- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by James Blum,
chief Health Information Officer at University of Iowa.
James, it's a pleasure to have you on the podcast today.
- Thanks. It's a pleasure to be here with you.
- Now. I know there's a lot happening
really in the healthcare space.
It's such a dynamic space,
and I know you're doing a lot at the University of Iowa
as well, so I'm excited for this conversation.
But before we dive into the meat of our conversation,
can you tell us a little bit more
about yourself and your background?
- Sure. Um, so prior to medical school, I was, uh, trained
as a computer scientist,
and then I, uh, I ended up spending a fair bit
of time in the research space doing large dataset analytics
after I got done with my residency and fellowship.
Uh, in addition to having an active clinical practice,
I'm an anesthesiologist and ICU doc,
and then about three years ago I was recruited, uh, here
to the University of Iowa to take the, uh, chief medical,
now the chief Health Information Officer role.
- Oh, that's fantastic to hear.
And what a great combination of skill sets
and backgrounds, especially for the current age
where technology and artificial intelligence as well
as digital health is such a big part of where healthcare
and healthcare delivery is headed.
- Yeah, it's a, it is an amazing time in medicine.
I think we're, we're moving into an era, uh, unlike with
EHRs, which I think were implemented a little too early, uh,
before the technology was truly ready.
I think we're, we're now moving into an era where
the technology is, is really primed for the problems
that we have in healthcare today.
So I'm, I'm super excited about what we're going
to see in the IT
and computing space in healthcare over the
next, uh, three to five years.
- Absolutely. So given where we're at right now,
and as well, uh, as an eye for the future,
what are the opportunities and headwinds
that you're looking at currently?
- Yeah, so I think like everybody we're looking at, uh, AI
as the current, uh, major opportunity
for us in the IT space in our provider space over the next,
probably as I said, sort of three to five years.
We're gonna start, I think, seeing benefits from
that in the next, next few months as we go through some
of our acquisition processes.
Uh, and I think that will just continue to roll
until it becomes more
or less kind of standard of standard of care
for mostly documentation purposes over the next, uh,
or I think over, it'll take us about five years
to truly change the way we're do doing documentation in
healthcare using ai.
- Got it. And I think too, as you mentioned, I can imagine
with those changes, even if it's a slow
and incremental change, can really make a big difference
for physicians and clinicians who are working
with patients at the bedside,
but also understanding how they could really optimize their
relationship with patients as well.
- Yeah, I, I think what we're gonna see is, uh,
I don't think this is gonna be slow and incremental.
I think this is gonna be truly transformative.
I think between, uh, generative AI
and communicating with patients
and being able to explain things to patient,
more patients more explicitly,
and communications that we write back to them,
and kind of asynchronous messaging, uh, in addition
to the ability for other technologies to make it so
that we can really spend time just communicating
with our patients and not be distracted, trying
to document things in the computer
is gonna really change the way the interaction, uh,
that we have with patients
and enable us to have a, a better, stronger relationship
with our patients, uh, over the, over the coming years.
- That's really great to hear.
And I'm wondering, given your role as chief health,
chief Health Information Officer,
how are you thinking about growth
and adding value to the organizational overall?
What does that look like for you?
- Yeah, so I think, um, growth
and value I think are, are terms that we throw around, throw
around a lot, and we don't necessarily, uh,
define them well.
When I think about growth as an organization,
typically I think about us serving more patients
and perhaps growing our footprint.
Well, I think that there's probably some technology now
that helps us determine where's the right place to move,
where there are opportunities for us to,
to influence healthcare, to provide care
that maybe doesn't exist in certain areas.
We're, we're a very large rural state, uh, you know, whether
that be in person or via, uh, telemedicine,
I think the opportunity for growth is actually pretty large
for us, but it's gonna come in very small bites, you know,
where can we provide additional care here?
There are other places, uh, in terms of value.
I stick with a very strict interpretation of that,
which is outcome over cost.
And I think the opportunity for value here is, is high.
I think that, uh, particularly on the, uh, on the cost side
of things, I think there's an opportunity for us
to dramatically reduce the cost of care using
advanced care models that are fueled by ai, that are fueled
by advanced technologies.
You know, you look at the combination
of remote patient monitoring with some AI
and communication tools, uh,
to help patients manage their chronic diseases such
that we can reduce the, the actual cost of that, such
that it becomes something that we really can coach a
patient, uh, intelligently
through their complex medical illness, I think is something
that we're going to see evolve over the next few, uh,
over the next few years.
Otherwise, I think the major area for us in terms
of growth locally is just in terms
of access at the University of Iowa, we are a profoundly,
um, fortunate organization in that we have the opportunity
to provide care to about one in four Iowans
and, uh, in, in any kind of regular budget cycle.
And we, uh, unfortunately have
not enough providers.
And so I think using these technologies we will be able
to make our visits, uh, more impactful.
Uh, we'll have fewer missed visits,
although I have to say most of our, most of our, uh,
our patients tend to be pretty compliant and,
and we have a relatively low nohow and cancellation rate.
Um, but I think we'll be able to maximize those visits
and perhaps have those visits be more impactful,
resulting in the need for fewer visits and, uh,
and deliver better outcomes for those patients, uh,
with the use of these technologies.
Not that the technologies will be making decisions for us,
they'll just make us more efficient.
And I think that we're truly to that point.
- That really makes a lot of sense.
And it's great to hear that you're already able
to leverage some of those technologies
to become more efficient.
And like you said, increasing access to care is so critical.
I know for a lot of organizations right now,
it's been challenging year financially.
And so when you think about one investment
or risk that's still worth making over the next 12 months
or so, what would you say that would be?
What's either worked well for you
or what do you see as being really crucial in places
that you're zeroing in on to spend some
of those precious healthcare dollars?
- Yeah. Um, I, I think that
this is on the provider wellbeing side of things,
the documentation, things that we've been talking about,
I think they are expensive.
I think we have to figure out how we're gonna pay
for these things long term.
But everything from generative AI
for asynchronous communications to those kind
of ambient listening to tools that exist in clinics, uh,
I think are gonna be the, are gonna be the,
the key things to invest in.
I do think that much of this is,
uh, gonna be erased to the bottom, uh,
because you already see the market getting super competitive
in the ambient space with contractual costs dropping,
uh, with every vendor that you talk to.
Uh, but at some point we're gonna hit a compute burden
and given the, the relative scarcity of GPUs
and other things, we're gonna face those challenges.
But I think this is gonna be expensive,
but I don't think it's gonna be expensive
as long in the long term as everybody thinks it's,
and so I think my approach to this is we need
to get these technologies in place.
We need to figure out where they're useful,
and then we need to figure out how we're gonna pay for them.
Whether that's either with increased productivity
or increased retention, whatever that might be.
However, we're gonna justify the investment,
but I think the, the size of that investment
is actually gonna go down per provider over, over the period
of years relatively quickly.
- I see. That makes a lot of sense.
And definitely taking a long-term view of
what the investments could do certainly is a smart
and strategic way to approach this situation.
Now, before we wrap up here, I'm wondering,
we've talked a lot about areas where technology
and healthcare delivery are coming together as well
as the provider wellbeing.
Is there anything else that you want to touch on in terms
of looking at the future of where you're excited about and,
and what additional professional growth
or growth areas for the health system are you looking at?
- Well, I think what I, what I'm really excited about,
I think a lot of the AI applications you see right now are
gonna be assistive as we sort
of talked about on this immediately.
I think the, the current height
and the current actual plateau productivity
are actually centered around documentation.
Um, I do think in probably
later this decade we will start
to see really assistive AI in clinical decision making.
And I think that's gonna be a, a very exciting time,
whether it's AI or just access to large sets of data.
I think we're finally gonna be to the point, uh,
that's taken us, you know, 40 years to get to
where we will actually be practicing medicine
that is AI
and really data assisted on a personalized basis,
which is, has been a long time coming.
Um, if you, if you look historically at the work
that was done at Stanford in the eighties, um, with, uh,
you know, di uh, with uh, uh,
differential diagnoses software,
we're finally gonna deliver on that,
I think in the next few years.
- That would be fascinating
and certainly to see that come to fruition, uh,
as you mentioned, really, really cool personalized medicine
and being able to more precisely treat people
and it seems like it would really be better
for outcomes in the patient experience overall.
- Yeah, I, I'm, I'm very excited.
I think we're gonna see, um,
I think we're actually gonna see you when you look at,
when you look at healthcare IT
and where it's actually demonstrated outcome benefit,
it's actually relatively limited.
You know, pharmaceutical barcode scanning and,
and things like that have definitely of, of value,
but a lot of things that we've done,
if not actually demonstrated improved outcomes,
but I think we're gonna see it with these,
with these technologies in the not to distant future.
- That's amazing to hear. James, thank you so much
for joining us on the podcast today,
and we're excited for you to join us
at our annual meeting in April.
I know it's a four day event.
We'll have more than 550 health system executive speakers
and leaders on some of the biggest issues and topics
and strategies for where healthcare is headed today,
especially focusing on technology,
artificial intelligence, and more.
So we're really looking forward
to those conversations continuing in this space.
James, thank you so much for being on the podcast today.
It's been a pleasure.
- Thank you very much. - It's so important
for leaders at the top of organizations to keep learning,
stay sharp, grow their networks
to help our audience better do this in a more simplified,
personalized, and meaningful way.
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