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R one is the leader in health care

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performance through smart orchestration.

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With more than twenty years of experience, r

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one partners with 1,000 providers,

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including 95 of the top 100 US health

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systems and handles over 270,000,000

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payer transactions annually. If you want to learn

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more about how you can transform your revenue

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cycle operations, visit us at wwwr1rcm.com.

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Hello, and welcome to the Becker's Healthcare podcast.

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My name is Will Riley from r one.

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I'm joined today by Lisa Tank.

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Lisa is president and chief hospital executive

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at Hackensack University Medical Center, part of Hackensack

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Meridian Healthcare.

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Welcome to the podcast. Thank you so much.

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Thank you for being here. Thank you for

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having me.

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Alright, Lisa. Well, to start us off, tell

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us a little bit about your role. Tell

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us a bit about, Hackensack University Medical Center.

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Absolutely. Thank you. So once again, thank you

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for having me.

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I'm Lisa Tank. I am a geriatrician,

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a board certified internist, and a board certified

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geriatrician,

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and,

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I'm the president and the chief hospital executive

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at Hackensack University Medical Center.

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Hackensack

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has been my home for about twenty five

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years. I trained there as a fellow. So

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I have grown in that institution, and the

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institution has become a large academic

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institution within the Northern New Jersey market.

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It is the academic flagship for Hackensack Meridian

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Health.

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It is a robust tertiary quaternary center, and

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it continues to thrive within a community that

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is highly competitive and a market

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that is highly,

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motivated,

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to perform

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the highest level of clinical care and very

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competitive in The US news market too.

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Tell us a little bit about the the

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the community around you. You're in Northern New

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Jersey. You said it's competitive from a health

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care perspective, but what's the demographic like? What

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what what's the what's the surrounding area? Absolutely.

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It is one of the

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you have the two largest airports,

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within that area. So you have the Newark

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Airport and, JFK

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within

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couple of miles. So there is a highly

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diverse community and highly,

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populated community, pretty dense.

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But I think the most important thing, I'll

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tell you is it's one of the most,

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popular counties to retire in. So you have

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a large

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aging

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population, with a high mix of

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patients living at home independently versus assisted living,

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independent living. So it has a quite

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a diverse age group too. And that's a

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critical part to remember as we deliver as

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we deliver health care across the entire continuum.

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Fantastic. Okay. That's great. And we're gonna come

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back and talk a little bit about patients

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and how you maintain patient's interest in that

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kind of environment later on. Let's talk first

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about technology,

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if we can. So, I mean, historically, health

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care has moved

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fairly cautiously,

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around new technologies and adopting new technologies. Right?

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Health care doesn't seem to have necessarily been

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a leader in many waves of technology.

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But,

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I'm curious whether you think that's the same

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with

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AI because it feels like, potentially, it's different.

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Can you talk about that a little? Yeah.

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I think you're absolutely right. Healthcare has always

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been a bit cautious and, sometimes I think

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lagging

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in terms of technology, but AI has revolutionized

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that.

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So if you look at health care currently

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with AI adoption,

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the

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end end consumer is health care. Right? And

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it is going to double

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into billions. Absolutely.

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So I think I think AI is a

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critical piece,

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and health care has understood now that anything

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to do with

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safety, quality,

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seamless cost efficiency. So I always come back

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to the quadruple aim. So the quadruple aim

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is really focused on couple of things. Right?

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This was something that was introduced by IHI

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in the February,

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and it focuses on patient experience.

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How are you going to deliver the best

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patient experience? Yeah. Second is how are you

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going to manage population health? That's chronic disease

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management

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and focused on predictive analytics.

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Third part about that is how are you

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going to deliver cost efficient, you know, value

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based care. Right? And now the fourth component

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is how are you going to focus on

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the well-being of your entire team, your workforce.

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So if you look at that, AI is

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a critical part of that. AI is embedded

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within those and it layers in your foundation.

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And what it tends to do is it,

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number one, streamlines administrative

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tasks

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and it optimizes clinical models.

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So if you combine those two together,

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what you have is a great focus on

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patient outcomes. Yes. I think that's why AI

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is taking on a whole different role.

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But I don't know if we are gonna

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touch on this, but one of the critical

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pieces that we have seen at Hackensack Meridian

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Health is we were one of the early

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adopters in AI.

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And what we did is as we developed

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AI, we created a governance model. And that

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governance model is already set up initially

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as soon as there is any project intakes.

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So if I have a great idea, it

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might be a great idea for me. But

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how are you going to have those guardrails

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embedded?

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And,

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what we've done is is a multi professional

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model. There's ethics involved.

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There's clinics clinicians involved. Legal is involved, compliance,

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etcetera. So what you are able to do

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is really deliver the highest level

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of evidence based care

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with

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AI modules built in

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with the governance structure. So you are always

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on point,

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and you're always,

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you have somebody watching that Yeah. Or not

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slipping or there is no what we call

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is a drift or variation.

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Sure. I wanted to yeah. It's I'm glad

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you went there because has it been difficult

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to get that governance system set up? I'm

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curious about whether it's required new skills or

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new ways of working or thinking, whether it's

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been a challenge to implement in the c

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suite, for example, at the health system, or

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has it do you feel like it's just

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evolved fairly fairly naturally as an extension of

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what people are already doing and thinking about?

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Yeah. I think I think it boils down

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to the culture of the institution you are

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in, Okay. It boils down to chain management.

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So if you are early early adopter and

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you are able to think through and be

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nimble and flexible enough

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to understand that if you are not going

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to have the guardrails, you're probably going to

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land up in a lane that is probably

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not

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safe for your patient

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and not conducive for your clinic for your

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clinicians to deliver health care. Uh-huh. So I

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think one of the things that we did

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upfront was

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we wanted to launch into

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AI,

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but we understood

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the risks with it. Mhmm. And we also

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wanted to take away the anxiety from all

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our, team members that this is not here

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to replace you. This is absolutely something that's

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going to be able to support you.

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And,

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I think that's that's how it all came

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about. Right? Okay. Yeah.

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Excellent. Continuing on the theme of of innovation.

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So in in health care innovation,

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you often hear about two sort of archetypes,

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incumbents

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like the large established health systems like you

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or established payers or or established, like, legacy

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vendors,

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right, who kind of power the landscape and

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control the data and the infrastructure and so

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on. And then new entrants, insurgents. Right? People

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coming in and changing the game and rewriting

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the rules and so on. Do you have

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a

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a point of view on how you see

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that dynamic playing out around the adoption of

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AI?

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Yeah. I think one of the things that

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we focused on,

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earlier on in Hackensack Meridian is we brought

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AI within our own

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infrastructure.

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So rather than working with vendors,

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we developed it within our infrastructure. So what

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we did is we took our EHR, which

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is Epic Yep. And built that AI platform

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within it. So for a great example is

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really thinking through clinical workflow.

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We build the algorithms and decision making

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absolutely in real time and at point of

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care. So what that did is it allowed

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the,

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clinicians to really be able to streamline their

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processes and engage with the patient.

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But what it also did is it actually

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made them change champions.

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And they started embedding the workflows

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much earlier on compared to other institutions.

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Right. So I think working with vendors is

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important, especially if you have a skills if

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you don't have a skill set Uh-huh. That

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they can bring to the table. But if

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you can develop it within your institution, which

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understands the culture.

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So our DTS team, that's our digital transformation

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teams, have been able to do that. So

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we recruited highly skilled professionals that had the

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experience in AI. We're able to That's interesting.

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And and you're able to do that and

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and have them want to come and and

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work for you a a large

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Yeah. Traditional,

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for want of a better word, health care

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provider. But I think the secret to that

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really is,

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and this is something I've learned in my

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journey as I have developed,

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at Hackensack,

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is how do you bridge the clinic clinicians

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with the operational?

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So one of the things I tell my

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residents and my students and

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folks I work with, my peers is, if

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there is a patient in that lane,

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that's your lane, irrespective

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of if you are in the operational track

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or you're on the clinical track. K. And

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what happened with AI

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and folks who came in were they were

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clinicians,

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and they have now developed a training or

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some form of specialization

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in AI. So what that really did is

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really brought those two areas together Yeah. And

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created a very

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high performing,

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workforce,

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that focused on outcomes. Right. I see. And

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you've talked a little bit about

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making things better from a clinical perspective and

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from an administrative perspective. Absolutely. So perhaps you

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feel that that that way of doing it

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is allowing you to get at that. Absolutely.

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And I think I think they're very connected.

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So Yeah. If you look at

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you know, I get asked this question all

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the time. Where are you

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where are you applying AI? Yeah. You're applying

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AI.

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So if clinically, if I'm applying AI, we

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are always applying AI.

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As clinicians, you want to know earlier on

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who is at risk for what.

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So if you already have the data, it's

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it's big data.

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Yeah. So if you embed that,

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AI in your EMR or EHR as we

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call it,

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you can understand who what we call is

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predictive analytics. Right? So you will know exactly

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who, at what age,

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which demographic is likelihood of developing. I'm just

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using example for diabetes.

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Right?

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And that's what you wanna know. And once

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you know earlier on, then you can develop

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the resource allocation towards that population.

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And the third part about that is you

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can have targeted therapies.

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Yep. Right? So you've already created a model

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and a macro environment that is cost efficient

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and sustainable Yep. Rather than throwing everything at

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a patient and

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hoping something sticks.

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And administratively,

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what we've done is we've really created models.

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For example,

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Hackensack University Medical Center, we are the fifth

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busiest ED in the country. Right? Emergency room

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in the country.

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What's the most important thing to me is

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throughput.

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How do we get patients

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through safely?

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So what AI has helped us administratively and

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taken the burden off the teams

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is create

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a a model that has predictive analytics built

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in when we are going to have the

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maximum amount of patients coming through the ED.

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How do you triage them and then build,

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staffing model on top of it and really

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create a streamlined process so you are getting

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the maximum productivity and the highest efficiency

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and best outcomes.

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Fantastic.

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Staying on the administrative side of a little

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bit Mhmm. Maybe looking more at the finance

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aspects of administration,

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but not solely there.

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We're used to thinking of health care administration

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being quite labor driven,

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labor centric

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with sort of technology

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support and tools and and aids and things

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like that. Right? But it but it feels

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like that is starting to shift and that

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with a a data centricity, for example, a

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focus on analytics and so on, that actually

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a lot of work can now be done

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through a technology first paradigm rather than a

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labor first paradigm.

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Do you see that playing out for you,

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and what are some of the implications of

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that? I think absolutely. I mean, one of

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the first places we saw it, with data

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and,

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AI again, you know, you can't use a

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say a sentence without AI anymore. But what

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it has done is in radiology.

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Right?

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K. It is tough to recruit radiologists.

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They are they are not as many radiologists

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that you would like. And radiologists

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have a lifestyle that they do quite a

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bit of work remotely.

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So what we did is

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give them those tools so that

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they can take large amount of data and

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process it with AI and with multiple data

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points and streamline it and create a module

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for them where they can have decision making

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in real

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time. Because in the past, what would happen

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is they would have to go back and

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do a second read and a third read

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and verification. Now you can do that together.

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So if you look at the labor costs

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versus

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the efficiencies with you have achieved with the

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data and analytics,

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they've been able to manage with not that

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large of a recruitment process, and they've been

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able to retain people because the work life

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balance has been better. Got it. So I

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think it's a it's a win win on

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both ends. Yeah. But I'll come back to

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the same point I always tell the team.

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You have to make sure it is patient

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centric. It has validation built in. And as

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you just mentioned to me, it has quality.

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The QI piece, really embedded. Yeah. Okay. Constantly

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querying and doing quality,

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you know, evaluations and performance.

387
00:14:57,819 --> 00:14:59,839
So you've talked about providing,

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new new solutions that help clinicians and physicians

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do their job well, that reduce administrative burden.

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You're bringing it back to the patient. Like,

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what what does all this mean for the

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00:15:11,579 --> 00:15:13,995
patient, for you? And and perhaps with an

393
00:15:13,995 --> 00:15:16,475
eye on the very competitive market that you're

394
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in where you have to stay ahead?

395
00:15:18,954 --> 00:15:21,034
I think it boils down to one only

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one thing. It's patient experience. Right?

397
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As they always say,

398
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everybody remembers how they were treated.

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00:15:28,820 --> 00:15:29,220
And,

400
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were you able to

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00:15:31,860 --> 00:15:34,500
speak to the patient in their what we

402
00:15:34,500 --> 00:15:36,440
call is not in the medical speak,

403
00:15:37,220 --> 00:15:39,540
really simplify it for the patient. And I

404
00:15:39,540 --> 00:15:42,179
think I think the biggest advantage, I'll tell

405
00:15:42,179 --> 00:15:44,605
you, through all this and the purpose we

406
00:15:44,605 --> 00:15:47,644
all do what we do is empowering the

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patient.

408
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Empowering the patient to be able to have

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insight and access, right, to their,

410
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to their information

411
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and have a partnership with the providers

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because we are in for the long run.

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And as you know, health care is moving

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00:16:04,120 --> 00:16:04,700
from a

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four walls of a hospital going into a

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00:16:07,720 --> 00:16:10,519
outpatient setting and a home setting. And our

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00:16:10,519 --> 00:16:12,200
goal is to really make sure that that

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00:16:12,200 --> 00:16:14,745
partnership it's not a sprint for us. It's

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00:16:14,745 --> 00:16:17,304
a partnership through the entire continuum, and we

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00:16:17,304 --> 00:16:19,565
wanna make sure that our patients trust us.

421
00:16:19,945 --> 00:16:22,424
So that's the foremost thing that's important to

422
00:16:22,424 --> 00:16:24,285
me. You know, North Star. Absolutely.

423
00:16:25,625 --> 00:16:27,304
Is there anything else, Lisa, that you want

424
00:16:27,304 --> 00:16:29,809
to to add before we before we close?

425
00:16:29,809 --> 00:16:31,490
Anything else on your mind as you think

426
00:16:31,490 --> 00:16:33,330
about next year, for example? Or

427
00:16:33,730 --> 00:16:35,250
I think I think it's all going to

428
00:16:35,250 --> 00:16:36,149
be about access.

429
00:16:36,529 --> 00:16:38,769
It's going to be about taking the care

430
00:16:38,769 --> 00:16:39,669
to the patient.

431
00:16:40,144 --> 00:16:41,664
All patients are not going to come to

432
00:16:41,664 --> 00:16:43,044
your come to the hospital

433
00:16:43,745 --> 00:16:45,205
and really leveraging

434
00:16:46,144 --> 00:16:47,605
all the different technologies

435
00:16:47,904 --> 00:16:50,485
and access points like telehealth, tele ICU,

436
00:16:50,865 --> 00:16:52,784
and all institutions are not going to be

437
00:16:52,784 --> 00:16:54,669
able to do that high level of care

438
00:16:54,669 --> 00:16:56,429
because the key is how are you also

439
00:16:56,429 --> 00:16:57,329
going to have

440
00:16:57,709 --> 00:16:58,690
financial sustainability

441
00:16:59,389 --> 00:17:01,149
and continue to evolve and,

442
00:17:01,709 --> 00:17:04,190
transform. So I think I think it's going

443
00:17:04,190 --> 00:17:05,089
to be a multifactorial

444
00:17:05,549 --> 00:17:06,049
way

445
00:17:06,349 --> 00:17:09,089
of providing health care in a different market.

446
00:17:09,684 --> 00:17:11,525
Lisa, thank you so much for sharing your

447
00:17:11,525 --> 00:17:13,285
thoughts today. I really appreciate it. It's been

448
00:17:13,285 --> 00:17:14,724
fun talking to you. Much. Thank you for

449
00:17:14,724 --> 00:17:16,345
having me. Thanks. Thank you.