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- This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr.
Nu today, Shey, who is the Chief Medical Information Officer
at, uh, lake Health, as well as the associate CMIO
of university Hospitals.
Dr. She, it's a pleasure to have you on the podcast today.
- Thank you very much, Laura. I'm happy to be here.
Thank you for having me.
- Now, I know we have a lot to talk about,
and you know, I'm definitely excited
to hear more from your perspective about some
of the different things that you're doing at
University Hospitals.
But before we dive into my questions,
can you tell me a little bit more
about yourself and your background?
- Yes, of course. Thank you again for having me.
So, my name is Tina .
Just like you said, I'm a pediatrician by training.
Um, uh,
several years ago I took a break from clinical practice.
I stayed home to raise my kids.
Um, but in 2011, I decided I was going
to give clinical informatics a try.
So instead of going back to clinical practice, uh, I went
for formal training, uh,
and became board certified in the field.
Um, after that, um, for several years, I, I worked
as an executive physician at, at Sunner Corporation,
which is now Oracle.
And at that time I traveled the United States, um,
helping set up clinical information systems
in various hospitals, health systems,
including standalone children's hospitals.
But I, I got passionate about revenue cycle.
So while I was at sunner, I decided
that revenue cycle was a very
interesting aspect of healthcare.
So I got formally trained
and certified by HFMA, uh,
that's the Healthcare Financial Management Association.
And since then I have been in both clinical informatics
and revenue cycle.
Um, as I've practiced, uh, in 2019,
I decided that I wanted to take a less, um,
traveling role, if I can call it that.
So I decided to take up a position
as Chief Medical Information Officer
and Vice President
of Clinical Informatics at Lake Health System in Ohio.
I was there for a little bit.
Then, uh, the health system merged
with University Hospital's health system in Cleveland, Ohio.
So from 2021, uh, I continued
to be the CMIO at, at Lake Health, um,
but also became the associate CMIO for university hospitals,
12 community hospitals.
I also have responsibility for, uh, several
of the academic centers service line at, uh,
and, um, also have responsibilities for uhs, um,
over 5,000 independent physicians.
Last, but not the least, what I do, um, uh,
I always make sure I have rev cycle in my
portfolio somewhere.
So , I continue to, um, help out with Rev Cycle.
Recently, uh, I became a physician leader, um, in,
in the health systems quality payment program.
So I tried to keep busy, and that's a bit about me.
- Well, that's a lot. I mean, amazing to hear, you know,
just kind of all the areas of healthcare.
You've touched from obviously your clinical care background
and being a pediatrician right through, you know,
the informatics, uh, background working at Cerner,
and then getting a passion
for revenue cycle, which is amazing.
I mean, what an important role within healthcare
to really sustain organizations.
Um, so it, it is really cool to see all
of those different areas that you've been able
to bundle together and bring into now, um, your role
with Lake Health and then university hospitals too.
I think that's really cool to see.
And along those lines, you know, what is one change
that you've made in the last year
or so that's had some really great results?
- Well, thank you for that compliment.
I have to tell you, I have a lot
of people helping me get all those things done,
but, um, I think what I'm most proud of,
because it, it just came off so well, um, was that, um,
university Hospitals decided to implement another
electronic medical record in this case, it was epic.
I had a background in center and several other EMRs,
but not Epic, but University hospitals decided
that was the direction we were going,
and what a great decision that was.
Um, in 2023, we went live with Epic.
It, it wasn't two, um, rollout two ways,
like we would like to call it one in March
and then in October, so about six months ago, we,
we rolled out the whole health system and,
and in that program it turned out so well,
and I've been doing this for now close to 12 years
across the United States.
I have to say, that's the best rollout
or implementation I've ever been involved with.
Uh, we had such great leaders get involved
operations, uh, up to the top.
Most leadership got involved.
Um, we had, um, of course UHIT, um, front
and center, so I was part of the leadership team that got
that to happen.
And, um, we had an initial budget of, um,
about $600 million.
We came under, came in under budget with about $200 million.
So to me, that's the first thing.
It's like, 'cause I'm always looking at the revenue,
making sure that whatever we're doing, you know,
we do not upset the apple cart
and then, you know, just get everything well done
and then we, we end up, um, losing a bunch of money.
No, this went out, went on and it's still going on.
It went off very well.
But I guess most importantly was the ability
to bring our clinicians and physicians along.
They are so happy to be on that EMR.
We had about 97% of them trained,
which I have never been able to achieve elsewhere, .
So that was to me, just amazing.
Our team was just amazing.
Um, I was, um, the CMIO at, uh, lake,
we now call it, uh, lake Health at that time.
And we were actively into integrating at
that time due to the merger.
And so we were able to both integrate and merge
and yet roll out Lake Health Medical Centers, the three
of them, roll them out onto Epic as well.
Everything went seamlessly.
Um, we ended up, um, with Nine Stars.
Um, epic gives out the stars for those who, um,
implement their EMR.
Well, so we're among the top 85% of the health systems
that use Epic in the us.
We, this program is the best I've ever done this rollout.
So if you ask me what,
what change did we make in the last year
that had great results,
rolling out Epic at university hospitals, had great results.
- Well, that's amazing to hear.
And you know, really cool to, to think
through those specifics that you mentioned.
I mean, bringing on 90%,
or excuse me, 97% of the clinicians trained
and then, you know, coming in under budget.
Um, I don't know any other system that I've heard of
that really can report the same.
And so I think it's really cool, obviously
that you had the technology platform
and the ability to do that.
But it seems like, you know, as well, having that, um,
the leadership just involved, as you mentioned, um,
made a big difference and really was able to, uh, produce
the great results from the implementation.
Because I know it's certainly not an easy task
to bring everyone onto it
and make a transition into one singular, um, EHR platform.
- Yes, absolutely. Right.
Our leadership there incredible in many places.
Operations at University Hospital, I have to say.
Very incredible team. They did well,
- Amazing.
Well, fantastic. And you know what, now
that you're on the other side of that EHR transition,
what are some of the top trends
that you're following in healthcare?
What do you really see as being top
of mind in being potentially impactful
for the organization going forward? So,
- Um, in 2019, I got involved in ai,
artificial intelligence, uh,
which we now call generative ai.
I was, um, since, uh, I, I was in revenue cycle
and revenue integrity at that point in time.
I was looking at just clinician documentation,
specifically physician documentation, thinking about
how could we improve, uh, uh, our providers
that documentation without increasing, um,
the burden on them.
So I got involved in that,
and we were looking at improving our case mix index
and, um, uh, we deployed
what we call computer assisted physician documentation.
That was back in 2019.
It, it turned out so well, we were able
to move our case mix index
aggressively without additional burden on the physicians.
Now that we're on the other side of, um, our epic rollout
and installation, we are now deploying this.
So I did that when I was CMIO at Lake Health.
Um, uh, have decided to go forward with this
and contracted with a third party,
and now we're deploying it across all the hospitals, uh,
the complete community hospitals I have responsibility for,
and also the academic center.
So I am very excited about this
because I've already done this, um, uh,
in the last few years.
And it has turned out real well.
It's really helped, um, uh,
with quality measures, helps with revenue.
It, it helps with safety,
it helps in very many areas, um, of healthcare.
So that's what I am gonna be focusing my attention on other
than stabilizing our clinicians
and physicians on this new EHR.
Uh, but, uh, generative AI is a, is a passion of mine,
and I'm about to really get excited, uh,
deploying this across the health system.
- That's fantastic to hear.
And really, you know, a cool use case for AI is something
that I know is evolving quickly within the healthcare space.
Uh, um, so that's really, um, interesting to hear
and definitely exciting to know.
I'll be looking forward to catching up
with you at some point to learn how everything's going now.
Thank you. Before we wrap up here,
how are you thinking about growth in the next 12
to 24 months or so?
Well,
- So thinking about growth, those areas I mentioned,
especially generative AI would be my focus.
I would be looking to see.
So when I first got into ai, um,
especially in clinical documentation, um,
it was very narrow.
That was five years ago. Not many health systems were on it.
I certainly hadn't used it until I started working in it,
um, with, uh, lake, uh, five years ago Now, like,
you know, AI has completely exploded .
And, um, I'm, I'm looking forward to seeing us grow in this,
especially to see how it lead you with, um, clinician
burden, physician burnout.
Uh, I want us to grow in that area.
So as much as it's up to me
and I can help our teams, our clinical documentation,
improvement teams, our revenue cycle, I'll be looking
to see us grow in that area.
I'm looking to see us also grow in the area of revenue.
Um, like, you know, that's a passion of mine.
And if you can help, um, physicians
and other clinicians understand
how their behavior a affects the revenue coming into the
organization, you would've done well.
And yet do it in a way that they're not burdened by it.
'cause reducing physician
and clinician burden is a goal of mine.
Um, there's no point, um, of taking care of patients
and then those who do it just feel totally burnt out.
So I'm looking to grow in that area.
Personally, I'm looking to grow in just my understanding of
how all of this comes together, all the ai,
generative ai, um, EHR,
just the integration of all those things.
And I'm looking to see how I can help, uh,
the community hospitals.
I, I am responsible for
how they grow operationally while,
while they use our analytics, which now we can generate.
Uh, I'm very excited about the analytics we are able
to bring in now and, um, all the data
and dashboard to see how operationally we can help the,
um, health system grow.
That's where I'm focusing on,
and I'm looking forward to this,
to this next couple of years.
- That's amazing to hear.
And you know what fun it'll be to really lean in on the AI
and generative AI space and see how things evolve.
Dr. Che, thank you so much
for joining us on the podcast today.
This has been such a fun conversation,
and I look forward to connecting with you again soon.
- Thank you. Thank you so much, Laura, for Hi,
having me here.
It's, it's been real fun talking with you, .
You touched on the areas of my passion, so
it was no hardship at all.
Thank you, .