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 Mario Gussol, director of interventional cardiology fellowships,
director of transcatheter valve therapies, and interventional cardiologist
at Allina Health Minneapolis Heart Institute. Doctor Kosil,
it's a pleasure to have you on the
podcast today.
Thank you for having us, Laura. My pleasure.
Absolutely.
Now I'm excited to have you on because
it'll be fun to hear just some of
the great things you're doing at Allina and
really how you're thinking about the future. But
before we dive in, can you introduce yourself
and tell us just a little bit about
your background?
Yeah.
Happy to. I'm an, interventional cardiologist here at
the Minneapolis Heart Institute, Allina Health.
And as you probably know, some of us
specialize a little bit in, structural heart disease.
So most of my practice, I would say,
sixty, seventy percent is probably structural heart disease,
which,
includes the,
valve interventions like, say, MitraClip,
Pascal,
TAVR
devices, tricuspid replacement devices, pulmonary replacement devices,
watchmen,
these kind of interventions.
I'm also, a director of the,
fellowship program, so I'm always,
at the pulse of what, the younger folks,
are feeling right now and in which direction
they wanna go when they apply to our
fellowships, interventional and structural,
and, yeah, have some administrative roles, here in
our practice too.
My my history is that I actually trained
in Germany first,
and then I did some training in United
States at the Mayo Clinic,
and this is my, second, private practice or
academically oriented private practice appointment.
That's fantastic to hear. You know? And interesting
to
understand that dynamic, what's leading the fellowship and
having your,
figure on the pulse of what some of
the up and coming generation and newer training
physicians are thinking about. What have you noticed
over the
last, couple years? Is there any trends or
or things that,
have come up that are different than they
were in the past?
Yeah. I I think that,
we in our training programs,
we we certainly have
seen an impact of, for example, the, COVID
pandemic.
There was some impact on training.
I would say we have observed a little
bit less,
independence
of,
trainees coming out of that,
you know, two, three, four years
than than we saw before.
There is, I think,
the
current trainees often try to cover multiple
subspecialties
during their fellowships
and may, you know, be a little bit
of undecided or unfocused
on, you know, their training trajectory,
where, you know, years ago, we have seen
folks, you know, clearly
voicing the interest in structural heart disease. We
can sometimes now see folks saying, like, oh,
I'm also interested in advanced heart failure or
always interested in advanced
coronary procedures.
And I always find that very difficult to
accomplish.
And I think due to the
job market being a little bit more uncertain
than it was years ago,
my feeling is that some,
fellows or trainees are trying to cover
as many subspecialties
as possible to actually, you know, have a
maybe competitive advantage over other applicants
where I think most of us still feel
like if you focus and follow one passion,
you probably have a better success.
That makes a lot of sense. You know,
it's just fascinating to hear about those trends.
And speaking of trends,
what are some of the top three or
so that you're following in health care right
now? What's top of mind for you and
and some of the big priorities you're thinking
about heading into the next year?
Yeah. I think one of the,
exciting
things or trends for me is certainly in
for many people,
artificial intelligence and how that is integrated in
our daily practice. I mean, there's so many
exciting,
studies or exciting projects out there in our
field. For example, how much information can you
get from an EKG alone,
in order to make even therapeutic decisions on
patients or finding
undiscovered
disease processes.
But I also find
artificial
intelligence simply in our
daily operational efficiencies very interesting. And that's I
think I'm even more interested in that.
What I mean by that is, for example,
we integrated,
about a year ago, Ambient AI into our,
clinic visits.
And I have to say that that for
me was a game changer.
Obviously, the notes are not maybe as personal
as,
they are when I dictate them personally,
but I find the value that I,
give to the patient by simply extending my
visit time by sometimes five, ten, maybe even
fifteen minutes
is
definitely
compensating for maybe a note that is not
as
nicely written than than a personal dictation.
The summaries are excellent.
I can literally leave my
patient room, and within a minute, my note
is written. It is such an
effective, efficient,
tool that I now have at my hands
at my iPhone, basically.
Yeah. And in in addition to the ambient,
artificial intelligence,
I hope that further tools that are similar
to that could
help us in our daily practice as well
to make, patient visits
and all the work that comes with it
after,
much more efficient. So I'm I'm really excited
to see,
more
integration of,
artificial intelligence in our operational
efficiencies. I'm excited about about that, I think,
very much.
Absolutely. I and, you know, as AI is
so interesting,
especially looking about technology,
and and what it could potentially do. For
you as a a physician, what are some
of the considerations
that you have to think about both on
the opportunity side as well as the risk
side when you're bringing more AI into the,
clinical practice?
Yeah. I think we,
you know, I think that, we
struggle with, efficiencies. Right? I mean, on a
daily basis,
for example, in our health care system, we
still
do a lot of manual processes when we
try to do schedule optimization,
for example, cath lab or the operating rooms.
And I think that with the limitations in
staffing, for example,
and the increase in volumes of,
certain procedures,
that those kind of operational efficiencies,
especially scheduling,
are,
you know, immense opportunities where I think, you
know, artificial tensions or at least,
you know, processes like this can can help
us. Where manual processes are probably,
you know, not effective enough.
The danger, of course, is if you,
integrate
artificial intelligence in more,
or gets it closer to
patient care. Obviously, the concern is always,
the control,
of the artificial intelligence outcome or the analysis.
And I understand that patients have concerns there,
and I think that
every health care system has to obviously,
provide,
safety security there if, you know, AI bots
are inside the,
electronic medical records,
helping with such efficiency that we don't, you
know, lose any,
patient safety
or data safety. And I think that's still
certainly a concern,
but I think the opportunities
are immense because,
overall, I think health care systems
need help in order to,
create the most efficient system and more most
effective systems.
Otherwise, we will not be able
to cope with the patient volumes,
appropriately.
That makes a lot of sense.
Fantastic to kind of think through all of
those things. I know there'll be a lot
of work around that, heading into the next
couple of years or so. Are there any
other trends that you're thinking about or following
right now or anything that you're really excited
about?
Yeah. I mean, I I think,
and I think maybe last year we talked
about that already. I'm I'm still very much
excited about the trend,
towards,
the value based care.
And maybe some people,
say patient first care. I think those are,
other words being used,
also.
We know that there's,
obviously
a big payer shift towards value based care
and maybe even towards
capitation.
I think
that that are,
in that shift, there are great opportunities,
also
great risks for health care systems because they
may not have the data integrity or data
granularity
to, you know, compete on that level yet.
And I think we approached that last year
as well, but I I still think that
in that process of really being patient focused
and value focused,
that there are great opportunities
for us to
select
the the appropriate interventions and treatments for patients
that create the greatest value for the patient.
And, hopefully,
both on the payer side and the health
care system side,
we see a win win situation.
I'm still excited about that, and, working in
in on those
value based care systems and contracts, I think,
for me personally, is is is an exciting
trend still.
Absolutely. That's amazing to hear. And, you know,
I I love that kind of,
analysis of how we're thinking about value and
what it really means for the patients and
and bringing the patient front and center into
everything that you're doing. I think, you know,
as we look at this evolution, how do
you see things playing out over the next
couple of years or so, especially given some
of the exciting things that are happening, being
able to collect more data and have more
information on patients as well as, you know,
the the real drive in health care across
the board to have better quality as well
as figure out how to lower cost in
a smart and meaningful way. Do you see
this effort accelerating, or where do you see
things headed?
Yeah. I think,
you know, when I, for example, started my,
masters of healthcare administration training about, you know,
two and a half years ago, when I
had my first
kind of interviews,
with folks who are in the midst of
administration,
I always sensed a great fear of this,
you know,
word value based care because people feared
that health care systems did not have enough
data
to actually compete on that level. Right? They
did they just didn't know
what the outcomes of patients, what the cost
that they incur actually are because sometimes that
granularity is not there. And over the last
two and a half years or so, I
I sense that there's
more excitement, maybe also, of course, of forced
excitement, but there's more excitement of having
that granularity
and getting closer to,
the goal of actually providing
enough data to compete on, for these value
based care contracts, but also,
maybe even advancing it further where you say,
well, are we are we getting to contracts
that are more even on a on a
capitation
level? So I think that
the the sense I have, and I'm obviously
not in the midst of administration, but I'm
very clinically focused right now still. But I
think that I can sense within the physician
groups, but also in the administrative group, that
there's this a more,
let's say, excitement, but also adaptation
of that process. And I hope it will
continue, and I hope and that because the
like you just pointed out, the the most
important thing here is, yes, we need to
have healthy health care systems that survive. That's
a very important aspect of it. But I
think
with that trend to value based care, patients
will have a better experience because it's not
the focus on fee for service. The focus
should and will be
their
outcomes, their experience, and the selection of therapies
that lead to that goal. And I think
it will take a long time. It has
been already a long time, but I can
sense at least that more and more
physicians and patients,
follow that trend.
That's fascinating to hear. Thank you for digging
a little bit deeper there. Now before we
wrap up our conversation, how are you thinking
about growth over the next twelve months or
so?
Yeah. I think,
that's a very good question. Right? And then
and and maybe I, focus a little bit
more here on, you know, my subspecialty
in structural heart disease because,
structural heart disease with the interventions that we
mentioned in the beginning
is projected
to see a lot of growth in the
next
two, three, four years. Many of the
procedures that were initially in trials and studies
are now commercializing.
We can talk about tricuspid valve interventions
like
the Evoque valve. We can talk about
many TAVR devices.
We can talk about,
devices
that, lead to therapies on the mitral valve.
We have many commercial products on a congenital
side of things.
All of this has now,
developed or
has surfaced in the commercial side of things
is is out of trials.
And I think we expect, of course, that,
many and we see that that many referrals
are now gonna come in to treat patients,
with these major valve diseases and and most
recent
studies with us here, but also,
the most recent, study,
shown at TCT shows that valvular heart disease
is is is
a growing problem,
and it's probably underestimated
and not treated early enough. So, overall, I
think the projections are pretty clear. Structural heart
disease,
glabular heart disease is will see growth.
In that, though, we also have to make
room. Right? We have staffing issues. We have
only so many slots to see patients in
our clinics. We have only so many slots
to treat patients in our,
cath labs.
And for that, I think the trend of,
what we, for example, do it here at
the Minneapolis Heart Institute is, to create,
space and and volume shifts into our ASC.
We have an ASC. We were one of
the first ones who adopted it. And I
think that,
trend
is another maybe trend that I'm excited about,
but also to see a shift from, you
know, lower acuity
interventions
from the hospital setting into the ASC and
then providing more space and slots for the
higher acuity interventions and more,
you know, time consuming interventions that are usually
structured interventions.
I think creating that, I wanna say, operational
efficiency,
using the ASC efficiently to shift
and focus
on higher intense
interventions here in our hospital, I think it's
also very,
exciting trend.
That absolutely is fascinating to hear and especially
looking at,
how more things can go into the outpatient
in the ASC. And, it's just been really
cool to see more cardiology in that space.
Doctor Gossel, thank you so much for joining
us on the podcast today. This has been
a a really fantastic conversation, and I look
forward to connecting with you again soon. Thank
you so much, Laura.
At athena Health, we know your ambulatory practice
wants healthier,
a healthier business, healthier care teams, and healthier
patients.
But the complexities
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.