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Newsday: Energy Demands, Unsustainable Spending, and Soft ROI with Jacob Hansen

Aversure offers virtual care solutions supported by a secure, scalable infrastructure that helps you to lead your organization into a future where cutting edge technology is at your fingertips. and Compassionate Care Converge. For more information, check them out at thisweekhealth. com slash AvaSure.

Bill Russell: Today on Newsday.

Jacob Hansen: making sure that organizations that health systems work with on pioneering AI are going to be around, we want to get away from wasteful spend. That means we need health tech vendors and health systems who have a view of the future that's not tied to a flash in the pan.

Now, let's jump right in.

All right, it's Newsday. Today I'm joined by Jacob Hansen, Chief Product Officer at AvaSure. Jacob, how's it going? Doing well. Good to see you again, Bill. Good to see you. I'm in the midst of waiting for this storm to hit. It is Wednesday. We were recording on a Wednesday. Don't worry. I'm in my office.

I have hurricane proof glass here. Although I would say every about 30 minutes a tornado warning is issued. It pops up on my phone and yeah, for those who don't know, hurricanes lead to tornadoes. Anytime wind whips at that speed, sometimes it forms funnels. When it forms funnels, it gets really really dangerous.

So we've got that going on. do we find you? You're in your

And then our big issue is water, access to water, cause we're in a high mountain desert. So that's the every winter it's, we hope for snow cause we need it to get through the next year.

Bill Russell: When I became CIO, all those years ago, became aware of the disaster zones and what you can impact.

One of the more interesting ones was Southern California. Obviously, we had seismic activity and water, you have the potential for tsunami. We were moving our data center to Las Vegas, so I had to research what are the things for Las Vegas. So Las Vegas is a desert as well but the two I don't think people recognize.

And we see that as a. significant risk factor. There's gonna be people who are lost their homes, significant mental damage has been done to them and they're all of a sudden going to show up on mass into Las Vegas. And that's one of the disasters they think about and plan for in Las Vegas, which is I had never thought about that before.

Yeah, same. There's somebody somewhere in some little room going what's the disaster for Topeka? And they come up with it and tell you what to do with it We're not going to talk about disasters today. You have picked out three good stories here.

Otherwise you don't have shelter. AI is like tuition. We're learning. There are benefits, but you're investing in the future. Yeah. And he says, it's a, he goes on, it's tempting to view AI as novel, disruptive technology. However, many health systems have been applying AI in their operations for years, sometimes without explicitly labeling it as such.

Everybody wants to talk about AI. And if you go to any health system, we'll be like, yeah, we're doing that. Every one of us probably has 50 or more applied AI tools. Not pilots, actually applied things that they're doing. It's embedded in our clinical systems. It's embedded in our sepsis. It's embedded in our radiology systems.

Our data teams are using it. And we certainly have been doing RPA, Robotic Process Automation, for years. And I think it's an interesting distinction. You've selected this story. What are your thoughts on it?

And I liked the article because I don't think he was suggesting that organizations shouldn't innovate. It's more that you've got to have a way to fund that innovation. You've got to know what to expect from it. And from our perspective at AvaSure, it's a heck of a lot easier to fund those innovative activities if that is tied to a broader platform that's got known quantifiable outcomes.

We want to get away from wasteful spend. That means we need health tech vendors and health systems who have a view of the future that's not tied to a flash in the pan. That's not a focus on some short term interesting thing to try, but where are we going to start from? What's our beachhead?

And how do we layer things on top and try things with the knowledge that we're not going to, burn out the fuse and be done.

Bill Russell: It's kind of cliche to say that we're not looking for cool. We're not cool. Look at me. I'm not cool, clearly. But CIOs aren't looking for cool. We're looking for, and you said it early on, you said, it's projects that have ROI and, when people hear ROI, they immediately hear numbers and money, but it's not only numbers and money.

It may someday completely change the paradigm for the delivery of care, and we believe that too. But we don't believe that time frame is a year or two years, although we're looking at it closely. But we do see five to ten years, things that used to be done. The great example is ambient listening. So ambient listening, typically, we're focused on creating that note.

You hear it all the time. Oh my, it created the perfect note. Oh, it's a great note and that kind of stuff. Now those players are moving well beyond that. And they're not only creating the note in multiple specialties, but they're also starting to take it all the way through to coding and they're saying, Hey, you know what, we can look at that note and determine what the best coding is, and now, and you can speak into what those rules are.

Jacob Hansen: it. I was just going to say the same thing. When you look at the areas where we've got the most experiences in industry under our belts rev cycle, radiology, medical imaging.

But you take what you just said, as we start to connect the dots between digital scribe and dictation using ambient listening and how that connects to documentation or the creation of structured data, which ties to a structured approach to billing, which leads to rev cycle the more we connect those dots, the better off we'll be.

But you look at how long those examples that he listed in the presentation have been around. Those have been working through the kinks for a very long period.

Bill Russell: . Especially sepsis. That's been well documented the stumbles that Epic had in that area.

That's the area that everyone's okay, we're investing in the future. We're going to get all those cameras out there because we believe. There's going to be a substantial change in the way care is delivered, and those cameras are going to be 100x return on investment in each one of those rooms.

your experience, is that how they're looking at it?

Jacob Hansen: I would say yes, and it doesn't stop at a camera. When you think about devices in every room, And you think about camera, microphone, speaker and then you tie that to integration engines, machine learning think about, so for computer vision that's all about either augmenting a human being or automating something away from needing to be automated.

Basically a triaging mechanism at the bedside with ambient listen, a verbal interaction and avatar on the screen. All of that only has value to the extent that it leads to action by somebody, right? They're bringing a blanket to the room. They're. Addressing questions about medication. They're finding out why the patient doesn't feel well, fixing the TV that doesn't work.

All of it's got to lead to somebody doing something, but hopefully it's the highest value work being done by a human being when it comes to patient care.

I'm sure you're talking to a lot of people and getting. A lot of different use cases. All right, we'll hit the next story. This one's Trillion Health Report reveals troubling trends in U. S. healthcare costs soaring, health declining. Unsustainable spending, stagnant life expectancy, rising mortality rates, worsening health is what we're seeing.

You know what's interesting about these studies? I really don't put a lot of weight in the stagnant life expectancy. I don't expect it to go up to 100 years old. First of all the people that are dying today didn't take care of their bodies 40 years ago. And there's almost nothing you can do about it.

So changing life expectancy is really a lagging metric of what did we do 30 years ago in healthcare? What did we do 40 years ago in healthcare or not even healthcare? In health, what were we telling people to eat when they were growing up? We were saying, Hey, the four basic food groups, we were starting to put all sorts of preservatives into the food.

And and now all of a sudden we're like, Hey, people are dying. Yeah, like we've learned a lot of stuff over those 40 years now. It's a lagging metric and I don't know if it's a decade or whatever. I don't put a lot of weight in that but I do put a lot of weight in the unsustainable spending category.

And the spending, the labor costs keep going up. The cost of our campuses keep going up. The cost of the technology keeps going up. These are the things that jumped out at me on this story. What are your thoughts on it?

Jacob Hansen: A couple of thoughts. One, to your point about life expectancy or even health trends.

I think something we don't. Talk about a lot on the traditional or core health care side, but gets talked about a lot more often on the payer side of the equation is just individual accountability and responsibility for our own health outcomes. Oh, come on. You're putting that on me? I'm putting it on myself.

For nearly 20 years, and yet, we're doubling spend in healthcare, what, every 5 to 10 years, not taking any cost out. It's a little bit disheartening, but it does motivate a focus on the right things, which is If we as health technology companies are not starting with a baseline of, I can only create value for my shareholders, the business's shareholders, if I am reducing Health systems spend in some sort of a significant way.

But the thing that is going to change some of those more distant outcomes that were referenced in the article has to tie to how technology solutions send people home generally on the path to rehabilitation with no expectation that they're going to come back. So much of it's tied to labor and staffing and cost, but did it cut costs without some expectation that a week later somebody's going to be back?

So just a good, maybe a wake up call, a reminder that everything we do as an industry needs to be tied to those kinds of clinical expectations.

Bill Russell: Jacob, I love your insights there. I remember a conversation I had with the doctor and I caught him on a bad day.

It's take this for what it's worth. But he was really frustrated with being a doctor. I'm like, you get to do so many good things. He goes, yeah, but he goes, are we really making a difference? He goes, I sent this person home today and they're just going to be back.

And he goes, and then there's other people I send out and I know they're leaving here and going to In N Out Burger. And it's I just told them you've got to cut down on this and whatever. but they're just going to keep doing those things. And on that day, that was very frustrating for that doctor.

I'm sure if I caught him a week later he'd have a positive story and say, no, I made a difference today. It feels better. But that day for him was like, just frustrating. It's like, how do I have more of an impact outside of like, when they walk out my door, how do I, Feel like I still have my arms around them.

Like I'm still, I'm putting my arm over their shoulder and saying, Hey, I'm going to walk with you. I'm going to help you make better decisions.

You don't need surgery and you won't be back. Let's talk about that. And most of the patients were instead saying, I want the quick fix. Look, I just want my shoulder to feel better. It doesn't really matter. Just let's just do the surgery. Super disheartening. So he literally left that work to focus on something different.

And that was, naturally just going to hover over the, land that I was living in. And so Microsoft in a partnership with, I don't remember the name of the electric company, but they are going to revitalize that whole plant. And the reason is to power their data center. literally, they're going to fire up a nuclear generator to power all those data centers.

Are we making enough progress with regard, in your reading and the stuff you're coming across, do you think we're making enough progress? in terms of reducing the amount of energy that's required to generate this much compute? Or are we just going to, is this another one of those things that's just unsustainably, we're just going to continue to rise?

And the continued move to cloud from traditional on prem data center driven things. The debate over what needs to be in private cloud, what can really be in public cloud, what can be shared. From a multi tenant standpoint, I, it, you read that and all you can think is whose job is it to sit down and wonder in 10 years, do we have any way of hoping that the pace of creating power and even the geographic requirements of data centers can keep up with the demand that just our industry alone, ignoring all the others, is creating for this kind of infrastructure.

Bill Russell: Yeah, it would all be fine. Like we can use as much energy as we want, as long as it was clean energy, right?

So if it was hydroelectric, Generating enough to run all the data centers. No one would be saying anything. Cause it's eh, what's the big deal. But as this hurricane churns over the Gulf. being whipped up by the warming waters of the Gulf of Mexico. You sit there and go two hurricanes in one week.

That's, and yeah, what are we talking about here? And at what point. It really becomes a regulatory thing. Things don't change unless it's regulatory. Google, Amazon, and Microsoft can say all they want about, oh, we're conscious and whatever. I trust Apple, by the way, more than I trust those three.

Because when Apple says, hey, we're going to reduce the footprint and stuff. just bought the new phone and got the trade in and stuff. And like the trade in box they gave me uses so little cardboard to send a phone via mail. And I was like, they literally are investing in this stuff.

By the way I do know health systems are starting to look at this have great conversation. It was led by Mike Pfeffer at Stanford. He started talking about. Sustainability and UCSD was talking to, they had a really dynamic conversation of how we're going to measure this, how we're going to drive it down, what is really necessary from a compute standpoint and putting some metrics in place for their cloud providers to say, we expect you to make progress in these areas.

Jacob Hansen: We'll see where it goes. That's for sure. Should be interesting to watch.

Bill Russell: Jacob. It is. Oh, I did a lot of talking this time. I apologize. Next time. I'm gonna make you do most of the talking. Great to chat either way. It could be the impending doom of the hurricane hitting and stuff. I just, I wanna get all the words out.

Stay safe. Yeah. Thanks, I appreciate that. And look forward to the next time we get together. Thank you, sir.

Thanks for listening to Newstay. There's a lot happening in our industry and while Newstay covers interesting stuff, another way to stay informed is by subscribing to our daily insights email, which delivers Expertly curated health IT news straight to your inbox. Sign up at thisweekealth. com slash news.

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