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This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr. Jeff Hoffman,
chief Medical Information Officer at Nationwide Children's. Jeff,
it's a pleasure to have you on the podcast today.
Great to be here.
Now, I know we have a lot to talk about. There's so much happening,
especially heading into the fall, um, really with children's health, you know,
a very much a busy season. But before we dive into the broader discussion,
can you tell us a little bit more about yourself and your background?
Sure. Uh,
I am a clinical informaticist and pediatric emergency medicine physician at
Nationwide Children's Hospital here in Columbus, Ohio.
I've been a Chief Medical Information officer for about 12 years and seven years
ago founded a division of clinical informatics in our department of peds.
So I currently serve as the division chief as well.
We have 10 physician informaticists and four clinical informatics fellows in our
division,
and we also supervise about three dozen or so e h r provider builders across the
organization. So it's pretty, pretty large group that, uh, that is focused on,
uh, provider, uh, interaction with technology and the service of,
uh, healthcare and all the other goals we have at the institution.
Absolutely. That's great to hear.
And I know that sitting between the technology side of it as well as the medical
and healthcare provider side, you know,
it just seems like a perfect place to be right now with all the opportunities
and digital transformation and,
and working technology into the broader healthcare delivery, um, process.
So I'm excited to hear your perspective on how that's all working. Um,
given where we're at today,
what are some of the big opportunities as well as headwinds that you have your
eye on right now?
Yeah,
so right now we're certainly in an incredible period of opportunities in health
IT and the use of information technology for, for health and wellness.
Um, you know,
for years we've been hearing and talking about things like big data,
precision medicine,
all these buzzwords without really a clear idea of how these things would
directly impact what we do every day.
And I think we're finally at the point where these technologies, uh,
really have,
have matured to the point that we may be getting close to some re reaching some
of those lofty promises, uh, they held out. Um, yeah,
I don't have to say much about the hype this year, especially around ai, uh,
generative AI and the large language models like chat, G P T and all that. Um,
but with, with tools like that and the,
and the advances we've made in predictive analytics in general,
I think everyone's now starting to see the potential for using tools like this
in all kinds of different areas. Workforce efficiency, patient engagement,
process automation, safety, quality, um, research. Um,
of course we're, we're right at the top of the Gartner hype cycle right now. Uh,
I don't even think it's peaked yet. And on the other side is that dreaded,
you know,
trough of disillusionment before things sort of settle down into practical
applications with real benefits. So there's definitely headwinds. Um,
and I think it's gonna depend on, um,
I think those headwinds are really gonna depend,
determine how these tools are gonna be be used and what impacts they're gonna
really have. I mean, first of all, we got this incredible, um,
you know, over hype right now,
and a lot of companies are trying to capitalize on these inflated expectations.
So everyone's rushing into incorporate generative AI and such into their
platforms with, you know, different levels of success.
And I think AI algorithm is probably the new buzzword. Um, so, you know, having,
you know,
having the knowledge and skills to kind of figure out if products and product
claims are for real, um, you know, if you don't have that, uh,
you might be wasting a lot of time and money on products that don't live up to
their promises.
So just sort of dealing with all of that noise coming from the vendor
community, not knowing, you know, which are really good products,
which ones haven't really been, uh, well tested yet in the wild. Um,
and then on top of that, uh,
we're facing a lot of pressure with provider and staff burnout,
workforce shortages, you know, margins are being squeezed,
patient expectations are at an all time high,
especially with all this new technology out there. Um,
and the amount of change these tools bring on is gonna,
are gonna tax providers and staff who may be already struggling. So, um,
you know,
the challenge that me and a lot of my counterparts elsewhere have is trying to
figure out, you know, which of these tools are most valuable, um, how to, how,
you know,
how quickly to implement them and how to minimize just the burden of change that
we're gonna impose on our, on our workforce, and trying to do that.
And that's a real delicate balance.
And I can imagine it,
it seems like the last couple years there's just been so much thrown at the
clinical workforce in particular, trying to, um, you know,
manage some of the challenges with covid and then workforce shortages and those
kinds of things. And then now with additional data, as you mentioned,
information, looking at how you can develop and deliver more, um,
precise medical care and thinking about outcomes, um, how do you really,
I guess,
work through some of the people part of that change and making sure that people
trust the technology and are excited about it,
and then use it in the right way to deliver the best outcomes.
Those are really good questions. Um,
and I think one of the big mistakes oftentimes is we get so excited about the
technology and what it can do,
that we put it in there without really thinking about how it integrates into
the, into the workflow that people do every day. And sometimes it's,
it's actually that it's an assistant that's adding into their workflow something
that, you know, might, might, you know, immediately provide benefit or help,
but oftentimes it requires adjusting or changing a workflow that people might be
very comfortable with.
And so you first have to deal with just that anxiety around change in general.
And then you throw into that the fact that, you know,
some of these tools come without much explanation as to what they're doing and
why. So to basically develop, you need to develop a fair amount of trust,
uh, with the people that are gonna be using these tools and trust in two ways.
One, that you have confidence that these tools, you know,
have the accuracy they need, uh, don't, don't introduce additional risk, um,
are equitable. Um, and at the same time trust that if,
if things don't turn out that way that you're in position to, to,
to deal with those,
either mitigate those issues or maybe maybe switch to some other, uh, process.
So I think just that two-way communication and trust, um,
is really important. And if you, if you lose that early,
it's really hard to get it back.
That's such a great point, and definitely something to keep in mind, um,
for all healthcare leaders as they're looking at this transition. Now, I,
I wanted to ask, what do you,
how are you thinking about growth and development as well as adding value to
Nationwide Children's overall in the near future?
What does that really look like for you? So.
There's a few different ways to think about growth. You know,
obviously as a provider organization,
we're looking for opportunities to expand our services, our service offerings,
geographic reach,
but the explosion of telehealth has really dramatically changed the competitive
landscape we're in. You know,
we're a freestanding children's hospital in central Ohio,
and we're the largest provider by far of pediatric services in our local region.
And that has historically insulated us from a lot of competitive pressures,
even in a state like Ohio,
where we have four major children's hospitals within probably a two to three
hour drive of each other. Um, but with telehealth now in the mix,
we really have needed to double down on our areas of strength. We need to, we,
we really are focusing on creating more dynamic destination programs and
offering services that are difficult to find elsewhere.
And the same thing's happening in terms of our IT platforms and services,
you know,
pretty much any clinical program these days rely heavily on technology to
support all their patient care needs, population, health,
quality improvement and so on. Um, so as a result,
we've been heavily investing over the past several years in core capabilities
really to take care of all those areas and to maximize the functionalities in,
in what we have and what we own. So the E H R, of course, telehealth platforms,
analytic tools and such. In our case,
we put together a strong data science team so we could develop internal,
internally things like predictive models and, uh, you know,
use natural language processing, augment and virtual reality, things like that.
Um, so we built up the technical infrastructure and skilled workforce to deploy
these tools in,
in real work clinical settings so that we can study their benefit and we
continue to look for new opportunities, you know,
to really take care of patients and families, but as importantly,
to take care of our providers, our nurses,
and the rest of our nearly 14,000 employees. So, so really it's,
it's around really identifying what we are best at investing
in that,
and then letting that be our calling card both in our region and outside of
our region.
I love that. I,
I think it's sort of just fascinating to hear about and think about ways that
telemedicine, virtual care and all those other different and,
and unique care delivery, um, I guess modalities, um,
that have been popping up really can change the way you look at, um,
healthcare in, in the competitive landscape. Now, I know, um,
especially in the last year, uh,
just resources within the hospital have been a little bit more pinched than
usual, whether it's financial, manpower, work hours, et cetera,
but it's still important to kind of look it through and think about, you know,
where are areas we need to double down,
as you mentioned that we're doing really well. So from your perspective,
what is one risk or investment that's still worth making this year?
So this might seem like an obvious choice,
but I really think everyone should at least dip their toes into
the newer AI tools if they can. The, especially the generative AI tools, um,
things like chat, g p T based applications somewhere in their organization.
You know,
I don't expect everyone to have the technical capabilities to train their,
our own, their own large language model or,
or even tweak one that's commercially available. Um,
but I think it's important to begin to understand what these things can do and,
and as importantly, what they can't do,
what everyone's comfort level is with this technology in terms of accuracy,
bias, potential, legal liability, um, because, you know,
this is a train that's coming and you, you can't,
you're gonna be faced with using these tools at some point. Um,
and like I said before,
every vendor seems to be baking these sorts of tools into their products.
And new companies seem to be popping up everywhere with entirely new types of
products based on these kinds of technologies.
So with all the hype and swirl and all these choices, it,
it can really be hard to know where to start.
My suggestion would be either to trial a feature like this in one of your
existing applications, or, um,
perhaps applied by a large or stable vendor that you trust, uh,
or you can be more adventurous, try something, you know, totally new, um,
even from a small or a new vendor, um,
in an area basically where you can afford,
afford it to fail if it doesn't deliver on its promise. You know,
I personally have no doubt that these tools are gonna become ubiquitous and
essential in the coming years. So, you know,
you certainly don't wanna be left behind and you don't want to be behind the
curve in adopting them.
But really anybody who's trying to be on the cutting edge with these tools,
I say caution, um, until we have more history with them,
it's hard to know what specific, you know,
technologies or platforms will fall utterly flat and which ones will be
transformational. So I,
I think it'll be really interesting to look back at this period and maybe,
you know, five, six years from now and see what stuck and what sank.
Yeah, truly, it seems like right now they're just, uh,
such a broad field of technologies and companies and both established as well as
startups that are trying to figure out where the sweet spot is for, um,
really making a difference in the healthcare space. And when you look at,
you know, um,
yourself and Nationwide Children's and adopting new technologies or innovations,
um, like you said, obviously you don't wanna be, uh, first to the punch, but,
but don't wanna be lost either. Where do you really see yourself on that, um,
I guess innovation scale in terms of, um, being able to,
to wanting to jump in and, and, but,
but also making that balance with not, you know, uh,
taking on too much risk with something new.
It is, it is a very delicate balancing act, um,
partly because the resources to do these kinds of things,
whether you're buying a, a commercial product or,
or building things in house with local resources,
it's expensive and there's risk involved. I think that, um, you know, in,
in our case, uh,
what we have decided to do is take a very deliberate,
uh, use case focused approach. Um,
while this meaning find things where we know we have a need,
there isn't necessarily something out there that can do what we want it to do,
or maybe in some cases there are and, and, and try them out and see,
see how they work. So, you know, we've,
we've deployed some really innovative predictive analytics tools, uh,
for some of our high risk patient populations. Um,
and that was done after a, a, a significant amount of not just development time,
but testing and running scenarios and simulations and figuring
out what the impact would be, not just on the benefits,
but also the burden that they sometimes put on work workforce, uh, members. Um,
and then also, um, you know, we, we definitely,
uh, want to want to try to,
um, see what our peers are doing. We want,
we want to make sure that what the expectations that are being put on us by our
patients, by our families, by our staff, um, you know,
how others are addressing those. Um,
because I think this is an area where we can really learn from each other. I,
I don't think all of us, uh, really can afford to, uh,
try things out ourselves without having some indication of,
of how it's gone elsewhere. And I know that means someone has to go first,
and sometimes that's us, but we're also happy to let others go first and,
and us follow quickly behind.
That makes a lot of sense and truly seems like a, a very smart strategy, um,
in approaching the very many, uh,
new technologies and opportunities there are in the digital transformation
space. Now, before we wrap up our conversation,
I just wanted to return to growth one more time.
Where do you see some of the best opportunities in the future?
I know we've talked through a few different, uh,
key changes that are happening as healthcare evolves and healthcare delivery
changes. What, what's your perspective on the future more long term?
So from where I sit, um,
what I see as some of the best opportunities for growth are in
extending existing expertise, our existing expertise into, into new areas,
new markets. Um, obviously telehealth and remote patient monitoring,
e-consult services play a big part, but also really, um,
developing and maintaining really strong partnerships regionally, nationally,
and some cases internationally.
There's historically been a lot of friction for outside providers and new
patients trying to interact with health systems, and we're no exception to that.
You know, patient access has historically been a major challenge, and I know,
uh, we and others deal with that all the time. Uh,
some of that can be facilitated or helped with technologies we're focusing on
ones that can improve communication, both internally and externally.
Certainly looking for ways to streamline operations, uh,
referral routing automation, these AI powered chatbots.
We're looking into paperless workflows we're trying to adopt and really lowering
barriers to access, uh, from things as sort of that,
that aren't always on the radar. Things like, uh, you know,
transportation and travel difficulties where telehealth might be a solution or,
you know,
language barriers where remote interpretation services or auto translation tools
could really be helpful. So, you know,
focusing application of these tools and technologies can really attract new
patients, looking for key services that, um, that we can offer and, uh,
allow us to retain our existing patients who might be tempted to look elsewhere
because we can provide the same amount of patient engagement that our peers do,
and certainly they expect from dealing with, you know,
other industries that have already adopted a lot of these same tools and, and,
and technologies.
That's a great point. It definitely, you know, makes a lot of sense. Uh,
thank you so much for joining us on the podcast today, Jeff.
This has been really a fun and interesting conversation and I look forward to
connecting with you again soon.
It's been fantastic. Thank you.
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