1 00:00:00,060 --> 00:00:03,640 Would you like to exchange best practices and ideas to improve care, 2 00:00:03,790 --> 00:00:05,520 enhance operational efficiency, 3 00:00:05,580 --> 00:00:07,960 and address financial challenges with your peers? 4 00:00:08,600 --> 00:00:12,400 Becker's Healthcare is facilitating these conversations at their eighth annual 5 00:00:12,580 --> 00:00:15,240 health IT digital health and R C M meeting. 6 00:00:15,580 --> 00:00:19,560 You can check your eligibility for complimentary attendance at the link in the 7 00:00:19,560 --> 00:00:22,040 description. We are excited to welcome you in October. 8 00:00:22,630 --> 00:00:25,080 This is Laura Dedo with the Becker's Healthcare Podcast. 9 00:00:25,740 --> 00:00:27,880 I'm thrilled today to be joined by James Linn, 10 00:00:28,150 --> 00:00:32,120 executive director of Revenue Cycle Systems Optimization at University of Miami 11 00:00:32,140 --> 00:00:34,720 Health. James, it's a pleasure to have you on the podcast today. 12 00:00:35,530 --> 00:00:37,280 Thank you so much. Happy to be here, Laura. 13 00:00:38,060 --> 00:00:41,440 Now I'm looking forward to our discussion because I know that the revenue cycle 14 00:00:41,440 --> 00:00:43,960 is such an important area of any organization, 15 00:00:43,960 --> 00:00:45,680 but especially for hospitals and health systems, 16 00:00:45,700 --> 00:00:48,600 and there's a lot changing around the revenue cycle right now. 17 00:00:48,600 --> 00:00:51,840 Some very exciting things happening. So I'm looking forward to our discussion. 18 00:00:51,860 --> 00:00:53,400 But before we dive into my questions, 19 00:00:53,440 --> 00:00:56,280 I was wondering could you tell us a little bit more about yourself and your 20 00:00:56,280 --> 00:00:57,113 background? 21 00:00:57,230 --> 00:00:58,400 Yeah, absolutely. Um, 22 00:00:58,460 --> 00:01:02,520 so I've been at the University of Miami for about a year and a half now. Um, 23 00:01:02,520 --> 00:01:07,120 came down in October of 2021. But, um, in this role that I'm in today, 24 00:01:07,120 --> 00:01:10,440 sort of building a team of architects that works collaboratively between 25 00:01:10,440 --> 00:01:13,200 operations and it, um, to develop solutions, 26 00:01:13,430 --> 00:01:17,200 whether it's core revenue cycle or some of the ancillary administrative things 27 00:01:17,200 --> 00:01:20,560 that surround revenue cycle. Um, before coming to the Miami, 28 00:01:21,280 --> 00:01:24,560 I did work for Epic Systems, um, large E M R in the, 29 00:01:24,560 --> 00:01:27,480 in the healthcare space in Verona, Wisconsin. Um, 30 00:01:27,480 --> 00:01:29,840 had a privilege of working with a lot of health systems, um, 31 00:01:29,840 --> 00:01:30,840 throughout my time there, 32 00:01:30,840 --> 00:01:35,440 understanding various revenue cycle demands and revenue cycle needs, um, 33 00:01:35,540 --> 00:01:37,120 before making the jump over to Miami. 34 00:01:38,730 --> 00:01:42,740 Amazing. Wow, that's awesome to hear. And definitely from your time at Epic, 35 00:01:42,740 --> 00:01:45,900 you know, I know that's a huge organization and like you mentioned, 36 00:01:46,080 --> 00:01:48,980 I'm sure you connected with and touched on lots of different health systems. 37 00:01:49,320 --> 00:01:52,980 Was there anything that you consistently saw, um, with the systems that were, 38 00:01:53,240 --> 00:01:53,620 you know, 39 00:01:53,620 --> 00:01:57,940 kind of the top performing ones or those that were really able to adopt the 40 00:01:57,940 --> 00:02:01,060 technology in and move forward in the swiftest fashion? 41 00:02:02,320 --> 00:02:05,340 It sounds cheesy sometimes, but the an, 42 00:02:05,440 --> 00:02:09,780 the honest answer is those that truly put the patient at first. Uh, 43 00:02:09,780 --> 00:02:13,620 and I mean that in the sense that while obviously financials matter, 44 00:02:13,790 --> 00:02:17,820 while obviously everything around a health system is important, 45 00:02:18,310 --> 00:02:23,220 those that made their decisions and drove every single aspect 46 00:02:23,220 --> 00:02:25,380 of their business around the patient's experience, 47 00:02:25,450 --> 00:02:28,260 both medically from an administrative perspective, 48 00:02:28,410 --> 00:02:31,900 from a financial revenue cycle, statements, claims and billing perspective, 49 00:02:32,520 --> 00:02:34,660 if they use that as their true north, 50 00:02:35,110 --> 00:02:38,620 those are the groups that are consistently in the news of of being outstanding, 51 00:02:38,720 --> 00:02:43,220 the doctors of technology, outstanding industry leaders in other all aspects. 52 00:02:43,320 --> 00:02:43,700 It that, 53 00:02:43,700 --> 00:02:47,580 that seemed to really be the common thread because it allowed them to be, 54 00:02:48,520 --> 00:02:49,180 it allowed them, 55 00:02:49,180 --> 00:02:53,540 it opened them up and allowed them to be more focused on questions around, 56 00:02:54,320 --> 00:02:54,840 you know, 57 00:02:54,840 --> 00:02:58,860 what's best for the business through the lens of what's best for the patient. 58 00:02:59,280 --> 00:03:03,420 And if they focus on what's best for the patient, the business comes. Um, and, 59 00:03:03,600 --> 00:03:06,020 and I'd say that's probably the most common theme is, is, 60 00:03:06,080 --> 00:03:09,700 is making sure that the patient part was in the very forefront of their, 61 00:03:09,700 --> 00:03:10,660 of their decision making, 62 00:03:11,090 --> 00:03:14,500 both at the clinic clinical and clinician level all the way through the, 63 00:03:14,500 --> 00:03:16,100 the business and the administrative function. 64 00:03:17,120 --> 00:03:20,180 That's such a great point. Thank you so much for pointing that out, James. 65 00:03:20,480 --> 00:03:24,180 Now what are some of the opportunities that you're seeing from your vantage 66 00:03:24,180 --> 00:03:27,300 point at University of Miami Health as well as the headwinds that you have your 67 00:03:27,300 --> 00:03:28,133 eye on? 68 00:03:29,060 --> 00:03:30,240 So the University of Miami and, 69 00:03:30,340 --> 00:03:34,520 and not unlike other academic medical centers all across the United States, 70 00:03:35,260 --> 00:03:39,000 we pride ourselves on being, having the best faculty. And, 71 00:03:39,020 --> 00:03:42,160 and I think when I worked at Epic, a lot of people said that, 72 00:03:42,160 --> 00:03:45,760 and I think Miami means it and they have the data to support it. Um, 73 00:03:45,820 --> 00:03:50,080 in terms of, at the forefront of it is how do we empower our faculty, 74 00:03:50,420 --> 00:03:55,240 our our physicians and our providers to do what they do best. Um, 75 00:03:55,240 --> 00:03:59,000 so the opportunities we have in front of us is how to make their job more 76 00:03:59,280 --> 00:04:01,480 efficient in what their core mission is. 77 00:04:01,850 --> 00:04:03,520 Their core mission is caring for patients. 78 00:04:04,140 --> 00:04:08,720 The core mission is designing and developing in new research studies to find new 79 00:04:08,720 --> 00:04:12,000 treatments and new diagnoses, methodologies. Um, 80 00:04:12,060 --> 00:04:15,720 and if we are not doing everything we can in from a revenue cycle perspective 81 00:04:15,740 --> 00:04:18,040 and from an IT perspective, then we're not doing our jobs. 82 00:04:18,780 --> 00:04:23,760 So the opportunities are to find ways to make what they do more efficient. 83 00:04:24,020 --> 00:04:27,800 So I see AI as a huge opportunity for physician efficiency and physician 84 00:04:27,800 --> 00:04:31,520 development. I see automation and coding, um, 85 00:04:31,520 --> 00:04:34,760 and automation of understanding what the physician's documentation are. 86 00:04:34,840 --> 00:04:37,320 I think if you look back over the last 20 years, the, 87 00:04:37,460 --> 00:04:41,600 the driver of clinical documentation wasn't necessarily medical necessity. 88 00:04:41,700 --> 00:04:44,640 It was billing , um, and billing requirements and, 89 00:04:44,660 --> 00:04:47,080 and and billing obligations to in, 90 00:04:47,080 --> 00:04:50,800 whether that's insurance audits or insurance payments and insurance 91 00:04:51,080 --> 00:04:55,160 reimbursement. And as we move to a more AI driven or automation driven world, 92 00:04:55,660 --> 00:05:00,280 we can infer and drive the conversation to the right place and empower the 93 00:05:00,280 --> 00:05:01,960 physicians to say what they wanna say, 94 00:05:02,500 --> 00:05:04,920 say what they need to say to speak to their peers. 95 00:05:05,060 --> 00:05:07,520 The the doctors they're referring to the pathologists, 96 00:05:07,520 --> 00:05:11,520 they're sending lab labs to the patient who's trying to understand and, 97 00:05:11,520 --> 00:05:16,000 and deal through this treatment plan or various diagnosis or comorbid conditions 98 00:05:16,000 --> 00:05:20,410 that they have. The, the physician at the, 99 00:05:20,510 --> 00:05:24,050 at the fundamental core of what they do is to translate what's happening into an 100 00:05:24,050 --> 00:05:27,530 actionable next step. And I think through AI and through automation, 101 00:05:27,550 --> 00:05:32,090 we can make it easier for them to document charge, um, 102 00:05:32,150 --> 00:05:36,210 and prove the level of medical necessity to meet the requirements that we have 103 00:05:36,310 --> 00:05:39,050 for charging and doing those various other things. 104 00:05:39,630 --> 00:05:43,330 And I think the headwind in that is the industry's moving there fast, right? 105 00:05:43,340 --> 00:05:46,090 We're seeing massive developments, um, 106 00:05:46,160 --> 00:05:50,210 both from Epic but also all many other tech companies and other health systems 107 00:05:50,240 --> 00:05:52,770 like the University of Miami who are innovating in this space. 108 00:05:52,770 --> 00:05:56,370 And so it's actually the type of work that gets me most excited, um, 109 00:05:56,390 --> 00:06:00,940 cuz it truly has an opportunity to benefit without getting in the way. Um, 110 00:06:01,420 --> 00:06:04,140 I think the next big category, if you think of, 111 00:06:04,160 --> 00:06:08,380 if you think maybe go more broad outside of just providers and think about how 112 00:06:08,380 --> 00:06:12,620 do we make sure their prov their schedules are as full as possible, um, 113 00:06:12,880 --> 00:06:17,020 in a way that is meets the expectations of their contract and their clinic 114 00:06:17,020 --> 00:06:17,840 panel. 115 00:06:17,840 --> 00:06:20,780 So we obviously don't wanna overburden providers with more than what they're 116 00:06:20,900 --> 00:06:22,180 expected and are capable of doing. 117 00:06:22,560 --> 00:06:26,940 So I'm not saying go to five minute slots or something that's unattainable and 118 00:06:26,960 --> 00:06:29,580 un non feasible. We're not trying to work like a factory here, 119 00:06:30,040 --> 00:06:33,900 but patients knowshow for reasons we can predict, um, 120 00:06:34,340 --> 00:06:37,980 patients late cancel for reasons we can predict and intervene against. Um, 121 00:06:37,980 --> 00:06:42,220 and provider time might not always be optimally used, um, 122 00:06:42,220 --> 00:06:44,980 both in a clinic, in a hospital, in a research setting. 123 00:06:45,360 --> 00:06:49,700 So thinking about how can technology inform operational decisions. 124 00:06:50,360 --> 00:06:53,380 Um, and so that's one of the big opportunities we have is leveraging these, 125 00:06:53,480 --> 00:06:54,540 you know, you know, 126 00:06:54,540 --> 00:06:59,460 machine learning and natural language model processes to understand where the 127 00:06:59,460 --> 00:07:00,140 opportunities are, 128 00:07:00,140 --> 00:07:05,060 both for documentation but also just using time that the providers are giving us 129 00:07:05,410 --> 00:07:06,820 most efficiently and effectively. 130 00:07:08,220 --> 00:07:10,260 I love that. I think it makes a lot of sense, you know, 131 00:07:10,260 --> 00:07:14,900 and it's really forward looking in terms of how the technology can 132 00:07:15,270 --> 00:07:19,420 boost the providers, make them happier, make the organization more efficient, 133 00:07:19,480 --> 00:07:22,780 and certainly get to a space where you're smartly um, 134 00:07:22,780 --> 00:07:23,940 connecting with patients and, 135 00:07:23,940 --> 00:07:26,300 and doing what needs to be done to deliver that care. 136 00:07:26,300 --> 00:07:30,580 So I think that is such a great example in and really dovetails into my next 137 00:07:30,860 --> 00:07:31,120 question. 138 00:07:31,120 --> 00:07:35,180 And looking at revenue cycle obviously is important for the entire organization 139 00:07:35,200 --> 00:07:36,780 as a foundation for it. Um, 140 00:07:36,880 --> 00:07:40,420 but as you're thinking about growth and development in the future, how, uh, 141 00:07:40,440 --> 00:07:41,273 are you, 142 00:07:41,780 --> 00:07:44,620 I guess how are you adding value to the health system and and what does that 143 00:07:44,620 --> 00:07:45,453 really look like? 144 00:07:45,900 --> 00:07:49,820 That's great. So the, from a true finance perspective, 145 00:07:49,820 --> 00:07:52,980 from my finance hat on, there's two ways to grow a business, 146 00:07:54,380 --> 00:07:56,830 grow revenues or reduce cost. 147 00:07:57,760 --> 00:08:00,580 And we are focusing on both very aggressively. 148 00:08:01,120 --> 00:08:05,180 The University of Miami is making substantial investments in our community in 149 00:08:05,180 --> 00:08:07,820 terms of additional facilities. We have a lot of, 150 00:08:07,820 --> 00:08:12,020 we have three major construction projects in flight right now that are 151 00:08:12,410 --> 00:08:16,020 deploying new state-of-the-art facilities to various communities within the 152 00:08:16,020 --> 00:08:19,640 Miami-Dade Broward County area. Because at the end of the day, in order to grow, 153 00:08:19,640 --> 00:08:22,360 you have to physically grow, you have to hire more faculty, 154 00:08:22,360 --> 00:08:23,480 create new positions, 155 00:08:23,620 --> 00:08:27,680 create new state-of-the-art facilities that have both research capabilities as 156 00:08:27,680 --> 00:08:29,400 well as patient care, um, 157 00:08:29,400 --> 00:08:33,160 facilities to see patients across all the spectrums of all of our service lines 158 00:08:33,220 --> 00:08:36,480 cuz we're, you know, a fully diversified academic medical center. 159 00:08:37,490 --> 00:08:38,470 So when I think about growth, 160 00:08:38,550 --> 00:08:40,990 I think about making sure that we can do those investments and do those 161 00:08:40,990 --> 00:08:42,510 investments smartly. Um, 162 00:08:42,510 --> 00:08:47,110 that means making sure we have the margin to purchase and pay for the 163 00:08:47,270 --> 00:08:47,610 construction, 164 00:08:47,610 --> 00:08:51,190 but also we have the technology that allows us to be innovative in the way that 165 00:08:51,190 --> 00:08:52,630 those clinics are being built. 166 00:08:52,690 --> 00:08:54,990 So we're not just building another 1980s hospital, 167 00:08:55,310 --> 00:08:58,060 we're building something that would be appropriate and we'd be proud of in the 168 00:08:58,060 --> 00:09:00,260 nine, in the 2000 forties or 2000 fifties. 169 00:09:01,300 --> 00:09:05,830 I think the way that we help with that and the way that my team focuses 170 00:09:06,090 --> 00:09:09,190 on this is how do we do more with less than, um, 171 00:09:09,290 --> 00:09:12,470 so as we scale up and add more visits per day, 172 00:09:12,610 --> 00:09:14,950 add more providers on in our clinics, 173 00:09:15,330 --> 00:09:18,790 how do we make sure we're doing that in a way that empowers the patient to 174 00:09:18,950 --> 00:09:21,190 schedule themselves, to register themselves, 175 00:09:21,810 --> 00:09:25,230 to reach out and get ahold of someone when they have a question and get to the 176 00:09:25,230 --> 00:09:26,470 right place most efficiently? 177 00:09:26,930 --> 00:09:30,550 And that's all focused primarily on the revenue side and a and a lot of those 178 00:09:30,550 --> 00:09:33,070 things, I'll admit, they drive cost, right? We do. 179 00:09:33,250 --> 00:09:36,590 We have to pay for the technology, we have to pay for the faculty, 180 00:09:36,650 --> 00:09:39,070 we have to pay for the construction. Um, 181 00:09:39,210 --> 00:09:40,870 and so it's important that we're also having, 182 00:09:41,000 --> 00:09:44,630 we're focusing on the other side of that equation, which is cost. Um, 183 00:09:44,630 --> 00:09:46,310 and that's the, the work that we do, the, 184 00:09:46,310 --> 00:09:49,950 the relationships we have with vendors, um, whether that's one, 185 00:09:50,130 --> 00:09:54,590 how we process statements or how we process insurance verifications or 186 00:09:54,910 --> 00:09:55,250 authorizations. 187 00:09:55,250 --> 00:09:59,310 If they were being strategic about are we leveraging all the technology we 188 00:09:59,310 --> 00:10:03,590 should and are we getting all, everything we could out of it? Um, 189 00:10:03,590 --> 00:10:06,750 a good example is Epic comes out with new technology, 190 00:10:06,970 --> 00:10:10,710 new code sets every quarter. Um, something that is, 191 00:10:10,810 --> 00:10:13,750 is hard for a health system to keep up with at our scale, but we, 192 00:10:13,840 --> 00:10:17,670 we've put a lot of energy into making sure that every time Epic says, Hey, 193 00:10:17,880 --> 00:10:20,070 university of Miami and all their other customers, 194 00:10:20,220 --> 00:10:23,590 look at this new programming that we developed or this new workflow or this new 195 00:10:23,590 --> 00:10:28,070 content that we're putting out. Use it. Um, and we find ourselves if, 196 00:10:28,130 --> 00:10:31,750 if health systems don't focus on that and make sure that's a core priority is 197 00:10:31,750 --> 00:10:34,310 keeping up to date with your, with your software updates, 198 00:10:34,450 --> 00:10:38,470 so to say that you then are not taking advantage of the licensing costs you're 199 00:10:38,550 --> 00:10:40,550 spending money on. So it's a big focus. So it's not all, 200 00:10:40,550 --> 00:10:45,110 it's making sure we're not duplicating our costs fo buying things more than once 201 00:10:45,130 --> 00:10:48,510 to do the same outcome, outcome and function. Um, 202 00:10:48,930 --> 00:10:53,070 and then making sure that for everything that we're doing we're appropriately 203 00:10:53,300 --> 00:10:57,590 incurring the right at cost and not over not too many costs that we shouldn't be 204 00:10:57,590 --> 00:10:59,430 incurring overall in the first place. 205 00:10:59,870 --> 00:11:02,630 I think the combination of those two things, the, you know, 206 00:11:02,650 --> 00:11:06,150 making sure that we're actively growing and growing at the rate that we need to, 207 00:11:06,520 --> 00:11:10,350 we're keeping our costs controlled and then also finding places to reduce cost. 208 00:11:10,610 --> 00:11:11,510 That's where my team, 209 00:11:11,510 --> 00:11:15,670 and that's how we think of where our value is to the organization. Um, 210 00:11:15,670 --> 00:11:18,190 because at the end of the day, you can keep, you can keep adding more people, 211 00:11:18,190 --> 00:11:19,870 you can keep dropping more charges, 212 00:11:19,930 --> 00:11:23,430 but if you're not doing it within the realm of what is needed, 213 00:11:23,530 --> 00:11:26,910 you're doing something because of something of a workflow you did 20, 214 00:11:26,910 --> 00:11:27,750 30 years ago, 215 00:11:27,810 --> 00:11:31,310 you're gonna fall behind and your cost curve's gonna catch up with your revenue 216 00:11:31,400 --> 00:11:34,190 curve. Um, and you're gonna, you're, you're, 217 00:11:34,190 --> 00:11:36,270 it's gonna happen before you realize it and before you know it, 218 00:11:36,270 --> 00:11:39,070 you're gonna be losing millions if not billions of dollars a year, 219 00:11:39,070 --> 00:11:40,870 which we see in the press all the time. 220 00:11:41,210 --> 00:11:45,470 But these massive health systems all over the US that are, you know, for many, 221 00:11:45,470 --> 00:11:46,830 many quarters, 222 00:11:47,250 --> 00:11:50,790 not just cuz of covid but even post covid we're reporting massive operating 223 00:11:50,790 --> 00:11:54,980 losses is because they really struggled to control cost while, 224 00:11:55,030 --> 00:11:58,260 while also pushing various levels of, of revenue growth. 225 00:11:58,780 --> 00:12:02,620 I think the last thing that I would note on this topic is 226 00:12:03,880 --> 00:12:07,170 there's always opportunity in your existing, we call this your same store. 227 00:12:07,390 --> 00:12:12,090 So the existing faculty with the existing clinic time with the existing or time 228 00:12:12,090 --> 00:12:13,970 with the existing inpatient beds, 229 00:12:14,790 --> 00:12:17,890 we find that we're not always utilizing those resources to the highest 230 00:12:17,890 --> 00:12:21,370 potential. So a lot of our projects are actually just analytics in nature. 231 00:12:21,880 --> 00:12:25,690 It's helping develop reports that aren't just numbers on a page, 232 00:12:26,150 --> 00:12:28,170 but are are, you know, 233 00:12:28,530 --> 00:12:32,690 graphical representations that provide a directional recommendation for what the 234 00:12:32,850 --> 00:12:34,610 business can do. A good example, 235 00:12:34,670 --> 00:12:38,490 we recently had a project where we started monitoring more discreetly all of our 236 00:12:38,490 --> 00:12:42,730 outpatient ambulatory rooms, um, when were patients being put in them, 237 00:12:42,730 --> 00:12:45,930 when were they being removed, when were providers and c nurses entering them, 238 00:12:46,710 --> 00:12:50,450 and how effectively were we using that real estate because as we add more 239 00:12:50,450 --> 00:12:50,910 faculty, 240 00:12:50,910 --> 00:12:54,010 we can't all of a sudden add a bunch of more rooms unless we build a new 241 00:12:54,170 --> 00:12:56,570 building. Um, and we found that we had a bunch of, 242 00:12:56,570 --> 00:13:01,530 of our satellite locations that were operating at like 70, 80% utilized. 243 00:13:02,030 --> 00:13:02,250 Um, 244 00:13:02,250 --> 00:13:05,850 and we were able to use the data to find out where was the time not being used, 245 00:13:06,430 --> 00:13:06,710 um, 246 00:13:06,710 --> 00:13:10,290 and then suggest that maybe that's where we put the new faculty member or maybe 247 00:13:10,310 --> 00:13:14,330 we could adjust some sessions or some panels around to be a, uh, 248 00:13:14,390 --> 00:13:19,370 to be aligned in a model that is more conducive to the real estate that we have. 249 00:13:19,520 --> 00:13:22,210 Just one example of, of a project that we've done that doesn't, 250 00:13:22,400 --> 00:13:25,090 it's not changing the revenues, it's not changing the costs, 251 00:13:25,190 --> 00:13:30,130 but it's providing insights into the, the how we're using the things that, 252 00:13:30,560 --> 00:13:34,930 that we have at our disposable, whether that's real estate or time, um, 253 00:13:35,150 --> 00:13:39,370 you know, advanced practitioner time, physician time, et cetera is a, you know, 254 00:13:39,370 --> 00:13:43,170 big analytical focus for my team to, to drive growth at the organization. 255 00:13:45,600 --> 00:13:46,433 Absolutely. I love that. 256 00:13:46,560 --> 00:13:49,960 I think that makes a lot of sense and definitely great examples of areas and 257 00:13:49,960 --> 00:13:54,760 spaces where it really is helpful for the organization to make sure 258 00:13:54,950 --> 00:13:57,680 that, you know, as you mentioned, the revenue's in a good spot, 259 00:13:57,680 --> 00:13:59,000 their costs are controlled, 260 00:13:59,000 --> 00:14:02,360 they're set up for the future and success once you know you're able to do that. 261 00:14:02,660 --> 00:14:05,080 And along those lines, you know, I, 262 00:14:05,240 --> 00:14:09,120 I know as you have been talking about a lot of the hospitals and health systems 263 00:14:09,420 --> 00:14:13,000 are in a, a more financially challenging spot than they were a few years ago, 264 00:14:13,000 --> 00:14:14,320 especially before the pandemic, 265 00:14:14,780 --> 00:14:18,720 but it's still so critical and crucial to make sure you're set yourself up to be 266 00:14:18,720 --> 00:14:21,160 successful in the future for growth and development, et cetera. 267 00:14:21,500 --> 00:14:22,720 So from your perspective, 268 00:14:22,770 --> 00:14:26,360 where do you see is one area that's still really important to make investments 269 00:14:26,540 --> 00:14:27,560 in this coming year? 270 00:14:30,580 --> 00:14:34,440 The, the first one is people. Um, I think the, 271 00:14:35,200 --> 00:14:39,140 you can't build greatness without greatness, right? 272 00:14:39,160 --> 00:14:42,780 You need people that have experience, passion, 273 00:14:43,720 --> 00:14:47,780 and a desire to be involved in the mission of the business. 274 00:14:48,560 --> 00:14:50,340 So, and that means, you know, 275 00:14:50,340 --> 00:14:53,420 evaluating our people in the right positions that they're currently in, 276 00:14:53,480 --> 00:14:55,660 are there people that aren't here that we need to bring here? 277 00:14:56,160 --> 00:14:59,300 And that's hard cuz it's a, it's ultimately just a game of, of, of good, 278 00:14:59,650 --> 00:15:00,860 good challenging recruiting. 279 00:15:00,900 --> 00:15:04,220 I think there's a recruiter here that I talked to on a regular basis. I, 280 00:15:04,220 --> 00:15:08,180 as I find, you know, great talent for my teams and they said to me, 281 00:15:08,180 --> 00:15:10,140 and I'm sure they're quoting someone else, 282 00:15:10,200 --> 00:15:14,260 so I don't know the appropriate original quotation on this is that the best 283 00:15:14,260 --> 00:15:17,020 people aren't looking. Um, 284 00:15:17,040 --> 00:15:21,660 so the most talented employees that you could have, the most gifted, creative, 285 00:15:22,520 --> 00:15:26,420 um, urgent individual who can help drive innovation, 286 00:15:26,420 --> 00:15:29,580 whether it's clinical or IT or business administration, 287 00:15:30,370 --> 00:15:33,060 most of them aren't looking for jobs, right? They're in a job, 288 00:15:33,090 --> 00:15:36,100 they're doing outstanding work, they're crushing it, right? 289 00:15:36,100 --> 00:15:39,340 They're doing something, adding a ton of value at another organization. 290 00:15:40,040 --> 00:15:43,180 And in order to recruit, you can't always go to the, the, the, 291 00:15:43,240 --> 00:15:46,260 the places that you think of when you think of recruiting. 292 00:15:46,260 --> 00:15:47,700 We can't just post on LinkedIn, 293 00:15:48,000 --> 00:15:52,020 we can't just post on Indeed or post on our jo in Workday for a job posting. 294 00:15:52,120 --> 00:15:54,300 You'll, you'll absolutely find great people doing that. 295 00:15:54,760 --> 00:15:56,540 I'm not saying that no one great is looking, 296 00:15:57,080 --> 00:16:01,940 but a lot of the people that you want are in a stable job that they like 297 00:16:02,200 --> 00:16:06,300 and you have to find a way to convince them that your mission is worth them 298 00:16:06,300 --> 00:16:08,420 leaving and fighting for. So that, that, that's one, 299 00:16:08,640 --> 00:16:11,500 and I'm gonna cheat and add another one, um, because I can, 300 00:16:11,580 --> 00:16:15,340 I guess since we've got the time, um, is that the, 301 00:16:16,000 --> 00:16:20,750 the other big I think place that I think it's worth taking risk on is 302 00:16:21,220 --> 00:16:24,360 pushing the envelope on ai, right? 303 00:16:24,360 --> 00:16:29,040 And I think it's easy to sit and wait for some tech company with a bunch of 304 00:16:29,040 --> 00:16:33,520 venture capital funding to come around and offer you this product at 50% margin 305 00:16:33,950 --> 00:16:37,520 that adds value to the business. That's easy, that's lazy. 306 00:16:37,840 --> 00:16:39,900 I would almost say I don't, 307 00:16:39,900 --> 00:16:42,460 I don't mean that to say there's no good products out there, but that's, 308 00:16:42,460 --> 00:16:43,220 that's the, that's the, 309 00:16:43,220 --> 00:16:46,380 that's the reactionary approach as a business or as an innovative, 310 00:16:46,520 --> 00:16:47,500 as an innovative company. 311 00:16:48,210 --> 00:16:52,100 What a company who's innovative should be doing is get out in front of this and 312 00:16:52,100 --> 00:16:56,100 play with the technology. Go invest in chat G B T private for healthcare. 313 00:16:56,160 --> 00:16:57,860 Go invest in, you know, 314 00:16:58,080 --> 00:17:02,100 Amelia AI for conversational s m s and voice conversations. 315 00:17:02,280 --> 00:17:07,260 Go invest in, um, Microsoft facial recognition api. 316 00:17:07,360 --> 00:17:07,700 So like, 317 00:17:07,700 --> 00:17:11,980 go find something that even though there might be a big sticker price for what 318 00:17:11,980 --> 00:17:16,740 it's going to do, invest in it, bring it in and challenge the heck out of it, 319 00:17:16,790 --> 00:17:18,380 right? Rip it apart, 320 00:17:18,680 --> 00:17:23,540 put it back together and build something that can help disrupt the way 321 00:17:23,540 --> 00:17:26,660 you do the business today. Um, because the worst thing, 322 00:17:26,760 --> 00:17:31,580 the worst you could do is that you install a product that 323 00:17:31,580 --> 00:17:33,140 works somewhere else, right? You, 324 00:17:33,140 --> 00:17:36,700 you help build your portfolio of tools to help empower users. 325 00:17:36,720 --> 00:17:39,780 That's the worst thing that could happen. The best thing that could happen, 326 00:17:39,920 --> 00:17:44,500 or probably the most likely thing is you're gonna disrupt so many workflows and 327 00:17:44,560 --> 00:17:46,700 so many things that you do in your health, 328 00:17:46,720 --> 00:17:49,700 in the health system to help improve the patient experience, 329 00:17:49,890 --> 00:17:53,100 improve the bottom line, increase utilization for providers, 330 00:17:53,400 --> 00:17:57,020 do all these things that we've talked throughout this podcast about, um, 331 00:17:57,040 --> 00:17:58,380 in terms of, you know, 332 00:17:58,380 --> 00:18:01,580 innovating and disrupting the way that business is done in healthcare. 333 00:18:01,800 --> 00:18:06,420 But the only way health systems can do that is if they take a risk and invest in 334 00:18:06,420 --> 00:18:09,260 those technologies and invest in the base technology. 335 00:18:09,310 --> 00:18:12,620 Don't invest in the most shiny thing over here that has the prettiest sales 336 00:18:12,620 --> 00:18:13,453 pitch deck. 337 00:18:13,760 --> 00:18:18,540 Invest in the best brain and the best tech stack that you can get your eye 338 00:18:18,540 --> 00:18:20,220 hands on and then play with it, 339 00:18:20,220 --> 00:18:24,940 invest in it and spend the time that you need to spend to make it work for you 340 00:18:25,680 --> 00:18:28,940 and it'll pay dividends down the road. Um, those are, 341 00:18:28,940 --> 00:18:31,540 those are things I think it's worth taking a risk on cuz you're, you're, 342 00:18:31,540 --> 00:18:34,740 you're gonna make your r o i it might not be right away. Um, 343 00:18:34,740 --> 00:18:37,740 but as long as you believe in the product, you believe in the technology, 344 00:18:38,130 --> 00:18:40,420 it's gonna pay dividends. And then to my first point, 345 00:18:40,800 --> 00:18:43,260 if you've got really smart people working for you, 346 00:18:43,720 --> 00:18:48,180 people that are motivated by the mission, motivated to do good, 347 00:18:48,690 --> 00:18:51,140 motivated to care about the patient first, 348 00:18:53,160 --> 00:18:57,260 you're gonna make magical things happen. Um, in terms of innovation, innovation, 349 00:18:57,360 --> 00:19:02,220 growth, reducing costs, improving the patient experience, all the things that, 350 00:19:02,410 --> 00:19:06,780 that those fancy pitch decks that you got from the venture firm show you, 351 00:19:06,880 --> 00:19:09,620 you're gonna do that yourself. You're gonna do that with your team, 352 00:19:09,810 --> 00:19:13,860 with your technology, with your partners that care about you, um, 353 00:19:13,860 --> 00:19:16,900 rather than just being another line item in someone else's p and l. 354 00:19:18,760 --> 00:19:21,480 I love that. That's such an amazing way to look at it and think about it. 355 00:19:21,480 --> 00:19:25,080 And I can imagine, you know, it's uh, easier said than done, 356 00:19:25,180 --> 00:19:28,040 but certainly it makes a lot of, uh, um, 357 00:19:28,320 --> 00:19:30,840 a lot of sense for hospitals and health systems and you know, 358 00:19:30,840 --> 00:19:32,960 when you have your internal team set in place, 359 00:19:33,420 --> 00:19:36,560 how do you empower them and embolden them to do some of these exciting, 360 00:19:36,620 --> 00:19:38,000 the fancy things that you're talking about? 361 00:19:39,100 --> 00:19:42,150 Freedom. I give them freedom, right? And I, 362 00:19:42,150 --> 00:19:45,150 and that's because I'm given freedom. I'm, I don't, you know, 363 00:19:45,290 --> 00:19:50,150 my boss and my leadership team gives me the ability to go kind of 364 00:19:50,150 --> 00:19:51,150 take risks and, 365 00:19:51,570 --> 00:19:55,710 and tackle projects that I think you're gonna help us in partner with operations 366 00:19:55,770 --> 00:19:58,670 and convince them of the value. They, they, they trust me in doing that. 367 00:19:58,670 --> 00:20:02,070 And I do the same thing for my team. Um, I have a good example. 368 00:20:02,110 --> 00:20:05,150 I have this patient flow architect who I recruited out of a happy job. 369 00:20:05,630 --> 00:20:07,590 I went and called him and I said, I want you down here in Miami. 370 00:20:08,240 --> 00:20:12,190 After some negotiation, I convinced him to move down to the, the beautiful, 371 00:20:12,210 --> 00:20:14,230 the beautiful south Florida. And he is not, 372 00:20:14,340 --> 00:20:18,470 he's not turned back or regretted it, but I said to him when he first came here, 373 00:20:18,930 --> 00:20:20,430 I'm not just gonna assign you tickets. 374 00:20:21,090 --> 00:20:24,750 I'm not just gonna assign you a PM and assign you a project and tell you to go 375 00:20:24,750 --> 00:20:27,910 do it. I'm gonna introduce you to people that matter here. 376 00:20:28,570 --> 00:20:30,670 I'm gonna introduce you to our c e o of the hospital. 377 00:20:31,170 --> 00:20:33,230 I'm gonna introduce you to the head of patient movement. 378 00:20:33,570 --> 00:20:37,630 I'm gonna introduce you to the head of patient safety and, and public safety. 379 00:20:38,130 --> 00:20:41,430 And I want you to work with them and figure out what they need. I, 380 00:20:41,590 --> 00:20:42,550 I think I know what they want. 381 00:20:42,550 --> 00:20:45,750 They've talked to me about it before and here's some starter points to start 382 00:20:45,750 --> 00:20:48,380 preparing. I, you know, I don't leave them stranded off in the world, 383 00:20:48,880 --> 00:20:49,940 but I just sort of say, 384 00:20:50,560 --> 00:20:54,020 I'm gonna let you go figure out what you want to do and come back to me and let 385 00:20:54,020 --> 00:20:55,700 me know and then we'll workshop it together. 386 00:20:55,770 --> 00:20:58,860 Then in our one-on-ones that we have every week, they bring in ideas, 387 00:20:59,160 --> 00:21:01,980 we workshop 'em, some of 'em die, some of 'em evolve, 388 00:21:02,130 --> 00:21:05,980 some of them get put on the table for later. Um, 389 00:21:06,600 --> 00:21:10,620 but I sort of, I, you know, like I said, I, I'm trying to find these geniuses, 390 00:21:10,620 --> 00:21:13,540 these unicorns out in the industry, bring them to University of Miami, 391 00:21:14,000 --> 00:21:17,980 the exciting place to work and then give them freedom to do what they do best, 392 00:21:18,110 --> 00:21:21,420 which is think creatively develop. And then I sit there, 393 00:21:21,940 --> 00:21:24,900 I sit in my seat and one help workshop with them, 394 00:21:25,040 --> 00:21:29,740 hoping if I can even keep up with their speed of, of work, um, 395 00:21:29,840 --> 00:21:33,220 and then help bring down barriers, whether that's an IT barrier, 396 00:21:33,220 --> 00:21:36,100 whether that's a decision making barrier or operational barrier, 397 00:21:36,260 --> 00:21:37,580 a technical whatever the thing is, the, 398 00:21:37,580 --> 00:21:41,580 the thing that could potential potentially roadblock a project like this. Um, 399 00:21:41,600 --> 00:21:44,820 and then I intervened to help with that type of stuff to keep them out of the 400 00:21:44,820 --> 00:21:46,500 messiness of some of that. Mm-hmm , 401 00:21:46,500 --> 00:21:49,220 I'm sure a lot of people listening experience that in their own, 402 00:21:49,360 --> 00:21:52,780 in their own in, in their own industry or in their own health systems. Um, 403 00:21:52,960 --> 00:21:56,460 and I try to tackle that for my team cause it can be really easy for them to get 404 00:21:56,710 --> 00:22:01,460 these really creative minds to get bogged down in politics 405 00:22:01,560 --> 00:22:02,900 or bogged down in process. 406 00:22:03,200 --> 00:22:07,300 And I see my role as their leader to help push through some of that and help 407 00:22:07,300 --> 00:22:11,180 them just do what they do best, which is, you know, create creative ideas, um, 408 00:22:11,180 --> 00:22:12,980 and get them deployed as fast as possible. 409 00:22:13,850 --> 00:22:16,570 I love that. Thank you so much for going through everything there and, and just, 410 00:22:16,950 --> 00:22:20,530 you know, what a, a fabulous system you have set up. It sounds like an amazing, 411 00:22:21,190 --> 00:22:24,770 um, department and organization to work for. Now, before we wrap up, 412 00:22:24,930 --> 00:22:27,810 I wanted to get your thoughts on growth and development. 413 00:22:27,810 --> 00:22:30,730 Where do you see some of the best opportunities for yourself as well as the 414 00:22:30,730 --> 00:22:31,570 teams that you work with? 415 00:22:32,950 --> 00:22:35,200 It's a good question and I think about this a lot. Unfortunately. 416 00:22:35,280 --> 00:22:37,040 I have a boss who, who, uh, 417 00:22:37,610 --> 00:22:41,960 asked me that question on a regular basis cuz he sees the vision, he's, 418 00:22:41,960 --> 00:22:45,160 he has his own vision and I have mine and we try to find places to align them 419 00:22:45,360 --> 00:22:49,760 together. I think the best opportunities that I have, we have, um, 420 00:22:50,460 --> 00:22:53,200 is to continue to go down this path of painful automation. 421 00:22:53,880 --> 00:22:56,960 I think we've gotten to a point where we are playing off of, 422 00:22:56,970 --> 00:23:00,760 we've already taken the low hanging fruit. It was delicious, it got, 423 00:23:00,760 --> 00:23:02,520 it had great outcomes. We, you know, 424 00:23:02,520 --> 00:23:05,120 we baked an amazing apple pie with the low hanging fruit, 425 00:23:05,540 --> 00:23:08,520 but now we gotta get the stuff that's a little bit higher up and a little bit 426 00:23:08,520 --> 00:23:12,200 harder to operationalize, a little bit harder to change it infects more users, 427 00:23:12,230 --> 00:23:15,120 affects more maybe, you know, 428 00:23:15,120 --> 00:23:19,120 technology debt that we have to take that we have to deal with in terms of bloat 429 00:23:19,120 --> 00:23:20,680 or things that need to be cleaned up. 430 00:23:21,020 --> 00:23:25,080 So the biggest opportunity is building a stronger foundation, um, and, 431 00:23:25,100 --> 00:23:29,440 and finding a way to not only think about the really cool things out there like 432 00:23:29,620 --> 00:23:30,060 ai, 433 00:23:30,060 --> 00:23:34,760 but use that type of project to find things in your foundation that are 434 00:23:34,760 --> 00:23:37,040 cracking. Um, and maybe I don't, I don't, 435 00:23:37,040 --> 00:23:40,440 maybe not there's no structural integrity issue, but, or hopefully there isn't. 436 00:23:40,580 --> 00:23:43,120 But if there is, obviously deal with that first, but if there isn't, 437 00:23:43,120 --> 00:23:46,260 it's doing the preventative maintenance you need to do, um, 438 00:23:46,560 --> 00:23:50,220 to ensure that that building continues to stay strong and you can add more 439 00:23:50,240 --> 00:23:54,820 floors, add more, diversify your team and, and do over mul bigger opportunities. 440 00:23:54,880 --> 00:23:55,380 And I, 441 00:23:55,380 --> 00:23:59,180 I think of the things that my architects are focused on and our team is working 442 00:23:59,180 --> 00:24:02,660 on and the things that constantly hold them up. Um, and it's, it's, 443 00:24:02,660 --> 00:24:05,820 it's some of the debt in terms of historical decisions that were made that need 444 00:24:05,820 --> 00:24:09,500 to be revisited. And that's not easy work. I mean that's time intensive. 445 00:24:09,770 --> 00:24:12,180 It's selling the idea to the business owners. 446 00:24:12,290 --> 00:24:14,580 It's convincing them that it's worth the risk of changing, 447 00:24:14,690 --> 00:24:19,420 it's helping them understand the opportunity. Um, and I think the biggest, 448 00:24:19,520 --> 00:24:20,353 the best, biggest, 449 00:24:20,370 --> 00:24:24,380 best opportunity for growth that I see for us is to continue to do more, right? 450 00:24:24,650 --> 00:24:27,460 Find more areas to tackle within the business, 451 00:24:27,550 --> 00:24:31,340 partnering with operations to, to help them deliver faster. 452 00:24:31,760 --> 00:24:33,020 So I think for all the, you know, 453 00:24:33,020 --> 00:24:36,500 for all the greatness that I think I have on my team in terms of the great 454 00:24:36,500 --> 00:24:39,780 people that I, that surround me, um, there's equally, 455 00:24:39,840 --> 00:24:44,540 if not more talent in the business that's being maybe held back by current 456 00:24:44,760 --> 00:24:49,300 policy or current procedure or current decisions. I mean like any health system, 457 00:24:49,300 --> 00:24:51,940 it's every once in a while you gotta open up that policy and say, 458 00:24:51,940 --> 00:24:54,180 is that the right one? Does it need to be redone, 459 00:24:54,500 --> 00:24:59,460 re revisited reoriented to b to better oriented to the new technology we have or 460 00:24:59,460 --> 00:25:00,293 just the new ecosystem. 461 00:25:00,860 --> 00:25:04,580 I think a good example of this in my mind is a lot of workflows got quickly 462 00:25:04,580 --> 00:25:08,460 developed around covid arrivals into clinics. The ways that, 463 00:25:08,460 --> 00:25:10,500 the ways that patients were screened before surgery. 464 00:25:10,880 --> 00:25:14,060 We had to really quickly as an industry figure out how to deal with this, 465 00:25:14,520 --> 00:25:15,353 you know, 466 00:25:16,170 --> 00:25:20,180 this pandemic that came upon and came back multiple times to haunt us 467 00:25:21,160 --> 00:25:25,780 and now we have to sit here and say, how do we continue to drive us, you know, 468 00:25:26,270 --> 00:25:30,580 prioritize the safety of our employees and the safety of our patients while also 469 00:25:30,580 --> 00:25:32,620 innovating and being more creative around how we, 470 00:25:32,640 --> 00:25:36,860 how we can adjust our workflows, not necessarily to a pre pandemic state, 471 00:25:36,880 --> 00:25:40,580 but to a new state in terms of what do we want our arrival to look like? 472 00:25:40,680 --> 00:25:42,700 How do we wanna leverage kiosks or, 473 00:25:43,000 --> 00:25:47,860 or digital front door type experiences now that we have can rethink cuz we have 474 00:25:47,860 --> 00:25:50,180 different things that are pressuring us. Cause it's not that none, 475 00:25:50,280 --> 00:25:52,980 not everything shut down because of the original, you know, 476 00:25:52,980 --> 00:25:57,060 the covid pandemic errors that we, that we saw across the community. 477 00:25:57,280 --> 00:25:59,700 So that's what, that's kinda what I would mention is just the, 478 00:25:59,800 --> 00:26:03,860 the opportunity is to do more by, you know, focusing on the foundation, 479 00:26:03,990 --> 00:26:08,380 developing more core functions, making sure those are running efficiently, 480 00:26:08,560 --> 00:26:10,660 and then intentionally build on that with, 481 00:26:10,660 --> 00:26:14,620 with additional areas of focus and rethinking the way that, you know, 482 00:26:14,940 --> 00:26:17,420 workflows or processes or policies are, are employed. 483 00:26:18,870 --> 00:26:21,840 Fantastic. James, thank you so much for joining us on the podcast today. 484 00:26:21,840 --> 00:26:25,360 This has been such a fun and insightful conversation and I'm looking forward to 485 00:26:25,360 --> 00:26:28,280 meeting you in person as well at our Health IT Digital Health and Revenue Cycle 486 00:26:28,280 --> 00:26:29,160 event in October. 487 00:26:29,640 --> 00:26:33,080 I know we'll definitely be continuing the conversation and it'll be fun to see 488 00:26:33,080 --> 00:26:33,913 you there. 489 00:26:34,520 --> 00:26:35,680 Absolutely. Thank you so much for the time. 490 00:26:40,030 --> 00:26:43,260 It's so important for leaders at the top of organizations to keep learning, 491 00:26:43,450 --> 00:26:45,180 stay sharp, grow their networks, 492 00:26:45,570 --> 00:26:48,700 help our audience better do this in a more simplified, personalized, 493 00:26:48,760 --> 00:26:52,700 and meaningful way. Becker's Healthcare has launched my bhc, 494 00:26:53,170 --> 00:26:56,140 it's your trusted Becker's healthcare experience and more with content, 495 00:26:56,140 --> 00:26:58,420 connections, events and learning opportunities. 496 00:26:59,090 --> 00:27:03,780 Join the community free of charge@www.my dot becker's 497 00:27:03,940 --> 00:27:06,060 hospital review.com and we'll see you there.