- Prepare to dive into the forefront
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- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Michelle Stansbury,
vice President of Innovation
and IT applications at Houston Methodist.
Michelle, it's a pleasure to have you on the podcast today.
- Well, thank you very much for having me, Laura.
- Now I'm excited to have you back.
I know you've been on the podcast a few times
and speak with us regularly, which is great.
Um, you're so innovative at Houston Methodist
and it's really cool to see the projects you're working on.
But for anybody that you know is just joining the pod, uh,
Becker's Healthcare podcast is just subscribed.
Can you tell us a little bit more
about yourself and your background?
- Sure. Well, um, as again, you introduced overall my title,
but I have been with Houston Methodist for 31 years now.
Um, I've had the complete joy
and honor of being able to serve at this institution
and see the overall growth of, um, how,
what we have done in those 31 years.
Right now, my role is really focused in two main areas.
My traditional role, which is the vice president
and IT over all of our applications
that support Houston Methodist,
but also, um, I am the vice president of our Center
for Innovation and work very, very closely
with our chief innovation officer, which is, um, Dr.
Roberta Schwartz. So we all kind
of hold these dual roles in the, in our organization
and it has served us extremely well.
Um, one and I will just speak kind of overall
to Roberta's role.
Not only is she our chief innovation officer,
but she is the executive vice president
and CEO of our largest, um,
hospital within overall our system.
Um, which serves her well in that aspect of being able to,
you know, create sort of innovation
and then be able to roll it out,
but then working very closely with me that on the IT aspect,
so she and I are able to bring IT
and operations together to work, um, very quickly on a lot
of these innovation initiatives.
- That's great to hear. And you know,
certainly your model is unique
and impressive to see what you've been able to do,
how nimble, um, you know, Houston Methodist is
because of, of the way you operate
and how you have those dual roles.
So, um, it's always fascinating to think about.
Now, I'm wondering right now,
what are you working on at Houston Methodist?
What's, uh, you know, your focus in top of mind?
- Sure. Well, there's really kind of three main areas
that we are focused on in the organization
and lots of different initiatives within each
of these three areas.
And one is really on our patients
and it is, you know, to really look at
how can we make sure that
the journey our patients take within our organization,
whether it be through a clinic,
through inpatient outpatient services, even on the backend,
that they are getting the type
of service in the way that they want to.
And that is completely different for many individuals.
One would prefer it mostly in a digital perspective,
some prefer it still just the calling in on the phone.
Um, but also two of how can we make sure that
that journey is as seamless
and providing that great service that they have come
to expect overall from our organization.
The other is how are we creating those
efficiencies for our clinicians?
And when I talk about our clinicians, it's our physicians,
our nurses, our staff,
and um, making sure that they're able to do
what they do best
with in working overall within this digital world.
Right now, everyone has heard about all of the burnout that
of course the physicians and nurses
and so forth are having to deal with, with working overall
with the EMR, but how can we make that that journey, um,
that they're having to do with working in this, um,
electronic world better
and get them back to doing what they do best,
which is taking care of our patients
and that's what they were trained for.
The third one is really gets down
to operational efficiencies.
And what I mean by that is we're all financially challenged
and will just continue to become so, you know,
in many organizations.
And so what digital technologies can we bring into place
that will be able to help the institutional become really
more efficient in our operations, um,
to help become more financially responsible?
So that's kind of the big three main areas
that we focus in on,
but it's, you know, kind of looking at overall within
the aspect.
And I, I want to talk a little bit about when I talk to,
you know, to say about our model
and how we can scale quickly in our organization.
I mean, um, I'll give you a couple
of examples overall there.
One is really on our virtual initiatives
and I know many people have heard about our virtual ICU,
but it's, it's, it's really the um,
emphasis that helped us to be able to scale quickly
because we created this virtual operations command center
that is staffed by clinicians.
So once you have that in place
and which is what we created at over forwards,
our virtual ICU,
which has been tremendously value added to our organization.
But now that we had that, we were able to be able
to do many other things from a virtual perspective.
One was our virtual nursing program.
Um, and not only with that
but our virtual, um, our telestroke, tele neuro
telepharmacy being able to do virtual consults.
But the other piece was on we, we utilized one technology
for our virtual ICU,
but as we're moving towards in our OR organization
and understanding the multiple use cases from a virtual
perspective, we've been working with overall an organization
to be able to put cameras
and audio technology in every one of our patient rooms.
And we're doing that so that
we can expand all of these other use cases.
So late last year we sort of went into a pilot mode
of working with this vendor, saw the potential,
and now it's about expanding.
So within summer, probably June
and July, we will have expanded across 2,600 rooms
of being able to have this camera technology integrated
with the TV so
that our virtual command center can now have conversations
overall from a virtual nursing perspective.
We can do virtual consults, we can have overall, um, virtual
pharmacy services, anything that needs
to be done overall with these cameras.
We're also working to put these same kind
of camera technologies within overall in our eds.
So that's kind of one area
that we are really just overall just expanding
and quickly rolling it out across our institution.
The other is within using um, biomedical devices
and there's an organization that we're working
with right now that has um, a device
that captures vital, vital signs.
And that device is probably about the size
of a silver dollar that you can place on a patient when they
come over all into our institution.
It captures vital signs information as I said,
that quickly goes over all with into the EMR,
but also has alert watch capabilities
that our virtual command center is monitoring as well
to be able to help predict
or look to where there's um,
potential decline overall within a patient.
And I will see, we've seen like three instances
where these devices, uh, being able to watch um,
overall within our operations command center have detected
things from our patients that weren't detected on the floor.
And it's not to say that um,
anything was being done wrong on the floor,
it was just they were able to detect it earlier,
notify the nursing staff, which they were able to go in then
and be able to take, um,
action on overall what was happening.
So we've expanded that across very quickly since we saw
such value add overall in utilizing these devices.
And so now it's being used across our organization
and overall within our patient care unit.
But again, also for those patients coming into our ED
that um,
or look to be admitted,
we are also using these devices on them as well.
We've also been able, because,
and this is where I get into really of clinical efficiency
and operational efficiency, most organizations
that are still taking vitals are doing it from a Q4
perspective because these devices are, um,
monitoring constantly.
We've been been able to reduce those Q4 vitals down to Q six
and sometimes Q eight.
So, um, really being able
to help overall from a patient perspective if you think
about patients that, you know, trying to rest at night
and also from the nursing perspective of having to get
around and be able to take all of those vitals.
Um, so that's kind of another area.
Another big area is really overall kind of in the AI space.
And I will tell you, I know AI is really that, um,
what I say is kind of the next frontier that everyone's
so excited about and such great opportunities.
We've been able to see some unique opportunities
with not only creating those efficiencies
by using the technology within our ORs,
but also being able to use it through vendors
who are using our data.
And it's our data to overall compare, create sort
of this digital twin and,
and compare it to multiple years of Medicare data to be able
to help predict overall
what is a potential necessary need for patients coming back
or could be readmitted.
Um, so to tell you whether
or not you should be able to, you need
to see this patient in seven days.
'cause typically you have people or patients coming back,
you tell them, I need to see you in 14 days.
This is now better able to predict by patient to say, Nope,
I need to see you within seven days,
but based on what we're seeing, I could see you in 21 days.
So it's really targeting more towards the patient
and not just a general sense of overall in 14.
And then another vendor that we're working
with is helping us overall with um,
having our clinicians be able to better predict
where it is from a length of stay perspective,
what is preventing us from getting patients discharged.
It will over all real time take our data
and say as monitoring to be able to say, here's
what is lacking that needs to be done in order
for these patients to be discharged.
So getting the right information at the right time
to be able to help with operational flow
within our organization.
And I mean, you know, those are just kind of a few things
that we're working on, um,
that have helped us overall expand in the organization,
but many other areas that we're looking at, um,
how we can use the technology to in our organization, kind
of those three key areas that I talked about.
- That's amazing to hear. And you know,
certainly I appreciate you going into all
of those three areas and, um, explaining, you know, what is
so crucial about them because as you mentioned, you know,
um, having the technology
that can support becoming more eff efficient and
and cost effective can make such a big difference
for the institution overall.
And you know, I I think is so cool what you're talking about
with the virtual pharmacy services
and some of the other areas where, you know, um,
bringing in additional opportunities and access points
to patients so that they can continue to receive care
and just make it easier for that patient journey overall.
- Well, and that's kind of the ultimate goal for us.
I know a lot of organizations, um, up north kind
of in the east have really had
to focus in on value-based care and remote services at home.
Um, you know, in
that aspect we're very fortunate in the state of Texas.
It's, you know, the, we're still kind of a big fee
for service state,
but we want to learn from technology on how that we can, um,
utilize those virtual services
overall within our operations.
Um, one to create the efficiencies
that overall we're looking for, you know, for our clinicians
and our patients, but learning from that technology as well
so that we can begin to expand when it makes sense
for our organization for those
external virtual type services.
And that's what we've had this other unique opportunity
where I think is, you know, some people had
to really focus on how do you do it externally
before you could learn it internally.
We've had the fortunate to be able to say, Nope,
we're learning all how to utilize this technology first,
you know, internal to our operations
and gain those efficiencies, um, while still now learning on
how that we could begin to explore utilizing those services
for external, um, opportunities as well.
- That's amazing to hear and
and really cool to, to think about now from your
perspective, what are the technologies
and concepts that you're wasting towards
and what are you pivoting away from?
- Well, I, uh, it is an interesting question
and, um, I think it is something
most everyone is looking at.
And I kind of talked about those items that we're,
we're racing towards right now.
And it, it, it's, this is a year
that we're calling expansion overall in
our, in our organization.
We've got so many new technologies, technologies that
have worked for us
and I kind of talked a little bit about those.
And so our goal is
to get those expanded across our organization
as quickly as possible.
We also have our new hospital, um, our hospital
of the future that is gonna be opening up in 2025
and that will be here before we know it.
So while we have planned, um, overall
for those new technologies,
we're utilizing them in our current facility.
So of course when that facility does open up,
it is not net new,
but it will have all of the new technologies
that we've been, you know, kind of using throughout,
scattered throughout our organization.
So we've got that big piece.
So really this was the year of expansion for us.
I will be honest, we're not, um, out um,
sort of exploring every new opportunity
'cause we have a lot on our plate right now,
but we are keeping our eyes open for anything, you know,
that is potentially new and exciting.
I would say AI as a big, um, opportunity.
And when you talk about ai, there's kind of two,
two concepts to think about.
AI was built in overall from a vendor's product, which many
of those we're using today.
And the other is generative ai. How are you using it?
You know, such as a chat GPT
or Bard of those kind of concepts, you know,
that you build yourself.
And we're, we're looking at both of them.
I mean, we are beginning to explore the opportunity,
which I know that some groups are right now today,
which is creating our own cat, GPT
or bared type environment with our own data.
'cause we can trust our data.
That's the big piece that I think many organizations are
struggling with is how do you trust the data right,
that is being created on some of these items.
So, you know, it's just conceptually we're looking at
that right now, um, wanting to explore use cases prior
to it being open up from a clinical perspective.
And that's what I would say, you know,
we're looking at are there things we can do in the backend
from a revenue cycle to learn from it prior
to us opening it up.
So, you know, kind of racing forward, here's what I'd tell,
I think every organization,
and I can't tell you how many conferences I go to today
that everybody wants to talk about ai.
So I, I think that's going to be,
I think 2024 is gonna be the year of ai.
I really do. Um, things we're pivoting away from.
Um, I, I, I can't, I don't know
that there's things we're pivoting away from.
I think we're being very cautious on some of the new items
that we're looking at because one of the things
that's very important for Houston Methodist on any
of these new technologies that we look at is that it has
to have a solid ROI has to it.
You know, we don't just bring in technologies just
because they look good
or wow isn't, that has the cool factor to it,
but what problem is it solving for
and what type of ROI, um, so I would say, well,
and one last piece Laura would probably be what it,
how much, um,
because cyber is such another issue going on today,
and especially with what happened overall with the recent,
um, with change healthcare, every vendor
that we're looking at, we really have to evaluate them on
what type of security have they built into their system.
Is it fairly close to
what we would have our expectations to?
If so, maybe we work with them
to really get it built out from the security standards we
need, or if they haven't even thought about it,
it may be something we will not even consider
until later on that they do.
So I don't know, it's kind of to be able to say things
that we're pivoting away from other than
what we're keeping an eye on in those aspects.
Um, I do know in, you know, we've looked at a couple
of vendors here recently
that we just could not put a solid ROI on.
We really liked the technology, but the return wasn't there.
And so that's sort of probably the things
that I would say most that we're kind of pivoting away from,
not overall in general.
- That's fascinating to hear it
and just really helpful to think through your strategy
and how you really approach, um, what technology
and digital health and transformation looks like for you.
Looking ahead, how do you see healthcare delivery changing
in the next five years or so?
What do you see as continuing to elevate and rise
and how will things change?
- Well, I have to tell you, I love every the,
when everyone asked me,
what do you think five years from now,
probably 10 years ago, I think it was easier for anyone,
especially in the technology space to be able to say, sure,
five years from now this is what we will probably see
because technology is changing so quickly and rapidly.
Um, you know, it's very hard to predict kind
of what's gonna happen in the next five years.
But where I would tell you, I think that you're going
to see, you know, more advancements,
I would tell you in this space kind of overall with ai,
how is it really going to help overall with patient care
help our clinicians?
Um, I know some people are worried, it's like, oh,
is AI gonna take over physician?
No, I think you, you need, um, someone referenced it
to me here the other day as the co-pilot, right?
AI is gonna be the co-pilot to our physicians to be able
to quickly be able to generate information
that the physicians who've had the medical training
and knowledge to be able to say, yes, that is valid.
No, I, you know, no, I need more information.
So I think you're going to see more
of an advancement in that area.
And then the other piece that I really think that is going
to help jumpstart
and really help us more is
getting patients the services from a virtual perspective
where they need it, when they need it
and at the time that they need it.
Um, you see sort of this massive sort of movement now
where you're able to do virtual urgent care, you're able
to do virtual type services when and where people need it.
No longer do they have to end up running to the clinic
or having an appointment.
I think you're gonna start to be able to see, as I told you,
with these, um, with this device that we're working on.
Part of the what is
that we're ultimately looking at is when patients come
to the ed, do we really feel that they're acute enough
to be overall admitted to the hospital or, or no.
But we do need to continue to watch them
so we can send them home with overall these devices
and monitor them from home.
So that's what I think you're going to see is really more so
of how are some of these services being
provided outside of the physical space
of a healthcare institution
and more of kind of this, um, home
or in, in digital kind of space to be able
to provide more services there, which keeps people, I mean,
look, the reality is is most people don't wanna have
to go into a hospital if they don't have to.
And so could you see some of those services?
That's where I see where it is big health,
health systems can really begin to work towards.
And, and again, that's kind of what we're,
we're working towards is looking at over
how could we utilize the technology, how can we use
what we have already structured
with our virtual operations command center.
That helps us to be able to provide now more
of those services externally.
I also think you're gonna see a lot
of these big health systems
that are gonna really help overall with
smaller community hospitals.
And I would not say, you know, these are kind of rural kind
of hospitals that needs more of the acute type services, but
but don't have the services available
in their own hospitals.
So they're gonna be looking for these big health systems
that could potentially offer those services to them
and to their patients who are there in
the surrounding community.
But very much it is, I think advancement in AI's,
advancement in wearable
and the data that's coming in, um, in virtual services.
I just think there's so much potential that is out there
for overall for not only just patients, clinicians,
but health systems as well.
- That's amazing to hear.
Michelle, thank you so much for joining
us on the podcast today.
That's been such a fun and interesting conversation
and I look forward to connecting with you again soon.
- Sure. I look forward to see you in April.