1 00:00:05,235 --> 00:00:07,285 - This is the Becker's Healthcare Podcast, created 2 00:00:07,285 --> 00:00:08,445 by the team of Becker's Healthcare, 3 00:00:08,605 --> 00:00:10,325 a multimedia company devoted to the people 4 00:00:10,345 --> 00:00:11,645 who power us healthcare. 5 00:00:11,915 --> 00:00:14,765 Four new 15 minute episodes are released daily containing 6 00:00:14,925 --> 00:00:16,685 industry news analysis and thought leadership. 7 00:00:16,685 --> 00:00:19,605 From powerful healthcare decision makers Support our show 8 00:00:19,705 --> 00:00:22,525 by leaving it a five star rating and review on Apple Podcast 9 00:00:22,745 --> 00:00:24,005 or other platforms you use. 10 00:00:24,155 --> 00:00:26,005 It's a chance to tell us what you like about the show 11 00:00:26,025 --> 00:00:27,245 and act on your feedback. 12 00:00:27,245 --> 00:00:29,205 Thanks for listening. Now here's the episode. 13 00:00:30,355 --> 00:00:32,805 - This is Laura Dedo with the Becker's Healthcare Podcast. 14 00:00:33,385 --> 00:00:35,285 I'm thrilled today to be joined by Michael Hassel Berg, 15 00:00:35,495 --> 00:00:38,085 chief Digital Health Officer at URMC. 16 00:00:38,085 --> 00:00:40,405 Michael, it's a pleasure to have you on the podcast today. 17 00:00:41,135 --> 00:00:43,005 - Thank you, Laura. Excited to be here. 18 00:00:44,105 --> 00:00:45,605 - Now, I know we've got a lot to talk about. 19 00:00:45,605 --> 00:00:47,485 There's so much happening in healthcare technology, 20 00:00:47,485 --> 00:00:49,685 and particularly when you think about digital health, 21 00:00:49,995 --> 00:00:52,085 just such an emerging and fast growing field. 22 00:00:52,145 --> 00:00:53,565 But before we dive into my questions, 23 00:00:54,025 --> 00:00:55,125 can you tell us a little bit more 24 00:00:55,125 --> 00:00:56,525 about yourself and your background? 25 00:00:57,315 --> 00:01:00,245 - Sure. Um, Michael Hasselbeck, as you said, 26 00:01:00,345 --> 00:01:02,925 I'm the Chief Digital Health Officer at the University 27 00:01:02,925 --> 00:01:04,405 of Rochester Medical Center. 28 00:01:04,905 --> 00:01:07,725 Um, those of you who are not familiar with URMC, 29 00:01:07,865 --> 00:01:12,245 we are a large academic health system in upstate New York. 30 00:01:12,645 --> 00:01:15,085 Actually, the, probably the largest health system in the 31 00:01:15,085 --> 00:01:18,085 state of New York, outside of the city of Rochester 32 00:01:18,425 --> 00:01:20,525 or outside of New York City. 33 00:01:20,825 --> 00:01:24,965 Um, background, I am a nurse by clinical training. 34 00:01:25,245 --> 00:01:28,365 I went on to become a psychiatric nurse practitioner. 35 00:01:28,725 --> 00:01:32,645 I started my career in rural New York state 36 00:01:32,655 --> 00:01:36,365 where I was the only psychiatric, uh, provider 37 00:01:36,585 --> 00:01:37,885 for about six counties. 38 00:01:38,105 --> 00:01:41,045 So became really passionate about rural healthcare 39 00:01:41,185 --> 00:01:43,245 and how we could increase access 40 00:01:43,245 --> 00:01:45,085 to care out into those communities, 41 00:01:45,455 --> 00:01:48,205 which led me into the path of technology. 42 00:01:48,665 --> 00:01:52,725 Um, and I've been working pretty much exclusively in 43 00:01:52,925 --> 00:01:56,045 that kind of intersection of clinical care 44 00:01:56,545 --> 00:01:57,885 and, uh, technology 45 00:01:58,225 --> 00:02:00,805 for about the last 15 years of my career. 46 00:02:02,805 --> 00:02:03,935 - Well, that's amazing to hear. 47 00:02:03,995 --> 00:02:06,295 And you know, I'm wondering at what point did you 48 00:02:06,885 --> 00:02:09,935 find yourself really gearing more towards looking at, 49 00:02:10,035 --> 00:02:11,535 you know, how can I, um, 50 00:02:11,835 --> 00:02:13,815 really dive into the digital health space, 51 00:02:13,835 --> 00:02:16,615 the technology space, and use that interest 52 00:02:16,675 --> 00:02:19,815 and, um, knowledge that I have in order to improve care 53 00:02:19,995 --> 00:02:21,455 for patients in the community? 54 00:02:21,855 --> 00:02:25,455 I can imagine obviously having the, um, clinical background 55 00:02:25,455 --> 00:02:27,015 that that's really valuable. 56 00:02:27,035 --> 00:02:30,295 And then, you know, what other things that you do in order 57 00:02:30,295 --> 00:02:32,735 to make sure that you had the technology background as well? 58 00:02:33,885 --> 00:02:37,295 - Well, interesting. When I finished my doctorate degree 59 00:02:37,355 --> 00:02:41,015 and I ended up joining faculty, uh, at the university, 60 00:02:41,535 --> 00:02:44,855 I actually had a very forward-thinking chair of psychiatry, 61 00:02:45,195 --> 00:02:48,095 um, who about 15 years ago knew that 62 00:02:48,515 --> 00:02:51,615 as our health system grew its geographic reach, 63 00:02:51,745 --> 00:02:53,255 there was gonna be a huge need 64 00:02:53,315 --> 00:02:56,655 for getting behavioral health out into, again, 65 00:02:56,655 --> 00:02:58,055 the communities that surround us. 66 00:02:58,235 --> 00:03:02,605 So, um, it was my chair actually who said, if, um, 67 00:03:03,085 --> 00:03:05,645 I bring you on as faculty, I want you 68 00:03:05,645 --> 00:03:09,765 to develop a telemedicine, uh, program for our department. 69 00:03:09,785 --> 00:03:13,645 And this was well before telemedicine was a cool thing 70 00:03:13,905 --> 00:03:15,965 or even reimbursed in the state of New York. 71 00:03:16,305 --> 00:03:19,165 And I was a really good grant writer, 72 00:03:19,425 --> 00:03:23,565 and I was able to get several grants to allow me 73 00:03:23,565 --> 00:03:27,525 to start building a statewide, um, telepsychiatry program. 74 00:03:28,305 --> 00:03:30,725 Um, and, you know, quickly learned 75 00:03:30,835 --> 00:03:35,165 that this technology was able to allow my 76 00:03:36,205 --> 00:03:39,565 clinical providers to continue to, to deliver 77 00:03:39,565 --> 00:03:43,565 that high quality care in these regions of the states 78 00:03:43,675 --> 00:03:46,125 that did not have psychiatric providers. 79 00:03:46,525 --> 00:03:50,685 I ended up going back on to get further education, 80 00:03:51,385 --> 00:03:55,445 um, uh, ended up going on to get a business background 81 00:03:55,515 --> 00:03:58,525 because I became really anxious 82 00:03:58,865 --> 00:04:00,765 around my telemedicine program 83 00:04:00,765 --> 00:04:04,645 because essentially I was chasing grant 84 00:04:04,645 --> 00:04:07,685 after grant to pay for those services. 85 00:04:08,185 --> 00:04:12,365 And, um, when I went back to school, I, I really started 86 00:04:12,705 --> 00:04:16,205 to understand the business of healthcare. 87 00:04:17,115 --> 00:04:20,325 What did it really mean when the a CA started 88 00:04:20,325 --> 00:04:23,205 to get rolled out when people were talking about this move 89 00:04:23,235 --> 00:04:24,725 from volume to value? 90 00:04:25,425 --> 00:04:27,845 Um, and that background was a game changer for me 91 00:04:27,845 --> 00:04:32,325 because I started measuring my telemedicine, 92 00:04:32,625 --> 00:04:35,845 um, programs that I was developing no longer 93 00:04:35,845 --> 00:04:38,645 through the lens of a clinician or a researcher, 94 00:04:39,025 --> 00:04:41,405 but I started measuring 'em through the lens of a payer, 95 00:04:41,695 --> 00:04:45,725 which allowed me to really develop some early 96 00:04:46,455 --> 00:04:51,085 risk-based contracts, uh, with our insurers in our state to 97 00:04:51,665 --> 00:04:54,605 pay for our telemedicine programs that we developed. 98 00:04:54,905 --> 00:04:57,645 Um, after that, you know, I had, 99 00:04:57,925 --> 00:05:00,325 I had successfully had figured out reimbursement 100 00:05:00,385 --> 00:05:01,725 for telemedicine early 101 00:05:01,905 --> 00:05:04,365 and figured out the regulations for telemedicine, 102 00:05:04,465 --> 00:05:07,965 but could not grow my programs any further 103 00:05:07,965 --> 00:05:10,565 because I couldn't graduate psychiatrist 104 00:05:10,865 --> 00:05:12,525 or psych mps fast enough 105 00:05:12,525 --> 00:05:15,245 to take on more patients on the other end of that video. 106 00:05:15,585 --> 00:05:19,285 So, ended up moving into innovation, um, 107 00:05:19,285 --> 00:05:23,685 started thinking about technologies that didn't require the, 108 00:05:23,705 --> 00:05:25,565 the need for a clinician on the other end. 109 00:05:25,745 --> 00:05:30,525 So moved into the, the, the world of mobile apps partnered 110 00:05:30,555 --> 00:05:35,245 with our engineering, uh, school to start developing, um, 111 00:05:35,915 --> 00:05:38,365 cognitive behavioral therapy mobile apps 112 00:05:38,435 --> 00:05:41,365 that we could prescribe out of our electronic health record 113 00:05:41,425 --> 00:05:45,525 to patients moved on from mobile apps, uh, 114 00:05:46,035 --> 00:05:48,765 into the world of virtual reality. 115 00:05:49,185 --> 00:05:52,765 Um, started, you know, again, working with engineers 116 00:05:52,945 --> 00:05:55,165 and our computer scientists at our university 117 00:05:55,305 --> 00:05:57,765 to start developing mindfulness 118 00:05:57,945 --> 00:06:01,805 and meditation applications within VR headsets 119 00:06:01,875 --> 00:06:04,765 that we could deploy out into our communities. 120 00:06:05,225 --> 00:06:08,165 And then about six years ago, 121 00:06:08,485 --> 00:06:10,925 I really got heavily involved in data science 122 00:06:11,065 --> 00:06:14,485 and machine learning and really became interested 123 00:06:14,745 --> 00:06:16,525 and could you use data 124 00:06:17,225 --> 00:06:19,885 and, uh, machine learning methods 125 00:06:20,225 --> 00:06:22,925 to essentially risk stratify patients, 126 00:06:23,135 --> 00:06:26,765 match the the right patients, uh, with the, 127 00:06:26,825 --> 00:06:29,925 the right provider at the right time and in the right place. 128 00:06:30,185 --> 00:06:34,965 And again, over time developed this leadership role 129 00:06:35,105 --> 00:06:36,885 and innovation for my health system. 130 00:06:37,065 --> 00:06:41,165 And then when covid hits, um, you know, we needed a digital 131 00:06:41,725 --> 00:06:44,245 strategy, like every health system in the, in the country. 132 00:06:44,425 --> 00:06:47,565 And that's when I got put into my current role 133 00:06:47,585 --> 00:06:50,245 of Chief Digital health officer to really lead 134 00:06:50,355 --> 00:06:53,965 that digital transformation strategy for our system. 135 00:06:55,785 --> 00:06:58,205 - That's amazing to hear. And what a great career journey. 136 00:06:58,345 --> 00:07:01,365 Um, you know, in, in such, um, such a, 137 00:07:01,805 --> 00:07:03,645 a great place you put yourself in, especially 138 00:07:03,645 --> 00:07:05,445 as you mentioned, when the pandemic hit, um, 139 00:07:05,505 --> 00:07:07,565 and really needing to have the digital strategy up 140 00:07:07,565 --> 00:07:08,605 and quickly running. 141 00:07:08,785 --> 00:07:10,205 Um, this is fascinating. 142 00:07:10,625 --> 00:07:13,245 And now here too, we're a few years removed from that. 143 00:07:13,595 --> 00:07:14,965 What are the headwinds that you're seeing 144 00:07:15,025 --> 00:07:16,125 and have your eye on right now? 145 00:07:16,125 --> 00:07:18,485 What are you spending your, uh, time and attention on? 146 00:07:19,115 --> 00:07:22,205 - Yeah, you know, I think a free health system in the 147 00:07:22,205 --> 00:07:25,605 country right now is struggling with margin pressures 148 00:07:25,905 --> 00:07:27,645 and, you know, labor costs, 149 00:07:28,105 --> 00:07:30,925 and we're seeing big shifts, uh, 150 00:07:30,995 --> 00:07:33,805 from our payers into government pools. 151 00:07:34,185 --> 00:07:37,965 Um, which for a health system where primarily 152 00:07:38,705 --> 00:07:41,445 we get our reimbursement still through fee for service, 153 00:07:41,955 --> 00:07:44,925 that ends up putting even further pressure on us. 154 00:07:45,505 --> 00:07:50,405 The other things that, you know, we're seeing is, um, a 155 00:07:51,075 --> 00:07:53,965 clinician burnout and clinician stress 156 00:07:54,305 --> 00:07:58,925 and, you know, that is causing labor shortages for us, 157 00:07:59,175 --> 00:08:00,645 which we're struggling with, 158 00:08:01,225 --> 00:08:05,685 and we're really seeing it in on our post-acute side in our, 159 00:08:05,685 --> 00:08:08,005 in our skilled nursing facilities that, 160 00:08:08,115 --> 00:08:09,605 that are part of our health system. 161 00:08:09,705 --> 00:08:12,365 You know, we're, we're seeing staffing mandates, uh, 162 00:08:12,365 --> 00:08:14,245 coming out from the regulators. 163 00:08:14,775 --> 00:08:16,405 Again, we have those shortages. 164 00:08:16,585 --> 00:08:19,645 So it's, it's very difficult for us to, uh, 165 00:08:19,675 --> 00:08:24,485 discharge patients from our acute hospitals into post-acute 166 00:08:24,485 --> 00:08:27,685 settings because, you know, they are beds closed 167 00:08:27,685 --> 00:08:30,565 because we don't have staff to, to serve 'em. 168 00:08:30,585 --> 00:08:34,925 So, you know, all of that combined is, is, you know, 169 00:08:34,945 --> 00:08:37,805 really causing significant stress on, 170 00:08:37,945 --> 00:08:39,565 on the healthcare ecosystem. 171 00:08:39,985 --> 00:08:42,165 You know, I think the last headwinds 172 00:08:42,195 --> 00:08:44,285 that we've seen over the last couple of years, 173 00:08:44,375 --> 00:08:46,485 which in some ways is exciting. 174 00:08:46,825 --> 00:08:50,325 Um, but at at the same time, um, you know, 175 00:08:50,365 --> 00:08:54,285 I think push pushes further stress on incumbents like the 176 00:08:54,285 --> 00:08:57,285 University of Rochester is the significant investment 177 00:08:57,595 --> 00:09:01,205 that we're seeing from industry and retail into healthcare. 178 00:09:01,425 --> 00:09:04,525 You know, what we're, we're, we're, we're, we're seeing, um, 179 00:09:05,225 --> 00:09:09,645 you know, almost, uh, commoditizing, um, healthcare services 180 00:09:09,645 --> 00:09:12,205 through, you know, by these big retailers 181 00:09:12,275 --> 00:09:16,125 that are moving in, which is really driving, you know, 182 00:09:16,485 --> 00:09:18,525 consumerism for, for our patients. 183 00:09:18,785 --> 00:09:22,605 And so, you know, those are other headwinds that, you know, 184 00:09:22,765 --> 00:09:26,645 i I and my health system has to keep an eye on. 185 00:09:29,275 --> 00:09:31,195 - Absolutely. I think all of those things you mentioned are 186 00:09:31,195 --> 00:09:32,835 just so crucial and critical 187 00:09:32,935 --> 00:09:35,675 to a health system's ability to provide care. 188 00:09:35,735 --> 00:09:37,955 As you were talking through some of the clinician burnout, 189 00:09:38,025 --> 00:09:39,555 obviously staff shortages, 190 00:09:39,555 --> 00:09:41,555 and then trying to figure out how 191 00:09:41,555 --> 00:09:43,675 to do things on the post-acute care side in, 192 00:09:43,695 --> 00:09:46,635 in all the while, while the disruptors are coming in from 193 00:09:46,635 --> 00:09:49,835 other industries and trying to, you know, carve out a space 194 00:09:49,835 --> 00:09:51,035 for themselves in healthcare too. 195 00:09:51,315 --> 00:09:55,355 I can imagine there's a lot, um, of pressure in thinking 196 00:09:55,355 --> 00:09:56,555 through all of these different things 197 00:09:56,555 --> 00:09:58,115 and dynamics happening in the market. 198 00:09:58,375 --> 00:10:00,675 So, you know, when you look at your position 199 00:10:00,695 --> 00:10:02,195 as a chief digital health officer, 200 00:10:02,905 --> 00:10:04,635 what does that look like for you? 201 00:10:04,735 --> 00:10:06,835 How are you kind of meeting some of these challenges, 202 00:10:06,835 --> 00:10:08,915 helping this guide system through it, 203 00:10:09,015 --> 00:10:11,435 and then really looking at growth as well overall? 204 00:10:12,785 --> 00:10:15,315 - Yeah, you know, a, a lot of, a lot 205 00:10:15,315 --> 00:10:19,515 of my role from a strategy standpoint is helping 206 00:10:20,035 --> 00:10:23,435 identify not only opportunities for my health systems, 207 00:10:23,575 --> 00:10:26,435 but new partnerships, uh, for, for my health systems. 208 00:10:26,455 --> 00:10:31,155 So where I see the potential for growth, uh, for us, 209 00:10:31,815 --> 00:10:36,185 um, is gonna be through working with, you know, 210 00:10:36,195 --> 00:10:39,705 other verticals that, that we have traditionally not worked 211 00:10:39,705 --> 00:10:42,585 with, uh, before as a health system incumbent. 212 00:10:42,845 --> 00:10:46,345 So, you know, trying to talk with these industry partners 213 00:10:46,345 --> 00:10:48,745 and retailers and seeing, you know, where, 214 00:10:48,875 --> 00:10:50,505 where we bring value to them 215 00:10:50,845 --> 00:10:53,185 and, you know, where they bring value to us. 216 00:10:53,325 --> 00:10:56,705 And so a lot of my role is, you know, you know, 217 00:10:56,705 --> 00:10:58,705 traveling the country and getting to meet 218 00:10:58,975 --> 00:11:01,385 with leaders in these other verticals 219 00:11:01,405 --> 00:11:04,265 and truly trying to understand their business models and, 220 00:11:04,265 --> 00:11:08,185 and where there is overlap with, with my health systems 221 00:11:09,065 --> 00:11:10,185 strategy and priorities. 222 00:11:10,525 --> 00:11:12,145 And then, then I think at the same time, 223 00:11:12,445 --> 00:11:15,545 is incumbents coming together and forming new partnerships. 224 00:11:15,545 --> 00:11:18,665 There's probably never been a better time for health systems 225 00:11:18,845 --> 00:11:20,425 to start really partnering up, 226 00:11:20,425 --> 00:11:23,065 especially on the virtual care side 227 00:11:23,285 --> 00:11:24,985 and the digital health side and, 228 00:11:25,285 --> 00:11:29,425 and us starting to pool our resources to together to, 229 00:11:29,565 --> 00:11:31,105 to grow and be successful. 230 00:11:31,245 --> 00:11:33,345 So, you know, I think to me, you know, 231 00:11:33,345 --> 00:11:34,825 that's the really exciting part. 232 00:11:34,825 --> 00:11:36,825 Healthcare is gonna look really different 233 00:11:37,255 --> 00:11:38,265 five years from now. 234 00:11:38,265 --> 00:11:40,145 It's gonna look really different six 235 00:11:40,145 --> 00:11:41,305 months to a year from now. 236 00:11:41,365 --> 00:11:44,345 And, and I think it's, it's gonna be these partnerships 237 00:11:44,345 --> 00:11:48,185 that's gonna allow us to, to really be successful in scale. 238 00:11:49,495 --> 00:11:50,715 - That's so interesting to hear. 239 00:11:50,715 --> 00:11:52,595 And certainly being able to have those types 240 00:11:52,595 --> 00:11:55,165 of partnerships, um, you know, I I can imagine 241 00:11:55,905 --> 00:11:57,805 we will reinvent and redesign healthcare 242 00:11:57,805 --> 00:11:58,965 in ways we couldn't imagine. 243 00:12:00,145 --> 00:12:02,405 - Oh, it a, a abs. Absolutely. 244 00:12:02,705 --> 00:12:07,695 Um, you know, I, I think, you know, the other opportunity 245 00:12:08,205 --> 00:12:12,455 that, that we have to, to, to push care towards is 246 00:12:12,885 --> 00:12:14,615 outside of our hospital walls 247 00:12:15,115 --> 00:12:18,895 and moving them into the homes of our patients, 248 00:12:19,315 --> 00:12:22,255 the communities that, that our patients live in. 249 00:12:22,755 --> 00:12:24,655 And when you think about that, you know, 250 00:12:24,655 --> 00:12:27,855 you really start thinking about the daily lives that 251 00:12:28,395 --> 00:12:33,335 our patients, um, have, you know, what myself, you know, 252 00:12:33,335 --> 00:12:37,215 what is, what is my daily journey in in, in my communities, 253 00:12:37,275 --> 00:12:41,535 you know, the grocery stores, I go to the banks that, 254 00:12:41,915 --> 00:12:45,975 you know, I, I stop in, um, you know, the gas stations, the, 255 00:12:46,075 --> 00:12:47,735 the, the convenience stores 256 00:12:48,155 --> 00:12:51,055 and you know, what are, you know, what are outside the box 257 00:12:52,315 --> 00:12:56,695 places that, you know, we could deliver healthcare into, um, 258 00:12:56,795 --> 00:13:00,735 and, and partner with, uh, those, those other verticals 259 00:13:00,735 --> 00:13:04,615 that are along the daily journeys of, of our patients. 260 00:13:04,915 --> 00:13:07,935 And, you know, our health system has been thinking about, 261 00:13:08,035 --> 00:13:10,015 you know, where those opportunities are 262 00:13:10,195 --> 00:13:13,495 and, you know, we're, we're really kind of excited about, 263 00:13:13,675 --> 00:13:16,895 you know, some of the pilots that we're gearing up to 264 00:13:17,035 --> 00:13:18,135 to launch here soon. 265 00:13:19,275 --> 00:13:20,365 - Well, that's amazing to hear 266 00:13:20,365 --> 00:13:22,525 and definitely we'll be excited to speak more about those 267 00:13:22,625 --> 00:13:23,845 as you're able to announce them. 268 00:13:24,395 --> 00:13:28,555 - Yeah, absolutely. - No, you know, as you mentioned, um, 269 00:13:29,315 --> 00:13:31,595 URMC in like most hospitals 270 00:13:31,595 --> 00:13:33,755 and health systems right now, margins are tight 271 00:13:33,775 --> 00:13:34,795 and certainly there are a lot 272 00:13:34,795 --> 00:13:36,635 of pressures there on the financial side, 273 00:13:36,735 --> 00:13:39,235 but I'm wondering from your perspective as we're talking 274 00:13:39,235 --> 00:13:41,715 through all the things that, and possible potential 275 00:13:41,715 --> 00:13:45,475 opportunities, um, you know, what are some of the real risks 276 00:13:45,535 --> 00:13:47,995 or investments that are still worth making this year, even 277 00:13:48,695 --> 00:13:51,955 as, you know, the financial and and budgets might be tight. 278 00:13:53,575 --> 00:13:58,035 - So, you know, I am, I am very bullish on, 279 00:13:58,215 --> 00:13:59,355 on generative ai. 280 00:13:59,775 --> 00:14:03,435 Um, and you know, it's, it's really interesting if, 281 00:14:03,695 --> 00:14:08,235 if you had listened to me speak on podcasts, 282 00:14:08,535 --> 00:14:11,595 uh, maybe two years ago, uh, I was 283 00:14:12,345 --> 00:14:16,515 very pessimistic around the place 284 00:14:16,585 --> 00:14:19,675 that artificial intelligence has, uh, in, 285 00:14:19,675 --> 00:14:21,035 in the healthcare industry. 286 00:14:21,255 --> 00:14:23,435 And that was partly through some of 287 00:14:24,175 --> 00:14:27,635 our own experience at the University of Rochester of, 288 00:14:28,095 --> 00:14:31,315 you know, partnering with our data science institute 289 00:14:31,775 --> 00:14:34,235 and, you know, trying to, um, 290 00:14:34,235 --> 00:14:37,715 develop machine learning models to improve our, 291 00:14:38,295 --> 00:14:40,035 our healthcare service delivery. 292 00:14:40,955 --> 00:14:44,945 And with the exception of computer vision 293 00:14:45,485 --> 00:14:50,065 and developing models to help support our radiologists, uh, 294 00:14:50,365 --> 00:14:51,525 triage scans 295 00:14:51,665 --> 00:14:56,125 or dermatologists to, you know, triage consults 296 00:14:56,275 --> 00:15:00,085 that they, they, they, they might, um, prioritize. 297 00:15:00,825 --> 00:15:02,805 We did not have a whole lot 298 00:15:02,805 --> 00:15:05,525 of success applying machine learning into 299 00:15:06,445 --> 00:15:09,805 language data within our electronic health record. 300 00:15:09,985 --> 00:15:13,165 And, and, you know, it, it, it, it actually made a lot 301 00:15:13,165 --> 00:15:16,205 of sense, you know, and when we look back retrospectively, 302 00:15:16,385 --> 00:15:21,085 you know, our data in our electronic health record has a lot 303 00:15:21,085 --> 00:15:23,085 of noise in it, a lot of variability. 304 00:15:23,545 --> 00:15:28,405 And, um, our ability to leverage a machine 305 00:15:28,465 --> 00:15:29,925 to identify outliers 306 00:15:30,105 --> 00:15:33,205 or patterns in that data, you know, we, we, 307 00:15:33,225 --> 00:15:37,925 we really struggled, fast forward to , um, the age 308 00:15:37,925 --> 00:15:39,005 of generative AI 309 00:15:39,025 --> 00:15:41,285 and these large language models that come 310 00:15:41,285 --> 00:15:44,365 to us already pre-trained on, you know, a, 311 00:15:44,445 --> 00:15:47,125 a a trillion parameters, essentially the, 312 00:15:47,305 --> 00:15:48,885 the entire, uh, internet. 313 00:15:49,625 --> 00:15:53,005 We are blown away with the 314 00:15:53,925 --> 00:15:56,965 applying these models to our 315 00:15:57,855 --> 00:15:59,445 electronic health record data. 316 00:15:59,825 --> 00:16:03,365 And, you know, we, at, at my institution, 317 00:16:03,775 --> 00:16:06,685 we've been actually working with large language models 318 00:16:07,225 --> 00:16:11,725 and some of these generative AI tools for 319 00:16:12,545 --> 00:16:14,165 almost nine months now. 320 00:16:14,665 --> 00:16:17,805 And, you know, we've seen massive, 321 00:16:18,395 --> 00:16:22,925 massive strides on reducing administrative burden 322 00:16:23,025 --> 00:16:26,445 for our clinicians, you know, using these models 323 00:16:26,665 --> 00:16:30,445 to triage patient messages using these models to 324 00:16:31,255 --> 00:16:32,925 synthesize our charts 325 00:16:33,185 --> 00:16:36,685 and, you know, pull out the data that it's really pertinent 326 00:16:36,685 --> 00:16:40,285 for the clinician to see at that specific visits. 327 00:16:40,625 --> 00:16:44,085 You know, the, the use of these models to, um, 328 00:16:45,015 --> 00:16:49,205 allow our clinicians to document in an ambient way, 329 00:16:49,505 --> 00:16:51,685 you know, both by partnering with industry, 330 00:16:51,745 --> 00:16:56,205 but even our own ability to develop our own speech detect 331 00:16:56,585 --> 00:17:00,125 and, uh, ambient documentation tools, you know, 332 00:17:00,505 --> 00:17:04,845 our development time, uh, in our innovation team around 333 00:17:05,365 --> 00:17:10,085 building AI tools, you know, free large language models 334 00:17:10,145 --> 00:17:14,325 and generative ai, it would take us six months to a year 335 00:17:14,505 --> 00:17:17,965 to develop a natural language processing model, um, 336 00:17:18,155 --> 00:17:22,045 with which, again, more, more times than not failed, um, 337 00:17:22,155 --> 00:17:24,885 when we were finally finished our dev time. 338 00:17:25,065 --> 00:17:28,885 Now, you know, by tuning these, these pre-trained models 339 00:17:29,585 --> 00:17:34,125 has gone from six months to a year, to days to weeks for us 340 00:17:34,125 --> 00:17:35,405 to develop our own tools. 341 00:17:35,625 --> 00:17:40,215 So like I am, I am confident 342 00:17:40,525 --> 00:17:44,975 that artificial intelligence will 343 00:17:45,375 --> 00:17:46,935 transform healthcare for the better, 344 00:17:47,515 --> 00:17:50,165 and it's never been easier for health systems 345 00:17:50,665 --> 00:17:53,445 to develop their own models 346 00:17:53,785 --> 00:17:56,845 and tools to solve their current problems 347 00:17:56,845 --> 00:17:57,845 that they're struggling with. 348 00:17:59,605 --> 00:18:00,865 - That's fascinating to hear, 349 00:18:00,865 --> 00:18:04,345 and certainly, you know, it can be, um, so interesting 350 00:18:04,345 --> 00:18:07,105 to see how, you know, the technology can make a difference 351 00:18:07,105 --> 00:18:09,945 and just a little bit of time in, in, um, you know, 352 00:18:09,965 --> 00:18:12,745 the past year, especially as you mentioned with genis, uh, 353 00:18:12,855 --> 00:18:15,825 real development in rapidly evolving, um, 354 00:18:15,825 --> 00:18:17,185 usefulness in healthcare. 355 00:18:17,325 --> 00:18:18,825 It is just really been cool to see. 356 00:18:19,635 --> 00:18:21,385 We've been talking about a lot of different areas 357 00:18:21,605 --> 00:18:22,865 of potential opportunity. 358 00:18:23,005 --> 00:18:25,505 Is there anything else you wanna touch on about growth 359 00:18:25,505 --> 00:18:26,665 and development for the future? 360 00:18:27,695 --> 00:18:32,225 - Yeah, you know, when I think about the last 361 00:18:33,235 --> 00:18:35,625 three and a half, four years, you know, 362 00:18:35,625 --> 00:18:37,065 essentially when covid started 363 00:18:37,325 --> 00:18:41,825 and we all shifted to, um, virtual care 364 00:18:42,565 --> 00:18:45,025 and, you know, delivery, uh, 365 00:18:45,285 --> 00:18:49,505 of care using digital modalities, you know, our focus 366 00:18:49,725 --> 00:18:54,265 as a health system in those early years of the pandemic, 367 00:18:54,805 --> 00:18:58,785 you know, was really honed in on our patients. 368 00:18:59,165 --> 00:19:03,425 You know, we really wanted to, you know, create 369 00:19:03,945 --> 00:19:06,025 convenience, seamless access, um, 370 00:19:06,405 --> 00:19:10,705 to care within our health system using, um, virtual tools. 371 00:19:11,325 --> 00:19:14,065 You know, we, we leveraged this for, you know, 372 00:19:14,165 --> 00:19:17,145 new patient acquisitions so we could continue to, 373 00:19:17,605 --> 00:19:21,345 to grow our, our patient lives a as a health system. 374 00:19:21,845 --> 00:19:24,865 You know, we, we then really focused in on 375 00:19:25,005 --> 00:19:28,985 how do we leverage technology to, you know, 376 00:19:29,215 --> 00:19:32,505 keep our patients engaged with our health system, um, 377 00:19:32,685 --> 00:19:34,705 you know, really creates that stickiness 378 00:19:34,705 --> 00:19:38,225 and that glue so they continue coming back, um, to, 379 00:19:38,405 --> 00:19:40,945 to receive care, um, uh, 380 00:19:40,945 --> 00:19:42,985 through the services that we provide. 381 00:19:43,685 --> 00:19:46,785 But when I, when I think through our successes 382 00:19:46,805 --> 00:19:50,105 and we had a lot of successes focusing in on the patients, 383 00:19:50,805 --> 00:19:54,145 you know, in some ways it was at the detriment 384 00:19:54,285 --> 00:19:56,545 of our clinicians and our providers. 385 00:19:56,645 --> 00:19:59,705 You know, our patients have never 386 00:19:59,765 --> 00:20:04,365 before had the level of access, 387 00:20:04,505 --> 00:20:08,445 direct access to our clinicians than that they, they do now 388 00:20:08,475 --> 00:20:10,605 through, through digital technologies. 389 00:20:12,395 --> 00:20:15,655 At the same time, our clinicians have never been 390 00:20:17,505 --> 00:20:20,275 bombarded with more data, you know, 391 00:20:20,285 --> 00:20:22,675 which is being collected from these technologies 392 00:20:23,375 --> 00:20:25,875 and being pushed back to our clinicians than ever 393 00:20:25,875 --> 00:20:28,915 before, which is again, causing significant 394 00:20:29,695 --> 00:20:31,115 stress and, and burnout. 395 00:20:31,495 --> 00:20:35,515 So in some ways, you know, our digital transformation 396 00:20:36,115 --> 00:20:39,075 strategy has, has really pivoted, you know, 397 00:20:39,075 --> 00:20:42,435 where we were really narrowly focused in on, you know, 398 00:20:42,445 --> 00:20:45,515 using technologies, you know, for our patients. 399 00:20:45,975 --> 00:20:50,485 Now we're pivoting to how do we focus in on our clinicians. 400 00:20:50,755 --> 00:20:54,955 When you think, think back of just the history of technology 401 00:20:54,975 --> 00:20:58,195 and healthcare, technology has not been the friend of, 402 00:20:58,415 --> 00:20:59,595 uh, of the clinician. 403 00:20:59,615 --> 00:21:01,675 You know, you think about the last major technology 404 00:21:01,675 --> 00:21:04,195 that was supposed to improve the lives of our clinicians, 405 00:21:04,575 --> 00:21:08,315 the electronic health record, it's did the exact opposite. 406 00:21:08,935 --> 00:21:12,835 So, you know, going forward, you know, we are, we are now, 407 00:21:13,015 --> 00:21:15,835 you know, really digging our heels in on 408 00:21:16,095 --> 00:21:19,035 how do we leverage generative AI and, 409 00:21:19,055 --> 00:21:23,915 and some of these tools to reduce the burden off 410 00:21:24,075 --> 00:21:26,195 of our, our, our clinicians' shoulders 411 00:21:26,375 --> 00:21:29,515 and allow them to do what they really went 412 00:21:30,985 --> 00:21:35,555 into the field for actually providing clinical care, um, 413 00:21:35,865 --> 00:21:37,475 with patients, um, 414 00:21:37,615 --> 00:21:40,915 and really giving them their own time back, giving them 415 00:21:40,915 --> 00:21:43,995 that precious pajama time so they can get out of work 416 00:21:44,535 --> 00:21:46,915 and go home at a decent hour 417 00:21:47,015 --> 00:21:49,475 and spend it with their own loved ones and, and, 418 00:21:49,495 --> 00:21:50,635 and, and family members. 419 00:21:51,215 --> 00:21:53,355 Um, and that's really where we're honing in. 420 00:21:53,415 --> 00:21:56,235 And so, you know, on the, the provider side, 421 00:21:56,425 --> 00:21:59,395 it's really focusing in on leveraging, you know, uh, 422 00:21:59,395 --> 00:22:00,915 generative AI technologies. 423 00:22:01,455 --> 00:22:03,835 And then, you know, for our nurses, you know, 424 00:22:03,835 --> 00:22:07,915 we're really starting to do a deep dive into virtual, um, 425 00:22:08,065 --> 00:22:11,915 nursing, uh, care models, uh, within our hospital walls, 426 00:22:12,335 --> 00:22:14,635 you know, leveraging some simple, you know, 427 00:22:14,635 --> 00:22:16,075 video conferencing technology, 428 00:22:16,215 --> 00:22:20,035 but then overlaying on top of that, you know, uh, 429 00:22:20,595 --> 00:22:24,995 computer vision, um, uh, you know, speech recognition, uh, 430 00:22:25,375 --> 00:22:29,635 AI to really, um, reduce the burden on our nurses 431 00:22:29,935 --> 00:22:31,275 and make them more efficient. 432 00:22:31,415 --> 00:22:34,515 So for me, you know, growth in the future, if, 433 00:22:35,055 --> 00:22:37,325 if we don't have clinicians to provide care, 434 00:22:37,545 --> 00:22:40,245 it doesn't matter what technologies, uh, that, 435 00:22:40,245 --> 00:22:42,085 that we have for our patients, uh, 436 00:22:42,155 --> 00:22:43,525 it's not gonna be successful. 437 00:22:43,625 --> 00:22:46,885 So we are really focusing in on, on, 438 00:22:46,945 --> 00:22:48,925 on our cl clinical workforce right now. 439 00:22:51,265 --> 00:22:53,165 - That's amazing to hear. And certainly very, 440 00:22:53,165 --> 00:22:55,365 very needed in terms of, you know, making sure 441 00:22:55,365 --> 00:22:57,845 that the clinical workforce has what they need and, 442 00:22:57,845 --> 00:23:00,645 and can deliver the care that is appropriate and, 443 00:23:00,705 --> 00:23:02,405 and important for the community. 444 00:23:02,635 --> 00:23:03,845 Michael, thank you so much 445 00:23:03,845 --> 00:23:05,245 for joining us on the podcast today. 446 00:23:05,245 --> 00:23:07,805 This has been such a fun and, and interesting conversation 447 00:23:08,345 --> 00:23:09,685 and certainly, you know, looking forward 448 00:23:09,685 --> 00:23:11,285 to touching you on many of these topics too, 449 00:23:11,305 --> 00:23:12,805 at our annual meeting next April. 450 00:23:13,225 --> 00:23:16,325 Um, you know, we're having more than four 50 speakers there 451 00:23:16,325 --> 00:23:18,645 talking about technology and healthcare, 452 00:23:18,945 --> 00:23:21,125 and especially some of those disruptions too, 453 00:23:21,375 --> 00:23:24,085 while also tackling workforce issues, challenges in, 454 00:23:24,085 --> 00:23:25,205 in the financial issues. 455 00:23:25,305 --> 00:23:27,325 So definitely looking forward to that. 456 00:23:27,545 --> 00:23:30,325 And, um, excited to have you, um, join us 457 00:23:30,325 --> 00:23:31,845 as well on a podcast to get in the future. 458 00:23:31,955 --> 00:23:33,765 This has been just a really great conversation. 459 00:23:34,515 --> 00:23:36,525 - Yeah. Thanks again for having me, Laura. 460 00:23:36,625 --> 00:23:37,845 It was, it was a lot of fun. 461 00:23:40,035 --> 00:23:42,605 - It's so important for leaders at the top of organizations 462 00:23:42,605 --> 00:23:45,045 to keep learning, stay sharp, grow their networks 463 00:23:45,425 --> 00:23:48,005 to help our audience better do this in a more simplified, 464 00:23:48,005 --> 00:23:49,645 personalized, and meaningful way. 465 00:23:50,245 --> 00:23:52,685 Becker's Healthcare has launched my bhc, 466 00:23:53,195 --> 00:23:55,165 it's your trusted Becker's healthcare experience 467 00:23:55,165 --> 00:23:56,925 and more with content, connections, 468 00:23:56,945 --> 00:23:58,405 events and learning opportunities. 469 00:23:58,995 --> 00:24:00,125 Join the community free 470 00:24:00,125 --> 00:24:05,085 of charge@www.my dot becker's hospital review.com 471 00:24:05,185 --> 00:24:06,005 and we'll see you there.