1 00:00:00,640 --> 00:00:03,199 Philips is a health tech leader focused on 2 00:00:03,199 --> 00:00:06,000 innovation that improves the health and well-being of 3 00:00:06,000 --> 00:00:09,460 people. Our health care technology and informatics solutions 4 00:00:09,599 --> 00:00:12,559 help care teams diagnose, treat, and manage more 5 00:00:12,559 --> 00:00:16,244 patients with greater precision, speed, and confidence across 6 00:00:16,244 --> 00:00:19,225 the care journey. With Philips, clinicians are empowered 7 00:00:19,285 --> 00:00:21,765 with streamlined insights in the moments that matter 8 00:00:21,765 --> 00:00:24,904 for every patient. Better care for more people. 9 00:00:25,204 --> 00:00:25,704 Philips. 10 00:00:29,170 --> 00:00:31,010 Hello, and welcome to the Becker's Health Care 11 00:00:31,010 --> 00:00:33,250 podcast recorded at the 9th annual health IT, 12 00:00:33,250 --> 00:00:35,969 digital health, and RCM conference in Chicago. I'm 13 00:00:35,969 --> 00:00:38,929 joined today by Laura Petula, deputy CIO at 14 00:00:38,929 --> 00:00:40,469 the department of veteran affairs. 15 00:00:41,445 --> 00:00:42,885 Laura, to get us started, can you please 16 00:00:42,885 --> 00:00:44,645 share a bit about yourself, your role, your 17 00:00:44,645 --> 00:00:45,785 background, and your organization? 18 00:00:46,164 --> 00:00:48,164 Sure. Thank you so much for inviting me 19 00:00:48,164 --> 00:00:50,804 here today. And, as you said, my name 20 00:00:50,804 --> 00:00:52,804 is Laura Petula, and I am the deputy 21 00:00:52,804 --> 00:00:55,125 chief information officer for the Department of Veterans 22 00:00:55,125 --> 00:00:58,810 Affairs, the electronic health record modernization integration office, 23 00:00:59,189 --> 00:01:00,890 also known as EHRM IO. 24 00:01:01,350 --> 00:01:02,549 I love to say that I am a 25 00:01:02,549 --> 00:01:04,629 geek. I'm a nerd, and I love being 26 00:01:04,629 --> 00:01:06,790 weird, and I embrace every single one of 27 00:01:06,790 --> 00:01:07,189 those, 28 00:01:07,989 --> 00:01:08,489 characteristics. 29 00:01:08,950 --> 00:01:10,790 I also love people, and I love to 30 00:01:10,790 --> 00:01:12,765 serve. And that's what draw what draws me 31 00:01:12,765 --> 00:01:13,944 a lot to the department. 32 00:01:14,245 --> 00:01:16,005 I've been in the IT space for over 33 00:01:16,005 --> 00:01:18,325 30 years, and over 20 of them, I 34 00:01:18,325 --> 00:01:20,564 spent at the Department of Veteran Affairs serving 35 00:01:20,564 --> 00:01:21,704 our beloved veterans. 36 00:01:22,724 --> 00:01:24,900 So as a self proclaimed nerd, somebody obviously 37 00:01:24,900 --> 00:01:26,579 with your ear down, like, listening to what's 38 00:01:26,579 --> 00:01:28,099 going on in the industry, you know, as 39 00:01:28,099 --> 00:01:30,260 I'm sure you're aware, AI adoption is exploding 40 00:01:30,260 --> 00:01:31,159 in health care. 41 00:01:31,619 --> 00:01:34,420 In your view, what's the most significant or 42 00:01:34,420 --> 00:01:37,079 promising application of this technology right now, 43 00:01:37,435 --> 00:01:40,015 And, how is this informing your organization's innovation 44 00:01:40,075 --> 00:01:40,575 strategy? 45 00:01:41,915 --> 00:01:44,234 So AI has woven its threads into the 46 00:01:44,234 --> 00:01:47,375 fabric of our lives since 19 fifties or 47 00:01:47,435 --> 00:01:49,135 or a little bit before that too. 48 00:01:49,490 --> 00:01:51,409 But what sets this era apart is the 49 00:01:51,409 --> 00:01:53,409 depth and breadth of its integration in today's 50 00:01:53,409 --> 00:01:53,909 world. 51 00:01:54,210 --> 00:01:57,829 We have huge challenges today in diverse environments, 52 00:01:57,969 --> 00:02:00,130 and so I think that AI is allowing 53 00:02:00,130 --> 00:02:02,390 us to help break some of those challenges 54 00:02:02,450 --> 00:02:03,109 and barriers. 55 00:02:04,055 --> 00:02:06,454 Like, for example, telehealth has brought them a 56 00:02:06,454 --> 00:02:08,854 lot of good changes. We can now reach 57 00:02:08,854 --> 00:02:10,775 people who are in rural communities who would 58 00:02:10,775 --> 00:02:12,694 have had to travel a 100 miles or 59 00:02:12,694 --> 00:02:15,034 more in order to receive care. So accessibility 60 00:02:15,254 --> 00:02:17,175 and some equity has also been brought to 61 00:02:17,175 --> 00:02:19,739 the table because of AI. And it has 62 00:02:19,739 --> 00:02:21,919 had a a profound impact on individuals 63 00:02:22,379 --> 00:02:23,120 like me. 64 00:02:23,500 --> 00:02:26,139 I have a chronic condition, and AI helps 65 00:02:26,139 --> 00:02:28,219 me monitor that and and and be able 66 00:02:28,219 --> 00:02:30,459 to coach myself to ensure that I am 67 00:02:30,459 --> 00:02:33,019 healthy. And many of these are are rule 68 00:02:33,019 --> 00:02:35,235 based products and services as well. 69 00:02:35,794 --> 00:02:38,034 But the impact of AI in health care 70 00:02:38,034 --> 00:02:41,335 extends beyond just reaching individual experiences. 71 00:02:42,115 --> 00:02:44,294 As I said, it is about breaking barriers, 72 00:02:44,675 --> 00:02:45,414 and also, 73 00:02:46,194 --> 00:02:48,900 I anticipate that the growth will continue. 74 00:02:49,199 --> 00:02:51,219 Some of the three concepts that I usually 75 00:02:51,759 --> 00:02:52,579 that I have 76 00:02:52,879 --> 00:02:53,379 is, 77 00:02:54,000 --> 00:02:55,459 I talk about empowering 78 00:02:56,000 --> 00:02:56,500 patients, 79 00:02:57,519 --> 00:02:58,819 sense making of data, 80 00:02:59,120 --> 00:03:01,375 and access to all patients. And so we 81 00:03:01,375 --> 00:03:04,655 will be empowering with AI capabilities and more, 82 00:03:04,655 --> 00:03:07,394 not just AI, AI in the general term, 83 00:03:07,694 --> 00:03:09,954 it's empowering patients to participate actively 84 00:03:10,414 --> 00:03:12,894 in their health environment, as well as their 85 00:03:12,894 --> 00:03:15,610 healthcare team. And since making of data and 86 00:03:15,610 --> 00:03:17,949 information so their patients, clinicians, 87 00:03:18,569 --> 00:03:19,310 and administrators 88 00:03:19,610 --> 00:03:22,169 can focus on defining the best strategies for 89 00:03:22,169 --> 00:03:24,509 the best healthcare outcomes, and finally, 90 00:03:24,810 --> 00:03:26,189 access to all patients, 91 00:03:26,569 --> 00:03:29,055 right, That regardless of their socioeconomic 92 00:03:29,675 --> 00:03:32,015 background or factors, location, or otherwise, 93 00:03:32,395 --> 00:03:34,715 we can be removing some of those physical 94 00:03:34,715 --> 00:03:36,795 barriers to health care and allow them to 95 00:03:36,795 --> 00:03:38,015 have a healthy life. 96 00:03:38,635 --> 00:03:39,135 So 97 00:03:39,439 --> 00:03:41,520 on a daily basis, health care leaders are 98 00:03:41,520 --> 00:03:44,400 managing greater and greater volumes of data on 99 00:03:44,400 --> 00:03:46,479 more devices across a growing number of health 100 00:03:46,479 --> 00:03:47,699 care settings and populations. 101 00:03:48,479 --> 00:03:51,360 In this complex environment, what clinical data integration 102 00:03:51,360 --> 00:03:53,919 tools or practices are you seeing drive improvements 103 00:03:53,919 --> 00:03:56,215 in patient outcomes and operations, and operations? And 104 00:03:56,215 --> 00:03:57,675 can you share an example or 2? 105 00:03:58,534 --> 00:04:01,575 So data is everywhere Mhmm. Today, and I 106 00:04:01,575 --> 00:04:03,575 love data. Right? Data has been one of 107 00:04:03,575 --> 00:04:05,675 the things that I've focused my career 108 00:04:05,974 --> 00:04:07,194 for for many years. 109 00:04:07,750 --> 00:04:09,830 And I believe that the greatest opportunities for 110 00:04:09,830 --> 00:04:10,969 data might be, 111 00:04:11,909 --> 00:04:13,830 is is how do we make it useful 112 00:04:13,830 --> 00:04:16,069 to clinicians, especially in the health care space. 113 00:04:16,069 --> 00:04:17,910 Right? How do we make it useful to 114 00:04:17,910 --> 00:04:18,410 clinicians, 115 00:04:18,790 --> 00:04:21,395 and how do we, also make it meaningful 116 00:04:21,615 --> 00:04:23,375 and with the highest quality that we can 117 00:04:23,375 --> 00:04:23,875 provide? 118 00:04:24,335 --> 00:04:26,654 So as you know, we're implementing an electronic 119 00:04:26,654 --> 00:04:29,154 health record a modernized electronic health record, 120 00:04:29,615 --> 00:04:33,520 and, we currently manage around 70 terabytes of 121 00:04:33,520 --> 00:04:35,860 information. So if you can think about that, 122 00:04:35,920 --> 00:04:38,020 it's about maybe 23,000 123 00:04:39,600 --> 00:04:42,240 high definition movies, you know, that can could 124 00:04:42,240 --> 00:04:44,160 get stored there every day. We have that. 125 00:04:44,160 --> 00:04:46,000 We manage that. We curate that. We make 126 00:04:46,000 --> 00:04:48,105 out of the quality, and we make sense 127 00:04:48,105 --> 00:04:51,225 of that data for for our clinicians. And 128 00:04:51,225 --> 00:04:52,904 one of those examples that we have in 129 00:04:52,904 --> 00:04:56,105 VA is, a a product, a combined product 130 00:04:56,105 --> 00:04:58,605 that we have, we call it VX 130, 131 00:04:59,064 --> 00:05:01,225 which is all of the information from our 132 00:05:01,225 --> 00:05:03,600 own medical centers. We have a 130 different 133 00:05:03,759 --> 00:05:04,580 medical centers. 134 00:05:05,040 --> 00:05:07,379 We put it out into one big place, 135 00:05:07,680 --> 00:05:10,020 and that's what we call VX 130. 136 00:05:10,639 --> 00:05:11,620 And that information 137 00:05:12,080 --> 00:05:15,439 now is being used for large language models. 138 00:05:15,439 --> 00:05:18,074 We curate it. We we we also bring 139 00:05:18,074 --> 00:05:20,274 it and make it avail available to our 140 00:05:20,274 --> 00:05:21,014 our physicians 141 00:05:21,314 --> 00:05:23,095 through a tool that we call Google. 142 00:05:23,475 --> 00:05:25,814 And Google basically allows you to 143 00:05:26,274 --> 00:05:28,834 search a patient and from that patient and 144 00:05:28,834 --> 00:05:31,189 all the these notes that you and it 145 00:05:31,189 --> 00:05:33,670 is across all of the longitudinal health record, 146 00:05:33,670 --> 00:05:34,889 and it tells you exactly 147 00:05:35,430 --> 00:05:38,410 what, diagnoses, what node, what lab result 148 00:05:38,790 --> 00:05:40,790 was exactly that around that talked about die 149 00:05:41,189 --> 00:05:43,129 diabetes. So that's making information 150 00:05:43,430 --> 00:05:43,930 meaningful 151 00:05:44,485 --> 00:05:46,245 to clinicians so that they don't have to 152 00:05:46,245 --> 00:05:48,805 be sifting through all sorts of data for 153 00:05:48,805 --> 00:05:51,064 hours to find out any of this information. 154 00:05:52,245 --> 00:05:54,884 So how can health care organizations better support 155 00:05:54,884 --> 00:05:56,805 IT and clinical teams as they carry out 156 00:05:56,805 --> 00:05:59,120 innovation efforts? And, what are some of the 157 00:05:59,120 --> 00:06:00,740 common pitfalls in this area? 158 00:06:01,519 --> 00:06:02,259 Well, so 159 00:06:02,639 --> 00:06:03,860 so with VA, 160 00:06:04,800 --> 00:06:07,039 we have a long history of many decades 161 00:06:07,039 --> 00:06:07,779 of innovation. 162 00:06:08,639 --> 00:06:10,725 So for me, one of my main goals 163 00:06:10,725 --> 00:06:12,564 as well is to make sure that not 164 00:06:12,564 --> 00:06:15,125 only people love the electronic health record, which 165 00:06:15,125 --> 00:06:17,285 is in itself a challenge because nobody loves 166 00:06:17,285 --> 00:06:18,264 their their EHRs, 167 00:06:18,645 --> 00:06:21,464 but I also wanna make sure that innovation 168 00:06:21,524 --> 00:06:23,365 is at the forefront of anything that we 169 00:06:23,365 --> 00:06:26,310 do. Not because we're implementing a a a 170 00:06:26,310 --> 00:06:29,050 COTS product are we going to stop innovating. 171 00:06:29,189 --> 00:06:31,290 We will need to continue to see 172 00:06:31,590 --> 00:06:34,310 how do we become the those enablers for 173 00:06:34,310 --> 00:06:34,970 the organization 174 00:06:35,750 --> 00:06:38,009 so that we can continue to ensure 175 00:06:38,389 --> 00:06:39,904 VA has that, 176 00:06:40,444 --> 00:06:40,944 innovation 177 00:06:41,324 --> 00:06:45,085 spirit and continues to deliver innovative solutions for 178 00:06:45,085 --> 00:06:47,105 our veterans and our clinical workforce. 179 00:06:48,125 --> 00:06:50,225 Out of curiosity, when it comes to adopting 180 00:06:50,285 --> 00:06:51,024 some of these 181 00:06:51,569 --> 00:06:53,509 newer technologies or innovations, 182 00:06:53,970 --> 00:06:56,050 how does that differ at, like, an organization 183 00:06:56,050 --> 00:06:58,629 like the VA versus a traditional health system? 184 00:06:59,089 --> 00:07:01,669 So if you can imagine, VA, we have, 185 00:07:02,209 --> 00:07:03,829 like I said, about a 132 186 00:07:04,289 --> 00:07:07,064 different medical centers. Right? The way that we 187 00:07:07,064 --> 00:07:08,764 grew up, and this goes to culture, 188 00:07:09,464 --> 00:07:12,524 in VA, we were all different organizations, 189 00:07:12,985 --> 00:07:13,725 let's say 190 00:07:14,345 --> 00:07:16,904 50 years ago, right, 40 years ago, where 191 00:07:16,904 --> 00:07:18,045 every one of those 192 00:07:19,349 --> 00:07:21,829 facilities grew up with their own culture, grew 193 00:07:21,829 --> 00:07:22,729 up with a 194 00:07:23,189 --> 00:07:24,969 a baseline of a product, 195 00:07:25,269 --> 00:07:27,829 but they each customized it to serve their 196 00:07:27,829 --> 00:07:30,169 needs. Like our our facilities, 197 00:07:30,949 --> 00:07:33,704 they know or whatever comes in because of 198 00:07:33,784 --> 00:07:35,704 the the work that we do, they might 199 00:07:35,704 --> 00:07:38,024 have come in when the the granddaughter was 200 00:07:38,024 --> 00:07:40,504 being born, and now the granddaughter is in 201 00:07:40,504 --> 00:07:43,084 college. Right? So all that cultural, 202 00:07:43,784 --> 00:07:46,419 understanding of who the veteran is, we need 203 00:07:46,419 --> 00:07:48,819 to take into consideration when you're implementing a 204 00:07:48,819 --> 00:07:49,879 modernized technology. 205 00:07:50,180 --> 00:07:52,180 You wanna make sure that you preserve the 206 00:07:52,180 --> 00:07:55,300 culture of caring and the culture of making 207 00:07:55,300 --> 00:07:57,139 sure that the patient is always at the 208 00:07:57,139 --> 00:07:59,139 center of everything that we do while at 209 00:07:59,139 --> 00:08:01,915 the same time making sure that our clinical 210 00:08:01,915 --> 00:08:04,795 staff can really transform the way that that 211 00:08:04,795 --> 00:08:06,574 they're doing work. So 212 00:08:06,955 --> 00:08:08,574 this is a massive undertaking, 213 00:08:09,275 --> 00:08:11,995 but the clinical community is really the one 214 00:08:11,995 --> 00:08:14,970 that is really changing the practices and standardizing 215 00:08:15,189 --> 00:08:18,170 the practices. So the clinical practices are changing. 216 00:08:18,389 --> 00:08:19,370 They are evolving. 217 00:08:19,670 --> 00:08:22,250 They're look looking and using new technologies. 218 00:08:22,709 --> 00:08:24,410 They're looking and and understanding 219 00:08:24,949 --> 00:08:27,189 what other concepts can they bring to the 220 00:08:27,189 --> 00:08:27,689 table. 221 00:08:28,185 --> 00:08:29,725 So I don't know that it is 222 00:08:30,264 --> 00:08:33,085 markedly different than a very large organization, 223 00:08:34,184 --> 00:08:36,664 that is trying to, change the the main 224 00:08:36,664 --> 00:08:38,125 difference, I think, is that 225 00:08:38,585 --> 00:08:39,884 VA grew from, 226 00:08:40,709 --> 00:08:41,850 if you would, islands 227 00:08:42,309 --> 00:08:45,509 of medical centers that they started to come 228 00:08:45,509 --> 00:08:47,690 in through the years. We started to centralize, 229 00:08:48,230 --> 00:08:51,029 and now we're starting to really modernize many 230 00:08:51,029 --> 00:08:51,929 of those technologies. 231 00:08:52,470 --> 00:08:53,769 Okay. I like that answer. 232 00:08:54,335 --> 00:08:55,855 What would you say your top piece of 233 00:08:55,855 --> 00:08:57,394 advice for health care leaders 234 00:08:57,774 --> 00:08:59,615 is as they prepare for, you know, further 235 00:08:59,615 --> 00:09:02,514 advancements in technology and greater demands for care? 236 00:09:03,535 --> 00:09:05,475 I would say that one of the main 237 00:09:06,459 --> 00:09:07,839 advices I would give 238 00:09:08,220 --> 00:09:09,279 is be diligent 239 00:09:10,139 --> 00:09:12,080 and be very, very disciplined. 240 00:09:12,860 --> 00:09:14,799 You wanna make sure that as you're 241 00:09:15,179 --> 00:09:18,139 bringing a new technology, as you transform an 242 00:09:18,139 --> 00:09:19,039 entire organization, 243 00:09:19,914 --> 00:09:21,215 that you know exactly 244 00:09:21,754 --> 00:09:23,375 who you're doing it with, 245 00:09:23,914 --> 00:09:26,154 not who you're doing it to, right, but 246 00:09:26,154 --> 00:09:27,835 who you're doing it with, how you're doing 247 00:09:27,835 --> 00:09:29,535 it, that you do have 248 00:09:30,075 --> 00:09:32,394 groups of people that are working with you 249 00:09:32,394 --> 00:09:33,535 to make these changes. 250 00:09:33,980 --> 00:09:35,820 Make sure that you have a really good 251 00:09:35,820 --> 00:09:38,080 process of identifying any changes, 252 00:09:39,500 --> 00:09:42,300 and documenting the changes and how those changes 253 00:09:42,300 --> 00:09:43,440 are going to be, 254 00:09:44,379 --> 00:09:46,460 used. One of the things that I've talked 255 00:09:46,460 --> 00:09:48,300 to all of my folks is always 256 00:09:48,825 --> 00:09:51,144 you know, many people look as to what 257 00:09:51,144 --> 00:09:52,904 are the resources you're gonna use, what are 258 00:09:52,904 --> 00:09:54,504 the activities that you're gonna do, and what 259 00:09:54,504 --> 00:09:56,285 are the outputs that you're gonna produce. 260 00:09:57,304 --> 00:09:59,384 We always want to extend that. We don't 261 00:09:59,384 --> 00:10:01,384 wanna get get stuck on the output. We 262 00:10:01,384 --> 00:10:03,225 wanna make sure that we actually look as 263 00:10:03,225 --> 00:10:05,700 to what is the outcomes that we're providing 264 00:10:06,000 --> 00:10:07,940 and what is the value that we're delivering. 265 00:10:08,399 --> 00:10:10,160 And so if you have that in mind, 266 00:10:10,160 --> 00:10:12,639 I think that your focus will always be 267 00:10:12,639 --> 00:10:15,360 towards doing the right things right and delivering 268 00:10:15,360 --> 00:10:17,519 the right things to the right folks. Mhmm. 269 00:10:17,519 --> 00:10:18,019 Mhmm. 270 00:10:18,399 --> 00:10:19,884 Well, Well, Laura, thank you so much again 271 00:10:19,884 --> 00:10:21,245 for joining us today on the Becker's Health 272 00:10:21,245 --> 00:10:23,165 Care podcast. It was an absolute pleasure, and 273 00:10:23,165 --> 00:10:24,445 I I hope you have a lovely rest 274 00:10:24,445 --> 00:10:25,805 of your day. Oh, thank you so very 275 00:10:25,805 --> 00:10:26,305 much.