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This is Gracelyn Keller with the Becker's Healthcare
podcast, and I am excited now to be
joined by doctor Joseph Izzo, who is the
chief medical information officer at San Joaquin General
Hospital. So, doctor Izzo, thank you for joining
me today.
Let's get started by having you please share
a bit about yourself and your background and
your role in your organization.
Yeah. Thank you for having me. So as
you said, I'm the chief medical information officer
for San Joaquin.
We're a level 2 trauma center and a
public hospital in the Central Valley of California.
I'm also a practicing physician. I've worked in
the
emergency department for over 6 years. And I
actually got my start, in computer science before
I transitioned into medicine. And since that, I've
been really working at the intersection between health
care and technology.
But particularly to my role, I oversee the
health informatics and the clinical reporting teams. And
you might say that our efforts are mostly
directed at optimizing how clinicians engage with technology,
fostering innovation, and and really ensuring clinical data
stewardship. So I I do hope with that
that my insights are valuable to the listeners.
And again, I I appreciate you having me.
Absolutely. Well, thank you for taking the time.
And let's start our conversation today with AI
adoption. So as we know, this is exploding
in health care right now. So in your
view, what is the most significant or promising
application of this technology,
and how is this informing your organization's innovation
strategy?
Right. You know, AI to me is excelling
in spaces
that are traditionally considered, I think, the administrative
burden of medicine, especially,
these areas that are very important to clinical
medicine but are far enough,
away from patient care where I think the
margin for error is a little bit more
forgiving. You know, I I don't think the
tools are quite where they need to be
right now for direct patient care. And, of
course, not everyone may feel that way, and
that's certainly an institutional decision. But these areas
are traditionally burdensome to providers too, so it's
it's a bit of a win win. I
think the most pressing example that everyone's familiar
with is AI scribes, but I will say
that that really is the case. You know?
In 2 of the depart emergency departments
I work in, and
even in our pilots at the hospital, the
feedback is is just tremendous. You know, I've
received paragraphs of gratitude from some of the
physicians who have piloted the products, and it's
more or less a day and night diff
difference, for how their their charting changes and
and how much administrative burden is on them.
But I've also been really impressed with some
of the recent work in in, medical record
space, revenue cycle,
clinical documentation improving, even automating nursing processes, and
we've been exploring that at our hospital. And
separately too from my role at San Joaquin,
I've done some fractional work with large language
models and agentic AI, and I've seen tremendous
success too in areas of quality and safety
auditing. And I've what I've noticed in all
of these spaces, what it's doing is freeing
up, staff and clinicians to do more creative
and patient focused tasks.
But, to your other question, for us to
stay strategic, we really first had to start
with, a robust executive governance structure and policy,
and we really do vet any of these
AI tools, for the reasons I mentioned. And
I I personally authored the policy for a
hospital, and I've been very proactive in getting
clinician leaders involved in the dialogue,
particularly with a physician innovation group who vets
the products, try to attend many of the
vendor conferences, including Becker's.
Take attend local meetups and societies, and really
stay informed so that we can make the
best decisions on this technology. But either way,
our strategy is that we are moving forward,
and we wanna take advantage of these tools,
that are promising.
Absolutely.
And kind of going off of this AI
AI adoption,
technological advancements within health care, we see that
leaders are managing greater volumes of data and
more devices on a growing number of care
settings and populations. And this is a complex
environment. So what clinical data integration tools or
practices are you seeing drive improvements
in patient outcomes? And can you share some
examples of this?
Yeah. Certainly. The truth is, I I think
our organization is is actually limited in this
space with very small teams of analysts. You
know, we're a public hospital, like I mentioned,
and that's not too uncommon from talking to
other individuals from those spaces.
And I end up, helping out with a
fair number of the coding, the report writing
myself.
But on the plus side, I think that
means that our teams are really close knit
and really understand the data and are able
to make changes so,
that we do drive these improvements you mentioned.
And in that context, what's what's really worked
for us is being
quite intentional,
about reconciling all of these sources of data
that you mentioned
and kind of ingesting them
into really only 1 or 2 sources of
of truth. You know, if there's a census
that says a 170 patients
were at in the hospital at any given
moment, it should be true across any data
we query. And,
for us, we do use our our EMR's
cloud enterprise data warehouse for that purpose. But
I've seen other successful strategies where,
some of our clinics have done their own
homegrown versions and similar efforts like that. But
like you mentioned, there there's so many,
different areas to pull data from and and,
sources of data. And another thing in that
in that vein is is actually being really
realistic with workflows
because I I think, everyone's familiar that most
EMRs have a number of ways to maybe
document or perform the same task. And so
if there's, say, 5 different ways to document
a fall risk, then that's effectively 5 potentially
different locations on the back end to find
that data. And for us, standardizing these workflows
has been really important.
Now, of course, there's a delicate balance between
forcing folks to do something that is laborious,
but produces the perfect data, and then optimizing
their workflows. And I think we've learned really
to walk that line.
The example that really comes to mind in
in this space is actually about using interpreter
service,
for our patient. And, you know, we know
we're doing it, but a problem is really
being able to demonstrate that we are, I
say, for the case of auditing or for
quality improvement. Because like you mentioned, this is
so much disparate data. There's data from the
health plan. There's data from interpreter and service
networks, from registration, from nursing notes, from physician,
progress notes, and so on. And however, by
ingesting this all into one place, and then
coming up with standard,
reasonable, but expected workflows, we've actually been able
to address this problem
and make very good visualizations
for the units to see how their staff
are at documenting this data. And we've seen
tremendous progress. Some departments actually went from ostensibly
very low compliance in in in documenting that
they were using interpreter service to near a
100% just by able to have visibility
and by having continuous quality improvement. And the
truth is a lot of our efforts are
structured just like this.
Absolutely.
And kind of going off of both of
those points,
I would love to know how you think
that health care organizations can better support
IT and clinical teams as we carry out
innovation
efforts. And then what are some of the
common pitfalls that you're seeing here?
Sure. I think, like I mentioned, we found
the the most important first step is really
to have that governance structure in place to
protect these teams and gives them that space
to to really explore. You want to be
on the same page as an institution as
you've got new technology.
And I think it's also important to really
foster communication
between these teams.
It really isn't helpful if these teams are
working in silos and pursuing technology that may
not be best for the whole organization.
As a example, the clinician innovation group I
mentioned regularly communicates with IT and the executive
teams to make sure we're in agreement.
On the flip side, actually, though, there is
a tendency I've seen, maybe being a little
bit too bureaucratic or overprotective,
and I think it's something to be aware
of. It's probably the most common pitfall I've
seen, in my experiences.
And to be fair, you know, a lot
of these tools, particularly the AI ones, are
a little intimidating at first glance, and that
probably is what motivates the desire to be
protective.
But what we realize is even if we
think we're being protected by being too strict,
that will potentially limit innovation. And so as
we've grown in this journey, we've learned to
better strike that balance. But ultimately, I think
it's important really to trust these teams. And
more importantly, I I would say listen to
them. You know? Give them that leeway to
explore, but also that infrastructure to ensure the
success.
Absolutely. And as we wrap our conversation up
today, I'd love to end on your top
piece of advice for healthcare leaders as they
prepare to
take on further advancements in technology and greater
demands for care in the future.
Sure. I think it's really important,
to stay informed of the technology and these
use cases and the applications,
and really be aware of the limitations. You
know, it's something I try to work into
my role daily, because it's really easy to
fall into a trap maybe of pursuing this
technology,
like AI for the sake of AI, which
is probably another common pitfall to your previous
question, as well as maybe products that overpromise
and don't necessarily deliver. And I think I
found the best way for me and my
team to insulate against that is to really
be as informed as possible. And I think
the time is now
to do that, especially if you're listening to
this podcast.
And I feel like the barrier to entry
is a lot lower than it's ever been
with some of the general available tools such
as large language models. But, just like your
last question, ultimately, I I keep coming back
to the goal should really be to build
up these clinical and technology leaders, listen to
their guidance, and give them that space to
to work with these tools within the proper
guardrails and governance to feel protected.
Well, doctor Izzo, thank you so much for
taking the time today to join me on
the Becker's HealthCare podcast and share your insights
with our listeners.
Yeah. Thank you again for having me. I
really appreciate it.