At athenahealth,
we know your ambulatory practice wants healthier, a
healthier business, healthier care teams, and healthier patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters
most? That's where athenahealth can help. Our AI
native all in one solutions reduce administrative burdens,
streamline billing and payments, and deliver critical insights
when clinicians need it most. That means fewer
clicks, more time for patients, and stronger bottom
lines.
Practicing medicine is complex, but running a practice
can be that much simpler with athenahealth.
See how simpler is healthier@athenahealth.com.
This is Laura Dirda with the Becker's Healthcare
podcast.
I'm thrilled today to be joined by doctor
Reuben Pillay, who's a chief innovation officer at
UAB Health System, as well as executive director
at the Hiersink Institute for Biomedical Innovation
and assistant dean of AI and biomedical innovation
at Hirschink School of Medicine. Doctor Pele, it's
a pleasure to have you on the podcast
today. Yeah. It's a pleasure to be here
with you, Laura. Thank you for having me.
Absolutely.
Now I'm excited to be in conversation with
you because I know there's so much happening
in health care
and innovation today, particularly
thinking about how technology and AI
are really making a difference on the operational
clinical workflows at health systems. So I'm looking
forward to learning more about what you're doing
at UAB. But before we dive in, can
you tell us a little bit more about
yourself and your background?
Yeah. Absolutely. So, you know, I am
a a physician who holds a PhD in
business administration.
As you said in the introduction,
I hold many positions within the UAB health
system and school of medicine,
and these are overarching
roles.
So chief innovation officer of the UAB health
system.
I'm the executive director of the Hirsch Institute
for Biomedical Innovation,
at the School of Medicine, and our focus
there is on
AI. It is leveraging artificial intelligence and digital
technology.
And then, of course, you know,
I hold a professorship in medicine.
I'm also the assistant dean for AI and
biomedical innovation at the School of Medicine.
And all of these roles,
you know, enable
me to to sit at the intersection
of,
not just r and d and product development,
but actually the the implementation
within the UAB health system as well. So,
you know, and,
we have designed
the role
to to be able to execute those, those
functions seamlessly.
So yeah.
Well, it's amazing to hear. And, you know,
certainly, noisy techs who integrate everything together
and have that kind of functionality.
Now what opportunities and headwinds do you have
your eye on right now?
Well, I mean, at the moment, you you
know, there's a lot of discussions
about artificial intelligence
in health and health care, both clinical and
nonclinical.
We're focused
on,
you know,
what I would call
fees highly feasible and impactful opportunities
at this stage.
And, obviously,
when we look at those, the kind of
key opportunities
fall in the nonclinical
space.
So, obviously,
solutions
addressing,
ambient intelligence and workflow related challenges,
you know,
really for us a really high priority,
whether it's with documentation,
triage, prior authorization.
These are kind of key focus areas for
us now.
And that's premised on the fact that we're
able to give,
immediate time back,
you know, for clinicians and reduce,
leakage and denial. So that to me is
is something that we're spending a lot of
our time, energy, and resources
at the moment.
We also are a pretty large health system
with
operations across
the state.
And so for us, the predictive operations
are a high priority.
So,
you know,
in terms of predicting bed flow or our
scheduling,
staffing, etcetera,
across
our ecosystem
is critical. So, you know, we we've,
investing a lot of time and energy in
building solutions
to to help us do that.
I think the third area is,
remote patient monitoring,
and
building out the
hospital at home concept. And and the whole
premise of that is,
can we can we decant,
lower acuity care into patients' homes,
improve the experience
for them, and, of course, reduce the total
cost for for care delivery. So I would
say,
you know, those are the,
key areas that I'm focusing on, at the
moment.
As you would have observed, none of those
had direct
clinical.
But I think it's just where technology is
and AI specifically is at the moment that
the highest value proposition
is rarely in the operation space.
In terms of, you know, headwinds,
I think,
it's,
you know, headwinds is is is,
is a,
I would say, strong term, but but, yeah,
I mean, there are challenges we face always.
One is
getting the c suite buy in. I think
that's
always a challenge,
you know, to be able
to sell concepts and and access resources to
be able to to execute that.
I think, payment alignment is always a challenge.
You know, you know, trying to
figure out how,
we could capitalize on the value
from,
the operational,
solutions we're deploying as well as the the
hospital at home and remote monitoring. So, you
know, that's a big challenge at the moment.
I think,
not to be understated,
is the issue of, you know, workforce
fatigue as we
aggressively
try to get some visible wins.
It it means that, you know,
it requires change management from a workforce point
of view. And
my sense is that there is
some kind of workforce,
fatigue attributable
to these
chronic,
attempts to change,
you know, by implementing technology. So I would
say,
you know, those are the three three opportunities
that I think
are critical that we're focused on and three
of the main headwinds that we're facing now.
Having said that, you know, I I think
we have also,
put strategies in place to to mitigate these
headwinds to ensure success.
I hope that makes sense.
Absolutely. And, you know, I think that's really
smart, especially looking at the big challenges ahead,
as you mentioned, focusing on some of the
AI technologies that can help with operational workflows,
but also understanding
how you can, you know, make sure you've
got that deployment,
monitoring across
the board so that, you know, the technology
continues to have the type of impact that
you want it to have. And then, two,
to think about the workforce and make sure
you've,
got the right plan in place to leverage
your human strength as well as the technology
too. So, you know, when you think about
those factors that are mitigating some of these
risks, what have you built there at UAB,
that's been critical in order to to
keep the workforce on track as well as
align with,
the the payment and ideas of of technology
that are really critical for you today?
Yeah. Absolutely. So one of the key functions
of our Institute for Biomedical
Innovation
is leading the literacy and capacity development,
component of this.
So this, you may or may not be
aware, but,
UAB
and the Hearsink Institute,
we have the largest training program in in
AI medicine globally.
And we're one of the few schools of
medicine that has, training programs in health care
innovation. So,
you know, it's and and these programs
are both
academic and credit bearing. So you can come
and get a graduate certificate
or or masters or even doctoral level qualifications
for us. But we have been very, very
deliberate
about making this literacy available in a noncredit
bearing
platform
to to all employees within the health care
system and the school of medicine. So and,
you know, I think
with
literacy,
it's much easier to
be able to communicate
to the workforce what you're trying to do.
You know? One of the key
strengths or or one of the
key kind of mitigating strategies is just really
being able to
communicate
what you're trying to do in a persuasive
manner.
And, you know, you're more likely to succeed
if,
those that you're communicating
with and to,
understand the language,
understand
the the the logic and rationale,
and, you know, buy in is much easier
when people are informed. And that's across the
board. You know? If our leaders
are literate and have a good understanding,
of
technology,
the impact, etcetera,
you know, they're more likely to support it
and and buy into it. The same applies
to the workforce. So
I think
it's been, I would say, one of our
key
drivers of success is our focus
on innovation, digital,
AI literacy
across the board
and, of course,
you know, a robust
communication
stress less persuasion strategy.
It's all about communication. You know? So,
we're pretty deliberate about how we go about
that.
And that makes a lot of sense, and
it's helpful to dig a little bit deeper
there. Thank you so much, doctor Pele.
Now how are you thinking about growth and
adding value to UAB overall as you continue
down this path and,
examine new technologies and innovations that could make
a difference?
Yeah.
I I mean,
you know,
setting up
a innovation institute like
we had here,
was critical,
to
our
broader
growth strategy.
You know, I think every
health system
needs an innovation
operation,
to be able to very, very quickly,
you know,
either source
and validate and deploy and
and evaluate
or
develop them internally. So,
you know, that's the applied function that the
institute performs as well. So,
you know,
we work very, very closely with the health
system, and my role as, chief innovation officer,
as I said, overarches.
So I have real time knowledge of the
challenges that we face,
and I bring it back to the institute,
and we try and design responses
to that.
And we have a kind of queue fast,
scale fast,
approach to this, you know, with,
ninety day sprints,
pre agreed exit criteria. We shut down,
what doesn't move the needle,
and,
we over resource what does. So so you
you have this kind of internal operation
that you really need.
I would say from a
time and general resource allocation point of view,
we spend about 6060%
of all our efforts and resources,
solving
challenges related to our existing operation,
you know, as I alluded to in terms
of the opportunities.
I think we spend about, I would say,
15 to 20% of our resources
on what we call peripheral innovation,
market expansion strategies, etcetera,
and about 10% on really disruptive
kind of ideas. So having that kind
of strategic approach to innovation
is is is absolutely critical to, one,
you know, maintain and be competitive with operations
and then also,
become more competitive
by,
value added products and services as well.
And to have all of that in place
means, you know,
you have to have,
you you know, an approach to doing things.
You know? We have a defined
process in place. We have a clinician in
the loop design approach.
We have
critical partnerships
with health related
accelerators,
the start up ecosystem,
you know, etcetera etcetera. So
you really need a robust
innovation approach that that's all encompassing, you know,
to be able to succeed in doing that.
And and we're fortunate to have that here.
That's amazing to hear. And, you know, what
a great opportunity
to have that innovation institute had that built
out now, especially as I know things are
changing so quickly. Technology is evolving rapidly, but
so is the broader health care ecosystem. So
to have that nimbleness,
to be ready to change on a diamond,
really meet the needs of the day, it
seems like a huge, huge benefit on the
strategy side.
Absolutely. And one of the strengths is the
the institute has, I would say, not a
100% autonomy, but we're pretty close there in
terms of being fully autonomous and,
you know, deploying,
or instituting our own processes,
determining,
you know, which projects require investment, which projects
do we actually
terminate, etcetera, etcetera. So, you
you know, if you have an innovation operation,
one of the critical success factors is making
sure they they have a a fair amount
of, autonomy to do that. Absolutely. I can
imagine, as you said, that makes a big
difference. Now
what is one risk or investment that's still
worth making this year
or over the next twelve months, especially as,
you know, there's some uncertainties ahead on the
financial, economic, and, overall health care side?
Yeah. I mean,
I think
we have to
make an investment in some foundational,
some foundational,
I would say,
structures,
because that,
you know, that enables you to layer and
capitalize
on,
the the the
technology and AI kind of
opportunities
that that we're in the midst of at
the moment. And and I think to achieve
that,
I think any organization,
should consider what I call some kind of
enterprise,
AI data data layer. You know, having
an interoperable,
privacy preserving
data fabric,
you know,
with the,
appropriate guardrails and monitoring.
And I think,
you know, having
that,
layer in place at an enterprise level
pretty much derisks
all other AI and
technological
innovation for us. So, you know, it gives
us trustworthy
data. It gives us an opportunity
for rapid model deployment,
and it enables continuous governance. So so
to me,
you know, it's almost make sure you invest
in a solid innovation foundation
first.
I think that's a risk,
we're taking. And in fact, we're that's the
approach we're taking. And and,
you know, it's premised on the on the
principle
that we have to own our own data
flywheel,
or we'll just be renting,
for the future. So so, you know, strategically,
it makes sense for us
to have our own,
data flywheel, and and that's what we're doing.
Got it. That's helpful to know and, you
know, really interesting to think about that data
fabric and creating the data flywheel as well.
I know data is so important to
powering everything on the AI and technology
side, and really having
a strong data system as well as clean
data
is essential, but not easy. So how have
you gone about doing that? Yeah. And it
speaks to the broader strategy I spoke about
earlier on to grow value. I mean, we've
you know, we're we're we're part of what
the institute does apart from all of our
training programs, etcetera,
we also have an AI lab here that,
you know,
makes,
hard to access models available to faculty and
students to do r and d. But we
also have an AI factory that we, you
know, where we build our own solutions.
It's been a strategy that's very deliberate
to to build as as many of the
solutions in house as as possible.
And so you could see
from a
from our strategic approach of insourcing
that having our own enterprise AI data layer
makes sense.
So, you know,
that's kind of our approach for now is
is to build and insource as approach
as opposed to go the
outsourcing
approach. So so, you know, every
I guess, every health system will be will
be different if they have a technology
AI strategy that's that's leaning towards more an
outsourced approach.
That may not be a priority. So our
our strategy has been one that
is is built on
a insourcing
self development. So so AI, you know, makes
sense to us. It it's it's an investment
we have to make.
That's, you know, really critical to hear and
definitely part of the overall strategy. I know
you mentioned, you know, working with the other
c suite leaders to make sure they understand
those investments
is important and critical. So I I think
when you're looking into the future as well,
what do you see as some of the
best opportunities for continued growth and development?
Yeah. I mean, it depends on your time
frame that you're looking at, but I would
say in the next decade,
two kind of key opportunities for us would
be on autonomous care pathways,
you know, ability to manage chronic disease at
scale using AI navigators and remote diagnostics. I
think that's gonna be
something
that's,
you you know, really going
to position us for success within the decade.
I think,
precision operations,
you you know, from a cost point of
view,
especially as I said for
hospital
systems that are,
you know,
have
big geographical
footprints,
you know, digital twins of of hospitals and
systems to simulate, optimize capacity,
throughput, cost, etcetera. I think that,
is achievable within the next decade.
I think, you know, post the decade,
we could start seeing
robotics enabled service lines start emerging. So,
you know, that's kind of how I look
at things.
You know? I think the next decade,
is gonna belong to health systems that are
able to adequately
combine
humans with technology.
You know? And our job is to is
to architect that future responsibly
and, make the ROI,
undeniable. I think that's
that's certainly been that's certainly how I look
at,
the opportunities moving forward.
That's fascinating to hear. Doctor Pele, thank you
so much for joining us on the podcast
today. This has been a really
insightful conversation, and I look forward to connecting
with you again soon.
Absolutely.
Thank you for having me, Laura.
At athenahealth, we know your ambulatory practice wants
healthier,
a healthier business, healthier care teams, and healthier
patients.
But the complexities of modern health care tech
make it hard for you and your care
teams to focus on what matters most.
That's where athenahealth can help. Our AI native
all in one solutions reduce administrative burdens,
streamline billing and payments, and deliver critical insights
when clinicians need it most.
That means fewer clicks, more time for patients,
and stronger bottom lines.
Practicing medicine is complex, but running a practice
can be that much simpler with athenahealth.
See how simpler is healthier at athenahealth.com.