This is Laura Diet with the Becker healthcare
podcast, I'm thrilled today to be joined by
Doctor. Christopher Long chief Medical Ops. Or Chief
Digital Officer an associate Dean as well as
clinical professor at Uc San Diego Health. Doctor.
Long hers is a pleasure to have you
on the podcast today.
Sir Oh, thank you so much for having
me.
Now I'm really looking forward to our discussion.
I know there's a lot happening at Uc
San Diego Hal having to do with technology,
Ai, and really some revolutionary things on the
clinical care side. But before we dive into
that discussion, can talk a little bit more
about yourself and your background?
Sure.
I've been involved in healthcare administration leadership for
about 20 years. I finished my pediatric training
Packard Children's Hospital at Stanford. And joined what
I thought was going to be a 2
year project to implement electronic health record at
and, of course, that turned into a much
longer and more involved project. It was a
lot of fun because I had a background
that helped perfectly prepare me. Which is I
had taken time off during medical school to
do a master's degree in healthcare care informatics.
And so after implementation of the electronic health
record there, we found some really important outcomes
associated with reduction mortality
when we implemented our physician order entry and
I subsequently
ended up as the Chief Medical Information Officer
founded a fellowship program and clinical informatics at
Stanford.
I spent 15 years there
in total before I came down here at
Uc San Diego about 9 years ago. And
Initially came down to Uc San Diego to
serve as the Cio for the health system
and the professional schools, including the school of
Medicine
But after a few years, I stepped into
an additional role as the associate Chief Medical
Officer hoping to lead our quality and safety
in partnership with Our. Quality and patient safety
officer.
We learned a lot in that, particularly around
our public data reporting and local quality improvement
initiatives, with And I continue to chair the
quality council to this day, which has been
a really gratifying part of my role,
ultimately
ended up in the Chief Medical Officer role
and
been
continuing to help lead enterprise initiatives and we're
now expanding as we acquire new hospitals and
affiliate with others
and
have actually just hired
Chief Medical Officer for Hill crest La jolla,
as well as for our East campus, which
used to be the Prime auto hospital.
And so it's been a lot of fun
to experience period of huge clinical growth under
the leadership of our Ceo, Patty Mason.
That's great to hear. And you know, really
exciting to think about how technology has evolved
in the health space from coming in to
help implement a Ehr system to then completely
leading a, you know, a It digital initiatives,
it is really a cool career trajectory, from
your perspective, what are some of the biggest
issues that you're following in health care for
20 24?
Sure. There's a lot going on in health.
And
like, any large portion of the economy, I
think it starts with finance.
That we've seen things like Medicare advantage
plans going belly up,
our colleagues
at Scripps health
recently
discontinued
support of their Medicare Advantage plan. We've seen
a bunch more patients
And these are older sicker patients that are
really hard to manage from a risk standpoint.
And so
these type of financial questions are particularly difficult.
In the setting of the much larger trends.
So
we've seen, of course, inflation affecting supply cost
by 10 percent to 12 percent particularly here
in California,
We have strong labor presence and we've seen
labor costs increased 10 percent to 15 percent
and of course all the while.
Our reimbursement is not going up 10 or
15 percent.
It might be going up 2 or 3
percent or 4 percent and that's only for
the commercially insured patients, you know, we still
have
pretty fixed reimbursement in our government plans. And
so taken all together,
it's a really challenging time from a financial
standpoint and forces us all to really focus
on value and what investments we're making that
most directly benefit the patients that we serve.
That's such a great point. And know interesting
they bring up some of the different health
plans in the landscape of working with payers
as well as
thinking through how patients were able to access
and afford care, and then bringing that into
the broader strategy of
how you're caring for patients and thinking about
those patient populations. So, it's really interesting to
hear from your perspective and when taking that
into consideration and and looking ahead, what are
you most excited about for the future and
what makes you nervous?
Well, I am extraordinarily excited about the digital
transformation of health
and not just Ai, but that's certainly the
latest in a suite of tools.
For example, in our managed population, we run
a large Medicare shared savings plan accountable care
organization. And we started in that population doing
remote patient monitoring
and actually have over 3000 patients now. With
devices at home, transmitting blood pressure and glucose
ratings and our patients with diabetes
and
those type of
remote patient digital kind of tools.
And that's allowed us to better manage population.
We actually have data showing a reduction
blood pressure in our hypertensive patients, a reduction
hemoglobin A1c of our patients with diabetes.
And the kind of care
allows us to not only drive better outcomes
and reduce hospital emissions, but also save cost
to system overall and keep people healthy, keep
people out of the hospital So that's really
exciting from my standpoint because it's not something
it would have been possible 10 or 20
years ago.
On top of that, you layer in some
of these new Ai tools such as large
language models
or even just traditional machine learning. And we're
finding all sorts of
outstanding outcomes in the clinical side we found
earlier detection of Sepsis resulting in 20 percent
drop of mortality in our emergency department patients
with Sepsis, which is
really, really huge.
And
translates to 50 lives saves on annual basis
just here at Uc San Diego.
Imagine if that, you know, translated across the
300000
lives lost every year across America.
Similarly, we've leveraged large language models for things
like Ai generated draft messages to respond to
patients on the portal. And we found that
that decreases is cognitive burden decreases physician burnout
and results in increased satisfaction.
So lots of promising opportunities, and that's just
on the clinical side. Think about the business
side and there's certainly huge opportunities to help
make our revenue cycle more efficient so that
as we
acquire and affiliate with new hospitals, we can
expand our services
without having to, you know, add as many
people as we would otherwise.
And that efficiency also translates to better employee
satisfaction.
You know, we know that some of the
wrote tasks that can be done by Ai
you know, when we automate that that makes
our employees happier as well. So that that
leads to increased retention, increased
satisfaction at work and
overall sort of better healthcare care experience.
That's been fantastic to hear. And you know,
especially thinking about Ai in artificial intelligence,
in in some of the ways that as
you said, you can really help people have
a better work experience.
And at the same time, you know, help
become more efficient overall, I think that's really
cool and beneficial.
I I know, looking ahead to... Do you
see that will make health leaders more effective
and successful over the next 2 to 3
years? What do they need to know, especially
given the,
evolving health landscape and in tools that are
gonna become available to them?
That's a great question.
I think the skills from a leadership standpoint
don't change much over time. And building a
high functioning teams, teams that are
diverse and work well together, I think as
a skill that will continue to be important
I I think that as Ai begins to
really creep into every corner of health care
delivery, having a superficial understanding of how these
tools work.
Is actually important for some of our executive
leaders.
And I recently wrote an opinion with Dr.
Bob Walked and others about by the role
of the Chief Health Ai officer,
and we're fortunate to recruit. Doctor Car duke
Singh that serve as our Chief Health Ai
officer,
here at Uc San Diego Health. And I
think it's just a fantastic and important role
in moving forward to
identify where the opportunities are to leverage these
tools to drive the, clinical and business outcomes
that matter to our patients and to the
organization. And so that's 1 area that I
think investment is really needed. And
the thing that makes me nervous is not
about sort of bad tools it's about tools
that are poorly implemented with And so having
those local Ai governance and review processes, I
think are gonna be really, really important to
making sure that we drive the outcomes we
want and do not...
Inadvertently introduce unintended consequences.
That's touch a great point. Do you bring
up especially on the governance side. I know
things are changing quickly? So for health systems
that are really at their front stages of
of trying to implement Ai or figure out
what their strategy is. Where do you start?
What is most important for health organizations to
tackle so that they're not putting themselves to
undue risk as they're taking on and,
try and to implement new Ai technologies.
Yes, our local governance has been really helpful
in thinking through that. So for example, some
of our early
opportunities
were around
a low risk kind of areas
in the business that would not impact kind
of clinical care. And so we were looking
in cycle operations and other areas
even when we again
introducing clinical Ai,
we
ensure that our governance processes and principles like
keeping a human in the loop for accountability
we're adhere to, and that helps to really
mitigate potential risk. So that local governance, local
Ai principles, you, driving,
the problems is that should be solved. I
think is really key.
Fantastic. Doctor. Wagner. Thank you so much for
joining the podcast today. This has been a
really amazing discussion. And I look forward to
connecting with you again soon.
Absolutely. Thanks for having me, Laura.