1 00:00:02,240 --> 00:00:02,899 At athenahealth, 2 00:00:03,279 --> 00:00:05,940 we know your ambulatory practice wants healthier, 3 00:00:06,319 --> 00:00:09,279 a healthier business, healthier care teams, and healthier 4 00:00:09,279 --> 00:00:09,779 patients. 5 00:00:10,160 --> 00:00:12,400 But the complexities of modern health care tech 6 00:00:12,400 --> 00:00:14,240 make it hard for you and your care 7 00:00:14,240 --> 00:00:15,974 teams to focus on what matters most. 8 00:00:16,614 --> 00:00:18,315 That's where athenahealth can help. 9 00:00:18,695 --> 00:00:21,495 Our AI native all in one solutions reduce 10 00:00:21,495 --> 00:00:22,635 administrative burdens, 11 00:00:23,015 --> 00:00:25,914 streamline billing and payments, and deliver critical insights 12 00:00:25,975 --> 00:00:27,515 when clinicians need it most. 13 00:00:27,894 --> 00:00:30,475 That means fewer clicks, more time for patients, 14 00:00:30,535 --> 00:00:34,710 and stronger bottom lines. Practicing medicine is complex, 15 00:00:34,929 --> 00:00:36,689 but running a practice can be that much 16 00:00:36,689 --> 00:00:37,829 simpler with athenahealth. 17 00:00:38,530 --> 00:00:42,149 See how simpler is healthier@athenahealth.com. 18 00:00:43,975 --> 00:00:45,494 Hello, everyone. This is Scott King with the 19 00:00:45,494 --> 00:00:46,875 Becker's Healthcare podcast. 20 00:00:47,254 --> 00:00:48,934 I'm thrilled today to be joined by a 21 00:00:48,934 --> 00:00:52,314 very special guest in doctor Nolan Cheng, executive 22 00:00:52,375 --> 00:00:55,174 vice president corporate development strategy and finance with 23 00:00:55,174 --> 00:00:57,335 the Permanente Federation. Doctor Cheng, how are you 24 00:00:57,335 --> 00:00:59,460 doing today? I'm great. How are you today, 25 00:00:59,460 --> 00:01:01,219 Scott? I'm good. You know, it's actually kind 26 00:01:01,219 --> 00:01:03,059 of a nice sunny day in Chicago. We've 27 00:01:03,059 --> 00:01:05,780 had some good luck with, weather the last 28 00:01:05,780 --> 00:01:08,099 few weeks here. But, yeah, excited it's Friday 29 00:01:08,099 --> 00:01:10,519 as we record to get to the weekend. 30 00:01:10,965 --> 00:01:12,965 And that's interesting that it's sunny in Chicago, 31 00:01:12,965 --> 00:01:14,564 but it it's overcast and a little bit 32 00:01:14,564 --> 00:01:16,265 drizzly out here in Southern California. 33 00:01:16,965 --> 00:01:18,405 It's quite the opposite of what you would 34 00:01:18,405 --> 00:01:20,004 think on any given day. I definitely agree 35 00:01:20,004 --> 00:01:21,224 with that. Exactly. 36 00:01:21,525 --> 00:01:23,640 Maybe it'll switch up soon. But as we 37 00:01:23,640 --> 00:01:25,560 wait for the weather to get good for 38 00:01:25,560 --> 00:01:27,880 everyone, there is a lot going on in 39 00:01:27,880 --> 00:01:29,480 health care, doctor Cheng. So we have a 40 00:01:29,480 --> 00:01:30,920 lot to get to. I I really wanna 41 00:01:30,920 --> 00:01:32,040 get your opinion on some of the kind 42 00:01:32,040 --> 00:01:33,880 of the big topics and trends in health 43 00:01:33,880 --> 00:01:35,400 care. But before we get started, can you 44 00:01:35,400 --> 00:01:36,760 please just tell us a little about yourself 45 00:01:36,760 --> 00:01:38,515 and your work in health care? Yeah. Thank 46 00:01:38,515 --> 00:01:40,454 you, Scott, and thank you for having me. 47 00:01:40,674 --> 00:01:42,994 So by training, I'm a family medicine physician. 48 00:01:42,994 --> 00:01:44,674 But like Scott said, I get to serve 49 00:01:44,674 --> 00:01:47,314 as the executive vice president in the Permanente 50 00:01:47,314 --> 00:01:49,875 Federation. It's the national arm of all the 51 00:01:49,875 --> 00:01:52,055 Permanente medical groups in Kaiser Permanente. 52 00:01:52,769 --> 00:01:54,209 And in that role, I have a broad 53 00:01:54,209 --> 00:01:57,429 set of responsibilities, including strategy, corporate development, 54 00:01:58,289 --> 00:02:00,069 finance, a lot of the business functions. 55 00:02:00,609 --> 00:02:02,689 And I really pursued this role because I 56 00:02:02,689 --> 00:02:03,509 think affordability 57 00:02:03,810 --> 00:02:06,045 is going to be, if not the biggest, 58 00:02:06,045 --> 00:02:08,044 one of the biggest challenges of our generation 59 00:02:08,044 --> 00:02:09,025 of health care 60 00:02:09,324 --> 00:02:11,324 professionals. And so it's something that I wanted 61 00:02:11,324 --> 00:02:12,925 to be able to jump into to make 62 00:02:12,925 --> 00:02:15,324 a difference and really improve care that we 63 00:02:15,324 --> 00:02:17,264 deliver across the country for our patients. 64 00:02:18,150 --> 00:02:19,669 That's fantastic. And doctor Chiang, I think we 65 00:02:19,669 --> 00:02:20,949 were talking before, and I think you said 66 00:02:20,949 --> 00:02:23,030 you came into this role during the pandemic. 67 00:02:23,030 --> 00:02:25,430 Is that correct? Yeah. Maybe a few months, 68 00:02:25,669 --> 00:02:28,150 in this specific role, few months before the 69 00:02:28,150 --> 00:02:30,949 pandemic hit. And and jeez, it became a 70 00:02:30,949 --> 00:02:33,814 storm pretty quickly. I remember asking my colleagues 71 00:02:33,814 --> 00:02:35,334 that were in their roles longer. It's like, 72 00:02:35,334 --> 00:02:37,354 this is this normal? And they said, absolutely 73 00:02:37,414 --> 00:02:40,055 not. And since that day of five years 74 00:02:40,055 --> 00:02:40,555 before, 75 00:02:40,854 --> 00:02:42,375 I'm just wondering when it's gonna get back 76 00:02:42,375 --> 00:02:43,034 to normal. 77 00:02:43,974 --> 00:02:45,735 Right. Right. And and, you know, you can 78 00:02:45,735 --> 00:02:47,759 argue that it didn't. It didn't get back 79 00:02:47,759 --> 00:02:49,360 to normal, and the things are are much 80 00:02:49,360 --> 00:02:50,819 different now. How 81 00:02:51,120 --> 00:02:53,840 how interesting was that time for you to 82 00:02:53,840 --> 00:02:55,599 kinda take on way more than you probably 83 00:02:55,599 --> 00:02:57,680 bargained for? And do you do you think 84 00:02:57,680 --> 00:02:59,780 that's kinda set you up to to deal, 85 00:03:00,215 --> 00:03:02,375 kinda troubleshoot things and come up with solutions 86 00:03:02,375 --> 00:03:03,915 maybe quicker than you would have? 87 00:03:04,775 --> 00:03:07,495 Yeah. For sure. It it definitely, the role 88 00:03:07,495 --> 00:03:09,735 is different, especially early on than when I 89 00:03:09,735 --> 00:03:12,055 expected it to be. For me, the focus 90 00:03:12,055 --> 00:03:13,495 in coming to this role was how do 91 00:03:13,495 --> 00:03:14,635 I translate finances 92 00:03:15,450 --> 00:03:17,849 into ways that are meaningful for physicians? Because 93 00:03:17,849 --> 00:03:20,250 for physicians, we go we spend many, many 94 00:03:20,250 --> 00:03:22,730 years, decades, if not, training how to be 95 00:03:22,730 --> 00:03:23,629 the best clinicians. 96 00:03:24,170 --> 00:03:26,090 But if we're trying to solve affordability, how 97 00:03:26,090 --> 00:03:27,710 do we see that not as a negative, 98 00:03:27,955 --> 00:03:30,354 but as a positive? Because we've taken this 99 00:03:30,354 --> 00:03:31,794 oath as physicians to be able to take 100 00:03:31,794 --> 00:03:33,395 care of our patients. And if one of 101 00:03:33,395 --> 00:03:35,314 their big pain points is affordability, how do 102 00:03:35,314 --> 00:03:36,995 we recognize that as a barrier to the 103 00:03:36,995 --> 00:03:38,134 care that we can deliver? 104 00:03:38,514 --> 00:03:40,215 So but taking a step back then 105 00:03:40,560 --> 00:03:42,640 when the pandemic hit, it was more thrust 106 00:03:42,640 --> 00:03:45,040 into how do we mobilize around a patient, 107 00:03:45,040 --> 00:03:46,640 keeping the patient and the needs at the 108 00:03:46,640 --> 00:03:49,280 center in a very resource limited environment as 109 00:03:49,280 --> 00:03:51,300 we know whether it be protective equipment, 110 00:03:51,840 --> 00:03:53,460 ventilators, all these devices. 111 00:03:53,925 --> 00:03:56,004 If all of a sudden this hospital census, 112 00:03:56,004 --> 00:03:58,164 inpatient census went up dramatically, were we gonna 113 00:03:58,164 --> 00:03:58,985 have the beds, 114 00:03:59,284 --> 00:04:01,125 the the technological platforms to be able to 115 00:04:01,125 --> 00:04:02,504 take care of them? It was a scramble 116 00:04:02,884 --> 00:04:04,884 in a limited resource kind of world. But 117 00:04:04,884 --> 00:04:06,150 in many ways, I think that 118 00:04:06,549 --> 00:04:08,789 it really helped prepare me for where we 119 00:04:08,789 --> 00:04:09,530 are today. 120 00:04:10,389 --> 00:04:12,310 We still have to provide those business functions, 121 00:04:12,310 --> 00:04:14,310 but how do we translate what we're seeing 122 00:04:14,310 --> 00:04:16,629 into financial performance? Because it really isn't the 123 00:04:16,629 --> 00:04:18,729 finances that drive the strategy of the organization. 124 00:04:19,064 --> 00:04:20,504 It should be the other way around. What's 125 00:04:20,504 --> 00:04:22,904 your strategy? What's the current environment? And how 126 00:04:22,904 --> 00:04:25,144 do the financial outcomes determine whether or not 127 00:04:25,144 --> 00:04:27,464 we're being successful? In the midst of the 128 00:04:27,464 --> 00:04:30,185 pandemic, it was a raging fire. I think 129 00:04:30,185 --> 00:04:32,024 most people in health care right now say 130 00:04:32,024 --> 00:04:33,785 that the fire hasn't died down and maybe 131 00:04:33,785 --> 00:04:34,990 a little bit more smoldering. 132 00:04:35,370 --> 00:04:37,209 But there is a lot of uncertainty now, 133 00:04:37,209 --> 00:04:39,310 and it continues to be resource limited. 134 00:04:39,850 --> 00:04:41,529 So how are we solving for these things? 135 00:04:41,529 --> 00:04:43,290 How are we adapting our systems as an 136 00:04:43,290 --> 00:04:43,790 organization 137 00:04:44,170 --> 00:04:45,310 to be able to empower 138 00:04:45,689 --> 00:04:48,189 our clinicians, our physicians, our health care teams 139 00:04:48,330 --> 00:04:49,610 to be able to take care of our 140 00:04:49,610 --> 00:04:51,405 patients who are in their 141 00:04:52,105 --> 00:04:54,185 own experiences and in their own world in 142 00:04:54,185 --> 00:04:55,965 a very tumultuous period of time. 143 00:04:56,745 --> 00:04:58,905 Absolutely. And and, doctor Chang, I think, you 144 00:04:58,905 --> 00:05:01,064 know, something that that had really kinda hit 145 00:05:01,064 --> 00:05:01,965 hit its stride 146 00:05:02,425 --> 00:05:03,944 or started to at least, and now it's 147 00:05:03,944 --> 00:05:05,004 kinda in full force 148 00:05:05,360 --> 00:05:07,360 for now is is AI. And, you know, 149 00:05:07,360 --> 00:05:08,500 health systems use 150 00:05:08,959 --> 00:05:10,560 AI. They have so many uses for it. 151 00:05:10,560 --> 00:05:12,399 We we're seeing, you know, under other industries 152 00:05:12,399 --> 00:05:15,360 obviously use AI. But, you know, it's reported 153 00:05:15,360 --> 00:05:18,160 that nearly half of medical practices reported using 154 00:05:18,160 --> 00:05:20,100 AI in some capacity in the last year. 155 00:05:20,404 --> 00:05:22,564 It remains a key topic for health IT 156 00:05:22,564 --> 00:05:25,045 leaders. From your perspective, what are the use 157 00:05:25,045 --> 00:05:27,605 cases that are now making a difference, and 158 00:05:27,605 --> 00:05:29,545 how are you leveraging them in your organization? 159 00:05:30,645 --> 00:05:32,884 It's a it's a fantastic question, and it's 160 00:05:32,884 --> 00:05:35,225 one I think that's oftentimes pivotal for organizations. 161 00:05:36,009 --> 00:05:37,949 Because when we talk about artificial intelligence, 162 00:05:38,569 --> 00:05:40,490 it's technology which should be part of your 163 00:05:40,490 --> 00:05:43,290 solution. It shouldn't replace your strategy. Technology, in 164 00:05:43,290 --> 00:05:45,370 my mind, is not the strategy. It's how 165 00:05:45,370 --> 00:05:47,610 do you apply technology to your strategy. And 166 00:05:47,610 --> 00:05:49,930 we started this conversation talking about the pandemic, 167 00:05:49,930 --> 00:05:52,074 and it was great. And Kaiser Permanente that 168 00:05:52,074 --> 00:05:54,314 we already had a significant amount of investment 169 00:05:54,314 --> 00:05:55,134 in the infrastructure. 170 00:05:55,754 --> 00:05:58,254 So during the pandemic, we went from maybe 171 00:05:58,314 --> 00:05:59,854 90% in person 172 00:06:00,555 --> 00:06:02,954 and 10% virtual to flipping that to almost 173 00:06:02,954 --> 00:06:05,694 98% virtual and 2% inpatient. 174 00:06:06,180 --> 00:06:07,300 And luckily, we had a lot of the 175 00:06:07,300 --> 00:06:10,259 technologies in place. And so the ability to 176 00:06:10,259 --> 00:06:12,339 text patients to let them know that we're 177 00:06:12,339 --> 00:06:14,180 ready because during that period of time, remember, 178 00:06:14,180 --> 00:06:15,779 people weren't willing to come in the building. 179 00:06:15,779 --> 00:06:17,540 And so we'd have people wait in the 180 00:06:17,540 --> 00:06:19,514 parking lots in their cars and be able 181 00:06:19,514 --> 00:06:21,875 to predict wait times and text them to 182 00:06:21,875 --> 00:06:23,395 let them know, yeah, now it's safe to 183 00:06:23,395 --> 00:06:25,014 come in and be seen. 184 00:06:25,875 --> 00:06:26,935 Having the technological 185 00:06:27,395 --> 00:06:29,395 platforms to be able to do deal visits, 186 00:06:29,395 --> 00:06:30,595 to be able to make sure that we're 187 00:06:30,595 --> 00:06:33,000 able to connect with patients because our organization, 188 00:06:33,459 --> 00:06:35,379 we're not just value based care. I like 189 00:06:35,379 --> 00:06:37,459 to say we're longitudinal value based care. To 190 00:06:37,459 --> 00:06:38,980 see me as a permanent day physician, you 191 00:06:38,980 --> 00:06:40,279 have to have KP insurance. 192 00:06:40,660 --> 00:06:42,420 So our patients stay in the system for 193 00:06:42,420 --> 00:06:44,259 a lot longer. So that way, we're able 194 00:06:44,259 --> 00:06:45,720 to deliver on outcomes 195 00:06:46,020 --> 00:06:48,665 and drive quality and affordability through that. And 196 00:06:48,665 --> 00:06:50,425 so what I oftentimes mean by that, if 197 00:06:50,425 --> 00:06:52,345 if a patient's switching helplines every two to 198 00:06:52,345 --> 00:06:53,085 three years, 199 00:06:53,545 --> 00:06:55,384 it leads to more fragmented care. But if 200 00:06:55,384 --> 00:06:57,464 you stay in the system for seventeen years 201 00:06:57,464 --> 00:07:00,024 or more, then you really can't understand the 202 00:07:00,024 --> 00:07:01,725 return on things like investing, 203 00:07:02,149 --> 00:07:03,050 in treating hypertension 204 00:07:03,830 --> 00:07:06,870 or a vaccine or preventative screening. And so 205 00:07:06,870 --> 00:07:09,189 that really aligns my interest with those of 206 00:07:09,189 --> 00:07:11,110 the patients. And why I say that is 207 00:07:11,110 --> 00:07:12,810 because that really highlights how we 208 00:07:13,110 --> 00:07:14,009 apply technology. 209 00:07:15,014 --> 00:07:17,095 So during the pandemic, being able to see 210 00:07:17,095 --> 00:07:17,595 somebody 211 00:07:18,134 --> 00:07:19,354 through a video visit 212 00:07:19,654 --> 00:07:22,615 was really powerful to see the fears that 213 00:07:22,615 --> 00:07:25,035 they have in their eyes and the frustrations 214 00:07:25,095 --> 00:07:27,175 that they're experiencing allowed me to address their 215 00:07:27,175 --> 00:07:29,014 clinical need, but also the needs that they 216 00:07:29,014 --> 00:07:31,079 may not be aware of. But then you 217 00:07:31,079 --> 00:07:32,919 fast forward it to what we're doing today. 218 00:07:32,919 --> 00:07:35,099 So I say we're longitudinal value based care, 219 00:07:35,159 --> 00:07:37,659 but we are a relationship based organization, primarily 220 00:07:37,719 --> 00:07:39,959 that relationship between a physician and the care 221 00:07:39,959 --> 00:07:40,939 team and a patient, 222 00:07:41,399 --> 00:07:42,379 but even between 223 00:07:42,839 --> 00:07:43,979 us and our regulators, 224 00:07:44,279 --> 00:07:46,794 us and our payers. So we've applied technology 225 00:07:46,794 --> 00:07:48,074 over the past couple of years to be 226 00:07:48,074 --> 00:07:50,074 able to augment that. I mean, one of 227 00:07:50,074 --> 00:07:52,414 the big things that that we've really highlighted 228 00:07:52,474 --> 00:07:54,894 out there is our ambient AI technology. 229 00:07:55,834 --> 00:07:57,995 So we know that there's pain points. There 230 00:07:57,995 --> 00:07:59,995 are problems that our physicians are asking us 231 00:07:59,995 --> 00:08:02,319 to solve in regards to burnout and not 232 00:08:02,319 --> 00:08:04,160 having that connection with the patients. But we 233 00:08:04,160 --> 00:08:05,620 also hear that from our patients. 234 00:08:06,079 --> 00:08:08,079 We ask them about the experience. Like, how 235 00:08:08,079 --> 00:08:09,379 was your time with your physician? 236 00:08:09,839 --> 00:08:11,919 It was frustrating for me to hear that 237 00:08:11,919 --> 00:08:14,019 sometimes my patients would say, doc, 238 00:08:14,455 --> 00:08:15,975 you're spending more time on the computer than 239 00:08:15,975 --> 00:08:17,975 you are with me. And that's heartbreaking. Right? 240 00:08:17,975 --> 00:08:20,455 Because everything I'm putting into that computer really 241 00:08:20,455 --> 00:08:21,814 is to take care of that a patient. 242 00:08:21,814 --> 00:08:23,035 But using 243 00:08:23,335 --> 00:08:25,514 ambient AI dictation systems 244 00:08:25,975 --> 00:08:27,990 allow me to sit need in a face 245 00:08:27,990 --> 00:08:30,149 to face with my patient and have a 246 00:08:30,149 --> 00:08:30,649 really 247 00:08:31,110 --> 00:08:32,089 connected conversation 248 00:08:32,629 --> 00:08:34,549 where I'm not worried about the time of 249 00:08:34,549 --> 00:08:35,909 the day. Am I gonna be able to 250 00:08:35,909 --> 00:08:37,690 capture everything by by keystrokes? 251 00:08:38,149 --> 00:08:39,129 Allowing the technology 252 00:08:39,509 --> 00:08:41,190 to do that for me, not only improve 253 00:08:41,190 --> 00:08:41,850 the documentation, 254 00:08:42,195 --> 00:08:45,014 but also improve the experience with our patients 255 00:08:45,315 --> 00:08:47,735 so that they have more confidence, more understanding 256 00:08:47,955 --> 00:08:49,254 what we're trying to do. 257 00:08:50,115 --> 00:08:51,794 On the front end of a lot of 258 00:08:51,794 --> 00:08:54,134 these things, something that we're really excited about 259 00:08:54,330 --> 00:08:55,529 is we were able to come up with 260 00:08:55,529 --> 00:08:58,250 something called the KP intelligent navigator or the 261 00:08:58,250 --> 00:08:59,470 Kaiser Permanente intelligent 262 00:08:59,850 --> 00:09:00,350 navigator. 263 00:09:01,370 --> 00:09:02,750 When I first started practicing 264 00:09:03,290 --> 00:09:06,170 over twenty years ago, the predominant interaction with 265 00:09:06,170 --> 00:09:07,934 face to face visit. But through some of 266 00:09:07,934 --> 00:09:10,014 the technology that I just mentioned, there's so 267 00:09:10,014 --> 00:09:12,514 many different tools that we have available now 268 00:09:12,575 --> 00:09:14,174 to be able to meet our patients' needs, 269 00:09:14,174 --> 00:09:16,095 whether it be face to face visits, mid 270 00:09:16,095 --> 00:09:19,934 visits, telephone, email, chat, you name it. This 271 00:09:19,934 --> 00:09:22,549 can be overwhelming for our patients because most 272 00:09:22,549 --> 00:09:24,409 of them are not medically trained. 273 00:09:24,870 --> 00:09:26,470 So when they interact with us, whether it 274 00:09:26,470 --> 00:09:28,070 be through our portal or one of our 275 00:09:28,070 --> 00:09:29,129 call center agents, 276 00:09:29,589 --> 00:09:31,269 they just tell us what's going on with 277 00:09:31,269 --> 00:09:32,870 them. But how do we connect them with 278 00:09:32,870 --> 00:09:34,245 the right resource? Because they don't know if 279 00:09:34,245 --> 00:09:35,445 this is something they need to go to 280 00:09:35,445 --> 00:09:36,964 the ER for or if this is something 281 00:09:36,964 --> 00:09:38,644 that can just do an EVA zip for. 282 00:09:38,644 --> 00:09:41,845 Right? But using large language models, we were 283 00:09:41,845 --> 00:09:42,345 able 284 00:09:42,884 --> 00:09:45,044 to leverage the experience of our physicians in 285 00:09:45,044 --> 00:09:47,139 getting our patients to the right resource. And 286 00:09:47,139 --> 00:09:50,019 so we've been excited because for our 4,900,000 287 00:09:50,019 --> 00:09:52,519 members in Southern California, we've deployed this technology, 288 00:09:52,899 --> 00:09:54,340 and it's able to get the patient to 289 00:09:54,340 --> 00:09:56,019 the right place at the right time with 290 00:09:56,019 --> 00:09:57,220 almost a 98% 291 00:09:57,220 --> 00:10:00,019 accuracy and also also almost a 9% increase 292 00:10:00,019 --> 00:10:01,080 in patient satisfaction 293 00:10:01,674 --> 00:10:03,355 when we look at these things. And it's 294 00:10:03,355 --> 00:10:04,894 caught some pretty scary things 295 00:10:05,355 --> 00:10:06,654 for patients that are 296 00:10:07,115 --> 00:10:10,154 really interacting the portal virtually and just typing 297 00:10:10,154 --> 00:10:12,575 things in. We've been able to catch things, 298 00:10:12,634 --> 00:10:14,955 minding the patient's chart and saying this patient's 299 00:10:14,955 --> 00:10:16,980 at high risk for a cardiac event. We 300 00:10:16,980 --> 00:10:18,580 need to get them to the ER. And 301 00:10:18,580 --> 00:10:20,820 so there's been really some wonderful things that 302 00:10:20,820 --> 00:10:22,820 have come out in how we're applying artificial 303 00:10:22,820 --> 00:10:24,840 intelligence really to augment the relationship, 304 00:10:25,379 --> 00:10:26,980 let our patients know that we know them 305 00:10:26,980 --> 00:10:28,360 even at the point of booking, 306 00:10:28,695 --> 00:10:31,014 leveraging all their past data, what the words 307 00:10:31,014 --> 00:10:32,375 that they're using to be able to make 308 00:10:32,375 --> 00:10:34,615 sure that they're able to navigate the system 309 00:10:34,615 --> 00:10:36,695 in a seamless fashion. Because we don't want 310 00:10:36,695 --> 00:10:39,174 our patients spending their discretionary energy trying to 311 00:10:39,174 --> 00:10:40,774 figure out where do I need to go. 312 00:10:40,774 --> 00:10:42,375 We wanna connect them, make sure that we're 313 00:10:42,375 --> 00:10:44,315 able to address the concerns that they have. 314 00:10:45,309 --> 00:10:46,509 Yeah. I think that's great. A lot of 315 00:10:46,509 --> 00:10:48,669 times when we talk with system leaders, you 316 00:10:48,669 --> 00:10:49,570 know, their focus 317 00:10:50,350 --> 00:10:52,990 in utilizing AI is kinda just system wide 318 00:10:52,990 --> 00:10:54,990 for efficiency. So it's I I think it's 319 00:10:54,990 --> 00:10:56,370 wonderful to hear how patient 320 00:10:56,684 --> 00:10:59,105 focused, yours has been. And 321 00:10:59,404 --> 00:11:00,065 as virtual 322 00:11:00,764 --> 00:11:03,565 care expands from AI enabled tools and remote 323 00:11:03,565 --> 00:11:06,924 monitoring to to broader digital health platforms, introducing 324 00:11:06,924 --> 00:11:07,745 new technology 325 00:11:08,285 --> 00:11:10,605 brings challenges. So what advice do you have 326 00:11:10,605 --> 00:11:12,144 for leaders trying to navigate 327 00:11:12,659 --> 00:11:13,879 everything from governance 328 00:11:14,820 --> 00:11:17,059 to patient engagement? And can you share an 329 00:11:17,059 --> 00:11:19,779 example of how your organization has balanced innovation 330 00:11:19,779 --> 00:11:21,159 with operational constraints? 331 00:11:22,259 --> 00:11:24,579 Yeah, Scott. That's wonderful question because I think 332 00:11:24,579 --> 00:11:26,659 you articulated a lot of the challenges. Right? 333 00:11:26,659 --> 00:11:28,394 So as you bring on all these different 334 00:11:31,035 --> 00:11:33,514 address pain points, one of the things uniquely 335 00:11:33,514 --> 00:11:35,195 for us is, you know, Kaiser Permanente, we're 336 00:11:35,195 --> 00:11:36,795 an integrated system. So we have the health 337 00:11:36,795 --> 00:11:38,554 plan. We have a hospital system and delivery 338 00:11:38,554 --> 00:11:40,715 system and the physician groups. We're able to 339 00:11:40,715 --> 00:11:41,995 look at that and say, how do we 340 00:11:41,995 --> 00:11:44,540 integrate this into a unique patient experience? 341 00:11:45,320 --> 00:11:46,460 Because it's not the technology 342 00:11:47,000 --> 00:11:48,620 and the people and the facilities 343 00:11:49,160 --> 00:11:51,320 and the experience that are separate. Right? All 344 00:11:51,320 --> 00:11:53,480 these elements have to come together if done 345 00:11:53,480 --> 00:11:54,860 well to create a cohesive 346 00:11:55,455 --> 00:11:55,955 experience. 347 00:11:56,495 --> 00:11:59,055 Because in as you bring in different technologies, 348 00:11:59,055 --> 00:12:01,695 as we adopt change, everybody knows the hype 349 00:12:01,695 --> 00:12:03,855 curve. There's a point where it gets more 350 00:12:03,855 --> 00:12:05,934 complicated as you add more on and before 351 00:12:05,934 --> 00:12:06,915 it becomes seamless, 352 00:12:07,340 --> 00:12:09,200 And the patients can get lost in that. 353 00:12:09,500 --> 00:12:11,500 So for us as an organization, we always 354 00:12:11,500 --> 00:12:12,779 try to take a step back and say, 355 00:12:12,779 --> 00:12:14,720 what's the problem that we're trying to solve? 356 00:12:15,019 --> 00:12:16,700 And then go from there. And then what's 357 00:12:16,700 --> 00:12:19,100 the role of each of the elements of 358 00:12:19,100 --> 00:12:21,340 the solution, the facilities, the people, the space, 359 00:12:21,340 --> 00:12:22,799 staff, the stuff, the technology, 360 00:12:23,534 --> 00:12:24,975 and then we try to bring it together 361 00:12:24,975 --> 00:12:25,475 cohesively. 362 00:12:26,575 --> 00:12:29,714 The governance is critically important because we have 363 00:12:29,855 --> 00:12:32,414 the technology arms in the organization, the clinical 364 00:12:32,414 --> 00:12:33,714 arms, the health plan, 365 00:12:34,014 --> 00:12:36,029 and you called out, like, if it's focusing 366 00:12:36,029 --> 00:12:39,149 on efficiency or revenue or outcomes, it really 367 00:12:39,149 --> 00:12:41,470 does dictate a different solution, but we try 368 00:12:41,470 --> 00:12:42,769 to balance that. So 369 00:12:43,070 --> 00:12:45,149 the seven principles that we really focus on 370 00:12:45,149 --> 00:12:45,889 are transparency, 371 00:12:46,350 --> 00:12:46,850 accountability, 372 00:12:47,470 --> 00:12:47,970 safety, 373 00:12:48,350 --> 00:12:49,889 equity, quality, privacy, 374 00:12:50,524 --> 00:12:52,924 and clinician oversight, and we try to balance 375 00:12:52,924 --> 00:12:55,325 that. So even right before this, I was 376 00:12:55,325 --> 00:12:57,325 on our AI council. We're looking at some 377 00:12:57,325 --> 00:12:59,404 different technologies and saying, how do we apply 378 00:12:59,404 --> 00:13:01,424 this? And everybody got to give their perspective, 379 00:13:01,725 --> 00:13:03,504 be able to find what's the right solution. 380 00:13:04,149 --> 00:13:06,950 So I talked about the ambient dictation. There's 381 00:13:06,950 --> 00:13:08,490 a quality element to that. 382 00:13:08,870 --> 00:13:10,789 And so how long do you hold hold 383 00:13:10,789 --> 00:13:12,870 these things? How do we check things? Because 384 00:13:12,870 --> 00:13:14,409 as you introduce new technologies, 385 00:13:15,669 --> 00:13:17,909 it oftentimes isn't a replacement. Hopefully, it's an 386 00:13:17,909 --> 00:13:18,409 augmentation. 387 00:13:18,815 --> 00:13:20,575 But if you're not thoughtful about how this 388 00:13:20,575 --> 00:13:22,274 impacts cost, affordability, 389 00:13:22,894 --> 00:13:24,034 quality, experience, 390 00:13:24,575 --> 00:13:27,054 then it can go sideways pretty quickly. We 391 00:13:27,054 --> 00:13:29,454 also leverage our patient advisory councils where we 392 00:13:29,454 --> 00:13:31,454 ask our patients to give us input really 393 00:13:31,454 --> 00:13:33,460 early on and say, help us understand what 394 00:13:33,460 --> 00:13:35,299 you think about this. How would this be 395 00:13:35,299 --> 00:13:37,460 received well or not? And also our care 396 00:13:37,460 --> 00:13:39,379 teams as a whole. And so those are 397 00:13:39,379 --> 00:13:41,399 some governance and operational principles. 398 00:13:41,779 --> 00:13:44,259 But it oftentimes will come down to change 399 00:13:44,259 --> 00:13:44,759 management. 400 00:13:45,855 --> 00:13:48,254 Technology and we oftentimes when we talk about 401 00:13:48,254 --> 00:13:50,254 artificial intelligence, we'd like to say that it's 402 00:13:50,254 --> 00:13:51,235 augmented intelligence. 403 00:13:51,774 --> 00:13:53,134 Because if you don't frame it right, it 404 00:13:53,134 --> 00:13:54,674 can be something that's quite fearful. 405 00:13:55,214 --> 00:13:57,054 You and I were talking earlier about, you 406 00:13:57,054 --> 00:13:59,570 know, what what's the health care environment like? 407 00:13:59,570 --> 00:14:01,009 And I said, when are things gonna get 408 00:14:01,009 --> 00:14:03,809 back to normal? The people that are taking 409 00:14:03,809 --> 00:14:05,970 care of our patients on the frontline are 410 00:14:05,970 --> 00:14:08,289 feeling that same angst. I mean, we still 411 00:14:08,289 --> 00:14:10,450 hear hear about burnout and a lot of 412 00:14:10,450 --> 00:14:11,429 fear and anxiety. 413 00:14:11,815 --> 00:14:14,615 And so you introduce more change that does 414 00:14:14,615 --> 00:14:16,415 it heighten the fear and anxiety, or does 415 00:14:16,415 --> 00:14:19,095 it leave it? If applied right, if they 416 00:14:19,095 --> 00:14:20,774 know that we're trying to solve their pain 417 00:14:20,774 --> 00:14:22,774 points, then hopefully should leave it, but also 418 00:14:22,774 --> 00:14:25,120 get them allow them to be engaged. So 419 00:14:25,120 --> 00:14:26,799 that's why we we shift oftentimes from saying 420 00:14:26,799 --> 00:14:29,519 artificial intelligence, which can be sound scary, to 421 00:14:29,519 --> 00:14:31,360 augmented intelligence because we wanna be able to 422 00:14:31,360 --> 00:14:33,039 augment our people. But then we have to 423 00:14:33,039 --> 00:14:34,659 be able to connect with them and understand 424 00:14:34,720 --> 00:14:37,360 how much discretionary energy. If they're solving for 425 00:14:37,360 --> 00:14:38,740 some other clinical implementation, 426 00:14:39,360 --> 00:14:41,475 a quality program that we're trying to put 427 00:14:41,475 --> 00:14:43,715 in place, do they have the discretionary energy 428 00:14:43,715 --> 00:14:45,335 to implement something around technology? 429 00:14:46,035 --> 00:14:48,274 Do they understand the long game? Because in 430 00:14:48,274 --> 00:14:50,274 that high curve, there's a period where it's 431 00:14:50,274 --> 00:14:52,529 gonna be inefficient before it gets efficient. And 432 00:14:52,610 --> 00:14:53,810 we have to bring them along in that 433 00:14:53,810 --> 00:14:56,290 journey, help paint that picture so they understand 434 00:14:56,290 --> 00:14:58,070 the impact to them them. So 435 00:14:58,370 --> 00:14:59,430 while it's about technology, 436 00:15:00,210 --> 00:15:02,529 there's also a lot of elements about basic 437 00:15:02,529 --> 00:15:03,029 management 438 00:15:03,410 --> 00:15:05,330 at the individual team and also at the 439 00:15:05,330 --> 00:15:06,550 organizational level. 440 00:15:07,665 --> 00:15:09,504 Yeah. You know, you just had basically a 441 00:15:09,504 --> 00:15:12,384 lot of great thoughts and advice on dealing 442 00:15:12,384 --> 00:15:13,045 with emerging 443 00:15:13,904 --> 00:15:15,665 tech just there. But if you had to 444 00:15:15,665 --> 00:15:18,004 kinda zero in on your number one 445 00:15:18,384 --> 00:15:20,209 piece of advice for health care leaders as 446 00:15:20,209 --> 00:15:23,250 they prepare for further advancements in technology and 447 00:15:23,250 --> 00:15:25,269 rising demands for care, what would that be? 448 00:15:26,209 --> 00:15:26,709 Yeah. 449 00:15:27,250 --> 00:15:29,009 I mean, I think there's so many different 450 00:15:29,009 --> 00:15:31,169 things, but one of the things that's being 451 00:15:31,169 --> 00:15:32,769 trained as clinician, one of the things that 452 00:15:32,769 --> 00:15:34,524 we would learn in our training is when 453 00:15:34,524 --> 00:15:36,365 you're running to a code, the first pulse 454 00:15:36,365 --> 00:15:38,445 you check is your own. Right? So I 455 00:15:38,445 --> 00:15:40,384 think it's important to know where we're at 456 00:15:40,524 --> 00:15:42,625 individually as leaders as as an organization. 457 00:15:43,884 --> 00:15:46,304 If we don't acknowledge the fear or anxiety 458 00:15:46,445 --> 00:15:48,605 or the overwhelming challenges that we're facing, I 459 00:15:48,605 --> 00:15:51,040 think we can be dazzled by the shining 460 00:15:51,040 --> 00:15:52,100 new piece of technology 461 00:15:52,480 --> 00:15:54,080 and just go down that road and lose 462 00:15:54,080 --> 00:15:56,179 sight of what we're really trying to accomplish. 463 00:15:56,960 --> 00:15:59,360 So are we using technology to solve for 464 00:15:59,360 --> 00:16:01,120 the fears and anxieties that we have in 465 00:16:01,120 --> 00:16:01,860 an increasing 466 00:16:02,274 --> 00:16:03,095 volatile marketplace, 467 00:16:03,475 --> 00:16:05,014 or is it really aligned around 468 00:16:05,394 --> 00:16:06,294 the pain points 469 00:16:06,754 --> 00:16:09,875 of applying our our organizational strategies and solving 470 00:16:09,875 --> 00:16:13,315 for that because the marketplace is looking for 471 00:16:13,315 --> 00:16:16,399 value. Right? We hear about the struggles in 472 00:16:16,399 --> 00:16:18,879 decreasing rates. People want a better experience. They 473 00:16:18,879 --> 00:16:21,059 don't understand why the cost is going up 474 00:16:21,279 --> 00:16:23,200 and why they can't get in to see 475 00:16:23,200 --> 00:16:25,120 somebody or get a medication or just get 476 00:16:25,120 --> 00:16:27,440 an issue met. So I think the big 477 00:16:27,440 --> 00:16:29,139 keys piece is really understanding 478 00:16:29,565 --> 00:16:31,004 where we're at and the problems that we're 479 00:16:31,004 --> 00:16:32,845 trying to solve and then applying the technology 480 00:16:32,845 --> 00:16:35,245 because you don't want the technology leading. Because 481 00:16:35,245 --> 00:16:36,605 as you go out there and meet with 482 00:16:36,605 --> 00:16:37,745 all these great companies, 483 00:16:38,365 --> 00:16:40,945 they oftentimes will have solutions looking for problems 484 00:16:41,580 --> 00:16:44,220 versus understanding the problem and applying a solution. 485 00:16:44,220 --> 00:16:47,100 So definitely understanding what we're trying to solve 486 00:16:47,100 --> 00:16:49,420 and and how it moves the organization forward 487 00:16:49,420 --> 00:16:51,420 is probably the key thing that I try 488 00:16:51,420 --> 00:16:53,100 to keep central as we look at these 489 00:16:53,100 --> 00:16:53,920 different solutions. 490 00:16:54,584 --> 00:16:56,024 I think it's a a great number one 491 00:16:56,024 --> 00:16:57,704 piece of advice for for dealing with for 492 00:16:57,704 --> 00:17:00,985 further advancements in technology. And, doctor Chang, the 493 00:17:00,985 --> 00:17:02,345 last thing I want to ask you that 494 00:17:02,345 --> 00:17:03,784 we ask a lot of leaders on the 495 00:17:03,784 --> 00:17:05,865 podcast is, how are you evolving as a 496 00:17:05,865 --> 00:17:06,365 leader? 497 00:17:07,065 --> 00:17:09,085 Yeah. That's a fantastic question. 498 00:17:10,559 --> 00:17:11,059 Different 499 00:17:11,359 --> 00:17:13,539 times require different leadership 500 00:17:14,079 --> 00:17:15,139 skill sets, and, 501 00:17:15,599 --> 00:17:17,519 we talked about before the pandemic, a lot 502 00:17:17,519 --> 00:17:19,519 of it was you know, the solution hadn't 503 00:17:19,519 --> 00:17:21,539 really changed over many years. 504 00:17:21,839 --> 00:17:23,759 If we grew a 100,000 members, we knew 505 00:17:23,759 --> 00:17:25,924 how many hospitals or examiners we need. A 506 00:17:25,924 --> 00:17:27,305 lot of it was around efficiency. 507 00:17:27,765 --> 00:17:29,845 There weren't a whole lot of disruptions that 508 00:17:29,845 --> 00:17:32,325 came about, but the pandemic, if anything, was 509 00:17:32,325 --> 00:17:34,025 an absolutely great accelerator. 510 00:17:34,805 --> 00:17:36,565 Today is very, very different than it was 511 00:17:36,565 --> 00:17:38,484 five years ago. So for me, evolving as 512 00:17:38,484 --> 00:17:41,730 a leader is really not focusing or balancing. 513 00:17:41,730 --> 00:17:43,109 We always are gonna need efficiencies, 514 00:17:43,569 --> 00:17:45,909 but understanding how we focus on transformation. 515 00:17:46,690 --> 00:17:48,609 And so it's really more about connecting with 516 00:17:48,609 --> 00:17:50,710 the hearts and minds of people and storytelling 517 00:17:51,329 --> 00:17:53,569 and bringing them along on the journey because 518 00:17:53,569 --> 00:17:54,230 we will 519 00:17:54,684 --> 00:17:56,924 go we will go much further together. I 520 00:17:56,924 --> 00:17:59,164 think during these periods of uncertainty, it's easy 521 00:17:59,164 --> 00:18:01,505 to splinter or divide as an organization, 522 00:18:01,805 --> 00:18:04,125 divide as a team, and that's not going 523 00:18:04,125 --> 00:18:06,285 to really help us accomplish our mission. In 524 00:18:06,285 --> 00:18:08,785 Permanente Medicine, we are a large group, 525 00:18:09,350 --> 00:18:11,350 practice with a social mission. I mean, people 526 00:18:11,350 --> 00:18:12,869 join us for that mission. And so if 527 00:18:12,869 --> 00:18:15,190 we stay true to that, I'm confident we 528 00:18:15,190 --> 00:18:17,830 will be able to really augment the value. 529 00:18:17,830 --> 00:18:19,529 Because I think during this period of time, 530 00:18:19,990 --> 00:18:22,535 people need that that belief and that mission 531 00:18:22,535 --> 00:18:23,894 and trust in that vision. So for me 532 00:18:23,894 --> 00:18:25,654 as a leader really is how are we 533 00:18:25,654 --> 00:18:27,575 engaging? How are we telling stories? How are 534 00:18:27,575 --> 00:18:30,315 we listening is probably the most important element. 535 00:18:30,615 --> 00:18:33,654 So I'm applying my time is critically important. 536 00:18:33,654 --> 00:18:36,230 Having conversations like this and getting the message 537 00:18:36,230 --> 00:18:38,149 out there and highlighting the opportunities is one 538 00:18:38,149 --> 00:18:39,349 of the ways I look to do that. 539 00:18:39,349 --> 00:18:41,909 And so it's not necessarily solving as many 540 00:18:41,909 --> 00:18:44,730 problems as broadening the conversation for me. 541 00:18:45,190 --> 00:18:46,869 Well, doctor Shane, thanks so much for joining 542 00:18:46,869 --> 00:18:48,149 us on the podcast. I thought this was 543 00:18:48,149 --> 00:18:50,515 a great conversation, very informative, and and looking 544 00:18:50,515 --> 00:18:52,674 forward to working with you again soon. Likewise, 545 00:18:52,674 --> 00:18:53,954 Scott. Thank you so much for having me. 546 00:18:53,954 --> 00:18:55,494 I look forward to our future discussions. 547 00:18:55,954 --> 00:18:56,454 Absolutely. 548 00:18:58,994 --> 00:19:01,875 At athena Health, we know your ambulatory practice 549 00:19:01,875 --> 00:19:02,775 wants healthier, 550 00:19:03,234 --> 00:19:05,970 a healthier business, healthier care teams, and healthier 551 00:19:05,970 --> 00:19:06,470 patients. 552 00:19:07,009 --> 00:19:09,410 But the complexities of modern healthcare tech make 553 00:19:09,410 --> 00:19:11,410 it hard for you and your care teams 554 00:19:11,410 --> 00:19:13,029 to focus on what matters most. 555 00:19:13,410 --> 00:19:16,529 That's where athenahealth can help. Our AI native 556 00:19:16,529 --> 00:19:19,305 all in one solutions reduce administrative burdens, 557 00:19:19,765 --> 00:19:22,725 streamline billing and payments, and deliver critical insights 558 00:19:22,725 --> 00:19:25,525 when clinicians need it most. That means fewer 559 00:19:25,525 --> 00:19:28,404 clicks, more time for patients, and stronger bottom 560 00:19:28,404 --> 00:19:28,904 lines. 561 00:19:29,605 --> 00:19:32,805 Practicing medicine is complex, but running a practice 562 00:19:32,805 --> 00:19:34,637 can be that much simpler with athenahealth. 563 00:19:35,337 --> 00:19:39,038 See how simpler is healthier at athenahealth.com.