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June 23, 2023: From Data and AI Governance to Population Health, Brent Lamm, CIO for UNC Health shares their trajectory for 2023. How has UNC Health prioritized succession planning and continuity in leadership? What challenges does UNC Health face in terms of access to healthcare services in North Carolina? How does UNC Health address the issues of affordability in the healthcare industry? What are the key priorities for UNC Health, particularly in terms of provider and teammate burnout? How does UNC Health ensure access to care for individuals living in remote locations, such as rural areas? What strategies and partnerships does UNC Health utilize to educate and connect patients with their clinicians? How did UNC Health navigate the operational challenges of implementing on-demand virtual care and integrating it into their existing systems?

Key Points:

  • Urban and rural
  • Top priorities
  • Remote access
  • Brand recognition
  • Partnerships
  • Digital tools
  • Operational challenges
  • Data and analytics

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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.

we all know at this day and age how important a strong data governance function is, and I think this recent. , explosion We're seeing around generative artificial intelligence, maybe challenging some of that.

We've got, data lakes and lake house models now, instead of traditional data warehouse models that data governance takes a different form or different shape, but you still need it. And it's still critically important.β€Š πŸ“

πŸ“ 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.

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β€Š (Main) πŸ“

all right. Today we are doing a keynote show and we have a special guest, Brent Lamm, CIO for UNC Health. Brent, welcome back to the show. Thanks, bill.

It's great to be with you today. ,

you know, same name, different title. We did an interview a little while back and you were I think the title was c t o at that time.

Was that

right? Deputy CIO. Yeah. I had the privilege of serving as the Deputy CIO here at U Health for I think six or seven years when it was all said and done. It was

great. Wow. So, talk about the transition, that whole idea of Deputy cio, I was talking to somebody yesterday and we were talking about the interim CIO role and this person, that's their work.

And they said, a lot of that's drying up because a lot of institutions, they're taking it to heart and training the next generation and really living out the succession planning within the organization. Talk about your transition a little

bit. Yeah. To that point, , UNC Health has done a great job of really prioritizing succession planning and making sure we've got continuity in leadership, , and doing that the right way.

, and so, , the previous c i o my boss for many years, she, , think this year eclipsed her 41st or 42nd year with u n c Health. She started as a nurse. Yeah. Yeah. And really grew her career, , in a phenomenal way. And so, know, for me, , worked with her over the past decade, , you she had done a great job of allowing me to constantly take on more and more.

And so for me, this transition has been seamless because she had really allowed me to position myself, , be able to take over the reigns of the team, , and the organization, , from day one. , and so it was great. It's been a, it is been a really great transition. In my thinking, it's making me realize, one day I'll need to hand the reins over to someone else.

, know, that may or may not be something I have any influence over, but I, it certainly is something that I wanna make sure we do is to set up good succession planning within the team for the

future. Well, I usually start with this question, , I'll backtrack a little. Tell us a little bit about UNC Health.

Yeah. So for those who don't know anything about UNC Health, , we are affiliated with the University of North Carolina at Chapel Hill. , Tar Hills for those basketball fans out there or women's soccer and, and many other sports actually. so we're a, about a 8 billion health system now.

, we've got 14 hospitals at our, my last count within the system, about 75, 7600 physicians. , we've got hospitals and practices that span from. The coast to the mountains of North Carolina, really statewide. , you know we're very focused on our mission of improving the health and wellness of North Carolinians and all of the communities that we serve.

We serve all 100 counties of the state, , as a, an integrated delivery network, , collaborating with and coordinating with healthcare organizations all over North Carolina and beyond.

Are your institutions in what would be considered urban centers, like Chapel Hill's not considered urban, is it?

I think technically the triangle for those who know North Carolina geography.

Right. Raleigh Durham and Chapel Hill. Comprise what's known as the triangle region of North Carolina. And so I think we would call that our urban section. , but you did touch on something there, North Carolina. Little, probably, , lesser known fact behind the state of Texas, North Carolina has the second largest rural population in the country.

, so we, we really do have a. Bimodal mission of serving, the urban parts of North Carolina, the triangle specifically being the centerpiece, , also all of the rural parts of North Carolina as well. And the vast majority in terms of numbers of our hospitals are actually in what would be considered rural North Carolina.

And how we coordinate care for rural North Carolina is really important to our mission.

The triangle is still. One of the fastest growing areas in the country, isn't it?

It is it absolutely is. , I, I don't know if I have my facts, up to date on this, but at one point a few years ago, , triangle region was, per capita, the second fastest growing municipality area in the country behind somewhere in Texas.

Yeah. Yeah. I was in, , Charlotte last week and I always count the cranes. That's how I tell if an area's growing. Yeah. And clearly Charlotte's growing. Yeah. Every time I'm in the Raleigh, , Durham Chapel Hill area, you just see it's just, it's continuing to. , yes. Just, just continue to grow. And a lot of, , organizations are planting, , , with the education, with all the education that's around there it's a great place.

I think people go to college there and then decide I wanna live here. And so it's a great source of, , talent. There are very

few people who move to North Carolina and decide to leave, I'll tell you that. It's an easy place. I'm a native, so I'm biased as can be, but it's a wonderful place to live and raise a family.

All right. Let's talk about top priorities. Yeah. The, , and the thing I love about talking with you is, , you, you do bridge that gap between rural healthcare and urban healthcare. , talk a little bit about what the top priorities are. Yeah, from a U N C health perspective at this point.

So I would say the first one is as a perfect segue from our previous dialogue there it's access.

So we really, as the state is growing, as the triangle region continues to boom, grow. We, we have more and more citizens of North Carolina that we need to provide high quality healthcare services for every day, and it's growing every day. , so continuing to keep up with the demand and access for folks moving here and the aging population.

, it's really, really a challenge. Access is a huge priority focus for us right now. , then secondly, I would say affordability, like every other healthcare system across the country. This has not been a fun, , year from a fiscal perspective. It's been tough. We are no different than everyone else who's having to navigate these headwinds across the industry.

then I think our third, probably, , priority is, provider and teammate burnout. You know, , everyone is dealing with this one as well with staffing shortages across healthcare. , and, you the digital tools that we love, To talk about and we really are, using to drive positive transformation for our patients.

They do have a side effect, and that's a toll on our providers and care teams at times in terms of, it's another channel of communication and another, , task on the plate for a lot of our teammates and providers every day.

So let's talk about some of your remote locations. You said you go from the.

Essentially from the sea all the way out into the mountains. Let's assume I live in, in a mountain area. I'm probably an hour from the closest u n c campus and whatnot. , if I'm seeking care, is it typically, , driven by an app on my phone? Is it driven by, , seeing something on a billboard?

, is it driven through partnerships? How do you educate me on how I gain access to UNC clinicians?

Well, first and foremost, I think we're very fortunate in that U N C has a broader ecosystem, has a tremendous brand recognition, , reputation within North Carolina. North Carolina, , many, many years, decades ago, made the decision to invest in higher education.

We had. Great state leadership who made that a priority. And that really permeates today, , across the state in that there is this, , think for most North Carolinians, or at least many North Carolinians still a strong affinity for the U N C brand and in all that stands for with our mission. So that, that, first and foremost via, people know you typically in North Carolina.

So, The U N C and U n C health brand. , yeah we, we do, , absolutely lean heavily on our partnerships. We're, , we, you the provider of last resort for the state of North and so we serve all 100 counties of the state, like I mentioned earlier, and we've got deep relationships with providers and hospital systems all across the state and are very proud that we partner.

, know, with them, even where we compete in some markets with others we partner very strongly as well. So, it's brand recognition, it's partnership. , know, we do have a, , mobile presence now we're very proud of. We've launched within the last. Four or five years, , that has grown dramatically.

, we have a UNC Health Mobile app that our patients can download no matter where they are. , them access to 24 by seven. Virtual on demand care, , has, urgent care closest to me, the ability to reserve a spot like OpenTable, , MyChart access immediately, et cetera, gps right to the door of wherever, whichever U N C health facility you're gonna go to.

Et cetera, et cetera, et cetera. Common capabilities, I know in today's digital age but we have it available and we actually are really proud. We just, , won the CIO 100 award, , for what we've done with our mobile presence. , and I'm excited, for the team with all the work they've done to really get that out there.

It's interesting because, I mean, standing up a mobile app, , today is not all that difficult, but a bunch of the things that you mentioned operationally are cha , on demand virtual care. How did you go about doing that? Because that's an operational challenge for a lot of health systems.

Y Yeah, I mean, that's actually a really good story for us. We did something that, a lot of, , , you know, organizations do and no matter what the technology. Arena or area. We partnered first. We partnered with a third party who could help us bring that, , provider capacity to, to the table to help us get there.

And just within the last year, we've pivoted now. To where that virtual on demand care is now being fulfilled by our, , UNC Health Physicians. So it was a partner early and then transition internalize, , bring that back inside and make that a seamless transition for our patients.

But the other thing that's challenging about it is, internal systems and tracking it.

A lot of the internal systems that we're using weren't really designed for that workflow. How did you address some of those challenges? Yeah, we

worked with our third party partners to really make sure we got everything into our Epic electronic health record system. So, , to the providers, it wasn't always in the way they wanted it.

We all know the dreaded media within Epic who, for those of us who worked with the Epic system. , know, we, we made that, work, if you will, , as best we could at the beginning and then. We gradually got it better and now everything happens within our epic at UNC system.

It's all done just like a physical encounter at one of our practices,

I was talking to a CIO and he was asking me a question about how do we improve the digital literacy of our patients? And I looked at him, I'm like, I'm not sure I even understand the question cuz I, I see like, Three year olds with an iPad navigating like their seasoned pros.

And, , did you end up having to write portions of your application? ,

We, we did not do any custom code development. No. We did everything working with third parties and building within Epic and our integration, , vendor solutions. But if I could be able just, , take off a little bit on your comment there.

Just like three weeks ago I was, , rounding with one of our hospital executive teams and. , our hospital, c e o at our facility in Goldsboro, North Carolina. He asked me, he said, Brent, what's the MyChart or patient portal activation rate? Does it really vary between like the triangle and the rural counties?

And I, I hadn't, it hit me in the moment, we hadn't really looked at that. So Microsoft teams messaged one of our. Analytics leads and directors and asked that question. By the time I got back to, , the office that afternoon, the team had a nice, Tableau visualization, together and I was blown away.

It was amazing how homogenous the percentage. Of activation rates are across all 100 counties. , so it, it showed me, it demonstrated to me that, there, at least for us, there's not that much of a divide between who's using these, the digital solutions, , between our urban and rural settings.

I love that, you did a teams message out there and this. , it sounds pretty easy for people. Oh, and I got back to the office and there was all the data, and I could see how it was all there. , again, I, I know the, , the, some of the tools you're using, it does have that data available, but I understand the complexity of data within healthcare, , are, are there areas you feel like you're leading out with regard to the use of data in the delivery of care in your

communities?

Yeah. , the first area that comes to my you know, we're we're very proud of our data and analytics team. It's been a bright spot for us and something that we started a real, , focus journey on with the advent of our enterprise data warehouse back in 2008, 2009, and we've really, , pushed hard on that to mature.

Every year we. Started our data science team with a team of PhD and masters data scientists back in 2015. We've been invested heavily in that space. Machine learning, most recently ai, generative ai. , but, , I, one of the maybe less sexy parts of this that I think has worked really well for us is what we call our analytics community.

So we took the approach that we'll never be able to satisfy all of the demand for data reports and analytics within a centralized IT and, shop, right? Well, whatever capacity we create, the demand will be higher. Right. You know, , so we, we took a really, a strong approach to saying we've gotta have folks embedded within that hospital, within that department, within that administrative unit, within that clinical unit, who actually have the ability to work with the data to do that ad hoc analysis to create, the kinds of.

Reports and visualizations that are needed in real time to help move things forward within that given, , business operation or clinical operation. And so we now have over 450 teammates across the system that are not in the central IT organization. They're embedded in, dozens of departments and units of the organization, but they get a common set of training.

They use common tools, they use common data sets, and we really work hard. We have a manager of this community within our team who really is sort of the spearhead of all this. And she does an amazing job of helping them connect as. This virtual analytics organization, so she's got biweekly we call 'em tact talks, right?

The analytics community talks where there's information sharing. Our team talks about here's a new tool, or here's a new data set, or, Updates we've made to a given data set. We use Microsoft Teams within that community extensively for them to collaborate with each other. They've got tons of teams and channels dedicated to different topics, , any of those analysts have the ability to request on Linea, what we call tech consult, to work with our team who might have a little bit more deeper technical expertise on a given.

, topic or subject that they're working with. And so I, that, that has exponentially multiplied our capacity to be able to work with data and analytics, sort of, at the source, if you will where that information is needed for that operational or clinical manager or director or executive.

I,

I suppose you support research as well. U N C. Yeah. Being a research institution, , is that outside of UNC Health or do you act as a source of anonymized data for those teams doing that research? Yeah,

in fact, , not to get long-winded about it, but my journey to U N C actually started with this exact topic.

So I left IBM back in 2009, , after a a wonderful 10 years there, , to come actually help stand up our research informatics, , area. Right around the time that we were launching our enterprise data warehouse with our patient administrative data. And so that has just grown, wonderfully since 2009.

And so we have a research informatics team within the School of Medicine on the. University side of the fence within the broader U N C ecosystem that works collaboratively with our U N C health IT team and analytics team. There really are like a, another part of our team and they.

Really do all of the data mining analytics for, , I R B approved research studies or, , work preparatory to research, et cetera, and really have gotten to really a strong assembly line of being able to data sets to our research teams. , to your point, UNC. We're a top 20 n i h funded academic organization.

We're number six in terms of public, , institutions across the country for NIH based research. It's a very important part of our mission. Well,

Let me ask you this. You're gonna give away some free consulting here. So some of your peers, , struggle in this area. And let's assume you were standing this up again.

What were some of the key. , principles, what were some of the key, , , design, , criteria in order to do this correctly? And what have you learned since then that you've adjusted along the way?

Yeah, I think, , One thing probably that stands out to the most in, in, Rachini Moosavi, our chief Analytics officer on our team.

She's gonna enjoy this part because she tried to tell me for years how important data governance was. And I, for a while there, , years ago I was, I'm just not getting this. I, I don't, couldn't quite wrap my head around but, but obviously, , we all know at this day and age how important.

A strong data governance function is, and making sure that the data that you're using at the enterprise level for leaders to make decisions are certified. They're high quality, they're well curated. I think this recent. , explosion We're seeing around generative artificial intelligence, maybe challenging some of that.

We've got, data lakes and lake house models now, instead of traditional data warehouse models that data governance takes a different form or different shape, but you still need it. And it's still critically important. , I think that maybe was one of our, , mistakes early on.

We didn't quite do enough there. And I think, if we were gonna go back and redo it again, hindsight being 2020, I think we should have been a bit stronger and invested a little bit deeper in that space.

Yeah, it's a great topic. Data governance is a great topic because it's becoming, , if it's becoming vogue again, in vogue, I guess is the terminology, ,

β€ŠWe'll get back to our show in just a minute. Ever wonder how technology can reshape the patient experience? Join us for our next live webinar, the Patient Experience, a Technology Perspective on July 6th. At 1:00 PM Eastern Time, we're bringing together expert speakers to dive into the intersection of technology and healthcare.

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We hope to see you there. Now, back to our show.

you mentioned cost of care being one of those priorities.

I I'd love to just entertain a little bit of, what are some of the things we can do or around the cost of care to, , keep care affordable in the communities that we serve.

Yeah, no, that's a great question. You the things that we're thinking about right now, , we're working really hard to leverage automation, , as best we can in our revenue cycle.

I think there's a lot we can continue to do there. We are all using some form of computer assisted coding, or, know, other, , more advanced capabilities from the vendors today. But I think there's more we can do there. We just, , a really positive success story around this with, , implementing Epic payer platform.

, had a, great partnership with one of our payer partners. , we've seen, , , a decrease in denial rates from 8% to 2% working with that payer partner. , through through the collaboration that we've done with the payer platform technology, we just rolled out an. Other, , automation solution.

This one we actually use as a service. , helps us with prior authorizations for, , procedures and certainly, we know many procedures in healthcare have a high cancellation rate at the last minute, , due to prior authorization not being finalized in time. I don't think we're alone with that challenge, , in healthcare and we're working really hard to implement solutions to get that down.

, we've. Seen some early success with that as well. , think just general back office administration, there's an opportunity to reduce costs. , our service desks, we're really rethinking those, , hr, it, et cetera, , facilities in terms of what we could do with. The generative AI chat bot capabilities that are, readily available now.

, you know, I don't know that there's any one magic bullet to addressing affordability. Our old CFO used to say, 20 nickels makes a dollar. , and I, I I think that applies in healthcare now. I think it's how do we continue to push on every one of these fronts to really, figure out how we get that, that full dollar when it's all said and done.

It's interesting for our, , 2 29 project meetings, , the CIOs each present for 10 minutes. And one of the CIOs said, I don't really have anything exciting and innovative to share. I said, well, what really is the mark of your institution? He goes, we're operationally excellent.

Like through this difficult time, we've been, , you know, we've been profitable. And he goes, cuz we are operationally excellent. And I'm like, Those are probably the sexiest terms that, that a hospital administrator could hear right now. , the, talk to me a little bit about, pop health, social determinants and those kind of things.

I know you guys, because of the nature of UNC Health and you being in all those counties, you're probably looking at those numbers pretty closely. , How are we driving better population health outcomes across, I guess, the entire state?

Yeah. Yeah. So, , this is a bright spot for us, , U N c, , school of Medicine and U n C Health.

We, we have really been a leader in primary care, , for a long time. , where, I think our, , medicine program is, perennial number one, number two. Program in the country, , in terms of, of, schools of medicine. , so we've really, , built very strongly on that foundation of strong primary care.

, on a technology perspective, we really have tried to squeeze every drop out of the Epic platform as possible. We are extensively, Using Healthy Planet, we have customized it heavily. In early years before Epic had a lot of the outta the box bells and whistles and capabilities.

It's been a space that we've really focused it's, it's been the showcase for us internally in terms of using agile project management methodology. We started, , our healthy planet in popula or really our population health journey. So, Within Epic right off the bat. We went live in 2014, , and we've, we've had a very active set of agile teams working on application build and reporting and we've been very aggressive in terms of bringing in claims data. Through our payer partners with our value-based contracts, , we've partnered with the state in terms of making sure that we're exposing all of the community-based services through that, that can really help address, , , S D O H issues, , for our patients.

We've got a tight connection with the statewide, , , network and platform that exposes those community services and continuing to grow our independent network. We have a very strong performing a c o. , we have one of the highest performing ACOs in the country.

, we've really worked hard to continue to grow that in a careful and thoughtful way.

What do you attribute the ACOs, , levels of performance

to, , I, I certainly, as a CIO I wanna say the technology

And as the host, I really want you to say technology, but Yeah. Yeah. I realize it's a lot

of things.

Well, and there's a lot of things for sure. , but, but I will say on the technology angle of it, and I mean this part truly sincerely, that is one of the bright spots across the breadth of the U n C health system, where the clinical and operational leadership really understand the value of partnering with it.

, we've had strong partnerships with that leadership team from day one. They've not had a lot of turnover in their leadership, and we've continued to mature that environment. They're the showcase we stand up and talk about in terms of here's how to engage with us, here's how we can best work with you to drive patient focused outcomes.

, so I, I really do think we've moved the needle quite a bit in terms of leveraging the technology. , you for our providers and our care managers, especially in the population health space I saw a statistic, , from the team. I think Epic may have helped us with this, but I think something like 3.3 million care gap closures we did last year, , across our, , , value care population, , which was amazing.

So it shows you we're, we really are using the tools to their, , we believe. Fullest extent to, to really drive our population health forward.

When you said independent providers, it's just dawned on me. Are, do they remain independent and they become like a community connect partner? of UNC Health.

So we have all three. So we've, our clinical integrated network, , consists of u n c health, employed or contracted providers. , it consists of some community connect partners. We have, I think, , nine or 10 active, , community connect partners now across the state. , then we have true independents that are also part of our network that are using.

Other EHRs and other it not provided by U N C Health, but we integrate with them from a claims perspective. We integrate with them through healthy Planet, link within Epic, , you really do a lot of work pushing analytics through our provider portals, , and healthy Planet to those independent providers to help keep that care coordination as tight as possible.

Wow, I'm having flashbacks that, that last group that you mentioned, how hard that is to drive the metrics and whatnot into, , that was, , I was early on in that process of putting some of that stuff together. It's pretty hard now. , I'm gonna bring the, it, just for the record, I'm gonna bring the conversation into generative ai.

, I think it would be cliche to talk about generative AI if it wasn't, if it didn't have so much promise in healthcare. Yeah. It wasn't such the center of conversation right now. Yesterday we had the. EU AI Act, which doesn't really impact us in the US except it will inform what we potentially do moving forward, , as a government.

I don't suspect that the US will regulate it as much. , but I'm hearing from people. That there's an awful lot of excitement at the promise of ai and also caution as they look at it of, where can we put this in place? I'm curious how the conversations have evolved for you and your role.

Yeah, we're, we are all over this, , from our team we're placing a pretty heavy bet on this. , we were not part of Epic's, , initial announcement at HIMSS where they announced their partnership with Microsoft and, , Stanford, and I believe it's Wisconsin and uc, San Diego. We're a part of that pilot for the initial generative AI work around auto drafting responses to patient MyChart messages.

But we quickly, , work with Epic to be added to that group. So we were the fourth, in that cohort of health systems to partner with them. , we have that up and running now and. Our development or test environment with our first set physicians working with that. And we'll go live more broadly in early August with our environment.

, we're really excited about that, that I think for all of us, we know that's just dipping the toe in the water, , for this technology. But we're really excited about putting it in front of our physicians and other providers so they can see. The power of this. , but above and beyond that, we've also we're excited.

I hope this week will announce, more broadly, , a partnership we've got with Microsoft. We've, , stood up and have a fully functional internal. A general purpose chatbot, so an internal chat, G p t, , that is live now and being piloted by the first, dozen sets of users. , you one question would be why would we do that?

Why would U N C Health wanna do that? Well, the reason why is because with that internal, , chat, G P t, if you will, what we call it, Ava, , ai, virtual Assistant, , so Ava, , with Ava, what it means is our teammates and providers can. Really use generative AI chat bot technology without having to worry about am I putting p h i into chat g p t?

Am I putting something that's u n c health sensitive information? , they can use it, , much more confidently for whatever they're trying to use it for. We've got our legal team working, with it actively to. Draft legal documents. We've got our physicians, , beginning to pilot it, drafting patient letters or other correspondence, prior authorization, , letters, et cetera.

Our internal communications team is beginning to use it to, edit or refine or draft and initial drafts of, , communications. , so we've got, I could go on and on. I won't, we're looking at partnerships with several other organizations now around this. I'm a believer.

I, I think it's going to be a game changer for healthcare. I think we have to be thoughtful and careful about how we use it and how we implement we have crafted a formalized set of guiding principles. The first one of which is a human will be in control. , we're not gonna have any fully autonomous.

AI within the, at least the foreseeable future is something very important that we think that it needs to be, , an assistant. I love Microsoft's branding of copilot. I think that analogy is a brilliant one. , and and beyond that, we've stood up group to really help us, , define a responsible AI framework that's gonna bake in, trustworthiness, , ethics, et cetera, , and make sure we're doing that right.

We call that our AAA group. It's our ai. An automation advisory, , group that feeds into our broader information services governance team. , so, so I, I could probably talk for another 30 minutes about things we've got going on, but to suffice it to say, We are all over this. We really believe in this.

We think it can be game changing for us and for healthcare. , we think it can really help improve health outcomes. We think it can help bend the cost curve. , I think, early on it could really help us with, , provider and teammate burnout.

Is this a, well, first of all, I love the. , governance model.

I get this question a lot and we discuss it a lot in our CIO groups of where does AI governance belong? It sounds like you made it a, a subgroup Yeah. Of, of a larger group. , talk a little bit about that. Like why did you choose that route and then, What's the makeup of that group?

Yeah. I little bit of background.

I think one of the things about, every organization has a, its uniquenesses in their own culture. Right? Right. for us, , very proud to say, our clinical and operational business leaders a decade ago, Really bought into, , information services governance. And so, , I chair our information services, , oversight committee, our executive function.

I'm the only member of our IS team on that group. I chair every other member is our system, C F O, our system chief medical Officer, our system, , , , , from our c e o round table, from our hospital systems, , a chief nursing officer, , a Chief operating Officer, , from one of our hospitals.

And that's a rotation. So it we really bring all the different parts and pieces together. And so, , think our information services team governance group, Makes a lot of decisions that are probably beyond traditional IT or analytics. We make a lot of business decisions, , in that group.

, some may criticize that and say, that's not how it should be done. It's worked well for us. , so it was just a really natural fit, as we're thinking about this. Expand on that just a little bit. . know, we've talked a lot over the last few months that really, AI is a new and exciting technology in different a lot of ways.

But at the end of the day, how we go about evaluating new solutions, implementing new solutions, supporting new solutions around ai, we don't think are, it is gonna be fundamentally different than other technologies, right? So we're gonna use our proven. Processes. Our I T I L, idle methodologies.

Our standard is, , , practice and solutions and processes. What is different about it is this. Ethical trustworthiness, bias aspect. And so the reason we stood this group up as a, , supplement, if you will, to our existing information services governance, was to try to address that unique aspect of artificial intelligence.

That's the part of this that I think so many across the globe are, wrestling with and many are fearful of. So we're trying to make sure we're being very thoughtful about that.

How are you gonna measure its success? It's interesting. Yeah, because I see this thing is the wild West right now.

It's like all of a sudden this will probably happen to you. I was talking to somebody, they said, I walked into this physician practice and they were using chat g p t to do this, and this. It's like, and that's when the CIO said, oh my gosh. Hold on a second. Like, we have to get in front of this.

It sounds like you've gotten in front of it, but you know, I'm sort of wondering, If. We're gonna wish we had put a set of metrics on the front end that we can look back on later and say, look, we saved this many hours, we saved this much money. , so that we can quantify the use of ai, not just chat GPT and generative AI in that respect, but all the different forms of ai.

I mean, it's a embedded in Epic and other things, , and sort of measured the impact it's having on the health system. That's

a great question. So, , the good timing, I actually gave a talk on an update to our executive council just last week around, , we're doing and we're routinely providing 'em updates, as you would imagine right now there's a lot, so much interest in this space.

Yeah. So I think we're focused on four areas and I think those four areas are gonna have different success metrics and criteria, so, The four areas that we're kind of categorizing things around our AI work are, improving health outcomes. There's certainly some things that are gonna happen in that space.

The one I'm the most excited about right this moment is where we have a emerging collaboration with American Heart Association and Microsoft around using, , imaging, , AI to. Look through our millions of historical images that we have in our vendor neutral archive to look for where we may have undiagnosed or undetected, , conditions, and really try to see if there's things we could do for our patients to do preventative work and make sure they're.

Primary care and cardiology teams are aware of what may have been missed before. So that's, improving outcomes. , second, burnout. We've talked about that with the epic work we're doing and I think that's just dipping the toe in the water to try to help, provide some, some AI based assistance to our care teams.

Three is experience. I think, we can do a lot with our teammates, experience a lot with our patient experience. As AI continues to evolve I, we're being a little more careful on the patient facing AI because that, to me, that's a higher risk. We don't want to damage that relationship with a patient.

So I think we're gonna be very careful with that one. But I do think we're gonna look for trusted partners who are doing improve things. We're using AI to help improve the patient experience. And then the fourth. , is, bending the cost curve, right? And I think that's where, the CFOs the Chief Operating officers are really looking to say, Hey, how can we leverage this technology to eliminate, low cognitive tasks?

How do we automate processes, leveraging some AI to. Provide that extra intelligence, beyond a basic classic decision tree type technology. So I think those are the four areas. I think all of 'em are gonna have different, success metrics and I think we believe, at least right now, that we need to be working actively in all four of those spaces.

And it's that's really interesting. I liken this to when the personal computer first came into. The picture, it's like, Hey, , marketing would like to use a personal computer. No, we didn't have CIOs back then, so it was, well, in some cases we did, and they would go a personal computer on your desk.

Okay. And we started to see 'em pop up all around. This feels to me like that same kind of thing where people are going, Hey, I think I could use this here. They're gonna do a pilot. It's going to either succeed or fail. They're gonna do another pilot that's gonna succeed. They're gonna. And we're just gonna see this proliferate pretty rapidly is what it feels like to me.

I'm curious in your seat how it feels to you? ,

so I agree completely, in fact, so you and I are close in our analogies. I've been for the last six or eight weeks, , to a lot media groups, reporters or journalists. And, , as we're working this journey and the analogy I've been using is, , spreadsheets.

So, spreadsheet technology, when it came on board, I mean, could you imagine what it would've been like to be A C F O or a finance leader or analyst? , before the advent of spreadsheets I don't even imagine. I couldn't fathom how that would've been to do so much of the calculation manually with calculators or other, technology.

I may be giving away my age a little bit, but

yeah you're younger than me. Cause Yeah, my first job was looking through reams, , like, you stacks and if people can't see my hands these things were. Beyond legal paper, whatever it was called back then, computer paper, , of Nielsen Reports.

And people would come over to me, this is my internship, they'd come over to me and say, Hey, I need, this data compiled in this way. And I would literally go through without a computer and like hand write this stuff and do the analysis and handed to that this sheet was amazing.

And to make, to go back to your original point, think about what roles and, job functions, use spreadsheets. I mean, virtually everybody uses spreadsheets in some capacity. Within our organization, our physicians use spreadsheets. Our, nursing leaders use spreadsheets. Our administrative leaders use, I mean, everybody uses a spreadsheet at some point.

That's what I think is gonna happen with this AI technology. To your point, it's gonna sort of permeate ubiquitously across everyone's, job function. There's gonna be some way that you're gonna use this, , do your job, more productively, , and probably more efficiently.

This will probably be the last question. , do you ensure that people don't get left behind you have early adopters and you have, , late adopters, but how do you make sure that. People are aware of what the potential is and bring them along.

So there, there's a. Little bit of an aspect of you. The last thing you just said there, I wanna touch on, I think one of the questions I'm getting asked a lot now from third parties is, Brent, what's UNC Health's stance on being transparent to patients or other third parties that AI was used in some capacity for the given workflow, , that, that they interact with?

And, I don't know that we as a nation as any, any sort of unit have that all worked out. But I think we need to be more transparent than less transparent. I think we need to be transparent that, yeah. This draft was generated by ai, you know, humans still a control or this was done by an ai.

Component, I think it's important and I think that can also help with bringing people along cuz awareness can breed, , education, , about a topic. , beyond that, one of the things that we are doing is we've got our human resources team actively engaged in our. , AI advisory group. So, that's something we wanna make sure is upfront, that we're being very thoughtful and careful about our teammates and that, helping everyone understand that this is a technology that probably will be like the PC or spreadsheets to our previous conversation.

That's gonna be ubiquitous no matter what. And something we all probably need to have some basic understanding of and awareness about how to use. And so, my, my hope is that we can bring everybody along, maybe that's a rose colored glasses view, but I'm a pretty, pretty big optimist.

Almost, pretty much all the time.

Yeah. Well, you have to have the glass, , mostly full. As a cio, cuz , it gets empty throughout the day, so it's good to start with a full glass. You know as I'm thinking about that, the interesting thing is the number of places we use algorithms to figure things out or to calculate things or whatever.

, there's not a lot of transparency, like, I don't. I don't ask my physician, Hey, how was this calculated? How was this? Was this calculated? Using a computer? Was what type of algorithm? To a certain extent as a patient, , I placed my trust in UNC Health, and I trust that you have the standards and the ethics and the professionalism to ensure that you're using high quality, , standards across the board.

I, I'm afraid that if you put it at the bottom, this was generated via. , an AI model. Then we bring the bias where think about how we've been trained. We've been trained by James Cameron, that AI's gonna destroy us someday. That's right. , and like it or not, there's some people that, that is their reality and they're looking at it going, I don't want AI involved in my health.

we know it's not Terminator. It's not a sentient being, it really is very sophisticated, , computer models and statistics that are being applied to the things we're doing today. Now, that could change in the next 20 or 30 years, but that's easily how far we are away from.

A thinking computer at this point.

I think you just made my point that I don't think we have this figured out yet. I think, that's what I'm saying. I think there's, more transparent than less, but we don't have this figured out a Absolutely. I think, , if I could make one last point on this, one of the things that we've been talking a lot about lately is the, Parallel with self-driving cars, we have how many, hundreds or thousands of wrecks Yeah.

That are, That are, , every day, on our highways, , that we're a human's fault. And, if a self-driving car makes one mistake, it's gonna be a. Dramatically different story. I think the same will apply in ai, right? If the AI makes a mistake one time, versus how many times does a human make it the same mistake?

So I think that needs to be factored in as well. I think. Your earlier point, bringing people along, educating people, literacy of ai, these are gonna be really important topics. Maybe that's an interesting place to think about new business opportunities right now.

Brent, I wanna thank you for your time.

Fantastic conversation. I learned a ton. Anytime. I learned a ton. I really appreciate the conversation, so thank you for, , coming on the show and sharing your

experience. Thanks, bill. Really appreciate it.

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