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the description. We are excited to welcome you in October.
This is Laura Dedo with the Becker's Healthcare Podcast.
I'm thrilled today to be joined by Dr. Greg Ry,
chief Medical Information Officer at the University of Rochester Medical Center.
Drand is a pleasure to have you on the podcast today.
Thanks, Laura. Yeah, it's great to be here.
Now, I know we've got a lot to talk about. This is, you know,
such an important year in space,
the intersection between clinical care and medicine and it informatics.
But before we dive into my questions,
can you tell me a little bit more about yourself and your background?
Yeah, um, so I'm an orthopedic surgeon. Uh,
I practice and do, uh,
sports medicine and shoulder surgery at the University of Rochester Medical
Center. Uh, I'm also our Chief Medical Information Officer. Um,
we are a nine hospital, uh, mid-sized, uh,
system in, uh, kind of the Finger Lakes region of New York. So we,
we cover basically from, uh, Buffalo to Syracuse down south to the,
to the Pennsylvania border. Um, I've been in my role for about,
uh, three years, and I still practice clinically, uh,
doing orthopedic scene patients one day a week and doing surgery about three
times a month. And then the rest of my time is, uh, spent, um,
translating between technology and workflow.
Got it. Wow. That's, you know, such a, uh, huge undertaking.
I can imagine to really be the person that is the liaison between the, um,
medical teams and then the IT teams too. And from that vantage point,
where do you see some of the big opportunities in the future as well as the
headwinds that you have your eye on today?
Yeah, I think, you know, I'll,
I'll start with headwinds because I think we're all kind of feeling it right
now. You know, obviously, um, there's tremendous, uh,
financial pressures in, in healthcare, uh,
and there's a significant amount of clinician burnout both on
the nursing side and the provider side.
And so we really need to be leveraging technologies
that help us automate processes and be more efficient. Um,
but a lot of those require changes in workflow.
And our frontline clinicians, nurses, providers, uh, doctors,
residents, uh, all, you know,
are at a point where it's just very difficult for them to engage in all
of these changes. Uh, and so there's definitely a, a balance. Uh,
and so my team is, uh, really working hard, uh, focusing on, you know,
some very key strategic initiatives, um, to, to help us, uh,
through, but we're really, um, trying to focus on a few as opposed to,
you know, I think with the pandemic,
there was a lot of stuff that got put on the back burner, um, and, you know,
there was a long backlog, uh, and it's easy to just say, all right,
we're gonna do it all at once. Um, but understanding, you know,
what the organization is capable of doing, we really are, are, um,
kind of laser focused on trying to figure out, okay,
what can we do well and effectively that actually leads to less, uh,
burnout increased, uh, provider, uh, and uh, nursing satisfaction.
That makes a lot of sense. You know, and it's really,
it seems like the word of the year is just that simplification and really
focusing in on where the most value is gonna be. So from your vantage point,
what does that look like? Where,
where are you able to add value and really see the organization and potentially
get back to more of a growth trajectory in the future?
So I think right now we're still kind of pushing through with our,
our digital transformation strategy. So we had kind of a three-pronged, uh,
five year approach, uh, focused on access first and then engagement and then,
uh, driving value, uh, at the end. And so access was all about, uh,
the digital front door and, you know, how do you find a provider?
How do you schedule an appointment online?
How do you do on-demand telemedicine and, and, and all the other, uh,
things, e-visit you, check in, um, and that sort of thing.
And we're largely kind of through that.
And we were going to be heading towards engagement,
which was how do you engage with the patients outside of the,
the four walls of the medical center, um, you know, through, uh,
clinical care pathways, uh, digital therapeutics, um, uh,
apps and, and things like that. Um, but we've really pivoted more towards,
um, value sooner. Uh,
and where we're looking at value is really around automating things. Uh,
a lot of the, uh, I'll say adminis trivia, uh,
stuff that our nurses and our providers, uh, need to do on our,
on a regular basis. And so that's, you know,
leveraging things like ambient voice technology, um, looking at, uh,
ways that you can do, you know, more, um,
remote nursing activities or automate different, uh, nursing tasks,
um, things like that.
Got it. That's fascinating and,
and really seems like there's a lot of opportunity there when you look at
bringing in automation and, um, making I,
I guess streamlining with some of the,
whether it's artificial intelligence or other technology, bringing it in. Um,
what does it look like to incorporate it and really integrate that into the
larger workflows? How do you do that with the, um,
the teams that you have with the nurses, doctors and, and clinical teams,
just to make sure that, you know,
everybody understands why that change is happening and feels like it's, uh,
a helpful change versus a scary change?
Yeah, I think that that's really been the biggest focus,
I would say on our organization as a whole,
is just kind of looking at our organizational change management process. So,
um, you know,
we historically would talk about a change coming and we'd send out a,
a mass email that was designed for everybody. It was designed for nurses,
doctors, administrators,
and they were supposed to understand the whole program and the why.
But when you do that,
you kind of lose the what's in it for me for each of those specific groups
because the what's in it for me is very different when you look at a nurse or a
doctor and an administrator. And so, um,
we're taking a more strategic approach about just that kind of awareness stage
and trying to focus on, uh, verbal in-person delivery or,
uh, via, uh, you know, by Zoom or you know, um,
something like that as opposed to email and then actually having some ability to
assess, you know, does the organization actually want this change?
So you delivered the message. Did people actually hear it and say, okay,
we want to participate in this, um, or not.
And that's historically something that we haven't done. We've just kind of said,
we're gonna do this, and then we roll out some training that says, alright,
um, you know, here, here's what you're gonna need to know to be able to do it.
And then it would just kind of go live on the go live date and,
and kind of we would move on. And so we're really focusing on, okay,
are people ready to actually engage? Did we really get the word out? Uh,
and then we're still delivering the training.
And then after training we're trying to determine, okay, you know,
do they really have the skills that they need to be effective at this?
And then after we're training,
we're building in more of a stabilization process with these technology, uh,
implementation so that, you know,
it's not just turning the technology on and walking away,
but how are we going to evaluate whether it was actually effective and what
process do we have built in for making sure that we're getting the most out of
it? That obviously slows down how quickly you can move to the next thing.
And so, again, for us, it's kind of a little bit of a less is more approach.
We're we're doing less projects,
but we are aiming to execute much more effectively, uh,
and drive a better ROI out of those few projects as opposed to kind of just
dumping many projects on everybody.
That really makes a lot of sense and sounds like a great approach to get
everybody on board and kind of the one-on-one connections as well as, you know,
making sure people really understand, uh,
what benefit they're driving from the change. Uh, now from your perspective,
I,
I know that we've talked through this being somewhat of a challenging time right
now in healthcare across the board and for many industries as well. Um,
but still needing to keep an eye on the future and, you know,
what is still a risk or investment that's worth, worth making this year,
even if, you know, is a little bit of a, um,
more pinched financially than before. It didn't have, you know,
staffing shortages and other things that could be, uh, prohibitive and limiting.
Uh, where do we still need to spend some of our precious health healthcare
resources?
So I think, you know, if you asked me two months ago,
you know, I I definitely would've said, uh, in, in the area of the,
you know, ambient ai, um, stuff to help with documentation burden,
particularly with my lens as a, as a physician. Um, you know,
cuz that's a large portion of, of what we do. Um, I, you know,
I would say focus on documentation or, or in-basket. Um,
but I would say with the advent of, uh,
G P T four and these large language models and
understanding how quick those are probably going to evolve over the next several
years, we've actually kind of paused a little bit, uh, in,
in thinking about when we want to invest to make sure that, you know,
we're taking a platform approach and that we're being cost effective with these
things. Because I think the cost of those types of solutions,
obviously is significantly decreased, literally in the last couple of months.
So I think, you know,
one thing that we're really focused on right now is our clinical
predictive, uh, uh, analytics. Um, you know, we,
uh, had our sepsis, um, predictive model that we rolled out,
I think, um, mid covid and, you know, we were having quite a few issues with it,
you know, just firing, you know,
we used to have the Covid bpa and it was the most ignored BPA in the,
in the history, uh, of BPAs, um,
BPAs for those who don't know our best practice advisories,
there's a little pop-ups that basically, you know, fire in the chart and say,
Hey, this patient might have sepsis, but they almost never did.
And so providers kept clicking out of it, uh, and it became more of a, uh,
a nuance in the, in, uh, a nuisance in the background. And so we went with,
you know, something we thought would be more intelligent, um,
or EMRs predictive model. Um,
but even with that in instituting workflows, it was still firing, you know,
73 times, uh, for every positive, uh,
patient with sepsis. And, you know, for our, our doctors and nurses,
you know, that's like, if your GPS takes you to the wrong place,
74 out of 75 times, um, you're just not gonna use it. And so they,
so they weren't using it. Um, and you know, there's potential and, you know,
tons of opportunity to save patient lives, um, if this is employed correctly.
And so we've kind of revisited with that and, and have, um, you know,
engaged with some, some newer technology that allows that to fire, you know,
three times for every patient.
And it kind of fits within the clinician workflow and allows you
to engage with the model almost like a clinical consult, which, you know, is,
is, uh, much easier, um, on, on our clinicians and,
and nurses and yields better adoption and obviously, um,
because people are using it better, better outcome in, in life saved.
That's great to hear. It really seems like it's something that, uh,
makes a big difference for the organization. So, uh, certainly, um,
very inspiring to hear about now. I wanted to,
before we wrap up our conversation,
look into the future just a little bit further.
Where do you see some of the best growth opportunities for you as well as the
teams that you work with?
So I, I think it's definitely gonna be within, you know, uh, the,
the large language models. Um, you know,
the ability of those things to help with those administrative,
uh, tasks that are all, um, put on us and, and are really, um,
creating the largest amount of clinician burden. So the documentation,
the in basket tasks.
I think what'll be interesting is whether this is something that
is solved by industry or the EHR vendors
or whether that's something that, you know,
we actually task our own innovation labs and innovation teams, uh,
on solving, um,
because the ability to create those things has just gotten, um,
so much easier. And obviously we have to work through all of the, um, you know,
the privacy, uh, considerations, uh, with them and,
and really understanding what the, what the risks are. Um,
so I think there's a lot of work that needs to go into evaluating our approach
around those models. And, you know,
that's something hopefully we'll be doing this year and then obviously, um,
starting to really engage with that next year.
Fantastic. I, I love it. It's just so, such a, a great way to think through,
you know,
how you're leveraging the technology and those large language models to, um,
really make an impact on patient care as well as the administrative tasks,
operational efficiency and those kinds of things. Um, Dr. McCanty,
thank you so much for joining us on the podcast today.
This has been such a fun discussion. And,
and I'm also looking forward to seeing you in person at our Health IT Digital
Health and Revenue Cycle event.
It'll be great to have you speaking on a panel and really just adding a lot of
color to the different themes we talked about here,
as well as the overall discussion at the event. So we're looking forward to it.
Yeah, I'm really excited. You know, I, it's funny, you know,
that's gonna be in the, in the fall and it's just gonna be, I,
I bet a lot is gonna have changed between now and the fall,
so I'm really looking forward to getting together with everybody and, and, uh,
talking.
Absolutely. It'll be a lot to catch up with.
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