June 2, 2022: Today on TownHall Mark Weisman, CIO and CMIO at TidalHealth interviews Mark Crowe, Director of IT Innovations at Sentara Healthcare about creating the hospital of the future. What does he look for when choosing what new technologies to implement? How can smart TVs be used to improve the patient experience? How does he get early adopters on board with new technologies?
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Today on This Week Health.
One of the key strategies that I've learned has been that it's great to find a new technology, but deploying it by itself is going to have a zero net value. The critical factor here is identifying which pressure points that a clinician wants to change the operational workflow, and you attack it from that segment first.
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Welcome to the show. My name is mark Weisman. I am a practicing internal medicine, physician CIO, and the CMIO. And today I have with me mark Crow. Who's the director of it innovations at Sentara healthcare and welcome to the show.
Thank you. Good to be here, Dr. Weissman.
Now I appreciate that. Appreciate you joining me.
So, mark, I think you have one of the cooler jobs in the world. So if you would just go ahead and tell people a little bit about what you do.
Yeah. So that's a bit of a laundry list, but we'll start with the beginning. How's that? First of all, I've been with Sentara healthcare now Southeastern Virginia integrated delivery network for 18 years.
Now. It's hard to believe somebody would put up with me that long, but nonetheless so I'm in this new role called director of it innovations as of November of last year. Prior to that. I was in the it infrastructure lights on doors, open job. And in fact that was my entire career. So it was pretty exciting to be in this innovative space.
So. One of the reasons I thought we should, we get together and chat had to do with one of your projects that you're working on, building a, renovating a new hospital and getting to pick the toys, so to speak that the staff gets to use to make the patient experience better, to make the provider experience better, the nurse experience better.
So I was hoping just to pick your brain at a high level. When you're tackling an innovation project like this, what are you looking at? What are you starting? Are you looking, are you looking at patient experience first or do you look for the clinical toys? What are you going for when you want to make a hospital of the future?
Yeah, that's a great question, Dr. Weisman, and I think what I'll do is I'll pan out a little bit further from that question into more of the. Situation that every hospital is dealing with. The reality is patients are looking for an experience as close as possible as they can to home. Now, you and I both know that there's only so much you can do on an inpatient experience, but to the extent that technology has dramatically changed over the past three years, There's opportunity there for us to really dig in and lean into the technology that's been delivered to date and what we're seeing future state.
So one of the things that our CIO came to me with was, Hey, you're going to be going to a conference your news soon. I'm going to give you some homework What does that patient room of the future look like I said, well, it depends on who you ask that question. It's a rather broad question. Wouldn't you agree?
So the answer really came down to what are the pain points for a patient when they're inpatient? Now I've been very fortunate that I have not been an inpatient in my entire life journey so far knock on wood, but family and friends around me. And some of the significant pain points that we look at from a digital technology enablement perspective is where do they see a educational gap.
Where do they see a schedule gap and how can they get Netflix to work on the darn TV I'm oversimplifying, but that's really what it comes down to. So one of the first things that we hear from patients over and over again is they have no idea what their schedule looks like each and every day. Am I supposed to get an x-ray?
today am I going to get lab work done today? When are they going to come in and take my vitals? All of that information is usually delivered manually or verbally from an LPN that walks in the room, a CNA that walks in the room or a doctor or a nurse. So that type of work area is where we're really looking for opportunities to reduce administrative type work, if you will.
So. The clinicians can work at the highest level of their licensure. So those types of questions. When am I scheduled for an exam? What am I scheduled for an x-ray lab and so forth? Why not display that within the patient's room? So what's the biggest common denominator that most consumers in the us have in far as consumer electronics in their living room or den today.
Well, they're using a lot of voice, but it sounds to me like you're looking to put the white board manufacturers of the world out of business because that's the tool of choice for every hospital. So tell me, what do you got up your sleeve here?
Yeah. Good question. There's common denominator. You'll find if you look at the consumer electronics data analytics, a large number of folks have smart TVs built into their house.
And more often than not, they have more than one. I personally have put my foot down and said only one, only one, but the truth is the digital whiteboard is a value added for our patients and for our clinicians, if you integrate it with the various devices, such as real-time location systems, where when the clinician comes in the room, That digital whiteboard can actually convert to significant information for the clinician to see about that patient.
Well, rather than looking at that operational expense and the capital needed to outfit every patient room with a digital whiteboard, why not start looking at smart TVs? So part of the homework I did at this conference was to see who's in this space and that's a new term to me, to the new spaces patient engagement.
Integration, I think that's the Gartner magic quadrant for this area. And so it comes down to the common denominator that we want to deploy is what's in most consumers, electronic world that is a smart TV. So. Is there a vendor out there that can take the opportunity around a digital whiteboard and integrate that into their entertainment system, which we're hoping would become a smart TV and see if there's a value added there.
So there's several vendors in this space that I've been looking at, and I'm really excited about what they're delivering especially the iterations they've done just over the past two years during the pandemic of we're getting a lot of feedback from our patients, all the things about. All the things about their procedures discharge information.
Usually that's been handed to them at the end, by a clinician, a nurse, a patient advocate, and is hopefully delivered with that patient advocate at their side family member or proxy. And sometimes there's a miss there. So why not have all of that be a part of. Entertainment system so that we can deliver content for education.
We can actually do survey scores, a liker scale, one to 10 on basic things. Like how's your experience so far, build it into the TV and integrated into your EMR so that you have raw data that you can aggregate within your electronic medical record. And you can see how you're doing almost in real time with your patient experience.
And then you can have your patient advocates and your clinics. Pivot based upon what they're seeing as a result.
There's so much in there that we can unpack, let's start with the EMR portal, because that's a tool that many health systems will have. Is that all you need, you just deploy the portal and off you go my chart, if that's your, if you're an epic shop or whatever Cerner has, or is the market bringing more unique tools to bear.
What I'm finding is that most EMR platforms do in fact, have a patient again. I'll call it a platform. Although some of them are mostly just a product, not necessarily a platform but there, Sarah, there is some incumbent value with utilizing the EMR platform and their product solution for patient engagement, because by nature it's already integrated.
So you do end up reducing your overall CapEx for investing in infrastructure to support another platform that layers over topic for your EMR. So there is advantages to do that. However, what I'm also seeing is that the. Players in this specific vertical have an enormous amount of CX and UX that they put in front of it.
That quite honestly, I'm not sure the EMR systems have really had a lot of deep bench when it comes to CX and UX, because their focus has been on the EMR. Not so much on what is the patient experience look like as an inpatient? So I am seeing a lot of what I would call very modern, very slick, very easy to navigate interfaces, built into these platforms that are external to the EMR.
I want to talk to you about the interface just for a second, because.Voice Technology is definitely one area where consumers are getting very comfortable with they'll say, I don't want to say it now because my phone will start talking to me, but hen word that starts with an S and they can ask for their nurse to bring them something, or the nurse could ask, Hey, could you page Dr.
So-and-so for me? Are you seeing anything from the large players in this space, whether that's an Amazon or an apple or. Players. Is that something you saw on your travels as you were exploring this hospital?
Yeah, there's a couple of vendors that are working with your I'll call them your ambient technology platforms.
There's not an enormous amount of space in there right now, because I think the skill sets are still not at a level where you can find a common operational value across an inpatient hospital experience. We did have a conversation. I had a conversation with Cedar Sinai. They actually did a pilot about 20. 16, I believe it was with 100 patient beds using a product that came through their innovation labs, their accelerator program called Ava a I V a. And what they found was that patients absolutely loved it. The limitation though, was that their primary. Was always around entertainment. So Alexa play Spotify for me and various movies and music and so forth.
Clinicians had a harder time uptaking and adopting. However, they did find that because there was some training opportunities with the operational side leadership decided it was value enough. Patients loved it to expand it. And I believe they expanded it up to 700 beds, current state and the feedback has been a higher utilization and adoption rate coming up from the clinicians.
We're not in a position right now with our deployment of new hospital, whereby we're seeing the value so much as we want to prepare for I'll call it behind the drywall work and make sure that we have the infrastructure in place so that when we see the value and when we have the opportunity to work with it, we already had the infrastructure in the back and the backbone is ready to support it.
What does that look like? You're talking about microphones or cameras or both. What do you, what are you embedding into the wall?
Yeah. So mostly what you're going to find is the technology wants power over ethernet. So if you can do a cat six behind the wall, you're pretty much going to be able to connect to anything.
However, there are areas where we're seeing wifi is a lot more dominant, especially when you're talking about RTLS. A lot of the infrastructure for your wifi now has. RTLS and RFID built into their access points. I, in fact, I just had a conversation with our CTO about the capabilities of that. So it's going to be a mix.
I remember way back when ZigBee networks were being used for RFID. And there was just too much of an incremental cost involved with adding that infrastructure, even though they say, yeah, just plug it into the wall on a power socket. Okay. So who's going to support it. Who's going to sustain it. So that's always one of the primary focal points is not just the initial capital outlay, but how do you operationalize at scale it and sustain it?
You had mentioned adoption being an issue. Talk to me when you're bringing some of these initiatives forward. You're the innovation guy. How are you getting that? Those early adopters to kind of jump on board with you. What's the, what's your strategy?
Well, the first strategy is talk with the business units about operational readiness.
One of the key strategies that I've learned has been. that It's great to find a new technology, but deploying it by itself is going to have a zero net value. The critical factor here is identifying which pressure points that a clinician wants to change the operational workflow, and you attack it from that segment first.
So. If you're going to deploy an ambient technology that promises to reduce keyboard time so that the physician or the clinician can actually spend more time at the bedside, you have to prove that value through demonstration, through iteration. And then from there at your executive operational level, you can actually syndicate that knowledgebase.
So that the adoption rate by nature starts out higher than what is anticipated if you're just going to deploy a widget. So the key factor I've found is identifying operational readiness, identify operational sponsors and have them syndicate this at their level. Not at it. I think one of the biggest mistakes I made in my career early on was.
Assuming that technology and it folks can run a project, operationalize it and show metrics of success in and of ourselves. And that's just absolutely not the way to run.
Good point. Absolutely. We all have our battle scars in that. Stacey, I think speaking of battle scars, we all have them where we thought something was a really great, innovative idea.
We brought it in. And didn't quite pan out the way we want that happens in the innovation space. It's just the nature of the beast. What's been your experience. How do you recover? How do you cut your losses? What do you do in that scenario?
We've been the victim of our own failures. When it comes to pilots.
Now, pilots are a dime a dozen. And the perfect example was when our EMR came out with a product called my chart bedside, and we had it thought it was a phenomenal product. And in fact, one hospital said, Hey, we'd love to pilot this here's the problem. It wasn't scary. It wasn't sustainable. The capital expenditure for deploying tablets for every patient room was exorbitant.
But more important than that, the feature set and functions that wasn't anything that a patient wanted in the first place. So the lesson learned there was okay, it's a great product. It looks cool. It has a lot of features built into it, but if it's not something that operations desires patients' desires is just going to sit there.
And in fact, it is still in the pilot mode several years later. Well, here we are fast-forward to what is the patient room in the future? Look. Our EMR epic has designed some even better opportunities within the, my chart platform to include my chart bedside TV. So now if you have my chart on your smartphone or you have it in the portal, There is a capability built in to control the smart TV.
So you can have edutainment, so you can engage in those H cap scores and you can in one way shape or another order meal service, if you're integrated with your cafeteria system. So I think that's the biggest lesson. Again. I know I'm repeating myself. It deserves repeating, never deploy a technology without engagement from operations, the funding from executive leadership and champions within there to syndicate that information across everyone.
Where are you finding your innovation ideas? Where do they come up to you or you walking the trade floors? What's read it in a journal. What comes, How do you find your inspiration in your stories?
Dr. Wiseman. I'll tell you it comes from all the above. There's no such thing as one person that is a genius when it comes to all things, innovation and innovation, as comes in many flavors, there's clinical innovation, there's technological innovation, there's clinical trials and research that we have to do that lead into innovation.
And then there's your investment areas where you have angel investors, VC who are coming together with the recognition that. Innovative space within healthcare is just ready for disruption. So what we've actually created at our company at Sentara healthcare is a intake process. Whereby ideas are submitted to us at the most generic high level.
We don't care what it sounds like. It looks like, feels like, just send it through and let's talk about it. So we actually have an intake form that comes from our intranet website through our portal where people can submit an idea. For anything. I'll give you a perfect example of one where everything just seemed to be the perfect storm and everything came together.
We had some fantastically creative nurse leaders at Sentara Norfolk, general hospital, downtown Norfolk, Virginia, who submitted an idea that had three sentences in it. We want to digitize our patient experience. We'd like to digitize our discharge forms. We'd like to do that on our floor. That was it. Fast forward to where we are now.
We've discovered that we have an enterprise. Effort right now to completely create a consolidated and unified edutainment system across every hospital. And that vendor allows us to create custom content, whether it be video or PDF or whatever, and that's their intake opportunity for them to do a video, which they wanted.
They wanted every member of their staff to create a video saying, hi, my name is mark Crow. I work on nine K at Sentara Norfolk general hospital. Welcome. Here's what you can expect. Everyone wants to do that. So now we have a platform in which we can do that. And it all started with one idea and finding out that we already have an enterprise solution underway.
Then on top of that, we had this, what is the patient remove? The future looks like. So now we have. Three different ideas to different platforms, but of which all of which can interface together. So we're pretty excited that we've, we're now syndicating the idea that no idea is a dumb idea, bring it forward and let's see we've got something there.
Absolutely love it. So let's wrap up here, mark. I think this has been a great conversation, very tactical hands-on information for those CIO. CMIS that like to play in that innovation space? You are a wealth of knowledge. Obviously. You've been doing the it thing for quite some time, and it's great to connect with you again, back to my Sentara days, mark was always known as being one more innovative leaders out there.
So it was great to great to speak with you once again, mark.
Thanks for having me, Dr. Wiseman. I enjoyed it.
All right. Have a good.
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