This is Laura Dirdo with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
Shah Edithin Pramco, who is the chief digital
and information officer at Baptist Health South Florida.
Shah, it's a pleasure to have you on
the podcast today.
Thank you. Great to be here.
Absolutely. Now I'm excited to talk with you
because I know you've been some doing some
really cool things at Baptist Health South Florida.
So we'll talk through some of your perspective
on what's going well, how you're thinking about
the future, and really,
what it means to continue to incorporate digital
technologies, AI, and more into the broader health
system. But before we do that, can you
tell us a little bit more about yourself
and your background?
Oh, for sure. Thank you. Once again, thank
you for having me.
I've I've been in technology for
over
three decades at this point. I've worked in
different industries,
media and entertainment, financial services,
travel transportation. So,
this is my
first
gig in health care, if you will.
So, you know, I
at Baptist Health, which is a large faith
based not for profit system, I have the
privilege of leading our technology and digital transformation
strategies,
which obviously ensures that our physicians, nurses, and
and all of the staff have the tools
they need to deliver
excellent patient care in, as you know,
highly increasingly
complex environment.
Absolutely. And, you know, it's so critical to
have that kind of vision in the health
care space, especially knowing how, as you said,
complex it is and how much it's going
to change in the coming years. And so,
you know, in thinking about that and from
your vantage point as leader of the technology
business,
what opportunities and headwinds do you have your
eye on right now? What's top of mind
for you when you're thinking about the next
twelve months or so?
Yeah. That's that's the core question for any
leader in health care industry today as we're,
you know, facing
a mix of significant challenges and and and
obviously incredible opportunities as well. On the headwinds
front, right, the financial press pressure is immense.
Hospitals
are are grappling with expenses for labor and
supplies.
All of this cost is increasing faster than
inflation, but then you compare that or couple
that with the Medicare and Medicare reimbursements that
don't
necessarily cover the cost of actual or the
actual cost of care. So this squeeze on
margins is a major concern. As you've seen
last year, a number of hospitals closed or
or otherwise had to deal with that situation
in really tough,
tough ways. And on top of that, we
also have the persistent workforce shortage. Right? So
this is,
high levels of clinician burnout,
which also impacts everything we do.
But and last but not the least, the
cybersecurity
threat,
is also an ever present and growing situation.
Right? It's not just a IT issue. When
you have an event or a or a
situation like that, what that, does is it
it disrupts
operations in in significant health care operations in
in significant ways, and it becomes a patient,
safety issue.
So
opportunities.
Right? So,
we've we've been
monitoring closely the rapid sort of essential of
artificial intelligence and adoption into
all industries that health care traditionally has lagged
in terms of adopting new technologies. But,
I am glad to see that
the, the adoption of AI in in health
care has been, I think, close to I
saw an article that said it's close to
double the rate of of the broader economy,
which is which is fantastic to see because
the opportunities to apply, like we discussed earlier,
all in in all of those headwinds or
challenges that we're seeing. There are ways that,
AI can and and other technologies, but specifically
AI can,
can help. So great to see that adoption.
And this isn't just about efficiency. Right? So
it's about,
that it this this is a strategy to
to,
address a number of different things, everything from
clinician,
burnout as well as, you know, the bad
actors are using AI to to to to,
to attack health systems from a security perspective,
and we need to be able to use,
AI to,
to to protect ourselves. So across the board,
I think,
as hype that as as AI is, and
I think the hype is in many ways
justified because it is a powerful and transformative
technology, and I think that opportunity,
sort of is is really broad within health
care to be able to use,
AI and associated digital capabilities to to make
a meaningful impact. Not just from a health
care operations perspective, but especially from a patient
care perspective.
That makes a lot of sense. And I
I think it's so interesting,
that you're talking about AI, how you can
boost,
clinical workforce as well as what it can
do in order to ensure that, you're operating
in a successful way, especially given some of
the challenges that you mentioned looking at financial,
inflation,
additional pressures,
coming down the pipe in the next couple
of months here, and then, you know, also
thinking about workforce shortages and,
clinician burnout. So, you know, when when all
of those things,
are are brought together, are there any use
cases that you've been really successful at at
Baptist Health South Florida to incorporate AI in
seeing some tangible results?
Yeah. I I think on the, on the
clinician
or or provider side of,
the house, ambient listening has been a significant,
you know, new addition to the toolbox, so
to speak. Right? It it's it's still being
deployed,
across all of our physician base, but,
but it's it's it's already showing significant
improvements
in terms of, you know,
the pajama time reduction, which is the time
that physicians are are are having to spend
after hours updating documentation, but also the cognitive
load. Right? So we really want the physicians
to be able to use their,
sort of bandwidth to to care for the
patients and diagnose and treat and so on
as opposed to figuring out the documentation. So
even the cognitive load,
improvement is sort of very visible as we,
I mean, as we are deploying this. On
the operational side too,
we have we've deployed a number of different
capabilities,
everything from, you know, tracking and following up
on incidental findings or on the pharmacy side,
being able to,
automatically detect and label things. So there's quite
a few of those capabilities that we are,
we've we've deployed or and are in and
then there's a very healthy,
road map of these new capabilities as well.
So we are very, very
utmost about
sort of being clear about the value of
these projects upfront. So there is a you
know, we we send it through
a process where we look at,
a, is this you know, is
is the quality there? B, is this going
to help in meaningful ways across all of
those different things that opportunities and challenges that
we talked about physician,
as an example, physician burnout is does this
help with that? Does this help with operational
efficiency? Does this help with better care for
patients? So we look at all of those
things, but, but we have now,
a road map that's, that's
being methodically rolled out.
That makes a lot of sense. You know?
And I appreciate you taking us a little
bit further behind the curtain there to see
how you're thinking about things and, you know,
what's really elevating the most importance.
And, you know, again, kind of keeping that
future focused, how are you looking at growth
and adding value over the next year or
so? I I think especially,
you know, getting that road map in place,
I know is important. But then what else
is coming down the pipe when you think
about the most meaningful ways that AI can
be incorporated into the organization?
For a little bit now, I think,
we we've we've seen that the, you know,
care is expanding beyond the traditional,
hospital walls. Right? So your
systems across the board, across The United States
are investing in improving their ambulatory footprint,
developing
hospital at program home type of programs in
some cases,
and definitely strength strengthening their virtual, digital,
telehealth type of services,
to to to to meet patients where they
are. Right? So that that does
two things, both growth and value. Right? So
it it allows us to grow seamlessly,
especially in the context of the challenge of,
you know, not having,
enough people to whether it's physicians or other
health care workforce, we have a shortage. So
having being able to deploy these technologies
alongside,
building capabilities, care capabilities outside of the traditional
walls through ambulatory and outpatient types of services.
Putting that together, I think, is is certainly
having a having a very positive impact,
in terms of our growth plans and our
ability to support the community that we serve.
That makes a lot of sense. You know,
it's really a helpful strategy when, you're looking
at how you can bring care closer to
the patients, whether it's at home or or
those ambulatory
facilities across the broader footprint, for the health
system, I think, is critical.
And and I'm curious. When you look at
that as being an important aspect of the
future and what you're doing as the health
system strategy and then, you know, from the,
IT department too,
Is there anything that you are,
needing more of from your teams or skills
and technical abilities, to do that? Or, you
know, really, what are are the types of,
I guess, people who are gonna be top
performers if you're looking at, you know,
that from the technology perspective,
in in how you can really think about
your teams differently in the next year or
so.
Yeah. That's that's actually a great question,
because two things. One is, you know, we
we were talking about growth,
which
typically means
growth in cost as well. Right? So we
we we need to add these capabilities. We
need to have the people or the the
the providers to support the patients and then
everything else, supporting functions or administrative functions such
as such as IT. Now if we don't
manage the cost from an IT perspective, which
tends to be a bit a meaningful portion
of the overall cost of growing,
the footprint,
what what then happens is, you know, if
the cost of IT grows linearly with with
everything else, then,
our you know, from a margin perspective, it
becomes really difficult for health care systems to
operate. So IT themselves has had to transform
and evolve. Right? So all of these
new capabilities, including AI and everything
else that has come
forward, we have to take advantage of it
ourselves and be able to bring our cost
down. So some of this growth or much
of this growth can be addressed in
a cost advantages or a cost neutral kind
of a way.
And that's been something that we've been very
focused on here over the last year to
two years,
to make sure that we are we are
making smart IT decisions as well,
that keeps the overall
cost lower
or trend you know, bend the cost curve
as we talk as we say internally,
to to be able to support all this
growth, but but,
allowing at the same time to make sure
that the the system has the margin to
be able to operate.
That makes a lot of sense. And, you
know, that operating margin is so critical.
I know every health care dollar is precious
for sure. And so when you look at,
where you're at today and then headed into
the future where there's a lot of uncertainties
and, you know,
even,
a lot of organizations are seeing some of
their margins being compressed. And so if you're
talking to your colleagues out there, what do
you see as being really one risk for
investment that's still worth making, you know, knowing
that,
there's gonna be potentially even more scrutiny on
every cost or spending decision coming up in
the next couple years?
Yeah.
Look. I mean, we we are in this
phase
or time where, you know, the the technology
advancements are coming at us really, really fast.
Right? So, I mean, when you if you
look at the technology news and updates every
week, there is a new
AI development or capability that comes to market.
So,
you know, and that's just AI, but there
are other things as well in the horizon.
There is Qualcomm coming in, then there is,
a number of other clinical technologies that are
coming forward as well. So the the
there are two underlying,
necessities, if you will, the core infrastructure from
an IT or technology perspective as well as
the cybersecurity,
sort of system, if you will, which includes
the the team as well as the tools
and and the processes,
everything including, you know, resilience
capabilities and business continuity planning. So that underlying
foundation, core
infrastructure with all the processes as well as,
security and and and everything else around that,
I think a lot of our,
when I look around in the industry, unfortunately,
many systems or,
many systems haven't had the opportunity for a
number of different reasons,
haven't had the opportunity to upgrade their systems
or upgrade their infrastructure.
So I think whether whether you invest in,
you know,
buying a new capability today or two years
from now, that that foundation is absolutely,
critical. In in the absence of that foundation,
two things,
or three things are likely are gonna happen.
A, it's gonna be difficult for you to
implement these technologies,
to take advantage of these transformative technologies. B,
it will be more expensive,
to to take care of, to to to
take advantage of it. And then three, it'll
take longer. Right? Because time to market has
become a major, major,
imperative for us. So investing,
in the core infrastructure
and and and the foundation, as I call
it, which includes cybersecurity as well,
I I think is going to be
something that everyone must do. And there are
many systems that are ahead of that curve,
and that's great, wonderful. But there's a lot
of others that are in it, and I
think that's that's something that they should I
would look at it as a, no regret
investment investing in the foundation to upgrade and
getting it, up to currency. I think that
would be something that I recommend.
That's great advice and, really critical to have
that kind of foundation because I know there's
like you said, there'll be so much more
advancement and technology is just gonna get better.
And so, you know, having the data and
that infrastructure in place to take on whatever
comes next, will be so, so helpful for
health systems as they're trying to navigate,
uncertainties on a variety of fronts. I think
as you're wrapping up the conversation here, I
I just wanted to take one more,
look with you, you know, in the best
opportunities for additional growth in the future, whether
it's for yourself or your teams or or
the health system at large. What, are are
some of the big picture items that you're
excited about and, are are really preparing for?
Yeah. That also a great question. I think
as I look ahead,
perhaps not next month, next year, but in,
you know, just a longer term road map.
It's clear that people are starting to
take their wellness more seriously than before, right,
especially the younger generation.
So,
you know, we
which which would mean,
many different things to a lot of different
folks. So as such, you see the the,
you know, the the supplement industry exploding, which
is expected to be, I don't know, a
120
or $130,000,000,000
industry by 2030.
But but people are making efforts to take,
take care of themselves, take control or ownership
for their own,
their own health and wellness,
which is wonderful to see. But I think
where that goes is ultimately now we would
need to,
cater to the community or or or a
population that is
that that needs or wants,
personalized medicine.
Right? So there is we are also starting
to see breakthroughs in genomics.
Recently, there was news that using CRISPR, someone
was able to, I think, address or or,
take care of the cholesterol high cholesterol issue.
So I think increasingly,
personalized medicine using some of these highly advanced,
technologies are are are going to start,
they'll start playing a much, much, much bigger
role or factor
in in,
in health care. Now, you know, as as
as a in addition to that or, with
that, there's also, I think, with,
an opportunity for something like an ambient
intelligence,
kind of an effort both inside the hospital
environment, but as well as outside of it
when when people are out and about doing
you know, going about their life. And I'm
being an intelligence
agent or or an assistant, a health assistant
that,
both that both the providers and the patients
or the consumers can rely on,
to to take in take care of,
you know, or a monitor
the patients, anticipate some of those needs. But
on the provider side of it, streamline clinical
workflow workflows,
without actually having to,
do a lot of work manually. I think
all of that, you know, from a from
an ambient intelligence perspective or an intelligent AI
agent,
health care assistant, whichever whatever you wanna call
it, I think that's going to be,
a big piece of it as well. Ultimately,
what all of this means is, you know,
between
technologies and the capabilities that support personalized medicine
as well as, you know, Ambient Intelligence. All
of that,
what that fits into us, you know, is
the integrated digital health ecosystem. Right? So this
journey that we've been on for the last
decade or two to to to assure in
sort of this digital era into health care,
I think that's going to now sort of
take off in in major ways and and
and
and see really steep adoption
and and growth. So that's my
sort of view,
for the future. I'm I'm really hopeful that
comes through because then then it then it
helps people as well as providers
sort of do whatever that we have to
do to to get take care of people
much, much better and faster.
I love it. Thank you so much for
joining us in the podcast today. This has
been a really fascinating conversation, and I look
forward to connecting with you again soon.
Thank you. Thanks for having me. This was
wonderful, and thanks for the great questions. I
really enjoyed the conversation.
Talk
to you soon.