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October 17: Today on TownHall Sue Schade, Principal at StarBridge Advisors speaks with Jane Moran, Chief Information and Digital Officer at Mass General Brigham. What differences did she notice stepping into the healthcare environment after her experience of over twenty years in global organizations outside of healthcare? Jane discusses extensive organizational changes and shares her ambitious strategy to increase efficiency, enhance stakeholder experiences, and streamline operations with the help of technology. We look at the application of AI, not just in diagnostics and treatment, but in administrative functions. What difference can digitized learning and AI make in healthcare processes?

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Transcript

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.

the second Tuesday of every month.

, no regular working . Book yourself in seven or eight hours worth of learning. Get yourself accredited.

People are excited about it. Listen, there's been a lot written about lifelong learning. you know, Virtually working together and learning together has created a real positive culture

Welcome to Town Hall, a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels and events dedicated to keeping health IT staff current and engaged.

We've been making podcasts that amplify great thinking to propel healthcare forward for over five years, and we want to thank our show sponsors. who help to make this happen. Armis First Health Advisors, Meditech, Transcarent, and UPerform. We thank them for investing in our mission to develop the next generation of health leaders.

Now, on to our show.

Hello, I'm Sue Shade, Principal at Starbridge Advisors and one of the hosts for the Townhall Show at This Week Health. Today, my guest is Jane Moran, Chief Information and Digital Officer at Mass General Brigham, which they fondly call MGB. Jane joined the organization in 21 after serving as CIO for global organizations outside I'm looking forward to hearing about her challenges moving into healthcare and what she has been able to accomplish with her team in her first two years at MGB.

Welcome, Jane.

Thanks, Sue.

Happy to be here. Great. Good to have you. Let's start by having you briefly introduce yourself and tell us about Mass General Brigham.

Sure. Hi, everybody. Jane Moran. As Sue said, I've been here at Mass General Brigham for two years. MGB is the largest employer and the largest health system in Massachusetts, and we're undergoing a very exciting period of transformation.

Our aim at MGB is to become an integrated academic healthcare system of the future, and there's a lot to accomplish. So I'm really happy to be here. Be part of this journey.

Great. Can you tell us just a little bit about your experience prior to coming into MGB and the healthcare industry?

Sure. Sure.

I actually spent a bit more time than 20 years. So I started out my career in the early 1990s as a developer working on portfolio management and trading platforms, sort of like the early FinTech. In about 2001, I ended up working for a company that got acquired by Thomson Financial and became the Global C I O for Thomson Financial.

It merged with Reuters. I became in like 2010, the global c i O for Thomson Reuters. And then in 2014 I ended up meeting the then c e o at an event. Of Unilever Paul Pullman and I became the global c i o for Unilever, the big consumer products goods organization. In those roles, starting out as a developer, I was coming out the c i o role a little bit differently than some CIOs, many CIOs actually.

do not come from a development background. They come from a business background, and generally finance, HR, procurement. I came at it looking at architecture, enterprise architecture. I was an enterprise architect. I worked on data systems, and I developed a lot of like core code. Back in the day custom developed applications, I frequently found myself over the years integrating with big platforms, big ERP and CRM platforms, so became very familiar with configuration and really how these big enterprises functions.

with thousands and thousands of systems. So kind of tying that forward to healthcare, I don't have any healthcare background prior to this role. My experience was as a patient. So that's how I really, I came at this role, was really with my own personal experience and excited to innovate in healthcare, in digital.

That's great. And we all come to healthcare as patients as well. And I think whether we've grown up professionally in the healthcare industry or not being able to maintain that perspective from the patient's view is critical. Well, I hope we can get more into what you are talking about in terms of the integrated academic.

health center of the future as well as the transformation that you're going through. So I know when we spoke first last year it was interesting. I had been the CIO, as at Brigham and Women's for many years. So it was interesting to hear your perspective coming into, a healthcare provider organization for the first time.

So if you can share some of the challenges and some of the key accomplishments in the first two years that you and your team have had, that'd be great.

Yes, absolutely. So Mass General Brigham has two very large academic healthcare systems. The Brigham, where I used to work, and Mass General Hospital.

And we have a dozen or so other hospitals as part of our ecosystem and community health centers, etc. We serve a population of about 2 million. We have about 2 million active patients. So it's a fairly large... network. There's about 80, 000 employees internally, maybe a bit more with consultants. And really kind of looking at , the entire organization holistically from a technology perspective, there were some really bright spots of technology, some really great technology being done on an individual level.

That's no different than a lot of multinational companies. Do you have great technology? However, I was finding that technology, while good on an individual basis, could not be scaled to benefit the rest of the organization. So we came at this, and we had thousands of programs going on. Thousands.

So there was a lot of duplicate work, a lot of duplicate systems, a lot of duplicate spend. And healthcare, as you know, is really challenged in terms of finances. So we needed to really be more efficient in how we were managing, as well as really look at it from the patient perspective and a patient is a patient, whether they're going to the Brigham, or they're going to see their primary care physician, or they go see a specialist, and we found that their experiences were different because the systems were different.

The processes were different. So we've looked at this under the lens of. First and foremost, who are the stakeholders in our environment? And we tailored our technology portfolio around the experiences that we wanted our stakeholders to have. So we really looked at our patients. our clinicians, we call them our care teams, our researchers, and our employees.

And if there was a fifth sort of experience, it was just around the core technology. So having efficient, network capability, and Wi Fi, and device management, and conference rooms, that all was kind of inconsistent and a bit of a mess, quite honestly. So we really looked at it from that lens, and from a technology perspective, we started to look at all the different technologies we have internally, and we grouped them into logical capabilities called a reference architecture.

This is really, familiar to many technologists. You have an enterprise architecture. It's sort of like the plan. You wouldn't build a house without an architecture plan. And sort of, we were just building and building. Good stuff, not so good stuff. But there was no overarching plan. So we put together a reference architecture.

Basically, that reference architecture said, here are the different business capabilities we want to support. Here are the technologies that we think, the platforms that we think should support them. And let's look at all the custom code. Is there another alternative? Is there a technology company out there that can fill this gap?

And so we started to think through our portfolio that way. And I guess if there was a 3rd piece of this, it was then. Having the experiences, knowing what we wanted to deliver, having our architecture plan, and then looking at our partnerships. You know, Who are we doing business with? And it turns out, we were doing business with Epic, that's our electronic health record.

But we didn't have strong partnerships with really any of the other tech companies. And so my experience coming in is that healthcare is pretty typical for healthcare, but it's atypical for anybody who's listening to this podcast. It's atypical for any for profit organization. Most for profit organizations, banking, for example, if you have strong relationships with all the hyperscalers, Microsoft, Google, AWS.

Software as a Service, Workday, Salesforce, and, solutions for infrastructure like Cisco, like Dell. And so, we went to those companies and started to work through how could they look at our portfolio with their core capability and help us streamline those functions with a platform that would serve everyone in the organization.

So it's a combination of experiences, architecture, and partnerships. I think those are the three biggest things that were both a challenge, but also our accomplishment over the last two years is to orient ourselves around that construct in terms of how we manage technology MGB.

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 Okay, that's a lot to follow up on there. One of the things that I think we were talking about just before we hit the record button that would be useful maybe for you to describe is how you organized this effort in terms of the staff. I know you've got the major areas and it's fairly different than it was and probably fairly different than a lot of.

Other large healthcare providers. So that could be really useful to understand for our listeners.

Absolutely. So, we had CIOs at all the different hospitals. So there was 15 CIOs. We had 15 CISOs, Chief Information Security Officer. They were all at the local level, working fairly independently. And then we had some centralized groups.

So, the EPIC team on the electronic health record, or the ERP team on PeopleSoft. We're in the process of moving to Workday, but they were centralized. So we had some centralized teams. We had a data and analytics team. And then we had all these people out in the field, managing one off systems and...

Theoretically deploying centralized assets is definitely a disconnect between what folks needed in our hospitals and institutions and what folks were doing centrally. So the big change was to change the role of the CIO. And in the past, the CIO had been managing Epic and managing infrastructure. We completely changed that role.

Our CIO is Dr. Adam Landman, whom you know and Adam is Lee. He's the CIO from GB and his role, all the CIOs of all the hospital systems report up to him. His job is to serve that community to ensure that they have a consistent. digital and technology experience and that we're actually serving them. He calls his team Solutions Delivery and I love that because it's about solving the problems every single day that folks have on the ground with technology.

So getting into the weeds, so to speak, in terms of what are they, what do they need to do? How can we better serve the people that are serving patients? And I think that has been the single biggest change that we've made In our centralized teams, there are centralized teams. So infrastructure, for example, or we have a VP of enterprise systems, which is, you know, our, human resources, our finance, our procurement systems.

We have a VP that is working on digital research operations. Those are centralized platforms. Those teams work in construct. We're Agile delivery. They're working in scrum teams with the people that are working in the CIO organization. So if you're on a centralized team, you're also working with somebody that is serving our patient community, our care team community, and our research community.

And that we have roughly 2000 people in this group. So it's a fairly large organization. I wanted to bring us closer to understanding what are the needs of people on the ground. So I think that has been the biggest shift. Is that I think the second biggest shift in people is just upgrading everybody's skill set.

So, this was an environment where there was a lot of custom code. And, like I said, not a lot of knowledge of other systems and technology partners. A lot of it was on prem. So not a lot of use of cloud service technology, whether it's software as a service, platform as a service, data as a service.

So we've been on a mission to really educate our employees around modern digital best practices and get folks up to speed. .

That's great. I'm gonna ask you a follow up question on the upskilling, if you will. Yeah. And with a team that big and with an organization where there has been a lot of custom, as I'm aware of, and people who've been there a very long time.

Any particular strategies that you had For sure.

Yeah, I mean, you need to create the culture I think, and encourage people, they, they need to want to upgrade their skill set. I think it's been a lot of fun. We've got a digital work and learn day one day a month. We've told our staff. The second Tuesday of every month.

, no regular working, no meetings. Book yourself in seven or eight hours worth of learning. Get yourself accredited. We're paying for accreditations with these big tech companies and some of the tech companies are giving us the content for free, which is great. But I think it's really great.

People are excited about it. Listen, there's been a lot written about lifelong learning. It keeps you fresh. It's fun. And it's fun to work on new things with new people. I still have a fair amount of the staff that works from home. So I think that this kind of, virtually working together and learning together has created a real positive culture in digital.

We work very hard, we're having fewer number of incidents, so that's got to be a positive outcome of all of this, and people are knowledgeable about what they're doing and Listen, I want to create career paths for folks. I mean, some people, they just want the paycheck and I get that. And we need people like that, but I'd say the majority of our staff really want to learn and just really weren't afforded the opportunity in the past to move out of their current role and do something slightly different.

It's motivating for the organization. To learn new things and to implement new technologies that have such a, significant impact on our community.

That's great. That's some great tips in terms of your approach to training. I'm going to pivot to AI. So, Dr. Keith Dreier. who I know from my days there. He's Chief Science Officer at MGB now. He was recently named in Time's 100 Most Influential People for his groundbreaking work in AI and imaging, I think in particular. So can you tell us about his work and any other ways that you're using AI at MGB?

Yeah, lots of good uses of artificial within our organization. I would describe Keith's role, Keith is a radiologist by training, and he has been working for a long time in using AI. With imaging, radiology imaging. So that's his area of expertise, and he's looking at it in terms of how can we develop, deploy, monitor.

to solve problems around diagnosis. So, for example, you have an image of a lung of a patient and can you look at that image and, using AI with millions of other images, start to understand what you're seeing in that current image of a patient and if that patient has any probability of developing cancer before you would actually see like obvious cancer in the image.

And so Keith's team is actually getting there where they can look at images and start to predict diagnoses of diseases or conditions and also looking at treatment using AI and looking at images. I think it's a really, they're just really at the beginning of this, but it's very powerful.

In terms of what are the algorithms that you would look at to kind of, diagnose. his focus has been, the integration of diagnostics, informatics and data science. With imaging and using AI sort of externally for patients, right? I'm using AI. Our team is using AI more internally.

So I'll give you some examples for administrative and improving administrative functions. So one of the things we're working on right now is Relieving our care team burden there's something called that many of the listeners will be familiar with MyChart, it's the application in Epic that helps manage your account and many patients, whether they're on Epic or Cerner or any other system, there's usually a utility that patients can email or text their clinician.

That has become, over the years, burdensome to our clinicians. They go home at night, they've got three or four hours worth of email back to patients. So we're really trying hard to reduce that burden. So we're using AI to look at the in basket to either direct some of the patient queries to nurses or to other administrators so that can answer the question more easily or to resolve the issue.

So a patient needs a... Prescription refill. If we can match that with the prescriptions that they have in their file, then we can automate some of these processes. We're also using AI to help draft responses. So based on the patient record or, whatever the question is, there's a lot that we can do to draft the record.

The clinician still needs to approve the note, go in and Help write the note, but it's giving our clinicians a way to relieve that really, it's a huge burden to go back and spend a bunch of time in email, writing to your patients. And our clinicians care so much, that's really important to them to close the loop on these communications.

Another use of AI is we're experimenting with a company called Abridge, which will help our clinicians when they go into a visit with the patient record the session, but it's generative AI. Generative just means you're creating a new data set off of the current data set. So what Abridge does is record the patient record.

a session, translate it, and then look at that translation to create a visit note as a draft. And we're getting really good sort of response on those visit note drafts. They're 90 percent, this is not live, but , if it works out, we've had a pilot, we're running another pilot. This could also save our clinicians quite a bit of time and how this is meaningful for them.

it eliminates the burden of having to go back and write the note. But for our patients, you know, how many times have you been in with your own doctor and they're behind the screen typing as opposed to looking at you and having to So I think it will also improve the patient experience. But there's dozens of other ways that we're using AI.

We're using it for capacity planning across our hospital systems. And so just, estimating open beds and then helping us to figure out if we have some sort of a health. event, or even if it's like a rainy night in Boston, and there's, a Celtics game if that we are running low on capacity, how can we reroute capacity to other hospitals so that we don't have a backup in our emergency department?

So, I think it's endless. I do think that, people get nervous about AI. I would just say, That we're having a very thoughtful discussion across our organization about the ethics of AI, how it's being used, what are the review processes like, ensuring that patient data is private, and how do we, we use that.

So it is a complex technology and requires a lot of thinking around how you employ it, but there have been some really positive use cases.

That's great. I know we're almost at time and there was more I wanted to talk about. We could just go deeper on the AI. A lot of great use cases. Good to understand what Keith is doing.

We'll try to get a separate interview with Keith about his work. on one of the shows at This Week Health. And I think, you know, if you're open to it, I'd love to talk to you again and go into this deeper and cover some of the other stuff that we didn't get a chance to cover. Any closing thoughts for this time?

Yeah, I

think, thank you for the opportunity, Sue. I don't think there's been a better time to be in. technology, and especially in the healthcare industry. I think that there's going to be a lot of positive transformation in healthcare through digital capabilities that will be positive for, our patients, our clinicians, our researchers, and our employees.

And so I'm really positive about the future of healthcare, quite honestly. I think that we're entering a really good

time. Great. Thank you, Jane, for all your insights, everything that you're doing. And I do hope we get a chance to talk again. So thank you.

Thank you, Sue.

  📍 I love this show. I love hearing what workers and leaders on the front lines are doing.

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