Imagine this. You're in the heart of Chicago
mingling with the brightest minds in health IT.
You've arrived at the 9th annual Health IT
plus Digital Health Plus RCM conference taking place
October 1st through 4th at the luxurious Hyatt
Regency Chicago.
Picture the excitement as you collect countless business
cards, forging invaluable connections with over 25 100
executive level attendees.
Feel the buzz of ideas flowing as you
engage in meaningful conversations about the future of
healthcare technology.
Envision yourself attending sessions led by over 415
elite speakers,
gaining insights that could transform your organization.
From digital transformation and telehealth to clinician burnout
and cybersecurity,
each topic is designed to spark new ideas
and provide actionable takeaways, but it doesn't stop
there. Imagine sitting in a packed auditorium listening
to motivating keynotes from some of the biggest
names in sports. Four time Super Bowl champion,
Rob Gronkowski,
WNBA
champion, and author, Lisa Leslie, and NFL legend
and ESPN analyst,
Eli Manning, will be there sharing their stories
and inspiring you to reach new heights.
All around you, the future of Health IT
unfolds, and you're not just a spectator.
You're an active participant.
Don't wait. You can find the event website
and get registered by visiting beckershospitalreview.com
and clicking on the events page. That's the
beckers hospital review.com
events page.
This is Laura Dirdle with the Becker's Healthcare
podcast.
I'm thrilled today to be joined by John
Maidstone, director of IT Learning, QA, patient education,
image community connect, and clinical IT shared services
at New York Presbyterian.
John, it's a pleasure to have you on
the podcast today.
A pleasure to be here. Hi, Laura.
Now I'm looking forward to our conversation because
I think it'll be really interesting to hear
more about what you're doing at New York
Presbyterian
and certainly share with our broader audience. Right
now, there's so much happening in health care,
and truly,
you know, it is a transformational
time. So I'm excited for our conversation. But
before we dive into my questions, can you
tell us a little bit more about yourself
and your background?
Yeah. Sure. So,
as you mentioned, I'm John Mason. I get
to live in the incredible,
Brooklyn, New York and work at New York
Presbyterian
as the director on their electronic health record
platforms team in our clinical IT shared services
group.
What that means is I see oversee a
couple different groups. 1 is our epic learning
team, which teaches our clinicians and administrative staff
how to get the most out of our
electronic health record investments,
our software quality assurance team, which makes sure
that we have a safe, reliable change management
process that protects our EHR platform so that
we continue to give the best and most
reliable tools to our caregivers,
patient education, which really focuses in on making
sure our patients have the tools they need
to be successful at managing their health and
outcomes after they leave our facilities,
and our,
our community connect team, which is actually a
team that
resells our Epic platform to private practices throughout
the New York market, which allows us to
ensure that we have this great shared record
of patient clinical data from across multiple care
facilities, whether it's our own at New York
Presbyterian,
Weill Cornell, and Columbia,
or if it's from your doctor down the
street that you prefer to go see. So
that's an avenue for us to make sure
that we have the most comprehensive
electronic health record available for our patients here
in New York City.
I'm really fortunate to have worked in health
care now for 14 years. And
as you mentioned,
things are always changing. I don't know if
I've recalled a point in time where we
got to take a break and catch our
breath and and let status quo kinda be
the normal. That doesn't seem to be something
in health care, but
I've really had a lot of good fortune
working in this industry. I started out my
career at the Cleveland Clinic in Ohio
and then joined HSS in New York, and
now I'm with New York Presbyterian.
And I've got to see so much and
learn a tremendous amount over that time period
and do the piece that I can do
to help transform patient care and hopefully make
an impact. So
I'm very excited by the work that we're
doing, and I'm happy to share even more
with you.
Well, that's amazing to hear and certainly a
really
a great career journey to bring you to
where you're at today.
Now as you mentioned, I wanted to get
your perspective first on some of the different
opportunities and headwinds you have your eye on
right now. What what's really top of mind
for you?
Well, I think that right now, one of
the biggest headwinds is the regulatory
environment.
I don't wanna get into politics, but across
our country right now, things are changing rapidly
depending on, laws that are going into place
or or laws that are being rolled back.
And
I think that's going to create a lot
of challenges both for the patient as well
as for the health care delivery organization.
You know, we're seeing things where they want
certain parts of the electronic health record to
potentially
be walled off from other segments of the
electronic health record in New York by way
of example.
And
those sort of
ideas, which come from a good place and
can hopefully,
or are are intended to hopefully create,
better solutions for the patients or safer solutions
for them,
actually ends up impeding a clinician's ability to
see the comprehensive
patient record in front of them if we
go down this route of, you know, blocking
off certain access to information such as HIV
status or abortion or certain medical care that
a patient has received.
We we need to see that whole medical
record to do the best job that we
can at supporting our patients. And so I
think these headwinds coming from this regulatory activity
is going to be
very interesting to watch
and certainly something that I think a lot
of people should be really concerned with and
advocating for themselves for.
I think that's such a great point. And
definitely,
you know, I'm thinking about those regulatory changes.
I can imagine anytime there's a new,
law or or policy that comes up or
is removed, you know, has a lot of,
unintended consequences.
So it's just fascinating to hear. I know
you had some opportunities. You wanna go through
it as well?
Yeah. Absolutely. I think a big opportunity that
exists is health justice.
You hear a lot about equity in modern
times, whether it's from, you know, staffing equity
from an HR perspective. But, you know, in
health care, we talk about health equity, and
at New York Presbyterian, we talk about health
justice.
And
what that really means is it's not just
ensuring that everybody has access to the same
services,
but it means that we take a look
at these systemic problems that exist in our
society,
and we try to determine how we can
best affect change
to get rid of some of those systemic
problems.
So what can we do in order to
boost health equity at New York Presbyterian to
make sure that our patients from a variety
of backgrounds and areas, we have patients that
come to us from all across the world,
how do we ensure that the care that
we deliver
is targeted
and specific
and approachable
for
each one of those individual patients. And it's
a big challenge to address the disparities that
exist because you have to really have your
blinders off and constantly scan the environment to
see what's happening all around us.
In New York City, we're really fortunate,
but also very challenged by the fact that
we have probably the most diverse patient population
in the world. We're really the crossroads
for
the rest of the world to come to
us, and
we get to encounter so many different people
with different languages, religious beliefs, backgrounds, identities. And
so
when we think about
everything that person brings with them, this whole
history of belief systems and things that have
guided their lives,
we need to be better at determining how
we can meet that person where they are
and identify the solutions or the treatments that
are going to make the most meaningful impact.
You can prescribe the right medication to help
a patient get better. But if they can't
afford that medication,
then really we're not doing anything to take
care of their problems. So we have to
look a lot more deeply at these situations
that are presented to us and not look
at things from a transactional nature. Just because
we've prescribed doesn't mean that we've done enough
there. And our DALIA Center For Health Justice,
I think, is such an important tool
to ensure that we are doing the best
job we can
to improve lives for our patients and to
deliver better outcomes.
So, I think that's a great opportunity that
we're really passionate about and something that I
think we're really innovating on at New York
Presbyterian
and
something that the rest of the country, I
think, is going to start growing their presence
in as time goes on.
Well, that's really cool to hear and definitely
seems like a great opportunity for patients as
well as the entire health care system.
Now I'm wondering when you look at your
role and responsibilities
currently, how are you thinking about growth and
adding value to the organization overall?
I think that
with the teams that I have the pleasure
to lead,
we can make a tremendous impact
across our enterprise.
Looking at our EPIC learning team by way
of example,
they help our clinicians and administrative staff learn
how to use this electronic health record technology.
So going to a class to learn how
to use Epic, it's really boring. It's not
a great experience, but it's something you have
to do because this is a central tool
in health care delivery nowadays.
But what can we do, or how do
we look past that and see
something a little bit more connected as far
as what we are able to affect from
a training perspective.
We know right now that physician and other
clinician
well-being
is something that is of
tremendous concern.
Burnout, especially after the pandemic,
is at an all time high.
And so our training team is being asked
to look at how can we better educate
those who serve
in order for them to
have minimal interaction
using this technology to focus more of their
time on patients, to get them then home
for dinner
so that they can spend time with their
families and have a more balanced life instead
of spending all of their time as a
physician in front of a computer after hours
catching up on documentation.
So, yes, a lot of people talk about
documentation
efficiency, and that is going to continue to
be an area that everyone focuses in on
from how we design the systems to how
the users interact with them.
But it's really important that I, as a
leader, talk with my team
about how do you see your part in
this
to help that clinician get more out of
the technology
and get more out of themselves so that
they can deliver world class care, but also
take care of themselves too.
So that's one way that I think not
only is that adding value back to our
organization,
but it's going to allow the organization to
grow If you allow people to refresh themselves
and invest in themselves and have the energy
to go about thinking of new ways of
doing things and thinking about new services that
we can provide or ways we can provide
better care, that's going to ultimately lead to
growth. And that's just what our learning team,
I think, can help do. We can support
those processes for,
out helping them happen.
With the,
patient education team,
I think that patient education is an area
that's going to have a spotlight on it
that just grows more over time.
Helping patients understand the care that they're receiving
and then how to handle aftercare
is of paramount importance.
We don't want to see our patients being
readmitted to our health care systems after we've
provided the corrective treatment for them.
We need them to understand
how to access resources that are available to
them within their communities,
what kind of support they should be looking
for from friends and family,
and what kind of tools should they be
accessing as well to keep themselves healthy.
Patient education is interesting because
I think it's an area that hasn't been
at the forefront
of conversation
in the past.
But what we're seeing, kind of like what
we saw with electronic health record vendors, is
that there's a lot of consolidation
going on for those companies that offer patient
education products that help your organizations then purchase.
And so you see all of these companies
kind of acquiring each other and,
launching their services.
But
are those services the right fit for your
organization? And so what I think I've observed
is that you'll see a health care system
that has dozens of patient education systems that
they've purchased because one suits a certain service
line really well,
but another doesn't suit other service lines at
all. And so you have a best of
breed situation happening with patient education.
And I think we need to
consider
not only the economic cost of doing that,
but, also,
what is the voice that we wanna have
as a health care institution when we interact
with our patients?
Do these tools align with that voice? Do
they have the character that best represents us?
And is the education
consumable in a way that's right for our
diverse patient population?
These are really difficult questions,
and I think that we are doing the
best job we can right now to identify
all of the tools that exist to educate
our patients across our massive enterprise
and consolidate where it makes sense and where
we can.
But,
ultimately, this is going to need to be
a focus area as time goes on, and
I think we're gonna start to see a
lot of innovation happen in that marketplace for
the vendors that create these products
as we move forward.
That makes a lot of sense. So, you
know, it is a really helpful
perspective when you're thinking about how to move
forward. I know there are so many different
opportunities out there and, like you said, vendors
to work with them, potential partners,
that are really trying to tackle a lot
of these challenging issues for clinicians as well
as, creating a better patient outcomes and experience.
And so
finding the right one and then identifying who
can be the best partner for you and
create the right results,
is really meaningful.
Now, you know, as we are talking through,
especially this idea of,
making connections and and, you know, finding partners
and investing in new technologies or capabilities.
I know that for many organizations,
finances are still tight. Margins are still thin.
And so when you look at,
needing to or wanting to make the right
types of partnerships and investments, what is still
really important in in our risk score investment
that's worth making this year?
So I think we've learned a lot about
vulnerabilities that exist over the past few years.
Thinking about the SARS CoV 2 pandemic,
ransomware,
hacking of various entities in the health care
industry,
acts of terrorism, and even natural disasters.
It's probably one of the most difficult times
in history to be a leader
and to determine how to build the best
resiliency
you can have in your organization.
The threats in front of us are numerous,
and they're barely predictable.
And we've worked so hard to push health
care forward
by modernizing and digitizing our processes, and that's
been the right thing to do. And it's
paid dividends for us. But along the way,
we started to forget the old ways of
doing things in order to make way for
the new.
Right now, I think we need to keep
moving towards the health care of tomorrow
while also looking back at how we did
things before adopting these different technologies.
If we had to run a hospital from
a 100 years ago, what would that look
like?
Our health systems today are vastly larger in
size and complexity than what existed in the
19 twenties. So navigating our current environment without
modern tools and conveniences,
it's almost unthinkable.
But that's what we must be thinking about
and where we must invest and focus our
energy.
We need better plans, backup systems, and tools.
We need more MacGyvers
and less crypto bros to rise to the
challenges before us and answer questions like, how
do we continue executing our essential services when
our systems are in an extended downtime?
What is the best standard of care we
can deliver when weather events cause bridges to
be washed out and trains inaccessible,
and we can't get our caregivers
to our campuses
to report for duty?
These are really difficult questions and and not
something that is a core competency of a
healthcare leader to just
determine the best path forward. It takes a
lot of extensive forethought,
planning, and investment.
So
the investment worth making this year, I think,
is focusing in on how you best prepare
for those downtime situations
when technology is inaccessible
or when natural events like natural disasters
happen. How does your organization
retool itself immediately
to react and and continue to deliver that
vital care to the patient population.
If you haven't created those plans,
if you haven't looked into the backup systems
that you may need to navigate this,
that's something that I think needs to be
brought to the forefront and prioritized
from an investment perspective.
That's fascinating to hear. You know? And, certainly,
like you said, when these
disasters happen and needing to go without technology,
I can imagine it's quite a different situation
than it was 10 years ago with, you
know,
a
a percentage of the team that never worked
off of pay paper records are always having
technology at their fingertips.
Yeah. I was having a conversation with our
COO, Brian Donley. And doctor Donley, when he
started out delivering care,
he was doing it on paper, but very
quickly Cleveland Clinic was an early adopter of
Epic, So he very quickly transitioned to using
an EMR in early 2000 I think it
was around 2001 that it was implemented at
Cleveland Clinic.
So he has that perspective
of how do you go back and work
in a paper chart. But if you think
about our new nurses or our new residents
coming,
onto the floors of our hospitals, they haven't
had that experience. So how can we
very quickly educate them?
How can we restore those paper tools that
existed in the past?
And how can we make sure that these
things can be operationalized
in a snap? Because, again, these things aren't
predictable
when
a a hacker attacks your network and everything
goes down. You don't have the insight of
when that's going to happen. So you need
to be ready today in this moment to
flip a switch and be ready to transition.
And I think that's a huge area of
opportunity for everyone to really focus in on.
That makes a lot of sense. Thank you
so much for, digging deep in there. Now
before we wrap up our conversation, I'm wondering
where do you see some of the best
opportunities for growth in the future?
I'm not sure if I'll ever answer this
question without first saying that it's by investing
in your
people. I I feel very strongly
that people are
the best tool you have to be successful
as an organization.
And if you invest in them, that's helping
them attain or unlock new knowledge, skills, and
abilities that they bring back to your organization.
So they help you see new things, new
opportunities.
And
I think investing in your human capital
is what's going to help you traverse the
turbulence of a VUCA world nowadays.
Organizations really are just collectives of people. So
to me, it doesn't make sense to prioritize
investing anywhere other than in those individuals who
comprise your firm.
But aside from people really being,
the growth catalyst,
I see a tremendous amount of growth coming
from new avenues of care delivery.
I was talking about running a hospital from
a 100 years ago,
But if you think about things, a lot
of care has transitioned over the past few
decades where you used to go to a
hospital to have all of your needs met.
And now we have a plethora of options
as patients to seek out our care.
But what's really interesting, I think, are the
advances in robotic process automation,
which I think is going to significantly
drive down costs in both manufacturing and logistics,
which I think means that we'll be able
to get more tools and supplies to patients
wherever they are, more seamlessly than ever.
And so when we think about concepts like
hospital at home, I think that's going to
make that more attainable as time goes forward
and more affordable for health care organizations
to build those services and make them available
to patients.
But there's other interesting things happening too.
Some companies like Amazon and Zipline started to
experiment with using drones a few years ago,
and they,
tested out delivery of prescriptions
to patients,
which is really cool. And I think it's
really interesting, and it it's just one method
that could better enable us to meet patients
where they are and help save or improve
lives.
And thinking about that drone concept,
you know, health care is really hard. In
in New York City, in some ways, it
can be a lot harder here. Between traffic
and train delays, sometimes we have immediate needs
that can't be easily met.
So what if our blood bank in Brooklyn
had a b negative blood that's vitally needed
at our campus in Washington Heights ASAP?
Well, in the future, could we have drones
that pick up that a b negative blood
from our one campus
and quickly fly it to our campus all
the way up towards the top of Manhattan
so that we can address the patient's needs
that immediately.
Whereas had we put it in a vehicle
and tried to drive it across town, it
could be an hour or more.
I think these things are really cool. I
think they're very difficult to execute on,
but it's something that I really get excited
about because I think it's going to really
transform
care delivery when we look at how these
new tools open up new avenues for us
to deliver care or to just build out
additional logistics that didn't exist for us before,
which makes delivering care for us even easier
as a health care enterprise.
John, thank you so much for joining us
on the podcast today. This has been such
a fascinating conversation, and I look forward to
connect with you again soon.
It's been a pleasure. Thank you so much,
Laura.