Hello, everyone, and thank you for tuning in
to the Becker's HealthCare podcast. We are thrilled
to be joined on-site here at Becker's Health
IT Digital Health RCM Conference in Chicago with
Ajay Kapre,
president and chief strategy officer with Elkay, and
doctor Safar Chaudhry, senior vice president, chief digital
officer, and chief AI and information officer with
Seattle Children's.
Ajay, doctor Chaudhry, thank you so much for
being here today.
Thanks for having us, Brian. Thank you for
having us, Brian. And it's an honor to
do it with doctor Chaudhry. Yeah. It's great
to have you both here. So so let's
get into the conversation.
Innovation can often feel like a like a
moving target.
What do you think are the core elements
that define true innovation in the health care
IT space? So far, can we can we
start with you? Yeah. So, certainly, the first
thing to think about in this space is,
are there any regulatory
compliance issues that we need to take care
of?
In addition,
there's going to be the cultural aspects
for the organization.
Change management is always really important when you're
implementing new technology.
And
there always has to be executive level sponsorship
and championing
to make things actually stick. The sustainability is
really important when thinking about innovation.
So that that change management piece, that that
executive buy in, I imagine, is is huge.
Ajay, what would you add here? You know,
I feel like true innovation,
it needs to solve real world problems
with scalable solutions and not just, you know,
talking about any flashy technology or a new
technology.
There should be real usage of any of
the innovation that you're leading towards.
Especially in health care, if you look at,
we need to simplify and not complicate
the processes for both health care providers as
well as the patients.
And if we focus on patient outcomes, improving
clinical workflows,
I think providing the real interop
solution, I think, you know, we can actually
get a big wins there.
Yeah. Some real tangible results. Right? Yes. Appreciate
that. Doctor Chaudhary, question for you.
From your experience, what are
the key factors that really either enable and
power innovation or hinder innovation in health care?
Are there common barriers that organizations out there
run into,
when they're trying to to integrate new technologies
and manage through that change as you mentioned.
Well, certainly, the the top of mind would
be finances.
Right? There's always financial constraints.
When you're thinking about innovation, people need to
know I agree with Ajay about simplification,
but at the same time,
can you afford to do it? And And
if you do it, is it going to
give you some sort of return? So those
are definitely constraints. Then you've got
the culture of your organization.
Some organizations are open to innovation. Some are
not.
I'm sure you've heard the statement that we
do it our way
and everybody's unique.
And they're not necessarily
unique, but that's what they feel they are.
And, of course,
there is a difference between generations
of culture within an organization that impact
the adoption of any level of innovation. So
an older physician like myself probably doesn't want
to adopt new things, whereas a Gen z
physician
grew up that way. They were digital to
start with and
we'll adopt those things. The the other thing
is when you're setting this up,
you've got to make sure that, as I
said before, the highest level of buy in.
Mhmm. So if you are the innovation champion,
let's say it's me,
I would then have to champion that. I'd
all have to also do the good communication
around it. So communication is also
the you know, why are we doing this?
Right. I always like to say, what problem
are we really trying to solve with the
innovation?
Or are we just trying to buy another
shiny toy? And if we have a shiny
toy, is that is that just gonna be
the flavor of the month? Right. Or is
it gonna be something that truly drives the
most important thing, which is patient outcomes?
So that's that's what we're gonna focus on.
Yeah. And and so far, I would never
describe you as an older physician. So I
I I appreciate the the humor there, but
let's dig dig deeper into sort of the
the the the cultural component here and, of
course, that that that champion that executive champion.
Ajay, can can you talk about sort of
what role leadership plays in fostering an innovative
culture within health care and and what leaders
can do to really sustain that innovation and
continue to encourage it? I think to start
with and, you know, I agree with Zafar,
everything he said. But, you know, to start
with,
anything you want to actually have innovation, you
need to actually set that culture.
Culture plays a very important role. And with
culture comes collaboration.
You need to listen more. You need to
hear more, talk more to people. What are
the real market problems out there? What can
I do to solve those? At the end
of the day, we are in healthcare IT.
We're here to serve patients
and patient care.
And if you look at it, you know,
it is really
80% is people, 15% is process,
5% is technology.
And if you think that way and if
you put culture as your main thing, align
with people
or even with partners,
you know, health system partner with who you
are developing
a innovative idea,
it all comes down to that culture plus
collaboration together.
I'll also give an example here. You know?
And these this line is not from me.
This is from Judy Faulkner, which says that,
you know,
if you wanna go fast,
go alone. If you're gonna go far, go
together.
Go as a team. So the team plays
a very important role when it when you're
talking about any innovation or you want to
bring it,
everyone wants to bring an idea very fast
to the market, but I feel like one
has to vet it properly. What are you
trying to solve? Is the market ready for
that idea to adopt? Adoption of the idea
is much, much more bigger than just going
as going as a shiny object just at
the start. Right. Right. And that shiny object
thing. If you're if you're focusing on the
people and the culture, it's gonna prevent the
shiny object syndrome. Right? If you're if you're
actually thinking about the teams and the people.
Yep.
Yeah. Appreciate that. So,
Zafar, can you can you also just elaborate
on how you think about this? So I'm
gonna add
obviously, I've said before you need an executive
sponsor,
but whoever that person is, that person has
to have a vision.
Right? I always tell people that if you
have a really big vision and you get
50% of the way there, you've done really
well.
So you somebody's got to show the organization
what blue sky thinking looks like
and then that person has to be a,
has to stick around and then has to
actually drive through
whatever innovation needs to be driven through. So
you may then be classified as a change
agent.
You may not be very popular in your
organization, but
you probably were hired to do that. And
so I think that's really important.
I agree with the collaboration piece. You have
to bring people on a journey,
and you have to show certainly clinicians, you
have to show them the why.
Right? Why are we doing this initiative
versus we should just do it because it
makes us look good. That's really important. People
need to be able to understand the narrative.
So telling a story
and communicating
that story is also really important,
in the process, in my opinion.
And can you elaborate too on sort of
you mentioned sort of you need somebody to
come to the table and bring that vision,
but you also mentioned that might not be
very popular necessarily sometimes. I guess, how you
how do you stay resilient and optimistic
and not fall into any sort of cynical
thinking when you're trying to be that vision
for the for the organization?
So I suppose it it really it really
boils down to the individual's personality. But I
always say to people that,
working in health care is is like a
marriage. Right? There's more rough times than good
times. But if you make it to 7
years, it's happy days.
And I've been in this for 38 years,
so it's probably a really bad marriage. But
you've got to always reset your clock. Right?
We're all running I would say in health
care now, most leaders are running on more
like half empty versus half full because of
all the changes and
the the costs and, like, everything that's causing
issues. But you've got to find yourself back
to why you do the work. So it's
easy in pediatrics because
coming to work every day knowing that you're
helping kids is a easy mission Mhmm. To
follow. Some aren't as easy. But in health
care in general, you're not in health care
if you don't wanna help people. Right. So
you have to bring yourself back
to that true north
probably every week. And once you do that,
then you remain that champion of change
if if you want to do something differently.
Right? So the question I ask people is,
do you wanna do more of the same
every day, or do you wanna do something
that actually will
allow us to stand out or you as
an individual to stand out or as a
team
to stand out.
It's hard to get there, but you have
to keep that focus.
There's a mindset.
I also say that it also involves,
you know,
probably a lot of drinking
and a lots of pizza. But there's usually
a time when you have to ground yourself
back.
That's usually on a weekly basis. Yeah. Absolutely.
Pizza's always great. Yeah.
So
LK has really been at the the forefront
of connectivity and interoperability
for years.
I'm wondering if you can share some specific
examples, doctor Chaudhry, of your your collaboration with
LK at Seattle Children's and and what what
that's yielded. So let's go back to the
earlier part of the conversation when I spoke
about, well, what problem are we trying to
solve? So what's really interesting about us is
at the time, we were trying to do
a CERNAT epic migration
in the middle of a pandemic.
And I bumped into AJ at a CHIME
conference, and we started talking about, well, I
have a problem. And the problem I had
is
when you ask a physician,
you know, what do you want to do
with your historical data? The answer is always
going to be, I want it all. And
in pediatrics, depending on what state you're in,
sometimes you have to keep 30 years' worth
of data.
And at the moment in time when we
were thinking about this conversion and we had
been on Cerner for 17 years, that was
17 years of data
that I had no clue on how to
convert,
where to put it, and how to make
it accessible in the format that clinicians would
want to consume it. Right? Because there's a
big difference between here's your data
versus here's your data, and you actually can
do something with that data. So this is
how we sort of started our journey in
partnership with Elkay in terms of we have
a data problem.
Rather not move it all into Epic because
that way, a really big database.
And can you give us ideas and engineering
skills to help us out of this particular
problem? So it goes back to what I'm
saying. We had a problem to solve.
They're the data engineers. Well, that's what AJ
told me at the time.
And so we said, here's a problem for
you to solve. But I'll let AJ tell
the rest of that story.
Yeah. I'll tell the rest of the story
is really when I met Zafar first time,
he
he told me that, you know, you better
do a good job.
And I said, what if we do a
good job? He said, I'll go to Becker's,
and I'll tell them how good you guys
are.
And I said, what if we don't do
a good job? He said, I'll go to
Becker's, and I'll tell them how bad you
are.
So it all summarizes pretty well. But, you
know, the opportunity came in, and I think
we work very closely with the clinicians, with
their even physicians, understanding their workflow.
See, I think, you know, one is data
and then understanding the data
going towards enterprise data management, archiving piece into
it is important what we are doing here.
But more than that,
if you look at it, a children's hospital,
sometimes the workflow is different than an academic
hospital, then it is different than an ID
and big ID and hospital. So you've got
to understand that. You've got to actually work
with them.
Because if you are archiving any existing data,
if the usage is there or informatics for
physicians to go back and look at some
of the old legacy data, then actually you
can see the real value
of that solution.
And I think Seattle Children also helped us
giving feedback, which we incorporated in our solution
to make it more stronger and go towards
the direction where we are today.
So I I also wanna say thank you
to Seattle Children and doctor Zafar Chaudhry in
partnering with us on this. Yeah. That that
that's really fascinating that that collaboration,
you took feedback from Seattle Children's too. Is
that do you think that's essential for for
a partner like yours to be open to
adjusting and iterating based on your partner's feedback?
I think feedback from any partner is extremely
important because, you know, you also have to
see from their side what are they trying
to actually achieve.
You have a solution which you want to
actually take it to the places. And if
you wanna make that differentiator in the market,
that collaboration, listening to them, you know, we
made numerous trips to Seattle Children just to
sit in a room, understand, do a whiteboard
session. What next can we actually do on
that? In fact,
even after our product was deployed, everything was
live, we still went back and looked at
it. What else can we do it? Because
that's the only way you can make your
product more richer.
And, these are some complex things that we
solve here at Elkay.
Interoperability
is out there and it's not everyone who
can do it. You know, today,
among all the things that we are doing
now, even Commonwealth, we have the platform that
is going to support Commonwealth.
So we're we're really trying to solve real
complex problems out there
around interoperability. Yeah. Yeah. But I wanna move
now to a a final question thinking here
because we're talking about data and, of course,
the rise of AI,
and and machine learning and these various solutions
that are coming coming to the fore. Data
is just essential for the effectiveness of the
of these programs and these this technology.
I and so so my question then, what
steps should organizations take to ensure their data
is reliable, accurate,
and ready for for these advanced technologies? Doctor
Choudhary, do you wanna begin on this question?
So you always have to start with governance.
Right? Data governance is really important in this
space,
and many organizations don't focus enough time.
And and data governance not just in the
IT realm
but with multidisciplinary
teams. Right?
I I can say data is correct and
a physician might tell me that data's incorrect.
So you need to include all of
these stakeholders
in your data governance group.
The other thing to look at is, well,
what is the quality of the data that
you actually hold?
Right? So we've talked about data warehouses in
the past
when it comes to analytics.
Now there's data lakes and data oceans and
probably now a data sea.
And really what you're looking at when you
talk about AI is
what are you pointing that machine learning to,
right? Are you pointing it to your data
warehouse,
which is probably a very small language model?
Are you pointing it to a very large
language model? Because in our case we have
17 years' worth of Cerner data. That's a
much bigger pool than just a year's worth
of data.
So you've got to validate the quality of
the data that you have
when you are trying to make clinical decisions.
Once all that has been done by the
IT team in collaboration with your clinicians,
then you need a team of like minded
clinical people who are now going to then
test.
Lots of testing has to happen. So when
we did our archive project with Elkay,
we ended up on version 14
of what we actually
launched.
Took 14 iterations
for us to test,
review,
satisfy a group of individuals,
and it's all contextually
mapped because that's the other important thing. Right?
I don't want to be a physician that
has data in system
a, and then I go to system b,
and then I have to find that data
all over again. I want all those data
points to be contextually linked
so that at a click of a button,
I can take action on data. Because when
you think about the average outpatient visit,
takes 8 minutes. In 8 minutes, you've got
to talk to the patient,
find all the data you need about that
patient, then make an informed decision
on what to do next with that patient.
That is not a lot of time.
So our job
at MIND
versus
our partners is to make sure that that
data is clean, available,
valid, usable,
at the right place, at the right time,
at the point of care. Yeah. Thank you
so much, doctor Chaudhry. Ajay, what would you
add to to that? I think, you know,
just to add to what doctor Zafar said.
I mean, it it all comes down to
the source of the data, quality of the
data, and reliability of the data.
If you have that good reliable data, that
becomes like a fuel. Or any AI application
or machine learning applications to really perform what
they are supposed to.
If at the start of the source of
the data itself is not good enough,
then you cannot actually get that end result
with all these
great tools which are available today.
In order to get there, you need to
have a very good interoperability
platform. You need to actually make sure the
validation of the product or validation of the
data is done correctly.
An organization need to put some focus on
it, put some area of expertise in it,
also partner with the right people there who
can help you get there.
Because all these big investment that you're doing,
if
the reliability of the data is not there,
you'll end up actually
getting not the result that you're looking for
in long term. Yeah. It's crucial that that
you have it. Yeah. It's the Absolutely. Excellent.
Well,
this really was a pleasure to to walk
through this conversation with both of you, Ajay,
and and doctor Chaudhry. Truly appreciate you taking
the time.
I also, of course, wanna thank LK for
sponsoring today's conversation.
To our listeners, thank you for joining us,
and please be sure to check out other
Becker's podcasts. Have a wonderful rest of your
day. And gentlemen, I hope you enjoy the
conference. Thank you so much. Thank you.