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This is Gracelyn Keller with the Becker's Healthcare
Podcast, and we are live at the 9th
annual health IT digital health and RCM conference.
I'm joined currently by Shelly Nash, who is
the senior vice president and global chief medical
information officer
at Fresenius Medical Care.
So, Shelley, thanks for joining me this morning.
To get us started, could you please share
a little bit about yourself, your background, and
your role? Sure. Thanks for having me. I'm
happy to be here. So my name is
Shelley Nash, and I am a physician by
background, but I've worked worked in technology
for over 20 years. I currently work with
Fresenius Medical Care, which is the
largest company in the world to supply,
services and,
machinery for dialysis. So we are a kidney
care company.
And that may sound like, you know, kidney
is very specific, but actually kidney disease affects
1 in 7 people in the United States,
over 35,000,000
people that means. So, you know, we play
a role in providing dialysis services.
We play a role in providing machinery for
not just our specific dialysis centers. We have
about 4,000 dialysis centers worldwide,
and we provide, devices
in about a 150 countries. So we're we're
a very large global company.
My background before coming to Fresenius was that
I was a physician,
chief medical information officer with AdventHealth
out of
Florida.
I had my own practice.
My background before becoming a CMIO was I
worked
in obstetrics and gynecology and then in clinical
informatics.
So I really always felt like technology could
really improve the care of patients and improve
the experience for providers, doctors, nurses as well.
Wonderful. Well, thanks for being here. And speaking
of technology, we're gonna start our conversation today
talking about AI adoption. So this is exploding
right now in health care. And in your
view, what is the most significant or promising
application of AI right now? And how is
this informing your organization's innovation strategy?
Yeah. I don't think you can read an
article online or go to a conference or
talk to someone in health care, especially health
care technology without AI coming up. Right?
AI, you know, has been used for a
while in the form of machine learning.
But I think now with large language models,
with ChatGPT,
it's it's really, as you said, exploding.
I think it can really play a place
in health care,
in frontline health care, even when we start
using it to decrease what we'll call administrative
burden. So doctors, nurses,
front desk folks do so much work every
day that could be done much easier by
technology.
So, for example,
the ability to summarize
information from a chart for someone who's doing
billing. Right? The ability
to answer simple questions around policies and procedures.
We're doing some work around that. So
I know there's vendors who are doing work
around, using AI for answering emails that doctors
get because they spend over half their time,
the literature shows, answering emails to patients and
doing those types of things. We're focusing more
on administrative
work
to make the life
of humans easier. Right? So, you know, we
always talk about in medicine,
people working at the top of their license,
but it's not just that. If we can
really take away some of those, I don't
wanna say mundane, but they are mundane tasks
of looking through, you know, screen after screen
and having summarizations.
I think that's the first place we'll go.
I do think we'll we'll move into things
like and we are doing that now, predictions.
So
having AI be able to look through the
chart in a way that a human could,
but in a faster way with AI so
that they can come to conclusions and predict
outcomes and really improve the care of patients
in that way.
And shifting gears just slightly to data.
Currently, healthcare leaders are managing greater volumes of
data and more devices across a growing number
of care settings and populations. This is a
complex environment that we find ourselves in. So
what clinical data integration tools or practices
are you seeing drive improvements in patient outcomes?
And I'd love to hear a specific example.
Yeah. Yeah. So you're right. I mean, we
have over 200 clinical applications that our clinicians
use every day. And if you think of
every hospital or every unit on a hospital
or every doctor's office, and in my case,
every dialysis center as its own little
company. Right? So someone, let's say the manager
is the CEO of the clinic. Every day,
there are so many different applications and places
they need to look. Right? They need to
look to see who hasn't showed up, what
patients are missing. Have there been any adverse
events?
You know? What's going on with their billing?
Have they not got bills out and they
need to do that to keep the lights
on? So one thing we did with all
these hundreds of applications,
because our users were telling us, you know,
we have to go to 5,000 dashboards. We've
got all these dashboards. We need to check
what's going on with so we created kind
of a we call it daily hub. So
one place which integrated information from dashboards. It
doesn't have the dashboard, but we created something
that
told our users, our clinic managers, and we've
rolled it out for clinicians as well. What
do you need to look at? And we
we, you know, we did something simple, and
you'll see EHR vendors do this as well
with green, yellow, red. So if there's a
new adverse event that happened, safety issue, it's
red. And they come in right away. They
just look at the list and they see
green, yellow, red. And then we just link
them through this hub, it's called it's called
their daily hub because it's their first place
they go every morning. Click that and it
gets them to go see what they need
to go to to review. So we did
integration kind of at a high level, but
it's been very successful.
We've seen a decrease in
days for billing to go out because they've
been able to find that. We've seen some
even increased
ability of filling open slots. So we've really
done a lot of work on that. And
I think that's kind of the way to
go. It's gonna be really difficult to get
rid of all of the applications hospitals and
doctors offices use, even though everyone's trying to
align them. So really trying to create tools
that make
people aware of what they need to look
at, I think are is really important.
And
how can healthcare organizations better support our IC
and our clinical teams as they carry out
these innovation efforts? And do you know of
any common pitfalls that you've seen here?
Yeah. I I think that what happens sometimes
in large health systems having worked for 1
for 10 years,
or in companies is that, you know, you
have folks that get ideas and they may
be in the c suite,
and they don't include the IT teams either
early enough or the clinical IT teams early
enough. So I think it's important to if
you come up with an idea for something
you wanna do, and I was in a
session yesterday where a CMIO said, you know,
often the clinical IT folks aren't pulled until
later. So So making sure that, you know,
you don't start projects without having everyone having
a seat at the table. And I'm not
saying everyone has to make the decision, of
course, and maybe the CEO who makes the
decision, but including everyone in the discussions early
because they may have a viewpoint that you
didn't think of. You know, people on the
front lines really might understand the workflow, so
you don't wanna create
tools that you think are going to work
for what you what you need if you
don't really have the direct input. So silos
is a big problem, I think, in health
care. My advice would be to include people
early, you know, to listen to everyone's opinion.
Obviously, you know, you can't always make decision
by consensus, but listen to them because otherwise,
what happens is you create these tools, and
I've seen this happen, and then people don't
use them. You think it's gonna be great,
but it isn't. But, I think one way
to avoid it is to really engage everyone
early on.
Absolutely. And as we wrap up our conversation,
I'd love to know your top piece of
advice for health care leaders as they prepare
for further advancements in technology and greater demands
for care. That's a big question. But, probably
my top piece of advice is don't be
afraid. You know, it's kind of interesting because
I'll be out talking to doctors and everyone
is scared. Oh, AI is taking over the
world. AI, I'll get rid of doctors. You
know, you can read articles online. And and
if you start thinking about
AI, you know, not as a scary thing,
I mean, anyone who you've watches Netflix, right,
AI is there. It's telling you what your
next pick is. Or if you use Spotify,
AI is giving you suggestions.
So I think health care organizations
really need to recognize that,
the way that they approach this,
should be very thoughtful. Don't just throw something
out that, you know, you think is gonna
save the world if you haven't engaged your
end users, your doctors, your clinicians,
and also patients. You know, patients are
have the idea that, you know, AI may
be replacing doctors. So, you know, be thoughtful
in the applications
that you create. Be thoughtful in how you
market this and really think of it as
a tool.
It may be, you know, we always talk
about how there's always, you know, a a
peak of excitement and then a trough of
disillusionment, you know, and that that may happen
as well, but don't give up on it
because I really do think the technologies that
are out there and how they're evolving is
really gonna change how we can take care
of patients and improve the experience for everyone
who works in health care.
Absolutely. Well, Shelly, thanks so much for taking
the time to join me today on the
Becker's Health Care Podcast. Again, we're live at
the 9th Annual Health IT Digital Health and
RCM Conference. Thank you. Yep. Thanks so much.