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Today on This Week Health.

We work very, very closely with our key partners that we have with our big systems, because if we can get it there that's the most ideal state, right? Instead of having to try to integrate and build in over all this additional functionality with utilizing another vendor. Sometimes it doesn't work. It's not always easy trying to integrate those other systems into your big EMR.

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Welcome to the This Week in Health Community TownHall conversation. My name is Reid Stephan, VP and CIO at St. Luke's health system in Boise, Idaho. And I'm joined today by Michelle Stansbury, who is the VP ofI nnovation and IT Applications at Houston Methodist. Michelle. Good to see you again. Thanks for making the time.

You too. And thank you for having me.

Glad you're here. I like to start out and just ask folks to, to share about their career background. I just think it's, there's so much learning and insight that we can glean as we talk to each other. Would you take just a few minutes and talk about your education background and the path that you follow that led to the role you have today?

Sure. Well, a traditional kind of background went into business administration, but really started my career often oil and gas. Of course, being from Houston, Texas that is a path that many took and was in that. Was in that kind of role for a few years and then got lured away by technology because of course, compact computers was here in Houston as well.

And so went to go join that organization really was very impressed with that company. In the midst of me being there, I ended up having my first child and had a few problems with my first child. And so got to see firsthand what happens in healthcare. Once I got through sort of the initial shock and everything seemed to be doing well with my son both my husband and I were looking around and just were so amazed at the activity.

And things that were occurring in healthcare space, that we both made this key decision that we really wanted to get into healthcare, which is interesting because I think as you talk to most individuals it isn't about let's, let's say it's not about money or anything else. I think it's just that greater power that people want to provide service.

It's a service oriented position. And so my husband actually went back to school, got a second degree in biomed. I just started looking around and was very, very fortunate to end up at Houston Methodist. So I've been there for 29 years. Still hard for me to say that at some point and hard to believe, but it's just the thing that I appreciate the most.

I don't do direct patient care. But want to make sure that we're doing everything possible for our patients. The consumers, our clinicians that are doing direct patient care. How are we making all of their lives easier with technology? And that's always kind of been my background even from when I was in oil and gas. And of course, when I was at the technology company of Compact.

That's a great story. And I'm always just moved by is so few of us have kind of just stumbled into healthcare. It's either been there's a family legacy or there's been an experience we had that brought us to it and it just really adds a powerful why to the work that we do. And I think you are. I have to ask. I think people that watch, this are going to be curious. So the horse picture behind you, and I've seen that before in calls, we've been on just take a second and share what that means to you and why it's there.

Sure. Well I will tell you from the time when I was old enough, probably to talk I wanted a horse. I didn't grow up in a family where we had a ranch to anything else. I've just always loved horses. So of course, when I got old enough and on my own, I bought my own raised my kids in the rodeo circuit. So from the time that they were five all on, up through college we did all kinds of rodeo activities.

I was on the road every weekend pulling horse trailers, loading them around. So you will see my, you can't see my office right now. It's all kind of in a Western theme. They're just beautiful animals. And through just, you really do get a special bond to them and appreciate. So I saw this picture.

It was in an art gallery and I just loved it. And it doesn't hold any significance of one of my horses that I have, but anyway, just really appreciate the arts and the beauty of the photo.

Yeah, well, I would expect nothing less from a Texas gal, so that's, that's great. Okay. Next question. So I've, I've always just been fascinated and impressed with the center of innovation that Houston Methodist has. I love how transparent you are about, about what you're doing and what you have the website that talks about. The strategy, the organizational structure, what you're working on. And I think you've been involved with that from the start. Can you just share your perspective on the journey things that you've learned, what you're most proud of with this center of innovation?

Our journey started about four years ago when there was really about three or four of us, it really started looking out kind of overall in the industry and what caught our eye was. Digital health technology was just kind of coming up around and the conference server circuits and kind of talking through it.

But the other piece that was up and coming were all of these outside influencers who were getting into healthcare, thinking they were going to solve healthcare. Right. They could do it much better than healthcare systems theirselves. And what they were doing, they weren't really trying to build hospitals.

That's, wasn't what they were trying to do, but they thought they could make the healthcare process easier. And we all know we've had issues of, okay. It filling out paper forms. How are we making scheduling easier? And so if you relay that back to digital technology and other industries, Airline banking food, all of that has been made so much easier with us from our smart phones.

And so this group of us, we kind of started looking around and thinking we need to do something. And it was almost, we took this approach of, we can either let these outside influencers disrupt us or we can disrupt ourselves. And that's what we decided to do. And so. we Kind of created this small, our chief innovation officer.

She calls it like a book club and it was okay. You all, you all start researching, finding out what's out there really kind of starting off in the patient access area. What's going on. And we would meet on a weekly basis. And so we called ourselves the DIOP group and it was digitally innovative, obsessed people.

And our CEO absolutely loved it. Stuck. He won't let us change us, even though we have formerly created our center for innovation. But what we found was clearly there were opportunities for us within overall our organization of how we could disrupt ourselves. And that's where it is that it has started.

And we continue to do that. And I I would say probably one of the things that. Extremely proud of is all the things that we have done on the front end to make that process for our patients getting services from us, much easier than it ever was before. I mean, we've made scheduling easier on the phone we've created where they can text us.

And it's, bi-directional texting where they absolutely love it. We've created these care pathways with an outside vendor that we use. Give sort of bite size information, which is what patients want. They don't like these long drawn individual notes, tell them everything you have to do right before you come in and everything, what you have to do outside.

And it's given it to them in their preference of communication. I mean, we've seen a reduction in length of stay. We've seen our H cap scores go way up. Our readmission rates go way down. So that was really a good implementation force as well, as I said, it was on the texting.

I think our probably next biggest area that we really believe. And I know you and I have talked about this is voice. And so we did one of the things that we do within ourselves. We do what we call a family review. So we get an idea about something that we need to change or make better. And so we began to do this family review of products.

Well, what's out there. Who's the new vendors that we're looking at who has the best product. It may not be a well-known company or something that is. Very widely distributed amongst other health systems. But if it's new, then we bring it in and we test it, we test it, we pilot it. And then if the pilot successful, we will deploy it.

And the one thing about our Diop group that I will say that has been extremely beneficial for us because when we say, and I know a lot of people say this, we fell fast or we succeeded. And the reason we are able to do that is because we all hold these dual roles. Even our chief innovation officer, she is our CEO of our largest hospital in our health system.

And she's our innovation myself, the reason the dual titles being an it applications and an innovation. Not, it takes a lot of additional work for those people who hold these dual roles. But guess what, we know where our problems are in our institution and they're all somewhat different for everyone. And if we pilot something and it's successful, we know how to roll it out quickly across our organization, because you're talking about operations and it partnering together to make it happen, but kind of getting back to voice.

We looked, we know that there's nuance, that's out there. A couple of other products. We saw some functionality lacking. And so we partnered with one of the largest voice vendors that are out there with Amazon, because look, they do it extremely well. And so we've built our own ambient listening product.

We've built a product that we use in our ORs, and we're now really partnering with them on how can we utilize voice within nursing. To help with the documentation burden that they have as well. We've got Alexa devices in all our rooms. We've got iPads and our rooms as well. So why not utilize those pieces of technology to help the efficiencies with overall within our clinic clinical staff?

So what we have found extremely beneficial is when I talk about partnerships with vendors, especially these new vendors, they've sometimes they have a product that's working in maybe a smaller institution, and they're looking for a really big health system to modify it, make it better so that they could sell it.

That's, what's been great for us. I cannot tell you there's probably five use cases that we've had with vendors, where we took their small niche product that they had, and we helped them develop it. So now that it's multifunctional, it is not just that small niche function that they were looking at and it's really helped us. And we've done it very quickly.

Yeah, that's great. There's a couple of things that I heard that really resonates. So one is this, this Diop is innovation group. You started with really important that you have people involved in that work that are close to what the real problems are. If it's too far removed, if it gets too theoretical. It may, it may look great on paper, but that may not resonate or translate to what the, what the need actually is. And you also described that you started with patient access, and I think that that's so smart because certainly through COVID we've seen just this. Really surge in this era of hyper consumerism and, and our patients and our consumers now are not just wanting, but expecting that we're going to meet their needs the same way they're met and other industries.

And I think that's such a target rich environment that's out there. So I also want to talk a little bit about voice. And so I'm glad that you raised that, that I'm aware of the work you've done with Amazon, which is amazing. Can you talk though, maybe in a more pragmatic sense. So for organizations that have already made huge investments and other vendors, whether it's an epic or whether it's a nuance, how do you kind of balance looking at different solutions? But still looking at it through the lens of good stewardship and a, an architectural roadmap that maximizes what you own. And then maybe trying to fill in the gaps with some of these emerging or niche kind of solution.

it's a valid question because I tell you one of the things that we do look at, and we work very, very closely with that Epic because it is our largest transactional system. And we all know, look, it's expensive, right? To put these systems and in, you don't want to just completely move away from them. But one of the things that we do look at is not just functionality, but what's the user experience. And if the user experience, isn't the most ideal that we're looking for and know that our consumers and patients want we'll challenge that.

And we'll look for other opportunities with these other vendors that you know of, how could we utilize their product and maybe it's for a short period of time. And this is where we challenge epic and we do work very closely with them. Ultimately what we tell them, we want to use your product. We want it to be embedded and that's what we're using.

But if we can't get that experience right away, then we're going to use this other product. Now we'll work with you to help you get, to make sure that it's better. And when that functionality comes along, We'll go away from the other product. I'll give you a prime example. There was a, and I, I'm not going to name a company name here, but there was one that we were looking at and it was really more for on ed check-in process and having all of that paper flow and everything work well, we found a company and it was really good and we were very close to going in and signing a contract with them.

But we sat down with epic and we said, look, this is where your product is lacking. And they said, Well, we have it on our roadmap, but when is that? One of the things that epic has been doing very well with us is they moved up that functionality in their roadmap so that we could get it within eight weeks.

So we forego, we decided not to go with that other vendor and wait for that functionality. So it's not to say that we always will, we will work very, very closely with our kind of key partners that we have with our big systems, because if we can get it, there that's the most ideal state, right.

Instead of having to try to integrate and and build in over all this additional functionality with utilizing another. vendor Sometimes it doesn't work and you have to, and then I will tell you, it's not always easy trying to integrate those other systems into your big EMR. But you know, we have been fortunate to figure out ways and we've got a great integration team that we work with at Houston Methodist. And we have been able to make it work, but that's not always the case. And, Here's why I would tell you you'll learn very, very quickly. What we did is we, and I said, patient access, we've got a group of us. And we said, let's look at all the entry points into Houston Methodist and follow those entry points and look how difficult.

And you'd be amazed if you truly sit down and really follow all those entry points and look at the friction, everybody this is a buzzword it's been around forever, right? Frictionless. But it was a huge eye opener for us. We had many points where it led into a dead end hole and it was just amazing that it had been there forever.

And we didn't experience in that time. So I would just tell anyone that is thinking especially in senior leadership everyone's no, no, no. Look, we made a huge investment in epic or Cerner, keep it there. Don't go out. You have to look at the experience of what you're getting and is that experience what you want your patients, because guess what, if it's easier someplace down the road, that's where they'll go.

And I think that's what we have found is that. For coming to the doctor's office or having some sort of imaging or lab or whatever, those are things you don't necessarily have to go to that health system for. You can go down the road and, and that's where I think that it's been most important as us is that we want to make sure that experience up front is very good.

There's the same with us that we look at the, the patient is at the center of everything that we do. So if that experience is good, you will maintain that relationship with us. So that's what I would say. And even just kind of in talking on voice, I will tell you one of the pieces. So not only that experience from our consumers and patients, we look at the experience from our clinicians as well.

So what we looked at in some of these other products where I told you there was missing functionality that we felt was important for us is the reason why we look to partner with Amazon and building our own ambient listening product.

Okay. I think that's great. Well, and on that note experience is king and I could not agree more. Michelle, it's always great to talk to you. I learned things every time. Thank you so much for spending a few minutes with me today.

Sure. Thank you very much for having me 📍 read.

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