1 00:00:02,240 --> 00:00:02,899 At athenahealth, 2 00:00:03,279 --> 00:00:06,480 we know your ambulatory practice wants healthier, a 3 00:00:06,480 --> 00:00:09,779 healthier business, healthier care teams, and healthier patients. 4 00:00:10,160 --> 00:00:12,480 But the complexities of modern health care tech 5 00:00:12,480 --> 00:00:14,240 make it hard for you and your care 6 00:00:14,240 --> 00:00:15,855 teams to focus on what matters 7 00:00:16,414 --> 00:00:19,295 most? That's where athenahealth can help. Our AI 8 00:00:19,295 --> 00:00:22,594 native all in one solutions reduce administrative burdens, 9 00:00:22,894 --> 00:00:25,875 streamline billing and payments, and deliver critical insights 10 00:00:25,934 --> 00:00:28,734 when clinicians need it most. That means fewer 11 00:00:28,734 --> 00:00:31,614 clicks, more time for patients, and stronger bottom 12 00:00:31,614 --> 00:00:31,829 lines. 13 00:00:32,710 --> 00:00:35,989 Practicing medicine is complex, but running a practice 14 00:00:35,989 --> 00:00:37,850 can be that much simpler with athenahealth. 15 00:00:38,549 --> 00:00:42,250 See how simpler is healthier@athenahealth.com. 16 00:00:44,565 --> 00:00:46,965 Hi, everyone. And thank you so much for 17 00:00:46,965 --> 00:00:50,104 tuning into this episode of the Becker's healthcare 18 00:00:50,245 --> 00:00:50,745 podcast. 19 00:00:51,365 --> 00:00:54,565 I'm Erica Carbajal, an editor with Becker's hospital 20 00:00:54,565 --> 00:00:57,465 review. And today, I'm joined by doctor Todd 21 00:00:57,524 --> 00:01:00,890 Smith, senior vice president and chief physician executive 22 00:01:00,950 --> 00:01:02,730 at Sutter Health in California. 23 00:01:03,510 --> 00:01:06,230 We're gonna be discussing his top priorities through 24 00:01:06,230 --> 00:01:07,930 the end of the year, ambulatory 25 00:01:08,230 --> 00:01:09,049 growth strategy, 26 00:01:09,510 --> 00:01:10,890 and clinical standardization. 27 00:01:11,814 --> 00:01:13,734 Doctor Smith, thank you so much for being 28 00:01:13,734 --> 00:01:15,275 on today. Happy to have you. 29 00:01:15,655 --> 00:01:17,034 Thank you for having me. 30 00:01:17,655 --> 00:01:18,155 Yeah. 31 00:01:18,534 --> 00:01:21,494 Well, as we enter the final stretch of 32 00:01:21,494 --> 00:01:23,655 the year here, can you start by telling 33 00:01:23,655 --> 00:01:25,974 us a little bit about what your top 34 00:01:25,974 --> 00:01:26,474 clinical 35 00:01:26,854 --> 00:01:28,769 or operational priorities are, 36 00:01:29,229 --> 00:01:32,109 what are you personally spending the most energy 37 00:01:32,109 --> 00:01:33,250 on right now, etcetera? 38 00:01:33,869 --> 00:01:35,170 Well, thank you, Erica. 39 00:01:36,030 --> 00:01:38,909 As as probably mentioned in previous podcasts as 40 00:01:38,909 --> 00:01:42,030 well, we have been really growing our physician 41 00:01:42,030 --> 00:01:43,329 and clinician base 42 00:01:43,924 --> 00:01:46,484 significantly over the past, really, two years or 43 00:01:46,484 --> 00:01:47,225 so, adding, 44 00:01:48,165 --> 00:01:50,984 over 1,500 to 2,000 new clinicians. 45 00:01:51,685 --> 00:01:52,424 And so 46 00:01:52,885 --> 00:01:54,805 once you hire them now, you need to 47 00:01:54,805 --> 00:01:58,005 actually get them onboarded operationally and up to 48 00:01:58,005 --> 00:01:58,505 speed. 49 00:01:58,890 --> 00:02:00,890 At the same time, we have been expanding 50 00:02:00,890 --> 00:02:03,209 our ambulatory presence. So one of the biggest 51 00:02:03,209 --> 00:02:05,849 issues that we've run into is obviously access 52 00:02:05,849 --> 00:02:07,450 to health care, which is a which is 53 00:02:07,450 --> 00:02:09,289 a national issue. We have the same problem 54 00:02:09,289 --> 00:02:11,209 as well. So the two big things that 55 00:02:11,209 --> 00:02:13,004 we've been focused on over the past really 56 00:02:13,004 --> 00:02:15,965 eighteen months or better is really improving our 57 00:02:15,965 --> 00:02:19,405 ambulatory footprint and improving and increasing our physician 58 00:02:19,405 --> 00:02:20,705 and clinician base. 59 00:02:21,805 --> 00:02:23,165 The 2025, 60 00:02:23,165 --> 00:02:24,544 we've opened approximately 61 00:02:24,844 --> 00:02:25,344 17 62 00:02:25,645 --> 00:02:28,064 ambulatory sites so far, and we have another 63 00:02:28,629 --> 00:02:31,430 probably five or six to go. And so 64 00:02:31,430 --> 00:02:33,269 most of my time right now has been 65 00:02:33,269 --> 00:02:33,769 spent 66 00:02:34,150 --> 00:02:35,989 around how do we get these new sites 67 00:02:35,989 --> 00:02:36,489 open, 68 00:02:36,789 --> 00:02:38,889 how do we make sure they're staffed appropriately, 69 00:02:39,030 --> 00:02:40,870 how do we make sure we've onboarded all 70 00:02:40,870 --> 00:02:42,409 the clinicians and the staff 71 00:02:42,735 --> 00:02:44,895 so that we can provide that access the 72 00:02:44,895 --> 00:02:47,134 patients are really needing from that standpoint? And 73 00:02:47,134 --> 00:02:50,194 focusing on providing that access and that experience 74 00:02:50,735 --> 00:02:52,574 as we're sort of moving into the last 75 00:02:52,574 --> 00:02:53,794 half of '25 76 00:02:54,414 --> 00:02:56,469 to try to create, you know, a better 77 00:02:56,469 --> 00:02:58,310 a better place not only for the patient 78 00:02:58,310 --> 00:03:00,729 to receive care but also for the clinicians 79 00:03:00,949 --> 00:03:01,610 to work. 80 00:03:01,909 --> 00:03:03,750 And so the other part of my day 81 00:03:03,750 --> 00:03:06,229 is spent really thinking about and supporting our 82 00:03:06,229 --> 00:03:06,729 clinicians, 83 00:03:07,430 --> 00:03:09,110 and what does that look like to practice 84 00:03:09,110 --> 00:03:11,625 at Sutter Health with the advent of new 85 00:03:11,625 --> 00:03:14,504 clinical technologies, with the advent of some of 86 00:03:14,504 --> 00:03:16,745 the support structures we have as we move 87 00:03:16,745 --> 00:03:19,245 forward. So a lot of work really around 88 00:03:19,385 --> 00:03:22,025 that that that clinical base to try and 89 00:03:22,025 --> 00:03:23,645 improve our access and experience, 90 00:03:24,104 --> 00:03:24,925 for the patients. 91 00:03:26,620 --> 00:03:28,699 Yeah. Thanks, doctor Smith. And I know you 92 00:03:28,699 --> 00:03:29,199 mentioned, 93 00:03:30,219 --> 00:03:33,900 just the onboarding piece. And, obviously, onboarding 2,000, 94 00:03:33,900 --> 00:03:35,520 no physicians, and and, 95 00:03:36,379 --> 00:03:38,460 you know, only a couple of years, no 96 00:03:38,460 --> 00:03:41,099 small feat. And I think onboarding continues to 97 00:03:41,099 --> 00:03:44,034 come up in conversations with physician leaders as 98 00:03:44,034 --> 00:03:46,215 as a challenge of sorts right now. So 99 00:03:46,275 --> 00:03:48,375 can you expand a little bit just on 100 00:03:48,754 --> 00:03:52,455 how the onboarding piece is structured and organized 101 00:03:52,594 --> 00:03:54,754 across the system, and who is really in 102 00:03:54,754 --> 00:03:55,655 charge of 103 00:03:56,620 --> 00:03:59,680 having that process be streamlined and organized? 104 00:04:00,699 --> 00:04:02,780 It it's a great question, Erica, because as 105 00:04:02,780 --> 00:04:04,400 you can imagine, with 106 00:04:04,699 --> 00:04:07,500 eight different medical groups across 26 107 00:04:07,500 --> 00:04:09,439 counties on in Northern California, 108 00:04:10,044 --> 00:04:11,884 you can imagine that there's a lot of, 109 00:04:12,444 --> 00:04:12,944 variation 110 00:04:13,245 --> 00:04:15,245 that can occur in that process. So what 111 00:04:15,245 --> 00:04:17,185 we've really been trying to do is 112 00:04:17,564 --> 00:04:19,964 each of the medical groups partners with our 113 00:04:19,964 --> 00:04:22,865 physician services and our operations people 114 00:04:23,245 --> 00:04:26,569 to create an onboarding process that that begins 115 00:04:26,629 --> 00:04:29,110 well before they actually start with, you know, 116 00:04:29,110 --> 00:04:31,990 creating their accounts and creating their schedules and 117 00:04:31,990 --> 00:04:33,050 opening them up 118 00:04:33,350 --> 00:04:35,689 and trying to create that sort of welcoming, 119 00:04:36,470 --> 00:04:38,490 feeling for when they actually start. 120 00:04:39,125 --> 00:04:40,884 It's still a work in progress. I would, 121 00:04:41,204 --> 00:04:42,964 I would not say it's done. I think 122 00:04:42,964 --> 00:04:43,464 onboarding 123 00:04:43,845 --> 00:04:46,564 is a journey, and it doesn't it doesn't 124 00:04:46,564 --> 00:04:48,404 start the day they start. It doesn't stop 125 00:04:48,404 --> 00:04:50,564 the day they start. And so part of 126 00:04:50,564 --> 00:04:53,039 that process is creating something that makes them 127 00:04:53,039 --> 00:04:55,039 feel welcome in the organization, something that helps 128 00:04:55,039 --> 00:04:57,539 them to understand it. So there are orientations 129 00:04:57,759 --> 00:05:00,319 for the physicians themselves and the clinicians with 130 00:05:00,319 --> 00:05:02,079 the medical group, so they understand what it 131 00:05:02,079 --> 00:05:03,759 means to be part of the medical group. 132 00:05:03,759 --> 00:05:06,000 There's another orientation piece which is actually part 133 00:05:06,000 --> 00:05:07,680 of the system, so they understand what it 134 00:05:07,680 --> 00:05:09,035 means be part of the system. 135 00:05:09,495 --> 00:05:11,574 And we partner with the medical groups to 136 00:05:11,574 --> 00:05:14,615 provide that. And then orienting them to the 137 00:05:14,615 --> 00:05:16,055 clinic they're gonna be working in and the 138 00:05:16,055 --> 00:05:17,675 people they're gonna be working with, 139 00:05:18,055 --> 00:05:20,214 and how do we support that particular piece. 140 00:05:20,214 --> 00:05:22,839 So it's an ongoing process that is jointly 141 00:05:23,300 --> 00:05:26,100 owned by the the medical groups themselves who 142 00:05:26,100 --> 00:05:28,199 are the hiring entity here in California 143 00:05:28,660 --> 00:05:31,620 as well as our foundation counterparts to provide 144 00:05:31,620 --> 00:05:32,839 that support for them. 145 00:05:33,779 --> 00:05:35,240 Yeah. Thanks, doctor Smith. 146 00:05:35,555 --> 00:05:36,694 Well, I know you mentioned 147 00:05:37,154 --> 00:05:40,035 ambulatory expansion and an access there as well. 148 00:05:40,035 --> 00:05:41,875 I know Sutter is in the middle of 149 00:05:41,875 --> 00:05:43,154 a $1,000,000,000 150 00:05:43,154 --> 00:05:46,134 expansion there. So with rapid ambulatory 151 00:05:46,514 --> 00:05:47,014 growth, 152 00:05:47,475 --> 00:05:49,654 how are you ensuring clinical integration 153 00:05:49,955 --> 00:05:52,939 and continuity of care across sites? What sorts 154 00:05:52,939 --> 00:05:55,420 of measures or practices are you putting in 155 00:05:55,420 --> 00:05:57,680 place to try to maintain that care quality 156 00:05:58,139 --> 00:06:00,379 as more services start to shift outside of 157 00:06:00,379 --> 00:06:01,519 the hospital walls? 158 00:06:02,300 --> 00:06:04,095 It's it's a great question because you're right. 159 00:06:04,095 --> 00:06:07,375 There is this this steady but constant shift 160 00:06:07,375 --> 00:06:10,334 of things in from the from the acute 161 00:06:10,334 --> 00:06:13,214 session to the ambulatory session. So one of 162 00:06:13,214 --> 00:06:14,654 the biggest things that we've done over the 163 00:06:14,654 --> 00:06:16,595 past couple of years is to really create 164 00:06:16,735 --> 00:06:18,035 an operating rhythm, 165 00:06:18,349 --> 00:06:21,169 which creates a way of communicating both at 166 00:06:21,310 --> 00:06:22,209 the individual 167 00:06:22,750 --> 00:06:23,569 clinic level, 168 00:06:23,870 --> 00:06:27,250 the facility level, the division level, which encompasses 169 00:06:27,470 --> 00:06:29,709 both foundation and hospital based, and then the 170 00:06:29,709 --> 00:06:30,209 system 171 00:06:30,764 --> 00:06:32,365 level. And creating that in such a way 172 00:06:32,365 --> 00:06:34,444 that there's a clarity of conversation and a 173 00:06:34,444 --> 00:06:37,004 clarity of metrics that we we are going 174 00:06:37,004 --> 00:06:38,605 to actually be looking at as we move 175 00:06:38,605 --> 00:06:40,444 forward. And those are some of the standard 176 00:06:40,444 --> 00:06:42,444 metrics around quality, around whether they're in the 177 00:06:42,444 --> 00:06:45,245 ambulatory world, around, you know, your infection rates 178 00:06:45,245 --> 00:06:47,040 and around, you know, things of that nature. 179 00:06:47,040 --> 00:06:48,740 You've got the acute ones as well. 180 00:06:49,360 --> 00:06:51,360 But one of the pieces that, as I 181 00:06:51,360 --> 00:06:53,199 was talking to one of my quality directors 182 00:06:53,199 --> 00:06:54,579 about this the other day, 183 00:06:55,360 --> 00:06:58,560 what we're learning is the onboarding in the 184 00:06:58,560 --> 00:06:59,060 ambulatory 185 00:06:59,439 --> 00:07:01,519 environment. We've got to be very careful about 186 00:07:01,519 --> 00:07:05,035 that Because typically in the acute environment, 187 00:07:05,415 --> 00:07:07,574 you've got, you know, nurses training nurses, and 188 00:07:07,574 --> 00:07:10,855 so there is a definite procedural bend that 189 00:07:10,855 --> 00:07:12,855 you you understand that. As you get into 190 00:07:12,855 --> 00:07:15,675 the ambulatory environment, you may not have that 191 00:07:16,220 --> 00:07:18,800 like training like in the process. And so 192 00:07:19,019 --> 00:07:21,660 making sure that we've onboarded our people in 193 00:07:21,660 --> 00:07:24,220 the clinic setting to understand what it means 194 00:07:24,220 --> 00:07:25,759 to do some of these procedures 195 00:07:26,379 --> 00:07:28,079 in that particular arena, 196 00:07:28,620 --> 00:07:30,675 is it's a different skill set for them, 197 00:07:30,754 --> 00:07:32,354 and it is something that we're realizing and 198 00:07:32,354 --> 00:07:34,514 we are actually implementing as we as we 199 00:07:34,514 --> 00:07:36,214 move forward from that bigger piece. 200 00:07:38,194 --> 00:07:40,694 Yeah. That's a great point. Thanks, doctor Smith. 201 00:07:41,314 --> 00:07:43,394 I think too, one of the things that, 202 00:07:43,394 --> 00:07:45,095 you know, as we continue to 203 00:07:45,750 --> 00:07:47,850 cover more on and hear about, 204 00:07:48,389 --> 00:07:50,710 you know, the health care's ambulatory boom, if 205 00:07:50,710 --> 00:07:51,850 you will, and the shift 206 00:07:52,389 --> 00:07:53,449 of that care, 207 00:07:54,310 --> 00:07:56,009 just questions and and implications 208 00:07:56,470 --> 00:07:58,089 of what it might mean for 209 00:07:58,724 --> 00:08:01,685 care in inpatient setting. So as this trend 210 00:08:01,685 --> 00:08:02,584 does accelerate, 211 00:08:03,044 --> 00:08:04,264 what considerations 212 00:08:04,644 --> 00:08:06,644 does it raise for hospital leaders? What are 213 00:08:06,644 --> 00:08:09,784 you thinking about, especially in terms of staffing 214 00:08:09,844 --> 00:08:10,344 or 215 00:08:10,660 --> 00:08:11,800 care model changes, 216 00:08:12,500 --> 00:08:15,240 to ensure that inpatient teams are equipped for 217 00:08:15,540 --> 00:08:17,540 a new new reality in the years ahead 218 00:08:17,540 --> 00:08:18,839 in terms of patient acuity? 219 00:08:20,500 --> 00:08:22,600 I think it's it's a good point because 220 00:08:22,660 --> 00:08:24,980 we are beginning to see changes in our 221 00:08:24,980 --> 00:08:27,425 case mix index in the inpatient world, 222 00:08:27,725 --> 00:08:30,044 implying that we are treating sicker patients in 223 00:08:30,044 --> 00:08:30,625 the process. 224 00:08:31,324 --> 00:08:33,565 And part of that is the recognition of 225 00:08:33,565 --> 00:08:34,544 how do we actually 226 00:08:35,485 --> 00:08:37,664 provide our teams with the capabilities, 227 00:08:38,125 --> 00:08:40,830 capacities to provide that care in a safe, 228 00:08:40,910 --> 00:08:41,410 effective, 229 00:08:41,790 --> 00:08:43,090 and consistent manner. 230 00:08:43,790 --> 00:08:45,389 Some of that is going to be ensuring 231 00:08:45,389 --> 00:08:47,470 that we've got regular training for them. 232 00:08:48,029 --> 00:08:49,230 Some of it is going to be how 233 00:08:49,230 --> 00:08:51,549 do we leverage technology? How do we actually 234 00:08:51,549 --> 00:08:54,815 employ technology so that individuals can be doing 235 00:08:54,815 --> 00:08:57,375 things that only individuals can do, and you 236 00:08:57,375 --> 00:08:59,875 can utilize some of the technology to help 237 00:09:00,014 --> 00:09:01,774 give you information that you might not have 238 00:09:01,774 --> 00:09:04,595 had at your fingertips? So things like, 239 00:09:05,054 --> 00:09:07,054 some of the predictive modeling that we are 240 00:09:07,054 --> 00:09:09,259 beginning to start to see in some of 241 00:09:09,259 --> 00:09:10,480 the environments around 242 00:09:10,940 --> 00:09:13,259 who might be deteriorating a little bit faster 243 00:09:13,259 --> 00:09:15,419 than you actually think they are. So instead 244 00:09:15,419 --> 00:09:16,240 of the teams 245 00:09:16,860 --> 00:09:17,360 responding 246 00:09:17,820 --> 00:09:20,220 once the crisis has occurred, which obviously is 247 00:09:20,220 --> 00:09:21,820 less efficient and not as good for the 248 00:09:21,820 --> 00:09:24,075 patient, how do we sort of incorporate some 249 00:09:24,075 --> 00:09:26,634 of that information a little earlier such that 250 00:09:26,634 --> 00:09:28,955 we can identify these people? These are this 251 00:09:28,955 --> 00:09:31,754 is emerging technologies in certain places, but certainly 252 00:09:31,754 --> 00:09:33,274 something that we're keeping our eye on, we're 253 00:09:33,274 --> 00:09:34,415 looking at, we're incorporating 254 00:09:34,955 --> 00:09:36,815 in such a way as to really equip 255 00:09:36,955 --> 00:09:37,615 our people 256 00:09:37,990 --> 00:09:39,690 with what they what they need. 257 00:09:40,070 --> 00:09:41,290 Other other ways 258 00:09:41,750 --> 00:09:43,769 are understanding, you know, if you think about, 259 00:09:44,149 --> 00:09:46,870 you know, observation or sitting or or patient 260 00:09:46,870 --> 00:09:49,129 or sitters that need to observe patients, 261 00:09:49,830 --> 00:09:52,330 really can we employ and have we employed 262 00:09:52,924 --> 00:09:55,804 electronic or visual virtual means of sitting. So 263 00:09:55,804 --> 00:09:57,985 that way, you can free up the individual 264 00:09:58,044 --> 00:10:00,284 from doing this. You can provide more real 265 00:10:00,284 --> 00:10:03,004 time information and allow the the nurses and 266 00:10:03,004 --> 00:10:04,924 the aids to be more attentive from that 267 00:10:04,924 --> 00:10:07,559 standpoint. So really trying to help them from 268 00:10:07,559 --> 00:10:08,940 a care model standpoint 269 00:10:09,320 --> 00:10:11,480 and give them the information when they need 270 00:10:11,480 --> 00:10:13,019 at the time they need it 271 00:10:13,480 --> 00:10:14,779 to be able to actually, 272 00:10:16,040 --> 00:10:18,700 do their jobs better in a safer manner, 273 00:10:19,160 --> 00:10:20,779 for for them and the patients. 274 00:10:23,154 --> 00:10:25,715 Yeah. Definitely will be interesting too to see 275 00:10:25,715 --> 00:10:27,634 what the predictive modeling and and what that 276 00:10:27,634 --> 00:10:29,154 might look like, you know, just a few 277 00:10:29,154 --> 00:10:30,855 years down the line. 278 00:10:32,195 --> 00:10:34,774 I wanna talk now about care standardization. 279 00:10:35,154 --> 00:10:36,774 I think it comes up increasingly 280 00:10:37,250 --> 00:10:40,370 not just as a way to improve care 281 00:10:40,370 --> 00:10:42,450 outcomes, of course, but also as a way 282 00:10:42,450 --> 00:10:45,889 to improve operational efficiency is is something we 283 00:10:45,889 --> 00:10:47,909 hear a lot about nowadays. So 284 00:10:48,289 --> 00:10:49,730 I think it's also one of those things 285 00:10:49,730 --> 00:10:52,035 across a large system, like many things in 286 00:10:52,035 --> 00:10:54,115 health care that might sound simple on the 287 00:10:54,115 --> 00:10:55,815 surface, but is incredibly 288 00:10:56,355 --> 00:10:59,495 tough to execute is what I hear, particularly 289 00:10:59,554 --> 00:11:02,535 when you think about the nuances and local 290 00:11:02,835 --> 00:11:06,430 settings and clinical autonomy of clinicians. So can 291 00:11:06,430 --> 00:11:07,970 you tell us a little bit about 292 00:11:08,430 --> 00:11:11,090 Sutter's approach here? What has the system done 293 00:11:11,310 --> 00:11:12,930 to try to make clinical standardization 294 00:11:13,310 --> 00:11:14,850 and evidence based pathways 295 00:11:15,389 --> 00:11:17,710 work in practice? And are there any lessons 296 00:11:17,710 --> 00:11:20,830 that have emerged about making this work at 297 00:11:20,830 --> 00:11:21,330 scale? 298 00:11:22,774 --> 00:11:24,774 That that's great insight, Erica. One of the 299 00:11:24,774 --> 00:11:26,714 things that we have learned is 300 00:11:27,174 --> 00:11:29,975 scale is helpful at times, and other times 301 00:11:29,975 --> 00:11:31,514 actually can get in the way. 302 00:11:32,134 --> 00:11:33,754 One of the pieces that 303 00:11:34,309 --> 00:11:36,789 we have been, working with over time is 304 00:11:36,789 --> 00:11:39,129 exactly what you talked about, which is identifying 305 00:11:39,190 --> 00:11:40,730 those clinical best practices 306 00:11:41,190 --> 00:11:42,629 in such a way that they can be 307 00:11:42,629 --> 00:11:44,870 available and they can be spread and adopted 308 00:11:44,870 --> 00:11:45,929 across the organization. 309 00:11:47,014 --> 00:11:48,715 We've learned that it requires, 310 00:11:49,254 --> 00:11:52,215 clinician leadership and involvement in development of those 311 00:11:52,215 --> 00:11:53,115 stricter pathways, 312 00:11:53,654 --> 00:11:55,735 both at the local level as well as 313 00:11:55,735 --> 00:11:57,975 at the system level. And then we've learned 314 00:11:57,975 --> 00:11:58,955 that there's a communication 315 00:11:59,335 --> 00:12:01,654 that has to take place on a very 316 00:12:01,654 --> 00:12:02,794 consistent basis 317 00:12:03,360 --> 00:12:05,779 so that there is the ability to learn. 318 00:12:05,919 --> 00:12:07,059 At the end of the day, 319 00:12:08,399 --> 00:12:11,120 being a learning organization allows you to adopt 320 00:12:11,120 --> 00:12:15,220 the technologies, adopt the pathways, and then iterate 321 00:12:15,279 --> 00:12:17,384 and improve them as they actually go. 322 00:12:17,785 --> 00:12:19,625 And one of the things that we've learned 323 00:12:19,625 --> 00:12:22,024 is we we put an operating calendar into 324 00:12:22,024 --> 00:12:24,024 place that I talked about before, which was 325 00:12:24,024 --> 00:12:25,625 the, you know, part of it is the 326 00:12:25,625 --> 00:12:27,945 local part of it's daily, weekly, and monthly 327 00:12:27,945 --> 00:12:29,785 check ins. But the other thing that we've 328 00:12:29,785 --> 00:12:31,465 actually started to do quite a bit now 329 00:12:31,465 --> 00:12:32,659 is we're we're celebrating 330 00:12:32,960 --> 00:12:35,919 successes. So we'll we will have system level 331 00:12:35,919 --> 00:12:38,799 meetings where we'll actually celebrate best practices, whether 332 00:12:38,799 --> 00:12:39,539 they're around 333 00:12:40,000 --> 00:12:40,500 infection, 334 00:12:40,879 --> 00:12:42,980 prevention, whether they're around, 335 00:12:43,440 --> 00:12:46,195 length of stay reductions, whether they're around discharge 336 00:12:46,415 --> 00:12:47,935 lounges, whether they're around, 337 00:12:48,575 --> 00:12:49,795 improvements in, 338 00:12:50,815 --> 00:12:54,835 throughputs in operating rooms or in emergency rooms. 339 00:12:55,055 --> 00:12:56,975 And what we're doing is we're highlighting the 340 00:12:56,975 --> 00:12:58,259 work that's being done, 341 00:12:58,740 --> 00:13:00,519 in various places in the organization. 342 00:13:01,299 --> 00:13:03,700 And then we've also developed, in a couple 343 00:13:03,700 --> 00:13:06,179 of places, we've developed the ability to send 344 00:13:06,179 --> 00:13:06,679 teams 345 00:13:07,299 --> 00:13:09,700 out to other places that are actually having 346 00:13:09,700 --> 00:13:10,200 challenges 347 00:13:10,544 --> 00:13:13,024 so that we can accelerate that sharing of 348 00:13:13,024 --> 00:13:13,764 best practices 349 00:13:14,304 --> 00:13:16,164 and measuring to the same outputs 350 00:13:16,625 --> 00:13:18,304 as we continue to kind of go go 351 00:13:18,304 --> 00:13:19,904 down this road. So it is a, 352 00:13:20,784 --> 00:13:22,004 it it is a journey. 353 00:13:22,625 --> 00:13:24,784 It is one that's never ending, but it 354 00:13:24,784 --> 00:13:26,899 is one that we believe that we can 355 00:13:26,899 --> 00:13:28,679 actually accelerate that, 356 00:13:29,139 --> 00:13:30,899 if we shine a light on the work 357 00:13:30,899 --> 00:13:32,580 that's being done in those place or doing 358 00:13:32,580 --> 00:13:33,159 it well. 359 00:13:34,899 --> 00:13:37,139 Yeah. Great point about sharing out those those 360 00:13:37,139 --> 00:13:37,879 best practices. 361 00:13:39,544 --> 00:13:42,184 Well, lastly here, just wanna talk about the 362 00:13:42,184 --> 00:13:45,384 chief physician, chief medical officer role. How do 363 00:13:45,384 --> 00:13:48,264 you see that role evolving in the next 364 00:13:48,264 --> 00:13:50,584 two to five years, let's say? What new 365 00:13:50,584 --> 00:13:53,879 skills or leadership qualities do you think will 366 00:13:53,940 --> 00:13:57,160 define the most successful CMOs of the future? 367 00:13:58,660 --> 00:14:00,419 That's a great question because I even I 368 00:14:00,419 --> 00:14:02,179 just have to look back two years because 369 00:14:02,179 --> 00:14:03,940 I've been in this role about two, two 370 00:14:03,940 --> 00:14:05,399 and a half years at this point. 371 00:14:06,035 --> 00:14:07,715 And just the skill sets I've had to 372 00:14:07,715 --> 00:14:10,455 develop at this point to to be successful. 373 00:14:11,315 --> 00:14:12,754 I think one of the things that is 374 00:14:12,754 --> 00:14:15,554 true is as you talk to chief physician 375 00:14:15,554 --> 00:14:16,054 executives, 376 00:14:16,754 --> 00:14:17,315 they are 377 00:14:18,049 --> 00:14:19,970 they there's there's a wider breadth of what 378 00:14:19,970 --> 00:14:22,449 we're responsible for now than the standard chief 379 00:14:22,449 --> 00:14:24,850 medical officer was. And most of the chief 380 00:14:24,850 --> 00:14:27,189 medical officers were responsible for just 381 00:14:27,569 --> 00:14:30,049 pretty much the quality. They were the clinical 382 00:14:30,049 --> 00:14:31,350 transformation throughput, 383 00:14:32,365 --> 00:14:34,845 in in interacting with the medical staffs, both 384 00:14:34,845 --> 00:14:37,105 the ambulatory as well as the acute. 385 00:14:37,725 --> 00:14:39,105 As we move forward, 386 00:14:39,644 --> 00:14:41,904 you notice that when at the outset, 387 00:14:42,284 --> 00:14:43,964 you know, what were we really working around 388 00:14:43,964 --> 00:14:45,184 the operations pieces, 389 00:14:45,669 --> 00:14:48,490 I'm much more involved in the operational 390 00:14:48,790 --> 00:14:50,870 day to day pieces as far as, you 391 00:14:50,870 --> 00:14:52,889 know, what drives the clinic 392 00:14:53,509 --> 00:14:55,830 referrals, what drives the clinic throughput, what does 393 00:14:55,830 --> 00:14:57,554 our staffing model actually look like. 394 00:14:58,434 --> 00:15:00,214 In the in the hospital, 395 00:15:00,514 --> 00:15:03,315 how does our emergency room throughput actually work? 396 00:15:03,315 --> 00:15:05,794 How is the operating room actually work? What's 397 00:15:05,794 --> 00:15:08,995 our supply chain, cost look like? When we've 398 00:15:08,995 --> 00:15:09,654 had challenges 399 00:15:09,955 --> 00:15:11,495 across the country around 400 00:15:11,955 --> 00:15:12,705 the the 401 00:15:13,269 --> 00:15:14,730 the IV fluid issues. 402 00:15:15,110 --> 00:15:16,870 We found that we were involved in what 403 00:15:16,870 --> 00:15:18,309 that looked like and that was a very 404 00:15:18,309 --> 00:15:19,450 operational issue. 405 00:15:19,909 --> 00:15:21,829 So I think that, you know, as we 406 00:15:21,829 --> 00:15:24,009 as we move forward, and then 407 00:15:24,629 --> 00:15:27,269 as we begin to think about what does, 408 00:15:27,269 --> 00:15:30,375 you know, hiring look like, what does acquisition 409 00:15:30,595 --> 00:15:32,674 of other organizations look like, how do we 410 00:15:32,674 --> 00:15:33,174 integrate, 411 00:15:34,274 --> 00:15:35,574 systems into ours, 412 00:15:36,034 --> 00:15:36,934 and having a, 413 00:15:37,954 --> 00:15:41,154 a medical viewpoint around an operational issue and 414 00:15:41,154 --> 00:15:43,360 being at the table for that. I think 415 00:15:43,360 --> 00:15:44,580 that's actually different 416 00:15:44,960 --> 00:15:47,620 than it was two or three years ago. 417 00:15:48,160 --> 00:15:51,519 I expect to see that continue. So I 418 00:15:51,519 --> 00:15:54,340 expect to see the successful chief physician executive, 419 00:15:55,375 --> 00:15:57,214 have a be well grounded in all the 420 00:15:57,214 --> 00:16:00,574 clinical pieces, be well grounded in the the, 421 00:16:00,574 --> 00:16:02,914 you know, the quality pieces, but also, 422 00:16:03,694 --> 00:16:06,434 becoming much more well versed in the operational 423 00:16:06,735 --> 00:16:08,514 pieces so they can 424 00:16:08,975 --> 00:16:10,194 be a thought partner 425 00:16:10,709 --> 00:16:12,629 with in my case, I'm a thought partner 426 00:16:12,629 --> 00:16:15,209 with the chief operating officer for the system. 427 00:16:15,829 --> 00:16:18,250 And I think that's a different skill set 428 00:16:18,549 --> 00:16:20,569 than many physician leaders, 429 00:16:21,110 --> 00:16:22,569 have had over the years. 430 00:16:24,085 --> 00:16:26,085 Yeah. Absolutely. I think it's a theme I've 431 00:16:26,085 --> 00:16:28,664 I've heard in, in a few recent conversations, 432 00:16:29,524 --> 00:16:30,264 as well. 433 00:16:31,285 --> 00:16:33,924 Well, doctor Smith, thank you so much for 434 00:16:33,924 --> 00:16:36,325 taking the time to join the podcast today. 435 00:16:36,325 --> 00:16:38,404 It's a pleasure having you on, talking about 436 00:16:38,404 --> 00:16:40,820 a lot of relevant topics that come come 437 00:16:40,820 --> 00:16:43,539 up and so often in conversations with clinical 438 00:16:43,539 --> 00:16:44,360 leaders. And, 439 00:16:44,740 --> 00:16:45,240 hopefully, 440 00:16:45,700 --> 00:16:48,600 we foster some some peer learnings here and 441 00:16:49,059 --> 00:16:51,299 hope to welcome you back to the podcast 442 00:16:51,299 --> 00:16:52,120 again soon. 443 00:16:52,615 --> 00:16:54,475 Very good. Thank you for having me today. 444 00:16:54,774 --> 00:16:56,554 Yeah. Thanks so much. Take care. 445 00:16:59,254 --> 00:17:02,134 At athena Health, we know your ambulatory practice 446 00:17:02,134 --> 00:17:03,035 wants healthier, 447 00:17:03,495 --> 00:17:06,339 a healthier business, healthier care teams, and healthier 448 00:17:06,339 --> 00:17:06,839 patients. 449 00:17:07,299 --> 00:17:09,539 But the complexities of modern health care tech 450 00:17:09,539 --> 00:17:11,380 make it hard for you and your care 451 00:17:11,380 --> 00:17:13,319 teams to focus on what matters most. 452 00:17:13,700 --> 00:17:15,480 That's where athenahealth can help. 453 00:17:15,779 --> 00:17:18,500 Our AI native all in one solutions reduce 454 00:17:18,500 --> 00:17:19,640 administrative burdens, 455 00:17:20,095 --> 00:17:22,975 streamline billing and payments, and deliver critical insights 456 00:17:22,975 --> 00:17:25,775 when clinicians need it most. That means fewer 457 00:17:25,775 --> 00:17:28,654 clicks, more time for patients, and stronger bottom 458 00:17:28,654 --> 00:17:29,154 lines. 459 00:17:29,855 --> 00:17:33,055 Practicing medicine is complex, but running a practice 460 00:17:33,055 --> 00:17:34,835 can be that much simpler with athenahealth. 461 00:17:35,570 --> 00:17:39,269 See how simpler is healthier at athenahealth.com.