1 00:00:05,105 --> 00:00:07,155 - This is the Becker's Healthcare Podcast, created 2 00:00:07,155 --> 00:00:08,315 by the team of Becker's Healthcare, 3 00:00:08,475 --> 00:00:10,195 a multimedia company devoted to the people 4 00:00:10,215 --> 00:00:11,515 who power us healthcare. 5 00:00:11,785 --> 00:00:14,595 Four new 15 minute episodes are released daily containing 6 00:00:14,795 --> 00:00:17,155 industry news analysis and thought leadership from powerful 7 00:00:17,155 --> 00:00:19,435 healthcare decision makers Support our show 8 00:00:19,575 --> 00:00:22,395 by leaving it a five star rating and review on Apple Podcast 9 00:00:22,615 --> 00:00:23,875 or other platforms you use. 10 00:00:24,025 --> 00:00:25,875 It's a chance to tell us what you like about the show 11 00:00:25,895 --> 00:00:27,115 and act on your feedback. 12 00:00:27,115 --> 00:00:29,075 Thanks for listening. Now here's the episode. 13 00:00:31,265 --> 00:00:33,635 - This is Laura Dedo with the Becker's Healthcare Podcast. 14 00:00:34,135 --> 00:00:36,155 I'm thrilled today to be joined by Bob Callway, 15 00:00:36,815 --> 00:00:38,675 the president and Chief Executive Officer 16 00:00:38,675 --> 00:00:39,795 of New England Life Care. 17 00:00:40,095 --> 00:00:41,995 Bob, it's a pleasure to have you on the podcast today. 18 00:00:42,405 --> 00:00:43,915 - Thank you, Laura. Thanks for having me. 19 00:00:44,575 --> 00:00:46,235 - Now, I know we've got a lot to talk about. 20 00:00:46,235 --> 00:00:47,955 There's so much happening right now in healthcare 21 00:00:48,015 --> 00:00:50,355 and certainly just some really fascinating, um, 22 00:00:50,495 --> 00:00:52,355 things you're doing there at New England Life Care. 23 00:00:52,375 --> 00:00:53,875 But before we dive into my questions, 24 00:00:53,895 --> 00:00:54,915 can you tell us a little bit more 25 00:00:54,915 --> 00:00:56,195 about yourself and your background? 26 00:00:56,545 --> 00:00:58,595 - Yeah, sure. Let me tell you both about me 27 00:00:58,775 --> 00:01:00,395 and a little bit about my company, 28 00:01:00,395 --> 00:01:03,435 because we're a little bit different than the, uh, 29 00:01:03,505 --> 00:01:05,555 than the typical healthcare organization. 30 00:01:05,735 --> 00:01:08,435 So, um, as you mentioned, I serve as the president 31 00:01:08,435 --> 00:01:09,915 and CEO of New England Life Care. 32 00:01:10,295 --> 00:01:12,315 Uh, my background, I was originally trained 33 00:01:12,335 --> 00:01:14,235 as a medical laboratory technologist 34 00:01:14,235 --> 00:01:17,075 and worked in acute care laboratories for a number 35 00:01:17,075 --> 00:01:18,395 of years early in my career. 36 00:01:18,975 --> 00:01:20,835 Uh, but most of my background, 37 00:01:20,955 --> 00:01:22,835 I hold advanced degrees in healthcare 38 00:01:22,835 --> 00:01:24,435 administration and in public health. 39 00:01:24,935 --> 00:01:27,635 Uh, and most of my background has been in, uh, 40 00:01:27,645 --> 00:01:29,235 large academic medical centers 41 00:01:29,335 --> 00:01:30,915 and physician group practices. 42 00:01:31,415 --> 00:01:32,475 And most recently 43 00:01:32,475 --> 00:01:35,675 before joining New England Life Care, uh, I worked 44 00:01:35,675 --> 00:01:36,955 with Atrias Healthcare, 45 00:01:37,285 --> 00:01:40,635 which is a very large physician practice here in, uh, 46 00:01:40,665 --> 00:01:41,835 eastern Massachusetts. 47 00:01:42,415 --> 00:01:45,435 Um, and one of the first participates in the, uh, 48 00:01:45,435 --> 00:01:48,955 pioneer Accountable Care organization, uh, which is, uh, 49 00:01:49,485 --> 00:01:52,035 where I spent most of my time, uh, working with 50 00:01:52,355 --> 00:01:53,595 and developing programs 51 00:01:53,735 --> 00:01:57,195 to perform favorably in an accountable care organization. 52 00:01:57,295 --> 00:01:59,235 And that's in part what drew me here 53 00:01:59,295 --> 00:02:02,515 to New England Life Care and for New England Life Care. 54 00:02:02,935 --> 00:02:05,515 Um, as I say, we're a unique organization. 55 00:02:05,895 --> 00:02:08,075 Uh, we are organized as a, not-for-Profit 56 00:02:08,715 --> 00:02:12,875 Hospital Services Cooperative, um, under Section 5 0 1 E 57 00:02:12,875 --> 00:02:14,235 of the IRS tax code. 58 00:02:14,615 --> 00:02:18,035 Um, and what that means in practical terms is that, uh, 59 00:02:18,175 --> 00:02:21,475 we provide a designated service, in this case it's, uh, 60 00:02:21,475 --> 00:02:26,435 home infusion services, uh, to, uh, not-for-profit hospitals 61 00:02:26,435 --> 00:02:28,235 that are members of the cooperative. 62 00:02:28,855 --> 00:02:32,035 And today there are 70 hospital members, uh, 63 00:02:32,175 --> 00:02:35,155 in the cooperative located in Massachusetts, Maine, 64 00:02:35,175 --> 00:02:36,515 New Hampshire, and Vermont. 65 00:02:37,095 --> 00:02:41,475 Um, and, uh, an interesting feature of the cooperative is 66 00:02:41,475 --> 00:02:43,595 that the member hospitals actually 67 00:02:43,655 --> 00:02:44,875 own New England Life Care. 68 00:02:44,895 --> 00:02:48,715 So we serve, if you will, as the infusion department, uh, 69 00:02:49,015 --> 00:02:52,115 for the 70 hospitals that, uh, that we represent. 70 00:02:52,575 --> 00:02:55,755 And internally, I maintain 70 profit 71 00:02:55,815 --> 00:02:58,435 and loss statements for all of the hospitals 72 00:02:58,435 --> 00:03:00,085 that are a member, member of the cooperative. 73 00:03:00,305 --> 00:03:03,085 So, uh, very interesting structure, uh, 74 00:03:03,705 --> 00:03:06,205 but in providing a really important services 75 00:03:06,465 --> 00:03:08,965 to the not-for-profit hospitals located 76 00:03:08,985 --> 00:03:10,165 in the region that we serve. 77 00:03:11,315 --> 00:03:12,335 - That's amazing to hear, 78 00:03:12,435 --> 00:03:14,575 and definitely, you know, a very big responsibility 79 00:03:14,675 --> 00:03:18,335 to be serving that community in such a, a large area 80 00:03:18,595 --> 00:03:20,175 of diverse population as well. 81 00:03:20,685 --> 00:03:22,055 From your perspective, what are some 82 00:03:22,055 --> 00:03:23,295 of your top priorities right now? 83 00:03:23,295 --> 00:03:25,015 What are you really spending most of your time on? 84 00:03:25,725 --> 00:03:27,175 - Yeah, it great question. 85 00:03:27,395 --> 00:03:30,935 Um, you know, we, we conducted, um, in the last few weeks, 86 00:03:31,155 --> 00:03:34,295 um, our town hall meetings where we bring together all 87 00:03:34,295 --> 00:03:37,255 of our staff who are spread all over New England, uh, 88 00:03:37,255 --> 00:03:39,775 to update them on what's going on with the business 89 00:03:39,835 --> 00:03:41,615 and what are our priorities at the moment. 90 00:03:42,155 --> 00:03:45,175 Um, and in that we shared with folks that, um, 91 00:03:45,435 --> 00:03:47,415 we had hoped coming out of the pandemic 92 00:03:47,605 --> 00:03:49,495 that things would settle down a little bit. 93 00:03:49,955 --> 00:03:51,975 Um, but in fact, the opposite is true 94 00:03:52,125 --> 00:03:55,335 that the market is changing so quickly both 95 00:03:55,585 --> 00:03:57,335 after effects of the pandemic, 96 00:03:57,795 --> 00:03:59,535 but just changes in the marketplace 97 00:03:59,965 --> 00:04:02,295 that it's really caused us to take a step back 98 00:04:02,635 --> 00:04:06,335 and reevaluate our strategic plans, um, over the course 99 00:04:06,355 --> 00:04:07,455 of the next couple of years, 100 00:04:07,475 --> 00:04:09,775 and in fact, shorten our strategic horizon 101 00:04:09,775 --> 00:04:12,935 because the market is changing quickly enough 102 00:04:13,355 --> 00:04:16,335 and new threats are emerging fast enough 103 00:04:16,485 --> 00:04:19,695 that it's really shortened our, our, um, our visibility. 104 00:04:20,155 --> 00:04:23,455 Um, so the things that we're working directly on now are the 105 00:04:23,455 --> 00:04:25,055 things that frankly, many 106 00:04:25,055 --> 00:04:27,215 of our member hospitals are dealing with today. 107 00:04:27,595 --> 00:04:31,255 So first and probably foremost is the shortage 108 00:04:31,315 --> 00:04:33,375 of qualified labor, um, 109 00:04:33,515 --> 00:04:35,295 to support the healthcare organizations. 110 00:04:35,515 --> 00:04:36,615 You know, lots 111 00:04:36,615 --> 00:04:39,015 and lots of people left healthcare during the pandemic. 112 00:04:39,675 --> 00:04:42,695 The pipeline of replacement staff isn't adequate 113 00:04:42,755 --> 00:04:44,815 to support the needs of the marketplace. 114 00:04:45,315 --> 00:04:47,975 Uh, and we've got a large, uh, population 115 00:04:47,975 --> 00:04:50,495 of healthcare workers who are approaching retirement. 116 00:04:50,875 --> 00:04:54,855 So we're innovating strategies around how do we continue 117 00:04:54,855 --> 00:04:58,495 to grow the organization in an environment that where, 118 00:04:58,505 --> 00:05:00,655 where there will simply not be enough staff 119 00:05:00,715 --> 00:05:02,095 to facilitate that growth. 120 00:05:02,595 --> 00:05:05,015 And that's taken on a number of different strategies. 121 00:05:05,015 --> 00:05:06,295 So that's sort of number one. 122 00:05:06,915 --> 00:05:10,695 The second is really a focus on driving 123 00:05:11,235 --> 00:05:16,015 interoperability and starting to deploy newer technologies 124 00:05:16,205 --> 00:05:17,855 that have come out in the marketplace, 125 00:05:17,915 --> 00:05:20,495 and particularly in the last six months or so. 126 00:05:20,955 --> 00:05:23,175 Uh, and particularly starting to deploy 127 00:05:23,695 --> 00:05:26,655 artificial intelligence and robotic process automation 128 00:05:27,285 --> 00:05:30,615 into our workflows, frankly, as a strategy 129 00:05:30,835 --> 00:05:34,455 to support the fact that there aren't enough staff available 130 00:05:34,595 --> 00:05:36,615 to do the work and grow the organization. 131 00:05:36,795 --> 00:05:39,735 So part of our strategy around dealing 132 00:05:39,805 --> 00:05:42,535 with staff shortages is working to make sure 133 00:05:42,535 --> 00:05:45,615 that we provide the tools that allow our staff to be as 134 00:05:46,215 --> 00:05:47,695 efficient as they possibly can 135 00:05:48,355 --> 00:05:51,775 and allow taking kind of the mundane work out of the work 136 00:05:51,775 --> 00:05:54,455 that they do and allowing them to work at the higher end 137 00:05:54,455 --> 00:05:56,975 of their licenses or their capabilities. 138 00:05:57,265 --> 00:05:59,405 So that's been a big change as well. 139 00:05:59,905 --> 00:06:03,445 Um, but I would also reflect it as both a curse 140 00:06:03,465 --> 00:06:06,005 and a blessing because while the drive 141 00:06:06,065 --> 00:06:09,525 for interoperability is really critical, both to kind 142 00:06:09,525 --> 00:06:10,645 of support the organization 143 00:06:10,665 --> 00:06:14,085 and to develop a patient-centric approach in managing care, 144 00:06:14,665 --> 00:06:18,005 um, the flip side to that is the rapidly increasing 145 00:06:18,525 --> 00:06:20,205 incidents of cyber attacks. 146 00:06:20,705 --> 00:06:24,285 Uh, we were a victim of a cyber attack earlier this year, 147 00:06:24,425 --> 00:06:27,045 and thankfully we're able to respond to it quickly. 148 00:06:27,585 --> 00:06:29,205 Uh, but a lot of time 149 00:06:29,225 --> 00:06:32,765 and effort has to go into protecting our information systems 150 00:06:32,985 --> 00:06:37,685 and keeping ahead of what is a burgeoning crisis in terms 151 00:06:37,785 --> 00:06:42,205 of, uh, the, the ability for, uh, threat actors to be able 152 00:06:42,205 --> 00:06:45,285 to invade systems that we use to care for our patients. 153 00:06:46,145 --> 00:06:49,325 Um, and then lastly, a big focus for us, particularly 154 00:06:49,325 --> 00:06:52,685 as a not-for-profit, um, is operating profitably. 155 00:06:52,985 --> 00:06:56,365 So, you know, we've seen both in an inflationary economy, 156 00:06:57,065 --> 00:06:58,805 but also as a result of sort 157 00:06:58,805 --> 00:07:02,365 of ongoing supply chain disruptions, both in terms of 158 00:07:03,045 --> 00:07:05,005 supplies, but also in pharmaceuticals, 159 00:07:05,455 --> 00:07:09,245 relatively rapid increases in the prices for, um, 160 00:07:09,345 --> 00:07:10,925 for the products that we purchase 161 00:07:10,945 --> 00:07:12,685 and that we use in patient care. 162 00:07:13,105 --> 00:07:15,165 Uh, and, and candidly, uh, 163 00:07:15,165 --> 00:07:16,965 third party payer reimbursement is 164 00:07:16,965 --> 00:07:18,005 not keeping pace with that. 165 00:07:18,145 --> 00:07:21,485 So this, we find this eroding our margins together 166 00:07:21,485 --> 00:07:22,845 with higher labor costs 167 00:07:23,265 --> 00:07:26,125 and needing to look at ways to make sure we can continue 168 00:07:26,125 --> 00:07:29,925 to generate sufficient margins to support the operations 169 00:07:29,945 --> 00:07:31,645 of the business and continue to grow. 170 00:07:33,775 --> 00:07:35,335 - Absolutely. I think that's fascinating and, 171 00:07:35,335 --> 00:07:38,095 and certainly a lot of the issues that you touched on, um, 172 00:07:38,275 --> 00:07:41,415 are top of mind for healthcare executives across the board. 173 00:07:41,565 --> 00:07:43,415 Certainly when you're looking at the 174 00:07:43,415 --> 00:07:44,895 labor shortages and challenges. 175 00:07:45,035 --> 00:07:49,575 Um, love to hear, you know, working on some of the AI RPA 176 00:07:49,635 --> 00:07:51,655 and, and other digital transformation aspects 177 00:07:51,655 --> 00:07:52,735 that can boost the workforce. 178 00:07:52,955 --> 00:07:55,495 And then, um, the supply chain disruptions too, 179 00:07:55,515 --> 00:07:57,055 it just seems like, you know, 180 00:07:57,055 --> 00:08:00,455 or continue a one-two punch of yeah, really just trying, 181 00:08:00,455 --> 00:08:03,215 trying to hospital financials and trying to figure that out. 182 00:08:03,675 --> 00:08:05,895 Um, you know, when you look at all those things, 183 00:08:06,125 --> 00:08:08,855 obviously bringing technology and can make a big difference, 184 00:08:08,995 --> 00:08:12,095 but how do you incorporate that into the broader culture 185 00:08:12,235 --> 00:08:15,615 of the organization and making sure people, um, you know, 186 00:08:15,715 --> 00:08:17,495 are, are working to the top of their abilities, 187 00:08:17,555 --> 00:08:19,455 but then also comfortable with the, um, 188 00:08:19,455 --> 00:08:20,855 digital transformation strategy? 189 00:08:21,285 --> 00:08:23,255 - Yeah, well, I think it's a great question. 190 00:08:23,475 --> 00:08:26,895 Uh, I sort of express that in terms of, um, 191 00:08:27,555 --> 00:08:28,855 our strategies 192 00:08:28,875 --> 00:08:32,775 or our tactics for dealing with, um, staffing shortages. 193 00:08:33,195 --> 00:08:36,095 Um, and we've really got kind of five approaches, one 194 00:08:36,095 --> 00:08:38,375 of which speaks directly to the question you're asking. 195 00:08:38,555 --> 00:08:41,855 So number one is that we, we recognize that we have 196 00:08:41,875 --> 00:08:45,255 to be much more innovative in recruiting 197 00:08:45,435 --> 00:08:48,375 for the limited staff that are available in the marketplace. 198 00:08:48,595 --> 00:08:51,135 And part of that requires us 199 00:08:51,155 --> 00:08:53,855 to make the organization an attractive one 200 00:08:54,235 --> 00:08:57,365 for healthcare professionals to want to join, right? 201 00:08:57,425 --> 00:09:00,605 So, um, you'll hear threaded through these strategies, 202 00:09:01,145 --> 00:09:04,405 the goal of what we refer to as creating allies 203 00:09:04,515 --> 00:09:06,045 with our employees, right? 204 00:09:06,115 --> 00:09:09,885 Embedding them and engaging them actively, um, in 205 00:09:09,905 --> 00:09:11,205 how the business is run. 206 00:09:11,665 --> 00:09:15,525 Um, creating an environment where people feel connected 207 00:09:15,525 --> 00:09:17,885 to the purpose, where their voices matter 208 00:09:17,985 --> 00:09:20,565 and where they feel connected with, uh, 209 00:09:20,575 --> 00:09:23,085 where the business is going and how we're gonna get there. 210 00:09:23,865 --> 00:09:25,485 Um, that will in fact, 211 00:09:25,605 --> 00:09:28,125 I think ultimately also make it an attractive place 212 00:09:28,125 --> 00:09:29,525 for people to wanna come to work. 213 00:09:30,505 --> 00:09:32,845 Um, that gets to the second piece, 214 00:09:32,845 --> 00:09:35,205 which is really focusing on staff retention, 215 00:09:35,235 --> 00:09:37,365 keeping the good staff that we have. 216 00:09:37,825 --> 00:09:40,405 Um, and that gets back to what I was just talking about 217 00:09:40,405 --> 00:09:44,005 around ke keeping people connected, having them feel a sense 218 00:09:44,005 --> 00:09:45,325 of purpose and commitment 219 00:09:45,345 --> 00:09:47,565 and engagement with the organization, uh, 220 00:09:47,675 --> 00:09:49,045 that their voice matters 221 00:09:49,225 --> 00:09:51,805 and that, that their folks listening to their points 222 00:09:51,805 --> 00:09:53,725 of view on how the business should re run. 223 00:09:54,185 --> 00:09:57,165 But there's also a big focus on our part around 224 00:09:57,815 --> 00:09:59,285 preserving staff wellness 225 00:09:59,665 --> 00:10:02,165 and identifying, reducing the signs of burnout, 226 00:10:02,215 --> 00:10:06,045 which we're really endemic during the the covid period. 227 00:10:06,825 --> 00:10:11,165 Um, you know, third for us is improving the efficiency 228 00:10:11,165 --> 00:10:13,005 and the productivity of the staff we have, 229 00:10:13,025 --> 00:10:16,005 and that's where I mentioned starting to apply things like, 230 00:10:16,105 --> 00:10:19,365 uh, artificial intelligence and robotic process automation 231 00:10:19,385 --> 00:10:22,245 and, and frankly, modern information system. 232 00:10:22,385 --> 00:10:24,605 So we'll be going through, uh, an upgrade 233 00:10:24,605 --> 00:10:28,365 of our electronic medical record in the next 18 months 234 00:10:28,905 --> 00:10:31,805 to provide a more ma modern platform that allows us 235 00:10:31,805 --> 00:10:34,525 to better, better digitize our, our systems. 236 00:10:35,185 --> 00:10:36,485 Um, and in AI 237 00:10:36,485 --> 00:10:39,165 and RPA, we've applied it in a couple of places already. 238 00:10:39,385 --> 00:10:41,725 So, um, we were able to, uh, 239 00:10:41,745 --> 00:10:43,765 to use robotic process automation 240 00:10:43,905 --> 00:10:47,765 to basically digitize order entry coming into our 241 00:10:47,765 --> 00:10:50,925 organization, uh, which had an enormous benefit. 242 00:10:51,105 --> 00:10:56,045 So historically, our orders came to us generally by fax, um, 243 00:10:56,425 --> 00:10:59,245 but were sometimes available through hospital's use 244 00:10:59,245 --> 00:11:01,565 of post-acute, uh, discharge software. 245 00:11:02,065 --> 00:11:05,325 Um, but all of that was ultimately converted to paper 246 00:11:05,835 --> 00:11:07,725 that our staff then end up having 247 00:11:07,745 --> 00:11:10,365 to reenter into our electronic medical record. 248 00:11:10,865 --> 00:11:14,565 And you can just imagine both the, the labor requirements 249 00:11:14,625 --> 00:11:17,485 to do that and the degree of error that comes 250 00:11:17,485 --> 00:11:21,365 with anyone trying to transpose information from, you know, 251 00:11:21,405 --> 00:11:23,765 a written document into an electronic record. 252 00:11:24,385 --> 00:11:26,885 So we actually use robotic process automation 253 00:11:27,225 --> 00:11:31,125 to receive those incoming faxes, digitize the results, 254 00:11:31,225 --> 00:11:33,605 and load it automatically into our 255 00:11:33,605 --> 00:11:35,005 electronic medical record. 256 00:11:35,465 --> 00:11:38,045 So we eliminate all of that manual data entry. 257 00:11:38,665 --> 00:11:41,205 Uh, we're applying that in some, in a number 258 00:11:41,205 --> 00:11:43,525 of areas also within our billing operations. 259 00:11:43,625 --> 00:11:46,605 And again, the goal here is trying 260 00:11:46,605 --> 00:11:50,005 to identify the mundane parts of the work that all 261 00:11:50,005 --> 00:11:52,205 of our staff do, whether professional staff 262 00:11:52,225 --> 00:11:53,485 or administrative staff, 263 00:11:53,985 --> 00:11:56,805 and remove that use technology to support that. 264 00:11:57,465 --> 00:12:01,565 So to your question about staff acceptance of that, um, 265 00:12:01,895 --> 00:12:03,885 there, you know, kind of two pieces to this. 266 00:12:03,945 --> 00:12:07,245 One is staff view it as incredibly valuable, right? 267 00:12:07,245 --> 00:12:09,765 We're looking for small wins here to show 268 00:12:10,585 --> 00:12:11,685 how the application 269 00:12:11,685 --> 00:12:14,765 of this technology can make their work lives better, 270 00:12:14,915 --> 00:12:18,005 because no one wants to have to do all of that mundane work. 271 00:12:18,385 --> 00:12:21,885 Uh, staff wanna be using kind of a higher level of judgment 272 00:12:22,065 --> 00:12:25,085 and capability in the work that they, uh, that they do. 273 00:12:25,145 --> 00:12:28,525 So we're seeing acceptance there from that point of view, 274 00:12:28,985 --> 00:12:30,125 um, and two, 275 00:12:30,305 --> 00:12:34,005 by actively engaging our staff in utilization of the software. 276 00:12:34,185 --> 00:12:36,925 So we were really clear as we went into this, 277 00:12:37,575 --> 00:12:41,445 we're not developing this, this software to replace anybody. 278 00:12:41,555 --> 00:12:43,845 This, this is not gonna eliminate jobs. 279 00:12:44,385 --> 00:12:47,565 Um, what it will do though is turn the trajectory 280 00:12:47,755 --> 00:12:51,845 that will require us to have less labor as we continue 281 00:12:51,845 --> 00:12:53,045 to grow, um, 282 00:12:53,425 --> 00:12:56,325 and it's labor working at, at a higher level 283 00:12:56,345 --> 00:12:58,045 of competency and capability. 284 00:12:58,905 --> 00:13:01,805 Um, so that's where our AI models come in. 285 00:13:01,805 --> 00:13:03,485 And then, you know, we're also looking at 286 00:13:03,485 --> 00:13:04,965 alternative staffing models. 287 00:13:05,305 --> 00:13:06,325 Uh, you know, given 288 00:13:06,325 --> 00:13:09,365 that there aren't enough infusion nurses, for example, 289 00:13:09,465 --> 00:13:12,845 to be able to support the healthcare marketplace, starting 290 00:13:12,865 --> 00:13:15,845 to look at places where, um, other kinds 291 00:13:15,845 --> 00:13:17,885 of staff can do the work that 292 00:13:18,485 --> 00:13:20,765 infusion nurses are, are not available to. 293 00:13:20,825 --> 00:13:24,525 So for example, here in Massachusetts, we're now using, um, 294 00:13:25,275 --> 00:13:27,845 LPNs to do IV line management. 295 00:13:27,875 --> 00:13:29,845 It's within their scope of practice. 296 00:13:30,225 --> 00:13:33,845 Um, and instead of having to deploy expensive, uh, 297 00:13:34,205 --> 00:13:36,645 infusion nurses to do that, so again, 298 00:13:36,645 --> 00:13:39,525 it's using the right folks at the right end of their scope 299 00:13:39,525 --> 00:13:41,085 of practice and their capabilities. 300 00:13:41,905 --> 00:13:44,645 Um, and then lastly, we're really starting to look at 301 00:13:45,065 --> 00:13:47,245 how we develop staff, right? 302 00:13:47,265 --> 00:13:50,445 And this will include training programs designed 303 00:13:50,625 --> 00:13:53,805 to create a clin, a pathway within the organization 304 00:13:54,275 --> 00:13:57,645 that allows staff to stay here, develop new skills, 305 00:13:58,105 --> 00:14:00,925 and move into increasing levels of, of, um, 306 00:14:01,385 --> 00:14:03,965 of capability within the organization. 307 00:14:04,105 --> 00:14:06,325 So we are looking at training, for example, 308 00:14:06,425 --> 00:14:08,405 our own pharmacy technicians so 309 00:14:08,405 --> 00:14:11,365 that they can work in the clean room taking folks without 310 00:14:11,365 --> 00:14:12,765 having that experience 311 00:14:12,765 --> 00:14:14,885 and actually building the training programs here. 312 00:14:15,025 --> 00:14:19,085 So multifaceted in terms of how we're gonna accomplish that, 313 00:14:19,585 --> 00:14:21,845 uh, and all rely on one another. 314 00:14:22,345 --> 00:14:25,565 But the essence to this, in, in the answer again 315 00:14:25,585 --> 00:14:29,325 to your question is you can't be successful in doing this 316 00:14:29,705 --> 00:14:33,125 unless you're engaging staff at every level to know 317 00:14:33,195 --> 00:14:35,525 what you're trying to accomplish as an organization 318 00:14:35,865 --> 00:14:37,125 and them feeling a part 319 00:14:37,185 --> 00:14:39,525 and engagement in achieving those goals. 320 00:14:41,545 --> 00:14:43,305 - Absolutely. That makes a ton of, of sense, 321 00:14:43,365 --> 00:14:44,385 and I, I really love it. 322 00:14:44,485 --> 00:14:45,985 Um, love that strategy there. 323 00:14:46,125 --> 00:14:47,545 Now, looking into the future, 324 00:14:47,885 --> 00:14:49,385 how do you see New England life care 325 00:14:49,745 --> 00:14:50,865 evolving over the next few years? 326 00:14:51,115 --> 00:14:53,565 What do you see as accelerating and changing over time? 327 00:14:54,315 --> 00:14:55,845 - Yeah, that's a great question too. 328 00:14:56,145 --> 00:14:57,365 Um, and you know, 329 00:14:57,465 --> 00:15:00,365 my answer would've been different if you had asked me that 330 00:15:00,365 --> 00:15:02,165 during the, uh, during the pandemic, 331 00:15:02,385 --> 00:15:06,405 but one of the things that we saw, um, really prior 332 00:15:06,465 --> 00:15:08,005 to the pandemic and, 333 00:15:08,225 --> 00:15:12,125 and sort of on steroids, if you will, during the pandemic, 334 00:15:12,825 --> 00:15:16,845 was, um, more migration of care out 335 00:15:16,845 --> 00:15:19,605 of acute care settings and into the home. 336 00:15:20,425 --> 00:15:23,485 And where that really got wheels, if you will, 337 00:15:23,485 --> 00:15:27,645 during the pandemic is, you know, one was CMSs, um, 338 00:15:28,235 --> 00:15:30,405 expansion of the hospital without laws 339 00:15:30,505 --> 00:15:32,245 or the hospital at home programs 340 00:15:32,985 --> 00:15:36,805 and providing reimbursement for those programs that, um, 341 00:15:36,945 --> 00:15:41,565 you know, that created just a waterfall of organizations now 342 00:15:41,565 --> 00:15:43,885 that are implementing their own hospital at home programs, 343 00:15:44,205 --> 00:15:45,365 bringing care into the home. 344 00:15:45,905 --> 00:15:49,925 Uh, that was sort of one, uh, one op uh, one, uh, feature, 345 00:15:50,385 --> 00:15:51,525 uh, of the pandemic. 346 00:15:51,905 --> 00:15:55,245 Um, you know, organizations were realizing that a lot 347 00:15:55,245 --> 00:15:59,165 of the care that is provided in acute care settings can be 348 00:15:59,405 --> 00:16:01,725 provided in the home, and we're simply lacking a 349 00:16:01,925 --> 00:16:03,165 reimbursement mechanism for that. 350 00:16:03,585 --> 00:16:06,765 Um, and we're also now seeing in large part, 351 00:16:07,065 --> 00:16:10,285 to compete favorably in accountable care programs. 352 00:16:10,665 --> 00:16:13,485 Uh, more and more programs aimed at trying 353 00:16:13,505 --> 00:16:17,125 to avoid patients going into acute care settings 354 00:16:17,505 --> 00:16:20,525 or being unnecessarily hospitalized for services 355 00:16:20,525 --> 00:16:22,245 that could be provided in the home. 356 00:16:22,345 --> 00:16:24,845 And home infusion is a big part of that, 357 00:16:24,845 --> 00:16:28,085 because it's not uncommon that patients go 358 00:16:28,085 --> 00:16:30,605 to the emergency room to get a line installed 359 00:16:30,825 --> 00:16:33,485 to start their antibiotic treatment, for example, 360 00:16:34,025 --> 00:16:35,405 and then get admitted for 361 00:16:35,405 --> 00:16:37,485 that when in fact those services could be 362 00:16:37,685 --> 00:16:40,405 provided equally well and equally safely in the home. 363 00:16:41,065 --> 00:16:43,725 So we expect that expansion's gonna continue. 364 00:16:43,945 --> 00:16:48,125 Uh, you see it in, in a number of the disruptors that are, 365 00:16:48,275 --> 00:16:50,205 that are moving into the marketplace. 366 00:16:50,305 --> 00:16:52,765 You look at places like Amazon and Optum 367 00:16:52,785 --> 00:16:54,045 and uh, so forth 368 00:16:54,275 --> 00:16:56,965 that are really focused on both the pre acute 369 00:16:56,985 --> 00:17:00,245 and the post-acute settings, recognizing 370 00:17:00,245 --> 00:17:02,565 that more care is gonna be happening in the home. 371 00:17:02,785 --> 00:17:07,045 So for us, that means both a, a a, you know, 372 00:17:07,045 --> 00:17:10,765 significant growth in the services that we provide, uh, 373 00:17:11,185 --> 00:17:14,045 but it also means that, uh, we've gotta think about 374 00:17:14,105 --> 00:17:15,965 how we do di things differently, right? 375 00:17:15,965 --> 00:17:19,525 Because, for example, providing home infusion 376 00:17:19,705 --> 00:17:23,965 for a hospital home patient, uh, is the same as we've done 377 00:17:24,025 --> 00:17:26,925 for many years for a, you know, a patient 378 00:17:27,195 --> 00:17:29,445 that has been discharged from an acute care setting. 379 00:17:29,785 --> 00:17:32,005 The difference here is the turnaround time. 380 00:17:32,005 --> 00:17:33,645 These are hospitalized patients, 381 00:17:33,665 --> 00:17:36,565 so you've gotta build your operation that allows you 382 00:17:36,565 --> 00:17:39,125 to prepare compounded medication 383 00:17:39,185 --> 00:17:41,525 and infusion supplies in a requi 384 00:17:41,535 --> 00:17:42,965 relatively quick turnaround. 385 00:17:43,305 --> 00:17:46,085 So that's a big change for our organization is trying 386 00:17:46,085 --> 00:17:48,805 to keep up with that, uh, with that pace of change. 387 00:17:49,505 --> 00:17:53,125 Um, I think the other thing we expect to see is that, again, 388 00:17:53,185 --> 00:17:57,885 the, the, um, pandemic taught us that many more therapies 389 00:17:58,515 --> 00:18:00,845 that we always assumed could only be 390 00:18:01,125 --> 00:18:03,165 provided in acute care settings, um, 391 00:18:03,545 --> 00:18:06,085 can in fact now be done in home, in the home. 392 00:18:06,385 --> 00:18:09,325 So, you know, you're seeing in the marketplace, for example, 393 00:18:09,875 --> 00:18:12,725 more movement of, um, cancer treatment 394 00:18:12,785 --> 00:18:15,405 for patients in the home, including some types 395 00:18:15,425 --> 00:18:16,685 of chemotherapy now 396 00:18:16,965 --> 00:18:20,565 provided in the home, um, that's supplemented by another, 397 00:18:20,865 --> 00:18:25,005 um, uh, service that emerged during the pandemic, 398 00:18:25,215 --> 00:18:27,725 which is the application of telemedicine 399 00:18:27,785 --> 00:18:29,205 and patient telemonitoring. 400 00:18:29,625 --> 00:18:33,045 Uh, right. And that emerged very quickly out of necessity 401 00:18:33,045 --> 00:18:35,885 during the pandemic, but that's gonna survive now, 402 00:18:35,885 --> 00:18:38,485 that will sort of be the platform that allows us 403 00:18:38,505 --> 00:18:39,645 to provide more services 404 00:18:39,745 --> 00:18:41,525 to the patient in the home environment. 405 00:18:41,985 --> 00:18:46,445 So, big impact for us, as we're, I mentioned at the outset, 406 00:18:46,445 --> 00:18:48,805 that the market is changing really quickly for us, 407 00:18:49,185 --> 00:18:51,605 and it's those areas where we're really starting 408 00:18:51,665 --> 00:18:55,125 to see the pace of change, um, just moving very, 409 00:18:55,195 --> 00:18:57,965 very quickly and many competitors, 410 00:18:58,105 --> 00:19:00,725 mo including not-for-profit competitors, um, 411 00:19:00,825 --> 00:19:04,405 and big tech moving into this area to try 412 00:19:04,405 --> 00:19:05,885 to capture a piece of the pie. 413 00:19:08,545 --> 00:19:09,825 - Absolutely. That's such a great point. 414 00:19:09,925 --> 00:19:12,425 And, you know, so interesting to think about how that pace 415 00:19:12,425 --> 00:19:15,025 of change has really made a difference, um, you know, 416 00:19:15,025 --> 00:19:16,145 over the past couple years. 417 00:19:16,605 --> 00:19:18,425 And certainly one of the things you mentioned at the top 418 00:19:18,425 --> 00:19:21,145 of our conversation too, is there being new threats as, 419 00:19:21,205 --> 00:19:24,185 as part of the reason why you're needing to, um, shorten 420 00:19:24,185 --> 00:19:25,225 that strategic horizon 421 00:19:25,365 --> 00:19:28,065 and looking at, you know, um, what's happening there. 422 00:19:28,125 --> 00:19:30,505 And so I was wondering, you know, is 423 00:19:30,505 --> 00:19:31,865 that typically looking at some 424 00:19:31,865 --> 00:19:33,505 of these non-traditional healthcare entrants or, 425 00:19:33,505 --> 00:19:36,105 or what other threats do you really see as arising now that, 426 00:19:36,125 --> 00:19:37,185 you know, may not have been there 427 00:19:37,205 --> 00:19:40,145 or part of that strategic process before the pandemic? 428 00:19:41,085 --> 00:19:42,575 - Yeah, it's a great question, 429 00:19:42,675 --> 00:19:46,095 and you're right that, you know, all of this environment, 430 00:19:46,555 --> 00:19:49,815 um, has really shortened our strategic horizon 431 00:19:49,905 --> 00:19:52,015 where we typically would've looked out two 432 00:19:52,015 --> 00:19:53,975 to three years in our strategic planning. 433 00:19:54,555 --> 00:19:56,215 You know, it's, right now it's impossible 434 00:19:56,215 --> 00:19:58,255 to look at the market and determine where it's gonna be 435 00:19:58,595 --> 00:20:01,655 and what the threats will be three years from now, uh, 436 00:20:01,825 --> 00:20:03,415 which has kind of shortened that up. 437 00:20:03,795 --> 00:20:07,455 Um, but the, you know, we, we see as the principle threats, 438 00:20:07,835 --> 00:20:12,175 the, so I mentioned, um, really a rapid invasion, um, 439 00:20:12,765 --> 00:20:15,335 into the, particularly the post-acute in the home 440 00:20:15,365 --> 00:20:20,215 marketplace, um, uh, again, by very large organizations. 441 00:20:20,435 --> 00:20:23,175 So, you know, you're seeing entrants around things like, 442 00:20:23,195 --> 00:20:28,015 you know, Amazon, Google, uh, Optum, um, most recently, 443 00:20:28,275 --> 00:20:30,895 um, you may have seen that Costco has announced 444 00:20:30,895 --> 00:20:32,855 that they're entering the primary care market 445 00:20:32,855 --> 00:20:35,415 and they're gonna be offering telemedicine and, 446 00:20:35,515 --> 00:20:39,495 and pri uh, uh, primary care services through their, 447 00:20:39,875 --> 00:20:41,175 uh, big box stores. 448 00:20:41,635 --> 00:20:44,055 Um, that's a momentum that's underway. 449 00:20:44,235 --> 00:20:48,525 And, um, the, the, the reality is that part of this is 450 00:20:49,045 --> 00:20:52,885 recognizing the patient centricity to care 451 00:20:53,115 --> 00:20:57,045 that these are organizations that are very much focused on 452 00:20:57,595 --> 00:20:58,925 what do patients want. 453 00:20:59,585 --> 00:21:01,805 And, you know, the marketplace is changing quickly, right? 454 00:21:01,805 --> 00:21:03,925 We're now seeing, um, the majority 455 00:21:04,025 --> 00:21:07,045 of the population in the United States at least, 456 00:21:07,065 --> 00:21:10,805 or Gen Xers, gen Ys, and they have very different, uh, needs 457 00:21:10,905 --> 00:21:14,005 and wants, uh, in the healthcare marketplace. 458 00:21:14,005 --> 00:21:16,725 They want immediate access, they want immediate contact, 459 00:21:16,835 --> 00:21:17,925 they don't wanna wait in line, 460 00:21:17,925 --> 00:21:20,165 and they don't wanna wait six months to get services. 461 00:21:20,705 --> 00:21:23,445 Um, and if you can't provide them as an organization, 462 00:21:23,445 --> 00:21:24,685 they're gonna go somewhere else. 463 00:21:25,225 --> 00:21:28,605 Um, so a lot of folks entering the market to try to be able 464 00:21:28,605 --> 00:21:30,645 to build on that desire 465 00:21:30,715 --> 00:21:33,005 that you're seeing coming from the, uh, population. 466 00:21:33,425 --> 00:21:35,925 Um, so we're looking at that both in terms of 467 00:21:36,025 --> 00:21:39,685 how do we deploy, how do we deploy technology to, to try 468 00:21:39,685 --> 00:21:43,125 to mimic that and meet that demand in our, in our members, 469 00:21:43,545 --> 00:21:46,565 but it's also gonna require some association 470 00:21:46,595 --> 00:21:49,285 with these organizations to really start 471 00:21:49,285 --> 00:21:52,765 to build partnerships to figure out how to do that, 472 00:21:52,985 --> 00:21:54,005 uh, collectively. 473 00:21:54,005 --> 00:21:55,965 Because, you know, if you're not doing it as part 474 00:21:55,965 --> 00:21:58,605 of a partnership, you're going to lose that part of your, 475 00:21:59,225 --> 00:22:01,285 uh, your care healthcare spectrum. 476 00:22:04,915 --> 00:22:05,915 - Absolutely. I, I love that. 477 00:22:05,915 --> 00:22:08,675 And, you know, really sets a, a really strong kind of, uh, 478 00:22:08,675 --> 00:22:11,795 vision in motion for how you're able to tackle some 479 00:22:11,795 --> 00:22:13,795 of these big challenges and leverage partnerships 480 00:22:13,815 --> 00:22:16,795 and connections creatively, um, within the industry to, 481 00:22:16,795 --> 00:22:18,235 to really deliver care and make sure people 482 00:22:18,235 --> 00:22:19,315 have access to care too. 483 00:22:20,175 --> 00:22:21,475 Um, I love that. 484 00:22:21,475 --> 00:22:23,115 Before we wrap up our conversation, 485 00:22:23,295 --> 00:22:25,915 I'm wondering if you could talk through what is something 486 00:22:25,915 --> 00:22:27,715 that you or your teams have done differently 487 00:22:27,785 --> 00:22:29,595 that has really made some great results? 488 00:22:30,985 --> 00:22:34,875 - Yeah. Um, well, I mentioned one already, um, which was, 489 00:22:35,135 --> 00:22:38,395 um, our first effort in applying, um, 490 00:22:38,865 --> 00:22:42,915 robotic process automation to improve the efficiency 491 00:22:42,935 --> 00:22:45,995 and the timeliness of order entry and processing. 492 00:22:46,415 --> 00:22:49,155 Uh, that was a huge success for us. 493 00:22:49,335 --> 00:22:53,515 So, um, we allocate, you know, roughly four to five 494 00:22:54,105 --> 00:22:58,395 FTEs a day within our organization, uh, simply, uh, 495 00:22:58,775 --> 00:23:01,915 taking orders and entering them into our electronic medical 496 00:23:01,915 --> 00:23:05,395 record and an untold number of errors that come 497 00:23:05,395 --> 00:23:07,875 with just anybody entering information 498 00:23:07,875 --> 00:23:09,315 or transposing information. 499 00:23:09,735 --> 00:23:12,195 Uh, so the application of RPA, 500 00:23:12,195 --> 00:23:14,675 there was an enormous success for us, right? 501 00:23:14,675 --> 00:23:18,275 It really took a huge demand off of the staff that manage 502 00:23:18,275 --> 00:23:22,075 that and dramatically reduce the, the number of errors 503 00:23:22,075 --> 00:23:24,155 that we see with the input of 504 00:23:24,155 --> 00:23:25,755 what is frankly, critical data, right? 505 00:23:25,775 --> 00:23:29,835 No one wants to put a, a, um, an order in incorrectly 506 00:23:30,035 --> 00:23:31,875 'cause that can result in direct patient harm. 507 00:23:32,335 --> 00:23:34,915 So that was a big success both in terms 508 00:23:34,915 --> 00:23:38,235 of improving the efficiency and productivity of our staff. 509 00:23:38,575 --> 00:23:41,755 Uh, this was by the way, a staff driven initiative. 510 00:23:41,895 --> 00:23:45,525 So the suggestion came from one of our staff to look at this 511 00:23:45,545 --> 00:23:46,685 as a, as a model. 512 00:23:46,865 --> 00:23:49,245 So, um, it accomplished our goals 513 00:23:49,265 --> 00:23:52,445 around engaging our staff in, in moving this forward, 514 00:23:52,825 --> 00:23:55,605 but it also accomplished the goal of ensuring 515 00:23:55,675 --> 00:23:57,765 that we keep our patients safe 516 00:23:57,945 --> 00:24:00,605 and provide good, effective safe care for them. 517 00:24:00,665 --> 00:24:02,165 So that was certainly one area. 518 00:24:02,905 --> 00:24:05,845 Uh, the other, uh, um, option I would, 519 00:24:05,905 --> 00:24:09,325 or the other, uh, project that we're working on that not 520 00:24:09,425 --> 00:24:13,245 yet complete, but I have very high hopes for, um, is 521 00:24:13,245 --> 00:24:16,525 where in the latter stages of a trial using 522 00:24:17,125 --> 00:24:20,325 artificial intelligence and natural language processing 523 00:24:21,025 --> 00:24:24,805 as the front end for patients calling into our organization. 524 00:24:25,425 --> 00:24:28,365 Um, specifically one type of patient where, 525 00:24:28,365 --> 00:24:30,645 which is on a therapy called TPN, 526 00:24:30,675 --> 00:24:32,525 it's a nutritional, uh, therapy. 527 00:24:33,145 --> 00:24:36,365 Uh, and often this requires a lot of management 528 00:24:36,365 --> 00:24:38,845 with these patients, uh, to make sure 529 00:24:38,875 --> 00:24:42,005 that they are not getting readmitted back to the hospital. 530 00:24:42,545 --> 00:24:46,165 So we're using a front end ai, um, uh, 531 00:24:46,465 --> 00:24:49,685 avatar if you will, to receive incoming patient calls, 532 00:24:50,225 --> 00:24:54,085 answer the standard questions that are roughly 80% of the, 533 00:24:54,225 --> 00:24:56,485 of the, um, calls that come in, 534 00:24:56,905 --> 00:25:00,485 and then triage those calls that can't be answered over 535 00:25:00,625 --> 00:25:02,845 to a registered nurse who 536 00:25:03,105 --> 00:25:05,285 before was answering all of these calls. 537 00:25:05,905 --> 00:25:09,005 Uh, so, uh, we've had some really interesting 538 00:25:09,005 --> 00:25:12,765 and really good acceptance by patients in the trials, um, 539 00:25:12,865 --> 00:25:13,925 to using this model. 540 00:25:14,145 --> 00:25:18,285 And, um, if it's successful here, we expect to deploy 541 00:25:18,285 --> 00:25:20,125 that in a number of different areas 542 00:25:20,615 --> 00:25:23,965 where our organization comes into contact with patients 543 00:25:23,965 --> 00:25:26,605 around the patient service interface. 544 00:25:27,105 --> 00:25:31,405 Uh, and that has promise for, uh, enormous cost savings, 545 00:25:31,705 --> 00:25:32,925 uh, and value. 546 00:25:32,925 --> 00:25:34,565 Because, you know, one of the values 547 00:25:34,665 --> 00:25:37,165 of AI here is it's learning, right? 548 00:25:37,185 --> 00:25:40,325 The more data I'm giving it, the more it's learning how 549 00:25:40,325 --> 00:25:42,885 to respond to even the unique questions that, 550 00:25:43,225 --> 00:25:44,285 uh, patients have. 551 00:25:44,385 --> 00:25:47,325 So it's a really exciting time, um, 552 00:25:47,465 --> 00:25:49,085 to be rolling things out like that. 553 00:25:49,105 --> 00:25:50,445 And we have very high hopes 554 00:25:50,445 --> 00:25:52,085 that this is gonna be a big win for us. 555 00:25:55,305 --> 00:25:56,345 - Absolutely. That sounds amazing. 556 00:25:56,605 --> 00:25:58,705 And, and those results really speak for themselves. 557 00:25:59,205 --> 00:26:01,465 Bob, thank you so much for joining us on the podcast today. 558 00:26:01,465 --> 00:26:03,505 This has been such a fun and interesting conversation, 559 00:26:03,525 --> 00:26:05,345 and I look forward to connecting with you again soon. 560 00:26:05,695 --> 00:26:07,785 - It's my pleasure. Again, thank you for having me. 561 00:26:09,975 --> 00:26:12,345 - It's so important for leaders at the top of organizations 562 00:26:12,345 --> 00:26:15,145 to keep learning, stay sharp, grow their networks, 563 00:26:15,705 --> 00:26:18,025 help our audience better do this in a more simplified, 564 00:26:18,025 --> 00:26:19,705 personalized, and meaningful way. 565 00:26:20,265 --> 00:26:22,745 Becker's Healthcare has launched my bhc, 566 00:26:23,215 --> 00:26:25,225 it's your trusted Becker's healthcare experience 567 00:26:25,225 --> 00:26:27,425 and more with content, connections, events 568 00:26:27,445 --> 00:26:28,465 and learning opportunities. 569 00:26:29,055 --> 00:26:30,105 Join the community free 570 00:26:30,105 --> 00:26:34,145 of charge@www.my dot becker's hospital 571 00:26:34,145 --> 00:26:36,025 review.com and we'll see you there.