1 00:00:00,925 --> 00:00:02,525 - Becker Healthcare Podcast made for the people 2 00:00:02,525 --> 00:00:03,565 who power US healthcare. 3 00:00:03,785 --> 00:00:05,765 I'm Molly Gamble. Becker is thrilled today 4 00:00:05,785 --> 00:00:07,125 to spend some time with Dr. 5 00:00:07,405 --> 00:00:09,885 Ashish Barad, chief Digital Information Officer 6 00:00:09,955 --> 00:00:11,365 with Allegheny Health Network. 7 00:00:11,665 --> 00:00:13,245 Dr. Barad, thanks so much 8 00:00:13,245 --> 00:00:14,725 for being our guest on the podcast today. 9 00:00:14,825 --> 00:00:16,645 How are you? And where does the podcast find you? 10 00:00:18,165 --> 00:00:19,545 - Thanks for having me, Molly. 11 00:00:19,945 --> 00:00:23,225 I am excited to be on the podcast, and I am doing well. 12 00:00:23,665 --> 00:00:28,065 I am in the city of Bridges, so Pittsburgh, Pennsylvania, 13 00:00:28,645 --> 00:00:30,865 um, has a lot of bridges. 14 00:00:30,885 --> 00:00:33,785 And being that I'm from Texas, um, it's a, 15 00:00:33,785 --> 00:00:36,065 it's a new venture, but it's a fantastic town. 16 00:00:37,645 --> 00:00:39,615 - Yeah. Well, for listeners who could use a, 17 00:00:39,695 --> 00:00:41,415 a refresh on Allegheny Health Network 18 00:00:41,515 --> 00:00:42,735 and based in Pittsburgh, 19 00:00:42,835 --> 00:00:45,255 can you share a few other key facts about the system 20 00:00:45,315 --> 00:00:47,975 and organization for our listeners just to get reacquainted? 21 00:00:48,935 --> 00:00:51,665 - Yeah, happy to. So, yeah, Allegheny Health Network, 22 00:00:51,965 --> 00:00:53,785 as you said, based outta Pittsburgh, Pennsylvania, 23 00:00:53,805 --> 00:00:54,825 and Western Pennsylvania, 24 00:00:55,645 --> 00:00:59,905 and is a 14 hospital system, about 2,500 beds, 25 00:01:00,445 --> 00:01:05,185 uh, 22,000 employees and about 3000, uh, physicians, uh, 26 00:01:05,245 --> 00:01:06,425 and other providers. 27 00:01:06,525 --> 00:01:11,105 And, um, we serve around 29 counties here, uh, 28 00:01:11,105 --> 00:01:13,265 in some portions of New York, Ohio, West Virginia, 29 00:01:13,555 --> 00:01:15,625 about 5 billion in annual revenue. 30 00:01:16,605 --> 00:01:21,545 Um, and we are owned by Highmark Health, uh, which is, um, 31 00:01:21,735 --> 00:01:24,745 obviously a very large insurance company. 32 00:01:25,205 --> 00:01:26,585 Uh, I believe it's the fourth, 33 00:01:26,585 --> 00:01:29,145 the fifth largest Blue Cross Blue Shield, uh, in the US 34 00:01:29,965 --> 00:01:32,425 and serves, uh, roughly five states, 35 00:01:32,565 --> 00:01:34,225 but also has national members. 36 00:01:35,005 --> 00:01:37,505 So it's just a, a unique aspect of 37 00:01:37,575 --> 00:01:39,505 what makes a HNA bit different. 38 00:01:40,015 --> 00:01:42,395 - Mm-Hmm. , you mentioned coming up from Texas. 39 00:01:42,755 --> 00:01:44,035 I, I should let listeners know, 40 00:01:44,035 --> 00:01:47,515 congratulations on passing the one year mark in your role 41 00:01:47,535 --> 00:01:48,595 as CDIO. 42 00:01:48,595 --> 00:01:50,355 You've been with Allegheny Health Network, 43 00:01:50,575 --> 00:01:54,795 but you took on a new role, expanded to include the CIO hat 44 00:01:54,815 --> 00:01:57,675 to your CDO role in January of 2023. 45 00:01:58,185 --> 00:02:00,795 What have been the biggest lessons you've learned in this 46 00:02:00,795 --> 00:02:01,795 time, in this past year, 47 00:02:01,865 --> 00:02:03,475 ways you've grown throughout this past 48 00:02:03,475 --> 00:02:04,795 year? What comes to mind? 49 00:02:05,605 --> 00:02:07,015 - Yeah, I appreciate the question. 50 00:02:07,075 --> 00:02:08,655 So thank you for the, for the congrats. 51 00:02:08,655 --> 00:02:12,655 It's, it's been, um, really nice to, uh, kind 52 00:02:12,655 --> 00:02:15,415 of own the quote unquote the, the full tech stack. 53 00:02:16,035 --> 00:02:18,815 And I think, you know, to, as far as the lessons learned, 54 00:02:19,095 --> 00:02:21,295 I think a few, you know, I came from a very, 55 00:02:21,295 --> 00:02:22,735 very large health system in Texas, 56 00:02:23,675 --> 00:02:26,015 and, um, I'm sure everybody liked each other 57 00:02:26,155 --> 00:02:27,255 and everybody was good friends, 58 00:02:27,555 --> 00:02:28,855 but you could only imagine 59 00:02:29,525 --> 00:02:32,975 that the Chief Digital officer's roadmap may not always 60 00:02:33,145 --> 00:02:36,815 align with the CMIO's roadmap, may not always align 61 00:02:36,815 --> 00:02:39,015 with the CIO's roadmap and many others. 62 00:02:39,755 --> 00:02:43,215 So, um, the fact that I wear all those hats, so, um, 63 00:02:43,515 --> 00:02:48,015 I'm in charge of the informatics shop as well with Epic, um, 64 00:02:48,315 --> 00:02:51,015 and the data shop as well as virtual help. 65 00:02:51,555 --> 00:02:54,175 So I do, uh, wear a lot of hats, um, 66 00:02:54,445 --> 00:02:55,935 depending on the meeting I go to, 67 00:02:56,335 --> 00:02:57,375 probably from 30 minutes to 30 minutes. 68 00:02:58,035 --> 00:03:02,685 But all of that really allows us to have one roadmap 69 00:03:02,785 --> 00:03:03,885 that's very succinct 70 00:03:04,385 --> 00:03:07,845 and has a kind of clear trajectory, vision, you know, 71 00:03:07,875 --> 00:03:09,165 roadmap to it. 72 00:03:09,225 --> 00:03:13,685 So that, that has really been, um, very helpful, 73 00:03:14,465 --> 00:03:16,605 uh, to really be able to create impact. 74 00:03:16,985 --> 00:03:19,765 And I guess that's the other point that I'll, uh, 75 00:03:19,765 --> 00:03:21,925 answer your question with, which is, you know, 76 00:03:21,925 --> 00:03:23,645 lessons learned in this role, 77 00:03:23,745 --> 00:03:25,285 not just at a Allegheny Health Network, 78 00:03:25,505 --> 00:03:28,085 but just in the industry, is, you know, 79 00:03:28,155 --> 00:03:30,445 it's not just about disrupting healthcare. 80 00:03:30,565 --> 00:03:32,205 I know we talk a lot about disrupting healthcare, 81 00:03:32,305 --> 00:03:34,845 and trust me, I'm, I'm a big believer on the fact 82 00:03:34,845 --> 00:03:38,085 that it needs to be disrupted, um, on some accounts. 83 00:03:38,625 --> 00:03:40,885 But, you know, I see a lot of disruptors. 84 00:03:40,965 --> 00:03:42,885 I don't always see a lot of factors. 85 00:03:43,185 --> 00:03:44,445 And what I mean, it's just, it's 86 00:03:44,445 --> 00:03:45,685 sometimes it is about the impact. 87 00:03:45,745 --> 00:03:48,685 And I think we need to be very clear, um, about 88 00:03:48,995 --> 00:03:50,405 what impact we're trying to achieve. 89 00:03:50,465 --> 00:03:52,565 You know, many people will say, be very clear about 90 00:03:52,565 --> 00:03:53,765 what problem you're trying to solve. 91 00:03:53,985 --> 00:03:55,885 And I think we say it a lot, 92 00:03:56,265 --> 00:03:58,845 but, um, I think many, many times, uh, we, 93 00:03:58,905 --> 00:04:01,405 we get over our skis at times trying 94 00:04:01,405 --> 00:04:03,645 to disrupt the process without really understanding 95 00:04:03,755 --> 00:04:05,085 what impact we're trying to achieve. 96 00:04:05,265 --> 00:04:06,525 So that's probably been one 97 00:04:06,525 --> 00:04:08,805 of the biggest lessons in the last couple of years here. 98 00:04:09,025 --> 00:04:10,485 Um, and trying to focus the team 99 00:04:10,485 --> 00:04:12,765 and focus everybody's efforts on the impact. 100 00:04:13,145 --> 00:04:16,945 - Mm-Hmm. . And then, I mean, I appreciate 101 00:04:16,945 --> 00:04:19,265 that a lot because I remember, uh, probably 102 00:04:19,265 --> 00:04:23,825 around 10 years ago, the slogan, oh, it was, what was it? 103 00:04:24,295 --> 00:04:25,945 Something fast, fail fast. 104 00:04:27,015 --> 00:04:28,745 This is gonna come more easily to you. Oh, yeah. I, 105 00:04:29,515 --> 00:04:30,515 - Right. 106 00:04:30,515 --> 00:04:32,265 I mean, I, the fail fast. Uh, I mean, I don't know. 107 00:04:32,265 --> 00:04:34,585 You know, I mean, I, we, uh, so I, 108 00:04:34,585 --> 00:04:36,265 before this for the listeners, you know, 109 00:04:36,265 --> 00:04:37,905 I spent 11 years at Baylor Scott 110 00:04:37,905 --> 00:04:41,905 and y um, so again, the the larger health system that I, um, 111 00:04:42,255 --> 00:04:45,465 that I alluded to earlier, and gosh, I learned so much. 112 00:04:45,585 --> 00:04:48,345 I called it my, um, you know, second fellowship. 113 00:04:48,525 --> 00:04:50,625 Um, so I am a pediatric gastroenterologist. 114 00:04:50,705 --> 00:04:52,745 I still practice, but it, 115 00:04:52,805 --> 00:04:55,225 it was such a fabulous learning experience, 116 00:04:55,225 --> 00:04:57,305 and we had a product team and experience team 117 00:04:57,325 --> 00:05:00,585 and a design team, and, um, you know, it was just, um, 118 00:05:00,985 --> 00:05:02,025 a very different experience. 119 00:05:02,025 --> 00:05:05,345 So part of that is we did, you know, bring a lot 120 00:05:05,525 --> 00:05:08,105 of traits from Amazon and Google and Best Buy 121 00:05:08,105 --> 00:05:09,305 and other retail aspects. 122 00:05:09,305 --> 00:05:11,385 And we talked a lot about within the product world 123 00:05:11,385 --> 00:05:14,345 of failing fast, um, and lessons learned there. 124 00:05:14,445 --> 00:05:18,305 And especially, you know, ones that I lead here is 125 00:05:18,305 --> 00:05:22,605 that I think what often we don't realize 126 00:05:22,705 --> 00:05:23,845 or think about, especially if you're, 127 00:05:23,845 --> 00:05:26,805 if you didn't grow up in healthcare, is that, you know, 128 00:05:26,825 --> 00:05:29,685 if you look, if you think back at the, the origins 129 00:05:29,685 --> 00:05:32,245 of healthcare and the history of, of everything we've done, 130 00:05:32,245 --> 00:05:36,765 including the EMR, it, it has been a bit up through the lens 131 00:05:36,765 --> 00:05:38,085 of safety first, right? 132 00:05:38,205 --> 00:05:39,725 I mean, even the, the Hippocratic Oath 133 00:05:39,725 --> 00:05:42,365 that I took in medical school do no harm, um, that, 134 00:05:42,365 --> 00:05:46,405 that inherently is saying, first think about safety, right? 135 00:05:46,585 --> 00:05:49,825 Do no harm. So the, and, 136 00:05:49,845 --> 00:05:51,305 and there's nothing wrong with that. 137 00:05:51,905 --> 00:05:53,905 Absolutely nothing wrong with that. We should absolutely 138 00:05:53,905 --> 00:05:55,025 think about that, especially in the age 139 00:05:55,025 --> 00:05:56,305 of ai as we look at that. 140 00:05:57,155 --> 00:05:59,685 That all being said though, fail fast 141 00:06:00,465 --> 00:06:03,725 is conceptually at odds, you know, with 142 00:06:03,795 --> 00:06:05,645 that concept of safety first. 143 00:06:06,305 --> 00:06:07,925 So right, as a doc, 144 00:06:08,545 --> 00:06:11,325 and I wanna bring in a new med, especially in pediatrics, 145 00:06:11,325 --> 00:06:14,005 and I want to give, you know, some experimental medication 146 00:06:14,005 --> 00:06:16,085 to a child for let's say Crohns disease. 147 00:06:16,705 --> 00:06:19,445 I'm not going to just experiment and fail fast 148 00:06:20,185 --> 00:06:22,285 and think about, you know, deal with it, 149 00:06:22,285 --> 00:06:25,245 and I'll learn, I'll iterative, we'll be agile, uh, 150 00:06:25,345 --> 00:06:28,005 and, and we'll sprint, you know, to figure out really, 151 00:06:28,185 --> 00:06:29,245 you know, what the process is. 152 00:06:29,345 --> 00:06:31,245 That's not gonna happen in medical care. 153 00:06:31,585 --> 00:06:34,685 If I'm in the ICU, I want it to be tried and true, 154 00:06:35,345 --> 00:06:39,165 and I want a lot of random, uh, controlled trials and, 155 00:06:39,185 --> 00:06:42,205 and peer studies, and I want my, you know, professors 156 00:06:42,225 --> 00:06:44,725 who mentored me to say, yes, I've done this 10 times 157 00:06:44,905 --> 00:06:47,245 and it works, or it doesn't work, or, try this. 158 00:06:47,795 --> 00:06:50,005 It's just inherent in our culture, in our training 159 00:06:50,435 --> 00:06:52,525 that we really take a long time 160 00:06:52,585 --> 00:06:55,245 before it actually hits bedside medicine. 161 00:06:55,825 --> 00:06:58,845 So I think to, to your point, you know, inside 162 00:06:58,915 --> 00:07:01,445 what we're trying to do with innovation now and digital 163 00:07:01,545 --> 00:07:05,645 and virtual and AI and what have you, it is this mentality 164 00:07:05,645 --> 00:07:08,685 of fail fast is, is really, uh, to many degrees, 165 00:07:08,875 --> 00:07:13,845 just very culturally abrasive, um, to kind of the, 166 00:07:13,865 --> 00:07:15,725 the core of, of how we're trained. 167 00:07:15,985 --> 00:07:18,885 And so I think, you know, that doesn't mean 168 00:07:18,885 --> 00:07:19,965 that it doesn't apply. 169 00:07:20,075 --> 00:07:22,165 That doesn't mean we can't do those things. 170 00:07:22,945 --> 00:07:26,645 But I think in my position, um, I'm well poised, I believe, 171 00:07:26,675 --> 00:07:29,565 just as a practicing physician that's, you know, 172 00:07:29,725 --> 00:07:31,525 I was section chief of a department. 173 00:07:31,845 --> 00:07:34,885 I was a leader in a children's hospital for 16 years. 174 00:07:35,065 --> 00:07:37,525 So I am, you know, I, I know the front lines. 175 00:07:37,685 --> 00:07:41,485 I know operations, I know clinic, clinical medicine enough 176 00:07:41,485 --> 00:07:43,005 to be able to know, you know, 177 00:07:43,625 --> 00:07:45,685 what's really gonna fly inside that model. 178 00:07:45,685 --> 00:07:48,885 What are you allowed to touch, if you will, and fast at, 179 00:07:49,105 --> 00:07:51,645 and what's kind of sacred ground, if you will. 180 00:07:52,345 --> 00:07:54,485 And you need to really be more thoughtful and careful 181 00:07:54,625 --> 00:07:57,605 before you start disrupting, uh, certain models. 182 00:07:58,145 --> 00:08:00,495 - Mm-Hmm. the slogan 183 00:08:00,675 --> 00:08:02,775 or motto I butchered, there was 184 00:08:02,885 --> 00:08:06,855 that from Mark Zuckerberg, the internal motto at Facebook 185 00:08:06,915 --> 00:08:09,895 for early 2000 tens that move fast 186 00:08:09,915 --> 00:08:13,375 and break things, which I think Facebook arguably very much 187 00:08:13,515 --> 00:08:14,895 has broken a lot of things. 188 00:08:15,355 --> 00:08:18,295 Um, but it, it talk about ideologically at odds. 189 00:08:18,375 --> 00:08:19,975 I think that is one slogan, like you said, 190 00:08:20,175 --> 00:08:21,455 culturally abrasive is a good term for it. 191 00:08:23,165 --> 00:08:24,815 - Yeah, no, I, and, and, 192 00:08:24,835 --> 00:08:29,455 and listen, I am that guy that wants to break things truly 193 00:08:29,675 --> 00:08:31,655 and really, you know, re-engineer it 194 00:08:31,715 --> 00:08:34,095 and rebuild it to be, you know, 195 00:08:34,095 --> 00:08:35,575 whether it be consumer centric 196 00:08:35,755 --> 00:08:37,375 or provide higher quality care 197 00:08:37,595 --> 00:08:39,415 and decrease the burden on caregivers. 198 00:08:39,415 --> 00:08:41,055 And we can go on and on, uh, 199 00:08:41,055 --> 00:08:42,895 because I think there's some fundamental things 200 00:08:42,895 --> 00:08:45,335 that we do need to kind of break, if you will, and, 201 00:08:45,395 --> 00:08:46,575 and put them back together. 202 00:08:47,315 --> 00:08:51,775 Um, so it is, it's just, it's a, it's, it, I, I, I often, 203 00:08:52,435 --> 00:08:54,295 um, I I feel like Dr. 204 00:08:54,455 --> 00:08:55,725 Je, Mr. Hyde sometimes, right? 205 00:08:55,725 --> 00:08:58,925 Where I'm on one on one side of it, I'm talking about 206 00:08:58,925 --> 00:09:01,565 how we're gonna break things, and then with the docs, I need 207 00:09:01,565 --> 00:09:04,045 to make sure that I'm thoughtful, careful, responsible, 208 00:09:04,275 --> 00:09:08,045 ethical, um, and pushing them at the right pace Mm-Hmm. 209 00:09:08,085 --> 00:09:09,645 to be able within their comfort zone. 210 00:09:10,575 --> 00:09:13,105 - Well talk a little bit about your vision, if you will. 211 00:09:13,605 --> 00:09:16,305 Uh, you mentioned you are a physician, 212 00:09:16,765 --> 00:09:19,065 you also are leading technology and digital efforts. 213 00:09:19,525 --> 00:09:21,865 What's the vision you're working toward at a HN, 214 00:09:22,645 --> 00:09:23,785 at a A HN right now? 215 00:09:23,805 --> 00:09:25,625 Can you spell it out for us in a bit more detail 216 00:09:25,625 --> 00:09:26,785 so we can envision it with you? 217 00:09:28,495 --> 00:09:31,905 - Yeah, sure. Um, well, I think that, you know, 218 00:09:32,325 --> 00:09:33,665 as I described the system, 219 00:09:33,975 --> 00:09:37,225 it's very important context now as we talk about vision. 220 00:09:37,925 --> 00:09:38,945 Um, you know, 221 00:09:38,945 --> 00:09:41,585 what worked in Texas is not necessarily gonna work 222 00:09:41,765 --> 00:09:42,945 in Western Pennsylvania. 223 00:09:43,205 --> 00:09:46,345 And I, I do think, you know, um, healthcare is local 224 00:09:46,685 --> 00:09:50,665 and the dynamics, the state laws, the, the policies, um, 225 00:09:51,245 --> 00:09:54,225 as well as just the demographics, the payer mix population, 226 00:09:54,485 --> 00:09:56,065 is it growing, is it not growing? 227 00:09:56,645 --> 00:09:58,545 You know, all those things are really relevant. 228 00:09:58,645 --> 00:10:00,785 So, you know, I'm sure Molly, as you talked to a lot 229 00:10:00,785 --> 00:10:03,745 of different, um, chief digital officer, strategy officers, 230 00:10:03,745 --> 00:10:06,385 what have you, um, there's, it, it, it's, 231 00:10:06,385 --> 00:10:09,065 it's gonna be inherently different based on 232 00:10:09,215 --> 00:10:11,305 what system they're at, what state they're at, uh, 233 00:10:11,305 --> 00:10:12,465 they're they're in, and, 234 00:10:12,565 --> 00:10:14,785 and what's the population that they're taking care of, 235 00:10:14,785 --> 00:10:16,865 and what that, what does digital mean to them? 236 00:10:17,165 --> 00:10:20,985 So, so having said that, being that, uh, 237 00:10:21,205 --> 00:10:25,905 we have a very large, uh, payer that owns us, um, 238 00:10:26,005 --> 00:10:29,025 and an enterprise, uh, that comes with that, with a, with a, 239 00:10:29,345 --> 00:10:31,545 actually with many more companies besides Highmark, Inc. 240 00:10:31,685 --> 00:10:33,465 Uh, in a diversified business model, 241 00:10:33,465 --> 00:10:37,185 including an IT company, um, a dental company 242 00:10:37,245 --> 00:10:41,745 and others, is we really look at a much broader ecosystem 243 00:10:41,925 --> 00:10:44,585 and, and how Allegheny Health Network really fits into 244 00:10:44,585 --> 00:10:46,025 that broader ecosystem. 245 00:10:46,805 --> 00:10:50,665 So we, we talk often about Allegheny Health Network being a, 246 00:10:50,845 --> 00:10:54,025 uh, pacesetter or a living laboratory, um, if you will, 247 00:10:54,025 --> 00:10:56,905 within the broader Highmark, uh, strategy. 248 00:10:57,005 --> 00:10:58,945 And that strategy is called Living Health. 249 00:10:59,645 --> 00:11:01,105 Um, and the, the Highmark Health Living 250 00:11:01,505 --> 00:11:02,825 Strategy, oh, sorry, excuse me. 251 00:11:02,825 --> 00:11:06,145 Living Health Strategy, um, really focuses, 252 00:11:06,525 --> 00:11:09,385 and I'll just be very kind of overly simplistic about it, 253 00:11:09,525 --> 00:11:14,385 is, um, is really creating, um, personalized, proactive, uh, 254 00:11:14,705 --> 00:11:16,425 simplified, um, experiences. 255 00:11:16,605 --> 00:11:20,265 And these experiences, um, really lead to more engagement, 256 00:11:20,605 --> 00:11:24,025 um, by, in, in, in Highmark Health terms, you know, 257 00:11:24,025 --> 00:11:25,025 the member or the patient. 258 00:11:25,925 --> 00:11:28,625 And if they're more engaged in their health, um, 259 00:11:29,005 --> 00:11:31,865 and then, you know, that can lead to better outcomes. 260 00:11:32,205 --> 00:11:36,505 Um, you know, as assuming we're, we're helping orchestrate 261 00:11:36,505 --> 00:11:38,865 and navigate them to the right, uh, solutions, programs, 262 00:11:39,105 --> 00:11:41,345 benefits, and those improved outcomes, um, 263 00:11:42,415 --> 00:11:43,705 make healthcare more affordable. 264 00:11:43,755 --> 00:11:45,305 Right? Which is important to us all 265 00:11:45,325 --> 00:11:47,065 as we know we're not on that, uh, trajectory. 266 00:11:47,885 --> 00:11:50,505 So, as I, I outline that, uh, being 267 00:11:50,505 --> 00:11:53,245 that it's the Highmark Health, um, living health strategy 268 00:11:53,425 --> 00:11:55,405 to say Allegheny Health Network plays a very, 269 00:11:55,405 --> 00:12:00,365 very important role, um, in, in seeing how we actually, um, 270 00:12:01,475 --> 00:12:04,525 make that actionable, make that really, truly, uh, come 271 00:12:04,525 --> 00:12:06,765 to life inside of a, you know, 272 00:12:06,765 --> 00:12:10,765 relatively large health system that is not also closed. 273 00:12:11,065 --> 00:12:13,645 Um, half our claims are through Highmark Health, 274 00:12:13,705 --> 00:12:15,245 and that means half our claims are 275 00:12:15,245 --> 00:12:17,365 through governmental business and other commercial payers. 276 00:12:18,025 --> 00:12:21,845 And so to be, um, doing that, um, inside 277 00:12:21,845 --> 00:12:24,685 of an open system is, is really complex. 278 00:12:25,195 --> 00:12:28,165 It's really tough. So building a strategy that, um, 279 00:12:28,165 --> 00:12:30,565 really works, uh, in both worlds. 280 00:12:30,585 --> 00:12:34,885 And, and so we are, uh, as of this year fully at risk, uh, 281 00:12:34,905 --> 00:12:37,525 in a value-based care arrangement with all lines 282 00:12:37,525 --> 00:12:40,325 of business, um, with Highmark Health, uh, 283 00:12:40,345 --> 00:12:43,365 but we are also living in the fee for service world, um, 284 00:12:43,555 --> 00:12:46,005 with, um, our other books of business, many of them, 285 00:12:46,005 --> 00:12:47,125 not all of them, but many of them. 286 00:12:47,705 --> 00:12:51,525 So, to, to then, that poses the issue for me 287 00:12:51,525 --> 00:12:52,685 as you asked me about the vision. 288 00:12:53,435 --> 00:12:56,725 It's how do you operate in both worlds at the same time 289 00:12:56,985 --> 00:12:59,805 and really create these wonderful experiences for all people 290 00:12:59,835 --> 00:13:02,285 that touch us and, um, and, 291 00:13:02,345 --> 00:13:04,125 and our health system in many different ways. 292 00:13:04,505 --> 00:13:09,045 Um, home virtual, um, physical assets, um, and digital 293 00:13:09,905 --> 00:13:12,405 and, and still really, um, you know, 294 00:13:12,405 --> 00:13:15,125 create those wonderful experiences, um, that lead 295 00:13:15,125 --> 00:13:16,405 to engagement and better outcomes. 296 00:13:16,985 --> 00:13:19,325 Um, it, it, it that's, you know, it's tough. 297 00:13:19,325 --> 00:13:21,165 That's the, that's the vision, if you will. 298 00:13:21,745 --> 00:13:25,325 Um, so, you know, within that, right, we're, 299 00:13:25,415 --> 00:13:27,885 we're really thinking about orchestration of care. 300 00:13:27,945 --> 00:13:31,045 That's kind of the, the key word that I'll use is, 301 00:13:31,145 --> 00:13:33,125 is really, you know, being with people. 302 00:13:33,585 --> 00:13:36,205 And I, I always envision a world where I know, we'll, 303 00:13:36,205 --> 00:13:37,325 we built, we will be building 304 00:13:37,385 --> 00:13:40,365 to especially generative AI now, in which, um, 305 00:13:40,625 --> 00:13:43,045 we should know you need us before, you know, you need us. 306 00:13:43,585 --> 00:13:46,125 And really, if you just simply said, you know, what is it 307 00:13:46,125 --> 00:13:47,925 that you really want healthcare to get 308 00:13:47,925 --> 00:13:49,405 to is, is I think we're there. 309 00:13:49,425 --> 00:13:52,805 We have the data, we have a lot of the tools to be able 310 00:13:52,805 --> 00:13:55,685 to do that, but we haven't really done that yet, right? 311 00:13:55,785 --> 00:13:58,005 So I wanna build a role in which, you know, 312 00:13:58,005 --> 00:14:00,645 before you know, that you need to engage with us, um, 313 00:14:00,705 --> 00:14:03,925 you know, we have enough data, information, trust, 314 00:14:04,065 --> 00:14:06,605 that's a big word there, um, to 315 00:14:06,605 --> 00:14:08,085 where we can then help orchestrate 316 00:14:08,085 --> 00:14:09,285 and navigate your healthcare journey 317 00:14:09,305 --> 00:14:10,725 before you know, you need us. 318 00:14:10,865 --> 00:14:14,165 And I think, um, as we really build that role 319 00:14:14,225 --> 00:14:15,365 and are able to do that, 320 00:14:15,465 --> 00:14:17,685 and I think a system like ours with the provider 321 00:14:17,825 --> 00:14:22,085 and a payer, uh, really in a blended way, um, is, 322 00:14:22,185 --> 00:14:24,685 is gonna have the, the data and the intelligence 323 00:14:24,685 --> 00:14:27,245 and the engagement capabilities, uh, to perhaps 324 00:14:27,765 --> 00:14:29,285 actually achieve that, to improve outcomes. 325 00:14:29,385 --> 00:14:31,325 So that's, that's the vision. Mm-Hmm. 326 00:14:31,365 --> 00:14:33,125 - , I mean, that's a pretty big vision. 327 00:14:33,225 --> 00:14:34,885 And just to clarify when you say that, 328 00:14:35,385 --> 00:14:37,365 how do you operate in both worlds at the same time? 329 00:14:37,385 --> 00:14:38,765 You're talking about the fee for service 330 00:14:38,825 --> 00:14:40,405 and the at at-risk models. 331 00:14:40,905 --> 00:14:41,965 - That's right. That's right. 332 00:14:42,435 --> 00:14:44,685 - Yeah. I, I mean, I remember the, 333 00:14:44,685 --> 00:14:46,605 the phrase about like having one leg 334 00:14:46,605 --> 00:14:48,165 and one foot on the dock, one on the boat. 335 00:14:48,235 --> 00:14:50,005 It's been put to you so many more times, 336 00:14:50,145 --> 00:14:53,165 but it's still very much true today, uh, as it was about 10, 337 00:14:53,165 --> 00:14:54,405 15 years ago, it sounds like. 338 00:14:55,615 --> 00:14:56,785 - Yeah, I haven't heard that, 339 00:14:57,005 --> 00:14:59,105 but it certainly feels like that many days. 340 00:14:59,365 --> 00:15:01,985 So, uh, yeah, that, that, that hits home. 341 00:15:02,605 --> 00:15:06,425 Um, and, you know, I think that, uh, again, you know, 342 00:15:06,455 --> 00:15:07,745 I'll put my physician hat on, 343 00:15:08,125 --> 00:15:11,905 and it's important to say physicians don't 344 00:15:12,715 --> 00:15:15,025 inherently treat patients different based on the 345 00:15:15,025 --> 00:15:16,705 insurance card that they carry. 346 00:15:17,645 --> 00:15:19,945 Um, when you walk into an emergency room, 347 00:15:19,945 --> 00:15:21,745 when you walk into an office, when you walk in 348 00:15:21,805 --> 00:15:25,385 and you do a video visit, the provider, the care team, 349 00:15:25,495 --> 00:15:27,505 it's not just physicians, but nurses, the care team, 350 00:15:27,505 --> 00:15:31,585 the whole EVS, it, they're not gonna look at that batch. 351 00:15:31,585 --> 00:15:34,225 They're not gonna look at inside that, you know, section 352 00:15:34,225 --> 00:15:36,385 of Epic and the storyboard to say, you know, 353 00:15:36,385 --> 00:15:37,465 which insurance are you? 354 00:15:38,405 --> 00:15:41,745 So as we solve for that, it's important that, you know, 355 00:15:41,745 --> 00:15:43,465 we treat people as people, um, 356 00:15:43,885 --> 00:15:48,425 and, um, so the, the solutions, the programs, the digital, 357 00:15:48,885 --> 00:15:52,745 the, even the, the, you know, the physical, um, uh, programs 358 00:15:52,745 --> 00:15:56,945 that we have, um, really be need to be able to solve, uh, 359 00:15:57,005 --> 00:15:59,065 for all of our people that we serve. 360 00:15:59,445 --> 00:16:02,105 Um, and so the challenge is, and, 361 00:16:02,105 --> 00:16:06,665 and they're there is how do you find, uh, ways to do that 362 00:16:06,915 --> 00:16:11,345 where you really don't have to go to the care teams 363 00:16:11,725 --> 00:16:13,265 and say, I need you to look at 364 00:16:13,295 --> 00:16:14,785 what bags they're wearing today. 365 00:16:14,965 --> 00:16:17,065 Are they, are they at risk or are they paper service? 366 00:16:17,245 --> 00:16:18,865 So it's a cha it's a tough challenge. 367 00:16:18,865 --> 00:16:20,865 And some across the country, we've talked to a lot 368 00:16:20,865 --> 00:16:23,945 of other health systems, some are going down that path 369 00:16:24,085 --> 00:16:26,385 and saying, we're gonna really, you know, do this kind 370 00:16:26,385 --> 00:16:28,585 of divergent model where we're gonna have care teams 371 00:16:28,585 --> 00:16:30,065 that only take care of that risk, 372 00:16:30,365 --> 00:16:32,465 and we're gonna have care teams that only take care of fee 373 00:16:32,465 --> 00:16:33,865 for service and nothing wrong. 374 00:16:34,625 --> 00:16:37,425 I just think that inherently we're trying to, um, 375 00:16:37,845 --> 00:16:41,625 really create a world in which, um, we're just proactive 376 00:16:41,625 --> 00:16:44,025 and preventative in the right way for all patients. 377 00:16:44,445 --> 00:16:47,745 Um, but we do need to be thoughtful about how that, um, 378 00:16:48,405 --> 00:16:51,615 you know, fiscally, um, uh, falls out. 379 00:16:53,915 --> 00:16:55,755 - Ashish Barad, chief Digital Information Officer 380 00:16:55,755 --> 00:16:57,795 with Allegheny Health Network, I wanna thank you again 381 00:16:57,895 --> 00:16:59,315 for being my guest fan on the podcast. 382 00:17:00,255 --> 00:17:01,555 Any closing thoughts you'd like 383 00:17:01,555 --> 00:17:03,075 to leave our listeners with as we wind down? 384 00:17:05,845 --> 00:17:10,465 - Oh, gosh. Um, I, um, would just say that, 385 00:17:10,765 --> 00:17:15,465 um, I would encourage all, I, I did not in any way, um, 386 00:17:15,635 --> 00:17:17,185 meant to mean to discourage any 387 00:17:17,185 --> 00:17:18,505 of the disruptors that are out there. 388 00:17:18,825 --> 00:17:20,545 I think that we need it in healthcare. 389 00:17:20,905 --> 00:17:24,625 I encourage, uh, others to get into this and help us. 390 00:17:25,225 --> 00:17:26,825 I think the future is partnership, 391 00:17:27,085 --> 00:17:30,545 and we absolutely need outside thinkers 392 00:17:30,805 --> 00:17:33,985 and other, uh, ecosystem partners that come in 393 00:17:34,005 --> 00:17:35,905 and help us disrupt ourselves. 394 00:17:36,525 --> 00:17:39,225 Um, and so, uh, I look forward to that role. 395 00:17:39,605 --> 00:17:41,745 And, um, and Molly, thanks again 396 00:17:41,745 --> 00:17:42,825 for having me on the Becker's podcast. 397 00:17:43,365 --> 00:17:44,385 - Thanks for being our guest.