Exciting things are happening at Becker's Healthcare. Stay
ahead of industry trends with the new Becker's
CFO plus Revenue Cycle podcast,
your go to source for insights from top
healthcare finance leaders. Tune in wherever you get
your podcasts.
And don't miss the tenth annual health IT
plus digital health plus RCM conference, happening September
30 to 10/03/2025
in Chicago.
Join thousands of
executives, engage with industry leaders, and explore the
future of health care innovation.
Learn more about our upcoming events at beckershospitalreview.com.
See you there.
This is Laura Dierdo with the Becker's Healthcare
podcast.
I'm thrilled today to be joined by doctor
Chris DeFletch,
vice president and chief medical information officer at
Penn State Health as well as professor at
Penn State College of Medicine
and emergency medicine physician at Milton s. Hershey
Medical Center. Doctor DeFletch, it's a pleasure to
have you on the podcast today. Hey, Hey,
Laura. Thanks for having me. Appreciate it.
Absolutely. Well, I'm looking forward to our conversation.
I know we have a lot to talk
about, and, certainly,
Penn State Health is going through a huge
transformation with EHR as well as, bringing in
new technologies and doing some really cool things.
And so I'm excited to talk about that.
But before we dive in, can you tell
us a little bit more about Penn State
Health and what makes it unique?
Oh, yeah. Absolutely.
You know, proud to say I've been at
Penn State Health for, for more than more
than two decades,
practice in emergency medicine the whole time and,
being able to to serve as the chief
medical information officer. You know, we've really grown
from
a single hospital,
Milton Hershey Medical Center, to now,
depending on how you count it, seven hospital
systems across all of,
Central, Pennsylvania.
We're we're lucky really enough to be able
to to to be able to take care
of all of our patients
in the Penn State area and the Penn
State region. We're talking,
an area that that you can get any
type of care that you want right here
at home. You don't gotta travel to Pittsburgh.
You don't gotta travel to Philadelphia.
You know, it's it's all done here, whether
you need it in the community
in Berks County or, you know, further west
or up north of the state college. And,
you know, we're academic tertiary care into Penn
State. So, you know, we're we're coming off
one of our,
really,
flagship moments.
Penn State
THON was this past weekend. And for those
of you who aren't familiar with THON,
it's the largest run student run philanthropic
events,
in the nation.
The university
students
raised over $17,000,000
for direct care for patients
pediatric patients suffering from cancer in the four
and so it's called the four diamonds fund.
And so
all of our,
pediatric patients who
are getting treated,
for cancer
get it get it taken care of by
the four diamonds fund. You know, you hear
things like, other companies who who do this
and they don't have care, but it's only,
you know, for people who aren't in clinical
trials. For us, it's everybody.
Anybody who comes to Penn State,
who has
a a child suffering from from cancer and
gets treated at our children's hospital gets it
done for free. And this is really on
the backs of these students. It's it's an
incredible
event that's turned out to be an event
for all the high schools in the area
as well. So they have mini thons
at all of our high schools, and they'll
build, you know, 10,000, 20 thousand dollars in
each one of these high schools,
in addition to the 17,000,000
that,
Penn State bond students do. It's it's it's,
it's heartwarming. It's it's incredible
that and it goes directly to care. There's
no intermediary. There's no other people. It's really
students collecting money for the care of these
these these, these pediatric cancer patients. And, you
know, that's one of many things that, that
Penn State, makes Penn State special.
That's amazing to hear. And what a unique
situation you have. Great to hear that the
students are so passionate about raising that money
and providing care for pediatric patients in the
community.
I think it's truly impressive and,
very indicative of the community you have there,
at Penn State Health.
It's the reason I've been here for so
long is it's it's about people taking care
of people, and that's all they care about.
I mean, it's it's you know, there's lots
of things in medicine, lots of technology, and
we're gonna get into that. And there's lots
of this sort of stuff. The other day,
it's about people taking care of people, and
and
and and Penn State students see that. And
and people who work at Penn State Health
see that. And and it's, it's it's really
it's it's really an honor, kind of incredible
to be around.
Well, absolutely. Yeah. And and I think, to
your point, I mean, it's something that, you
know, a lot of organizations
aspire to but have not been able to
achieve. So is there anything that you see
that makes Penn State Health special in that
way, the culture, the community?
You know, what really has been grown and
fostered there for years that, has created, you
know, this ability to truly, truly, support the
effort that you're doing and have that type
of community feel. Yeah. It's it's, what's it's
it's very interesting. We've gone through a lot
of transition at at Penn State Health over
the over the decades,
you know, starting off with, you know, the
philanthropic thought processes of,
of the Hershey Company, starting off the Milton
s Hershey Medical
Center with a single phone call and $50,000,000,
you know, back in the sixties to creating
a, a medical center and a medical school
that I went to,
in the middle of a cornfield in Hershey,
Pennsylvania,
really growing the town, right, and growing the
area about who we take care care of
and why we take care of it and,
and creating this
academic medical center that has now expanded to
a health academic health system,
across the region. It's really been incredible to
see. And at the core, it's about, you
know, people taking care of people. It's about,
us staying at home. It's about us taking
care of people in our region.
You know, we have to be able to
make ends meet. We have to be able
to
ensure that, you know, we can do what
we need to do to take care, take
care of patients from a financial perspective. It's
about the care. And one of the, the
ways that, you know, one of the, one
of the prouder things, I think. Over the
last couple of years, for me
is that ability to connect,
that strategic vision from the board to the
executive level,
down to the practical.
How do you go from, you know, theory
to practicality in a way? And it's hard.
I mean, it's really hard,
but the connection of people who, you know,
really, you know, grew up here, live here,
work here, have family members cared for in
our hospital is really what drives us. And
how we go about doing that.
That activity is such a, is, is such
a big deal.
So, so for me, it's, you know, setting
that strategic vision, aligning to it. Don't be
afraid to fail. I mean, if you, if
you go after something and you don't do
it well, that's okay. Let's go back after
it again.
Tying in the university and
research and activities
into it is such a big deal. You
know, give an example where, you know, I've
been lucky enough to serve on, a board
at, at Penn State University in the, in
the College of Engineering, really the Department of
Industrial Engineering, Industrial Manufacturing Engineering.
We actually were able to create,
an undergrad and a graduate degree in service
engineering.
Now that sounds funny,
but ultimately nowadays.
The United States is a service industry. Healthcare
is a service industry.
And, you know, while we do have some
manufacturing,
continuing across here, it's really about service. So
we've been actually,
able to create.
A degree at Penn state university,
in service engineering. So how do you, you
know,
manage projects? How do you understand the use
of input, throughput, output, and lean sig sig
the symbols inside of,
health care delivery processes and apply them in
a real practical sense? And so it's that
connection between
the academics and the practicality, I think, that
makes, is really a difference maker at Penn
State.
That's amazing to hear. Thank you so much
for sharing that history with us and certainly
how it's grown and developed into what it
is today. And, I'm curious, you know, thinking
through the last year or so, especially,
could you tell us a little bit about
the accomplishments you're most proud of?
Well, I you know, I think there's nothing
nothing bigger than the decision to to move
from, Cerner slash Oracle Health to, to Epic,
as our, health care delivery platform.
We didn't take that lightly. You know, we're
a long term,
Cerner client, actually,
over twenty,
years actually, about thirty years,
working with Cerner,
and the decision to, to, to move,
towards epic,
was significant
and, you know, not undertaken lightly. And really,
I think shows the ability of our organization
to say, you know, we've really had great
partnerships
with companies in the past, and maybe it's
just time to, to, to move, into a
different area. We've had great success with, Oracle
health and, and Cerner over the years, and,
you know, I'll continue to help,
you know, different groups like the VA VA
and DOD and others, to be successful,
with that platform. For for Penn State, it
made most sense. We've got a lot of
surrounding community hospitals,
who have EPIC, and exchange of information with
those companies is really an important thing for
the care of our patients. And so the
real coordinated decision,
to move in that direction,
you know, driven by some of our our
physicians and and clinical staff,
heard by our executive group,
really run through our,
administrative,
and and boards and the board, you know,
making the decision to move in that direction.
I think I'm really proud of that just
because it was such an inclusive conversation,
and it was done with the motivation
of the patient in the center,
which, again, it is our core. Again, people
taking care of people and how can we
do that most effectively and efficiently. And so,
you know, we don't do that lightheartedly. We've
got, you know, thirty years of data in
a Cerner system.
We've been taking care of patients, you know,
on that platform for a period of time.
So now we're on, we're on our epic
transformation journey. And, and, and I'm really,
and, and I'm really, really excited to, to
to help lead that.
Well, that's amazing to hear. And, certainly, you
know, looking at a project like that takes
a lot of,
time, effort, and resources from the leadership team
and and everyone on the front lines as
well of planning, that and then and then
making the transition. So I'm curious.
You talked about the discussions being inclusive and,
making the decision,
to make the switch as being, you know,
something that, you didn't take lightly or the
team didn't take lightly.
I think especially
knowing,
how much goes into a transition like this.
I guess, how did you balance
or how are you balancing,
the input with the potential output and and
sharing that, change management with the broader team?
Sure. Sure. You know, again, patient's always in
the center. No question. How do we get
that patient the the the best information for
code decision making, making, for be able to
take care of them in a most effective
and efficient way, to be able to engage
them
in their home, to be able to
incorporate,
the ongoing data for,
management of populations over time. All these things
come into play. And,
you know, we've we've again, we've had some
great success with with, Cerner and Oracle in
the past. And, you know, there was just
some areas that that we thought that that
Epic had a little bit of an upper
hand on. And,
again, with the interoperability
with other systems,
the ability to incorporate into, you know,
data that would be, able to be used
across systems,
to to be able to coordinate with other
systems and research and development for education and
and,
and research activities. We just thought really it
was the time.
You know, and so,
it made the most sense for us. I
think individual hospitals and health systems have to
make their own decisions independently of what the
needs are at that time.
But, you know, for us, you know, we
went through a process of
engaging our staff and demonstrations
and
know, opportunities. Some of them kinda had come
from other Cerner sites. Some of them come
from other EPIC sites. And, you know, we
take their, input very,
strongly, and that was really a driver
for the whole thing. And then, well, if
the if the,
if the working community and and patients and
things are sort of asking for that activity,
it's our obligation to look into it in
great detail, and that's what we did. And
in a in a really comprehensive
long term investigation and, you know,
costing and transformation
and and and all of the work that
needs to be done, we decided that was
absolutely the best thing for us. And, and
we're, again, looking very much forward to this,
this transformational activity.
That's great to hear. Thank you for digging
a bit deeper in there. Now
I'm wondering,
I can imagine some of the big growth
opportunities for the next twelve months or so
are also tied to the EHR transition. How
are you thinking about growth and and development,
especially during this time of a lot of
change?
Yeah.
So, you know, I I think,
I think, change is such a neutral word.
Sometimes people think it negative, something is positive.
I see advancements,
rather than change.
And so, you know, people that just move
from one thing to a next just for
the sake of change, it's not really worth
doing.
You have to take advantage of where the
advancement is, whether it's a technology or the
people on processes. More importantly for me, it's
the people in the process. How can I
simplify the experience of the patients?
How can I simplify the experience of our
physicians and nurses and APPs and and and
registration staff,
so that they can provide that better experience
inside of here? So for for us, it's
really about how do we advance our organization.
And we think this this platform helps
us, advance the organization. I think there are
other,
components of it that, you know, we rally
around, again, patients being first, but it could
also mean, you patients who are on clinical
trials,
patients who,
maybe,
need additional support at home in a unique
way.
So it's not only just the, the EPIC
transformation and advancement that we have with
that EMR platform. But it's also other technologies
that that be able to do that. So,
you know, advancing your telehealth or or,
you know,
hospital home programs, which has been been very
well received in our our community and, you
know, people able to,
take care of each other at home with
the support of Penn State's hospital at home
program, I think, has has been a big
difference.
I think there's some advancing technology in, you
know,
quote, unquote AI. I'm sure we'll get into
that a little bit because that's the, you
know, that's the catchphrase related to it, but
it's really about how can technology be leveraged
to improve
the care and outcomes of our patients. And
and
so for us, you know, change you know,
changing our core platform is one of it,
then being able to build upon that,
taking
advantage
of our university, and how can we incorporate
those
thinkers and knowledge into,
our health system in a way that we
haven't before in this new platform
to maybe develop
some technologies that haven't been seen before. But
more importantly, I think for us, it's it's
partnering with good companies,
who
want to, you know, have the same,
moral compass, that same
sort of ethic,
that it's about the patients and the patients
first. And, you know, we've been lucky to
find a number of those companies out there
that have,
associated
AI or other machine learning technologies that we
think, you know, may be a great partnership
with us to to advance
the needs of our patients in in our
area.
That's amazing to hear. And, you know, certainly,
a lot, as you mentioned, happening to improve
patient care, especially given technology, the data,
telehealth, virtual hair care, hospital at home,
really great advantages for health care providers to
continue to expand what they're doing and provide
a better experience for patients. And I know
you mentioned AI is something that is top
of mind. I know a lot of hospitals,
health systems, and organizations are, you know, looking
at the best use cases for AI ways
that they can really provide value through it,
but also understanding, you know, there are risks
involved there. So
what are those tech conversations like when you
look at new a AI technologies and and
governance and those kinds of things? Is that
something that you've,
broached in a meaningful way with the leadership
team?
Yeah. We have. You know? And and, again,
we we do this together. I think there's
sort of, you know, AI is kind of
a catchphrase now. And and
in my heart of hearts, I'm an engineer,
and I'm an emergency physician. So I I
I'm I'm very tied to the practical. What
is it going to make a difference for
me or my patients
to do this? Not the I love talking
theory, and I love in my
research space to be able to I've got
a center at Penn State called
the Center for Healthcare Organization
Transformation, which studies,
you know, systems systemness and and health care
delivery science and things like that. And I
love being able to think about that. But
but as a CMIO, an emergency physician, I
I really wanna say there's lots of these
people out here with the word AI. What
do they really mean by it? Right? Digging
into the technology, what does it make sense
to do? And, you know, there are some
that are just using the words
and not really understanding what it is. There
are some, you know, who will say, yeah.
We're using the catch phrase to get in
the door, but it's really, you know, basic
clinical decision support or machine learning to a
degree
rather than truly creating new,
new information. Right? So for for us, we
try and categorize it into, you know, is
it in the discovery space?
Space? Where's the data sits?
How does that data get incorporated into practicality?
Who owns that data whenever it gets generated?
And, ultimately,
is this an advantage
over,
what we're doing today or what we could
be doing today based upon other basic technologies?
I think the AI is real. I think
it has
tons of opportunity.
I think it's a little bit overblown right
now,
but we'll come back to some semblance of
reality. We did
lots of piling and piloting in the generative
AI space a few years ago.
Actually,
about five years ago, we were trialing some
stuff. And two years ago, we got deep
into a trial.
I think about now is the time that
we're starting to see it really have enough,
accuracy
and,
benefits
that you're starting to see some
efficiencies
gained
in the and we're really talking about the
document generative AI,
space. I think we're starting to see it
too in some of the,
imaging and pixelation activities in regards to diagnostics.
I think there's a lot of opportunity in
that space.
I think there's a lot of opportunity
in the,
NLP,
to AI
activities in,
nondiscrete data. I think we're probably gonna start
seeing some discovery in that,
over the next couple of years. And, you
know,
say it before, I'll say it again. Health
care is about people taking care of people.
And, like, working in this discovery space,
the people who you work with is such
a big deal. So I'm I'm you know,
at Penn State, I've got a great informatics
team, and I've I've got a great research,
group and a great college of medicine set
of leaders who are really, you know, advancing
the thought process at the college of medicine.
And same way within our our our health
systems of innovative leaders who are saying, okay.
Yep. We're We're gonna spend a lot of
our focus on epic and the transformation activities.
But, you know, we've got a couple of
these other spaces that, that we're gonna take
care of as well.
It's a lot.
But it's an exciting
time, to be able to be in health
care
and to see all of this stuff start
to come to fruition.
I I I joke a little bit. I've
been doing this such a long period of
time. I remember when
people used to say, oh, just going to
electronic records is gonna make things so much
better and more efficient and more effective.
Ask your normal doc on a daily basis
with, you know, who've
written handwritten notes and, and handwritten orders compared
to
CPOE and and electronic notes today,
and ask them, is there really a difference,
or not? And I think they may tell
you,
they may have a little bit of a
different experience. So with that knowledge and and
having done it for for such a period
of time, it is the
adaptation of the technology and the adoption of
it is such a big deal because at
the end of the day, it's people first,
it's process second, and it's technology third. And,
if I think if most people keep that
in mind,
keep their moral compass on something that makes
a difference for their patients, you'll see the
benefit to not only the people that you
influence on a daily basis, but your health
system.
I mean, that's really powerful stuff. And and,
you know, such an important lesson to remember
how, you know, the technology and health care
space has evolved.
I know a lot of opportunities ahead, but
challenges as well. Could you,
talk a little bit about some of the
challenges,
that you're seeing and planning for in the
next couple years?
Sure. Sure.
I I think, you know,
we we talk about,
what some people like to call social determinants
of health. I like to call them maybe
social indicators of of health outcomes,
really talking about the impact of the day
to day,
and how it then affects there.
I think we've got a whole generation
of
folks who grew up in the pandemic
and who are struggling,
with,
you know, day to day activities, whether it's,
depression, anxiety.
You know, we've got a whole generation that
are dealing with with that coming out of
the pandemic. We've got an economy that is
challenging for these
young folks who are coming out maybe with,
you know, lots of lots of debt from
school or,
you know, can't afford to put a down
payment on the house because,
you know, eggs cost $8 a a a
dozen.
You know, they're worried about feeding themselves. To
me,
that's where they're, you know, them then now
they're thinking about how do I even get
health care, or is health care even on
that list of things when I have all
these other things that are that are there?
Here's where I think,
we can make a difference. Here's where I
think technology can advance things. I think that,
you know, like, the hospital home has started
blurring that line between taking care of patients
in just the four walls of a hospital
to,
you know, the same type of care but
within their home. I think we've gotta, you
know, really get back to the basics of
that with,
with that type of care for
patients at home. You know, the reality is
in healthcare,
it's episodic. You know, you may have one
hospitalization, two primary care visits, and an emergency
department visit in a year. That's a lot.
Most people don't have one of those things.
But yet
the habits that they have or the need
for care or
need for, behavioral health or social support exists.
So I think that it's our obligation,
as a healthcare industry, especially healthcare IT, to
see how can we leverage this technology to
support
patients in a way that they haven't been
supported
in the past. And for me, behavioral health
and, you know,
underlying anxiety, depression, and how can we provide
support services in that space as part of,
a community service, not necessarily fee for service
or event activity.
I think, there's a lot in there. I
think AI has a a lot to do
in that space. I think you could do
the same thing with some other chronic diseases.
I think you could do the same thing
with medication management.
So I think there's gonna be a lot
of this,
incorporating,
you know,
the people
into the patient population. So instead of having
one or two or three episodes of care,
you know, at Penn State health in a
given year,
you you are a partner in health with
Penn State. And,
we help you through you and your family's
journey,
whether it happened to be through, you know,
pediatric cancer that's getting paid for by the
four diamonds fund, or
unfortunately, you break your leg and you come
visit me in the emergency department or
or some other treatment.
And so I think it's that,
that community
that that we have at Penn State Health.
I think it's that community that we grow
that you're not taking people, you know, out
of town or flying them great distances because
that's the only place that has that specialty
and really provide that care, not only at
your home, but having, you know, home care
done at the local facility. So I I
think that's where, you know, we're getting back
to basics again, and I I think that's
where technology can get us.
I love that. And and, you know, such
a really amazing picture that you paint of
health care as it's moving,
in a direction, again, closer to patients, but
supported by technology and all the different types
of investments that health care organizations are able
to make.
I'm wondering before we wrap up here, with
our last minute or two, what is the
number one thing that you're doing right now
to set Penn State Health up for long
term success?
Yeah. It's really the basics. And and and
building that epic foundation,
for Penn State Health over the next eighteen
months is really our priority.
You know, we'll build upon that platform.
We'll gain upon that knowledge,
and,
you know, we'll be lucky enough to leapfrog
a couple of different areas in regards to
the deployment in and of itself. But then
it's the add ons on top of there.
It's the how do we leverage our students
and
and and, and college of medicine? How do
we leverage our university?
How do we leverage the amazing,
you know, physicians who are innovated in in
and of themselves and allow them to innovate
and give them platforms to do so, whether
it's
generative AI or, you know, pixelization
of of,
pathology
specimens or or what whatever it happens to
be. You know, give them a platform to
be able to build upon the our our
new epic,
transformative
baseline,
to be able to to
engage,
their patients in a way they haven't been
able to engage them before.
So I I, you know, it's it's really
gonna be about rebuilding that foundation and then
then leapfrogging on top of that new foundation.
That's amazing to hear. Doctor Defletch, thank you
so much for your time today. It's been
a great conversation. I learned a lot, and
I look forward to connecting with you again
soon.
Great. Thanks thanks for having me. And I
I, you know,
started off with this, and I just wanna
thank everybody,
you know, at Becker's, but but most of
the people at Penn State who've, you know,
allowed Penn State to be so successful over
the years. And it's really, all the people
that I work with and the the the
patients that I get to take care of
and that we get to take care of
at Penn State that allows us to to
be so successful. And, man, I look forward
to, just doing some great things over the
next couple of years.