July 10, 2023: Corey Lyons, Staff Solutions Engineer at VMware joins Bill for the news. What is the role of VMware in the changing landscape of healthcare technology? How is healthcare moving towards the edge and becoming more dispersed? What does Best Buy and Atrium’s partnership mean for in-home hospital care, and what are the implications for technology organizations and staff? What are the benefits of using AI in administrative workflows?
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Today on This Week Health.
what else are we gonna do then to solve clinician burnout and do these other things that are quality of life improvements, not only for the people that are delivering the care, but the people receiving the care as well. There's so many possibilities. (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.
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Now onto the show.
(Main) 📍 alright, it's Newsday. And today we're gonna do really a technology session. We're gonna be talking how healthcare is moving to the edge and how things are getting more and more dispersed around healthcare. We're gonna do that with Corey Lyons, staff solution engineer at VMware.
Been in the industry for a long time. You don't look old enough to be in it. Corey, welcome to the show.
Thanks, bill. Yeah. The white and my beard may betray some elements of it, but yeah, I've been in industry for the better part of 20 years. Started in my early twenties in a healthcare organization, and then moved over here to VMware in 2014.
Yeah, and I joke that VMware has 98% market share or 99% market share within healthcare providers. Everybody has 'em in their data center, but doesn't have a hundred percent mind share. VMware has so many things it does that people just aren't aware of right now. It's really kind of amazing the tools that you can bring to bear in healthcare.
Yeah, I mean, it's been an interesting time even since I joined the organization roughly eight years ago, right? Nine years ago, the amount of intellectual property that VMware has added to their portfolio. I think there's a lot of additional capabilities that we're helping customers understand, but you can.
Look at the news on any given day and not see where technology's front and center and how the landscape shipping for the providers and the payers out there and the consumers of health services themselves. Right?
Yep. Well, let's start with one of those stories then. Access to care and care venues are changing pretty dramatically, pretty rapidly.
So best buy an atrium set to do an in-home hospital care. , and this is exactly what you think it is. Best Buy's not getting into healthcare per se. They're not gonna deliver healthcare, but they have this expertise around technology, the consumer, the home, and setting those things up. And so the partnership is really about Best Buy going in there and setting up multiple levels of acuity within the home, in partnership with Atrium, and then Atrium coming.
behind them and delivering the great care that they deliver in the markets that they serve. This is more and more of a recurring theme. We're seeing people go, you know what? We built these beautiful campuses, but more and more healthcare is being delivered outside of these buildings.
What does that mean for technology organizations and staff as they look at this burgeoning home health growth.
I think it's a really good innovation. Honestly. You I came from a provider landscape, both my parents are retired clinicians.
And the thing you want to do is try to touch as much people in a positive regard as possible. And if it moves more people into getting care in an effective and cost effective way doing that from home is a great thing I think for everyone, right? If the payer mix and the way that the organizations can help drive an outcome that improves the patient's lives by getting 'em out of a more intensive inpatient setting back to home in an environment that you know is probably better for them psychologically.
Right. And they can. Track the outcome as effectively as they could in a more costly inpatient or outpatient setting with maybe a step to something like an assisted living or a long-term care facility, but we're getting an equivalent result by doing that at home and monitoring their conditions with the updates to technology that exists.
That's a great thing I think for our organizations and the consumer.
What about the integration? So, since you're a technologist, and my background's as a CTO technologist as well the integration is interesting to me. We're introducing a bunch of new equipment, new telemetry, and it's all gonna be at the edge.
We want to incorporate that into not only the ehr, but also the analytics platform and our consumer experience platform and all those things. How are we gonna do that integration?
Yeah. So I think, one, you're gonna have some amount of caching that sits in those edge scenarios so that if something like a wifi outage occurs or whatever, you're not losing the telemetry that at one point you can go back and harvest.
Right? But the reliance on the connectivity at some point in saying, okay, we're getting the uploads of the data and we're alerting if there's a degradation in the condition or whatever we're trying to track. , but all that data is gonna flow into these health systems. And then, with that additional telemetry, it's really what business tools are you bringing to bear that lets you say, okay, well here's the adjacent benefits of this.
Not only the near term need like we're talking about, where it's like, okay, I'm tracking the blood pressure or the blood glucose, or the heartbeats and all those things and looking for signs of infection. But what other things can we do? If a consumer in the health organization says, oh, well I've got these capabilities to do this at home.
Now how can I better improve my outcomes and my health overall? By taking that initial footprint and saying, okay, well here's some analytics we can drive to say, look, you had a successful outcome because we did this hospital at home scenario. Would you like a continuous care delivery that leverages those same tools?
And maybe we have some analysis on the backend that proves why that's an effective business model to keep running with.
Yeah, no, absolutely. It's interesting, I'm feeling more and more. Like this is gonna be the golden age of technology in healthcare. We just spent all this time putting the EHR in place.
The e r p solutions in place, our PAC systems, we consolidated 'em and whatnot. We are talking about so many new options and opportunities based on these platforms that are out there and knitting these platforms together and creating experie. On top of it and that takes us to, one of the next stories, which I pulled this one out partially because it's chat, G p T and as we were talking before this show, if you haven't heard about chat, g p t, you, then you were I maybe on another planet for the last three months.
I, I joke that if there is a hype cycle, this thing is at the absolute peak of the hype cycle at this point. But this story sort of caught my attention. Doximity rolls out beta version of chat Chief PT tools for docs aiming to streamline administrative task. And essentially, Doximity has this platform and the platform allows them.
To send and receive faxes around medical conditions and seek and send those letters directly to insurers and whatnot. And they're gonna utilize chat c p t to essentially write some of that stuff and to consolidate some of those things. Now, I don't know if it's literally on chat, g p t, cuz I didn't know that they had those integration tools already built.
Or if it's built on. G B T engine 3.5, which I know does have the integration stuff built in. But this is interesting because I think what's happening is new technologies are coming out. People are looking at it and they're saying, Hey, we can integrate that into a process we have, into an experience we have into a product that we're taking to market.
It, it seems to. , pretty exciting. What do you think the opportunities are with chat G P T at this point?
Yeah, I think it's even broader than chat G P T, right? Because there's all these different model types. So this is where a strong area of focus for me has been over the last year and a half or so inside my organization as we're trying to help customers rationalize, what did these capabilities really mean in terms of business impact.
It's a good example to say like administrative workflows. What Automated routines can we do based off a large dataset and process analysis of how that historically has been done, right. In an organization where there isn't a whole lot of. , I will refer to it, I guess as change in the process or what the data that the artificial intelligence is being trained against and glean from, how the process should go.
There's not a lot of deviation in that, right? Because those processes are based off regulations, et cetera, and business processes that are already formally documented in some ways. So you're really just taking the machine learning capabilities and saying, Here's these data sets, here's these processes we're training, then the models that align most closely with those workflows, if you will, like how those conversations are had or those business processes are defined.
And then the automation is coming and saying, okay, well yeah, I understand this process because it's relatively rote. Like you asked for this. I know that the output for that should be ba. So if that's the case, what I'm asserting is, that's great, you're gonna fine tune then coming out of things like chat, G P T, what that outcome you're trying to deliver is that maybe isn't in that initial model and the training and the output.
So what's cool about the chat GTS and these massive language models that have been trained is that you're getting a derivative benefit. Then Bill from. That initial model and then saying, okay, well what am I gonna do to dial that in? Give it a finer polish them for the business problem I'm trying to solve.
So they get a leg up when they use something like a chat G p t and the a p I calls they can make over to those large trained models to say, okay, well I don't have to do all this heavy lifting. I don't have to out of the. Train a multi hundred million parameter model. I'm just able to layer the things I care about that differentiate my use case from the use case down the road.
And that's why these things are really red hot right now, I feel like.
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, health.com, 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. 📍
Another story, university of Kansas taps a bridge to roll out AI based medical transcription for thousands of doctors. And it's interesting the staff they throw out here at the University of Kansas Health, Providers spend 130 minutes a day on documentation outside of work hours.
That's the problem. Right? That, sure. And as you say, they can train the model to do some of this. And so the transcription is listening to the conversation transcribing, utilizing ai, we know a lot of organizations are using remote scribes. They're listening, but they're using remote scribes to do it.
This is at least tout. The ability to do this with technology, which is gonna just drive better efficiencies and those kind of things. But the thing about these tools as you were talking about the training models, they do get smarter with time, don't they?
Yeah. So I think this is what's so interesting and what customers and anybody that's interested in this space have to consider, right. You take a look at the way the model was originally created and we know full well, right? That you risk bias, you risk other things. If this is just a static point in time that you build these things and you never revisit it or review it and refresh it as frequently as your processes would allow.
So talk about something like a new diagnosis or a new nomenclature that comes. That maybe this AI would need to be able to pick up on like a brand new disease is named and discovered and all that. So there is a risk if you don't take thoughtful approach to how you're building these systems and training them and retraining them so that they already are always producing, pardon me, the most relevant results and outputs and having.
Some checks and balances, if you will, around what these really powerful things can do when just like a human can make a mistake, you're just amplifying . Then the risk that this thing makes a mistake and then nobody picks up on it for how much time.
Nothing can mess things up more than a poorly trained computer because Right, right, because there is no common sense.
It's interest. People were like, hey, this is the start of Skynet and this chat GBTs. But the reality is it has no original thought. It has no critical thought. It's not coming up with new ideas. It's just taking what it has and it's essentially representing it back out.
It has the appearance of getting. It's making connections that it didn't make before, but it's not going to be generative. It's not going to generate any new things, so it doesn't have the ability to pick up new things without us training it.
Yeah, and I think that's the thing that I'm encouraged by is like, can we as a society and a humanity come up with the right frameworks that say, okay, here's how we're going to, deal with the bias get the right audit controls in place so that there's a uniform language, if you will, some contractual overlay that we could put on these systems.
Then there's an easy ability to audit them, because at the end of the day, this stuff's not gonna go away. Right. I really do think we need to focus on the overlays and the processes by which we appropriately harness these things so that you are getting the best fidelity out of those systems. The best accuracy possible so that, it's easy at whatever entities need to go back and check on, the reliability of these outputs coming from these systems that we've got something That's universally agreed upon.
That's what I'm most optimistic about, bill, is we deal with this as a society and as healthcare entities looking to help harness this in the most appropriate way because the opportunities are massive, right? I think we all acknowledge that It's really nice to be able to change the temperature in your house with a smart thermostat and a voice assistant maybe.
And it's nice to get these reminders about the medications that you've inputted into the system, but having a conversation. Something with your clinician where the output is something that's streamlined documentation so they're not having to spend the 130 minutes that cited in the statistics.
Okay, what else are we gonna do then to solve clinician burnout and do these other things that are quality of life improvements, not only for the people that are delivering the care, but the people receiving the care as well. There's so many possibilities.
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.
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There's a great article, Pittsburgh Business Times Hitting the Mark.
It's about Highmark Health and whatnot. We can go into this story, but part of me would rather put you in that role. Now the CTO CIO at Highmark, you've rolled out this new program that they're talking about, which is driving better integration between providers and payers. And because they're driving that integration, they feel like they can drive down the overall cost and drive up the quality of care.
I'm putting you in the cio CTO role. What things do you think need to be in place in order to drive that level of efficiency, that level of quality improvement and how are you gonna go about doing some of those things?
Yeah, I think you have to look at the areas that are negatively impacting your organization out of the gate, right?
Like, is it. Labor costs, which I think just skyrocketed over the pandemic. Right. What are you doing then to say, well, we've got all this clinician drain this burnout. We don't have enough people coming into the care delivery setting to even help with that. Are there techniques and processes that you can harness then?
by casting a wider net and saying, okay, well here's a differentiated approach that I'm gonna bring to bear that addresses some of these challenges that every healthcare organization on the planet has faced over the last three years now. Right? And say, okay, well, there is some uniformity to this approach, a recurring theme that then says, okay, well what technologies exist in my toolbox, if you will.
do I have gaps then when I've done that analysis that says, okay, well I've identified these are the big hitters that I could go chase, whether it's the remote care delivery, right, or a shift to more telehealth. I think, that was clearly demonstrated that there is. Certain things that are a strong fit for, regulatory updates and a more enduring approach, especially in the United States, around what things can be effectively managed, where you don't have to spend half a day off work to go in and do things and.
Drive a more efficient workflow, not only for the consumer, like I said, but for the clinicians that say, yeah, I can do a much more effective cadence when I'm not having to, move from one room to the next room to the next room. And I'm just literally, grabbing a cup of coffee and onto the next patient.
And if I'm doing that in my PJs, so be it. Right? I think there's a lot of things that, the CTOs and the CIOs in these organizations can say. Here's the way we can deliver care in a differentiated way that still meets the regulatory bars that should be cleared. But it's really doing that kind of analysis to say, where is the most cost in the organization?
You figure out where that cost is, and then you develop updated processes and technologies that can backend those cost engines and try to drive them.
Yeah I love this group of stories, cuz again, as the optimist, I'm looking at this saying, yeah, clinician shortage burnout.
And you have, a story here about the increased use of AI for clinical notes chat, G P t, helping them with pre-op and those kinds of things is I think pretty interesting. Moving the care venues into the home. This feels to me. We're seeing more and more of these stories now as the CTO and the cio, I'm really worried about integration and platform thinking.
I'm worried about if you don't have those platforms in place now you're gonna end up with a very difficult tapestry of data and technology to orchestrate. And the more complex we, we've always. The more complex the technology and the data, the more prone it is to security threats. The more prone it is to breaking when you don't want it to break.
and those kind of things. Complexity is the enemy and we've gotta simplify these environments in order to continue this push, which I think is gonna be exciting. But we had 1300. Instances of 900 applications at my health system, I don't want to turn around in three years and be like, oh my gosh, we're up to 1800.
Applications at our system. That would be problematic.
Yeah. It's really what Canvas, bill, from my perspective, having been in the provider space prior to joining VMware is like, what Canvas, what common agreed upon stuff, and I know we've got fire and we've got HL seven and we've got those things, but that's not.
The one size fits all approach, right? I mean, there are things that are going to differentiate and be able to positively influence the healthcare ecosystem outside of just those messaging type regulatory entities. And trying to collaborate in a global sense, even on what can these learnings, what can all these new toolings with the right eye towards anonymization of the data.
Patient privacy clearly, right? All those other mandates that are, that security and governance piece, but there's so much that I think we can harness, and I agree with your optimistic outlook. Where can we just build these interoperability things for these other data types and these things that really drive a lot of effectiveness than with the workflows overall.
Are just so vast in healthcare.
Yep. Absolutely. Corey, I wanna thank you for going through the news with me. I really appreciate it.
Yeah, appreciate the time. Some great topics and good discussion. Thanks for your hosting me.
📍 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.
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