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March 29, 2023: Greg Miller, Chief Growth Officer at Lumeon joins Bill for the news. With the increasing shortage of physicians and nurses, can AI solutions, such as ChatGPT, help to solve the physician shortage crisis, and what are the possibilities and limitations of using AI in healthcare? How can automation and care orchestration using AI technology help in scaling care coordination efforts across an enterprise and reducing the burden on clinicians and administrative staff that are constantly in chasing mode? What are the three main issues that health system executives are trying to solve for, and how are these issues related to technology investment decisions in the healthcare industry? How do new technology platforms aim to serve clinicians and patients, and what are the benefits of this approach compared to the traditional view of healthcare technology as something that clinicians must serve?

Key Points:

  • EHR limitations in automating broader processes
  • AI potential to solve workforce shortages
  • Accelerating pace of AI advancements
  • Possibilities and limitations of AI and the importance of the human element in medical practice
  • Financial pressures leading to scaling back of technology investments
  • New technology platforms serving clinicians rather than healthcare serving technology

News articles:

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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.

It's all around us in every other industry that we interact with. Yet we have been reticent in healthcare to trust automation other than very specific. Singular tasks, that's not what we're talking about. I'm talking about workflow that dramatically impacts the efficiency and the productivity of care teams reduces the burden on the clinician for doing a lot of low level functions  (Intro)

Welcome to Newsday A this week Health Newsroom Show. My name is Bill Russell. I'm a former C I O 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 Newsday show partners and we have a lot of 'em this year, which I am really excited about. Cedar Sinai Accelerator. Clear sense crowd strike. Digital scientists, optimum Healthcare it, pure Storage Shore Test, Tao Site, Lumion and VMware. We appreciate them investing in our mission to develop the next generation of health leaders.

Now onto the show.

  (Main) 📍 all right, it's Newsday, and today we have a new guest host, Greg Miller with Lumeon. Greg, welcome to the show.

Thanks for having me. Watch your show every week and glad to be here.

Wow. So you know how this goes. You know what we're gonna do? We're gonna hit the news. There's a lot of stuff happening, you sent over a couple of headlines as well.

We'll try to hit as many of these as possible. We have South by Southwest some I don't know if we'll get to Scott Becker. I mean, there's just a lot of good stuff, a lot of stuff on the AI front as well. But this is your first time on. So I want to give people an idea of what Lumion does. What is lumion.

So at Loon we, we have a fundamental belief that care better coordinated as care better delivered. And the challenge we find in working with health systems everywhere is that while the people that are trying to do care orchestration have best intentions and they work really hard. The traditional care coordination is largely broken and it's broken because it is so human being it, and because it's human being dependent, it's also very expensive.

We also find that the way that air coordination is done within an organization, across specialties, across departments is highly variable. So it's not executed in a consistent way. And so when you combine the inconsistency and execution with the dependency on humans to do most of the work, it makes it very difficult to scale care coordination efforts across an enterprise.

What we really do is we apply automation to the function of care coordination is something we call care orchestration which is linking together the automation of multiple tasks into a process and a workflow.

Wow. People might ask, doesn't the E H R do this effectively?

We get that question all the time and the best way to think about it, bill, is what is an ehr?

It's a system of record for recording information. Now, a system of record can automate certain individual tasks like placing an order. Or refilling a medication, things like that. What EHR is not architected to do, is to have automation that applies to a broader process.

And a lot of times the care delivery process is outside the four walls of the health system, right? It incorporates a lot of different people. So being able to automate and orchestrate the multiple tasks, the people, the events and the activities that need to happen in order to achieve the best outcome that's really where care orchestration and automation can play a big role.

As many of the things that are done in the care coordination realm are manual in nature. Chasing a patient for this, chasing a clinician for that, reviewing results, a lot of that can be automated. And therefore reduce the burden on the clinicians and administrative staff that are constantly in chasing mode.

Yep. Reduce the burden. Reduce the burden. Well, let's start with that story then. And this one's interesting cause I think it capture. A bunch of stories in one, and this comes from Kevin md. Can AI Solve the Physician Shortage Crisis? And he Opens article by citing a couple of studies which show there's a shortage, which we know for decades we've been importing physicians and nurses from other countries to fill the gap.

However, with an increasing worldwide shortage of physic. Other countries, such as the European Union, are now out competing us and recruiting these same importable physicians and nurses. So there's a link to an article there, and there's also workforce dissatisfaction amongst the clinicians, and they ask the question, is there an AI solution?

We have seen that artificial intelligence systems such as chatGPT can now pass college exams and medical licensing tests, carry on interactive conversations with humans, answer complicated medical and other questions independently generate content and write articles such as exam essays. AI bots are now conducting initial interactive.

Job seeker interviews and make a decision right then. AI can now better identify anomalies in ECGs and imaging studies than many expert physician readers and so forth. And, and they go on to talk about this. The reason I bring this up, Lot of announcements this week, right? G p T four came out a couple weeks ago.

Then you had G P T four. It's going to be integrated into nuance for medical transcription. That will happen this summer for the people that line up for the pilot. Then you had Google Bard come out just today. It's a headline on the Wall Street. And that's going on. There's a lot of activity in this space.

It almost feels to me like this space is accelerating right now. I mean, I can't believe the pace at which this is going. It went viral in the fall, talking about G P T 3.5, and then they just made huge strides with G P T four. I mean, are we gonna see this integrated into all aspects? Of at least administrative computing and then eventually clinical.

I think there's a lot of loading fruit to which AI can be applied. I think, when you think about what IBM Watson did in coming out, in the moonshot we're gonna cure cancer that was a very lofty goal wasn't achieved. But

are you saying there's a lot of hype around this?

Is that what you're telling me?

Yeah, there is a lot of, and all you'd like do is listen to CNBC and listen to, all the, oh, it's an AI company. Well, the way I've always thought about it, AI is not a company AI a component of something else.

Part of the reason you're seeing an acceleration of so much ai, cuz the capabilities have gotten better and then therefore the ability to consume or to embed AI capabilities in other solutions as rapidly accelerated. I played around a lot with chat G P T, and I'm constantly amazed at what it comes back with and how conversational, interactive it really is.

And if that is, the future for where we're headed with healthcare. I'm very excited about it. There's lots of possibilities. Now, do I think you're gonna have ChatGPT salt, cure cancer? Probably not anytime soon, and I don't think you can ever take away the human element of what a physician does.

Oh, abs, absolutely no, no argument there. And I don't think anyone's gonna be make the bonehead mistake that IBM made and, and come in and I apologize to the IBM people. That was talk about setting the expectations amazingly high and underperforming. That would be the use case.

And I don't think G p t four is really doing that. They keep trying to tamp down the expectations and then people keep using it and doing what I'm doing. Like, so yes I'm playing around with it cause I'm doing a series. Of posts on G P T four on the Today Show. And the reason I'm playing around with it is I'm seeing these people say, Hey, I've never written code before.

I tell G P T what I want and it's writing the code for me. And I thought, all right, I'm gonna pretend like I've never written code before and I've, I have written code, but I just used G P T, I gave it the prompt and a couple things, and I said, write me a plugin. For WordPress that does this, and I just watched the code start coming up fully documented, and then it gave me instructions.

This is where, how you put it on your WordPress site. This is how you activate the plugin. This is how you, and I'm sitting there going, all right, I, and I did, I followed all this instructions and it worked the first time. I mean, it just worked. Yeah. I'm sitting there. . Wow. Let's just talk about it from an IT perspective.

I mean, you technology background. I have a technology background. I'm looking at this thing going. I betcha there's a lot of things within it that we could automate, that we could summarize, that we could potentially use it. I mean, we're already seeing it with nuance.

I'm thinking automations and programming at this point that can be done a lot quicker than they're being done today. That's my thought.

I agree. I as part of my role here at , I lead our marketing team as well, and I was playing around with it one day and came to the realization that I could probably replace some of my team members.

Who write a lot of content by just asking g p t or chat g p t, whatever it is I'm asking them about now, any of the man team members that are out there, I'm not serious about that, but I was absolutely flabbergasted by how accurate it was and fast, right? It didn't take long for it to put up with the answers.

In automation, I kind of separate my own mind. AI and automation because they're not synonymous. So for example, with Lumeon, we don't employ AI to do what we do. Our engine is deterministic, meaning that we know exactly what to do for every patient at the right time.

AI is predictive. We're not predicting what to do. We know exactly what needs to be done. I even take one of our customers, I can't name their name, but it's a national IDN that everybody would know. And one of the things that we measured with them was the amount of time a clinician would spend in, in the chart as a way to measure the benefits of automation.

In this one customer. Again, a very large customer. The amount of time that a clinician would spend in the patient's chart before we deployed was about 11 minutes after deployment. The amount of time clinician spends in the chart was two minutes. And so you see an 82% reduction in time for the clinicians.

So when you talk about unburdening

Yeah. And that's the key right there and I'm gonna come back to that, the next story cuz that measurable savings. is gonna be so critical.

We'll get back to our show in just a minute. We have a great webinar coming up for you in April. We just finished our March. On April 6th at 1:00 PM Easter time, the first Thursday of every month, we're gonna have our leadership series. This one is on CSO priorities for 2023. Chief Information Security Officers, we have a great panel.

We have Eric Decker within our mountain, Shauna Hofer with St. Luke's Health System out of Boise, Idaho, and Vic Aurora with Hospital four Special Surgery. And we are gonna delve into what are the priorities for security? What are we seeing? What are the new threat? What is top of mind for this group? If you wanna be a part of these webinars and we would love to have you be a part of them, go ahead and sign up.

You can go to our website this week,, top right hand corner, you'll see our webinar. And when you get to that page, go ahead and fill out your information. Don't forget to put a question in there. one of the things that we do, I think that is pretty distinct is we. like for today's webinar, we had 50 some odd questions that we utilized, in order to make sure that the conversation is the conversation that you want us to have with these executives.

So really appreciate you guys being a part of it and look forward to seeing you on that webinar. Now, back to the show. 📍

I'm gonna close this segment out, Craig Brockman captured it well, south by Southwest.

A another story of fierce healthcare. Carried it. And Craig Brockman, CEO O of OpenAI, which is chat cts parent company. He said, I think that the real story here in my mind is amplification of what humans can do. I think that will be true for knowledge work. It's like you hire six assistants and they're not perfect.

and they need to be trained up a little bit, but they're eager and they never sleep. They're there to help you. They're willing to do the drudge. I think that's what's going to be, what writing will look like. I think that's what coding will look like. I think that's what sort of business communications will look like.

And I think this is why Microsoft is trying to embed it in office. That's why they're embedding it in nuance because it is that assistant that's always sitting there waiting to help you. And I think it's good at writing, it's good at summarizing. It's good. Finding things within large text blocks and that kind of stuff.

And then obviously the coding stuff just amazes me. But you mentioned that time gap and savings of time and that kind of stuff. And I wanna go to this story cuz I think this is top of mind. Everybody who's out there right now is thinking about this health Becker's article Health systems are buying less technology amid financial pressures.

US hospitals and health systems are facing significant financial problems, which is leading them to scale back investments in technology. Political reported March 15th. As labor costs continue to rise and patient volumes continue to decrease, now ensure it's only patient volumes. There's a patient mix change that's going on.

There's medicaid re redetermination that's going on, and then the payers have more let's just say clout when we're renegotiating rates and when the commercial rates go down that's a problem. So hospitals and health systems are operating with tighter margins than ever, which is leading them to buy less technology.

We're hearing this over and over again. Times are changing. Health systems are tight. In terms of our conversation, what I wanna focus in on is the projects that IT teams and really operational teams should be bringing to health systems today. We heard from CIOs and they said, look, give me something with a one year or less roi, and I could probably get that in the budget if it's two years or less.

That's gonna be a big discussion. If it's two years or. We can't even talk about it right now. It's just not even a viable thing. So is that what you're hearing as well? That people want a measurable return quicker and something that's going to lead to strategic outcomes that they're looking to achieve.

Yeah. So, we talk to health system executives, not just CIOs the entire C-suite really every single day, all day long. And the common theme across all of them is there's three issues they're trying to solve for. Number one is workforce. I don't have enough people to do all the work that needs to be done, and the people that I have are already stressing burnout.

Now the second issue is I gotta reduce costs, and there's an urgency around that. And the third issue is I need to generate more revenue. And so the second item in there, the urgency around cost reduction, is right in line with what you were describing and what the article was talking about in that what we hear repeatedly is exactly what you said, you have to be able to draw a direct line of impact to cost reduction or revenue generation, or solving the workforce issues.

And that ROI needs to be within. Ideally the first year, first calendar year of the blame it. So that is consistent. We are seeing that everywhere we go.

Yeah. I'm hearing it more and more. you were talking about the lumion value proposition and it was very crisp.

It was very, Hey, here's the story and it saved this. I like two aspects of that. One is I put it in a story format. On a real world example, and it demonstrated the savings that they're looking for. Obviously it is about the workforce and the satisfaction that you're driving as well. Less time in the EHR, I think is a big win.

across the board. Yeah. For clinicians. But also that savings of time and it gets back to that quote from Greg Brockman, which is like, technology was meant to, , it was meant to be there to serve. And in healthcare, we seem to have gotten it a little backwards. It's like, we are here to serve the technology.

Oh, we gotta get all this information in, we gotta get it all documented, right? We gotta get it all. And I think what we're seeing is a lot of new technology platforms coming out that are saying, now let's switch this around. Let's serve the clinician, let's serve the patient, let's serve the institutions.

I would agree a hundred percent. One of the things that, from the same customer that I mentioned, we watch the adoption level by clinicians of the automation and, it's one of those things, or a slight analogy is, You get an autonomous driving vehicle, you get in it for the first time, you're a little nervous.

Your hands are like to be on the steering wheel. But then it takes off and you don't die. You don't wrap yourself around a tree, hopefully. And so when you think about automation within the healthcare context, Especially with physicians or the clinical community. These nurses are very much part of it too.

There's some nervousness around what is this automating and is it accurate? Is it right? And so in the same customer, we measured over the same period of time, which was about a 12 month period in the first month of deployment. Sure. We refer to as the override rate, meaning that whatever the automation did, the doc would go in and maybe override.

In the first month it was, it was probably around 60%. In the second month, it drops all the way down to about six. and the 6% of the time that they do override is necessary. For example, the automation may say, for this patient at this time, place, this order. Without any clinician involvement whatsoever.

Once they had a little bit of experience with it, they became very comfortable with it. So going back to the autonomous driving car, you might, be nervous at front at first, but in time you get very comfortable with the automation that's happening there. And I think this whole area of automation.

It's all around us in every other industry that we interact with. Yet we have been reticent in healthcare to trust automation other than very specific. Singular tasks like, a surgical robot or robots that deliver medications, and that's not what we're talking about. I'm talking about workflow that dramatically impacts the efficiency and the productivity of care teams reduces the burden on the clinician for doing a lot of low level functions, which I call low-hanging fruit to which automation can can be readily applied and eliminate saves time, saves money and so,

  we'll get back to our show in just a minute. Having a child with cancer is one of the most painful and difficult situations a family can face in 2023 to celebrate five.

At this week, health, we're going to give back. We are partnering with Alex's Lemonade Stand all year long. We've got a goal to raise $50,000 from our community, and we are already up over $12,000 and we are asking you to join us. There are two ways that you can do that. One is you can just hit our website.

There's a banner at the top that says Alex's Lemonade Stand. Click on that and you can give directly at that lemonade stent. another way that you could do that is we have been doing drives and we've been doing drives all year long in January and February. Our drive for March is something that the team came up with and I'm really excited about. We are going to vibe.

With the team and we're bringing captain. Captain is my producer's service dog and Captain will be with us for the entire event. You're gonna see us around the event doing interviews, the drive is get your picture taken with Captain you and a bunch of your friends with Captain. Get the picture taken, go ahead and post it on social media and Twitter linked.

And tag us at this week. Health. When you do that, we're gonna count the number of people who are facing the camera in the picture, and for each person in the picture with Captain facing the camera, we're going to give $1 to Alex's lemonade stand. So with your help, we hope to raise a bunch of money for childhood cancer at the VI event, we hope that you'll be a part.

It's gonna be exciting. We have some partners that are a part of this with us and we really appreciate them stepping up to help us fund this. We hope to raise a ton of money. Shore Test is a phenomenal partner. Order is another one. And Artis site, great companies, great products. Check them out and we hope that you'll participate with us and we look forward to seeing you at the Vibe event. Now, back to the show.

Yeah, we've got a bunch of other storage, unity Point is acquiring or merging with Presbyterian out of New Mexico.

That's a fairly sizable merger that we're looking at or acquisition. I don't remember the verbiage that was used. Either way it looks the same when it's done. They become one company and move on. I've seen that trend go way down, and I think it's because the regulatory environ.

This administration does not look kindly on hospital mergers and I think, the atrium merger with advocate got through I think because there was no overlap. But anytime there is overlap, I think there's gonna be a lot of scrutiny. On the loss of competition in those markets.

So, that story's out there. Let me close with this though. This is being recorded before we go to Vibe, what do you expect at Vibe? What are you looking for at Vive?

Well, from a lu perspective, we're looking for lots of leads, right? And new customers to talk to.

So that's a natural. But it's also a great venue for us to talk to investors, talk to additional partners, new partners. We're a foundation firm, so we support chimes who will be a chime as well. Which is actually my favorite event of every year, is just being able to be within the CIO community and see a lot of friends and learn a lot of new things.

So I'd say our effort at Vibe is one part lead generation, one part learning and education for all of our team that will be there. And then also I would say put it in the realm of strategic opportunities

Are you doing the hosted buyer? I've heard good things about it.

We are. We are, I love the hosted buyer.

I think it's a brilliant way of having meaningful meetings.

Yeah, I agree. And I know a bunch of CIOs have signed up for it and they're looking forward to the conversations. I like it just, it feels like the right way to do that in a little sacrilegious to say speed dating format.

But that is really what it is. It's a, hey, if it works. If it doesn't, it. But you know, within about, whatever it is, 20 minutes, 30 minutes, whether it's a good fit or not. And that seems to be an efficient way to do that. Greg first show I really appreciate you coming on and, look forward to future shows, especially if you're gonna send over this many articles for me to go through this is.

It is fun. I love having these conversations.

Well, I look forward to seeing you the next time. Thanks. All right.

We'll see you next week.

Yep, absolutely.

  📍 And that is the news. If I were a CIO today, I think what I would do is I'd have every team member listening to a show just like this one, and trying to have conversations with them after the show about what they've learned.

and what we can apply to our health system. If you wanna support this week Health, one of the ways you can do that is you can recommend our channels to a peer or to one of your staff members. We have two channels this week, health Newsroom, and this week Health Conference. You can check them out anywhere you listen to podcasts, which is a lot of places apple, Google, , overcast, Spotify, you name it, you could find it there. You could also find us on. And of course you could go to our website this week,, and we want to thank our new state partners again, a lot of 'em, and we appreciate their participation in this show.

Cedar Sinai Accelerator Clear Sense CrowdStrike, digital Scientists, optimum Pure Storage. Sure. Test Tao, site Lumion and VMware who have 📍 invested in our mission to develop the next generation of health leaders. Thanks for listening. That's all for now.


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