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the description. We are excited to welcome you in October.
This is Laura Ddo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr. Bradley,
karate Vice President and Chief Digital Engagement Officer at Frayer Health. Dr.
Karate, it's a pleasure to have you on the podcast today.
Pleasure to be here. Thank you so much.
Now I know we have a lot to talk about.
There's so much happening in healthcare and really a lot in the digital
transformation space as well. But before we dive into my questions,
can you tell us a little bit more about yourself and your background?
Yeah, ab, absolutely. Um, so first of all, I am a, uh,
practicing, uh, primary care physician. I still continue to see, um,
patients, and I think that's a very important part of, uh,
the work that I do. Um,
the second part is I am an informatician. So, um,
uh, in clinical informatics relatively, uh, newer boarded, uh,
subspecialty, uh, in the practice of medicine.
And just a little bit about, um, my background. So I did, um,
my, uh, medical training and then my, uh, fellowship training,
uh, at the Beth Israel Deaconess Medical Center and had the pleasure of
working with some amazing, uh, mentors that have been bringing in digital,
um, since the 1960s into the clinical care environment. Uh,
those include, um, Charlie Saffron and then, uh, his mentors,
uh, Warner Slack and Howard Blight. So, Warner, um,
had first been using the, uh,
computers when they were the size of refrigerators, uh, in, uh,
to interview a patient. Uh, he had one of the first, if not the first, um,
article about computing in medicine in the New England Journal in 1967.
Um, and so it was an amazing opportunity to really learn, um, you know, from,
from these folks and to be able to carry, uh, their, their legacy forward of,
of using, uh, computing and digital to really improve care,
uh, and the, and the care experience.
Absolutely. I, I really love that. And definitely, you know,
that gap between the technology and the patient care really, you know,
is so important. And I,
I know you can really do a lot and add to the experience as well as the overall
care you delivered by leveraging technologies in the right way.
So I can imagine that experience as both the clinician as well as the background
of technology really puts you in a great spot to, um, a advance that and,
and connect with both teams on a level they understand to really, you know,
forward some of these initiatives in a, um, a more efficient way than, you know,
if, if you didn't have one foot in both worlds, so to speak.
Yeah, absolutely. The, the, you know, technology for technology's sake,
there's nothing special about that, and it's not gonna move any needles.
You really need to integrate it into the problem that you're trying to,
to solve. You know,
the thing about the history of computing and medicine that
those that taught me would always point out is that the technology may change
periodically, but the underlying process is often the same. Uh,
we may be taking care of people now through video.
It used to be taken care of people through telephone was a novelty.
But it's essentially you're still trying to do the same function,
diagnosis and treatment. The tools may differ, but the,
the process is really the same.
And we'll have new things that will come out in the future that we're not even
contemplating, um, uh, right, right now. Um,
but ultimately it's, it's you not about the, the technology.
It's really about the, the care, uh, that we're trying to deliver, uh, to,
to our patients and the, and help them lead the best lives they can.
Absolutely. I love that. And,
and just such an important philosophy and way to approach, um, you know, that,
that, um, the technology side of healthcare now, when you look at,
um, where you're at today,
what are some of the opportunities that you see for freighter as well as the
headwinds you have your eye on?
Let me start with the headwinds, um, first,
cuz it's really what everyone in our industry is, is talking about.
We know that, uh, the costs of, um,
really, uh, skilled labor clinicians, uh, nurses,
including nurses and therapists, um, the costs are,
are rising. And, um, also supplies are,
uh, the cost of supplies are rising too.
So you have these on this whole one front of, of rising costs,
and then your reimbursements, if anything, um, if they're moving,
are generally moving, uh, in a lower direction for the most part.
And so it really challenges the business models, uh,
that healthcare systems have right now. So,
so that's the headwind I think everyone in our industry is, is talking about,
uh,
I'm gonna flip it to that being an opportunity and really
say, well,
how can we really work to have the right
same end goal, which is taking care of people, um, having them have the,
the best, uh, health outcomes they can,
but do it in a way that is possibly radically,
uh, different. And we're doing it because we're, we're forced to,
to change. Um,
so opportunities that I think we need to look at are how we can use technology
to, uh,
continue to automate as many functions as we as we can because we, you know,
frankly have a hard time, um, getting, getting staffed to help. So what, uh, uh,
what can we automate? Um,
another is what can the patient and family members do within certain
guardrails, um,
on their own without needing to run everything through a,
uh, a professional. Um, so my mentors that I mentioned,
Warner Slack would always, uh, often equipped that the patient or, uh,
family members, often the least u utilized resource, uh, in the healthcare team.
Um, and he had a, uh, a family member who had diabetes,
and he said, well, he had to take insulin and if, if insulin, um,
if he didn't have to do it multiple times a day,
we would bring people into the hospital to, to give this medication.
But that's not practical. So we're gonna have to rely on the patient,
their family members to learn and, and, and manage it. And, um,
of course, uh, people manage their, uh,
diabetes all the time with their appropriate, uh, education and, and tools.
So how do we move more into that, uh, into that direction? I,
I think digital, um, is gonna play a really important role in both the,
the education and the support as well as the, uh,
guardrails so that we can intervene if someone is, is falling off track.
That makes a lot of sense, you know,
and really seems like a very promising way to, uh,
utilize and leverage technology to, um,
keep people healthy as much as possible and do things that you were never able
to do, you know, without that digital lens. From your perspective,
how are you thinking about growth and development and adding to the health
system overall, especially in a time where, as you mentioned, you know,
there's some, um, across the board,
financial challenges as well as it can be challenging to have the staffing
resources that you need to even do some of the basics at times. Um, you know,
how do you add value to an organization during times like these?
I think it, it's going back to that, how can we do things? Um,
how can we do things differently? Um, I, if you'll,
if you'll allow me a quick analogy, um, I've lived in the Milwaukee,
Wisconsin area for the last, um, six or seven years.
It's on a beautiful lake,
and I've been trying to go out and enjoy that lake periodically and learn how
to, to sail. Um, you need wind to be able to move. And the modern,
uh, sales and the sale, if you think about sales as a technology, um,
helps you, helps you move, um, if you have, uh,
wind, uh, coming at just the right angle, even if it is coming, uh,
from the front, uh, you can harness it and move to a different position.
You might have to take a few zigzags or tax as they call it, but, uh,
but you really need that, that, uh, that headwind, um,
to, uh, be able to move.
And what I'm thinking right now with the risk of being a little bit too
pollyannish is that, you know,
this is an important forcing function for us to learn how to do things, um,
differently. So how can we use that technology?
Maybe we're not able to go straight at the target like we want, but, um,
but with a little bit of navigation and using the wins in our technology, we,
we, we can get there. But, you know, ultimately it comes down to being able to,
to offer services and to do things differently that don't have the same cost
structures. So, um,
how can we digitally engage people as much as possible to, uh,
fulfill, um, care gaps, uh, without having to go through,
uh, nurses and care coordinators or have everything done at a,
at a clinical visit. Um, how can we grow, uh,
new lives and, and essentially taking care of more people, um,
and how can we do it through digital means, uh, through telemedicine,
but also through digital therapeutics and other ways of reaching people and
delivering the, the content and care, uh, that people can, um,
can use to,
to further their health And how can we think about the right partnerships that
enable us to, um, to do that.
So those are some of the ways that we've been thinking about, um, growth and,
and value, uh, at, at this time.
I love that. I,
I think that makes so much sense and definitely is helpful to understand, um,
you know, what you're still able to do within, um, you know,
the context of,
of today's environment and thinking through some of that as well, um, in,
in how you can improve the patient experience and, and really, um,
be more targeted with patients. You know,
what is one investment that's still worth making this year towards that goal?
Um, in, in, in making sure that you've got the best care possible.
So the investments that we cannot afford to, to not make and,
and to not make, um,
to not solidly make are investments in data and investments in the
infrastructure, uh, to deliver, uh, patient engagement. Um,
both of them are at this point, non-negotiable, uh, uh,
areas that are needed to, uh, get where we want to be. Um,
and the conversation that I think we need to have is
how do we look at these areas as assets?
We generally will look at, um, buildings as,
as assets and, and real estate, et cetera,
but how do we look at the investments and data and how do we look at the
investments in the infrastructure for digital engagement as,
as, uh, strategic assets? Um,
so I think we need to keep the foot on the gas pedal in,
in both of these areas, um, for, uh, data,
it's clinical data,
but it's also being able to marry that and bring that together with context of,
uh, where a patient is, um, in their, in their life and in their neighborhood,
uh, in their communities, uh, to also bring it in with other sources of data,
claims data, uh, et cetera, to put,
really get that a whole picture of who a person is together and,
um, not just use it for risk stratification, but really u to bring it into, um,
clinical care to make it available for, um,
care teams to make it available for our, our, uh,
systems of care, uh, to make sure that they have the, um, right interventions,
uh, targeted, uh, to the right, to the right people. Um,
and then in, in terms of the digital, uh, engagement, um,
for us,
it's been to continuing to invest in our digital engagement platform that we are
are building. Um,
while we do use our electronic health record and the digital engagement
capabilities within that, uh, we've also needed to bring together,
uh, experiences from our other digital therapeutics tools, uh,
from our, um,
our video visits and telemedicine infrastructure to really make the best
experience, um, possible.
And we think that's just like having a, a,
you know, a building or a, a center that a lot of people come through every day.
It needs to be well functioning, it needs to be inviting,
it needs to be welcoming, uh, and it needs to, uh, work really well. So,
um, we're gonna continue to move forward with, um, with those investments.
I love that. I think that's so important. And, you know, your focus on it,
being able to have a systems in place that really allow the care teams to target
the right people for the right treatments in, in the right, uh, um,
type of care. And then the patient engagement as well, it seems like,
is very forward thinking in terms of, um, how patients are,
are really able to interact with the healthcare system overall. And, and so,
you know,
when you look at some of these changes that are happening and that you're
making, has the care team been pretty receptive to that?
Or have there been some, uh, challenges and questions in terms of, um, you know,
whether this is really moving forward in the right direction for patients?
So one of the things I think we have to think about,
and I I bring this up with our care teams, um, when I talk, you know,
either one-on-one with clinicians or, or in group, is, um,
what's that right balance between care team autonomy and work, and then, uh,
systemness and, and systems of care. And I think we're,
we've reached an inflection point, uh,
or a tipping point where the clinicians have so
much on their plates that they're asking for help. Um, and,
and this is an opportunity where we can bring in,
in digital in the right way to really provide that, that help.
Now the flip side of that is it can't be a digital that, uh,
a digital intervention that results in another inbox message or puts everything
back on the, on the clinician, that's really not going to work out.
But if we, if we're able to do it right, we're able to provide that,
that help, uh, for the, for the clinicians, uh, you know,
an example that we're looking, um, hard at is, you know, the,
the issue of, um, patient portal messages and their, their growth. So, um,
this is an important value add for patients. It's,
it's often where patients are starting the care journey, um, with a question of,
should I come in or, or should I be seen? Or what, what would you do for this?
Um, but it's, it's, it's a reflection of where the care model needs to,
to change. Um, but if we're still in a locked in a fee for service,
uh, world, uh, we're not able to to accomplish that.
So how may we solve the problem of the, uh, of, of helping patients?
Um, and, and part of that may be not putting those on the,
on the, the clinicians to respond to those messages.
That's looking at systems of care to be able to take the intent of that message
and really help a patient, uh, solve their problem as quickly as possible.
And it may not go through the, um, care team. So we're,
we're gonna have this balance of, of autonomy and, and control versus,
um, teamwork and, and, um,
and we'll see where that goes, but I think we're in a point now where the,
the balance is really stru, uh, going towards, um,
let's help the care teams as much as possible.
I love it. Thank you so much for going through that with us and, and really, um,
you know, highlighting how the care teams are working through that.
Before we wrap up our conversation, I wanted to take an eye and,
and look at the future. What do you see as some of the best places in,
in ways to grow and develop,
especially as healthcare and technology in particular is evolving?
Yeah, one of the things I think we all have to ask ourselves is what,
as a healthcare system, what, what is it that we are, um,
are going to, to do and, and be known for, um,
particularly academic systems, uh,
like us are going to take pride in,
in being able to solve complex, uh, problems and to be able to bring the latest,
uh, and best technology to patients and, and frankly, the,
some of the, uh, technology, um, whether it's, uh,
CAR T therapy that we've, um, been working on and,
and have a lab here for, or it's, um, any of the, uh, newer can,
newer other cancer treatments, antibody, uh, based treatments, et cetera. It,
it's nothing short of, uh, miraculous. Um,
but is that all that we're going to do?
And what about the broader health of the, of the communities?
And I think that's an opportunity for us to, um,
to continue to grow that if, if we abdicated or delegated.
Um, I think we're missing opportunities to really, uh, one,
provide the best care available to patients in a integrated and non
fragmented, uh, way. Um, and then, uh, two,
develop a lifelong relationship with patients. So, you know,
I think there's, there's often talk about, well,
what do we give up and is wellness and, um, and kind of that,
that low acuity something that we want to delegate, um, or,
or partner with. And I think we have to look hard at, at that and, and say,
you know, is, is that part of the full spectrum of care?
And if we're not gonna do it, do we have the right, um,
partners and infrastructure to be able to have those relationships, uh,
with people that, that span ages and, and span time? And,
and so I think that's one of the things that I think all health systems, um,
need to look hard at. And, and I think if we do it right,
it also does unlock opportunities for us to, um,
grow, uh, in, in both our, uh, value to patients,
uh, that we serve as, as well as to be able to grow our, um, our, uh,
footprint in, in our communities.
That's fantastic to hear and in what a fascinating and thoughtful way that
you're approaching, um, that those initiatives in,
in bringing technology into the fold. Dr. Karate,
thank you so much for being here today and for your time.
I've really enjoyed our conversation and so glad that you'll be able to join us
in October as well for our health IT Digital Health and Revenue Cycle event.
I, I know there'll be a lot of discussion around many of the themes here from,
um, technology automation and digital patient experience into AI and, and more.
So I'm looking forward to that and,
and so grateful that you'll be able to lend your expertise to us there as well.
There's a lot coming. Thank you for the conversation, Lauren,
and look forward to continuing it.
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