1 00:00:00,260 --> 00:00:00,905 - Hello everyone. 2 00:00:00,905 --> 00:00:01,945 This is Brian Zimmerman 3 00:00:01,945 --> 00:00:03,225 with the Becker's Healthcare Podcast. 4 00:00:03,645 --> 00:00:06,265 Thanks for listening to this episode on AI 5 00:00:06,265 --> 00:00:08,825 and healthcare, how to align and optimize. 6 00:00:09,445 --> 00:00:11,465 I'm pleased to be joined today by Dr. 7 00:00:11,535 --> 00:00:14,905 Tony Oliva, VP and Chief Medical Officer with Nuance 8 00:00:14,965 --> 00:00:16,825 and Microsoft Company to discuss how 9 00:00:16,825 --> 00:00:20,065 to integrate AI into your organization's yearly strategy. 10 00:00:20,565 --> 00:00:22,425 Dr. Oliva, thank you so much for being here today. 11 00:00:23,225 --> 00:00:24,965 - Oh, thank you. Happy to be here. 12 00:00:26,025 --> 00:00:27,325 - So, so let's dive in and, 13 00:00:27,325 --> 00:00:29,205 and the first question here is I'm just gonna, uh, 14 00:00:29,205 --> 00:00:31,885 prompt you to introduce yourself a bit further for folks 15 00:00:31,885 --> 00:00:34,005 that, that might not be familiar with you and, and, 16 00:00:34,005 --> 00:00:36,405 and just share some, some background about the work you're, 17 00:00:36,405 --> 00:00:37,605 you're doing at Nuance now. 18 00:00:38,275 --> 00:00:39,565 - Sure, sure. Sounds good. 19 00:00:39,705 --> 00:00:44,405 So, Tony Oliva, um, I am a family doc by training 20 00:00:45,015 --> 00:00:46,685 prior to coming to Nuance. 21 00:00:46,715 --> 00:00:49,645 Came back, came to Nuance in about 2013. 22 00:00:49,775 --> 00:00:54,365 Prior to that, I spent, uh, 15 years on the hospital side 23 00:00:54,425 --> 00:00:57,405 as a Chief Medical Officer, both at the, 24 00:00:58,005 --> 00:01:00,445 starting a very small community hospital all the way up 25 00:01:00,445 --> 00:01:01,445 to large system. 26 00:01:01,925 --> 00:01:06,565 CMO came over to Nuance, really focused on, 27 00:01:06,905 --> 00:01:10,165 um, their physician facing and 28 00:01:10,185 --> 00:01:13,645 or CDI, clinical documentation, improvement products, 29 00:01:13,645 --> 00:01:16,885 revenue cycle, um, improvement products, 30 00:01:17,585 --> 00:01:18,645 and obviously some 31 00:01:18,645 --> 00:01:21,365 of the physician documentation opportunities 32 00:01:21,435 --> 00:01:24,245 that were going on at that time with Dragon 33 00:01:24,425 --> 00:01:26,965 and now with, um, uh, Dax 34 00:01:27,225 --> 00:01:31,445 and, uh, other products that we've had, uh, over time, 35 00:01:32,185 --> 00:01:33,765 uh, as we've made the transition 36 00:01:33,785 --> 00:01:37,885 and now recently acquired by, um, Microsoft. 37 00:01:37,985 --> 00:01:40,365 And that whole process has been completed. 38 00:01:40,465 --> 00:01:43,485 So we're also, um, uh, part of a, 39 00:01:43,965 --> 00:01:47,365 a much larger organization now, um, with, uh, 40 00:01:47,885 --> 00:01:52,205 a lot more access, obviously, to technology, research 41 00:01:52,385 --> 00:01:54,725 and development than we had prior. 42 00:01:56,155 --> 00:01:57,645 - Yeah, yeah. CER certainly. 43 00:01:57,745 --> 00:02:00,965 Um, and, and it's an exciting time in healthcare in terms 44 00:02:00,965 --> 00:02:02,525 of the, the rise of technology, 45 00:02:02,525 --> 00:02:04,445 different technologies thinking here, course 46 00:02:04,445 --> 00:02:05,725 of artificial intelligence, 47 00:02:05,785 --> 00:02:07,965 and our healthcare leaders have always sought 48 00:02:07,965 --> 00:02:09,725 to really cut costs and drive efficiency. 49 00:02:09,785 --> 00:02:11,685 But, um, the, the hopes 50 00:02:11,685 --> 00:02:14,445 for an interest in artificial intelligence being used for, 51 00:02:14,505 --> 00:02:17,525 for these purposes has really grown substantially. 52 00:02:17,685 --> 00:02:19,805 I, I, I think everybody would acknowledge that. 53 00:02:19,825 --> 00:02:22,925 But curious to hear your, your exact take on 54 00:02:22,925 --> 00:02:24,885 what you think the real opportunities for, 55 00:02:25,225 --> 00:02:26,405 for artificial intelligence, 56 00:02:26,405 --> 00:02:28,445 thinking about machine learning here too, different, 57 00:02:28,445 --> 00:02:30,085 different types of technologies in healthcare. 58 00:02:30,085 --> 00:02:31,205 What's, what's your assessment? 59 00:02:31,875 --> 00:02:33,685 - Yeah, it's, it's really exciting. 60 00:02:33,925 --> 00:02:36,445 I mean, and, and really in just the last five years, 61 00:02:36,715 --> 00:02:40,205 it's just been, um, just been amazing at some of the things 62 00:02:40,315 --> 00:02:42,005 that have been coming out 63 00:02:42,005 --> 00:02:43,565 and even what we've been able to do. 64 00:02:44,105 --> 00:02:48,325 You know, I, when I think of opportunity inside healthcare, 65 00:02:48,545 --> 00:02:50,765 you know, cost savings always comes up. 66 00:02:50,965 --> 00:02:55,645 I think we also forget sometimes about the revenue side, um, 67 00:02:55,785 --> 00:03:00,045 and where some of these technologies can, um, support, 68 00:03:00,305 --> 00:03:02,005 you know, revenue production too. 69 00:03:02,305 --> 00:03:05,005 And we've cut a lot of cost out of healthcare. 70 00:03:05,385 --> 00:03:08,085 And, uh, you know, the, the old adage, you, 71 00:03:08,265 --> 00:03:11,725 you can't cost cut your way to success, 72 00:03:11,865 --> 00:03:13,325 it just isn't going to work, right? 73 00:03:13,425 --> 00:03:17,005 So there has to also be some focus on the revenue side. 74 00:03:17,145 --> 00:03:20,365 And yes, there's obviously some great efficiencies 75 00:03:20,545 --> 00:03:25,405 and the ability to, um, again, reduce costs with ai, 76 00:03:26,145 --> 00:03:27,605 but there is also 77 00:03:27,605 --> 00:03:30,365 because of those efficiencies, um, 78 00:03:30,435 --> 00:03:33,925 some real opportunities at at achieving revenue, 79 00:03:34,775 --> 00:03:36,965 especially on the physician side 80 00:03:37,025 --> 00:03:39,805 as we talk about opportunities to potentially 81 00:03:40,645 --> 00:03:44,605 increase patient loads, capture better documentation for 82 00:03:45,325 --> 00:03:47,205 improved revenue on the billing side. 83 00:03:47,465 --> 00:03:49,005 So there's many pieces here 84 00:03:49,005 --> 00:03:50,805 that the two kind of come together. 85 00:03:51,425 --> 00:03:53,365 Um, and I never wanna lose sight of 86 00:03:53,795 --> 00:03:57,605 what AI could potentially do on the revenue side as well 87 00:03:57,605 --> 00:03:58,605 as on the cost side. 88 00:03:59,685 --> 00:04:02,055 - Yeah, I, I, it's a great point, uh, in terms 89 00:04:02,055 --> 00:04:05,735 of not having this overemphasis on, on, on cost reduction, 90 00:04:05,735 --> 00:04:08,175 that's not gonna be enough to, to achieve success. 91 00:04:08,355 --> 00:04:11,695 And, and also it doesn't really, um, get that mindset, 92 00:04:11,695 --> 00:04:14,095 that focus on innovation where, where a lot 93 00:04:14,095 --> 00:04:16,215 of healthcare leaders are, are trying to go and, 94 00:04:16,235 --> 00:04:18,895 and thinking here too about sort of, of course, you know, 95 00:04:19,255 --> 00:04:21,255 hospital margins are still very, very thin 96 00:04:21,435 --> 00:04:23,215 and some, some real challenges there, 97 00:04:23,275 --> 00:04:25,815 but there has been some stabilization, um, 98 00:04:26,035 --> 00:04:28,375 and I, I think perhaps a re-engagement among, 99 00:04:28,375 --> 00:04:31,935 among some organizations in terms of thinking about their, 100 00:04:31,935 --> 00:04:34,695 their long-term strategic planning, capital planning. 101 00:04:35,115 --> 00:04:37,415 Um, and, and really thinking here, my my question 102 00:04:37,415 --> 00:04:39,175 for you then, Tony, is thinking about all of this, 103 00:04:39,595 --> 00:04:43,015 how can leaders really effectively incorporate AI into 104 00:04:43,015 --> 00:04:44,175 their business strategies? 105 00:04:44,715 --> 00:04:46,455 Are there any best practices you can share? 106 00:04:46,505 --> 00:04:48,975 Tools, resources, any, any, any tips for folks out there? 107 00:04:49,725 --> 00:04:51,135 - Yeah, so great question. 108 00:04:51,475 --> 00:04:52,935 Um, boy, I, and, 109 00:04:52,955 --> 00:04:55,495 and the opportunities are sort of mind-boggling, 110 00:04:55,895 --> 00:04:56,935 when you think about it. 111 00:04:57,475 --> 00:04:59,055 Um, which is a challenge, right? 112 00:04:59,055 --> 00:05:00,135 Because, you know, the, 113 00:05:00,155 --> 00:05:02,135 the concept is sort of where do you start? 114 00:05:02,475 --> 00:05:05,775 And I think there's a risk that there's a, a feeling 115 00:05:05,775 --> 00:05:07,735 that AI can sort of solve everything, 116 00:05:07,995 --> 00:05:10,415 but AI doesn't have to solve anything there. 117 00:05:10,415 --> 00:05:11,975 There're everything there, there are things 118 00:05:11,975 --> 00:05:13,535 that are already working, right, that, 119 00:05:13,535 --> 00:05:15,735 that don't really need to be impacted. 120 00:05:15,955 --> 00:05:18,935 So how do you start to think about, um, this 121 00:05:19,885 --> 00:05:22,775 margins are returning a little bit, um, 122 00:05:22,995 --> 00:05:26,295 but volumes aren't is what, you know, we're sort of hearing. 123 00:05:26,475 --> 00:05:28,335 So that's a real challenge. 124 00:05:28,875 --> 00:05:30,535 You know, there's some uncertainty is sort of 125 00:05:30,535 --> 00:05:31,775 where did the volumes go? 126 00:05:32,035 --> 00:05:36,335 And they've not returned to sort of pre covid, um, numbers. 127 00:05:36,515 --> 00:05:38,815 So that's a concern I think going forward. 128 00:05:39,035 --> 00:05:41,255 And we're really facing some headwinds. 129 00:05:41,475 --> 00:05:45,695 Um, I think on the policy side as far as where, um, 130 00:05:45,695 --> 00:05:48,375 dollars may come, especially in the Medicare 131 00:05:48,435 --> 00:05:50,855 and other, um, government programs. 132 00:05:51,035 --> 00:05:53,255 So there's still a significant, 133 00:05:53,445 --> 00:05:55,295 significant challenge out there. 134 00:05:55,955 --> 00:05:59,245 So the question is, you know, whether there's dollars that, 135 00:05:59,665 --> 00:06:04,245 you know, you, you want to sort of target towards innovation 136 00:06:04,385 --> 00:06:06,805 and AI that are becoming available, 137 00:06:07,145 --> 00:06:09,245 or can you even afford not 138 00:06:09,245 --> 00:06:11,485 to invest in some of this technology? 139 00:06:11,785 --> 00:06:15,765 And as I think about it, you know, the, the best places 140 00:06:16,015 --> 00:06:19,205 where we can make the biggest impact 141 00:06:20,025 --> 00:06:23,325 is on those things that require human beings 142 00:06:23,425 --> 00:06:25,125 to do something, right? 143 00:06:25,385 --> 00:06:27,085 So, uh, you know, the, the, 144 00:06:27,225 --> 00:06:29,445 the electronic record's been a great asset, 145 00:06:30,025 --> 00:06:32,485 but you still have to get stuff in there, right? 146 00:06:32,585 --> 00:06:34,245 It does, it doesn't do you any good 147 00:06:34,255 --> 00:06:36,525 until something gets put into that record. 148 00:06:36,905 --> 00:06:40,405 So when you think about the manual processes, 149 00:06:40,405 --> 00:06:42,765 whether you're a physician, whether you're a nurse, 150 00:06:42,995 --> 00:06:45,005 whether you're on the administrative side 151 00:06:45,025 --> 00:06:48,005 or the revenue cycle side, coding, whatever it may be, 152 00:06:48,535 --> 00:06:53,005 there are manual, um, uh, things that have to happen. 153 00:06:53,765 --> 00:06:55,965 I have to put documentation into the record. 154 00:06:56,475 --> 00:06:59,205 Well, can I do that in a way that makes that easier 155 00:06:59,465 --> 00:07:01,605 and less time consuming for me? 156 00:07:02,265 --> 00:07:05,485 I'm a nurse, I have to document lots of things all day long. 157 00:07:05,705 --> 00:07:08,485 Is there a way I can use technology or voice 158 00:07:08,745 --> 00:07:12,925 or, um, automation to get some of that stuff into the record 159 00:07:13,065 --> 00:07:17,565 so I don't have to look at it, go back to a, um, 160 00:07:18,045 --> 00:07:20,045 a computer and actually put it in 161 00:07:20,185 --> 00:07:23,885 or do something physically to get that information in? 162 00:07:24,425 --> 00:07:27,725 Can I evaluate a record using AI to 163 00:07:28,405 --> 00:07:33,205 identify opportunities to improve, uh, diagnosis capture, 164 00:07:33,665 --> 00:07:37,285 or on the inpatient side, improve revenue capture 165 00:07:37,675 --> 00:07:39,525 that should be appropriate 166 00:07:39,585 --> 00:07:41,205 and is appropriate for what we've done? 167 00:07:41,205 --> 00:07:42,245 We just haven't caught it. 168 00:07:42,745 --> 00:07:46,945 So I think as you start to look at ai, those are the places 169 00:07:47,155 --> 00:07:50,545 where you really need to start to focus on. 170 00:07:51,005 --> 00:07:55,105 And I think if you start to sort of prioritize those things, 171 00:07:56,005 --> 00:07:59,265 and then you add in the concept of 172 00:07:59,265 --> 00:08:01,145 where can I save cost doing those things, 173 00:08:01,285 --> 00:08:02,825 and where can I actually add revenue 174 00:08:03,285 --> 00:08:04,305 put to those two things? 175 00:08:04,325 --> 00:08:06,305 And if those two things sort of merge, 176 00:08:06,425 --> 00:08:07,465 I could save some money 177 00:08:08,005 --> 00:08:10,545 and increase revenue, I think that starts 178 00:08:10,645 --> 00:08:14,065 to really become your target as we think about that. 179 00:08:14,485 --> 00:08:16,625 And unfortunately, you just, 180 00:08:16,725 --> 00:08:18,265 you can't boil the ocean, right? 181 00:08:18,455 --> 00:08:20,785 It's, there's just so many things that you can do, 182 00:08:20,785 --> 00:08:23,585 and there's so many people working on so many little niches. 183 00:08:24,405 --> 00:08:27,385 You have to decide, uh, as an organization, you know, 184 00:08:27,385 --> 00:08:30,065 where your big opportunities are, where, 185 00:08:30,065 --> 00:08:32,145 where are you gonna get the biggest bang, 186 00:08:32,155 --> 00:08:35,945 where are your biggest challenges from the standpoint of 187 00:08:36,495 --> 00:08:38,465 both, um, efficiency 188 00:08:39,005 --> 00:08:42,985 and, um, potential of improving revenue and, 189 00:08:43,005 --> 00:08:44,145 and cutting costs. 190 00:08:45,325 --> 00:08:47,575 - Yeah. So you hit on, hit on a few things there, 191 00:08:47,575 --> 00:08:50,715 really thinking about revenue costs 192 00:08:51,055 --> 00:08:52,475 and sort of also the, the, 193 00:08:52,475 --> 00:08:53,875 the human beings involved improving 194 00:08:53,875 --> 00:08:54,995 their experience as well. 195 00:08:55,010 --> 00:08:56,405 Well, um, it, it, 196 00:08:56,405 --> 00:08:58,085 and I appreciate the, the specificity 197 00:08:58,085 --> 00:09:00,325 around do the documentation example too. 198 00:09:00,445 --> 00:09:03,005 I think that, that, that illustrates sort of where this, 199 00:09:03,005 --> 00:09:05,325 this planning can really be impactful. 200 00:09:05,905 --> 00:09:07,765 Um, I'm, I'm curious if we can get some more 201 00:09:08,005 --> 00:09:09,125 specifics maybe on the table here. 202 00:09:09,665 --> 00:09:12,685 Um, if you could tell me, sort of describe what it kind 203 00:09:12,685 --> 00:09:15,445 of looks like when, when an organization achieves alignment 204 00:09:15,545 --> 00:09:17,165 in their technology Yeah. 205 00:09:17,165 --> 00:09:19,725 And annual or multi-year business strategies. 206 00:09:19,845 --> 00:09:22,365 I think it's, it's one thing to talk about that as an idea, 207 00:09:22,545 --> 00:09:26,205 but what does it look like in practical measures and, and, 208 00:09:26,205 --> 00:09:27,485 and are there any success stories 209 00:09:27,485 --> 00:09:28,565 results that come to mind here? 210 00:09:29,235 --> 00:09:30,605 - Yeah, no, so absolutely. 211 00:09:30,625 --> 00:09:31,805 So as you think about, 212 00:09:32,385 --> 00:09:34,445 we could talk about the dragon ambient 213 00:09:34,445 --> 00:09:35,525 experience, for example. 214 00:09:35,825 --> 00:09:39,045 So the ability to capture ambient conversation 215 00:09:39,105 --> 00:09:40,885 and convert that into a note, right? 216 00:09:40,945 --> 00:09:43,965 So in the, in the current world, you know, um, 217 00:09:44,145 --> 00:09:46,805 or the majority of time we go in 218 00:09:46,805 --> 00:09:49,325 and see a patient, we capture a lot of information. 219 00:09:49,385 --> 00:09:50,885 We either enter it into the record 220 00:09:50,945 --> 00:09:53,125 and type it in there, we do it afterwards, 221 00:09:54,005 --> 00:09:55,565 entering information into the record. 222 00:09:56,195 --> 00:09:58,445 It's sort of been the traditional process. 223 00:09:59,305 --> 00:10:03,445 The ability to potentially short circuit that process 224 00:10:03,625 --> 00:10:04,765 of me actually having 225 00:10:04,865 --> 00:10:08,885 to enter the information becomes a huge value prop. 226 00:10:08,945 --> 00:10:12,605 And if you think about what, what we've seen is 227 00:10:13,115 --> 00:10:15,325 huge time savings for a provider. 228 00:10:15,385 --> 00:10:20,125 If you think of, I'm spending 20, 25% of my time documenting 229 00:10:20,345 --> 00:10:23,285 during the day, and I can shave that, 230 00:10:23,395 --> 00:10:27,805 that is significant amounts of time both for me personally 231 00:10:28,065 --> 00:10:31,445 as well as my potential of, of capturing revenue. 232 00:10:31,665 --> 00:10:34,445 And that's what we're seeing in the range of five 233 00:10:34,465 --> 00:10:36,845 to seven minutes per patient. 234 00:10:38,035 --> 00:10:42,135 So if you can put that into a context of a bigger picture 235 00:10:42,355 --> 00:10:46,415 for, you know, an organization looking at, you know, what 236 00:10:46,415 --> 00:10:50,335 that opportunity might mean to, to somebody, if you say, 237 00:10:51,275 --> 00:10:54,015 and, and the way I sort of think about this is, yes, 238 00:10:54,125 --> 00:10:57,055 it's impactful for me as a single doc, 239 00:10:57,595 --> 00:11:01,535 but as a leader, the potential exponential 240 00:11:02,155 --> 00:11:04,455 impact on an entire group 241 00:11:04,675 --> 00:11:09,095 or organization is, is gigantic, um, with that type of, 242 00:11:09,395 --> 00:11:11,935 of potential, um, savings or impact. 243 00:11:12,075 --> 00:11:15,015 So, um, if you just think about if, if, 244 00:11:15,115 --> 00:11:18,975 if you're a 30 physician primary care practice, 245 00:11:20,155 --> 00:11:24,695 and because of using ambient technology, 246 00:11:25,395 --> 00:11:29,055 you are able to increase just three per patients per day. 247 00:11:29,065 --> 00:11:32,695 We're seeing some in the range of, of, of four 248 00:11:32,755 --> 00:11:33,935 to six patients a day. 249 00:11:33,935 --> 00:11:36,615 But if you were just able to add three patients a day 250 00:11:37,315 --> 00:11:40,855 across your group, that's 90 patients a day, 251 00:11:41,435 --> 00:11:44,375 that's 18,000 patients a year 252 00:11:45,085 --> 00:11:47,255 potentially in a 30 person group. 253 00:11:47,725 --> 00:11:49,935 That is phenomenal when you think about that. 254 00:11:50,115 --> 00:11:51,615 So if I am a leader 255 00:11:51,675 --> 00:11:53,845 and I'm thinking, Hey, I need 256 00:11:53,845 --> 00:11:57,645 to increase volume in my primary care practices, 257 00:11:57,705 --> 00:12:00,005 we wanna bring more patients in, 258 00:12:00,765 --> 00:12:02,285 I have two choices to do that. 259 00:12:02,385 --> 00:12:05,725 Uh, my docs either that are currently seeing patients have 260 00:12:05,725 --> 00:12:08,325 to see more, I have to go out and hire new docs, right? 261 00:12:09,765 --> 00:12:14,165 18,000 visits is somewhere in the range of, 262 00:12:14,545 --> 00:12:17,485 you know, four, maybe five physicians 263 00:12:18,305 --> 00:12:19,645 to do that work, right? 264 00:12:20,265 --> 00:12:25,165 That's huge. Um, so if, if you think about the concept 265 00:12:25,465 --> 00:12:27,965 of, you know, going out 266 00:12:27,965 --> 00:12:32,165 and hiring five more physicians, um, the cost of, uh, 267 00:12:32,195 --> 00:12:35,045 even at, at the low end of being, you know, 268 00:12:35,045 --> 00:12:39,565 $500,000 per doc in, in bringing them up 269 00:12:39,565 --> 00:12:43,925 to speed, you know, you, you're talking about $2 million of, 270 00:12:44,065 --> 00:12:47,445 of potential, you know, um, cost to do that. 271 00:12:48,675 --> 00:12:52,015 Uh, if you could increase that productivity without, 272 00:12:52,605 --> 00:12:55,375 without significantly affecting their life 273 00:12:55,515 --> 00:12:57,495 and actually making their day better, 274 00:12:57,965 --> 00:12:59,975 even seeing three more patients a day, 275 00:13:00,955 --> 00:13:02,815 not only do you avoid having to go out 276 00:13:02,815 --> 00:13:04,775 and add those, um, additional docs, 277 00:13:04,775 --> 00:13:07,255 you're talking about adding somewhere in the range 278 00:13:07,335 --> 00:13:10,375 of $1.4 million a year in just direct revenue, 279 00:13:10,955 --> 00:13:13,175 not even counting the downstream revenue 280 00:13:13,365 --> 00:13:17,255 that you get from a family practice doc seeing, you know, 281 00:13:17,255 --> 00:13:19,215 another patient every day, right? 282 00:13:19,355 --> 00:13:23,975 So the, the ROI, um, both from a personal level 283 00:13:24,035 --> 00:13:26,815 of me being able to, to get through my day easier, 284 00:13:26,995 --> 00:13:29,935 not having to redocument things, missing things 285 00:13:29,935 --> 00:13:32,335 because I didn't remember them when I went back 286 00:13:32,335 --> 00:13:34,935 and documented them, being able to sit in front 287 00:13:34,935 --> 00:13:37,015 of my patient and actually have a conversation, 288 00:13:37,475 --> 00:13:41,535 and then the potential revenue impacts that that can come 289 00:13:42,645 --> 00:13:45,415 that we just don't think about in those volumes. 290 00:13:45,795 --> 00:13:50,255 Um, the potential impact on a large multi-specialty provider 291 00:13:50,735 --> 00:13:52,535 practice is just huge. 292 00:13:52,995 --> 00:13:57,615 And I think as we start to think about ai, we really need 293 00:13:57,615 --> 00:13:59,855 to think it about, think about it in those terms, 294 00:14:00,405 --> 00:14:05,135 because there it is, the, the, the cost difference 295 00:14:05,135 --> 00:14:09,935 of hiring a new physician versus giving them AI technology 296 00:14:10,115 --> 00:14:12,495 to do their work isn't even close, right? 297 00:14:12,525 --> 00:14:15,815 It's not even close. So I mean, that, those are real 298 00:14:16,485 --> 00:14:17,495 experiences, right? 299 00:14:17,865 --> 00:14:21,815 We're seeing that impact, you start to broaden 300 00:14:21,815 --> 00:14:25,695 that across all of healthcare while we're facing a, 301 00:14:26,015 --> 00:14:30,535 a provider shortage, while we're facing challenges with 302 00:14:31,075 --> 00:14:34,055 access, um, population wanting to go 303 00:14:34,055 --> 00:14:37,055 after markets, different things, uh, recruitment, 304 00:14:37,395 --> 00:14:39,855 the potential drip down through healthcare 305 00:14:40,115 --> 00:14:44,255 and the impact potentially that could have overall on, 306 00:14:44,395 --> 00:14:47,775 on the challenges we're facing overall with healthcare are, 307 00:14:48,035 --> 00:14:49,295 are just mind boggling. 308 00:14:49,475 --> 00:14:52,645 So that's how I sort of look at this te that's why I'm, 309 00:14:52,745 --> 00:14:55,845 you know, you start to get excited about this technology 310 00:14:55,915 --> 00:15:00,835 because it is at times even doing a better job 311 00:15:00,835 --> 00:15:03,835 of documenting that I would do on my own. 312 00:15:04,615 --> 00:15:06,435 And not only am I saving time, 313 00:15:07,155 --> 00:15:08,995 I potentially have an impact on revenue. 314 00:15:09,635 --> 00:15:12,155 I can see more patients that aren't being seen. 315 00:15:12,255 --> 00:15:16,435 So my community gets better care, uh, access to quality 316 00:15:16,615 --> 00:15:19,555 and um, uh, information in real time. 317 00:15:19,685 --> 00:15:21,275 Being able to go out 318 00:15:21,275 --> 00:15:24,515 and find specific information while I'm right there looking 319 00:15:24,575 --> 00:15:28,755 at it, potentially using AI to support diagnosis 320 00:15:29,385 --> 00:15:33,355 captive, uh, or identifying different diagnoses, um, 321 00:15:33,455 --> 00:15:35,155 ruling out different diseases. 322 00:15:35,275 --> 00:15:36,675 I mean, it just goes on and on. 323 00:15:36,895 --> 00:15:40,435 So I just don't think there's any shortage of, 324 00:15:40,815 --> 00:15:43,195 of opportunity and the excitement. 325 00:15:43,515 --> 00:15:47,515 I think we're just starting to feel the, just the initial 326 00:15:48,325 --> 00:15:51,475 surge of what this could potentially bring us in the future. 327 00:15:52,985 --> 00:15:55,275 - Yeah. And yeah, I appreciate you sort of flagging that. 328 00:15:55,335 --> 00:15:57,355 Uh, we haven't spent a ton of time on it in, 329 00:15:57,355 --> 00:15:58,955 in this conversation today, 330 00:15:59,055 --> 00:16:02,635 but flagging that potential, um, benefit yield 331 00:16:02,655 --> 00:16:03,675 for, for patients as well. 332 00:16:03,835 --> 00:16:05,795 'cause it stands for reason, as you sort of pointed out, 333 00:16:06,215 --> 00:16:08,355 you're able to see more patients, you're gonna be able to, 334 00:16:08,655 --> 00:16:11,475 um, provide more access to care to, to the community. 335 00:16:11,595 --> 00:16:13,475 I think anybody who's um, tried 336 00:16:13,495 --> 00:16:16,275 to schedule a doctor's appointment recently can appreciate 337 00:16:16,375 --> 00:16:18,835 how, how, how challenging it is to get in there. 338 00:16:18,855 --> 00:16:21,595 So it just seems like a real deep need for, for patients too 339 00:16:21,775 --> 00:16:23,475 to, to have these kind of improvements 340 00:16:24,095 --> 00:16:25,355 - It across the board. 341 00:16:25,385 --> 00:16:28,235 It's a win-win win. I mean, it just, I, I struggle 342 00:16:28,335 --> 00:16:29,475 to find the negatives. 343 00:16:29,715 --> 00:16:31,915 I really do. It's, it's, it's really hard that, 344 00:16:32,145 --> 00:16:34,595 that even if there is some negatives, they're offset 345 00:16:34,775 --> 00:16:39,075 so dramatically by the community impact the individual 346 00:16:39,595 --> 00:16:42,955 provider impact the financial impact on the organization 347 00:16:42,975 --> 00:16:44,755 and the employers of physicians. 348 00:16:45,075 --> 00:16:47,835 I mean, the reality is, is most hospitals 349 00:16:47,835 --> 00:16:50,035 that have employed physicians, you know, 350 00:16:50,185 --> 00:16:52,475 they subsidize those practices, right? 351 00:16:52,585 --> 00:16:57,515 They, it just, it's the natural end product of acquiring 352 00:16:58,075 --> 00:17:00,075 practices and, and running practices 353 00:17:00,455 --> 00:17:04,075 as a large organization versus, you know, a mom and pop and, 354 00:17:04,855 --> 00:17:08,155 and the, the opportunity of recapturing some of 355 00:17:08,155 --> 00:17:12,675 that re revenue, putting it back into other things instead 356 00:17:12,675 --> 00:17:15,075 of just into supporting physician salaries 357 00:17:15,175 --> 00:17:16,475 or provider salaries 358 00:17:16,895 --> 00:17:20,195 and just so many, you know, opportunities that 359 00:17:20,715 --> 00:17:23,915 you really need to think about it differently than just a 360 00:17:23,915 --> 00:17:25,235 capital investment. 361 00:17:25,575 --> 00:17:29,035 As we think about, um, where AI can bring in, I mean, 362 00:17:29,035 --> 00:17:30,875 we don't think about adding physicians 363 00:17:30,935 --> 00:17:32,675 as a capital investment, right? 364 00:17:33,135 --> 00:17:36,795 So adding technology that can increase productivity 365 00:17:37,015 --> 00:17:38,995 and all of these good down to, 366 00:17:39,455 --> 00:17:43,875 we gotta think differently about this from a, you know, 367 00:17:43,995 --> 00:17:46,595 a senior leadership perspective. 368 00:17:47,285 --> 00:17:49,325 Where is the best to, to do that? 369 00:17:49,505 --> 00:17:51,005 And, and then, I mean, 370 00:17:51,065 --> 00:17:54,365 we don't even wanna haven't even brought up the concept of 371 00:17:55,065 --> 00:17:56,525 what's the impact on burnout? 372 00:17:57,275 --> 00:17:59,485 Will it keep more providers practicing 373 00:17:59,485 --> 00:18:00,565 because, you know, 374 00:18:00,565 --> 00:18:03,045 they're happier getting out a little earlier during the day. 375 00:18:03,665 --> 00:18:06,685 Um, you know, it's, um, they're able 376 00:18:06,685 --> 00:18:08,005 to spend time with their family. 377 00:18:08,005 --> 00:18:11,645 They're not doing documentation at 10 o'clock at night when 378 00:18:11,645 --> 00:18:13,045 the rest of the family's asleep. 379 00:18:13,635 --> 00:18:18,245 There's so many things that I get excited about here that I, 380 00:18:18,365 --> 00:18:21,765 I just become no-brainers, uh, if you think about the need 381 00:18:21,785 --> 00:18:24,605 to, to take, uh, advantage of some of these things. 382 00:18:25,695 --> 00:18:28,065 - Yeah, the, the, the, the documentation side 383 00:18:28,065 --> 00:18:30,065 and burnout too is, is another huge piece of this. 384 00:18:30,065 --> 00:18:31,585 There's so many implications 385 00:18:31,605 --> 00:18:34,345 and possible ways this technology can, can touch the, 386 00:18:34,365 --> 00:18:35,385 the healthcare system. 387 00:18:35,925 --> 00:18:36,945 Um, and, and, and, 388 00:18:36,965 --> 00:18:39,265 and Tony, your, your excitement is coming through loud 389 00:18:39,265 --> 00:18:41,145 and clear , and it's, and it's great. 390 00:18:41,815 --> 00:18:42,825 - Yeah. It's, its funny 391 00:18:43,185 --> 00:18:45,185 'cause you know, I think back, you know, 392 00:18:45,185 --> 00:18:47,385 when I was seeing patients all the time 393 00:18:47,405 --> 00:18:48,865 and I'm looking at this technology 394 00:18:48,865 --> 00:18:52,425 and I'm going, oh God, how would I, you know, 395 00:18:52,505 --> 00:18:55,745 I would've just, I would've given anything to have some 396 00:18:55,745 --> 00:18:57,905 of this stuff back I was writing on paper 397 00:18:57,975 --> 00:18:58,985 back when I first started. 398 00:18:58,985 --> 00:19:02,185 Right? Right. So, I mean, it's just, uh, I see this 399 00:19:02,245 --> 00:19:05,905 and go, oh my gosh, um, a new physician coming into 400 00:19:06,695 --> 00:19:11,065 this world has such a different, is gonna have just a, 401 00:19:11,065 --> 00:19:15,265 such a different view of what they can do in healthcare than 402 00:19:15,335 --> 00:19:17,665 what we were capable of doing 25 years ago. 403 00:19:17,855 --> 00:19:19,945 It's just, it's, it's amazing to me 404 00:19:20,405 --> 00:19:21,865 and very exciting, obviously. 405 00:19:22,535 --> 00:19:25,945 - Yeah. Yeah. And, and, and I guess as we come to, we move 406 00:19:25,945 --> 00:19:27,545 to a close here, uh, shortly, 407 00:19:27,685 --> 00:19:30,625 but, um, I want, wanna get your take then, you know, you, 408 00:19:30,625 --> 00:19:32,785 you, you've talked about how this technology excites you, 409 00:19:32,785 --> 00:19:34,745 but what do you anticipate this all looks like 410 00:19:34,765 --> 00:19:35,945 in the next five to 10 years? 411 00:19:35,945 --> 00:19:39,025 Like, um, you, you just talked about sort of how uh, 412 00:19:39,105 --> 00:19:41,065 a physician coming up is gonna have a very different 413 00:19:41,065 --> 00:19:42,705 experience than, than than you did. 414 00:19:42,935 --> 00:19:44,265 What does that experience look like? 415 00:19:44,855 --> 00:19:49,585 - Yeah, I think, um, so two things. One is huge excitement. 416 00:19:49,785 --> 00:19:51,985 'cause there's so much we could potentially do, 417 00:19:52,525 --> 00:19:55,985 and we need to temper that with what we should do, right? 418 00:19:56,795 --> 00:20:00,615 And I think that's the biggest challenge for the industry, 419 00:20:00,795 --> 00:20:01,935 for us, right? 420 00:20:02,285 --> 00:20:06,095 It's, we could throw all kinds of stuff in front of docs. 421 00:20:06,555 --> 00:20:09,615 Is that the right thing to do? What should we be putting? 422 00:20:09,995 --> 00:20:14,135 Is it really affecting patient care, patient safety? 423 00:20:15,115 --> 00:20:17,495 My, um, experience going through 424 00:20:17,515 --> 00:20:20,895 as a CMO on the hospital side was very heavy 425 00:20:21,325 --> 00:20:22,495 into high reliability. 426 00:20:22,995 --> 00:20:25,975 Are we making a, a, a, the experience 427 00:20:25,975 --> 00:20:28,815 for a patient walking into a hospital safer, 428 00:20:29,045 --> 00:20:31,735 walking into a physician's office, safer. 429 00:20:32,475 --> 00:20:36,215 Um, so anything that we do to add to 430 00:20:37,015 --> 00:20:40,495 distractions and other things that may take away from 431 00:20:40,495 --> 00:20:42,975 what we can give that are positive, we have 432 00:20:42,975 --> 00:20:44,015 to be very careful of. 433 00:20:44,115 --> 00:20:47,445 So I think on our side, we have to be cautious. 434 00:20:48,155 --> 00:20:52,205 What sounds good sometimes doesn't actually play out good 435 00:20:52,545 --> 00:20:54,805 and could be, uh, um, problematic. 436 00:20:55,465 --> 00:20:56,845 So I think that's one thing. 437 00:20:57,465 --> 00:21:01,365 But I do think that as this technology gets better 438 00:21:01,625 --> 00:21:04,925 and better and better, some of that'll take care of itself. 439 00:21:05,945 --> 00:21:09,285 But I foresee, uh, uh, I mean, I foresee the ability 440 00:21:09,345 --> 00:21:12,885 of really being able to get back to 441 00:21:13,595 --> 00:21:16,365 walking into a room with a patient 442 00:21:17,025 --> 00:21:21,435 and just really, truly just having a conversation, talking 443 00:21:21,505 --> 00:21:23,675 through what I wanna do with that patient, 444 00:21:24,055 --> 00:21:27,035 how I wanna present the, you know, how I want their care 445 00:21:27,135 --> 00:21:30,235 to be, uh, to go forward, what's my plan? 446 00:21:31,015 --> 00:21:33,435 And then all of that stuff is being taken 447 00:21:34,215 --> 00:21:38,835 and used to develop a plan of interaction 448 00:21:39,345 --> 00:21:43,875 with, um, post visit information going to the patient, 449 00:21:44,305 --> 00:21:47,355 whether it's direct interaction with patients, 450 00:21:47,585 --> 00:21:49,875 getting my orders taken care of 451 00:21:50,135 --> 00:21:53,835 and done so that all I have to do is validate, um, them 452 00:21:54,015 --> 00:21:55,875 so I don't have to actually input them. 453 00:21:56,415 --> 00:21:59,835 You know, the, it is just what did I potentially miss 454 00:22:00,615 --> 00:22:03,795 in high, you know, based on risk, um, 455 00:22:03,805 --> 00:22:06,795 based on the conversation and the history of the patient. 456 00:22:07,255 --> 00:22:08,755 And there's just so many things 457 00:22:08,865 --> 00:22:11,635 that are just gonna be at the fingertips 458 00:22:11,635 --> 00:22:16,195 of somebody going in the future that we, you know, I used 459 00:22:16,195 --> 00:22:19,195 to walk out of the room and go open books. 460 00:22:20,195 --> 00:22:22,075 I mean, really, I mean, seriously 461 00:22:22,375 --> 00:22:24,795 and look up stuff that's gonna be gone. 462 00:22:24,975 --> 00:22:26,475 I'm just gonna have to say something, 463 00:22:26,935 --> 00:22:31,395 or it's gonna automatically identify something at risk 464 00:22:31,655 --> 00:22:33,155 and just put it there for me. 465 00:22:33,275 --> 00:22:35,115 I mean, just a huge difference. 466 00:22:35,375 --> 00:22:37,515 Um, but I do think we have to 467 00:22:38,775 --> 00:22:42,635 let the technology develop and not get out ahead of it, 468 00:22:42,635 --> 00:22:45,155 because I think sometimes if we get out ahead of it, 469 00:22:45,655 --> 00:22:48,315 we potentially could create risk, right? 470 00:22:48,375 --> 00:22:52,035 And that's, I think I get on our side, we have 471 00:22:52,035 --> 00:22:53,435 to be cautious and thoughtful. 472 00:22:53,855 --> 00:22:58,675 We have to put safety first as we, we roll these things out 473 00:22:58,935 --> 00:23:02,595 and, um, and present new opportunities to people. 474 00:23:03,745 --> 00:23:05,755 - Important point there around sort of the, 475 00:23:05,755 --> 00:23:07,115 the excitement's great, 476 00:23:07,115 --> 00:23:09,155 but you don't want the, the, the excitement sort 477 00:23:09,155 --> 00:23:10,955 of cloud judgment in terms of what you're, 478 00:23:10,955 --> 00:23:13,275 what you're applying the technology to. Right? Exactly. 479 00:23:13,505 --> 00:23:15,355 - Exactly. - Exactly. Yeah. 480 00:23:15,625 --> 00:23:18,275 Well, well, Tony, as, as you sort of laid out, like the, 481 00:23:18,295 --> 00:23:20,675 the, the implications of this technology touched 482 00:23:21,015 --> 00:23:23,955 so many different parts of, of the healthcare ecosystem and, 483 00:23:23,975 --> 00:23:27,555 and have a lot of potential to transform the, you know, 484 00:23:27,555 --> 00:23:30,155 the care experience for, for, for patients and, 485 00:23:30,155 --> 00:23:31,475 and for physicians of course, too. 486 00:23:32,135 --> 00:23:34,475 Um, but there, there's so much here we probably just scratch 487 00:23:34,755 --> 00:23:36,035 the surface on or barely touched. 488 00:23:36,415 --> 00:23:37,835 Um, so is there anything else 489 00:23:37,895 --> 00:23:40,435 before we sign off here, you want the listeners to, 490 00:23:40,435 --> 00:23:42,355 to hear from you on, on, on this topic? 491 00:23:43,025 --> 00:23:45,765 - Yeah, I, I, um, you know, know, not, not really. 492 00:23:46,005 --> 00:23:50,445 I do think that it's important for organizations 493 00:23:50,665 --> 00:23:52,565 to really take a step back 494 00:23:52,625 --> 00:23:57,155 and think about where are those things that 495 00:23:57,985 --> 00:24:02,555 have that biggest impact on my, my workforce, 496 00:24:03,295 --> 00:24:04,435 my human workforce, 497 00:24:05,145 --> 00:24:08,395 that I can make easier for them, right? 498 00:24:08,395 --> 00:24:09,595 That, that AI 499 00:24:09,895 --> 00:24:13,875 or new technologies that are coming out will ease 500 00:24:13,945 --> 00:24:15,275 that burden so that, 501 00:24:15,275 --> 00:24:17,795 that everyone can practice at the top of their license. 502 00:24:17,985 --> 00:24:20,195 There's, there's, there's no value 503 00:24:20,455 --> 00:24:22,315 for just putting stuff in. 504 00:24:22,415 --> 00:24:24,995 The value is doing the assessment, right? 505 00:24:25,655 --> 00:24:28,555 My value as a physician is seeing the patient, 506 00:24:29,365 --> 00:24:32,555 evaluating the patient, uh, examining the patient, 507 00:24:32,775 --> 00:24:36,435 making a diagnosis and a judgment on a plan to go forward. 508 00:24:36,825 --> 00:24:38,275 It's not then going back 509 00:24:38,275 --> 00:24:40,795 and putting the stuff in the record, which is important 510 00:24:40,905 --> 00:24:42,595 because I need to know what I did 511 00:24:42,695 --> 00:24:44,595 and other people need to know what I did. 512 00:24:44,735 --> 00:24:48,875 But if I can spend the majority of my time 513 00:24:49,605 --> 00:24:52,715 doing that first part, then that's a huge win, 514 00:24:52,715 --> 00:24:54,195 because then I can do it with more people. 515 00:24:54,575 --> 00:24:57,835 Uh, same goes for nursing, respiratory, pharmacy, 516 00:24:58,375 --> 00:24:59,435 you name it, right? 517 00:24:59,535 --> 00:25:01,915 So the ability to work at the top of your license, 518 00:25:02,655 --> 00:25:04,355 not doing those, those tasks 519 00:25:04,585 --> 00:25:07,515 that frankly we could potentially automate. 520 00:25:07,855 --> 00:25:09,995 Um, that's where you start to, that's 521 00:25:09,995 --> 00:25:11,915 where people should go back, start to focus. 522 00:25:12,425 --> 00:25:15,315 Talk to experts in the AI community. 523 00:25:16,465 --> 00:25:18,575 Where can they help? Where can we help? 524 00:25:19,155 --> 00:25:23,615 And then, um, you know, start a, a good strategic plan 525 00:25:24,185 --> 00:25:26,295 going forward about how to do this. 526 00:25:26,775 --> 00:25:29,815 I, I think you don't want to get stuck in this thing 527 00:25:29,815 --> 00:25:31,895 where you respond to every single person 528 00:25:31,895 --> 00:25:34,335 that comes in the door with a new idea, right? 529 00:25:34,715 --> 00:25:39,495 Or a new piece of a puzzle, um, that could get crazy, right? 530 00:25:39,555 --> 00:25:41,455 So I think you really need to think about 531 00:25:42,095 --> 00:25:43,615 a strategy around this. 532 00:25:44,075 --> 00:25:46,575 How do I really want to think about ai? 533 00:25:47,475 --> 00:25:51,495 How do I mesh all of this stuff together between cost 534 00:25:51,595 --> 00:25:55,615 and revenue and efficiency and productivity 535 00:25:55,795 --> 00:25:58,655 and my need for human resources 536 00:25:58,675 --> 00:26:01,615 and the elevating cost of those human resources 537 00:26:01,835 --> 00:26:03,895 so I can get them working at the top of their license. 538 00:26:05,185 --> 00:26:06,685 - Dr. Oliva, thank you so much for, 539 00:26:06,685 --> 00:26:08,365 for coming on the podcast today and, 540 00:26:08,365 --> 00:26:10,525 and really discussing, uh, you know, 541 00:26:10,675 --> 00:26:13,725 some exciting opportunities with, with AI and technology 542 00:26:13,745 --> 00:26:15,485 and what the future of healthcare can look like. 543 00:26:15,685 --> 00:26:17,125 I really appreciate you coming on the podcast. 544 00:26:18,125 --> 00:26:19,765 - Absolutely. Thank you. Thank you very much. 545 00:26:20,705 --> 00:26:23,125 - We also wanna thank our podcast sponsor Nuance, 546 00:26:23,245 --> 00:26:24,245 a Microsoft company. 547 00:26:24,665 --> 00:26:27,045 You could tune into more podcasts from Becker's Healthcare 548 00:26:27,145 --> 00:26:29,885 by visiting our podcast page at becker's hospital 549 00:26:29,885 --> 00:26:31,605 review.com/podcast.