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- This is Laura Dedo with the
Becker's Healthcare Podcast.

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I'm thrilled today to
be joined by James Blum,

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chief Health Information
Officer at University of Iowa.

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James, it's a pleasure to
have you on the podcast today.

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- Thanks. It's a pleasure
to be here with you.

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- Now. I know there's a lot happening

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really in the healthcare space.

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It's such a dynamic space,

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and I know you're doing a
lot at the University of Iowa

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as well, so I'm excited
for this conversation.

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But before we dive into the
meat of our conversation,

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can you tell us a little bit more

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about yourself and your background?

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- Sure. Um, so prior to medical
school, I was, uh, trained

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as a computer scientist,

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and then I, uh, I ended
up spending a fair bit

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of time in the research space
doing large dataset analytics

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after I got done with my
residency and fellowship.

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Uh, in addition to having
an active clinical practice,

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I'm an anesthesiologist and ICU doc,

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and then about three years
ago I was recruited, uh, here

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to the University of Iowa to
take the, uh, chief medical,

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now the chief Health
Information Officer role.

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- Oh, that's fantastic to hear.

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And what a great combination of skill sets

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and backgrounds, especially
for the current age

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where technology and
artificial intelligence as well

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as digital health is such a
big part of where healthcare

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and healthcare delivery is headed.

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- Yeah, it's a, it is an
amazing time in medicine.

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I think we're, we're moving
into an era, uh, unlike with

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EHRs, which I think were
implemented a little too early, uh,

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before the technology was truly ready.

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I think we're, we're now
moving into an era where

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the technology is, is really
primed for the problems

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that we have in healthcare today.

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So I'm, I'm super excited
about what we're going

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to see in the IT

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and computing space in healthcare over the

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next, uh, three to five years.

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- Absolutely. So given
where we're at right now,

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and as well, uh, as an eye for the future,

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what are the opportunities and headwinds

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that you're looking at currently?

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- Yeah, so I think like everybody
we're looking at, uh, AI

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as the current, uh, major opportunity

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for us in the IT space in our
provider space over the next,

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probably as I said, sort
of three to five years.

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We're gonna start, I
think, seeing benefits from

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that in the next, next few
months as we go through some

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of our acquisition processes.

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Uh, and I think that will
just continue to roll

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until it becomes more

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or less kind of standard
of standard of care

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for mostly documentation
purposes over the next, uh,

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or I think over, it'll
take us about five years

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to truly change the way we're
do doing documentation in

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healthcare using ai.

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- Got it. And I think too, as
you mentioned, I can imagine

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with those changes, even if it's a slow

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and incremental change, can
really make a big difference

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for physicians and
clinicians who are working

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with patients at the bedside,

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but also understanding how they
could really optimize their

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relationship with patients as well.

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- Yeah, I, I think what
we're gonna see is, uh,

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I don't think this is gonna
be slow and incremental.

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I think this is gonna
be truly transformative.

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I think between, uh, generative AI

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and communicating with patients

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and being able to explain
things to patient,

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more patients more explicitly,

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and communications that
we write back to them,

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and kind of asynchronous
messaging, uh, in addition

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to the ability for other
technologies to make it so

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that we can really spend
time just communicating

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with our patients and
not be distracted, trying

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to document things in the computer

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is gonna really change the
way the interaction, uh,

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that we have with patients

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and enable us to have a, a
better, stronger relationship

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with our patients, uh, over
the, over the coming years.

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- That's really great to hear.

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And I'm wondering, given
your role as chief health,

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chief Health Information Officer,

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how are you thinking about growth

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and adding value to the
organizational overall?

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What does that look like for you?

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- Yeah, so I think, um, growth

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and value I think are, are terms
that we throw around, throw

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around a lot, and we
don't necessarily, uh,

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define them well.

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When I think about growth
as an organization,

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typically I think about
us serving more patients

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and perhaps growing our footprint.

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Well, I think that there's
probably some technology now

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that helps us determine where's
the right place to move,

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where there are opportunities for us to,

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to influence healthcare, to provide care

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that maybe doesn't exist in certain areas.

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We're, we're a very large rural
state, uh, you know, whether

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that be in person or
via, uh, telemedicine,

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I think the opportunity for
growth is actually pretty large

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for us, but it's gonna come
in very small bites, you know,

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where can we provide additional care here?

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There are other places,
uh, in terms of value.

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I stick with a very strict
interpretation of that,

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which is outcome over cost.

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And I think the opportunity
for value here is, is high.

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I think that, uh, particularly
on the, uh, on the cost side

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of things, I think there's
an opportunity for us

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to dramatically reduce
the cost of care using

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advanced care models that are
fueled by ai, that are fueled

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by advanced technologies.

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You know, you look at the combination

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of remote patient monitoring with some AI

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and communication tools, uh,

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to help patients manage
their chronic diseases such

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that we can reduce the, the
actual cost of that, such

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that it becomes something
that we really can coach a

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patient, uh, intelligently

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through their complex medical
illness, I think is something

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that we're going to see
evolve over the next few, uh,

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over the next few years.

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Otherwise, I think the
major area for us in terms

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of growth locally is just in terms

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of access at the University
of Iowa, we are a profoundly,

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um, fortunate organization in
that we have the opportunity

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to provide care to
about one in four Iowans

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and, uh, in, in any kind
of regular budget cycle.

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And we, uh, unfortunately have

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not enough providers.

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And so I think using these
technologies we will be able

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to make our visits, uh, more impactful.

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Uh, we'll have fewer missed visits,

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although I have to say most
of our, most of our, uh,

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our patients tend to be
pretty compliant and,

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and we have a relatively low
nohow and cancellation rate.

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Um, but I think we'll be
able to maximize those visits

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and perhaps have those
visits be more impactful,

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resulting in the need
for fewer visits and, uh,

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and deliver better outcomes
for those patients, uh,

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with the use of these technologies.

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Not that the technologies will
be making decisions for us,

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they'll just make us more efficient.

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And I think that we're
truly to that point.

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- That really makes a lot of sense.

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And it's great to hear
that you're already able

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to leverage some of those technologies

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to become more efficient.

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And like you said, increasing
access to care is so critical.

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I know for a lot of
organizations right now,

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it's been challenging year financially.

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And so when you think about one investment

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or risk that's still worth
making over the next 12 months

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or so, what would you say that would be?

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What's either worked well for you

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or what do you see as being
really crucial in places

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that you're zeroing in on to spend some

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of those precious healthcare dollars?

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- Yeah. Um, I, I think that

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this is on the provider
wellbeing side of things,

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the documentation, things
that we've been talking about,

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I think they are expensive.

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I think we have to figure
out how we're gonna pay

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for these things long term.

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But everything from generative AI

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for asynchronous
communications to those kind

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of ambient listening to tools
that exist in clinics, uh,

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I think are gonna be
the, are gonna be the,

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the key things to invest in.

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I do think that much of this is,

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uh, gonna be erased to the bottom, uh,

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because you already see the
market getting super competitive

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in the ambient space with
contractual costs dropping,

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uh, with every vendor that you talk to.

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Uh, but at some point we're
gonna hit a compute burden

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and given the, the
relative scarcity of GPUs

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and other things, we're
gonna face those challenges.

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But I think this is gonna be expensive,

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but I don't think it's gonna be expensive

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as long in the long term
as everybody thinks it's,

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and so I think my approach
to this is we need

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to get these technologies in place.

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We need to figure out
where they're useful,

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and then we need to figure out
how we're gonna pay for them.

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Whether that's either with
increased productivity

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or increased retention,
whatever that might be.

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However, we're gonna
justify the investment,

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but I think the, the
size of that investment

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is actually gonna go down per
provider over, over the period

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of years relatively quickly.

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- I see. That makes a lot of sense.

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And definitely taking a long-term view of

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what the investments could
do certainly is a smart

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and strategic way to
approach this situation.

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Now, before we wrap up
here, I'm wondering,

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we've talked a lot about
areas where technology

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and healthcare delivery
are coming together as well

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as the provider wellbeing.

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Is there anything else that
you want to touch on in terms

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of looking at the future of
where you're excited about and,

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and what additional professional growth

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or growth areas for the health
system are you looking at?

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- Well, I think what I, what
I'm really excited about,

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I think a lot of the AI
applications you see right now are

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gonna be assistive as we sort

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of talked about on this immediately.

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I think the, the current height

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and the current actual
plateau productivity

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are actually centered
around documentation.

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Um, I do think in probably

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later this decade we will start

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to see really assistive AI
in clinical decision making.

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And I think that's gonna
be a, a very exciting time,

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whether it's AI or just
access to large sets of data.

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I think we're finally
gonna be to the point, uh,

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that's taken us, you
know, 40 years to get to

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where we will actually
be practicing medicine

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that is AI

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and really data assisted
on a personalized basis,

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which is, has been a long time coming.

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Um, if you, if you look
historically at the work

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that was done at Stanford in
the eighties, um, with, uh,

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you know, di uh, with uh, uh,

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differential diagnoses software,

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we're finally gonna deliver on that,

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I think in the next few years.

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- That would be fascinating

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and certainly to see that
come to fruition, uh,

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as you mentioned, really, really
cool personalized medicine

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and being able to more
precisely treat people

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and it seems like it
would really be better

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for outcomes in the
patient experience overall.

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- Yeah, I, I'm, I'm very excited.

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I think we're gonna see, um,

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I think we're actually gonna
see you when you look at,

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when you look at healthcare IT

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and where it's actually
demonstrated outcome benefit,

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it's actually relatively limited.

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You know, pharmaceutical
barcode scanning and,

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and things like that have
definitely of, of value,

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but a lot of things that we've done,

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if not actually demonstrated
improved outcomes,

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but I think we're gonna see it with these,

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with these technologies in
the not to distant future.

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- That's amazing to hear.
James, thank you so much

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for joining us on the podcast today,

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and we're excited for you to join us

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at our annual meeting in April.

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I know it's a four day event.

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We'll have more than 550 health
system executive speakers

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and leaders on some of the
biggest issues and topics

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and strategies for where
healthcare is headed today,

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especially focusing on technology,

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artificial intelligence, and more.

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So we're really looking forward

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to those conversations
continuing in this space.

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James, thank you so much for
being on the podcast today.

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It's been a pleasure.

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- Thank you very much.
- It's so important

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for leaders at the top of
organizations to keep learning,

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stay sharp, grow their networks

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to help our audience better
do this in a more simplified,

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personalized, and meaningful way.

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Becker's Healthcare has launched my bhc,

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it's your trusted Becker's
healthcare experience

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and more with content, connections,

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events and learning opportunities.

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Join the community free

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of charge@www.my dot becker's hospital

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review.com and we'll see you there.