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How is Intermountain Healthcare thinking about Patient Room ‘Next’? How can automation and AI help you support your physicians more effectively? Stephanie Lahr, CIO of Monument Health joins Bill Russell to discuss. Neteera’s Digital Nursing Assistant streamlines clinical workflows to drive adoption and impact care. The technology enables nurses to address other important issues and reallocates their time therefore decreasing burnout and increasing retention. Artisight is an IoT sensor network that not only uses AI to analyze data, it uniquely uses AI to generate new and previously inaccessible data sets to vastly improve organizational operations and financial performance.

This is episode 3 of 5 in our series Patient Room ‘Next’. Other guests include Billy Prows, VP at Intermountain and Fred Holston, Director of Healthcare at Sirius Healthcare (A CDW company). Stay tuned for more. 

Sign up for our webinar: Patient Room 'Next': Improving Care Efficiency - Thursday September 29, 2022: 1pm ET / 10am PT


This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.

Thanks for joining us. My name is bill Russell. I'm a former CIO for a 16 hospital system and creator of this week health, a channel dedicated to keeping health it staff, current and engaged. Welcome to serious healthcare's patient room. Next briefing campaign. I'm excited to get this topic going today. Today, we're talking with Stephanie LAR from monument health. She's the CIO CMIO dual role up there at monument health. And today's topic is how automation and AI can support your physicians more effectively. Great conversation, really enjoyed talking to her and you are really gonna enjoy this conversation.

I know you are cuz the, the use cases they are doing up there at monument are just really fun to talk about. Don't forget this whole thing, culminates with an excellent webinar panel discussion and we're gonna have experts. Talking about patient room next and how it improves care efficiency. Check out more information in the description box below, and you could register there. You can also just go to our website top right hand corner, click on the upcoming webinars and get registered that way. Don't forget to put a question in there. A lot of times people will drop a question. We have a space in there ahead of time. And if you. To us ahead of time. I can give it to the panelists and we can make sure we talk about the topics you wanna talk about. We wanna thank our sponsors for today. Our site net for giving us some time with Stephanie to discuss this great topic now onto 📍 the show.

All right. Today we are joined by Dr. Stephanie Lahr CIO CMIO for Monument Health. Stephanie, welcome to the show.

Thanks bill. Always great to be here with you.

I'm looking forward to this conversation. We're gonna be talking about patient room next, and there are so many challenges facing healthcare today, but none is more acute than clinical effectiveness. And in this series we've been exploring the technologies being applied. In the clinical setting to offset some of the challenges that are going on there today. We're gonna focus in on automation and AI and how that can support the physicians more effectively. so let's start with this. at monument health, how are you thinking about patient room next and clinical effectiveness?

Yeah. I think there are some foundational concepts that we are thinking first, and then there are some logistical and structural pieces we should talk about too. So I think philosophically and sort of foundationally, we're thinking about how can we restructure and reimagine the room itself. And what's in that room to my hashtags, reduce the friction and bring the joy back to medicine. And the reality is that the room itself needs to be smarter. In order to be able to leverage the kinds of technologies that I think are really going to allow us to do that friction reduction and bring the joy back to medicine, because we know that there are a lot of task.

And things that are happening in our clinical workflows that could probably be done a different way. And so again, kind of what we're thinking about is, how do we reimagine what's in the room, how the room is laid out, all of those kinds of things, even. So then as we talk about remodels and new buildings and all those kinds of things, we're really emphasizing.

What might this look like down the road or what might need to be there so that we can one analyze what's happening? Cuz I think that's another big part of this is everybody says, oh yeah, I wanna reduce the friction. I wanna eliminate the things that we, that make people annoyed. And then you say great.

So why like tell me, tell me what those things. I mean, like documentation is annoying and it's like, okay, tell me more. It's difficult to sometimes understand even what those high friction points are, or we're not right. We're taking anecdotes and saying things like, well, I'm pretty sure we'd be fine if EVs would ever clean the rooms on time.

Or I'm pretty sure we'd be fine if the nurses would ever get the patients discharged on time, or I'm sure we'd be fine if the doctors would write the orders in time, and those are all based on individual anecdotal experiences without data to support them. And yet no one in any healthcare system has the kind of resources it would take to really dig in and analyze those and collect that data.

So I think, again, foundationally, what we're looking at is what needs to be in the room and how do we do. So that we fix the right problem with the right solution. And some of that is putting things in the room that even might not be recognizable or impacting care today, but will give us the data we need so that we can do the automation and friction reduction in the right places in the future.

I love how pragmatic that is. we did a project called 60 back give clinician 60 minutes back in their day. And I remember. The recommendation came back of, Hey, if you just add two printers, you're gonna save five minutes per shift on. And I was just like, seriously, like that should have been done a while ago, but that's the pragmatic level that's going on.

But then you start moving up and you're saying, Hey documentation, other things. And now we get into those, those technologies that are some people classify as buzzwords, but we're starting to see things. Enter into these spaces, automation and artificial intelligence and, and even computer vision. So sure. These things coming together to give us that next layer of wins in the clinical effectiveness space.

Yeah, I think a really great example that comes to my mind is virtual sitters. So we in our own healthcare organization have had a person sitting in a room as a virtual sitter so that we can, and we've had cameras even in our rooms for a while, watching patients, giving them reminders, don't pull on that line.

Oh, if you're getting up and out of bed let somebody come in and help you. And that was a win from the standpoint of, okay. What we used to do is we stuck a person in every one of those. Well, that didn't work out very well. So we said, okay, well stick a person in a room and they can probably watch about 12 cameras.

And that's what we've seen is about 12 cameras can be watched by one person cuz they're doing all the looking. So bring AI into the picture. What if we could have AI doing most of the monitoring? And looking for those micro movements and things like that, that would suggest a pull at a line or a potential fall behavior or something like that.

So the person in the room is responding to already consolidated and, information that's been curated. With higher risk. Now we can take a person in the room who instead of can look, is gonna look at 12 rooms may be able to monitor maybe even 48 rooms certainly 30 plus rooms. And so we are on our way of transitioning from again, we, we already sort of moved away from, in the room sitters for the scenarios that make sense. There are situations that that is always still gonna be required clinically, but for those that didn't, we're able to take that virtual part and increase the effectiveness. It also increases the satisfaction for the person sitting in the room because it's extremely, mentally exhausting.

To just be scanning 12 rooms all the time, as opposed to having information, being fed to you and then responding to it appropriately. So I think that's a really great way of looking at how we can sequentially. Improve the efficiencies of things by layering on elements of technology and just where AI can be applied to be super helpful.

And it's not making a diagnosis, it's not suggesting the treatment. It again is just reducing the friction and allowing our caregivers to be more efficient and more effective.

Yeah, it's identifying something and then it's triggering a workflow is triggering an action is triggering an alert. it's really interesting. One of the technologies that Fred brought up was, Netra and he was just talking about these monitors now and we used to have all these, we have a million monitors in the room, but now he's talking about these monitors that are essentially Doing it wirelessly essentially through cameras and other devices and picking up vitals and whatnot, that can be fed right into the EHR. Some of this stuff is moving from, we used to talk about this of wouldn't it be neat to now we're seeing this stuff really play out.

Yeah. I, I mean, I've often made the remark that I wanna practice Beverly crusher medicine. Never, never do you hear her complain about oh, my stupid computer is really slowing me down today.

Yeah. It was always the tricorder, all those. And, and that is what some of this stuff is really doing. I mean, you think about a Tricor. Well, it never touched the patient and it gave her a bunch of clinical information. Neteera is, is another company that we are working with in looking at, what does it look like to capture touchless vital signs?

Where's the right place to do that. We're having conversations around. Maybe that belongs in an emergency room waiting room, maybe that would help us identify deteriorating patients in an emergency room waiting room. What, how could that come together? We're looking at it on the inpatient side and we think about things like quiet at night and helping people sleep better.

And those kinds of things. Well, if I need to capture some vital signs, wouldn't it be amazing if I could do it without somebody having to go in the room and. Blood pressure, cough and all those kinds of things. Now one of the tricky things that we're working through as well is now we're talking about truly a medical device and we have to work through the FDA elements of that.

And Neteera is working hard on all of those things, but the fact that there is something that I. I actually have a demo one, a prototype of it that I carry around in my bag with me and show people like this is so cool. Just this little plastic box could be mounted anywhere. Think of what we might be able to do with this information.

I'm also thinking about that kind of stuff. When we start talking about the kinds of things we might need to put into patient's homes, cuz again, we're gonna want that equipment to. Not something that they have to do much with, that can connect into our systems is relatively inexpensive and relatively hard to break.

So there's other ways to be thinking about that too, not just in our traditional patient room next, but what may be the truly ultimate patient room next, which may be in the patient's homes.

you and I have talked about art site and it it's really FA I was talking to somebody else the other day about art site and they were just shocked at how many models have been trained so quickly on the artificial intelligence model that you can essentially start training it and Instead of over years, you're training it in months to recognize things and identify things and then trigger alerts, trigger, alarms, trigger, that kind of stuff. And it really does take the place of a set of eyes anywhere. I mean, it could be in the patient room, but it could also be in a supply closet.

It's, it's really kind of an amazing adaptive technology use of artificial vision and artificial intelligence.

Yeah, I think for us, that was part of what was so compelling. When we started looking at that technology a little over a year ago was something we could use in a parking garage and in the, or, and in a clinic waiting room.

And in a hospital room all to improve efficiencies and improve experience. Like it really it's actually it's a platform approach. And I think it's a different way of thinking about platform approach. A lot of us have been we obviously we've looked at EHR from a platform approach. We look at our our pack systems, imaging systems from a plat as broad a platform approach as possible.

But I think it's gonna be really important. As we layer in artificial intelligence technology into sort of the foundations of the workspace, not the clinical space. If we're talking about providing clinical recommendations to a radiologist versus a cardiologist versus a gastroenterologist, those don't necessarily have to be tied to each other.

But if we're looking at putting that kind of technology in. From a workflow augmentation perspective across a health system, a platform approach really is going to be so advantageous. It's not that it's not possible to do it another way, but even as we think about switches and ports and the density of things that are needed and then the the transitions over time of what needs to be upgraded when and replaced when the fewer elements of that, that are D.

The better luck I'm gonna have as a CIO, making sure that those things happen on the schedule that they need to. And if I need to pull cameras from one place to put in another, it's not like, oh, well, those are just the cameras we use for hand hygiene. You can't use those cameras. Like, no, no, it's all one big platform. We're using it everywhere. And it's really giving us a level and a layer of intelligence we've never had before.

So here's the exit question. And I'm gonna layer it here. So the first layer is monument health is not exactly the wealthiest health system in the country, and it's not the largest health system in the country and we're talking AI, computer vision, and those kinds of technologies I think that would surprise people that we're not talking to Stanford and whatever monument health is getting out there.

And it's it's almost a necessity at this point to get ahead of this effectiveness curve. Because we're not printing new clinicians, we're not printing new nurses. We're not printing new doctors at the pace of which we need them. So we almost have to be thinking this way. How have you been able to make this happen and work at monument health, given your constraint.

Yeah. I mean, I think one is we have a really forward thinking leadership team. My chief nursing officer went with me when we went, for example, to see, and we saw naira and art site for the first time. And she was equally, if not more excited about it.

Than I was. So again, I think from our senior most leadership team, there's an understanding and acknowledgement and even an excitement around what we might be able to do. and I think actually the things that you are saying about us as a health system are probably the things that are allowing us to be a little more out in front on this.

We're small enough that. I don't have to ask 150 people for consensus in order to be able to move forward with something it's probably more like five or six. And if there's five or six really invested people in what we think we wanna do, then we go and do it. I think the other piece is a realization that not only are we not able to go and print these people and make them, but we are a community.

These caregivers, these physicians are nurses. We see them at the grocery store. We see them at restaurants. We want them to be happy in their lives as a part of our community. And a lot of this is not only just about the efficiency side, but we want them to feel good about where they work and the work they're doing.

And that's only gonna happen through changes that are. Really transformational in how that work is done. And so it's hugely important to us as we look at wanting to be a great place to work and be an independent, not for profit health system in this community, tied to our community for our generations to come.

Stephanie always great to catch up with you. And I look forward to keeping tabs on how this progresses cuz it's, it's a lot of fun and every time I talk to you, there's like another use case that you're throwing out at me that you guys are exploring. It is a lot of fun.

Thank you again for your time.

Good to see 📍 you bell.

I love catching up with Stephanie. What a great discussion I wanna thank our sponsors for today. Art of site and net tier for investing in our mission to develop the next generation of health leaders. Don't forget that this whole series ends with a great webinar. We have four magnificent healthcare leaders, Anna Baker, Garber, former C N I O for HCA. Billy pros, emerging technologies innovation at Intermountain, Fred Holston, director of healthcare. Sir healthcare CDW company. And of course, doctor Stephanie LAR CIO CMIO at monument health. And we are gonna hear about the tools, technologies use cases that they are implementing in what we are terming patient room next, the future of the patient room. You can register, check it out in the description box below, and there's a registration link as well. You can also hit our website this week. top right hand corner, upcoming webinars. It's right there for you. Love to have you 📍 join us September 29th at one o'clock Eastern time. Thanks for listening. That's all for now.

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