1 00:00:03,720 --> 00:00:06,980 It is so important for leaders at the top of organizations to keep learning, 2 00:00:07,170 --> 00:00:08,860 stay sharp, grow their networks, 3 00:00:09,290 --> 00:00:12,420 help our audience better do this in a more simplified, personalized, 4 00:00:12,480 --> 00:00:16,180 and meaningful way. Becker's Healthcare has launched my B h c, 5 00:00:16,690 --> 00:00:19,900 it's your trusted Becker's healthcare experience and more with content, 6 00:00:19,930 --> 00:00:22,260 connections, events, and learning opportunities. 7 00:00:22,890 --> 00:00:27,820 Join the community free of charge@www.my dot becker's hospital 8 00:00:27,820 --> 00:00:29,780 review.com and we'll see you there. 9 00:00:33,290 --> 00:00:35,820 This is Laura Dedo with the Becker's Healthcare Podcast. 10 00:00:36,480 --> 00:00:38,780 I'm thrilled today to be joined by Dr. Daniel Duran, 11 00:00:38,950 --> 00:00:42,660 chief Clinical Officer at LifeBridge Health. Dr. Duran, 12 00:00:42,660 --> 00:00:44,340 it's a pleasure to have you on the podcast today. 13 00:00:45,310 --> 00:00:47,140 Thank you, Laura. It's always a pleasure to be here. 14 00:00:48,360 --> 00:00:51,300 Now I know you've jumped on the podcast with us a few different times, 15 00:00:51,300 --> 00:00:54,700 and we always appreciate you and your time and expertise. Um, 16 00:00:54,800 --> 00:00:57,420 but for those of our listeners who have just joined us, 17 00:00:57,420 --> 00:00:59,820 could you tell us a little bit more about yourself and your background? 18 00:01:01,640 --> 00:01:03,320 Absolutely. So my name's Dan, 19 00:01:03,340 --> 00:01:07,080 and I'm the Chief Clinical Officer for LifeBridge Health. LifeBridge is a five, 20 00:01:07,300 --> 00:01:12,000 uh, hospital, 2.5 billion revenue provider in the state of Maryland. 21 00:01:12,540 --> 00:01:16,920 Uh, we have a real cross continuum of care type model. 22 00:01:17,100 --> 00:01:21,200 We have about as much revenue coming from outside the hospitals as within the 23 00:01:21,400 --> 00:01:23,800 hospitals. Uh, and you know, 24 00:01:23,800 --> 00:01:28,040 I think we've been very much at the forefront of things like value-based care 25 00:01:28,620 --> 00:01:32,080 and various different types of technological innovations and consumer-oriented 26 00:01:32,080 --> 00:01:36,760 innovations within healthcare these past few years. Uh, my role at LifeBridge, 27 00:01:37,080 --> 00:01:39,320 I focus on, uh, value-based care, 28 00:01:39,780 --> 00:01:43,160 and I also am over operations for our clinically integrated network, 29 00:01:43,210 --> 00:01:45,000 which encompasses, uh, 30 00:01:45,140 --> 00:01:48,720 the assets I told you about along with our partners network and, um, 31 00:01:48,720 --> 00:01:50,160 other affiliated groups, 32 00:01:50,620 --> 00:01:54,160 all of whom are part of this network delivering care to populations. 33 00:01:54,750 --> 00:01:59,600 Some of those populations are value-based populations and others are, 34 00:02:00,380 --> 00:02:05,360 uh, government programs that, that are, may have a value orientation to them, 35 00:02:05,360 --> 00:02:08,520 but they aren't necessarily capitated type populations. 36 00:02:11,650 --> 00:02:13,660 That makes a lot of sense, you know, and, 37 00:02:13,680 --> 00:02:16,620 and really is interesting to see how that, um, 38 00:02:17,160 --> 00:02:21,260 that's evolved with the value-based care and being on the forefront of it. 39 00:02:21,340 --> 00:02:23,940 I can imagine, you know, just really a lot of, uh, 40 00:02:23,940 --> 00:02:27,220 experimentation and figuring out what works. So that's great to hear. 41 00:02:27,670 --> 00:02:29,540 Based on where we're at today in healthcare, 42 00:02:29,570 --> 00:02:32,620 what are some of the big opportunities you have your eye on as well as the 43 00:02:32,620 --> 00:02:34,260 headwinds that are popping up? 44 00:02:35,170 --> 00:02:39,300 Well, I think the single biggest thing, uh, as a healthcare operator, uh, 45 00:02:39,300 --> 00:02:43,620 and it's a little more on the parts of my job that involve the medical group, 46 00:02:44,000 --> 00:02:47,100 um, and the hospital based physicians versus the, um, 47 00:02:48,120 --> 00:02:49,980 versus the network. But I, but there, 48 00:02:49,980 --> 00:02:53,340 there's a real provider shortage going on in healthcare today, 49 00:02:53,760 --> 00:02:57,220 and it has a little bit to do with covid that we're coming out of. 50 00:02:57,600 --> 00:03:00,220 And it has a little bit to do with, um, 51 00:03:00,360 --> 00:03:04,500 the changing nature of the workforce and, and the shift of, uh, 52 00:03:04,900 --> 00:03:08,260 patients and opportunities to care for them from the inpatient to the outpatient 53 00:03:08,260 --> 00:03:11,820 world. But I think it has a lot to do with the, 54 00:03:11,840 --> 00:03:15,500 in increase in demand related to the aging population. You know, 55 00:03:15,500 --> 00:03:20,500 that's just been my personal anecdotal experiences is that there are a 56 00:03:20,500 --> 00:03:23,740 fair number of retirements happening right now across the country. 57 00:03:24,150 --> 00:03:27,580 Folks that were maybe hanging on for a little bit longer, you know, 58 00:03:27,580 --> 00:03:31,900 during the pandemic, a lot of them are finally retiring. Uh, 59 00:03:31,960 --> 00:03:34,620 and then there are also a great deal, um, 60 00:03:34,800 --> 00:03:39,620 of patients that are in that 65 to 75 age group where they're starting 61 00:03:39,640 --> 00:03:43,820 to acquire chronic conditions and starting to have, you know, 62 00:03:43,820 --> 00:03:48,140 unfortunately real health issues in that sort of mid to early baby boomer 63 00:03:48,140 --> 00:03:50,380 populations. So as we see that, 64 00:03:50,940 --> 00:03:54,980 I see a lot of demand and I see hospitals, um, 65 00:03:55,040 --> 00:03:56,100 all hospitals that, 66 00:03:56,100 --> 00:04:00,780 that I'm aware of having real challenge populating and staffing key areas. 67 00:04:01,490 --> 00:04:05,220 This can be on the nursing side, it could be on the respiratory therapist side, 68 00:04:05,280 --> 00:04:07,900 and it's certainly on the behavioral health side, it's across the board, 69 00:04:08,280 --> 00:04:09,620 you know, but for physician leaders, 70 00:04:10,170 --> 00:04:14,060 what it means is one of your biggest priorities and, and, 71 00:04:14,120 --> 00:04:18,940 and headwinds that you're dealing with is, um, an ongoing provider shortage. 72 00:04:19,160 --> 00:04:22,740 And what I tell people that are getting into healthcare management or people 73 00:04:22,810 --> 00:04:24,020 that, you know, 74 00:04:24,020 --> 00:04:27,300 our peers asking my opinion as to whether when this will get better, 75 00:04:27,460 --> 00:04:30,620 I I just say don't plan on it. Getting better plan on. 76 00:04:30,720 --> 00:04:35,220 So this is a storm and I think it will be here for the rest of my professional 77 00:04:35,220 --> 00:04:38,380 career. You know, I plan on working another 20 or 30 years. 78 00:04:38,480 --> 00:04:42,140 So that's my personal opinion is I just looking at the demographics of this, 79 00:04:42,580 --> 00:04:44,180 I don't see it necessarily getting better. 80 00:04:44,680 --> 00:04:46,700 So it means you just have to learn how to live with it. 81 00:04:46,700 --> 00:04:50,660 You have to learn how to be in sort of a labor first mentality in that 82 00:04:51,450 --> 00:04:55,300 your first consideration before you think about their workflow or what they're 83 00:04:55,300 --> 00:04:57,940 gonna be doing. You have to make sure you have a competent person, 84 00:04:58,420 --> 00:05:02,180 a compassionate person, a qualified person in that chair to deliver care. 85 00:05:02,360 --> 00:05:05,060 So that is number one. Um, 86 00:05:05,720 --> 00:05:07,620 the second thing is kind of related to that, 87 00:05:07,620 --> 00:05:11,500 putting our hat on and thinking as the employer of the patient. 88 00:05:11,640 --> 00:05:14,700 So the first hat is kind of employees first in a way, 89 00:05:14,700 --> 00:05:18,700 but the second hat is who are our customers and who funds us really? 90 00:05:18,700 --> 00:05:20,620 And obviously the government is one entity, 91 00:05:21,400 --> 00:05:23,700 but the other entity is the payers and, 92 00:05:23,840 --> 00:05:27,940 and the money from them is coming from employers. And, you know, 93 00:05:27,940 --> 00:05:32,180 the need that I'm seeing is you're hearing more and more, um, 94 00:05:32,240 --> 00:05:35,340 as inflation has increased, you're hearing a few things like, first of all, 95 00:05:35,340 --> 00:05:37,780 health systems are very reasonably saying, 96 00:05:38,760 --> 00:05:41,660 we need more money to take care of patients cuz it's costing us more money. 97 00:05:41,760 --> 00:05:46,140 You can't have year over year wage growth in the 10% range and in some 98 00:05:46,140 --> 00:05:47,780 specialties higher, you know, 99 00:05:47,780 --> 00:05:51,820 once that goes on for a few years and it's compounded, your cost structure is, 100 00:05:52,640 --> 00:05:55,820 has grown by quite a bit. And you know, 101 00:05:55,820 --> 00:05:57,160 as I alluded to in the first point point, 102 00:05:57,160 --> 00:05:59,740 like that's not really within any one systems control. 103 00:06:00,200 --> 00:06:01,780 And so it's an impact in the whole industry. 104 00:06:01,780 --> 00:06:06,020 So it's reasonable to expect that payers would, would make concessions on rates. 105 00:06:06,440 --> 00:06:08,900 Um, however the payers are, 106 00:06:09,210 --> 00:06:12,660 they are beholden to employers and the employers are trying to maintain 107 00:06:12,690 --> 00:06:13,940 competitive salaries. 108 00:06:14,280 --> 00:06:17,220 And so these employers are out there really trying to pay more out to the 109 00:06:17,380 --> 00:06:18,160 employee, 110 00:06:18,160 --> 00:06:21,740 and they're tending to really wanna leave benefits flat from a cost perspective 111 00:06:21,880 --> 00:06:24,100 if at all possible. So there's, 112 00:06:24,290 --> 00:06:28,540 I've heard more conversation and buzz amongst, you know, my contracts, 113 00:06:28,600 --> 00:06:31,860 my contacts in the industry and, and elsewhere and, 114 00:06:31,860 --> 00:06:35,180 and even in other industries about the need, uh, 115 00:06:35,200 --> 00:06:39,700 to constrain healthcare costs within employees. You know, it was very, very, um, 116 00:06:39,840 --> 00:06:42,620 common conversation about 10 years ago. 117 00:06:43,000 --> 00:06:46,060 And then as the economy picked up and the focus was put elsewhere, 118 00:06:46,640 --> 00:06:49,700 you heard less about this within healthcare and then during covid you heard 119 00:06:49,700 --> 00:06:54,140 nothing about it. But really this is now an issue. Um, 120 00:06:54,520 --> 00:06:59,380 and so that kind of leads naturally to will we see a resurgence in 121 00:06:59,540 --> 00:07:03,020 interest in things like value-based care and, and value-based contracting. 122 00:07:03,020 --> 00:07:05,940 And I think we will, and I think we are seeing that. Um, 123 00:07:06,200 --> 00:07:11,060 and the last point is we are in the midst of an age of just incredible medical 124 00:07:11,070 --> 00:07:13,140 innovation, uh, you know, 125 00:07:13,320 --> 00:07:18,180 to a level that I have not experienced in my career, which is, uh, you know, 126 00:07:18,180 --> 00:07:19,620 surprisingly in its fourth decade, 127 00:07:19,940 --> 00:07:23,220 I happened to have published my first scientific paper in the nineties when I 128 00:07:23,220 --> 00:07:27,980 was pretty young. So I've been in health and science for about, you know, 129 00:07:27,980 --> 00:07:32,780 over parts of four different decades. And I have never seen, 130 00:07:33,360 --> 00:07:37,940 um, so many things coming outta the woodwork, uh, that are promising. 131 00:07:38,040 --> 00:07:40,140 And it, it's sort of, um, 132 00:07:41,050 --> 00:07:44,260 very humbling to think how we'll pay for all this and how we'll implement it all 133 00:07:44,360 --> 00:07:45,380 on the delivery side. 134 00:07:45,760 --> 00:07:49,300 But you have things like cart therapy that are revolutionizing cancer therapy. 135 00:07:49,360 --> 00:07:52,420 You have mRNA vaccines and other uses for mRNA, 136 00:07:52,420 --> 00:07:57,060 including personalized cancer vaccines. You have incredible, um, 137 00:07:58,380 --> 00:08:02,060 progress in biomedical engineering and things like spinal stimulator devices, 138 00:08:02,120 --> 00:08:06,900 you know, patients that are learning to walk again after being paralyzed with, 139 00:08:07,010 --> 00:08:07,580 with, um, 140 00:08:07,580 --> 00:08:11,260 implants that can sense their thoughts and then really those things to their 141 00:08:11,260 --> 00:08:14,980 muscles in a way that their broken spinal cord can't. 142 00:08:15,720 --> 00:08:19,340 So these things were like science fiction when I was training, and I'm not, 143 00:08:19,340 --> 00:08:22,380 you know, not that old. So it, it, you know, 144 00:08:22,450 --> 00:08:24,340 somehow we have to make good on all this. 145 00:08:24,440 --> 00:08:29,180 We can't let the first two things be the choke point that prevents us 146 00:08:29,410 --> 00:08:33,060 from democratizing and giving access to these incredible innovations. 147 00:08:34,770 --> 00:08:36,890 Absolutely. That's really exciting to hear. And, 148 00:08:36,890 --> 00:08:40,210 and just looking at where we're at today, as you mentioned in, in terms of, uh, 149 00:08:40,900 --> 00:08:44,890 healthcare innovation and in advancement. And I, I love that idea too, 150 00:08:44,890 --> 00:08:48,170 of just making sure that, you know, you keep your eye on the, 151 00:08:48,270 --> 00:08:52,810 the things that will bring it forward, um, and not, uh, you know, 152 00:08:53,200 --> 00:08:57,700 letting that die on the implementation side. Um, and, and two, 153 00:08:57,700 --> 00:09:01,580 when you think about and talk about value-based care, it's awesome to, 154 00:09:01,640 --> 00:09:05,260 to hear and see that it's accelerated to some degree and really, um, 155 00:09:05,420 --> 00:09:07,500 becoming more innovative there. From your perspective, 156 00:09:08,280 --> 00:09:11,620 how do you really see growth and adding value to your organization? 157 00:09:11,650 --> 00:09:15,180 What does that look like in, in, in a practical sense? Um, 158 00:09:15,320 --> 00:09:18,220 how do you think about that and how it will evolve in the future? 159 00:09:19,490 --> 00:09:23,460 Yeah, and this year, I think, um, where I'm focusing just, 160 00:09:23,480 --> 00:09:27,380 and a lot of it's just based on, on my role and where I focus as I referenced, 161 00:09:27,400 --> 00:09:28,000 um, 162 00:09:28,000 --> 00:09:32,820 really and centered on issues of clinically integrated network and 163 00:09:32,820 --> 00:09:34,860 value-based care that kind of come hand in hand. 164 00:09:34,860 --> 00:09:38,540 You're thinking about how do populations access networks of care, 165 00:09:38,920 --> 00:09:42,300 how is their care coordinated? How do they experience it? Um, 166 00:09:42,360 --> 00:09:43,900 so they have the sense of value, right? 167 00:09:43,900 --> 00:09:45,700 They have the sense that there is a good experience, 168 00:09:45,730 --> 00:09:49,300 that they're getting the outcomes they want and whoever's paying for it, 169 00:09:49,300 --> 00:09:51,860 which is typically some combination of them and their employer, 170 00:09:52,290 --> 00:09:57,020 that both entities feel that they're getting, um, better value than, 171 00:09:57,090 --> 00:10:00,580 than they can at the competition, right? So this year, 172 00:10:00,660 --> 00:10:02,300 I think for us it's about the, um, 173 00:10:02,820 --> 00:10:06,100 reinvesting and the capabilities of value-based care in a lot of ways because 174 00:10:06,100 --> 00:10:09,620 during c o the focus was very much on doing a, 175 00:10:09,780 --> 00:10:13,060 a huge number of things for, um, 176 00:10:13,200 --> 00:10:16,820 for the folks that we serve and for society, you know, uh, 177 00:10:17,210 --> 00:10:19,700 that we weren't asked to do and that nobody had anticipated, right? 178 00:10:19,820 --> 00:10:23,060 A lot was asked of health systems and, and a lot was given too. I mean, 179 00:10:23,060 --> 00:10:23,940 there was a lot of support, 180 00:10:24,040 --> 00:10:28,940 but it certainly changed the strategic and tactical focus for three to 181 00:10:28,940 --> 00:10:32,020 four years from when it hit until around now. 182 00:10:32,400 --> 00:10:35,420 And now I think we're kind of going back to an area where the, uh, 183 00:10:35,520 --> 00:10:37,820 the macro forces are pointing us more to, 184 00:10:37,880 --> 00:10:42,060 to focus on the total cost of care and the various different measures of 185 00:10:42,060 --> 00:10:43,900 quality, one of which is patient experience. 186 00:10:43,960 --> 00:10:47,580 So some people hold that separately, you know, I kind of, uh, 187 00:10:47,590 --> 00:10:51,740 think of it as in there with quality. Um, and then another thing that, 188 00:10:51,740 --> 00:10:55,540 that I think has clearly popped out to the side of that in the sense that it's 189 00:10:55,540 --> 00:10:58,940 exclusive from that is equity. Um, that is, 190 00:10:59,560 --> 00:11:02,820 if I go back to the pre covid iteration of value-based care, 191 00:11:02,820 --> 00:11:07,820 there was not a ton of focus on equity at the, um, 192 00:11:08,020 --> 00:11:10,900 reimbursement level. I mean, they, they would sort of ask you what, 193 00:11:10,960 --> 00:11:13,980 how you were doing quality-wise, and they would measure it, but they weren't, 194 00:11:14,560 --> 00:11:15,393 um, 195 00:11:16,210 --> 00:11:20,220 requiring as much and as thoughtfully as they are now in, in their, 196 00:11:20,290 --> 00:11:22,940 they weren't saying, listen, what are the outliers look like? 197 00:11:23,040 --> 00:11:25,540 Are all the different populations getting the same care? 198 00:11:25,600 --> 00:11:30,460 Are there folks that we know need extra things given to them 199 00:11:30,560 --> 00:11:34,300 to ensure the access in terms of coordination and transportation, et cetera? 200 00:11:34,960 --> 00:11:36,540 Can you prove to us that they're getting that? 201 00:11:36,560 --> 00:11:40,460 So we are seeing that more in value-based programs in this sort of new age of 202 00:11:40,460 --> 00:11:43,060 value-based care. Um, so the, 203 00:11:43,480 --> 00:11:48,140 the reinvestment and refocus on this is, um, 204 00:11:48,940 --> 00:11:51,980 I think it's a body of work. It's not any one, uh, 205 00:11:52,490 --> 00:11:56,190 line item investment, but strategically, 206 00:11:56,230 --> 00:11:59,630 I think of it as one investment that we're, that we're making, uh, 207 00:11:59,630 --> 00:12:00,463 this coming year. 208 00:12:04,500 --> 00:12:06,320 Got it. Absolutely. I love that. And it is just, 209 00:12:06,320 --> 00:12:09,960 it's definitely important to have those investments that will set you you up for 210 00:12:09,960 --> 00:12:14,560 success in the future. And to your point, when looking at the iteration of, 211 00:12:14,900 --> 00:12:15,150 um, 212 00:12:15,150 --> 00:12:19,960 value-based care now being able to take into consideration health equity more 213 00:12:19,960 --> 00:12:21,760 than in the past and, and, uh, 214 00:12:21,870 --> 00:12:25,440 what that means to care for the whole patient and patient populations, um, 215 00:12:25,440 --> 00:12:28,200 you know, it is amazing to hear from your perspective, 216 00:12:28,510 --> 00:12:32,360 obviously a lot of experience on the clinical side, but, you know, 217 00:12:32,580 --> 00:12:36,600 how are the technology supporting that data, supporting that, and, and really, 218 00:12:36,620 --> 00:12:36,920 you know, 219 00:12:36,920 --> 00:12:40,840 what do you need from the organizational level to make sure that people are, um, 220 00:12:40,840 --> 00:12:44,720 using the technology in and, uh, using the data in a beneficial way? 221 00:12:47,610 --> 00:12:51,940 Well, we've, we've made a lot of investments as a health system, as have many, 222 00:12:52,480 --> 00:12:56,180 uh, medium and large size health systems on patient navigation functions. 223 00:12:56,180 --> 00:12:59,660 Mm-hmm. things like call centers and command centers. I mean, 224 00:12:59,660 --> 00:13:02,460 all of this is sort of like, um, 225 00:13:02,640 --> 00:13:06,620 the brain of the health system that helps navigate the patient because a health 226 00:13:06,620 --> 00:13:09,380 system, if you just think about the two words, right? I mean, 227 00:13:09,380 --> 00:13:12,860 it's focused on health, but it's supposed to systematize something. 228 00:13:13,600 --> 00:13:16,700 And I think of it as in its smallest unit. It's, it's, 229 00:13:16,760 --> 00:13:21,700 we need to make sure that the patient is able to get where 230 00:13:21,700 --> 00:13:24,900 they need to go to get good care. Because before they were health systems, 231 00:13:25,490 --> 00:13:27,700 they were doctors and they were, they were, they had their, 232 00:13:27,710 --> 00:13:31,940 their shop with their little sign and, you know, they were all doing business. 233 00:13:31,960 --> 00:13:33,580 So you had that before you had health systems. 234 00:13:33,640 --> 00:13:37,460 So what we add to the equation is a way to supercharge that. 235 00:13:37,960 --> 00:13:41,740 And you see it in things like a command center or a call center, 236 00:13:41,800 --> 00:13:45,220 an navigation center, um, but you also see it in cell service tools. 237 00:13:45,220 --> 00:13:50,060 So increasingly it's in the automated digital apps that health systems have. 238 00:13:50,060 --> 00:13:54,780 And we've been working on ours for the last couple years to let the patient, um, 239 00:13:55,090 --> 00:13:57,140 have more of a self-directed, 240 00:13:57,450 --> 00:14:01,860 self-guided relationship with their data and with what's out there to help them. 241 00:14:02,280 --> 00:14:03,660 So they might put their symptoms in there, 242 00:14:03,660 --> 00:14:07,420 or they might use it as a way to look at their own records and their data. Um, 243 00:14:07,680 --> 00:14:08,500 and over time, 244 00:14:08,500 --> 00:14:12,220 I think those things will come together that certain patterns and data will be 245 00:14:12,220 --> 00:14:15,740 used to make push notifications to patients. And some places are, 246 00:14:15,800 --> 00:14:18,820 are already doing that, and in some corners of our organization, 247 00:14:18,820 --> 00:14:22,060 we're doing that. But I think that over time you'll see that come together, 248 00:14:22,060 --> 00:14:26,500 those investments of a consumer digital first approach where, 249 00:14:27,040 --> 00:14:31,180 uh, they, they have sort of authorship, um, and ownership of their data, 250 00:14:31,720 --> 00:14:36,140 but they're also having a bidirectional relationship with it. And, um, 251 00:14:36,140 --> 00:14:37,940 when they need to, they're speaking with a person, 252 00:14:38,200 --> 00:14:39,420 but they don't always need to, 253 00:14:39,420 --> 00:14:42,860 and they might just want to interact with their data or book their appointment 254 00:14:42,860 --> 00:14:45,940 online or look at their own chest x-ray, who knows? I mean, 255 00:14:45,940 --> 00:14:49,260 there are a lot of things they may wanna do. So setting up the, um, 256 00:14:49,260 --> 00:14:50,340 the infrastructure for that, 257 00:14:50,720 --> 00:14:54,660 and EHRs I think are getting better and better at this. Uh, and, 258 00:14:54,760 --> 00:14:58,380 and there's a whole cottage industry that help around helping health systems 259 00:14:58,840 --> 00:15:03,220 create their apps and their portals. But I also see that the big, um, 260 00:15:04,080 --> 00:15:07,100 you know, players in this, like Epic and Cerner have, 261 00:15:07,100 --> 00:15:11,940 have also made tremendous strides. Um, so I think there's the, the, 262 00:15:11,990 --> 00:15:13,180 those two functions, 263 00:15:13,400 --> 00:15:16,260 the health system sort of command center navigation function, 264 00:15:16,260 --> 00:15:20,020 that's usually a call center with a lot of data and resources behind it, 265 00:15:20,370 --> 00:15:24,260 coupled to the digital, the, the automated, the app. Um, 266 00:15:24,630 --> 00:15:28,780 these are two big things that, that many health systems are doing. It's, 267 00:15:28,780 --> 00:15:30,500 they're, they're too big industry trends, 268 00:15:31,200 --> 00:15:35,220 and they're very much related to value-based care in the following way. Um, 269 00:15:35,480 --> 00:15:39,700 number one, they, they engage the patient digitally, so you have a broader, 270 00:15:39,770 --> 00:15:44,420 more longitudinal relationship with them. And for most value-based programs, 271 00:15:44,700 --> 00:15:48,260 a big part of what you're trying to do is prove that the patients are getting 272 00:15:48,260 --> 00:15:49,660 certain type of preventative care, 273 00:15:50,730 --> 00:15:53,270 and there's the type of preventative care that everybody needs. 274 00:15:53,270 --> 00:15:55,870 And then there are also population specific types. 275 00:15:56,050 --> 00:15:59,430 So diabetics need to get their retina screened. They need to get, uh, 276 00:15:59,430 --> 00:16:01,870 checked for foot ulcers, they need to get an A1C done. 277 00:16:02,530 --> 00:16:05,950 So most of the different payer programs have these things in common. 278 00:16:06,090 --> 00:16:09,550 And if you have a touch point with a patient and some means of bidirectional 279 00:16:09,790 --> 00:16:13,430 communication for the 99.9% of the time that they're not in the hospital, 280 00:16:14,380 --> 00:16:18,630 that with them or with their caregiver, that's incredibly powerful. I mean, 281 00:16:18,630 --> 00:16:21,790 that's, that's always what we've been trying to accomplish with things like care 282 00:16:21,790 --> 00:16:22,623 managers. 283 00:16:22,770 --> 00:16:27,190 So these additional digital tools and capabilities make population health just a 284 00:16:27,190 --> 00:16:30,670 lot more possible. Um, and then beyond that, 285 00:16:30,690 --> 00:16:34,590 and this is the level that I think that most aren't quite there yet, in, 286 00:16:34,610 --> 00:16:38,870 in aggregating that data and having the ability to sort of ask, uh, um, 287 00:16:39,870 --> 00:16:41,230 patients for additional points of data, 288 00:16:42,060 --> 00:16:46,550 there's the chance to sort of predict things that we can't predict today to 289 00:16:46,550 --> 00:16:49,870 predict who is sick and who isn't sick, you know, with, 290 00:16:49,870 --> 00:16:51,590 with diagnoses they may not be aware of. 291 00:16:51,730 --> 00:16:55,430 So who should get an extra type of screening, for example, um, 292 00:16:55,430 --> 00:16:59,950 to predict who's about to get really ill to predict, 293 00:17:00,370 --> 00:17:04,390 um, who needs an extra appointment in person to check on them. 294 00:17:04,850 --> 00:17:07,670 And then also to predict who's going to be minimal to different types of 295 00:17:07,950 --> 00:17:09,270 interventions. Um, 296 00:17:09,450 --> 00:17:13,950 so the predictive aspects and predictive analytics has also been something that, 297 00:17:14,370 --> 00:17:15,950 I'd say it's been hot for at least a decade, 298 00:17:16,610 --> 00:17:19,430 but with all the machine learning algorithms and with this, 299 00:17:19,580 --> 00:17:23,990 with the fact that it's been 15 years since high tech and data is now so 300 00:17:23,990 --> 00:17:28,790 ubiquitous, um, you're really starting to see where this is, um, 301 00:17:28,790 --> 00:17:30,030 having an impact, 302 00:17:30,140 --> 00:17:35,030 that there's a huge open space here to where even doctors that don't work 303 00:17:35,030 --> 00:17:39,310 for a health system or providers that are out there on their own, um, there, 304 00:17:39,310 --> 00:17:42,710 there's a day coming where they can do very sophisticated things with data, 305 00:17:42,950 --> 00:17:45,350 I believe at a very low cost on behalf of patients. 306 00:17:46,830 --> 00:17:48,990 Absolutely. I, I love that. I think that makes a lot of sense, 307 00:17:48,990 --> 00:17:52,380 sense and so helpful to think through and understand on the data level, 308 00:17:52,480 --> 00:17:53,010 you know, 309 00:17:53,010 --> 00:17:56,580 what that can really do if you utilize it correctly and have the appropriate 310 00:17:56,580 --> 00:18:00,460 systems in place. Now, before we wrap up our conversation, I wanted to ask, 311 00:18:00,470 --> 00:18:03,460 where do you see some of the best opportunities for growth and development in 312 00:18:03,460 --> 00:18:05,260 the future, both for yourself as well, 313 00:18:05,290 --> 00:18:08,300 well as the teams that you work with as healthcare evolves? 314 00:18:09,280 --> 00:18:12,970 Well, I, I mean, I think it's really exploring, um, those things. 315 00:18:12,970 --> 00:18:16,370 So I think people grow when they're focusing on the things that they're most 316 00:18:16,370 --> 00:18:21,250 passionate about. And, um, value-based care, for me, 317 00:18:21,430 --> 00:18:22,610 the reason I have a, you know, 318 00:18:22,610 --> 00:18:27,330 great passion about it is I've seen people with a great deal of resources 319 00:18:27,430 --> 00:18:32,370 go through the health system, um, and, and not necessarily get much out of it. 320 00:18:32,430 --> 00:18:35,370 And I, I said this, this is the US health system, not, 321 00:18:35,550 --> 00:18:38,210 not any health system in particular. Um, 322 00:18:39,110 --> 00:18:40,890 so it's not just a question of resources. 323 00:18:40,950 --> 00:18:44,890 The idea about value is sort of the idea of can we achieve these outcomes with 324 00:18:44,890 --> 00:18:48,170 higher efficiency and can we achieve them more commonly? 325 00:18:48,470 --> 00:18:53,090 We know that the United States, right, PRODU has produced, 326 00:18:53,470 --> 00:18:55,610 um, a ton of healthcare innovations, 327 00:18:55,610 --> 00:18:59,050 maybe the majority of the innovations over the last hundred years or so, 328 00:18:59,590 --> 00:19:00,210 but we know that, 329 00:19:00,210 --> 00:19:03,850 that there are other countries that just totally outperform us when it, 330 00:19:03,850 --> 00:19:06,930 when it comes to getting the outcomes from those same exact interventions. 331 00:19:06,990 --> 00:19:11,370 So we just need to learn how to be more consistent. So I think that, um, 332 00:19:11,890 --> 00:19:13,410 a lot of the growth for organizations, 333 00:19:13,590 --> 00:19:17,010 and what I'm planning on focusing on is how can we take those things that we 334 00:19:17,010 --> 00:19:20,850 know we've done, like at our best for our, you know, on our best day, 335 00:19:20,850 --> 00:19:24,490 what is our department done on our best day? What, what has our team done? 336 00:19:24,990 --> 00:19:28,570 How can we bring that a game to every single encounter to, 337 00:19:28,630 --> 00:19:32,290 to the patients that didn't make it in front of us that day that we happen to 338 00:19:32,310 --> 00:19:36,290 all, you know, come together and do it well. So to me, that's the growth is, 339 00:19:36,310 --> 00:19:40,050 is how do we get more standardized? How do we leverage data to, 340 00:19:40,150 --> 00:19:44,530 to make healthcare like as reliable as the aviation industry? I mean, that, 341 00:19:44,530 --> 00:19:48,330 that's when I talk a lot with my teams about how do we get that level of 342 00:19:48,360 --> 00:19:49,930 reliability, um, 343 00:19:49,930 --> 00:19:53,810 because we certainly should have it in healthcare and we have it when we have 344 00:19:53,810 --> 00:19:57,050 things like an or, right? Or like a specific radiology exam. 345 00:19:57,230 --> 00:20:00,610 So the individual pieces, we know, um, 346 00:20:01,230 --> 00:20:05,330 we can do incredibly well, but we also know that longitudinally, 347 00:20:06,480 --> 00:20:11,460 you know, we, we, we still only get mammograms as a nation on like 30 to 40, uh, 348 00:20:11,490 --> 00:20:15,180 well, uh, on like 60% of the people that, that need them. I mean, that's, 349 00:20:15,280 --> 00:20:19,060 that's, imagine it's a plan only landed 60% of the time. Like we, 350 00:20:19,060 --> 00:20:21,700 that be a problem, right? So that, that's what I, 351 00:20:21,820 --> 00:20:24,860 I think it really is a lot about just how do we get more reliable? 352 00:20:25,000 --> 00:20:27,900 How do we bring all these innovations from, um, from data and, 353 00:20:27,920 --> 00:20:32,780 and big tech to just up our game and be as good as we can 354 00:20:32,840 --> 00:20:35,700 be on our best day, but for every case. 355 00:20:37,360 --> 00:20:40,060 That's amazing. Dan, thank you so much for joining us on the podcast. 356 00:20:40,440 --> 00:20:42,460 An inspiring note to leave on. Um, 357 00:20:42,460 --> 00:20:45,620 and I'm looking forward to seeing you in person as well of the Health IT Digital 358 00:20:45,620 --> 00:20:49,060 Health and Revenue Cycle event, um, in October here in Chicago. 359 00:20:49,150 --> 00:20:52,340 It'll be such a fun time. I know a lot of these themes will be talking, 360 00:20:52,530 --> 00:20:56,420 talking about there and, and really expanding upon digital technologies, 361 00:20:56,740 --> 00:20:59,580 artificial intelligence, and more. So I'm looking forward to it. 362 00:21:00,990 --> 00:21:03,020 Thank you so much, Laura. Always, always a pleasure.