This is Laura Dierda with the Becker's Healthcare
podcast. I'm thrilled today to be joined by
doctor Samuel Jones, who is the director of
inpatient EP services at the Chattanooga Heart Institute
Memorial Hospital. Doctor Jones, it's a pleasure to
have you on the podcast today. Thank you,
Laura. Looking forward to it. Absolutely. Now I'm
excited for our discussion to dig a little
bit deeper into some of the cool things
that you're doing at the Heart Institute. I
think certainly it's such an important time and
interesting and innovative time for heart care. But
before we do that, can you introduce yourself
and tell us just a little bit more
about your background?
Yes. I'm Sam Jones. I am a clinical
electrophysiologist
here at the Chattanooga Heart Institute with Memorial
Hospital,
and I've had a few roles over the
years. I've been,
in the service line,
EP for common spirit health for several years.
And then I've had various roles within the
American College of Cardiology
focusing on some of our registries, quality improvement,
advocacy, as well as strategy.
Overall, it really kinda fits into the niche
and things I'm interested in, including
how we're going to transform care.
ASCs are something that we've been looking at
very carefully that we may talk about more
today. Certainly, how we're gonna adopt AI is
something I've been following. And then just overall,
the future of our specialty.
Absolutely. You know, and that's a lot a
lot to cover, but I think we'll dive
right in here. So what are the top
three trends that you're focused on right now
in health health care as well as heart
care, thinking about ASCs? We just love to
hear some of the big things that are
on your mind today.
I would say the first one that I
think everyone in medicine is really worried about,
especially in cardiology, is workforce,
which really means access for patients.
Because right now, we have the epitome of
a supply demand mismatch, meaning that we've got
a lot of patients who wanna see us.
We've got patients that are getting older, and
they're just sicker. We've never seen patients quite
like this before. They've got more chronic diseases,
so they take up a lot of time.
There's a lot of complexity there. And with
all of this supply,
with all this demand that we're having of
these patients coming, how are we gonna actually
address it? Because
we may just not have enough clinicians, at
least in our current model, to take care
of it. They talk about within cardiology right
now that we're kinda shifting older.
We've got a gray tsunami. In other words,
all the gray hairs may not be around.
In 2019,
they said twenty seven percent of cardiologists
were over the age of 61.
And so you've got a lot of cardiologists
that are getting ready to retire, unfortunately.
Now that would be okay if we had
the training pipeline to accommodate for that. But
every year, we don't have enough coming out
of training
than we do that are gonna be leaving.
And the pathway
to get to being a cardiologist or to
be and being other subspecialists within cardiology is
just so long. It takes a while for
us to even, address that. Right now, they're
saying that we're probably gonna lose about 547
cardiologist every year just because those that are
leaving and those that are coming in. So
I think that's a big thing that we're
gonna have to we're gonna have to really
think about how do we address this problem.
The second thing I would say is is
AI.
Probably, there's not a a talk that you,
hear right now that AI isn't part of
that. But I think AI is not just
the the image acquisition. This is one of
the things in cardiology that we have it
doing so much for us in the imaging
space. But, really, it's gonna be how can
we use it in other things? How can
we use it to address some of these
workforce issues? And that could be with some
of our documentation, whether that's with ambient
AI scribes,
care navigation.
I think scheduling is something that can really
be used for,
triage. And so there's a lot of administrative
type functions for AI that we're gonna be
able to use as well as just clinical
decision support.
And,
if we do that right, then maybe we
can
help with some of the workforce issues just
by getting everyone to really focus at the
top of their license as part of the
cardiovascular care team. So that's gonna be a
big thing, but making sure that we're also
watching AI very carefully.
And I think the third thing is just
a transformation that we're seeing across all medicine.
One time, especially in cardiology, we were tied
to the hospital, and everything happened within those
walls of the hospital. But But that's no
longer gonna be the case, and we're seeing
sort of a transformation and a translocation
of care that's gonna go out. We mentioned
ASCs already, ambulatory surgery centers. We've seen that
happen in other specialties, whether it's with,
gastroenterology
and orthopedics and all of those same things,
those same principles
for why things are moving out of hospital
will happen in cardiology as well. So how
do we do that? How do we make
sure we're doing that in a in a
safe way? Because it can't just be about
making sure that we're we're saving money across
the board, although that is a big part
of it. But how are we actually expanding
access
and the experience for the patient?
And in that same area of care transformation,
it's gonna be more use of telehealth.
It's gonna be using more diagnostic rhythm and
device care to help us really get to
patients really where they are rather than have
them come to us.
I love that. I think all of three
things you talked about are critical, whether it's
in the workforce transformation and access to care
for patients, thinking through how
AI can help address some of those issues,
but also understanding
what it the risks are involved and how
you can smartly integrate that more broadly into
cardiovascular
care teams. And then finally, looking at that
transformation across all medicine going into the outpatient
setting, I think it's
cases into that space, it seems like,
you know, you're not meeting some of the
goals in terms of quality and value and
and bending the cost curve in health health
care and more, and then really working smartly
with the the teams that you have. And
so I I think that's a really interesting
analysis and overview. And, you know, if we
were to, dig just a little bit into
the workforce,
trend you mentioned,
How do you see,
realistically, the impact of losing that five hundred
to seven hundred cardiologist,
you know,
coming through to retirement,
you know, over the next several years? Like,
how are you proactively thinking about that, and
what does the field need to do in
order to, make sure that, you know, you're
in a place where people can still get
the the care that they deserve?
Yeah. This is gonna be a big thing
that cardiology has to address, and I think
it's gonna be a multi pronged approach because
you might just look at it and say,
let's just train more. Let's just open up
a lot of spots. Well, that's not really
how it works, and that's not how how
GME works. While there are some things that
we can probably do, as I mentioned, because
the pathway to become a cardiologist is so
long for training, that that's gonna take a
long time if we can even do that
at all. So there may be some things
within education. Are there ways in which we
can shorten some of that training? Can we
remove some of the barriers so that we
can do that? So that's one thing. But
I think it's important to know it's not
just about the physician. It's about the entire
care team. And I think in cardiology, we're
really blessed more more than any other specialty
that we have really embraced that idea
of how do we use everyone working at
the top of their license. And this is
gonna be critical because without that, we really
have no hope for it. Even within that
cardiovascular
care team, though, we need to redesign some
things, and we need to make sure that
we understand what are the care pathways
that we can utilize to really become more
efficient in the care that we're given. How
can we use the technology
that's coming on board so that that's helping
patients as well? How can we get to
more virtual diagnosis with patients with telehealth
and some of the other things that are
becoming available with technology? So it's gonna have
to be a multi pronged approach,
definitely looking at the training pathway itself for
cardiologists,
using the cardiovascular care team to the top
of the license,
instituting the technology and AI in other ways
that we haven't done before.
I love that. That makes a lot of
sense. You know, it is really helpful to
understand the big picture problem and then some
of the things that you're doing in in
in the field is doing in order to
prepare for the future. Now
speaking of,
just kind of some of those activities, what
are you most excited about right now? What's
really,
exciting for you as you think about what
we're able to do today in in the
cardiovascular
space and what's ahead?
Yeah. I think there's a lot to be
excited about, and you don't always get that
message from people, but it really is.
Right now, we're living in a phenomenal time,
and there's,
while there's the the burden is great, I
think that the opportunities then just are gonna
keep showing themselves more and more. Part of
that's just innovation,
and what we're seeing across the care pathways,
how we're able to do things in cardiology
with our procedures
quicker,
safer, and not always requiring the, the same
need to be in the hospital and ship
those out. So that innovation itself is gonna
be phenomenal.
I think the entire artificial intelligence, though, is
gonna showcase things that we haven't even dreamed
of about how that's going to do. Now
we're gonna have to monitor that carefully. So
while I'm excited about it, I have to
admit that I'm also a little bit concerned
to make sure that we understand what that
AI is gonna do for us.
And then just looking at
the efficiency
and the experience that we're delivering to patients.
I think this is something that people are
starting to realize.
We have to do this better for patients,
And we're gonna find that with some of
the translocation of care outside the hospital, this
has become a premium on making sure we're
providing that service to patients. In the end,
patients can definitely be served better with all
of those things. So the main thing I'm
excited about is just the innovation, whether that's
not just from the technology, but just from
the overall care delivery of pathways. How do
we institute our cardiovascular care team? How do
we institute telehealth to really transform this into
something that's gonna be a better system for
patients?
I love that. And that's certainly an inspiring
message when you think about how you can
do things that you've never thought of before,
and truly
make that experience and the patient journey,
much better. And two, some of the outcomes
and quality of care, I can imagine, are
ways that you can improve some of that
those things with AI too. Is there anything
you're doing at the Heart Institute right now
that, you've been just overcome by some of
the results or have been really excited by
some of the results?
Well, we do,
have a lot in the imaging space that's
going on, and I think that this is
something where we're seeing by
leveraging
some of the technologies that's come out, we're
able to get the right patient to the
right place at the right time. And and
what I mean by that is really in
the world of interventional cardiology.
You know, before, we would have a lot
of patients that would come to the cath
lab and get a diagnostic catheterization,
and it turns out they did not need
a stent. We didn't know that until they
had a heart catheterization.
But because of some of our CT workforce
issue, we've been able to actually have patients
get a noninvasive test.
And what's what we found with this is
that by doing this in a in a
very designated way, we have a champion who
watches carefully how we're doing with all these,
are we putting the right patients into the
CT scanner? How are we adjusting our flows?
And with all of that, we're actually having
less patients
go to the heart catheterization laboratory.
But that's okay because a greater percentage of
them actually get an intervention. They get a
stent. And so I think that's where we
need to go overall as a field. We're
trying to find out how do we get
the patient the right procedure at the right
time. And by leveraging that technology,
we're absolutely doing that. And so I think
that's gonna be one of many things that
we find that we can we can continue
to do.
Overall, like a lot of people, we're also
looking at how do we get more continuous
care going on, what do we do with
hypertension management,
lipid management, rhythm management,
all of those things that patients now have
access to at their home. We're not having
to wait for them to come in. We
actually can get some of that data sent
for us so that they're getting a more
continuous pathway of of care delivery.
That's helpful to understand, and thank you so
much for, digging deeper into that example. Before
we wrap up our conversation,
are you thinking about growth over the next
twelve months or so?
I think for everyone, it's it's a big,
issue.
Growth, though, can't just be about how many
more procedures are we doing, all that, but,
again, smarter pathways. And I've I've mentioned that
a few times, but I really think that
that's critical because
the new center of excellence
can't just be, what it used to be.
I think it's gonna have to be efficiency
of care to really make sure we're getting
the right thing for for the patient at
the right time.
So that comes down to access,
shifting care where it belongs at all times,
and making sure it always stays patient
centered. We're gonna continue
to use a lot of the new technology
and AI to do it, but we have
to make sure that when we do that,
we're still keeping the clinician front and center
with all of those things, that we're not
outsourcing this to,
artificial intelligence that is making the decisions for
us. You have to know who is responsible,
and we can't be dependent upon it. We
still have to drive that. And I think
that's what's gonna be really critical for us
as part of our growth strategy.
I love that. Doctor Jones, thank you so
much for joining us on the podcast today.
This has been a really fantastic conversation. I've
learned a lot, and I look forward to
connecting with you again soon. Sounds great, Laura.
Thank you for the time.