Today in health. It projects for the next year. 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. We want to thank our show sponsors who are investing in developing the next generation of health leaders, short test and artist side. Check them out at this week. health.com/today.

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All right. Today's story. We're going to start with what's going on at JP Morgan, and then I'm going to come back and make it very relevant and talk about the projects that we should be focusing on. Given our current reality. All right. So, , I'll use this story. As sort of a, , I, an example of what I think is going on in most of the presentations.

So essentially health details, $2.5 billion economic recovery plan to rebound from financial operational headwinds. All right. So essentially it's huge. , I think 25 billion ish. In revenue, maybe more than maybe. Maybe approaching 30 billion. So they're, they're big when they put a 2.5 billion economic recovery plan.

, you know, You get the context. It's, there's huge. That's not as big a number as it sounds given the size of that organization. So, let me give you some of the details from the article as part of the economic recovery initiative. The Catholic health system has targeted billions of dollars of opportunities and cost optimization and service line and revenue growth.

Executive said Tuesday, this work is underway and we believe that will help stabilize operations and allow us to continue to make strategic investments said their CEO to a room full of investors at JPM. Through these initiatives, the health system aims to stabilize its labor costs, specifically expensive contract labor while also investing in ambulatory care and ancillary services to drive higher patient volumes.

As more care shifts from inpatient to outpatient settings. I'm not going to talk about the strategy of that. I'm going to talk about the projects. That we need to address from an operational cost standpoint and efficiency. , anyway, I go on like many health system peers essentially continues to face significant financial and operational headwinds.

Such as workforce shortages, wage inflation, driving up expenses, COVID-19 related disruptions to patient volumes. And inflationary and recessionary pressure. These headwinds come as more care, continues to shift from inpatient to outpatient settings. Ascension health took a financial hit and the first three months of 2022 posting and operating income loss.

Of 671. A million dollars for the three months ending March 31st and its operating margin dropped. Two negative 10% on 6.7 billion in revenue. So if that's a quarter is 7 billion. Then times four would be 28 billion. So if there were about 28 billion. For the three months ended June 30th, 144 hospital health system posted an operating income loss of 239 million.

With an operating margin of negative 3.4% on 7.1 billion in quarterly revenue. This is following 2022. Where they reported a $1.8 billion loss. Which was negative 3.1% operating margin. All right. So I give you that story and that's going to be a recurring theme this year, and it's in, you already know it's a theme at most health systems and your health system.

, is probably no different. So. The. , all right, so we'll skip over that. And I was going to read the rest of the article, but there's no reason to, , I have another article I'm going to get to in a minute, , that talks about the projects that we should be doing. So. , I think this year is going to be this year and beyond.

It's going to be about workforce efficiency. Right. And, and even more than that, so workforce replacement is the right concept. But isn't really palatable, but I think the financial realities will set in and palatable or not. It will become an imperative. In the next year. So if I were an it leader in a health system today, I'd look inside it first.

But at the same time, you will need to be working with clinicians because that is where the situation is an incredibly cute. So what kind of projects are we looking at? Robotic process automation. Anything. That is workforce replacement. Right? So if we can automate processes, And if we can automate enough processes in a single workflow or those kinds of things, we are going to generate hours.

And that's what we're measuring right now. How many hours can we replace with technology? Okay. It is. Unfortunately again, it's workforce replacement. That's how you're thinking. Maybe not how you're talking, but it's how you're thinking. So RPA. How can we automate as much as possible? And this is where we moved to DevSecOps because when you treat your infrastructure as software,

You can then automate the heck out of it. But if it's still hardware based, if you're still thinking about how many servers am I dropping in and so forth and so on. You're still in the wrong paradigm. We have to think of automation. All right. The next thing is AI. If we've learned anything from chat GPT, it is that this technology is advancing.

Rapidly. And so if you look at chat GPT and I've been playing with it, I've been asking you questions. I keep a tab open on it. In my, , in my browser. It's incredibly helpful. It's a new way of searching the internet instead of. Asking it for, instead of going to Google and saying, you know, find this.

, I'm going to chatty beauty and I'm asking this specific question that I want to answer. And it's giving me very specific information back from the internet. It's, it's incredibly powerful. And if you see. That progress you'll know that chatbots and guides and assistance that is going to advance rapidly. So I would be looking at that because that replaces phone calls, anytime you can take a phone call and eliminate it, you are going to increase the efficiency of your health system.

All right. So in terms of AI in the clinical setting, and I was focusing on. And in it first, but I'm going to make it a little tangent here. So. , AI in the. , clinical setting. The best example of this is the work that Mayo's done may was taking like 18 items. Where they're utilizing AI. On, , data elements that are without question right there, just it's telemetry and that kind of stuff. And they're taking that, they're bringing it together and they're presenting insights in the clinical workflow.

To the clinicians. So they've gone through, they've looked at that there's transparency in the AI model. And they said these are relevance, relevant information that can be derived from the information that we have in the EHR. And so now they're taking it to the next level. They turning that data. Into information and it doesn't have to happen there. There's not a cognitive load on the clinician.

Right they're not having to do the math. They are not having to look at multiple locations. Bring that information together. It is brought to them. Those handful of data elements are being brought into an AI model. And what it's delivering out is relevant information that is not putting a cognitive load on the clinicians.

Again, time, hours, minutes. That's what we're trying to improve on here. And in the process, you're going to increase the quality of life of the clinicians. All right. , rationalization. Rationalized as many applications as possible, but make sure you follow through, get rid of the contracts, rationalize those applications, simplify your environment. Simplification of the environment is going to save hours and minutes. , computer vision is one of those areas where we are as a computer vision, coupled with AI is giving us the opportunity to replace people.

In certain circumstances. Right. Instead of a one to 16 ratio for nurse sitters, , in a, in a virtual setting. We can get to one to 32 because the computer vision is getting really accurate. And it's able to identify things. So you don't have to look at 32 different screens. It's going to prompt you at that time. And these models are getting incredibly accurate.

, ambient clinical listening. I'm not going to go into too much detail and we've been pursuing that as an industry for awhile. But again, if you can save clinicians minutes and hours, you should do that. That is what the focus is going to be for the next year, two years, three years. , clinical personalization.

I'm just going to go down there. Highly efficient workflows by individual practice. Each in every field in your system uses the EHR differently. The system has to fit them. Generic is not good enough. You're leaving time on the table. Hours of clinician time and you can't afford to do that. So, and you also have to seriously consider doing things differently, perhaps even approaching common tasks.

Differently. So let me give you the example. The example is a, an article that's from Becker's number of my chart. Messages drops after hospitals start billing for them study fine. So there's a study in JAMA, looking at the work that UCSFs did, and USCSF did a policy change that said clinicians can bill for certain messages.

And the people who put those messages in our prompts. With that. And essentially the number of messages dropped by 2%. Just the number of messages generated. Now, remember, during the pandemic, the use of messages. Absolutely exploded. Right. And so this drops it by 2%. That's clinician time. Okay. Now we can argue accessibility to care and that kind of stuff. This is a highly efficient.

All those things are really true, but you have a limited resource now, and that limited resources, clinician time, and you have to guard that time. And anyway, this is just a different way of doing it. I don't know if this is right for your house or something or your community or not right for your health system and community, but it's, it focuses in on what I'm trying to focus in on, which is.

, thinking outside the box, thinking about how do we reduce the amount of work that we're actually doing and how do we make that work much more efficient. Okay. So that's the, so what the, so what is you take all this negative information and it should give you an idea, put in context what we need to be focusing on.

Over the next 12 to 24 months. So that is the marching orders moving forward. Highly efficient. Operation. , and really high workforce efficiency, even to the point of workforce replacement. Not that I would talk about it in those terms, I can, cause I'm not an health it leader at this point. , but that's how I'd be thinking about it, for sure. Like how do we eliminate hours, hours, and minutes. That is what you're going for ROI in terms of absolute dollars.

, is, is not what I'm focusing on right now. What I'm focusing on is hours and minutes. And that will turn into an ROI in terms of dollars, but that's a, I almost started talking about that with the leadership team. We need to start thinking in hours and minutes, we have a workforce shortage. Where we're going to have to make some cuts. We're going to have fewer workers. How are we going to get the work done?

All right. That's all for today. If, you know, if some of that might benefit, one of the things you could do that could really help us at this week, health is share this show and the others in our, , channels. , the conference channel, this is the newsroom channel and we have the community channel with your peers that would really help us greatly.

, they can subscribe wherever they listen to podcasts, apple, Google, overcast, Spotify, Stitcher, you get the picture and you know what, send it out to somebody and say, Hey, we should talk about this. This was, , an interesting. Set of things that bill gets to throw out there because he's not currently a CIO for a health system and he can talk freely about how we should be thinking about things. I'm curious what you think.

Just an idea for an email to a friend. , all right. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders. Short test 📍 artist site. Check them out at this week. health.com/today. Thanks for listening. That's all for now.