This Week Health

Interview in Action @ ViVE '23 - Shafiq Rab, CDO & System CIO at Tufts Medicine

March 29: Today on the Conference channel, it’s an Interview in Action live from ViVe 2023 with Shafiq Rab, Chief Digital Officer & System Chief Information Officer at Tufts Medicine. Does technology offer solutions to the burden of cost for health systems? What is required for AI to be implemented effectively in an organization? What is the current state of AI and how can it potentially be utilized in the future for lower cost and better care?

We understand that staying ahead of the curve regarding Security Priorities can be challenging. Join us, April 6, 1:00pm, for this webinar to learn how CISOs in healthcare address Security Priorities for 2023 – insights that can help keep your healthcare organization safe and secure. https://thisweekhealth.com/ciso-priorities-2023/

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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.

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. A set of channels dedicated to keeping health IT staff current and engaged. Today we have an interview in action from the 2023 Spring conferences, vibe in Nashville and hymns in Chicago.

Special thanks to our sponsors on the, conference channel, which are sure Test, c d w, healthcare, Artis site and rubric for making this content possible and for investing in our mission to develop the next generation of health leaders. You can check them out on our website this week, health.com, now onto this interview.

All right, here we are for another interview and action from the VI conference down here in Nashville, and we're joined by Dr. Shae Rob with Tufts Medicine. How's it going? I

think it's going all right. I mean, except that it's a lot of struggle. That's pretty much it.

There's a lot of struggle. We've heard already from the floor how many organizations are struggling with the cost of.

Patients are struggling with cost of care, but health systems are just struggling with cost. The burden of cost and all the things that are going on there. Does technology offer any solutions or way out of this?

Well, you see, technology does offer, but at the end, technology can do so much.

It's more about the transformation workforce automat. But to even to do that until the payment system changes, healthcare is struggling a lot. We had three big things happening to us. The pandemic happened, then the uh, workforce shortage happened, and then all the money that Medicare and other people gave, they took him back.

And surgeries were decreased because that's where they make the most money. And a lot of people didn't even come back. . So that makes a big difference.

Yeah. So and now we have Medicaid redetermination going on as well. These are shocks to the system. We've seen shocks to the systems over the last couple of years, plus inflation.

Oh yes, of course. Yeah. And so, we had wage inflation. We also had costs of supplies and those kind of things. , we've talked in the past and you're, bullish on technology. I mean, there's a lot of things technology can do, but there's operational changes and then there's systemic issues with regard to pricing and reimbursements as you mentioned.

And we've gotta address those for sure. But I'm curious, as you see all the, conversations around technology the ChatGPTs and al and data lakes and all this other stuff. Is any of it resonating at this point?

Yeah, so I think here are the basic steps in my mind. The basic step is that first you have to digitize.

If you are not digitized, digitize, then you go to the next process, known as digitalization in which all your processes workflow. But as you are doing that, you train your workforce. to it But in all of these, the most important thing you are doing, you're creating a data layer on top like a data lake where you're getting all the information so you can serve that.

Up here is the part generative ai, which is ChatGPT-4 will be out and other things will up. The workforce has to learn how to use it, Just because I built one, I have a data lake, 104 fire services ready. It doesn't make any difference. So the part is, Chief operating officers, CEOs, and CFOs who are supporting the technology.

Like I'm a technology guy, I'm already in the cloud, I'm shutting my data centers. But that technology can only be useful if you make the cultural transformation of using that technology. And the holy grail in all of this is the place where you keep all the data, and from that data you start generating AI algorithms.

That Speeds up the process, gets the inefficiencies out, makes it easier to work, and at the same time, which very few people have done, is that even if you have a ChatGPT-4 it's only for the healthcare providers. We are not given access to the patient. Like patient from home should be able to run an algorithm on themselves asking, I'm diabetic, I have 120 blood sugar now.

what should I eat? Or should I eat the sweet and should I increase my insulin by 10? We have not evolved to that. So if until as you do that, the customer experience does not happen, why is that important? Because we want to take the cost out, and the cost means we want to take the utilization out.

Utilization out means that we can go to the payers, show it to them, we took the utilization out, give us a higher rate of in person,

I was just having that conversation. Increasing the number of touchpoints we have to make people healthier. That's right. And the touchpoints that you can have with technology is just greater.

It's just far greater. We just have a limited number of people to go around. When I think of chat, g p t four and the questions I've asked it and the answers that have come back, it's really interesting. But when I talk about it amongst healthcare, a lot of times I get, oh, it's overhyped. And I agree.

It's right now. It couldn't be any more hyped if we tried. But the thing that's interesting to me, How much progress it made on the legal side from GPT three to GPT four. And we're talking specifically about yeah. About open ai, but the amount of progress it made and then people are looking at it going, well, it still can't pass the medical exam.

It doesn't look at images, it doesn't do these things. But I sort of, as a technologist, I sort of look at it a little different, which is, oh my gosh, look how far it's come this quickly. Could we. On specific things so it could have a conversation with a patient.

So that is correct. \ nothing is perfect, right?

So we have to be aware of biases, we have to be aware of the sample and the population that we have. But one thing is for sure, nobody's going to stop AI to become part of our lives. It's not possible, right? Technology will keep on going faster and higher and higher till it gets to perfection.

So nobody's telling you to go use Chad GT four to diagnose something today, but Chad GT five, it'll be pretty darn close to give you that insight. More so you'll have choices that you can ask, like you just saw somebody presented an app that what drug cost where and what drug is cheaper in other place, the other place.

Those kind of questions, people will. And you will get those answers. Like today, when you use waste, you understand which route is better to take. Right. And then you shut it down and bring it back up. It tells you a new route to take. Yeah. You know what I'm saying? Yeah. So that things will happen. But the part that I'm trying to tell you is that if we take the inefficiencies out of healthcare, then we can increase the lifespan and then we can increase the quality of.

Like, why should a patient come to a place just to get his lab result? Like we used to go to the doctor just to know you got, you can get on your, on, on your phone today, right? Because you have to park, you have to find inconvenience. So the cost of healthcare is not only what comes out of the pocket, but other things.

And then we have to find funds flow. So this is very important to understand. Presently, only surgery gets paid. Spinal surgery, cardiac surgery, even though we are working on value-based care, but until as we control the circle, circle means the ecosystem of healthcare. A cardiac transplant surgeon does not get a patient by themselves.

Somebody sends it to them, right? So each part of the process of explained, then everybody makes money at the same time, the loop is closed and healthcare can become.

We'll get back to our show in just a minute. We have a great webinar coming up for you in April. We just finished our March. On April 6th at 1:00 PM Easter time, the first Thursday of every month, we're gonna have our leadership series. This one is on CSO priorities for 2023. Chief Information Security Officers, we have a great panel.

We have Eric Decker within our mountain, Shauna Hofer with St. Luke's Health System out of Boise, Idaho, and Vic Aurora with Hospital four Special Surgery. And we are gonna delve into what are the priorities for security? What are we seeing? What are the new threat? What is top of mind for this group? If you wanna be a part of these webinars and we would love to have you be a part of them, go ahead and sign up.

You can go to our website this week, health.com, top right hand corner, you'll see our webinar. And when you get to that page, go ahead and fill out your information. Don't forget to put a question in there. one of the things that we do, I think that is pretty distinct is we. like for today's webinar, we had 50 some odd questions that we utilized, in order to make sure that the conversation is the conversation that you want us to have with these executives.

So really appreciate you guys being a part of it and look forward to seeing you on that webinar. Now, back to the show. 📍

  📍

Let me ask you this as an exit question. So you've now served in multiple markets. when I came into healthcare, they used to say healthcare is local.

I guess I have , two directions I wanna take this question. One is, you served in different places. Are there distinctions in each of those places? And is healthcare still local? Are we seeing more and more national plays with regard to certain aspects?

Okay, so I'll be, get caught by answer. So I'll try to answer this.

As always, I answer truthfully In healthcare, there are places where you can have better payer mix. In healthcare, there are areas where you don't have good payer mix, right? That is the first difference. Medicare, Medicaid, self pay, right? As compared to commercial. So the health system that are in places where the commercial payers are there, they do far better than the ones that they don't.

That's the first difference. Second difference is that yes, there are some geographical differences. Like, you can get antivirus in New Mexico, I get it. You'll retinal virus in some areas. So some diseases are specific. Other than that, pneumonia has pneumonia, diabetes. Congestive heart failures.

Congestive heart failure. MI is mi. So eating habits, environment and the opportunity to good food and right. Nutrition also depends where you are, so that local part. If you are in somewhere rural America, you may not have access to the latest cancer treatment. You may not have access to the latest.

Or you may not even have a connection to the internet. So those are the various things that affects healthcare. So

yeah, Chicago, you didn't have that challenge. Do you have that challenge where you're at now?

Oh yeah. In Chicago, we have the west side of Chicago. In Boston, we have China downtown.

We have Lowell. So we do have those challenges. When I was in New Jersey, we had areas. So , those the difference that I told you about by payer mix, yeah. That is ubiquitous everywhere, but the delivery of care and the part, how do you convince the user of care to come to you or you go to them?

That part technology can make it easier.

Yeah, absolutely. Shaq, thank you.

Thanks for talking to me.

Keep fighting the good

fight.

Oh, a hundred percent.

Another great interview. I wanna thank everybody who spent time with us at the conference. I love hearing from people on the front lines and it's phenomenal that they've taken the time to share their wisdom and experience with the community. It is greatly appreciated.

We also want to thank our sponsors who make this content possible and our investing in our mission to develop the next generation of health leaders.

They are Shore Test cdw, healthcare, Artis site, and rubric. Thanks for listening. That's all for now.

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