1 00:00:00,080 --> 00:00:02,319 This is Laura Dierda with the Becker's Healthcare 2 00:00:02,319 --> 00:00:04,400 podcast. I'm thrilled today to be joined by 3 00:00:04,400 --> 00:00:07,200 Judd Hollander, senior vice president of healthcare delivery 4 00:00:07,200 --> 00:00:07,700 innovation 5 00:00:08,000 --> 00:00:10,400 and chief virtual care officer at Jefferson Health 6 00:00:10,400 --> 00:00:12,000 as well as professor in the department of 7 00:00:12,000 --> 00:00:14,900 emergency medicine at the Sydney Kimmel Medical College. 8 00:00:15,095 --> 00:00:16,135 Judd, it's a pleasure to have you on 9 00:00:16,135 --> 00:00:18,375 the podcast today. Laura, great to join you 10 00:00:18,375 --> 00:00:18,875 again. 11 00:00:19,335 --> 00:00:21,815 Absolutely. Now I'm excited for our conversation because 12 00:00:21,815 --> 00:00:23,494 I know Jefferson is on the forefront of 13 00:00:23,494 --> 00:00:25,414 a lot of innovative things happening in the 14 00:00:25,414 --> 00:00:27,574 health care space. And, truly, you know, it's 15 00:00:27,574 --> 00:00:29,335 always exciting to think about where you're at 16 00:00:29,335 --> 00:00:31,469 today and then where you're headed. But before 17 00:00:31,469 --> 00:00:32,750 we begin, can you just tell us a 18 00:00:32,750 --> 00:00:34,689 little bit more about yourself and Jefferson? 19 00:00:35,390 --> 00:00:37,149 Yeah. So I'll I'll I'll I'll start with 20 00:00:37,149 --> 00:00:39,229 myself, and then I'll get into Jefferson. I 21 00:00:39,229 --> 00:00:41,570 I sort of have a a wandering background 22 00:00:41,629 --> 00:00:43,409 to end up in health care administration. 23 00:00:44,185 --> 00:00:47,164 I trained in internal medicine and emergency medicine, 24 00:00:47,625 --> 00:00:49,245 practiced emergency medicine, 25 00:00:49,784 --> 00:00:52,125 developed, clinical research expertise, 26 00:00:52,585 --> 00:00:55,304 and led large clinical research programs first at 27 00:00:55,304 --> 00:00:57,065 Stony Brook, then at Penn, and then at 28 00:00:57,065 --> 00:00:58,125 then at Jefferson. 29 00:00:59,060 --> 00:01:01,399 So I come from a very research oriented 30 00:01:02,020 --> 00:01:03,079 analytic background. 31 00:01:03,859 --> 00:01:06,439 And at some point, it dawned on me 32 00:01:06,739 --> 00:01:08,519 that if I change the spreadsheet 33 00:01:08,819 --> 00:01:10,439 from nanograms per deciliter 34 00:01:10,924 --> 00:01:12,685 at the end of a number to a 35 00:01:12,685 --> 00:01:14,685 dollar sign in front of it, it was 36 00:01:14,685 --> 00:01:17,325 a little more strategic and, you know, and 37 00:01:17,325 --> 00:01:19,984 and it was a bigger play in terms 38 00:01:20,045 --> 00:01:21,745 of changing health care to the community. 39 00:01:22,284 --> 00:01:24,545 So I went back and took some courses, 40 00:01:24,605 --> 00:01:26,959 not an MBA, but took formal courses at 41 00:01:26,959 --> 00:01:27,459 Wharton, 42 00:01:27,920 --> 00:01:29,939 learned the skills that I needed 43 00:01:30,239 --> 00:01:32,079 in in order to make the leap from 44 00:01:32,079 --> 00:01:34,819 a career researcher, emergency physician, into 45 00:01:35,200 --> 00:01:36,099 health care administration, 46 00:01:37,280 --> 00:01:39,200 and then transitioned at the time I left 47 00:01:39,200 --> 00:01:40,420 Penn to go to Jefferson 48 00:01:40,924 --> 00:01:43,725 into, you know, ultimately, this SVP and chief 49 00:01:43,725 --> 00:01:45,344 virtual care officer role. 50 00:01:45,645 --> 00:01:48,125 When I got to Jefferson about twelve years 51 00:01:48,125 --> 00:01:48,625 ago, 52 00:01:49,645 --> 00:01:52,445 it was a three hospital health system, which 53 00:01:52,445 --> 00:01:53,665 is hard to imagine 54 00:01:54,159 --> 00:01:57,060 now that it's 32 hospitals and four gazillion 55 00:01:57,280 --> 00:01:58,420 outpatient ambulatory 56 00:01:58,719 --> 00:01:59,219 practices. 57 00:02:00,000 --> 00:02:01,859 And so I jokingly say, 58 00:02:02,319 --> 00:02:04,479 I'm the person that's launched the most virtual 59 00:02:04,479 --> 00:02:07,194 care programs in the world because I launched 60 00:02:07,194 --> 00:02:08,895 them in the original three hospitals 61 00:02:09,354 --> 00:02:11,194 and then with our first merger and then 62 00:02:11,194 --> 00:02:12,794 with our second merger and then with our 63 00:02:12,794 --> 00:02:14,895 third merger and then with our fourth merger 64 00:02:15,275 --> 00:02:17,675 and then the last one. And none of 65 00:02:17,675 --> 00:02:18,814 those first couple, 66 00:02:19,710 --> 00:02:22,370 mergers actually had virtual care programs. 67 00:02:22,750 --> 00:02:25,889 But, last combination with Lehigh, a very robust 68 00:02:25,950 --> 00:02:28,750 health care system that had 14 hospitals and 69 00:02:28,750 --> 00:02:31,069 extends through the Lehigh Valley, they had a 70 00:02:31,069 --> 00:02:32,530 great virtual care system. 71 00:02:32,830 --> 00:02:33,969 And and so 72 00:02:34,425 --> 00:02:36,905 we're we're now combining the best of both 73 00:02:36,905 --> 00:02:39,544 to develop an even better one than what 74 00:02:39,544 --> 00:02:41,884 we had before or they had before. 75 00:02:42,905 --> 00:02:44,824 That's amazing to hear. You know, really cool 76 00:02:44,824 --> 00:02:46,284 that you have the opportunity 77 00:02:46,745 --> 00:02:49,080 to start off, so many years ago with 78 00:02:49,159 --> 00:02:51,080 Jefferson as a small three hospital system and 79 00:02:51,080 --> 00:02:52,920 see it grow and and be part of 80 00:02:52,920 --> 00:02:55,080 that, on the virtual care space. And I 81 00:02:55,159 --> 00:02:57,240 I'm curious over the years, how have you 82 00:02:57,240 --> 00:02:59,560 seen virtual care grow? I mean, obviously, you 83 00:02:59,560 --> 00:03:01,879 know, had a great accelerator during the pandemic, 84 00:03:01,879 --> 00:03:03,615 but where are we at today? Did you 85 00:03:03,615 --> 00:03:05,635 imagine you'd be in this space where, 86 00:03:06,014 --> 00:03:08,495 virtual care is is such a integrated and 87 00:03:08,495 --> 00:03:11,074 integral part of access and communities today? 88 00:03:11,455 --> 00:03:13,534 So it's interesting because I think you might 89 00:03:13,534 --> 00:03:15,889 expect me to say no. It's bigger and 90 00:03:15,889 --> 00:03:17,509 more robust than I anticipated. 91 00:03:17,810 --> 00:03:20,050 But it it's actually across the country, it's 92 00:03:20,050 --> 00:03:21,430 smaller and less robust 93 00:03:22,129 --> 00:03:23,349 than I would anticipate. 94 00:03:24,289 --> 00:03:27,590 We actually began our program in 2015. 95 00:03:28,185 --> 00:03:30,105 And so by the time COVID hit, we 96 00:03:30,105 --> 00:03:31,645 were reasonably well established. 97 00:03:32,105 --> 00:03:33,705 And we went through many of the things 98 00:03:33,705 --> 00:03:36,105 you have to do with change management. Because 99 00:03:36,105 --> 00:03:37,865 if you think back, you know, now eleven 100 00:03:37,865 --> 00:03:40,344 years ago into what did people think about 101 00:03:40,344 --> 00:03:42,825 virtual care, they thought doctor Hollander was a 102 00:03:42,825 --> 00:03:44,819 little bit nuts in why do we need 103 00:03:44,819 --> 00:03:45,639 to do this. 104 00:03:46,099 --> 00:03:48,019 And under the leadership and guidance at that 105 00:03:48,019 --> 00:03:50,280 time of Steve Klaskow, who was our CEO, 106 00:03:51,139 --> 00:03:53,780 we decided what I think everybody accepts now, 107 00:03:53,780 --> 00:03:55,620 patients should get care how and when they 108 00:03:55,620 --> 00:03:58,254 want care. And so our goal 109 00:03:58,715 --> 00:04:01,055 was actually to make sure that the clinicians 110 00:04:01,115 --> 00:04:03,275 in the health system or in the three 111 00:04:03,275 --> 00:04:04,495 hospitals at that time 112 00:04:04,795 --> 00:04:07,034 were able to deliver care that was best 113 00:04:07,034 --> 00:04:08,014 for the patient. 114 00:04:08,474 --> 00:04:11,435 And so our incentive programs, thinking way back 115 00:04:11,435 --> 00:04:13,669 to then, were that you had to do 116 00:04:13,669 --> 00:04:16,550 12 calls in a year. 12 telemedicine calls 117 00:04:16,550 --> 00:04:18,870 in a year. And the amount of sort 118 00:04:18,870 --> 00:04:21,829 of pushing we needed to do to get 119 00:04:21,829 --> 00:04:24,009 clinicians to do 12 in a year 120 00:04:24,310 --> 00:04:25,209 was insane. 121 00:04:25,675 --> 00:04:27,675 It first year, there was an incentive on 122 00:04:27,675 --> 00:04:28,895 the individual clinicians, 123 00:04:29,355 --> 00:04:31,435 then that didn't work. So then we increase 124 00:04:31,435 --> 00:04:34,074 the incentive on the chairs, and ultimately, we 125 00:04:34,074 --> 00:04:35,935 increase the incentive on the departments 126 00:04:36,395 --> 00:04:38,085 so that the departments would not get allocated 127 00:04:38,085 --> 00:04:38,125 the same amount of money next year if 128 00:04:38,125 --> 00:04:38,699 people didn't make it. And I sit in 129 00:04:41,180 --> 00:04:43,520 make it. And I sit and think as 130 00:04:43,660 --> 00:04:45,520 I was going around meeting with everybody, 131 00:04:45,980 --> 00:04:48,480 I'm like, 12 calls is June 30. 132 00:04:48,860 --> 00:04:50,300 You could meet that goal. You could do 133 00:04:50,300 --> 00:04:52,620 it all the last day. But the goal 134 00:04:52,620 --> 00:04:54,805 was you needed to know how to do 135 00:04:54,805 --> 00:04:56,964 it. So if a patient wanted it and 136 00:04:56,964 --> 00:04:58,725 needed it, you could take care of that 137 00:04:58,725 --> 00:04:59,225 patient. 138 00:04:59,764 --> 00:05:00,264 And, 139 00:05:00,644 --> 00:05:03,144 you you know, people had, I would say, 140 00:05:03,604 --> 00:05:04,104 disproportionate 141 00:05:04,564 --> 00:05:06,884 angst about learning how to do it and 142 00:05:06,884 --> 00:05:09,180 annoyance with doing it until COVID hit. 143 00:05:10,199 --> 00:05:12,839 And then we actually kept this is real 144 00:05:12,839 --> 00:05:16,040 data. Over seventy percent of our scheduled visits 145 00:05:16,040 --> 00:05:18,540 for the first week COVID hit in Philadelphia 146 00:05:19,079 --> 00:05:21,879 by converting people from in person visits to 147 00:05:21,879 --> 00:05:23,339 to telemedicine visits 148 00:05:23,654 --> 00:05:24,395 because everybody 149 00:05:24,774 --> 00:05:27,095 knew how to do it. So we look 150 00:05:27,095 --> 00:05:27,915 like geniuses. 151 00:05:29,095 --> 00:05:32,475 And and people love patients love telemedicine. 152 00:05:33,095 --> 00:05:35,654 Some do, some don't. But I think our 153 00:05:35,654 --> 00:05:37,415 goal is we wanna take care of patients 154 00:05:37,415 --> 00:05:39,014 the way they want to be taken care 155 00:05:39,014 --> 00:05:41,090 of. And sometime clinicians, 156 00:05:42,590 --> 00:05:44,430 they wanna take care of patients the way 157 00:05:44,430 --> 00:05:47,389 they're comfortable taking care of the patients. And, 158 00:05:47,389 --> 00:05:50,210 yeah, you can't do the same physical exam. 159 00:05:50,590 --> 00:05:52,705 You could do a different physical exam. But 160 00:05:52,705 --> 00:05:54,225 when a patient comes to the office, you 161 00:05:54,225 --> 00:05:56,625 can't look in their house. And when patient's 162 00:05:56,625 --> 00:05:59,125 on telemedicine, you can look in their house. 163 00:05:59,585 --> 00:06:02,225 And so I think it's learning to take 164 00:06:02,225 --> 00:06:04,649 all the information available to you 165 00:06:05,129 --> 00:06:07,149 and do the best thing for the patients. 166 00:06:07,850 --> 00:06:10,490 Why I think, probably a follow-up question, it's 167 00:06:10,490 --> 00:06:12,569 not going as well as I might have 168 00:06:12,569 --> 00:06:13,069 expected 169 00:06:13,769 --> 00:06:15,689 is because the government refuses to make a 170 00:06:15,689 --> 00:06:16,589 long term commitment. 171 00:06:17,050 --> 00:06:19,689 Everybody thinks telemedicine costs less than in person 172 00:06:19,689 --> 00:06:22,125 care. Sure. You don't need real estate, but 173 00:06:22,125 --> 00:06:23,964 you do need to invest in products that 174 00:06:23,964 --> 00:06:26,144 will deliver a good telemedicine experience. 175 00:06:26,764 --> 00:06:29,004 And and with the government continually kicking the 176 00:06:29,004 --> 00:06:31,004 can down the road and paying for it 177 00:06:31,004 --> 00:06:32,685 for a couple months or a year through 178 00:06:32,685 --> 00:06:33,745 continuing resolutions, 179 00:06:34,389 --> 00:06:36,650 it's hard for health systems to really jump 180 00:06:36,710 --> 00:06:37,370 all in. 181 00:06:38,470 --> 00:06:39,910 Got it. That makes a lot of sense. 182 00:06:39,910 --> 00:06:41,750 And especially on the policy side, I know 183 00:06:41,750 --> 00:06:44,230 there's a ton, to always be considerate and 184 00:06:44,230 --> 00:06:45,370 mindful of. So, 185 00:06:46,324 --> 00:06:48,004 thank you so much for for digging in 186 00:06:48,004 --> 00:06:49,685 there. And, you know, I'm curious if you 187 00:06:49,685 --> 00:06:51,204 zero in on just the last year or 188 00:06:51,204 --> 00:06:53,204 so. Could you tell us about an initiative 189 00:06:53,204 --> 00:06:54,485 that you've led? What did you do, and 190 00:06:54,485 --> 00:06:55,464 what were the results? 191 00:06:55,925 --> 00:06:58,425 So I think the best thing we've done 192 00:06:58,644 --> 00:07:01,384 is think about how can we improve access 193 00:07:01,569 --> 00:07:02,389 for patients. 194 00:07:02,769 --> 00:07:04,449 And and we've tried to do that in 195 00:07:04,449 --> 00:07:06,850 several different ways. So one of, 196 00:07:07,330 --> 00:07:09,509 the Hallmark program that I'll discuss 197 00:07:09,889 --> 00:07:11,889 is our same day next day cancer care 198 00:07:11,889 --> 00:07:12,389 program, 199 00:07:13,089 --> 00:07:16,024 where we just fundamentally believe that that if 200 00:07:16,024 --> 00:07:17,544 someone tells you you have cancer, you shouldn't 201 00:07:17,544 --> 00:07:19,245 have to wait three weeks for an appointment. 202 00:07:19,544 --> 00:07:21,644 You you know, it's psychologically devastating. 203 00:07:22,024 --> 00:07:24,504 You're concerned about the outcome. And so we 204 00:07:24,504 --> 00:07:26,584 made the commitment to say, we're gonna get 205 00:07:26,584 --> 00:07:27,884 you in today or tomorrow. 206 00:07:28,199 --> 00:07:30,519 And we just challenged our teams to come 207 00:07:30,519 --> 00:07:32,519 up with a system to do it, and 208 00:07:32,519 --> 00:07:33,879 we were able to do that. And at 209 00:07:33,879 --> 00:07:35,479 this point, we have close to two thousand 210 00:07:35,479 --> 00:07:35,979 patients 211 00:07:36,279 --> 00:07:37,899 with new diagnoses of cancer. 212 00:07:38,360 --> 00:07:40,360 We've been able to get in literally the 213 00:07:40,360 --> 00:07:42,439 same day they called or or the next 214 00:07:42,439 --> 00:07:45,125 day, start them on their journey to care, 215 00:07:45,345 --> 00:07:47,444 connect them with chemo or surgery. 216 00:07:47,824 --> 00:07:48,964 And we've demonstrated 217 00:07:49,264 --> 00:07:51,904 we can get their first chemo infusion or 218 00:07:51,904 --> 00:07:53,125 their or their surgical, 219 00:07:54,305 --> 00:07:55,524 repair or fix 220 00:07:55,904 --> 00:07:58,639 done sooner through this program than we did 221 00:07:58,639 --> 00:08:01,839 the old ways. So we've worked on many, 222 00:08:01,839 --> 00:08:03,139 many access initiatives, 223 00:08:03,600 --> 00:08:06,240 but but that's probably the first one that 224 00:08:06,240 --> 00:08:09,220 was, you know, super successful in that realm. 225 00:08:10,464 --> 00:08:11,904 That's great to hear. And, you know, when 226 00:08:11,904 --> 00:08:13,904 you think about putting a program like that 227 00:08:13,904 --> 00:08:16,064 together and then seeing the results that you 228 00:08:16,064 --> 00:08:16,564 got, 229 00:08:17,425 --> 00:08:19,664 technology is one piece of it. How do 230 00:08:19,664 --> 00:08:20,704 you make sure that, 231 00:08:21,024 --> 00:08:22,944 the people that you're working with are really 232 00:08:22,944 --> 00:08:24,944 jumping in, integrating it the way you want, 233 00:08:24,944 --> 00:08:27,930 and, really, you know, running towards those outcomes 234 00:08:27,930 --> 00:08:29,210 so you can get there as quickly as 235 00:08:29,210 --> 00:08:29,710 possible. 236 00:08:30,649 --> 00:08:32,649 You know, I wish I had a great 237 00:08:32,649 --> 00:08:35,529 answer to that, but but what we've learned 238 00:08:35,529 --> 00:08:37,549 is it really begins with 239 00:08:38,169 --> 00:08:40,830 identifying, you know, it's people process and technology. 240 00:08:41,225 --> 00:08:42,825 So if you don't have the right people 241 00:08:42,825 --> 00:08:45,545 engaged, you're gonna have a problem. So we 242 00:08:45,545 --> 00:08:47,245 have, in the past, 243 00:08:47,545 --> 00:08:50,264 approached departments and said, hey. We got a 244 00:08:50,264 --> 00:08:52,904 a templated playbook for this. We're ready to 245 00:08:52,904 --> 00:08:55,545 go. Do you wanna do this? They have 246 00:08:55,545 --> 00:08:58,340 all said yes. But sometimes after a meeting 247 00:08:58,340 --> 00:09:00,420 or two, the answer is, well, yeah, we 248 00:09:00,420 --> 00:09:02,740 wanna do it, but not really because the 249 00:09:02,740 --> 00:09:05,320 change management with all our clinicians is difficult. 250 00:09:05,779 --> 00:09:07,160 The workflows are difficult. 251 00:09:07,700 --> 00:09:10,019 So, you know, we have learned to go 252 00:09:10,019 --> 00:09:11,559 where people want to 253 00:09:12,134 --> 00:09:14,695 play nice and develop things that are novel 254 00:09:14,695 --> 00:09:15,434 and different. 255 00:09:15,735 --> 00:09:17,495 So I think the first thing is selecting 256 00:09:17,495 --> 00:09:18,855 the right group of people to do it 257 00:09:18,855 --> 00:09:21,514 with. The the second thing is being 258 00:09:22,295 --> 00:09:24,955 both rigid and flexible at the same time. 259 00:09:25,254 --> 00:09:26,875 Like, we know what works, 260 00:09:27,919 --> 00:09:30,720 but that's not what everybody else wants. So 261 00:09:30,720 --> 00:09:32,419 it's finding the right compromises 262 00:09:33,360 --> 00:09:36,159 so people don't have to change everything they 263 00:09:36,159 --> 00:09:38,559 know how to do. They'll change enough of 264 00:09:38,559 --> 00:09:40,159 it that we could deliver the care and 265 00:09:40,159 --> 00:09:41,379 open up the access 266 00:09:41,745 --> 00:09:44,565 so that they're comfortable with it and make 267 00:09:44,784 --> 00:09:47,264 the change over time. And then the third 268 00:09:47,264 --> 00:09:49,424 part is the technology. In in our case, 269 00:09:49,424 --> 00:09:51,904 the technology is easy because they've all been 270 00:09:51,904 --> 00:09:52,725 doing telemedicine 271 00:09:53,024 --> 00:09:55,904 visits. So they're just gonna do the same 272 00:09:55,904 --> 00:09:58,410 type of visit they did using the same 273 00:09:58,410 --> 00:09:58,910 technology. 274 00:09:59,370 --> 00:10:01,210 What we're really changing is how you come 275 00:10:01,210 --> 00:10:03,690 in the enterprise central scheduling, how you get 276 00:10:03,690 --> 00:10:06,889 your access, who's available for the patient, will 277 00:10:06,889 --> 00:10:08,590 clinicians add on somebody, 278 00:10:08,970 --> 00:10:10,910 what happens if the first clinician 279 00:10:11,445 --> 00:10:13,144 seeing somebody is a nurse practitioner 280 00:10:13,524 --> 00:10:15,684 who's not entirely sure of the answer on 281 00:10:15,684 --> 00:10:17,865 somebody with a super specialized cancer? 282 00:10:18,404 --> 00:10:20,825 Rather than send them to the cancer specialist, 283 00:10:21,205 --> 00:10:23,445 they have permission to call and disturb that 284 00:10:23,445 --> 00:10:25,860 specialist in the middle of the day to 285 00:10:25,860 --> 00:10:27,700 get the answer so the patient gets off 286 00:10:27,700 --> 00:10:30,259 the phone with the answer. Those were major 287 00:10:30,259 --> 00:10:31,159 workflow changes 288 00:10:31,539 --> 00:10:33,779 that our our cancer service line and Sydney 289 00:10:33,779 --> 00:10:36,259 Kimmel Cancer Center were just more than happy 290 00:10:36,259 --> 00:10:38,039 to make, makes a big difference. 291 00:10:38,485 --> 00:10:41,285 Not everybody else can make those changes and 292 00:10:41,285 --> 00:10:42,425 adapt as fast. 293 00:10:43,524 --> 00:10:45,365 Absolutely. That makes a lot of sense. It 294 00:10:45,365 --> 00:10:47,285 just really speaks to the unique culture that 295 00:10:47,285 --> 00:10:48,884 you have there at Jefferson and, 296 00:10:49,285 --> 00:10:51,045 the team that you've been able to build. 297 00:10:51,045 --> 00:10:52,799 So that's really cool to see. 298 00:10:53,440 --> 00:10:54,959 Looking ahead, what are some of the big 299 00:10:54,959 --> 00:10:56,959 priorities and headwinds that you're focused on for 300 00:10:56,959 --> 00:10:57,940 2026? 301 00:10:58,399 --> 00:11:00,240 So I tend to think of things in 302 00:11:00,240 --> 00:11:02,580 the single biggest bucket is access. 303 00:11:03,200 --> 00:11:05,379 I'm old enough that I have had parents 304 00:11:05,440 --> 00:11:07,524 that have passed away and parents that have 305 00:11:07,524 --> 00:11:09,284 spent a lot of time in the hospital 306 00:11:09,284 --> 00:11:11,445 and, you know, friends and family that do 307 00:11:11,445 --> 00:11:12,024 the same. 308 00:11:12,404 --> 00:11:14,164 And the pressure point, I think, at health 309 00:11:14,164 --> 00:11:17,284 systems all across the country is access, access, 310 00:11:17,284 --> 00:11:18,179 and more access. 311 00:11:18,659 --> 00:11:20,740 How do you get in? So I I 312 00:11:20,740 --> 00:11:23,620 think we're thinking of, you know, how do 313 00:11:23,620 --> 00:11:24,839 we get access, 314 00:11:25,379 --> 00:11:28,019 transform, and engage as the three things we 315 00:11:28,019 --> 00:11:30,200 talk about all the time. But 316 00:11:30,575 --> 00:11:32,815 it begins by what you tie up people 317 00:11:32,815 --> 00:11:35,634 doing. So although I don't lead this initiative, 318 00:11:35,774 --> 00:11:38,434 I'm involved with it. We have Bala Yahia, 319 00:11:38,654 --> 00:11:40,035 our health system president, 320 00:11:40,414 --> 00:11:42,674 has a, you know, very bold initiative 321 00:11:43,029 --> 00:11:46,309 to reclaim 10,000,000 patient care hours over the 322 00:11:46,309 --> 00:11:48,629 next three years largely through the use of 323 00:11:48,629 --> 00:11:49,129 AI. 324 00:11:49,669 --> 00:11:51,690 We've grown out ambient listening 325 00:11:52,230 --> 00:11:55,210 to thousands and thousands of our clinicians, 326 00:11:56,245 --> 00:11:58,824 physician and APCs across the enterprise. 327 00:11:59,365 --> 00:11:59,865 Yesterday, 328 00:12:00,485 --> 00:12:03,544 Colleen Malozzi led a team that launched MBNAI 329 00:12:03,924 --> 00:12:04,904 for our nurses, 330 00:12:05,524 --> 00:12:07,764 on our first unit, which will free up 331 00:12:07,764 --> 00:12:10,164 nurses to be at the bedside more rather 332 00:12:10,164 --> 00:12:10,985 than documentation. 333 00:12:11,879 --> 00:12:14,920 So that may help create capacity. It may 334 00:12:14,920 --> 00:12:15,899 also help us 335 00:12:16,440 --> 00:12:19,019 recruit more people to take care of patients 336 00:12:19,399 --> 00:12:22,120 because the job may be better, burnout may 337 00:12:22,120 --> 00:12:24,139 be less, retention may be better. 338 00:12:24,545 --> 00:12:26,705 Then we split people or, at least, the 339 00:12:26,705 --> 00:12:27,904 way I think of it in the two 340 00:12:27,904 --> 00:12:30,725 buckets. There's practices that have capacity. 341 00:12:31,184 --> 00:12:33,585 That's easy. How do we identify the patients 342 00:12:33,585 --> 00:12:35,285 that need to see those specialists 343 00:12:35,825 --> 00:12:37,904 so they could take the open slots and 344 00:12:37,904 --> 00:12:39,665 we could provide better care to people in 345 00:12:39,665 --> 00:12:40,245 the community? 346 00:12:40,600 --> 00:12:43,320 So we have programs focused on where there 347 00:12:43,320 --> 00:12:45,960 is capacity, making sure we're giving patients the 348 00:12:45,960 --> 00:12:46,460 opportunity 349 00:12:46,919 --> 00:12:49,320 to know we have that capacity. And then 350 00:12:49,320 --> 00:12:51,639 there's the other side where we don't have 351 00:12:51,639 --> 00:12:52,139 capacity. 352 00:12:52,600 --> 00:12:54,835 And the challenge is how do we create 353 00:12:54,835 --> 00:12:55,735 more capacity 354 00:12:56,115 --> 00:12:58,675 without actually having to go build a multi 355 00:12:58,675 --> 00:13:01,335 office spec or a multi specialty office building. 356 00:13:01,715 --> 00:13:04,355 And so transitioning some people that work in 357 00:13:04,355 --> 00:13:05,014 the office 358 00:13:05,394 --> 00:13:06,535 to work at home, 359 00:13:06,970 --> 00:13:09,629 backfilling the office space with a new clinician 360 00:13:10,169 --> 00:13:11,309 creates more capacity 361 00:13:11,769 --> 00:13:13,610 without us having to wait ten years to 362 00:13:13,610 --> 00:13:16,169 build a building and find real estate. So 363 00:13:16,169 --> 00:13:18,730 I think it's making us more efficient at 364 00:13:18,730 --> 00:13:21,690 what we do, filling capacity where we need 365 00:13:21,690 --> 00:13:24,225 it, and creating capacity where we don't have 366 00:13:24,225 --> 00:13:26,625 it as the major strategies that I'm working 367 00:13:26,625 --> 00:13:27,125 on. 368 00:13:27,985 --> 00:13:29,264 That makes a lot of sense, and I 369 00:13:29,264 --> 00:13:31,264 appreciate the specifics that you talk through there. 370 00:13:31,264 --> 00:13:33,184 I mean, I think it's having those creative 371 00:13:33,184 --> 00:13:35,664 ideas to expand access in ways that are 372 00:13:35,664 --> 00:13:36,144 also, 373 00:13:36,705 --> 00:13:37,205 financially 374 00:13:37,889 --> 00:13:39,970 viable right now. I think every dollar and 375 00:13:39,970 --> 00:13:41,970 every minute of health care resources is so 376 00:13:41,970 --> 00:13:44,529 precious, and and so to find those, unique 377 00:13:44,529 --> 00:13:46,389 opportunities to continue to, 378 00:13:46,769 --> 00:13:48,690 evolve the system, it just seems to make 379 00:13:48,690 --> 00:13:50,050 a lot of sense, and I can imagine 380 00:13:50,050 --> 00:13:51,730 is, you know, really where there's a lot 381 00:13:51,730 --> 00:13:54,054 of attention and focus today. Yeah. Thanks, 382 00:13:54,434 --> 00:13:57,394 Laura. Perfect. Well, I think, you know, there's 383 00:13:57,394 --> 00:13:59,075 been a lot of changes in health care 384 00:13:59,075 --> 00:14:01,495 too, coming rapidly in in, 385 00:14:02,034 --> 00:14:03,954 you know, consistently. So what do you think 386 00:14:03,954 --> 00:14:05,315 the hardest thing you'll have to do in 387 00:14:05,315 --> 00:14:07,319 the next year will be? Oh, that's an 388 00:14:07,319 --> 00:14:08,779 easy one. Change management. 389 00:14:09,480 --> 00:14:12,120 It's it's all about change management. Too often, 390 00:14:12,120 --> 00:14:13,019 we think about, 391 00:14:13,399 --> 00:14:15,259 you you you know, the end result, 392 00:14:15,720 --> 00:14:17,639 but it's really about how do we get 393 00:14:17,639 --> 00:14:19,579 the people that are in the process 394 00:14:20,375 --> 00:14:22,375 to accept the fact that health care is 395 00:14:22,375 --> 00:14:24,695 changing, and it's not the same health care 396 00:14:24,695 --> 00:14:27,355 you might have trained in fifteen years ago. 397 00:14:27,815 --> 00:14:29,835 Like, if we have clinicians 398 00:14:30,455 --> 00:14:32,934 that haven't figured out how to use AI, 399 00:14:32,934 --> 00:14:35,470 where AI can be used, if we have 400 00:14:35,470 --> 00:14:37,870 clinicians that haven't figured out how to engage 401 00:14:37,870 --> 00:14:39,889 their patients in virtual care, 402 00:14:40,269 --> 00:14:42,990 then patients are gonna go somewhere else, and 403 00:14:42,990 --> 00:14:45,070 those clinicians aren't gonna be able to do 404 00:14:45,070 --> 00:14:46,210 their job well. 405 00:14:46,670 --> 00:14:49,154 Change is difficult. And I think for us, 406 00:14:49,235 --> 00:14:50,995 we need to have programs, and we do 407 00:14:50,995 --> 00:14:52,695 have programs with our leadership 408 00:14:53,154 --> 00:14:55,634 about how we can get the people we 409 00:14:55,634 --> 00:14:57,634 work with, the people we work under, and 410 00:14:57,634 --> 00:14:59,095 the people we supervise, 411 00:14:59,795 --> 00:15:01,955 how to embrace change and and to move 412 00:15:01,955 --> 00:15:03,894 forward into the next, decade. 413 00:15:05,129 --> 00:15:06,970 Absolutely. I I love that. And I think, 414 00:15:06,970 --> 00:15:08,570 you know, it's so true being able to 415 00:15:08,570 --> 00:15:09,549 have those folks, 416 00:15:09,929 --> 00:15:12,490 that really are able to take on, you 417 00:15:12,490 --> 00:15:14,490 know, new technologies as things are moving so 418 00:15:14,490 --> 00:15:16,829 quickly and change with whatever is needed, 419 00:15:17,370 --> 00:15:19,629 for that moment, I think is critical. 420 00:15:20,375 --> 00:15:22,294 When you look at AI in particular in 421 00:15:22,294 --> 00:15:24,455 bringing that into and integrating that into the 422 00:15:24,455 --> 00:15:25,355 broader organization, 423 00:15:25,815 --> 00:15:27,335 what are some of the ways that you've 424 00:15:27,335 --> 00:15:30,134 been able to, you know, whether it's roll 425 00:15:30,134 --> 00:15:32,375 it out or or communicate about it with 426 00:15:32,375 --> 00:15:33,355 the team to, 427 00:15:34,029 --> 00:15:36,590 ideally reach that spot where they're starting to 428 00:15:36,590 --> 00:15:38,750 integrate, especially for those who are on the 429 00:15:38,750 --> 00:15:40,610 more skeptical side, what's possible, 430 00:15:41,389 --> 00:15:43,470 to bring them along a bit more quickly 431 00:15:43,470 --> 00:15:44,850 and get them up to speed. 432 00:15:45,470 --> 00:15:47,970 So I think, you know, AI is fascinating 433 00:15:48,615 --> 00:15:50,955 because the right AI tools, 434 00:15:51,575 --> 00:15:52,715 people beg for. 435 00:15:53,095 --> 00:15:53,595 So 436 00:15:53,975 --> 00:15:56,215 it it's when we rolled out Ambient, and, 437 00:15:56,215 --> 00:15:58,695 again, not my program, Bracken Babula gets the 438 00:15:58,695 --> 00:16:00,794 credit for this in in our 439 00:16:01,254 --> 00:16:02,394 clinician practice. 440 00:16:03,429 --> 00:16:05,929 We got they describe it as love letters. 441 00:16:06,149 --> 00:16:09,509 It saved 84% of the documentation time was 442 00:16:09,509 --> 00:16:11,589 the actual data. You know, we talk about 443 00:16:11,589 --> 00:16:13,350 pajama time. No one wants to go home 444 00:16:13,350 --> 00:16:14,804 and document, but 445 00:16:15,284 --> 00:16:17,365 we're able to decrease the amount of doing 446 00:16:17,365 --> 00:16:20,585 that. And the original clinicians that piloted it, 447 00:16:20,884 --> 00:16:22,804 they took care of the change management because 448 00:16:22,804 --> 00:16:24,485 they just loved it so much. They spread 449 00:16:24,485 --> 00:16:26,085 the word to the person standing next to 450 00:16:26,085 --> 00:16:28,039 them, and it spread like wildfire. 451 00:16:28,580 --> 00:16:30,340 The the growth curve we have in our 452 00:16:30,340 --> 00:16:33,059 organization and the number of clinicians adopting it, 453 00:16:33,059 --> 00:16:34,580 it was hard to keep for us to 454 00:16:34,580 --> 00:16:35,799 keep up with the training. 455 00:16:36,259 --> 00:16:38,660 So I think if if we listen, and 456 00:16:38,660 --> 00:16:40,915 that's critical, if we listen to the pressure 457 00:16:40,915 --> 00:16:43,235 points for the people who work in our 458 00:16:43,235 --> 00:16:45,735 system and we solve the problem 459 00:16:46,274 --> 00:16:48,855 for those people that wanna be first movers 460 00:16:48,915 --> 00:16:49,975 in that space, 461 00:16:50,434 --> 00:16:52,754 they will spread the word. If we find 462 00:16:52,754 --> 00:16:55,210 a solution that doesn't work and we give 463 00:16:55,210 --> 00:16:57,230 it to those first movers and it stinks, 464 00:16:57,769 --> 00:16:59,370 it's very hard to come back and do 465 00:16:59,370 --> 00:17:01,450 the same thing again. So it it it 466 00:17:01,450 --> 00:17:03,549 again comes back to listening, 467 00:17:04,650 --> 00:17:07,609 solving the problem, and finding the right people 468 00:17:07,609 --> 00:17:09,345 to take the bull and run with it. 469 00:17:10,144 --> 00:17:11,345 I love that. I mean, it's just so 470 00:17:11,345 --> 00:17:13,105 simple, but at the same time, I know 471 00:17:13,105 --> 00:17:14,625 it's so much easier said than done. And 472 00:17:14,625 --> 00:17:16,224 to have something like Ambient two, you know, 473 00:17:16,224 --> 00:17:18,304 is that perfect use case where you can 474 00:17:18,304 --> 00:17:19,984 get love letters where you do, you know, 475 00:17:19,984 --> 00:17:22,085 make things so much easier for clinicians, 476 00:17:22,944 --> 00:17:24,619 that, you know, having that foot in the 477 00:17:24,619 --> 00:17:26,299 door to then think through, you know, what 478 00:17:26,299 --> 00:17:27,819 else can AI do for me is really 479 00:17:27,819 --> 00:17:28,319 powerful. 480 00:17:29,019 --> 00:17:30,779 Yeah. And I I think you you're right. 481 00:17:30,779 --> 00:17:32,779 It is way easier to say it than 482 00:17:32,779 --> 00:17:35,599 to do it. There are plenty of sleepless 483 00:17:35,740 --> 00:17:37,659 nights in trying to make these things go 484 00:17:37,659 --> 00:17:38,159 forward. 485 00:17:38,755 --> 00:17:40,515 But, you know, I think it's the mission. 486 00:17:40,515 --> 00:17:42,454 At the end of the day, I mean, 487 00:17:42,595 --> 00:17:45,075 the advantage of being an ER doc is 488 00:17:45,075 --> 00:17:46,994 you get to see what's broken in the 489 00:17:46,994 --> 00:17:49,654 health system, and there's so much to solve. 490 00:17:50,194 --> 00:17:52,454 So it's easy to stay really passionate 491 00:17:52,755 --> 00:17:54,299 and try and fix these things. 492 00:17:55,340 --> 00:17:57,500 Absolutely. And, you know, to that point, I 493 00:17:57,500 --> 00:17:59,259 wanted to talk about growth as well. Where 494 00:17:59,259 --> 00:18:00,799 do you see some of the best opportunities 495 00:18:00,940 --> 00:18:02,880 for organizational growth going forward? 496 00:18:03,259 --> 00:18:05,500 You know, that's a much more difficult question. 497 00:18:05,500 --> 00:18:07,019 I I I think that a lot of 498 00:18:07,019 --> 00:18:09,600 health systems are really thinking about diversification. 499 00:18:10,355 --> 00:18:11,815 Right? We have a university. 500 00:18:12,275 --> 00:18:14,115 We have a venture fund. We have a 501 00:18:14,115 --> 00:18:14,934 health plan. 502 00:18:15,474 --> 00:18:17,474 And it's if we're gonna take great care 503 00:18:17,474 --> 00:18:18,134 of patients, 504 00:18:18,595 --> 00:18:20,835 we can't be on the receiving end of 505 00:18:20,835 --> 00:18:22,214 everybody else's policies 506 00:18:22,779 --> 00:18:23,759 and not influence 507 00:18:24,220 --> 00:18:26,380 it. So much easier for us to give 508 00:18:26,380 --> 00:18:28,240 really good cost effective care 509 00:18:28,619 --> 00:18:30,380 if if we're control you know, people talk 510 00:18:30,380 --> 00:18:33,019 about controlling the whole premium dollar, but really, 511 00:18:33,019 --> 00:18:34,700 I prefer to think of it as controlling 512 00:18:34,700 --> 00:18:37,484 the whole patient journey while working with the 513 00:18:37,484 --> 00:18:39,585 patient to deliver an optimal journey. 514 00:18:39,964 --> 00:18:42,205 And if we could use the university to 515 00:18:42,205 --> 00:18:43,184 create staff 516 00:18:43,565 --> 00:18:45,265 and train in the right programs, 517 00:18:45,644 --> 00:18:47,724 and we could use the health plan to 518 00:18:47,724 --> 00:18:49,964 help the patients in our community pay for 519 00:18:49,964 --> 00:18:52,099 their care, and then we could deliver a 520 00:18:52,099 --> 00:18:53,480 cost effective care. 521 00:18:53,940 --> 00:18:56,179 Well, that's a great way to grow. But 522 00:18:56,179 --> 00:18:58,919 you you think about the the policy headwinds 523 00:18:59,059 --> 00:18:59,799 to everything. 524 00:19:00,099 --> 00:19:01,859 Well, this is now a lot of policy 525 00:19:01,859 --> 00:19:03,799 headwinds in a lot of different directions 526 00:19:04,244 --> 00:19:06,345 that we need to be prepared for. 527 00:19:06,805 --> 00:19:09,605 But I think growth is gonna be about 528 00:19:09,605 --> 00:19:12,105 making the best patient journey for the patient. 529 00:19:12,484 --> 00:19:14,345 And if we could do that, then 530 00:19:14,884 --> 00:19:16,565 we're gonna be the place patients want to 531 00:19:16,565 --> 00:19:17,224 come to. 532 00:19:18,110 --> 00:19:19,710 I love it. Judd, thank you so much 533 00:19:19,710 --> 00:19:21,309 for joining us on the podcast today. This 534 00:19:21,309 --> 00:19:24,049 has been such a fun conversation, very informative 535 00:19:24,110 --> 00:19:25,549 as well as the passion for what you 536 00:19:25,549 --> 00:19:27,710 do comes through in everything that you're talking 537 00:19:27,710 --> 00:19:29,710 about. So I appreciate your time today and 538 00:19:29,710 --> 00:19:31,070 look forward to seeing you in April. I 539 00:19:31,070 --> 00:19:32,845 know you'll be speaking on a panel at 540 00:19:32,845 --> 00:19:35,325 one of our annual meeting sessions coming up, 541 00:19:35,565 --> 00:19:37,404 and and so it'll be great to dig 542 00:19:37,404 --> 00:19:39,164 a little bit deeper as well as see 543 00:19:39,164 --> 00:19:41,265 you in person. So looking forward to it. 544 00:19:41,325 --> 00:19:43,085 Laura, thank you. I I I love the 545 00:19:43,085 --> 00:19:44,684 podcast, and I love the meeting in April. 546 00:19:44,684 --> 00:19:46,165 I look forward to seeing you there.