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This is Rosie Talaga with the Becker's Healthcare

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podcast.

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I'm thrilled today to be joined by doctor

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Cole Zanetti, chief health informatics officer at Ralph

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h Johnson VA Healthcare System.

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Doctor Zanetti, it's a pleasure to have you

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on the podcast today.

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It's a pleasure to be on. Happy Valentine's

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Day.

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Happy Valentine's Day to everyone listening.

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We have a great conversation in store diving

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into the key opportunities and challenges shaping health

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care. But before we get into it, I'd

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love for our listeners to get to know

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you a bit better. So could you please

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start by sharing a little bit about your

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background and your journey to your current role?

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Sure.

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So I'm,

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originally from a small town in,

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Upstate New York,

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called Otisville, New York.

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My parents didn't go to college. We come

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from a line of jazz musicians.

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So I grew up going to gigs, on

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the weekends and

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end up going into into health care because

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I was fascinated with

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science and and people

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and

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ended up going into informatics,

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primary care, and preventive medicine

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because I wanted to help with systems change

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to have broader impact on the lives that

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we are responsible for.

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And working in the VA is,

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the internal mission

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for me, to serve those that have served

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our country, and I can't think of

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a better organization to work for,

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with our our mission,

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vision, and values targeted towards that population.

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That's amazing. Thank you so much for the

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introduction. And I have to say jazz musicians

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sounds very cool,

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but it's really inspiring to see your fascination

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with

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science and people. And then it just seems

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like

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the VA health care system is a perfect

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match for you. So I'd love to talk

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more about your organization.

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And if you could please let us know

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what makes your health system so unique.

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Yeah. VA is the largest integrated health system

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in the country.

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We care for,

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over 9,000,000 veterans

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throughout Continental

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US and in certain US territories,

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and we have the largest,

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dataset

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to follow track support and provision care to

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our veterans

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from all backgrounds,

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ethnicities, socioeconomic

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statuses,

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and

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we have,

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an incredible,

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support and resources

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to

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provide the unique care that veterans need that

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are

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often not,

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taught about in medical schools, residencies, or in

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a private sector

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that that really is a unique demand for

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our our country and and and honor that

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we,

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get to serve in in in the way

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that's actually needed for those that have gone

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through what they've gone through.

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So it's a it's the largest health system

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in the country that has that level of

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integration and

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really think it also

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positions itself

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to be an innovation laboratory for the nation,

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to be on the cutting edge of where

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health care should be.

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Absolutely. That's that's

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very inspiring to hear about you being the

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largest integrated health system and all that you're

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doing to give back to that veteran population

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that has given us so much.

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So thank you so much for sharing that,

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and I'd like to look more closely into

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some of the milestones you've hit more recently.

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So looking back at the past year, what's

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the accomplishment that you're most proud of?

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Yeah.

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To to me, the VA has really stepped

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up around

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its focus on

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partnering with artificial intelligence,

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to

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ensure that we are at the bleeding edge

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of effective

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and efficient care for our veterans.

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So the work

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that's been done to look at what currently

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exists across the system, making sure that we're

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considering privacy and security

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and ethical approaches to its implementation

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is really critical.

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In addition,

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the aspect that we want to reduce administrative

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burden for the care teams that are provisioning

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care

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and return

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as much humanity

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to the experience of care interaction that we

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can by

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focusing on the veterans in front of us

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instead of the computer.

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So I think we've made incredible strides

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to execute on those efforts,

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and we'll continue to do so across the

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nation.

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That's great. And it makes me think of

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how you mentioned that you have the largest

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dataset to follow and track support care to

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veterans,

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which absolutely can be used to leverage AI

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and make everything more efficient. So that sounds

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great.

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And then it's great to acknowledge this win

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and

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how the steps you've been taking to really

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focus on artificial intelligence. And looking at where

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you can continue to grow and evolve,

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where do you see the biggest growth opportunities

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for your team in the next twelve months?

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It's integration

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within workflow

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so that we don't inadvertently

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create additional burden on teams.

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And we're leveraging

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AI in such a way that is really

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gonna help,

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the the care processes,

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that exist

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to amplify their their impact.

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So we constantly have to look at how

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things are integrated, not just that there's a

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artificial intelligence tool that can help, but how

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does it fit in, and how do we

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make sure it's connected to the right systems?

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How do we make sure that it's actually

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reducing

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check boxes and

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and steps

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in our care workflow

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so that as much time as possible spent

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with the human beings that we're here in

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charge to care for.

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So I I think the challenge

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is that in

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across health care,

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we

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have not done a good job of auditing

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the amount of time spent

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to do all of those administrative things as

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a part of our processes and rollouts,

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to meet certain standards.

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And it's important that

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these aren't looked at as

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insignificant

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effects.

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The more time that it takes care teams

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to do things, the more time it takes

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for patients and veterans to do things,

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the the less chance that we're gonna be

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successful

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in those efforts. So our challenge is

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looking at our system,

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authentically

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and and accurately and objectively

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to really assess the prioritization

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of reducing the burden so that we can

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focus on the on the people first.

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Absolutely. Focusing

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on that integration within

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the workflow, really optimizing everyone's time so that

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they can make the most impact.

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I think it's really important to not just

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think that you have to reinvent the wheel,

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but really enhancing and fine tuning what you

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have in front of you to make

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the most out of what you have.

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So it sounds like there's some exciting opportunities

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on the horizon.

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And I'm curious when you look at

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really focusing on this integration within the workflow,

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what are some of the big challenges that

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you're anticipating,

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and how are you preparing to tackle them?

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Yeah. I I think that the challenges that

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we face when we're partnering with

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artificial intelligence

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and trying to improve,

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the solutions so that they're most effective,

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for example,

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is how do we do so in a

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way that doesn't increase that that burden. Right?

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So when someone is

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getting a soap note, for example,

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that is created by an Ambient scribe,

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there still needs to be edits. There still

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needs to be adjustments and changes, and that

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takes time. Right?

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It's less time than having to write the

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full note, but,

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who who gets the most benefit by those

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edits and adjustments,

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and how is that benefit to improving a

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solution,

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an algorithm,

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you know, shared

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across the industry. And and

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those are things that are, being looked into.

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The other aspect is

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challenges of having to figure out what to

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to prioritize and focus on to give access

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to these tools because these tools aren't free.

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Right?

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You have to pay for them in trying

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to make business decisions around who, you know,

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who do we have to prioritize access to

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them,

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how do we account for

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these tools as a part of our infrastructure

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when they've not been there in the past,

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and and make sure that we're increasing

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the impact

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strategically as much as possible while weighing these,

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these important components.

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Absolutely. I think it's

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very important to know how

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crucial it is to not just understand which

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are the smartest investments, but for whom these

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are the smartest investments. Like you said, they're

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not cheap, so to making sure that

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it's really making an impact in the most

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effective way.

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So now I'd like to talk a little

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bit about the importance of staying proactive.

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What's the number one thing that you're doing

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right now to set your organization up for

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long term success aside from

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really focusing on this AI integration?

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Yeah. It's it's prioritizing the people, the staff,

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the veterans,

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and the the human connection in health care

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that

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acknowledges that we have people coming to us

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or we're going to them

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in an incredibly vulnerable state.

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These are

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individuals that are struggling,

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or looking for assistance to to sustain health

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and be there for their families and loved

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ones.

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And our job, our number one focus is

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how do we,

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disentangle,

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the

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elements that we have to accomplish

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to properly

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document the care

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to,

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to

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provide people what they need

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in the treatment or the care plan to

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make sure that people understand what's actually going

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on, not just the veteran or the patient,

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but the caregivers and the family that is

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also charged with the support after they they

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leave our walls. Right?

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It's

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that human connection and understanding that the the

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team is broader than

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just the health care team. It's the it's

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the the care

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team for the the veterans as well in

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the home that

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we wanna unburden,

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with

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as many things as possible so they can

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they can execute on their mission,

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and and,

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their love and care,

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for for those around them. So our our

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long term success is dependent on always reminding

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ourselves that that is the center,

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and we have to create environments, workflows,

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and,

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invest in technology

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that really unburdens

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that that center to to to to be,

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you know, what everybody went into health care

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for, which is supporting those that need it

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most.

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Absolutely.

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That I think that's a great great takeaway

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to always going back to the human connection

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in health care. These people are, like you

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said, at a vulnerable state, and I think

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that it's great to recognize that the team

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is broader than the health care team, and

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it's also the team at home.

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Thank you so much for joining us on

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the podcast today, doctor Zanetti. It's been great

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hearing your insights on integration with AI to

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unburden your team, but your overall long term

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goal to unburden the team at home. It's

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very inspiring,

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and thank you again. We look forward to

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collaborating with you soon.

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Thank you.