its meaning, altogether.

I do expect to see incremental progress. I do expect to see real world use cases of some of these technologies in use with real impact on patient outcomes. And that's actually what I get excited for is when somebody can show me the patient outcome or the provider outcome. So it's it's travel season that we're finally winding down.

But this one I'm excited for. So I got my fingers crossed,

Interoperability is an interesting topic, especially you mentioned clinically integrated. Yeah.

Manageable, platform.

You really can't do a clinically integrated network without

So we're working on a better solution. We have, we get the data, but really to drive it in a meaningful way. One of the ways we started working was four years ago the primary care network portion of it is we mandated that you had to be on one of three EHRs. To stay in the network.

I hate to ask the question, how many was there before that? Twenty something. Oh my goodness. Yeah, so that's challenging. interesting because I've heard people say, our strategy is we're going to get everybody on Epic, but that's not, when you're talking about the whole state of Georgia that's not realistic, is it?

As you know that, we're in a provider shortage and we're a booming population, especially in the state of Georgia. And so how do we make the physicians more efficient? And , how do you make the staff more efficient? And what is the right AI and what's not the right AI? Because it has to fit, especially in the state of Georgia, from downtown Atlanta to the executives living in Atlanta to the patients, some of the patients I service who are farmers out in Madison County who, may not have high speed internet.

You really do cover everything. When I think of Northeast, Southeast,

We go all the way. We have a network in Columbus. We have Macon. We have Augusta. Pretty much from Macon to Columbus to Augusta, that line and up. We have a network in a few clinics, ambulatory clinics below that.

Dr. First, you guys doing anything with AI?

Yeah,

There's a couple things. Now,

Yeah one of the things that we've been doing for a decade it's actually, it has four different patents on it, is around medication data and the normalization of that data.

And I think you've heard me talk about this a little bit before, but So this is actually not LLM agentic AI. This is actually something that was homegrown a decade ago, and I like to call it a very narrowly focused clinical grade AI, meaning it was created by clinicians for a very specific clinical purpose, and that is to achieve that semantic interoperability with medication data.

Tom and I both know we, we do a good job usually writing our scripts perfectly structured and you send them out into the ether. And if you're

talking about doctors right now, they usually do a good job. It's usually readable. It's usually,

yeah. He and I come from when it wasn't, definitely did paper.

The drug interaction checking, the a seamless med rec where the stuff can flow. And so this particular AI, which again we've been doing for 10 years, is around renormalizing anything that has lost its structure along the way. even on very basic use cases, we found that we can make a pharmacy technician, 25 to 30 percent more efficient, they can see more patients, or you can free up we were talking about Epic a second ago, you can free up a willow analyst from curating a very specific manual translation table to go do something clinically meaningful.

And so that's just a really small use case, not trying to boil the ocean, but, solve a very specific problem that, that doctor first saw over a decade ago. And then as a company, of course, we're trying to embrace AI in productivity, the agents, the transcriptions, the things like that.

Therefore, you don't have as many errors or those kinds of things going on. I'm curious, is there a specific area that you think AI will advance more quickly than others to add value to the clinician?

I think we are starting to use some AI scribes, right? And one of the things that we continue to add value as I'm learning how to use my AI scribe is in , suggesting specific diagnosis to help with.

Yes. It's going to be that person that sits there with you. And then learns from you because it learns your preferences and learns your patterns.

And that's interesting. That's going to be an exciting future as we look at it. And one of the things about ambient listening more and more it's becoming common.

Yeah. The table stakes, right? Yeah. If you were a physician going to a new organization and they said yeah, we don't, we haven't invested in ambient listening yet. You'd

sort of

look at them and go,

well.

so I'll tell you, as a regional medical director for primary care, I have the responsibility of interviewing new docs for the Athens, Gwinnett, that region.

That's a question that comes up. What are you doing? leveraging the technology? What are you doing with AI scribes? Those are questions that these folks coming out of residency programs are asking. Out of

residency?

I believe it.

It's like the ATM machines of old, right? The first bank that had an ATM was probably a great differentiator.

Past four or five years if you didn't have an ATM, you were not a bank anymore. It was an expectation.

Yeah.

What are some key initiatives

you're looking at in the year coming up, or?

and telehealth to yeah,

You cover the entire state.

It's not only that, it's allowing us to have dedicated virtualists and hiring dedicated virtualists in our primary, in our employee primary care network and allowing that coverage transition of care from hospital if they're not able again to see their primary care doc right away.

Yeah, I think one of the things otherwise is behavioral health. We have a true mental health crisis, as we all know, and being able to leverage telemedicine. That I'm not stuck with trying just to leverage the behavioral health in my area. I can pull in from other areas so that where there's maybe some excess care, caregivers here.

That we can use it in different parts of the state. In developing a network that's willing to have that give and take with us.

Oh, as far as that, we do have tele neurology for some of our, for our smaller hospitals.

That they're able to come in. And we started a tele nursing program where we're using centrally based RNs to watch over and help with some of the management in some of our hospitals where there may be some staffing.

want to close with this question. I'd love for the two of you to weigh in on it, which is you talked about incremental change.

We're seeing incremental change over time. What would need to change to have a significant move forward in terms of the quality of health we can provide or access to care or just any of the major problems

I'll go back to interoperability and actually Lacey Knight and I used to talk about this a lot.

If the incentives were aligned, and if there was, appropriate financial and clinical and you would think that those things are all there. They're just not. Cause if they were, this stuff would be happening already. Just like it happens in banking and aviation and retail. And so, I do think, to get that big leap instead of these incremental steps and there's nothing wrong with, crawl, walk, run, but I do think incentives is probably the key.

I

think part of it is getting

past

I just want to start you off at the conference with a really difficult question.

No, I've got, I think, a decent answer for this. I think it's getting past the bias and misunderstanding that AI technology makes medicine impersonal. I think it makes it more personable.

And having the ability in the office to show the images and talk about radiology and look at lab trends with the patients. Is all making using technology make it more personable. And some of it is a story we're here to tell this week of using technology. predictive analytics and looking at the different technology overlays into your system to be able to find those most at risk and who are the ones that really need a more personable touch and who doesn't and allowing us to be able to give that human touch to those people.

So I lied. I said that was the last question. I'm just curious, and this is just a goofy question to end with.

Growing up, who was like the doctor on TV or in a movie that you related to? You're like, yeah that's what

the relationship between the intern and the

Intern resident, and then also as we were talking before we started Medicine versus surgery, plays out very much so on Scrubs, that's interesting. How about you? Hawkeye

Pierce from M. A. S. H. I thought he made medicine personable to people. Yeah. And carried it out. I would have to say, wasn't TV or movie, but the, probably one of the characters in fiction that most influenced me with medicine was in the Rules of the House of God, the resident, the fat man.

The one who was Oh, it's a,

it's a famous book that we all must read as internists. Creighton, right? Yeah.

I can't remember exactly, but it was, and the fat man was the resident that everybody went to ask the questions and kept his calm and never got flustered. That was my goal was to

Yeah, I love that question.

I just learned it. Yeah, I might steal that from next

Gentlemen, I want to thank you for your time here. Really appreciate it. And thanks for listening. That's all for now.

Thanks

for listening to this Interview in Action episode. If you found value in this, share it with a peer. It's a great chance to discuss and in some cases start a mentoring relationship. One way you can support the show is to subscribe and leave us a rating. If you could do that would be great, thanks for listening. That's all for now.