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June 2, 2023: Chief Digital and Information Officer Kristin Myers shares what innovations Mount Sinai Health System has been implementing and other priorities. How has Mount Sinai Health System transformed digitally? How do they ensure seamless digital experiences for patients and employees? How does the clinical community contribute to and guide digital projects? How is artificial intelligence (AI) being applied and governed at Mount Sinai Health System? How do they balance rapid adoption of digital initiatives with oversight and quality control? What initiatives are in place to improve healthcare access for underserved communities? How do they incorporate patient feedback to improve their digital solutions?

Key Points:

  • Digital transformation
  • AI and intelligent automation
  • Clinical community involvement
  • Governance of AI
  • Healthcare access for underserved communities

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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.

Today on This Week Health.

That is something that everyone has to do in order to move fast. So I'm a big proponent of you can move fast, but you've gotta have governance.

Thanks for joining us on this keynote episode, a this week health conference show. 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. For five years, we've been making podcasts that amplify great thinking to propel healthcare forward. Special thanks to our keynote show. CDW, Rubrik, Sectra and Trellix for choosing to invest in our mission to develop the next generation of health leaders. Now onto our show.

Today we are joined by Kristin Myers, chief Digital and Transformation Officer at Mount Sinai Health System out of New York.

Kristin, welcome back to the show.

Thank you, bill. Great to be here.

You were one of the interviews I did in my first year. That was a really fun. Interview we talked about actually we talked a fair amount about women in leadership roles and then fast forward a couple years, you're now Chief Digital and Transformation Officer at Mount Sinai.

Before we go into that, tell us a little bit about Mount Sinai Health System. Sure.

So, we have a long history but in 2013 we merged with Continuum Health Partners. So we became a health system and it's around 11.3 billion in revenue in New York City. Eight hospital campuses with an icon School of Medicine.

We have about 7,400 physicians 43,000 employees. So research, education, and of course clinical care is really the mission of the organization. Wow.

Is there a certain area within New York that you guys serve or is it all of Manhattan?

So, it's all of Manhattan as well as Brooklyn, Queens and South and long Island.

Wow. That's a that's an amazing amazing area. There is a lot going on in healthcare. What are some of the system priorities right now at Mount Sinai? What are some things you're looking at in prioritizing right

now? I think there are two for me. The first is AI and intelligent automation, so making sure that, we're expanding efforts in our technology operations and clinical space and.

You know, These two areas can really help us generate revenue and reduce costs and improve operational efficiency and, also improve clinical outcomes. So we have a clinical data science team that builds and operationalizes AI and ML decision support applications. And. Really to improve clinical quality, safety, and the patient experience.

We're also looking at and have leveraged AI vendors and products in the radiology and imaging space. We also are focused on robotic process automation. And, this has helped us accelerate automation for many of the administrative processes that we have in place. We're also looking at G P T.

Large language models and the G P T integration with Epic for potential usage within the health system. So it's an exciting time around AI and intelligent automation, which we hear about every day. And secondly is digital transformation. I know that we've been talking about this for quite a few years, but, we took a step back and thought about what the vision for Mount Sinai should be from a digital perspective.

And so, our vision is around digitally enabling Mount Sinai as the preferred destination for our community by anticipating needs to easily provide equitable and seamless experiences. I think in the last two years, we've made immense progress in this area. We were able to release a branded mobile app called My Mount Sinai.

We've seen tremendous increase in activation and usage and, the ability to, increase. Billing personalization capabilities messaging, et cetera. It's been fantastic. So, we developed a roadmap in mid 22. We have focused specifically on access around enhanced digital scheduling care, navigation, virtual health.

And, we have worked hand in hand with operations and digital marketing really, on a organizational change management plan. We've got a great governance structure to make sure that we've got, rapid and data driven decision making. And again, I go back to it's about the experience of our patients and employees and there's been a transformation around culture also.

From the organizational perspective, we've gone from doing digital to being digital. So I'm very pleased with the progress that we've made, but we need to make more.

Yeah. Talk to me a little bit about, you've given me so much to ask at this point but talk to me a little bit about doing digital to really being digital.

What does that transformation look like and how does that feel to the to the consumer?

Yeah, I think that doing digital has been in the past very much focused on bringing in different digital products and just implementing them, maybe doing pilots, not scaling them across the organization.

Yeah maybe

rolling out Epic's, MyChart, but that's it.

Yeah, and I think being digital is really around, making sure you're scaling the digital products, but also. Integrating them into the workflow in a seamless way. And I think being experience led, whether it is focused on our patients and our employees to create that seamless experience, I think that as someone is, one of my team members always says to me around random acts of digital and that's something that we wanna avoid, right?

We wanna avoid all of the point solutions that don't integrate into, a seamless experience.

So yeah the seamless experiences is, especially on the digital side, is. Is interesting to me because the way you described it there's an awful lot of input that you get from the clinical side that they're looking at it saying, Hey, we have to do this in order to care for these patients in order to deliver high quality care, in order to provide access to the people in the community, and we need to be highly efficient and those kind of things.

How does the clinical community. Speak into the digital projects. How do they help guide the digital projects?

So they are completely integrated into the team from an informatics perspective, but also into the governance structure. And so we work hand in hand with them because, you could provide a seamless experience.

For our patients, but then have, four applications on the backend that, our physicians have to log in and out of. That's not a great experience for them. And so, we are very much focused on, it needs to be seamless to the patients, but it also needs to be seamless and a better experience to our employees and our clinical teams.

So I think you've gotta have that dual focus when you are designing digital products and then ultimately implementing them.

Yeah I remember when I first came into healthcare and the team was really proud of themselves, and they should have been, I mean, we had essentially done a single sign-on solution and they were saying, look it, these 14 clinical applications, it's a single sign-on, so it's seamless to the clinician.

And I said to 'em, like, I doubted it. I mean, the login is now seamless, but I doubt the rest of the experience. And sure enough, I talked to clinicians, they're like, Yeah. In order to do this, I have to go to this screen. Then I have to go over here to this screen. Then I'm like, yeah, I they've experienced digital in their personal world and they're looking at it going we're heading in the right direction, but we're still not there.

Yes, absolutely.

So gimme an idea on ai. I mean, AI is interesting. There's not a conversation that I'm having these days where we don't. Talk about artificial intelligence and where it fits, how, how does that governance group, how are they looking at ai? Are they looking at it as something that could be transformative in the near term long term?

Or how are they and how are they seeing it, and how do they think it'll be applied at Mount Sinai? Yeah,

so innovation is a key theme for the health system and for my department. And we know that there are AI products already implemented in our health system and, we see this as a growth area to really augment.

Many roles in the organization and, we're going to have to, work with these products in our day-to-day life. So we have two areas of governance. One is around, deploying products in the health system which is governed and ob overseen by Business Innovation Council, and it has executive leadership participation and sponsorship.

And then we also have a monthly AI governance meeting chaired by our C M I O and sponsored by myself and Dr. Rich and our C M O. To really review the development evaluation and validation and use of AI in our clinical settings and our research settings. So we need to make sure that the AI algorithms that are used, even if they're internally generated or it's a vendor product.

Safe, equitable effective and ethical. So in terms of key AI initiatives we have a number of predictive models that have been developed at Mount Sinai and have been deployed around malnutrition falls delirium discharge planning and respiratory insights. We also have another number of vendor products that we use in radiology and imaging, as I said.

And then in the, on the business side, we're looking at and we have implemented conversational ai. So we do have, a web-based chat bot that's also integrated into my Mount Sinai. Providing that self-service. We want that omnichannel digital experience that we have in other industries.

We also are looking at and about to pilot ambient. So, the ability to have automatically documentation of care into a clinical note. And our physicians are really excited about. Being able to experience that. We're also looking at deploying a product in our clinical command center that really looks at data driven decision making around throughput which is exciting.

And then, there's a lot of AI based coding and automation products that we have implemented as well. And then we have our robotic process automation program. It's a program I started a few years ago to automate high volume, repeatable processes. And I think that it's been very successful.

We've deployed in supply chain finance, our lab radiology and in my department and, we've saved over 75,000 hours annually through these automations, which is huge. So, Look, I think this is an area that most CIOs or CDIOs need to focus on. There are, areas that you can deploy today.

But the next, four to five years are just going to be very exciting. But we need to make sure that, we have the right controls in place. To ensure that, anything that's being deployed is done in an ethical manner. So I think that, the fact that we have got governance over AI and we set that up last year has been a big help in terms of overseeing it.

Yeah, it's, it, AI has been interesting to me cuz it's, On the clinical side, I've always said, we're gonna see AI move very rapidly on the administrative side. And I think we are seeing that. And then, but I was kind of surprised with the G P T things that are coming out to see the.

The rapid adoption of managing the inbox generating drafts to respond to inbox messages and that kinda stuff. You're seeing Stanford U C S D and others move really rapidly. How do you move rapidly while maintaining, obviously and I'm not saying Stanford and U C S D aren't, cuz they obviously are, but how are you gonna move rapidly and how are you gonna maintain that oversight and quality of those initiatives?

Yeah, so look, we have just implemented G P T into our Azure environment. We're spinning up our epic and G P T integration. It'll be up and running next week which is really exciting.

So, so you're moving you're moving rapidly as well.

Look, I think you've gotta have the right controls in place, and I think that we've had.

A multidisciplinary committee looking at this, we've got our head of ip, we've got our legal team involved we have our clinicians involved, researchers. You've gotta take a team oriented. Approach when you're looking at this to make sure that you're addressing all of the HIPAA concerns, security related concerns.

We had our CISO look through everything and make sure that he felt very comfortable that is, the baseline, right? That is something that everyone has to do in order to move fast. So I'm a big proponent of you can move fast, but you've gotta have governance.

Yeah, absolutely.

They, in the geography you talked about, there is a it's very distinct. Access is interesting. Even though people are pretty close together, there is still an access challenge. What are some of the things you're doing to take healthcare to the community, to those people that are potentially underserved in your communities?

Yeah, I think, we have, a number of initiatives specifically around ensuring that, our patients in the underserved communities have got either born broadband access, that they've got the ability to get devices to be able to either communicate, with their physician using my Mount Sinai or if they're part of our remote patient monitoring.

They're able to have a device to be able to communicate appropriately with the physician. I also think we are very much focused on equity and, as part of our digital governance, we've made sure that, we have a focused meeting as part of the governance process on diversity and equity in digital.

And that has been a driver to ensure that, we translate my Mount Sinai and our website to at least our top five languages at Mount Sinai to ensure that, we're, we are providing, that equity to our patients. So again, it's a huge focus for us. But you know, there's always work to do and we, we have a lot to do

five languages.

That's amazing. We had that in, in Southern California as well, and it's a distinct challenge to represent all those languages at your points of care. It's a distinct language to serve your community. In the language that they speak as well.

That's amazing.

I also think, on, on this, again, it's getting the feedback from our patients and making sure that we're, designing an experience that, they actually require. And, we do that with patient interviews. One-on-one interviews with our consumers, so patients that aren't actually Mount Sinai patients.

And also our consumer surveys that we launched and, getting that feedback and incorporating it. I think it's, all about continuous

improvement. And has anything surprised you as that you hear from the consumer where they say, Hey, we really want this from our health system, or We really want this from a digital solution, from the health system.

I mean, it's. If we go back a little ways, it's interesting cuz Steve Jobs for all the amazing things that he did, he, the one quote he gave us, which was really interesting was they don't know what they want because I haven't created it yet, or we haven't, apple hasn't built it yet. And it's interesting to a certain extent Knowing what I know about health systems, I wonder if the consumers even know what's possible.

I mean, with all these AI tools and automation and the intelligent interoperability and all the things we could do for the consumer are they asking for anything that surprises you or is it at this point, is it's just access to the different services that you offer?

So one thing that I found very interesting as part of the patient interviews is, yeah, look, the patients are very empowered and they do a lot of research before they, choose a specific physician or a specialist.

I, you assume sometimes that, when they see a primary care physician and they're given a referral that you know they're going to follow that pathway. And I think what we found in the interviews is that, many of our patients. Create spreadsheets and go to multiple websites and look at all of the patient comments that, you know are around the internet on a particular physician.

And so what they actually asked us to do is incorporate a lot of that information on our website so that they didn't have to go to, multiple websites, articulate that information. Which I thought was interesting. That's, so we're working actually on that. We do have, the star rating, but they would like a lot more transparency as it relates to consumer comments.

And, luckily for us, we have amazing physicians and so, the comments will be, extremely positive. So, I think that's an easy win, for instance.

Yeah. Transparency is really that's phenomenal. I love that, that's what they're asking for. Is there what progress have you made or initiatives have you done to let people know what the cost of healthcare is going to be all along the way?

I mean, we have this challenge in the US around surprise bills have you been able to make some progress in terms of letting people know, what different services are gonna cost heading into it?

Yeah, look it's going to be a challenge. I think that, we are lucky that we are an epic environment and so, they have tools that, we're implementing that, are able to show from insurance, what the perspective cost will be.

But I, I see a lot of challenges with this. I think that, patients may not understand it. There's gotta be a lot of education around it, and I see it less as a technology challenge and more of an operational challenge as to how are health systems going to. Handle the number of questions that come up operationally.

Because, we're having a lot of discussions around, does this go to, the billing office, to customer service billing, or is this a front end access challenge. And yeah, we're working through that. But it, I think transparency is excellent for our patients.

It's just going to require education around this and the ability to respond quickly and efficiently.

Wait, we started with, there's a lot going on in healthcare and you hold the digital transformation officer titles. I'm wondering as you're looking at the technologies at the the staffing shortages and challenges that we have and some of the other.

Maybe supply chain issues and whatnot we have in healthcare. But what, what does, what do you think we are going to be looking at, say, three to five years from now in healthcare? What will be markedly different and how, how will that be experienced by the clinician and how will that be experienced by the patient?

Look, I think that the products that we use are, all going to have APIs with either G P T or other products. So, Again, I think that we're going to see improvement in patient experience. I think we're going to see clinical workflows be optimized. And I also see research being accelerated quite frankly.

Look at even, we just talked about epic and, the clinician efficiency around administrative tasks, right? So with the inva. I think that generation of clinical notes, letters responding to the patient queries that's coming at us right now. The text classification of Large volumes of unstructured text within the E H R I think there's going to be more patient facing chat bots, conversational assistance helping clinicians find information more easily with text summarization or, even being able to Be able to generate a discharge summary easily.

I think that's something that we'll see in the next probably year. So as I said, I think that, AI will be something that is going to, we're going to have to work side by side with, and it will just augment the jobs that we're currently doing, whether it's clinical education and research,

it's interesting to me watching these, the G P T tools integration into Azure integration into Epic.

You have Google Bard, and they're coming, they had the initial misstep, but they're coming back with some really interesting tools and whatnot. It's this is gonna be a fascinating time to see who can. Take these tools to med school and then make them really effective assistance for for our clinicians and for the patients.

It's gonna be really, This is gonna be a really fun time, I think, to to see the progress that the promise of technology that's been around for a while when we put all these digital tools in. I think we're gonna realize a lot of the benefits over the next three to five years is gonna be really fun time, I think.

Yeah, I agree. I, as long as there's the right governance and the policies and the controls in place and we make sure that. It's free from bias. Right. And appropriate. Yeah.

    We'll get back to our show in just a minute. I am excited about our webinars this year. They have been going very well. What I've done is I've gone out and talked to people in the community and said, what works in webinars?

And they came back and said, look, this is what we want. We want a webinar that is not product centric. It's really focused in on the problems of health care. And we want people on there that are actually solving those problems. And so we have done that. And the response has been fantastic this year. We have another webinar coming up.

It is the future of care spaces. Where care is being delivered is changing rapidly. Even the care spaces within the hospital themselves are changing. Technology is being added in different types of technology. A. I obviously computer vision and whatnot is changing that modality as well as what's going on in the home and whatnot.

So we're gonna have that webinar June 8th at one p. m. Easter time. We usually have it on the first Thursday. Happens to be a little too close to my anniversary. So we're going to do June 8th at 1 p. m. Eastern time future of care spaces. We would love to have you be a part of it. If you are interested in being there, go ahead and hit our website.

Top right hand corner. We have a card. You can click on that card and go ahead and fill out the form and get registered today. We would love to have you join us we look forward to seeing you there. Now back to our show.

Yeah, alright. So let me give you two exit questions. Is there I mean, is there a specific technology that you're keeping an eye on right now?

Could be specific vendor product or specific area that you're keeping an eye on that you think is gonna have a significant impact.

I know we've spoken so much about G P T, so I

can't say Well, no. Let's let's go down that path. There's a lot of stuff going on there. So what promise do you see in G P T?

What challenges do you see?

Look, I think that our data science teams are looking at, using G P T, creating those models to optimize patient discharge planning, for instance. Our Dean of AI is looking to, that integration of G P t with Azure to accelerate and enhance research and specifically using large language models and pathology.

I think that, so many of our vendors that we have relationships with also are starting to leverage it, epic. We also use Obama as our conversational AI tool to improve patient experience and that will be integrated even service delivery. So ServiceNow is, has got a partnership with Nvidia.

And, I'm actually very excited about that. So any way that we can make our service delivery experience much more seamless within the health system as well as more efficient for our team I'm really excited to see that roadmap in the future.

Yeah, it is. Man, it is gonna be really interesting to watch.

I was curious that you brought up the ServiceNow solution as well because I'm seeing a lot of systems go to platforms. They are they're looking for platforms. Azures one of your platforms obviously. I mean, you've talked about Epic as a platform now ServiceNow as a platform. How important is platforms in your overall strategy?

Yeah, extremely important. We, about, I would say three to four years ago had 1200 applications in our portfolio. We've reduced it down to, I would say less than 800 right now, and I think it's extremely important in terms of having a more seamless experience for employees.

Ensuring that, we're optimizing cost appropriately. We shouldn't be having pilots that never scale across an organization and you have to be able to finish them and to, decommission them and, archive the data. So we have a whole program around that. But, we are platform first and.

Unless there is, a compelling case to be made for a best of breed.

So, final question here. So talk to me about the chief officer role. You moved into that role. What is, what does that role look like? What is the day-to-day look like?

What is the focus of that role?

Yeah. So the title is Chief Digital and Information Officer. There you go. Transformation. I was appointed cio three, three years ago. And when I think about, the work that, I'm focused on and my department is focused on, it's really around transformation and, from a digital perspective.

And, that is why the title changed because. It was really a recognition of the fact that, the digital experience and organization was part of my department and that, that was not going to be a separate department in the organization. Which is why, the, I would say the CDO and CIO role is now one at Mount Sinai,

and you are correct.

Chief Digital and Information Officer. it's interesting that cdo, cio. Title and role. I see coming together more and more because the the tool sets all need to work together.

You can't have like a front end tool set of digital and a backend tool set of all the things you have to integrate and the. The workflows and all the things that you talked about before. If that's all in the same organization that the workflow tends to work better together, the data tends to flow better together and all those things.

That's the thing we're hearing more and more is that the, it's a seamless experience for the organization When those two things fall together.

Yes. Absolutely.

Well, I, Kristin, I wanna thank you for your time. I know how busy you are. Has your organization come back into the office? Are you guys still remote and in the office Sure.

Sort of hybrid.

Yeah we're hybrid. So I'm in the office the majority of the week. And Thursdays here, And with my leadership team, in fact each week which is exciting. So, I think that we live in a hybrid world and I don't see that changing anytime soon.

Does New York feel like New York still though?

I mean, is it still Yes. Is he a lot of energy on the streets

and stuff? Absolutely. I don't know if you can see outside my window, but yes, there's a lot of, a lot going on.

Fantastic. Kristin, thank you for your time. I really appreciate it. Thank you, bill.

I love the chance to have these conversations. I think If I were a CIO today, I would have every team member listen to a show like this one. I believe it's conference level value every week. If you wanna support this week health, tell someone about our channels that would really benefit us. We have a mission of getting our content into as many hands as possible, and if you're listening to it, hopefully you find value and if you could tell somebody else about it, it helps us to achieve our mission. We have two channels. We have the conference channel, which you're listening. And this week, health Newsroom. Check them out today. You can find them wherever you listen to podcasts. Apple, Google, overcast. You get the picture. We are everywhere. We wanna thank our keynote partners, CDW, Rubrik, Sectra and Trellix, who invest in 📍 our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.

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