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 Welcome to this Week in Health It where we discuss the news, information and emerging thought with leaders from across the healthcare industry. This is Bill Russell recovering healthcare, c i o, and creator of this week in Health. It a set of podcasts and videos dedicated to training the next generation of health IT leaders.

This podcast is brought to you by Health Lyrics, helping you build agile, efficient, and effective health. It Let's talk visit health lyrics.com to schedule your free consultation. We are recording a series of discussions with industry influencers at the Chime Hymns 2019 conference. Here's another of these great conversations.

Hope you enjoy. Alright, I'm gonna have you introduce yourself because you know, we talked about this on the last podcast is people spell your name wrong and say your name wrong. So, I, I wanna make sure I don't do it wrong. So if you could introduce yourself, if that be great. Great. Hi everybody. . Hey, I'm Tressa Springman.

I'm the, uh, senior Vice President and c i o at LifeBridge Health in Maryland. So it is Tressa, not it's Tressa. Got it. It's the word assert backwards. Oh really? Hmm. Although I don't think that was intentional . It was also my great-grandmother's name. Oh, there you go. My, uh, my son is dating a, a girl named Tess and she makes it clear it's not Tessa, it's not, you know, it's Tess.

Was it short for content? No, it's Tess. That's that man. I like, I don't know. When you name a kid, you gotta really think through what's, what's the ramifications are, are the emails gonna be misspelled for the rest of their life? So I went by nickname Teddy for 18 years 'cause I didn't wanna deal with trash Therea Theresa.

So. Yeah. And now you figure as a c I O they should at least figure out and learn your name for sure. Although at this point you'll see my last name spelled wrong all the time. . Well, it's two N's. Two N's. Got it? Yep. Alright. So enough about your name. Uh, we're here at the, uh, CHIME conference. I, uh, you know where I wanna start?

I wanna start at the last Chime conference where you presented on your, uh, digital hospital. Great. Um, give us, uh, actually just give us the like two minute of what you guys are doing around the digital hospital. Great. Well, I'm sure you're hearing quite a bit about virtual care. Right. And in Maryland, under a global budget, we're really being encouraged to make sure that, um, our sites of care are the most clinically effective at the lowest cost point.

So that's really created a huge catalyst for telehealth. So, yeah, because, because there's a different, uh, mechanism done by the state of Maryland in terms of your reimbursement. That's correct. We have a waiver from Medicare and are under this global budget, which really encourages us to make sure that we're keeping the growth and the total cost of care beneath the rest of the nation.

So it caused you to step back and say, we need to be innovative here. And so what'd you guys end up doing? That's right. Well, aside from making investments in a lot of non-hospital components of the healthcare delivery system, um, We now are putting, um, technology in place in the form of this virtual hospital to help us really facilitate those transitions of care that in other care settings where it's still reimbursed through volume, um, you see those silos in the episodes.

You know, you, you come into a doctor's office or you leave a hospital and, and that's the end of your interaction at LifeBridge with the virtual hospital. Um, driven by telehealth and then a, a digital platform and technology as well as c r m. Um, we are creating digital touchpoints when our patients, before our patients come after they leave, and are really using it to encourage in referral activity.

So, so, texts, emails, those kinds of touch points, video chat. Oh, okay. Yep. And is, is this initiated by, so your, your virtual, um, I keep calling it different things. That's right. Virtual hospital. What? Virtual hospital. Virtual hospital. Virtual hospital. Um, is that primarily, uh, staffed by, uh, non-clinician? It's more, uh, care navigator kind of people.

So when we started out, we had a traditional contact center, but did appointment scheduling and we started bringing on board clinicians, um, largely mid-level, um, or EMTs actually. And, you know, LifeBridge, one of our core, um, facilities, Sinai Hospitals of Jewish tradition, so our virtual hospital has, um, US privileged mid-levels and nurses that went home to Israel.

And so now for a much more cost competitive footprint, we have American clinicians, um, fulfilling this role in our virtual hospital. So it combined at one point so that it was not just the administrative getting that appointment scheduled. But if while scheduling that appointment, it's clear you have a patient in crisis, it turfs right on over to the clinical agents who then attend to the patient in that way.

This is interesting. I mean, the reason this is interesting to me is 'cause uh, we, I end up talking to a lot of clients who have five, six call centers. Yeah. And so if you have that kind of, first of all, if you have that kind of footprint of five, six call centers, you probably have some dysfunction and whatever, just lines of communication.

But this could be a path where they go all, we have these five or six call centers and we bring it in. But it, there's an awful lot. I would imagine. There's a lot of workflow work. There's a lot of tremendous process. Tremendous, tremendous. You know, and that's where it starts moving traditional healthcare it into other industries.

That's where, um, contact center software, so that these agents, we have agents in the Philippines as well. Oh wow. So that they have a very, uh, just like an agent at Amazon, they have a very . Prescribed approach to how they are to handle a patient or a consumer who's inquiring. And those are just scripts that are built in the contact center software.

And then c r m we have, um, Evariant, which is a, a form of Salesforce sits on top of Salesforce. Right? Yeah. And, and that helps us make sure that if we've already had a touch with you, either a physical touch or a digital touch, that we know about it and we can use that to continue that relationship we have with you.

Um, and then it's all wrapped around, uh, you know, telehealth and then just traditional workflows. And of course, um, we're integrating these different tools with our E M R because obviously that's essential to the provision of care. Right. So you're, um, your, your virtual hospital, how many screens do they have?

That's one of the things we see in these call centers. They have Sure, sure. Lots. Lots. You know, 10 50 screens, lots of, well, so my C M I O is also the medical director of our virtual hospital, and when he joined me, . His passion was, um, telehealth and virtual care. So we, we brought his interest and his talent together and used that as a launch point for our clinical and administrative contact center to move into this idea of a virtual hospital.

Um, you know, we do hundreds a week now, um, virtual ed tele triage. So you walk into one of our ERs and within five minutes you're getting a video visit by an er, mid-level. So you've seen a clinician and the orders are entered, um, the meds might be prescribed before you even actually physically see the care provider.

So it's, it's really helped, um, create not only, um, better care, but also, um, it's, it's, it's really helped us to start leverage technology like other industries have. So you . Just listened to this session on machine learning and ai, and it was out there. I mean, it's, it's big. Yeah. Um, and I think people assume that, uh, I mean, I've talked to some people who are saying, Hey, you know, what are, what are health systems doing with machine learning and ai?

The, the real answer to that is it's been implemented in a lot of different areas. Sure. But it's still kind of daunting. I mean, how do you, when you walk out of a session like that, um, I'm, I'm curious how other CIOs feel when they walk out, like. Oh gosh, that's, this is too big to even start, or is. It's like, okay, I'm gonna break this down for my team.

How do you, what do you walk out and think? So it's funny 'cause at the end of that session, I, I turned to Doug, who's an old friend of mine, Doug Abel, and I said, wow. As if we don't have enough going on, I better get up to speed. But, you know, um, and I'm a, I'm a, a junkie when it comes to reading things and Harvard Business Review.

I think it was in January of this year, they did a fantastic summary piece dissecting the basics of AI and the different levels of maturity. And um, it really helped give me confidence that, um, yes, it's a tremendous opportunity, but we don't need to go crazy just yet. You know, we're used to business process, uh, automation.

Automation. Right. And that's the first level of ai. Yeah, like scripts. Yeah. Keyboard emulation. Yep. R r, that's first level ai. Yep. So that's the things that we're doing very well. Um, the next layer, we at LifeBridge have a tool that sits on top of our E M R called the Rothman Index. And it gathers all these tidbits from the E M R and it alerts our physicians when, um, there's a patient who's decompensating.

That maybe doesn't physically look like they're going south, but their, uh, E M R and lab values, et cetera, are suggesting that they're going south. Um, again, these are predictive, you know, I think that, um, . , if we step away from just the practical reality that there's so much information out there and that our ability to really have the right information at the right time for the right decision, um, it, it's just overwhelming.

Think of the burden that is, that brings to our care providers, right? And then start thinking about how to use the ability for AI and machine learning to have access to all of that very quickly. Merely to offer up to your care providers what's the right decision to make right? And allow them to still make that decision, but have it be a fully informed decision where they don't have the burden of having to read 90 hours a weekend just to keep up with it.

So look, I think there are vast opportunities. We've all seen it though, with even the self-driving car. It's been talked about for a long time. Yeah. It hit that peak now it's coming down a little bit. That's right. It's coming down. It'll get there. I think it'll get there. Um, it would be great if the majority of the time in our life we're all about things with intention and choice.

Um, I don't know if it's gonna be in, uh, our near future, but it's exciting. Yeah, it is exciting. So this conference. This conference is huge. 45,000 people, a million vendors and, and whatnot, education sessions. Um, I assume you come with a plan. I have a plan. Um, is the plan around making sure you look at certain technologies, certain, I mean, what, what kind of plan do you have?

Sure. Um, well first of all, the c I O forum is huge. Right? Really, um, being able to touch base and, and see if, um, My peers are feeling what I'm feeling, seeing what I'm seeing, reacting in the same way, have a tip or two with something I'm struggling with. Um, then I absolutely spend the majority of the next day.

Tomorrow I'll be walking the floor. Oh, really? So you walk the floor? I walk from zero. Do you hide your CIO title thousand Sometimes. Sometimes I put on a pair of tennis shoes and, uh, you know, usually people are, are pretty kind to me. But, you know, I'm really looking for a couple things. I'm looking for new entrants.

I'm looking for trends 'cause you see them on the floor. Right? And then I'm looking to hunt down specific vendors that I have a conversation in need of. Right. Um, and then of course, the, the rest of the time is, is really, um, connecting with peers that I haven't seen. Um, I have a couple of contracts I need to close.

Um, and a few different, um, I would say . One fantastic thing about HIMSS is that as a c I O, usually there are about five to 10 vendors that you've been curious about, but your schedule just can't accommodate it. And, you know, when you commit your time and, and you're bringing them to your organization with all their resources, ooh, excuse me.

Um, at least I can feel, um, better about coming here and learning a little bit more than asking them to commit all those resources when in fact, We might not have anything that's even a close fit. So I usually take some opportunity to do that. So I have about six or seven very specific vendors where, um, I need to become a little bit better educated.

And so do you bring team members to sort of get them, bring them along? I try to, I have a couple folks here this year. I, um, we, we had a big go live last week and we are in the middle of a big due diligence. Um, there's always something, it always happens at the end. There's always something, right. I, uh, I'm most excited or my, uh, I'm responsible for h i m as well, and we have an h i m analyst and, um, she's fantastic, but she's, you know, young and bright, eye and bushy tailed and has never been to himss and I'm, I'm trying to make sure I can hunt her down so that like, By the end of day one, her head isn't just spinning.

Yeah. It's like, Hey, this is a lot bigger than we think it is. Right, exactly. It's like, yeah, it's huge. Uh, yeah. I, the, uh, the, I had two very young, uh, . They don't like being called this, but millennials who came to HIMSS one year, and I said to 'em like, look, when you come back you have to do a presentation to everybody.

That's right. And they did videos just like this and came back and they're like, Hey, we talked to this vendor, this vendor, this vendor. And it, they did such a great job, actually. Some of that's sort of inspiration for That's neat. These conversations. So that's neat. Um, yeah. Uh, the, so are you hearing anything from your peers that has sort of surprised you or interesting in terms of trends or, or things that people are saying?

No, not really. I mean, I'm, I have my ear to the ground on the, um, announcements by c m s and O N C. I think they will obviously be very informing. As you know, when budgets are tight, you always start with, all right, what's on the list? That's regulatory in nature, so, That'll definitely have some influence.

I'll tell you the two things I'm hearing so far, and I'm purposefully getting in front of people and having these conversations. Uh, one is around social determinants. It's like, yep. Um, okay. It's getting to a point now where we have to figure out something. We don't know what we're gonna do yet. Yeah. Um, I mean, some are further along than others, but they're like, all right, we gotta gotta figure out how we're gonna get this data together.

Uh, and then the other is around, uh, the consumer digital experience. Oh, big time. Although, although your virtual Yeah. Cares somewhat that, but, um, people are saying, yeah, it's more than a phone. It's more than, you know, it's Yes. Um, you know, how are we going to interact with these people? How are we gonna break down like this morning talk?

How are we gonna break down those silos of loneliness and isolation and whatnot? So those have been two of the things that are I, I think are interesting. People are looking at technologies to say, how do we move care out of our ? Facilities, which yeah, will be an interesting financial challenge, . Well, so we're definitely doing that because we're incented to do that, right?

Yeah. So, I don't know, it'll be interesting to see, but you're right. I mean, I think we're really on point for digital and consumerism. Um, feeling very comfortable about that. We have a long way to go. Um, but I think we're that you don't team something to feel too confident at this point. That's right.

That's right. They've got a lot work to do. That's, that's right. Well, the good news is there's a lot of neat work being done down here. I mean, with Epic breaking apart their APIs and, and App Orchard and whatnot, you're seeing some creative solutions, and that's where I think you guys collaborating and talking about what you can bring to market is interesting.

Well, I, I say, you know, there's a whole generation that grew up without watching. Because Apple invented the smartphone . And wouldn't it just be up to Apple to reintroduce a watch? And now, you know, yeah. All, all these folks want watches. Again, it's the same. When we started in the industry, we were doing native development.

I worked for E D S I was a systems engineer, right? And now we went to vendor off the shelf. And EMRs largely are becoming a utility play. And we're gonna innovate around the edges doing development again, it all comes back together. Just comes back together. Ressa. Thank you. Always appreciate the time.

Thank you. Appreciate it. I hope you enjoyed this conversation. This shows a production of this week in Health It. For more great content, you can check out our website at www.thisweekinhealthit.com or the YouTube channel at this weekend, health it.com/video. Thanks for listening. That's all for now.