1 00:00:00,080 --> 00:00:01,760 Hi, everyone. This is Scott King with the 2 00:00:01,760 --> 00:00:03,220 Becker's Healthcare Podcast. 3 00:00:03,759 --> 00:00:06,000 I'm thrilled today to be joined by doctor 4 00:00:06,000 --> 00:00:06,980 Deepti Bolenini 5 00:00:07,440 --> 00:00:10,320 of Christos Health Trinity Mother Frances Hospital serving 6 00:00:10,320 --> 00:00:11,539 as the medical director 7 00:00:11,919 --> 00:00:13,299 quality and regulatory. 8 00:00:13,919 --> 00:00:15,859 Doctor Bolenini, how are you doing today? 9 00:00:16,364 --> 00:00:18,204 I'm good. Thank you for having me, Scott. 10 00:00:18,204 --> 00:00:20,125 How are you? I'm good. Thanks so much 11 00:00:20,125 --> 00:00:21,405 for joining us. I know we're getting into 12 00:00:21,405 --> 00:00:23,244 a lot of kind of the big issues 13 00:00:23,244 --> 00:00:24,845 in health care and and all the really 14 00:00:24,845 --> 00:00:25,664 unique things, 15 00:00:26,045 --> 00:00:27,804 you're doing with your role. But before we 16 00:00:27,804 --> 00:00:29,804 get started, do you mind just telling us 17 00:00:29,804 --> 00:00:31,505 about your role and and your background? 18 00:00:32,289 --> 00:00:32,789 Certainly. 19 00:00:33,170 --> 00:00:36,689 I'm Deepti Bolenini. I'm an on-site physician advisor 20 00:00:36,689 --> 00:00:39,890 and medical director for quality regulatory at CHRISTUS 21 00:00:39,890 --> 00:00:41,670 Trinity Mother Frances Hospital. 22 00:00:42,210 --> 00:00:45,329 It's in Tyler, Texas, the flagship hospital for, 23 00:00:45,649 --> 00:00:46,949 CHRISTUS Health System. 24 00:00:47,414 --> 00:00:50,134 I'm a board certified internist by background, and 25 00:00:50,134 --> 00:00:52,534 I have been practicing hospital medicine for past 26 00:00:52,534 --> 00:00:53,434 seventeen years. 27 00:00:53,975 --> 00:00:56,295 Over the years, I have developed interest in 28 00:00:56,295 --> 00:00:56,795 regulatory, 29 00:00:57,094 --> 00:00:59,754 financial, and quality aspects of health care, 30 00:01:00,149 --> 00:01:02,710 and, I have had the opportunity to grow 31 00:01:02,710 --> 00:01:05,189 into these roles that bridge both bedside and 32 00:01:05,189 --> 00:01:05,689 boardroom. 33 00:01:06,310 --> 00:01:08,709 What drives me is the belief that high 34 00:01:08,709 --> 00:01:11,849 quality care and operational excellence are not mutually 35 00:01:11,909 --> 00:01:12,409 exclusive. 36 00:01:12,924 --> 00:01:14,924 They must go hand in hand, and I'm 37 00:01:14,924 --> 00:01:18,944 passionate about bridging those gaps, enhancing integrated approach 38 00:01:19,245 --> 00:01:20,144 between disciplines, 39 00:01:20,765 --> 00:01:24,525 advancing value based care, and driving evidence based 40 00:01:24,525 --> 00:01:26,625 decision making that is patient centered. 41 00:01:27,759 --> 00:01:29,039 I I think that's a great point that 42 00:01:29,039 --> 00:01:30,579 those those things are not mutually, 43 00:01:31,519 --> 00:01:32,019 exclusive. 44 00:01:32,799 --> 00:01:35,599 What opportunities and headwinds do you have your 45 00:01:35,599 --> 00:01:36,739 eye on right now? 46 00:01:37,519 --> 00:01:40,045 Well, that's a good question. Right now, health 47 00:01:40,045 --> 00:01:42,604 care is at a pivotal crossroads with both 48 00:01:42,604 --> 00:01:45,265 incredible opportunities and significant headwinds. 49 00:01:45,884 --> 00:01:46,864 One of the opportunities 50 00:01:47,405 --> 00:01:50,304 is the continued push towards value based care. 51 00:01:50,685 --> 00:01:51,424 More organizations 52 00:01:51,804 --> 00:01:54,969 are realizing that fee for service isn't sustainable, 53 00:01:55,030 --> 00:01:57,750 and there's a momentum towards aligning incentives with 54 00:01:57,750 --> 00:01:58,649 patient outcomes. 55 00:01:59,189 --> 00:02:00,890 While adoption has been uneven, 56 00:02:01,269 --> 00:02:04,229 models like ACO reach and bundled payments are 57 00:02:04,229 --> 00:02:07,209 promising for achieving financial and clinical alignment. 58 00:02:07,965 --> 00:02:10,544 There's also technology that's one of the opportunities 59 00:02:10,685 --> 00:02:13,264 where, it's creating its pathways for transformation, 60 00:02:13,805 --> 00:02:16,224 which we couldn't have imagined a decade ago. 61 00:02:16,685 --> 00:02:19,905 AI is already starting to reshape, the workflow's 62 00:02:20,125 --> 00:02:22,625 clinical decision support and patient engagement. 63 00:02:23,800 --> 00:02:26,060 However, if it it has to be implemented 64 00:02:26,199 --> 00:02:27,500 thoughtfully with transparency 65 00:02:27,800 --> 00:02:28,539 and guardrails, 66 00:02:29,000 --> 00:02:31,719 and AI could help solve long standing issues 67 00:02:31,719 --> 00:02:32,539 like inefficiencies 68 00:02:32,840 --> 00:02:35,020 in care delivery and clinician burnout. 69 00:02:35,705 --> 00:02:36,905 But we also face, 70 00:02:37,625 --> 00:02:40,205 serious headwinds. The most pressing is, 71 00:02:40,905 --> 00:02:41,405 the 72 00:02:42,105 --> 00:02:44,125 financial pressure that is intensifying. 73 00:02:44,745 --> 00:02:47,145 The margins are razor thin, and, yeah, I 74 00:02:47,385 --> 00:02:48,985 the other day, I saw in the Becker's 75 00:02:48,985 --> 00:02:51,110 news, like, the hospitals closing. 76 00:02:51,489 --> 00:02:54,289 And with with current inflation and increased labor 77 00:02:54,289 --> 00:02:55,349 costs and reimbursement 78 00:02:55,650 --> 00:02:56,150 pressures, 79 00:02:56,449 --> 00:02:59,430 many systems are struggling to stay solvent, especially 80 00:02:59,489 --> 00:03:00,549 safety net providers. 81 00:03:01,090 --> 00:03:03,189 We're gonna see a great need for 82 00:03:03,525 --> 00:03:07,385 innovation in operating models, partnerships, and capital deployment. 83 00:03:08,165 --> 00:03:10,985 The other major headwind is the workforce crisis, 84 00:03:11,764 --> 00:03:15,365 with early retirements and staffing shortage shortages across 85 00:03:15,365 --> 00:03:16,105 health care, 86 00:03:16,439 --> 00:03:18,573 which, you know, limit services. 87 00:03:19,000 --> 00:03:21,879 This this isn't just about, filling roles. It's 88 00:03:21,879 --> 00:03:22,939 about redesigning 89 00:03:23,319 --> 00:03:26,439 the way teams work and finding sustainable models 90 00:03:26,439 --> 00:03:27,099 of care. 91 00:03:27,479 --> 00:03:29,819 So we are balancing immense opportunity 92 00:03:30,120 --> 00:03:33,135 with real structural challenges, and leaders need to 93 00:03:33,135 --> 00:03:34,194 be approach need 94 00:03:34,735 --> 00:03:37,455 to approach this both with urgency and long 95 00:03:37,455 --> 00:03:38,275 term thinking, 96 00:03:38,814 --> 00:03:39,474 I believe. 97 00:03:40,254 --> 00:03:40,995 You mentioned 98 00:03:41,534 --> 00:03:42,034 technology 99 00:03:43,135 --> 00:03:44,354 and AI there. 100 00:03:45,050 --> 00:03:46,349 How how much testing 101 00:03:47,050 --> 00:03:48,110 and and kind 102 00:03:48,409 --> 00:03:50,730 of thinking or mapping out does your system 103 00:03:50,730 --> 00:03:53,629 do before you adapt to and start regularly 104 00:03:53,770 --> 00:03:56,010 using a new technology or a new feature 105 00:03:56,010 --> 00:03:56,750 of AI? 106 00:03:57,455 --> 00:04:00,415 We certainly have a test period over many 107 00:04:00,415 --> 00:04:01,955 months before we incorporate, 108 00:04:03,055 --> 00:04:06,094 it as for real and take feedback from 109 00:04:06,094 --> 00:04:09,375 our teams and our leadership. So it's not 110 00:04:09,375 --> 00:04:11,694 a one day decision making. We have lot 111 00:04:11,694 --> 00:04:14,120 of tools available now, and they're emerging. 112 00:04:14,979 --> 00:04:15,460 So, 113 00:04:15,780 --> 00:04:18,839 we do go with the a testing period 114 00:04:19,139 --> 00:04:21,860 and see how adaptable it is, how easy 115 00:04:21,860 --> 00:04:24,045 it is to maneuver by the staff, take 116 00:04:24,285 --> 00:04:26,764 feedback from them, and then implement it if 117 00:04:26,764 --> 00:04:28,225 it's bringing value. 118 00:04:29,324 --> 00:04:30,764 I think that sounds great. Thanks so much 119 00:04:30,764 --> 00:04:32,944 for sharing that. Mhmm. Also curious, 120 00:04:33,245 --> 00:04:34,785 how do you think health care organizations 121 00:04:35,085 --> 00:04:37,899 should be thinking about growth and value creation 122 00:04:37,899 --> 00:04:39,759 in today's environment from the perspective 123 00:04:40,220 --> 00:04:41,519 of a physician adviser? 124 00:04:42,539 --> 00:04:43,019 Sure. 125 00:04:43,339 --> 00:04:45,659 As a physician adviser, I see growth and 126 00:04:45,659 --> 00:04:48,319 value creation through the lens of clinical alignment, 127 00:04:49,019 --> 00:04:50,959 care quality, and operational efficiency. 128 00:04:51,634 --> 00:04:54,514 While in today's environment, growth along with expanding 129 00:04:54,514 --> 00:04:57,555 service lines or increasing patient volumes, it's about 130 00:04:57,555 --> 00:05:00,675 creating systems that support clinicians in delivering high 131 00:05:00,675 --> 00:05:01,735 value care. 132 00:05:02,115 --> 00:05:04,914 That starts with clinical documentation integrity where I 133 00:05:04,914 --> 00:05:06,134 play a major role, 134 00:05:06,470 --> 00:05:10,069 appropriate utilization management, and ensuring that care decisions 135 00:05:10,069 --> 00:05:12,470 are both medically necessary and are aligned with 136 00:05:12,470 --> 00:05:13,209 best practices. 137 00:05:14,149 --> 00:05:16,470 One of the most impactful ways to drive 138 00:05:16,470 --> 00:05:19,129 value is by bridging the gap between clinical 139 00:05:19,189 --> 00:05:21,050 teams and administrative goals. 140 00:05:21,355 --> 00:05:23,995 In my role as a physician adviser, I 141 00:05:23,995 --> 00:05:26,415 help translate these clinical realities into 142 00:05:26,795 --> 00:05:29,134 actionable strategies for improving outcomes, 143 00:05:29,835 --> 00:05:33,134 optimizing resource use, and supporting reimbursement integrity. 144 00:05:33,759 --> 00:05:35,220 This alignment is crucial, 145 00:05:35,520 --> 00:05:37,839 especially in value based care, which is coming 146 00:05:38,000 --> 00:05:39,120 or which is the current, 147 00:05:40,639 --> 00:05:42,500 challenge that the hospitals are facing, 148 00:05:43,279 --> 00:05:46,819 where quality, efficiency, and patient outcomes are interconnected. 149 00:05:47,694 --> 00:05:50,175 There's also an opportunity to leverage data more 150 00:05:50,175 --> 00:05:53,694 meaningfully, whether it's identifying variation in care or 151 00:05:53,694 --> 00:05:55,314 targeting avoidable admissions 152 00:05:55,775 --> 00:05:59,134 or reducing denials through stronger documentation and peer 153 00:05:59,134 --> 00:06:00,035 to peer collaboration. 154 00:06:01,060 --> 00:06:03,459 Growth comes from improving not just what we 155 00:06:03,459 --> 00:06:06,019 do, but how consistently and efficiently we do 156 00:06:06,019 --> 00:06:06,519 it. 157 00:06:07,060 --> 00:06:10,439 Well, ultimately, adding value means empowering care teams, 158 00:06:10,579 --> 00:06:13,699 aligning clinical and financial goals, and building systems 159 00:06:13,699 --> 00:06:14,439 that support 160 00:06:14,834 --> 00:06:16,935 evidence based patient centered care. 161 00:06:17,235 --> 00:06:19,334 That's where the role of a physician adviser 162 00:06:19,394 --> 00:06:20,295 becomes a catalyst 163 00:06:20,675 --> 00:06:22,915 and not just for compliance, but for strategy 164 00:06:22,915 --> 00:06:23,415 growth. 165 00:06:24,675 --> 00:06:27,555 We we've heard you discuss the opportunities and 166 00:06:27,555 --> 00:06:28,055 headwinds 167 00:06:28,519 --> 00:06:30,040 in health care you have your eye on 168 00:06:30,040 --> 00:06:30,779 right now. 169 00:06:31,080 --> 00:06:32,300 What's one risk 170 00:06:32,680 --> 00:06:33,180 or 171 00:06:33,480 --> 00:06:35,959 investment worth making this year that might deal 172 00:06:35,959 --> 00:06:37,980 with those opportunities or headwinds? 173 00:06:39,080 --> 00:06:41,175 Well, I would say, as a from my 174 00:06:41,175 --> 00:06:43,495 perspective as a physician adviser, one of the 175 00:06:43,495 --> 00:06:45,014 most worthwhile investments this year is, 176 00:06:46,534 --> 00:06:50,314 intelligent automation, particularly in areas like clinical documentation, 177 00:06:50,774 --> 00:06:53,514 utilization review, and administrative workflows. 178 00:06:54,519 --> 00:06:56,919 Healthcare is still playing catch up, when it 179 00:06:56,919 --> 00:06:57,819 comes to AI, 180 00:06:58,199 --> 00:07:00,379 especially compared to other industries across. 181 00:07:00,759 --> 00:07:03,979 But with growing workforce pressures and operational complexity, 182 00:07:04,199 --> 00:07:06,439 we really can't afford to keep relying on 183 00:07:06,439 --> 00:07:08,620 manual processes that slow down care. 184 00:07:09,095 --> 00:07:11,495 I see real potential in tools like ambient 185 00:07:11,495 --> 00:07:14,775 documentation, which our organization uses, which can reduce 186 00:07:14,775 --> 00:07:17,735 the burden on physicians and improve documentation quality 187 00:07:17,735 --> 00:07:18,715 at the same time. 188 00:07:19,254 --> 00:07:21,769 There's also growing use of AI in streamlining, 189 00:07:22,550 --> 00:07:25,129 medical necessity reviews, prior authorizations, 190 00:07:25,430 --> 00:07:28,389 and revenue cycle tasks. These are areas where 191 00:07:28,389 --> 00:07:30,789 a small amount of automation can lead to 192 00:07:30,789 --> 00:07:33,689 outsized gains in both efficiency and accuracy. 193 00:07:34,470 --> 00:07:35,689 Not to replace human, 194 00:07:36,149 --> 00:07:38,785 touch to it, but it it definitely improves 195 00:07:38,785 --> 00:07:39,524 the efficiency, 196 00:07:39,904 --> 00:07:40,964 cut downs the 197 00:07:41,665 --> 00:07:44,884 brings out more productive time for, our staff. 198 00:07:45,504 --> 00:07:47,824 Of course, the risk is that, we adopt 199 00:07:47,824 --> 00:07:50,705 these tools without engaging clinicians or without clear 200 00:07:50,705 --> 00:07:51,205 guardrails, 201 00:07:51,699 --> 00:07:53,879 and that can lead to mistrust or misuse. 202 00:07:54,339 --> 00:07:56,660 But as a physician adviser, I see my 203 00:07:56,660 --> 00:07:59,779 role as helping guide those conversations and making 204 00:07:59,779 --> 00:08:02,580 sure we are implementing technology in ways that 205 00:08:02,580 --> 00:08:04,759 support and not replace clinical judgment. 206 00:08:05,474 --> 00:08:07,394 And I believe if we do this right, 207 00:08:07,555 --> 00:08:10,594 we not only improve operational performance, but we'll 208 00:08:10,594 --> 00:08:12,514 give our providers more time to focus on 209 00:08:12,514 --> 00:08:14,854 what really matters. That's patient care. 210 00:08:15,474 --> 00:08:17,634 You mentioned the human touch. How important is 211 00:08:17,634 --> 00:08:19,094 it to you and your system, 212 00:08:19,449 --> 00:08:21,129 you think, to make sure a human is 213 00:08:21,129 --> 00:08:23,689 there for a lot of these AI usages 214 00:08:23,689 --> 00:08:26,410 and kind of overseeing things and making sure 215 00:08:26,410 --> 00:08:27,470 things are going well? 216 00:08:28,410 --> 00:08:30,889 All the time. All the time. AI does 217 00:08:30,889 --> 00:08:31,870 screen cases, 218 00:08:32,490 --> 00:08:35,665 and gives us a more preliminary data, but 219 00:08:35,665 --> 00:08:37,605 it's the main, the nurse or 220 00:08:37,985 --> 00:08:40,625 the physician or the advanced care practitioner who 221 00:08:40,625 --> 00:08:44,304 is making the ultimate call. So, so that 222 00:08:44,304 --> 00:08:46,465 they are not spending time on on a 223 00:08:46,465 --> 00:08:48,465 manual label where they are going case by 224 00:08:48,465 --> 00:08:50,889 case, but it the AI helps screen through 225 00:08:50,889 --> 00:08:52,909 the cases and brings up the more 226 00:08:53,289 --> 00:08:56,169 main, main cases that that the staff can, 227 00:08:56,409 --> 00:08:57,230 screen through. 228 00:08:57,769 --> 00:09:00,009 So it's always there. The human touch is 229 00:09:00,009 --> 00:09:03,105 always there. It's it's more it's helping us 230 00:09:03,345 --> 00:09:06,065 complement our workflow and, bring us back our 231 00:09:06,065 --> 00:09:06,964 productive time. 232 00:09:07,504 --> 00:09:08,824 And the last question I have for you, 233 00:09:08,824 --> 00:09:10,384 I just wanted to ask, where do you 234 00:09:10,384 --> 00:09:12,865 see the best opportunities for growth in the 235 00:09:12,865 --> 00:09:13,365 future? 236 00:09:14,384 --> 00:09:16,870 From my perspective as a physician adviser, some 237 00:09:16,870 --> 00:09:19,190 of the biggest opportunities for growth in the 238 00:09:19,190 --> 00:09:20,649 future will come from improving 239 00:09:21,029 --> 00:09:24,250 how we align clinical care with operational strategies. 240 00:09:25,029 --> 00:09:27,669 One area I see real potential is better 241 00:09:27,669 --> 00:09:31,049 leveraging clinical data to drive decision making, 242 00:09:31,424 --> 00:09:33,345 not just at the bedside, but at the 243 00:09:33,345 --> 00:09:34,164 system level. 244 00:09:34,705 --> 00:09:35,845 As physician advisers, 245 00:09:36,144 --> 00:09:37,684 we are in a unique position, 246 00:09:38,065 --> 00:09:40,164 to identify the patterns and utilization, 247 00:09:41,184 --> 00:09:43,125 how the resources are being used, 248 00:09:43,585 --> 00:09:44,085 documentation, 249 00:09:44,465 --> 00:09:45,284 and outcomes. 250 00:09:45,750 --> 00:09:48,790 So that insight can inform everything from care 251 00:09:48,790 --> 00:09:50,730 redesign to value based contracting. 252 00:09:51,509 --> 00:09:54,330 So another opportunity I see is, standardizing 253 00:09:54,710 --> 00:09:56,410 and optimizing care pathways. 254 00:09:56,870 --> 00:09:59,350 There's still a lot of unwarranted variation in 255 00:09:59,350 --> 00:10:00,470 care among the, 256 00:10:01,504 --> 00:10:04,464 across, so which impacts both quality and cost, 257 00:10:04,784 --> 00:10:05,284 by 258 00:10:05,985 --> 00:10:08,964 by helping teams implement evidence based practices, 259 00:10:09,664 --> 00:10:10,565 regular education, 260 00:10:11,024 --> 00:10:14,065 and lunch and learns. It ensures that, it 261 00:10:14,464 --> 00:10:16,245 and ensuring that medical necessity 262 00:10:17,110 --> 00:10:17,610 is, 263 00:10:18,149 --> 00:10:21,029 what is taken into account, and we can 264 00:10:21,029 --> 00:10:24,549 improve consistency and reduce waste and ultimately deliver 265 00:10:24,549 --> 00:10:26,710 more value. That's where I feel my role 266 00:10:26,710 --> 00:10:28,090 is very pivotal. 267 00:10:29,384 --> 00:10:31,945 I also, think that there's a big opportunity 268 00:10:31,945 --> 00:10:35,565 in bridging silos between clinical teams, case management, 269 00:10:35,785 --> 00:10:37,325 revenue cycle, and compliance 270 00:10:37,865 --> 00:10:41,065 because growth isn't just about external expansion. It's 271 00:10:41,065 --> 00:10:42,764 also about internal integration. 272 00:10:43,610 --> 00:10:46,429 When these teams are aligned and integrated, 273 00:10:46,889 --> 00:10:49,769 patient get more seamless care and clinicians are 274 00:10:49,769 --> 00:10:52,809 better supported, and the organization can run more 275 00:10:52,809 --> 00:10:53,309 efficiently. 276 00:10:54,490 --> 00:10:55,470 And finally, 277 00:10:55,850 --> 00:10:58,570 we can't talk about growth without addressing the 278 00:10:58,570 --> 00:10:59,070 workforce. 279 00:10:59,825 --> 00:11:01,904 As a physician adviser, I see growing value 280 00:11:01,904 --> 00:11:04,725 in investing in clinician engagement and education, 281 00:11:05,345 --> 00:11:06,725 especially around documentation 282 00:11:07,184 --> 00:11:10,085 and quality metrics and evolving care models. 283 00:11:10,705 --> 00:11:13,264 When we empower our physicians and advanced care 284 00:11:13,264 --> 00:11:13,764 practitioners 285 00:11:14,210 --> 00:11:16,610 with the right tools and knowledge, they become 286 00:11:16,610 --> 00:11:19,350 the active drivers of improvement and innovation. 287 00:11:20,210 --> 00:11:21,889 So for me, the growth the future of 288 00:11:21,889 --> 00:11:24,710 the growth lies in smarter alignment of data, 289 00:11:25,490 --> 00:11:26,629 people, and processes, 290 00:11:27,169 --> 00:11:28,870 all rooted in clinical integrity. 291 00:11:29,795 --> 00:11:31,555 Well, doctor Boni, thank you so much for 292 00:11:31,555 --> 00:11:32,995 joining us on the podcast. I think it 293 00:11:32,995 --> 00:11:34,514 was a great discussion, and I look forward 294 00:11:34,514 --> 00:11:36,675 to working with you again soon. Thank you, 295 00:11:36,675 --> 00:11:38,355 Scott. Thank you for having me. Have a 296 00:11:38,355 --> 00:11:39,095 good day.