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Would you like to exchange best
practices and ideas to improve care,

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enhance operational efficiency,

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and address financial
challenges with your peers?

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Becker's Healthcare is facilitating these
conversations at their eighth annual

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health, IT digital
health and R C M meeting.

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You can check your
eligibility for complimentary
attendance at the link in the

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description. We are excited
to welcome you in October.

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This is Laura Dedo with the
Becker's Healthcare Podcast.

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I'm thrilled today to be
joined by Dr. Rob Bart,

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chief Medical Information
Officer at U P M C. Dr. Bart,

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it's a pleasure to have
you on the podcast today.

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Thank you for having me, Laura.

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Now, I know we have a lot to talk about
healthcare and digital technologies in

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healthcare, um, are are rapidly evolving
and the field is moving quickly.

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But before we dive into
my broader questions,

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can you tell me a little bit more
about yourself and your background?

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Yes, I'm happy to. So, uh,

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clinically I'm a pediatric critical
care physician and I've been doing that

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for, I guess over 30 years now.

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And it was about the time of my pediatric
critical care fellowship that I got

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involved in healthcare technology. Um,

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I was training at Duke and Duke
was one of the early adopters of,

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uh,

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digital flow sheet for care delivery
and documentation in the ICU

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environment.

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And so I was involved in the
implementation deployment, um,

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in my critical care fellowship,

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and that sort of got me very
interested in healthcare technology.

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And as my sort of career progressed
across the country ending up

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at Children's Hospital Los
Angeles, um, I was involved,

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um, with an enterprise electronic
health record deployment back in

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2002,

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which partly seems not too long
ago and partly seems a long

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time ago. Um,

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but that ultimately led me to a
physician as a chief medical physician

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at, uh, Cerner Corporation. So I've
worked on the vendor side for a few years,

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and then prior to joining U P M C,

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I was the Chief Medical
Information Officer at the
Los Angeles County Department

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of Health Services where we sort of
transformed and transitioned care there

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to a new, um, electronic health
record. And in the summer of 2017,

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I came to U P M C, um, never really
thought I'd leave Los Angeles County.

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I, I really enjoyed and I think
thrived on on the mission there,

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but I think I've also,

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Dr tried to drive myself to always
learn more and the opportunity

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to come to U P M C where they had
a large in insurance services arm

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as well as a group called
U P M C Enterprises,

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which does a lot of technology
hibernating investing.

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Um, it just made U P M C a very
attract attractive environment to,

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to come to and to,

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to learn some of the things that I
didn't know about healthcare technology.

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That makes a lot of sense and
what a fascinating career journey,

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being able to obviously start off as a
physician, a critical care physician,

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and then, um,

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get into the technology role doing some
integrations over to the vendor side

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with Cerner and then LA County.
Um, from your perspective,

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when you really look at the breadth of
what you've been able to experience, um,

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where do you see the
technology really, um, headed?

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What are some of the opportunities that
are on the horizon right now as well as

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the headwinds that you have your eye on?

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A a lot of the technology
that we've implemented within,

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um, the healthcare delivery, I'll focus
on sort of the delivery part of it.

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First, um,

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really was the digitization
of healthcare processes

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that had been developed over generations
of care being delivered using

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pen and paper, you know,

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maybe fax machines using
triplicate forms, et cetera,

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which some of my colleagues
will probably remember,

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but we didn't in, in many respects,

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the technology footprint didn't
advance healthcare as much

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as I think at least I expected
it to. I think that we,

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we predominantly, um, did change,

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did improve care by digitizing it,

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but we didn't sort of make this sort of

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Olympic leap to the next level,

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which I think that's what I sort of
thought I was doing back in 2002.

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And I think that we're now at the
point with being able to inject

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intelligence into the technology
platforms that I think what I thought

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we were doing 20 years ago is
something we potentially can be doing

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from, you know, today going
forward. And so that's what I,

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I look forward to is, you know, the,

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is potentially the future of what
we're gonna do, um, based on sort of

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the base or platform of what we've
implemented within u the US healthcare

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delivery systems over
the last 20 years or so.

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Absolutely. That's really
fascinating and I know, um,

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what you've been able
to do there at U P M C,

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it really has a sophisticated platform
being able to incorporate a lot of

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different technologies. And so, you
know, it it, it's awesome to see where,

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how far things have come, especially
from those days of, you know, uh,

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primarily using fax machines
in the triplicate, um,

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copies and trying to do everything,
um, along those lines. So, you know,

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once you have that foundation, um,
in place, what's the next step in in,

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if you have a quick minute to or thought
for hospitals and health systems that

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mm-hmm. <affirmative>, you know,

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maybe are still on the stage of trying
to inform that base of a great platform

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or, uh, something that they
can really rely on before, um,

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launching into the future. You know,

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what's important to know about
building that strong platform, um,

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for any type of healthcare organization?

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Yeah, so, so I think that,
so U P M C sir has two,

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um, there, there's one, one aspect
that's somewhat unique. Um, uh,

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for those of you who are
familiar with U P M C,

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we are an organization that's
predominantly concentrated in the state of

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Pennsylvania with a small outpost in,

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in New York state and a small outpost
in Maryland. When I say outpost, we,

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we have hospitals in those states,

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but most of our core care deliveries
in the state of Pennsylvania,

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and it's grown over the years
through acquisition. Um,

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the acquisition and that process has
been healthy for the organization to meet

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critical amass, but it also means
that we've incurred a fair amount of,

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of technical debt. Um, and what I mean
by that is our electronic health records,

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um, we have, I have more than
one, I have mul multiple EHRs.

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And so I think our challenge will
be a little bit unique in that

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we need to sort of modernize our care

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delivery infrastructure
at the same time that

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we sort of keep our eye on being
able to make sure that our current

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platforms and future platform we'll
be able to leverage intelligent

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intelligence within the platform. Um,

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we're very interested in artificial
intelligence, which, you know,

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I'm sure most of my colleagues
in in healthcare IT are,

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are interested in and most interested
in it in areas that will help improve

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the efficiency and effectiveness
of care delivery. Um,

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I know that there's been a lot of
focus on artificial intelligence in the

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clinical decision making
space, but I, I think that,

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that we have to build sort of comfort
with artificial intelligence within

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care delivery and
comfort also means trust.

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And I think leveraging artificial
intelligence and what it can

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provide us in being able to
optimize the efficiency and

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effectiveness and throughput
and care delivery, for example,

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is one way that we can develop comfort
and trust with it. You know, imagine,

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you know,

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solutions that help you optimize
the number of patients you can see

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in a clinic day,

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or the number of patients that can
go through one of our facilities

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ORs in a very safe, effective manner, um,

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that allows us to create better scale
with the limited human and physical

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resources we have. I think that's
one of the challenges in healthcare,

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but that,

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that opportunity then
allows healthcare as a,

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as an industry to become much
more comfortable and trusting

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of artificial intelligence.

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I think those are sort of the
building blocks that we'll need

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as we're starting to develop that trust,

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then being able to turn it
back into some of the, uh,

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care, clinical care decision making
processes that I think a lot of people are

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targeting artificial intelligence
with aiding clinicians. Um, in,

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in that instance, I, I don't think,

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I'm not one that believes that clinicians
will be completely out of the loop.

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I think, um,

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maybe the a in the a in
artificial intelligence
should actually be referred to

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as augmented intelligence helping
me as a physician make a better

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and faster decision as
opposed to replacing my

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ability to make a decision. But
as I said, the, I think the,

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the stepping stones to that are being
comfortable in letting artificial

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intelligence really help us tune our
operational efficiency and effectiveness.

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That makes a lot of sense. You know,
and it's really fascinating to look at,

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especially how artificial intelligence
has evolved in the past few months and,

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um, really become part of the
everyday workflows in many cases and,

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and lots of new opportunities there
as well. Uh, from your perspective,

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how do you think about growth and adding
value to the health system overall?

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Is it focused on some of the things you
were mentioning terms of the, the, um,

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clinical technologies and
artificial intelligence or,

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or where else do you see as being really
great ways that you as the C M I O

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of U P M C can really make a difference?

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I, I think one of the,
the big areas of in,

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in adding value to an organization and,

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and in my instance
specifically the U P M C,

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is to be able to sort of discern

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the tens if not hundreds of
technology opportunities out there.

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And really identifying the ones that have

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value both in improving or
maintaining the high quality of

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care we deliver,

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or improving or maintaining the
experience we wanna offer patients and

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consumers while at the same
time being able to offer a

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true financial return on investment. Um,

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and you really have to turn over a lot
of stones in technology to identify those

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opportunities, but I think tho that's
where you really achieve, uh, you know,

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value for your organization.
Um, you know, I'm a little wary,

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as much as I mentioned,
talked about artificial
intelligence a little while ago.

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I'm a little wary that it'd be
probably pretty easy to spend,

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I don't know, a hundred million dollars
on a bunch of artificial intelligence

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and not have a lot to show as far as
return on investment either from a

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quality of care or a return
on investment financially.

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And so I think that although there
are a lot of opportunities out there,

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we have to be really thoughtful about
which technologies truly bringing

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value to the process of care
delivery for U P M C as well

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as value to the patients and consumers
who seek to get their care here.

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And um, you know, and
that's something, uh,

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a comment I think when I, when I worked
at Cerner, which you know, was a,

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is a publicly traded
company at the time, um,

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I think one of the things I learned
there was that you have to be able to

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deliver value.

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And so as I look at that and whether it
was a LA county prior to coming to U P M

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C or here at U P M C,

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even though we're a private
not-for-profit entity, the,

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the thing that always, um,

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is driving me is does that drive the
best value for the organization in

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accomplishing the goals that we want for
our patients or the goals that we want

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for our clinicians and being efficient
and effective in care delivery.

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Um,

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as well as always looking
at an opportunity where that
can potentially return a

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financial investment. I, I think if you,

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if you don't put those as some of the
requirements when you're trying to solve a

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problem that you're presented with,
you'll come up with a solution,

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but it might not be the highest
value solution for your organization.

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I, I think that makes a lot of sense
and I'm sure will resonate with a lot of

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hospital health system leaders as
they're talking through, you know,

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what AI strategy really
makes sense for them,

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how they should be thinking about it in,
in being very thoughtful in terms of,

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um, how they're using
their healthcare dollars.

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I know right now I is really an
important time in healthcare.

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A lot of organizations are
facing tighter budgets than,

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than they have in the past and slimmer
resources, both manpower and otherwise.

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So, uh, given that, do you
see any areas that it's, uh,

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really important to continue to
make investments or, you know,

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maybe a risk worth taking in the next
year, uh, to just to make sure that um,

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the hospital or health system really
is in a place that it can grow going

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forward?

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I, I, I think, um, you
know, a couple areas I I,

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I've sort of hammered on the point of of
efficiency within your organization and

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looking at technology that relieves

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the individuals who are, um,

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involved in moving patients through
the care continuum and really aids and

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supports that, I think that is
worth definitely investing in.

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Cuz I think there's,

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there's this balance of improving the
process but at the same time trying

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to decrease some of the
burden of effort in all of the

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individuals who are involved in streaming
together care delivery, you know,

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whether that's the clinician at
the frontline or the technologist

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supporting the clinician or even
the back office finding those

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investments that in this
instance it might not have

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the most direct financial reward to
the organization or returns to the

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organization,

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but if it really decreases
burden of effort,

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which I think every healthcare system
is, is struggling with this challenge,

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you know,

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as we're sort of in this prolonged
emergence from the COVID 19 pandemic,

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that's an investment worth making cuz
I think it's important to also realize

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it's important to invest in the
processes that people are involved in

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because at the end of the day, healthcare,
no matter how much technology it has,

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is ultimately gonna depend on
having people who are happy and

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proficient in the care delivery process.

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And easing that burden is
gonna help them be a little,

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hopefully a little happier and hopefully
a little more proficient in the process

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of care delivery.

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That's a really great point and definitely
is something to keep your mind on

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and, um, your eye out for,
for the healthcare delivery
team, I know it's been,

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uh, definitely a rough few years and
certainly, um, being able to make things,

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uh, easier for them and more efficient
and and more seamless in the care

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coordination I can imagine, um, is really,

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really impactful on the
organization overall.

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Yeah, I, I absolutely, I think, you know,

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there's so much focus on machines
and artificial intelligence and we,

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there will all be always be humans in,
in the care delivery process and, and,

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uh,

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I think you cannot replace sort of
the healing factors related to, to,

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to human interaction,
human touch that occurs in,

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in healthcare and, um, you know, that's,

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we need to be able to sort of relieve
the burden so that peace can actually

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resonate and come through to all
the patients who receive care,

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whether it's at U P M C
or at other organizations.

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Absolutely. I I love that idea
and thought. Um, Dr. Bart,

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before we wrap up our conversation
here, I wanted to ask,

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where do you see the best opportunities
for growth and development in the

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future?

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What does that look like for yourself
as well as the teams that you work most

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closely with?

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That, that's actually probably the hardest
question you've asked. Uh, I think,

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you know, from an organizational
perspective, I think U P M C,

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we see a lot of the future of
care delivery being in, um,

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in the ambulatory, both
traditional ambulatory and,

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and the post-acute space and,

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and the footprint of acute
care or hospital based care,

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I think is gonna shrink or we at least
we believe it's gonna shrink over the

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next few years. So I think that's where,

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where the growth opportunities
are gonna be. Um,

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and I think to, to support that, you know,

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we've certainly seen a movement away from,

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uh, patients and consumers interacting
with healthcare systems in sort of

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traditional manners as in, you know,

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prior to the pandemic.

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And I think along with that move into

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new models of ambulatory care
or new models of post-acute

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care and even acute care that may not
occur within hospitals. I think that,

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that it's gonna require, um,

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a new form of sort of digital
interaction with patients

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and consumers.

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And I think we've certainly
seen sort of a huge interest

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from patients in wanting to interact
with healthcare systems through their

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smartphone and through other devices. Um,

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and so I think as those administrative
duties start to become more

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digitized and much more, uh,
seamless with, with patients,

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I think that you'll see new
care models come out of that,

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that that really a,

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allow the new footprint of
technology with some of the new

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intelligence that's being pushed
into healthcare technology to allow

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opportunities for growth.
Um, I think, you know,

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we're aggressively explor exploring
sort of new models of outpatient

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care. Um, things that, uh, we wouldn't
have considered prior to the pandemic,

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but I think the,

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the pandemic forced us to see

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opportunities or, or, um,

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experiences that we previously
wouldn't have thought of.

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And we've realized we can do
this very safely in this new

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venue of care that's not a hospital.

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And I think that's where a lot of the
growth is gonna occur. You know, it's

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maybe, maybe the future
will include more, you know,

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home visits, which is from, from doctors,

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whether they're virtual
or physical. Um, you know,

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not too different from a hundred
or 150 years ago when physicians

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predominantly made house calls.
Um, maybe that is sort of a,

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a sort of back to the future sort of
vision, but there's gonna be some,

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some construct around that. The,

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what we have done and traditionally
moved into acute care in the shape of

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hospitals a lot,

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I think a lot of that's gonna get
deconstructed into new models of care in

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venues that are much more comfortable
for the patient to receive their care in.

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That really makes a lot of sense,
you know, and it is a great, uh,

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vision of the picture that you're
painting, um, in terms of, you know,

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where healthcare is
headed and how really, uh,

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physicians and clinicians can be most
impactful on patient care. Dr. Bart,

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thank you so much for joining
us on the podcast today.

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This has been really fun conversation
and I'm excited to see you as well at our

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event in October for health IT
Digital Health and Revenue cycle, uh,

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five event in Chicago.

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I think it's gonna be a lot of fun and
I'm looking forward to continuing the

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discussion then.

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00:21:21,660 --> 00:21:25,640
Oh, I, I appreciate you taking the
time to, uh, spend a few moments,

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be Laura and I look forward
to, to meeting you, um,

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in October during that event.

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00:21:36,150 --> 00:21:39,360
It's so important for leaders at the
top of organizations to keep learning,

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00:21:39,510 --> 00:21:41,080
stay sharp, grow their networks,

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00:21:41,590 --> 00:21:44,760
help our audience better do this
in a more simplified, personalized,

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00:21:44,820 --> 00:21:48,840
and meaningful way. Becker's
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00:21:49,310 --> 00:21:52,320
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00:21:55,310 --> 00:22:00,080
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