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March 6, 2024: In this episode of This Week Health, it’s a double Interview In action with Terri Couts from the Guthrie Clinic and then Laura O’Toole of Suretest & Mike Mattews at Yale New Haven. They delve into the transformative journeys of healthcare institutions as they navigate through the complexities of modern IT challenges and innovations. From the expansive operations of the Guthrie Clinic to the intricate automation projects at Yale New Haven Health, our guests share their firsthand experiences. How does Guthrie Clinic defy the common perception of a 'clinic' with its extensive network and multifaceted services? What drives their focus towards IT efficiency and the creation of a data lake, and how do they manage the balance between cost and quality in healthcare IT? Yale New Haven Health's exploration into automation and its impact on operational efficiency and patient care further enriches our understanding. What lessons can we learn from their approach to automation in clinical systems, and how does this reflect on the broader trends in healthcare technology? These discussions not only provide insights into the challenges faced but also highlight the innovative strategies employed to overcome them.

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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, where we are dedicated to transforming healthcare, one connection at a time. 📍 Today , we have an interview in action from the 2024 conferences, the spring conferences, VIVE in LA, HIMSS in Orlando.

Special thanks to our sponsors, Quantum Health, Gordian, Dr. First, CDW, Gozeo Health, Artisite, and Zscaler. You can check them out on our website, thisweekhealth. com. Now, onto our interview

  (Interview 1) 📍 hi, I'm Drex, and we're at Vibe 2024 and with me I have Terry Kautz from the Guthrie Clinic, which is kind of a misnomer.

It is. I think in my head when I hear a clinic, it's oh, it's just a tiny clinic. A lot of people think that. That is not what Guthrie is. Tell us a little about Guthrie. Yep, so we're a six hospital system in the state of New York and PA, and we're all in Pennsylvania and New York. Cover about a 10, 000 square mile region.

We have 40 multi specialty clinics across that region. Home health, hospice mental health care. A lot of world. Yeah. What's going on at home? What are some of the things you're working on that are big deals right now? Obviously costs, trying to maximize the spend in IT, looking at things that will help us with efficiency, integration, looking at platform kind of approaches.

We're also looking at data standing up a, sort of a data lake so that we can actually operationalize and get insights from that data. That took me a little bit of time to get our SLT team on board with that, because concessionally they think it's just a report, right? So I'm just figuring that out.

If you've not done it, it's hard to wrap your head around. It's hard to wrap your head around. Yeah. So, got in there, so we're starting that. And we have acquisition that we actually just kicked off really, so we acquired it on February 1st and working through that transition.

Yeah, that's a ton of work. That's a ton of work. Terminase or no code. Yes. Yeah. Very aggressive. Yeah. Part of a divestiture from Ascension, so we have a lot of, we don't have a long runway to get that transition done. Right. You were on a panel earlier, yesterday I guess. Yes. What was the panel? What did you guys talk about?

How'd it go? Yeah, we talked about How do you manage an IT team that's lean versus cost? How do you get the right product in your system and make sure that you're doing it for the, quality outcomes versus, the new shiny object? So, that kind of stuff. Yeah.

I think everybody's talking about it.

Okay, so I have one more question. This is the bonus round. It is a question about if you had a life coach, but it was any fictional character, who would your life coach be and why? I would say Tinkerbell. Because she appears to be small and fragile and this little thing, but she's actually mighty and a little bit feisty and kind of gets stuff done, so I would say T.

So, that's a lot like you. Yeah, I know. So that would be a good life coach. Yes. Okay, awesome. Hey, thanks for your time.   (Transition) 📍 📍 📍 ​

  (Interview 2) , here we are for our first interview in action from the floor.

And we are joined by Laura O'Toole with Suretest and Mike Matthews with Yale New Haven. And excited to talk to you. A title of VP Emerging Technology and Chief of Clinical Systems, which is a catch all for a lot of things, isn't it? It sure is. It sure is. And titles continue to change over the years.

I've been at Yale for a very long time and, started out as a biomedical engineer And ran clinical engineering for a number of years, got very interested in the clinical IT piece of it. The convergence of, between clinical engineering and way back then in IT, and it was kind of fledging at that point and kind of grew.

So the title of emerging technology came about three years ago, I think, added to my and just looking at new technology was coming to the health system while I was still managing multiple Epic teams and non Epic teams across the health system. But we built a very small We've University, we're an academic medical center obviously and we look for those innovation partnerships both financial partnerships and commercial partnerships with specific vendors.

And it's been a, it's been really an exciting time for the last couple of years in talking to a lot of startups and we'll do actually speed dating here. I've done it for a couple of years and actually made some decent relationships with the speed dating piece of it.

So, it's been interesting. The chief of clinical systems came more from the engineering side of the house and dealing with all the clinical it and whether it be in cardiology and neurology, digital pathology, radiology. I started my career kind of in imaging and put our first PAC system in, so.

Repurse pack system. 40 years. So, yeah. So, we're in the SureTest booth. I'm looking at the word automation. Yeah. What problems are we trying to solve with automation? Specifically for SureTest, it's I was given the responsibility of bringing automation to the health system in, to our department now called DTS about 18 months ago.

So, COVID. It hit us hard financially like everybody else difficult to get people employed so we were looking for opportunities in automation. Started out, primarily in RPA and when I met Laura, I think, at the first five maybe, in Miami she reached out.

I was just getting started in the automation piece, and Laura and I started talking about it, and I've managed several Epic teams. And the testing portion of it is difficult. And Laura was, talking about ways automate that process. And we, like all others And I've run just about every EPIC clinical team as I've rotated around.

And every one of them I've talked to, whether it be lab or radiology pretty much developed their own testing scripts from the ground up and what I was also noticing from a leadership standpoint is trying to get our folks, our analysts, to take the time to test properly during EPIC go lives, optimizations or any of the events that happened to us.

Lots of acquisitions like like many of the health systems was difficult getting them to the table. We didn't have a dedicated testing team at the time. So, our analysts had the build component. Of it and the testing component of it. And it made it difficult for them to do that.

When Laura and I talked about it, it made perfect sense to, to automate that. It fit really well into kind of my start into the automation area and the RPA piece of it. So, yeah, and we've got a whole bunch of initiatives now in kind of the optimization end of Epic.

And we've got, a few acquisitions that are on the plate as well. I would imagine automation comes in handy when it comes to acquisitions and M&A type of work Laura, ask you, when you're talking to new organizations, is there a barrier when you're talking about automation?

Or is the barrier like, hey, already doing this, and it may not be the best, but it's ours, and we love it, and it sort of works. Sure. I mean, everybody is very protective of what they do. and the test scripts that they developed and built. And one of the beautiful things about Yale, it took us a while to get started and to get everybody on board and engaged, but because of the discipline and the rigor and the way that their team works, and they're so methodical, dedicated a project manager to our work together.

So where it took time to get everybody on board to say, ah, I don't know. Everyone wants to hold onto their test scripts, but when they saw our global library and they saw how fast it could turn around development this whole goal, was speed to value. It takes time, because people are very protective of their work, and we respect that.

So, we try to go at the pace of our clients, and we're learning so much from them. And it's just been fabulous to have them as a partner.

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with an implementation like this, there's a certain amount of fear like, Hey, you're taking work away from me.

But the reality is, there's so much work. Exactly right. Automation everywhere. Right. Whether it be So uh, automating, the test scripts that we're working with, Laura but just automation Whether it be in RevCycle as well, is the initial reaction is that, it's, Gee, you're trying to automate me out of a job. And the reality is we just don't have enough people to do the work that's necessary.

It's not that. And to Laura's point, I think that the For this particular implementation, I think it was, Convincing folks that the automation absolutely works. Because they've spent so much time. developing scripts And running through those scripts, they don't trust the automation. They also were very leery about, geez, how much time is it going to take us to build these scripts to be able to set it up?

I've got all this work to do, I can't take the time to do that. But the reality is once they get started they've embraced it. And it's, the time they spend is time well spent. And they're an analyst to this point, from the how long have we been working at this, Laura? Probably about, in earnest, probably about six months, I would say.

Yeah. In six months time, it went from apprehension to really accepting it. And, we've got an access, we call it Access 365. It's just that it's a program to be able to bring more patients to our health system and improve the way patients interact with us. And it's going in multiple ways after two years, and I kind of challenge Laura to say, can you bring that?

Automation to this particular project in Wave 1 and we've done that. And I think the analysts are the true gauge of whether this is working. Because they're now telling us this is really good. And, I think the other thing about this is, I've been around the clinical IT portion for so long.

And so if you take folks like And when we were putting Beaker in and Beaker Pathology in, there's after CP doing the AP, we're doing it in some of our smaller community hospitals, but the pathologists want to test the heck out of everything because they don't trust the IT team to actually do it.

They want to be, but they don't have the time to do it. They really don't. So, we're able to convince them to use this automated solution to be able to do some other testing on a usability level. And it's been really positive. And once you get the platform in, I would imagine the ideas start to flow.

Hey, can we automate that over there? Is that possible? That's exactly what's happening. So it's been really cool. And the Yale team is just phenomenal. And once it clicked, and they realized, I can get these hours back to work on, if it wants to test, to work on more strategic projects, they spend it's just been a great partnership.

And the team that Mike put together, the governance that they put together, that's really where I think it's going. It's been a big distinction for us because they have such great governance and got buy in along the way. So 40 years has taught you a few things? A couple of things. A couple of things.

Took a little lumps on the way. So governance matters. Getting key stakeholders on board matters. What are some of the other things that you look for in a successful project? Oh yeah, no, I think the stakeholders is a big one. Right? No matter what project we're doing. grew up outside the normal IT department.

Had my own clinical department that grew into basically imaging. very used to working directly with the stakeholders, mostly clinicians. Whether it be the chair of radiology or, the chair of pathology, we're in a partnership. But even those folks needed our help to gain stakeholder acceptance.

You know it very well, that acceptance in that environment is not always a given, even if the chair or others are the champion of the project. When I left, I was at a large IDN, so when I left that IDN, I started doing some consulting work in an academic medical center. And I remember sitting down at the CIO and I'm like, we had the same title, we were both in healthcare, we had very different jobs.

I mean, an academic medical center is so complex with the research and all the Specialties and I mean, we had those specialties, but it's just a different, I know it's, it was a different level at the university as well. Yeah, no, the political environment has been interesting over all these years.

it's changed but not a lot. There's still different agendas, from the research side of the house. I've always straddled the line between the academic side in the IT side in building the relationships and getting those. Those buy ins is what's kept me going for 40 years, to be honest with you.

And you learn some stuff the hard way. And kind of adjust to it. 40 years in the same place. 40 years, 17 jobs. Wow, isn't that crazy? Yeah. Mike, thank you for your time. Really nice meeting you. Laura, always great you, my friend.   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, and we want to give a big thanks to our partners who make this possible.

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