1 00:00:00,235 --> 00:00:02,205 - Prepare to dive into the forefront 2 00:00:02,225 --> 00:00:05,525 of healthcare innovation at our 14th annual meeting coming 3 00:00:05,545 --> 00:00:06,645 up on April 8th 4 00:00:06,645 --> 00:00:10,765 through 11th at the Hyatt Regency in Chicago, with thousands 5 00:00:10,765 --> 00:00:13,965 of industry leaders converging over four dynamic days 6 00:00:13,985 --> 00:00:16,805 of discussions on crucial topics from health IT 7 00:00:17,185 --> 00:00:18,685 to executive leadership. 8 00:00:18,995 --> 00:00:21,325 It's where the future of healthcare takes shape. 9 00:00:21,865 --> 00:00:24,085 We can't wait to connect with you in person 10 00:00:24,305 --> 00:00:26,725 and engage in these important conversations. 11 00:00:27,715 --> 00:00:30,125 - This is Laura Dedo with the Becker's Healthcare Podcast. 12 00:00:30,745 --> 00:00:32,805 I'm thrilled today to be joined by Dr. Richard Zain, 13 00:00:32,805 --> 00:00:34,205 chief Innovation Officer at uc Health. 14 00:00:34,465 --> 00:00:36,525 Dr. Zane's, a pleasure to have you on the podcast today. 15 00:00:37,905 --> 00:00:39,725 - Lovely to be here. Thanks for having me. 16 00:00:41,065 --> 00:00:43,325 - Now I know we'll get into a lot of the different things 17 00:00:43,325 --> 00:00:45,125 that you're doing there at uc Health and, 18 00:00:45,145 --> 00:00:46,525 and really what you're looking ahead for. 19 00:00:46,585 --> 00:00:48,685 But before we dive into the broader discussion, 20 00:00:48,685 --> 00:00:49,685 can you tell us a little bit more 21 00:00:49,685 --> 00:00:50,805 about yourself and your background? 22 00:00:52,315 --> 00:00:55,405 - Sure. So I am a practicing physician. 23 00:00:55,625 --> 00:00:57,045 I'm an emergency physician. 24 00:00:57,625 --> 00:00:59,965 Uh, I chair the Academic Department 25 00:00:59,965 --> 00:01:01,525 of Emergency Medicine at the University 26 00:01:01,525 --> 00:01:02,685 of Colorado School of Medicine. 27 00:01:02,805 --> 00:01:05,045 I also, I'm a professor at the medical school 28 00:01:05,045 --> 00:01:08,605 and the business school, and as chief innovation officer, 29 00:01:08,925 --> 00:01:12,525 I work with the senior leadership team at our health system, 30 00:01:12,895 --> 00:01:17,005 which is a 14 hospital system based in Colorado to 31 00:01:17,725 --> 00:01:20,405 identify problems where there may 32 00:01:20,945 --> 00:01:23,085 be a technological solution. 33 00:01:23,185 --> 00:01:26,045 And sometimes, most of the time it's a combination of 34 00:01:26,675 --> 00:01:28,845 process people and tools. 35 00:01:28,905 --> 00:01:31,405 And the tools are, are where we look 36 00:01:31,405 --> 00:01:32,925 for technological solutions. 37 00:01:33,555 --> 00:01:35,915 When we do that, we think about 38 00:01:35,915 --> 00:01:38,315 what our ideal partnerships look like, 39 00:01:38,655 --> 00:01:41,195 and our ideal partnerships are the problem statement is 40 00:01:41,195 --> 00:01:43,635 valid and there isn't an out of the box solution 41 00:01:44,305 --> 00:01:47,495 that we have a potential partner 42 00:01:47,565 --> 00:01:49,135 that understands the problem statement 43 00:01:49,275 --> 00:01:52,655 and we culturally are aligned, uh, 44 00:01:52,655 --> 00:01:53,855 that we're gonna be a customer, 45 00:01:54,375 --> 00:01:56,535 a co-development partner and an investor. 46 00:01:57,115 --> 00:02:00,575 And when we find a problem statement that needs to be solved 47 00:02:01,395 --> 00:02:05,335 and a partner that is as interested in solving the problem 48 00:02:05,395 --> 00:02:09,135 as as we are, and we can meet all three of those criteria, 49 00:02:09,955 --> 00:02:11,735 we usually can hit it out of the park 50 00:02:12,355 --> 00:02:16,145 and then we help that product or that company scale. 51 00:02:16,255 --> 00:02:18,265 Because if it's a problem for us, it's a problem 52 00:02:18,285 --> 00:02:20,585 for the other 2000 hospitals 53 00:02:20,585 --> 00:02:21,865 or systems in the United States. 54 00:02:24,505 --> 00:02:25,915 - Well, that's so fascinating and 55 00:02:25,915 --> 00:02:27,755 and I really think that's an interesting approach 56 00:02:27,755 --> 00:02:30,075 and a great approach to have that win-win situation 57 00:02:30,075 --> 00:02:33,115 of being able to work with companies that, you know, 58 00:02:33,115 --> 00:02:36,035 really are solving problems or challenges for the system 59 00:02:36,255 --> 00:02:39,075 and, and then again, help them grow and scale 60 00:02:39,095 --> 00:02:40,355 and learn from, you know, 61 00:02:40,355 --> 00:02:42,635 that real world application within uc health. 62 00:02:42,775 --> 00:02:43,955 So that's really cool. 63 00:02:44,115 --> 00:02:46,115 I, I'm wondering, can you dive a bit deeper 64 00:02:46,295 --> 00:02:48,955 and tell me about one of the most successful partnerships 65 00:02:48,955 --> 00:02:50,875 or projects from the last year or two? 66 00:02:51,335 --> 00:02:54,475 Uh, what did you do and how did you measure the results? 67 00:02:57,405 --> 00:02:59,455 - So I like to say that I, I have one 68 00:02:59,455 --> 00:03:01,655 of the most interesting jobs that exist in healthcare. 69 00:03:02,155 --> 00:03:04,455 And the reason I believe that is 70 00:03:04,455 --> 00:03:08,455 because I get to be creative with other creative people 71 00:03:09,115 --> 00:03:11,015 to address problems that 72 00:03:11,605 --> 00:03:14,615 very frequently have palpable solutions. 73 00:03:15,355 --> 00:03:19,175 So even though scientists are remarkably creative 74 00:03:19,355 --> 00:03:20,855 and work incredibly hard 75 00:03:21,035 --> 00:03:24,735 and are highly challenged, sometimes they wait years 76 00:03:25,115 --> 00:03:27,855 or decades for things to come to fruition. 77 00:03:29,015 --> 00:03:31,855 I get to say that so many people did not die, 78 00:03:32,355 --> 00:03:36,225 or people's lives were, were better 79 00:03:36,485 --> 00:03:38,785 or we were able to care for more patients in a, 80 00:03:39,045 --> 00:03:40,465 in a more cost effective way 81 00:03:40,895 --> 00:03:42,385 through the projects that we do. 82 00:03:42,925 --> 00:03:46,145 So that's really why I love, uh, what it is that I do. 83 00:03:46,965 --> 00:03:49,705 And the best problems are the ones 84 00:03:50,055 --> 00:03:52,945 that are identified at the front lines, not problems 85 00:03:52,945 --> 00:03:55,665 that I think may exist, not problems that companies come 86 00:03:55,665 --> 00:03:57,825 and tell me I have, uh, 87 00:03:57,845 --> 00:04:00,225 but problems that people who are responsible 88 00:04:00,225 --> 00:04:04,185 for the work say, Hey, we can't get through this problem. 89 00:04:04,885 --> 00:04:07,905 Uh, do you think you can help us think about a solution? 90 00:04:08,725 --> 00:04:11,625 And when we do that, the first thing we do is have people 91 00:04:11,635 --> 00:04:13,265 articulate a problem statement 92 00:04:13,845 --> 00:04:16,445 and in a pretty structured way, meaning 93 00:04:17,945 --> 00:04:20,875 here is the introductory sentence, not introductory, 94 00:04:20,875 --> 00:04:22,395 five paragraphs or five pages. 95 00:04:23,385 --> 00:04:25,435 Here is the quantification of the problem. 96 00:04:26,015 --> 00:04:27,435 If we were able to solve this, 97 00:04:27,975 --> 00:04:29,475 we would find two more cancers 98 00:04:29,535 --> 00:04:32,965 or we would find 2000 more cancers because 99 00:04:33,725 --> 00:04:36,085 although two is important, 2000 is really compelling. 100 00:04:37,215 --> 00:04:41,915 And then here are the other systems that attempted to, 101 00:04:42,335 --> 00:04:43,395 to solve it or not. 102 00:04:43,735 --> 00:04:45,115 And we'll do an environmental scan 103 00:04:45,415 --> 00:04:47,555 and we'll go across the country usually, 104 00:04:48,015 --> 00:04:49,075 uh, through connections. 105 00:04:49,075 --> 00:04:50,235 Sometimes we'll get on a plane 106 00:04:50,735 --> 00:04:52,715 and see if anybody has actually solved it. 107 00:04:52,935 --> 00:04:54,035 And if they have, we're gonna 108 00:04:54,035 --> 00:04:55,395 learn and we're gonna implement. 109 00:04:55,405 --> 00:04:58,355 We're not gonna go and start a company or we're not gonna go 110 00:04:58,355 --> 00:05:00,115 and partner with a company to start a new product. 111 00:05:00,695 --> 00:05:01,995 Uh, but if they haven't solved it, 112 00:05:02,135 --> 00:05:03,035 and it's a problem for us, 113 00:05:03,035 --> 00:05:04,235 we know it's a problem for everybody. 114 00:05:05,195 --> 00:05:07,695 So those are the types of problems that are most ideal. 115 00:05:08,155 --> 00:05:11,865 And you know, we're as strategic as, 116 00:05:12,365 --> 00:05:13,585 uh, we can be. 117 00:05:13,775 --> 00:05:15,225 Very often we're opportunistic, 118 00:05:15,225 --> 00:05:16,985 meaning another system will say, 119 00:05:16,985 --> 00:05:18,025 Hey, have you heard of this company? 120 00:05:18,085 --> 00:05:19,705 Or a company will come to us 121 00:05:19,705 --> 00:05:22,385 and we'll say, wow, that looks very interesting and, 122 00:05:22,405 --> 00:05:23,465 and we'll do a deep dive. 123 00:05:24,245 --> 00:05:25,545 Uh, but that's how we function. 124 00:05:25,545 --> 00:05:28,465 And then we think about how we keep in our guiding 125 00:05:28,465 --> 00:05:30,505 principles of how we deliver work. 126 00:05:30,895 --> 00:05:32,865 Meaning how does it affect the patient? 127 00:05:33,605 --> 00:05:36,545 How does it not make care more expensive and complex? 128 00:05:38,225 --> 00:05:41,405 How do we preserve provider workflow? 129 00:05:41,425 --> 00:05:43,925 How do we make it easier and not harder for our providers 130 00:05:44,505 --> 00:05:46,285 and how do we make it better for our patients? 131 00:05:48,325 --> 00:05:49,465 - That's such a great point. 132 00:05:49,525 --> 00:05:51,585 And you know, I really appreciate that thought process 133 00:05:51,585 --> 00:05:56,185 because so much goes into, um, having those kind of, um, 134 00:05:56,375 --> 00:05:59,045 ways of trying to make sure you're solving the right problem 135 00:05:59,305 --> 00:06:01,005 and, and, uh, really being impactful 136 00:06:01,025 --> 00:06:04,365 and meaningful with how the solution is rolled out now, 137 00:06:04,555 --> 00:06:06,525 what are some of the top priorities that you have 138 00:06:06,525 --> 00:06:07,805 for the next 12 months or so? 139 00:06:07,805 --> 00:06:09,285 What will really be top of mind for you? 140 00:06:10,495 --> 00:06:13,865 - Well, what we're working on now is broadly, 141 00:06:14,885 --> 00:06:16,345 we spend a lot of time 142 00:06:17,065 --> 00:06:19,545 thinking about the virtualization of care. 143 00:06:20,725 --> 00:06:23,345 And when people say virtual health 144 00:06:23,365 --> 00:06:27,705 or telehealth, they have an immediate picture 145 00:06:27,965 --> 00:06:30,465 of a doctor in front of a computer speaking 146 00:06:30,465 --> 00:06:33,545 to a patient on the other side, that's not what we mean. 147 00:06:35,035 --> 00:06:37,815 We mean using intelligence and intelligence. 148 00:06:38,045 --> 00:06:40,695 Like innovation can mean everything and nothing, uh, 149 00:06:40,875 --> 00:06:43,255 but using math, whether it's AI 150 00:06:43,255 --> 00:06:44,735 or whether it's prescriptive analytics 151 00:06:44,795 --> 00:06:48,215 or generative AI to do the work 152 00:06:48,285 --> 00:06:51,135 that would usually require people to do so that the people, 153 00:06:51,795 --> 00:06:55,295 um, can use human brains to adjudicate. 154 00:06:56,515 --> 00:06:59,895 So what we like to do is think about 155 00:07:01,365 --> 00:07:05,315 human adjudication and think about what we can automate. 156 00:07:05,935 --> 00:07:10,165 So we think a lot about automating care 157 00:07:10,615 --> 00:07:12,765 where there are so many confounding variables 158 00:07:12,765 --> 00:07:16,885 of single human can't possibly adjudicate 2000 159 00:07:16,945 --> 00:07:18,525 or 2,500 variables. 160 00:07:19,105 --> 00:07:22,605 And then we do the same with administrative automation. 161 00:07:23,105 --> 00:07:25,765 Things like how do you do capacity management 162 00:07:25,765 --> 00:07:27,005 across 14 hospitals? 163 00:07:27,505 --> 00:07:30,605 How do you load balance acuity across different units? 164 00:07:31,745 --> 00:07:35,725 How do you do revenue cycle and automate it? 165 00:07:36,185 --> 00:07:41,115 Uh, how do you interact on a, on a patient basis, 166 00:07:41,895 --> 00:07:46,465 uh, with, you know, a verbal, uh, like a, 167 00:07:46,665 --> 00:07:49,385 a series like, uh, interface. 168 00:07:50,045 --> 00:07:54,025 So that's a lot of what we work on is making it easier 169 00:07:54,205 --> 00:07:58,665 for our patients, making it more accurate and safer 170 00:07:59,365 --> 00:08:00,385 and more automated. 171 00:08:01,165 --> 00:08:02,945 And broadly that's what we look at. 172 00:08:03,405 --> 00:08:05,625 And we do everything from helping 173 00:08:06,185 --> 00:08:08,425 providers choose pharmacotherapy for their patients so 174 00:08:08,425 --> 00:08:11,105 that when they prescribe a medication, 175 00:08:11,805 --> 00:08:13,305 not only is it the right medication, 176 00:08:13,765 --> 00:08:16,985 but it's also a medication that their payer 177 00:08:17,445 --> 00:08:20,025 or their pharmacy benefits manager actually covers. 178 00:08:20,725 --> 00:08:22,825 So we don't have a third 179 00:08:22,825 --> 00:08:24,585 of the prescriptions being left at the pharmacy 180 00:08:24,705 --> 00:08:25,705 'cause the patient shows up 181 00:08:25,725 --> 00:08:28,585 and realizes there's a $500 copay. 182 00:08:28,845 --> 00:08:30,945 We know exactly what that copay is gonna be 183 00:08:31,365 --> 00:08:32,665 and we can have a conversation 184 00:08:32,665 --> 00:08:34,185 with the patient when it's gonna be something 185 00:08:34,185 --> 00:08:36,145 that is substantive for that patient. 186 00:08:36,805 --> 00:08:40,745 So our pharmacy left behind rate went from, you know, 20 187 00:08:40,765 --> 00:08:42,185 to 30% to almost zero 188 00:08:42,495 --> 00:08:46,865 because we are able to drive patients to medications 189 00:08:46,905 --> 00:08:48,425 that are clinically equivalent 190 00:08:48,685 --> 00:08:50,545 and covered by their their payer. 191 00:08:51,365 --> 00:08:55,325 Uh, we've been able to do things like harness, you know, 192 00:08:55,325 --> 00:08:58,645 linguistic modeling and AI to keep track 193 00:08:59,145 --> 00:09:00,485 of incidental findings. 194 00:09:01,465 --> 00:09:03,805 And incidental findings, um, are scary 195 00:09:04,275 --> 00:09:08,805 because there are thousands upon thousands of tests done. 196 00:09:09,305 --> 00:09:11,925 And even though the tests are done for a specific reason, 197 00:09:12,395 --> 00:09:15,125 sometimes tests identify other things 198 00:09:15,125 --> 00:09:16,365 that need to be followed up. 199 00:09:17,765 --> 00:09:19,345 If I do a chest x-ray on you 200 00:09:19,345 --> 00:09:20,705 because I'm worried that you have pneumonia, 201 00:09:21,745 --> 00:09:23,465 I will say you do or don't have pneumonia. 202 00:09:24,125 --> 00:09:27,665 But if there's also something there could be a nodule 203 00:09:28,005 --> 00:09:30,665 and a nodule on a chest X-ray could be cancer, 204 00:09:31,575 --> 00:09:34,945 then we need a process to be able to, to keep track of that. 205 00:09:35,765 --> 00:09:37,625 And there wasn't great processes 206 00:09:37,765 --> 00:09:39,185 and this is a national problem. 207 00:09:39,685 --> 00:09:42,345 So sometimes the report will be written, 208 00:09:42,445 --> 00:09:44,585 the report will be forwarded to a primary care doctor, 209 00:09:44,585 --> 00:09:46,905 even if that primary care doctor didn't order that test. 210 00:09:47,445 --> 00:09:49,185 And then it would rely on the primary care doctor 211 00:09:49,405 --> 00:09:53,345 or their assistant to read the entire report, make note 212 00:09:53,695 --> 00:09:56,465 that John Smith has a nodule 213 00:09:56,485 --> 00:09:58,625 and needs to have a follow-up chest x-ray in a year 214 00:09:58,685 --> 00:10:00,985 or even a CT scan to follow that up 215 00:10:01,485 --> 00:10:04,105 and then multiply that times all the types of tests 216 00:10:04,105 --> 00:10:07,025 that people get, whether it's chest x-rays or pap smears 217 00:10:07,025 --> 00:10:10,505 or mammograms or biopsies 218 00:10:10,565 --> 00:10:13,145 or blood tests or MRIs. 219 00:10:13,685 --> 00:10:15,665 The MRIs are done for a specific indication, 220 00:10:15,765 --> 00:10:18,465 but there's often something else that is seen. 221 00:10:18,965 --> 00:10:20,265 So how do we keep track of that? 222 00:10:20,405 --> 00:10:21,625 We invested 223 00:10:21,625 --> 00:10:23,665 and partnered with a company called Eon Health 224 00:10:24,215 --> 00:10:25,425 that does exactly that. 225 00:10:25,605 --> 00:10:29,505 And what we found is that we went from pretty good, 226 00:10:30,515 --> 00:10:33,655 um, following up incidental findings, not great, 227 00:10:34,235 --> 00:10:38,255 pretty good maybe okay to 98.3%, 228 00:10:39,025 --> 00:10:42,975 which is hundreds upon hundreds 229 00:10:43,515 --> 00:10:47,735 of either cancers being eliminated from someone's 230 00:10:48,575 --> 00:10:52,705 problem list or identifying a cancer way earlier than it 231 00:10:52,705 --> 00:10:54,145 otherwise would've been identified. 232 00:10:55,365 --> 00:10:59,065 So that is a big win for us and our patients. 233 00:11:01,655 --> 00:11:03,175 - Absolutely. It, it is really impressive and, 234 00:11:03,195 --> 00:11:06,375 and what a great and empowering story of how, you know, 235 00:11:06,395 --> 00:11:07,495 the team can work together 236 00:11:07,755 --> 00:11:09,975 and bring technology in the process, um, 237 00:11:10,195 --> 00:11:11,895 to be a huge difference maker 238 00:11:12,115 --> 00:11:15,215 and move the needle for um, patients who really, 239 00:11:15,315 --> 00:11:17,175 as you mentioned in the beginning of our discussion, 240 00:11:17,675 --> 00:11:20,735 are having their lives saved by the fact that these techno 241 00:11:20,755 --> 00:11:22,295 or that their, um, cancers 242 00:11:22,295 --> 00:11:23,815 and illnesses are identified early 243 00:11:23,875 --> 00:11:26,335 and then the right treatments are, are administered. 244 00:11:26,475 --> 00:11:29,055 So that's really powerful and great to hear. 245 00:11:29,555 --> 00:11:31,735 Uh, before we wrap up, I'm wondering, you know, 246 00:11:31,755 --> 00:11:33,055 if you look into the future 247 00:11:33,155 --> 00:11:35,815 and just all the possibilities as technology continues 248 00:11:35,815 --> 00:11:38,455 to evolve and as healthcare, um, evolves as well, 249 00:11:38,795 --> 00:11:41,575 how do you anticipate that your role in teams will change? 250 00:11:44,165 --> 00:11:47,855 - I think that there will be exponential pressure 251 00:11:48,455 --> 00:11:52,145 because of the fundamental alterations 252 00:11:52,525 --> 00:11:56,605 and the finances of medicine that we've seen post pandemic. 253 00:11:57,365 --> 00:11:58,685 I am very fond of saying 254 00:11:58,685 --> 00:12:00,285 that it's white knuckle time in healthcare 255 00:12:00,425 --> 00:12:03,125 and it's white knuckle time in healthcare, uh, 256 00:12:03,125 --> 00:12:07,965 health systems are not able to generate the amount 257 00:12:07,965 --> 00:12:10,845 of margin that they need to be sustainable. 258 00:12:11,105 --> 00:12:12,685 And there are exceptions to that rule, 259 00:12:13,665 --> 00:12:15,765 and that is the biggest change. 260 00:12:16,465 --> 00:12:19,765 And healthcare cannot be 261 00:12:19,905 --> 00:12:22,565 or can no longer be the last bastion of industry 262 00:12:23,055 --> 00:12:26,645 where deploying technology increases complexity and cost. 263 00:12:27,375 --> 00:12:31,275 We need to deploy technology to decrease complexity, 264 00:12:31,335 --> 00:12:35,315 to decrease cost, to make things safer, better, faster, 265 00:12:36,305 --> 00:12:39,035 meet patient patients where they want to be in a way 266 00:12:39,035 --> 00:12:43,835 that they can actually afford, that society can handle 267 00:12:43,905 --> 00:12:44,995 that type of a cost. 268 00:12:45,195 --> 00:12:48,035 'cause the cost now is not sustainable societally. 269 00:12:49,095 --> 00:12:53,315 And one of the things in addition to payer reform, 270 00:12:54,495 --> 00:12:58,035 pharmaceutical reform is going to be understanding 271 00:12:58,425 --> 00:13:00,235 what technology can and should do 272 00:13:00,735 --> 00:13:02,835 and where that line between technology 273 00:13:02,835 --> 00:13:04,835 and humans interfaces. 274 00:13:07,405 --> 00:13:09,205 - Absolutely. Dr. Zane, thank you so much 275 00:13:09,205 --> 00:13:10,645 for joining us on the podcast today. 276 00:13:10,675 --> 00:13:12,565 This has been a fascinating discussion 277 00:13:12,565 --> 00:13:14,445 and I look forward to connecting with you again soon. 278 00:13:15,545 --> 00:13:16,245 - Thanks. Bye.