1 00:00:00,000 --> 00:00:03,520 Would you like to exchange best practices and ideas to improve care, 2 00:00:03,670 --> 00:00:05,440 enhance operational efficiency, 3 00:00:05,500 --> 00:00:07,840 and address financial challenges with your peers? 4 00:00:08,320 --> 00:00:12,160 Becker's Healthcare is facilitating these conversations at their eighth annual 5 00:00:12,460 --> 00:00:15,240 health, IT Digital health and RCM meeting. 6 00:00:15,660 --> 00:00:18,960 You can check your eligibility for complimentary attendance at the Lincoln, 7 00:00:19,320 --> 00:00:21,960 the description. We are excited to welcome you in October. 8 00:00:23,050 --> 00:00:25,500 This is Laura Dedo with the Becker's Healthcare Podcast. 9 00:00:26,280 --> 00:00:28,740 I'm thrilled today to be joined by Dr. Greg Ry, 10 00:00:28,910 --> 00:00:32,340 chief Medical Information Officer at the University of Rochester Medical Center. 11 00:00:33,350 --> 00:00:35,460 Drand is a pleasure to have you on the podcast today. 12 00:00:36,960 --> 00:00:38,900 Thanks, Laura. Yeah, it's great to be here. 13 00:00:39,720 --> 00:00:42,180 Now, I know we've got a lot to talk about. This is, you know, 14 00:00:42,180 --> 00:00:44,180 such an important year in space, 15 00:00:45,080 --> 00:00:49,620 the intersection between clinical care and medicine and it informatics. 16 00:00:49,620 --> 00:00:51,260 But before we dive into my questions, 17 00:00:51,320 --> 00:00:53,580 can you tell me a little bit more about yourself and your background? 18 00:00:55,250 --> 00:00:58,940 Yeah, um, so I'm an orthopedic surgeon. Uh, 19 00:00:59,140 --> 00:01:00,620 I practice and do, uh, 20 00:01:00,620 --> 00:01:04,300 sports medicine and shoulder surgery at the University of Rochester Medical 21 00:01:04,300 --> 00:01:09,100 Center. Uh, I'm also our Chief Medical Information Officer. Um, 22 00:01:09,280 --> 00:01:14,220 we are a nine hospital, uh, mid-sized, uh, 23 00:01:14,220 --> 00:01:19,220 system in, uh, kind of the Finger Lakes region of New York. So we, 24 00:01:19,240 --> 00:01:23,500 we cover basically from, uh, Buffalo to Syracuse down south to the, 25 00:01:23,920 --> 00:01:28,900 to the Pennsylvania border. Um, I've been in my role for about, 26 00:01:29,240 --> 00:01:31,940 uh, three years, and I still practice clinically, uh, 27 00:01:31,940 --> 00:01:35,500 doing orthopedic scene patients one day a week and doing surgery about three 28 00:01:35,500 --> 00:01:38,780 times a month. And then the rest of my time is, uh, spent, um, 29 00:01:39,130 --> 00:01:41,820 translating between technology and workflow. 30 00:01:43,140 --> 00:01:46,680 Got it. Wow. That's, you know, such a, uh, huge undertaking. 31 00:01:46,800 --> 00:01:51,720 I can imagine to really be the person that is the liaison between the, um, 32 00:01:51,720 --> 00:01:56,120 medical teams and then the IT teams too. And from that vantage point, 33 00:01:56,120 --> 00:01:59,160 where do you see some of the big opportunities in the future as well as the 34 00:01:59,160 --> 00:02:00,800 headwinds that you have your eye on today? 35 00:02:02,700 --> 00:02:04,390 Yeah, I think, you know, I'll, 36 00:02:04,390 --> 00:02:08,310 I'll start with headwinds because I think we're all kind of feeling it right 37 00:02:08,310 --> 00:02:12,030 now. You know, obviously, um, there's tremendous, uh, 38 00:02:12,100 --> 00:02:15,710 financial pressures in, in healthcare, uh, 39 00:02:15,850 --> 00:02:20,750 and there's a significant amount of clinician burnout both on 40 00:02:20,750 --> 00:02:23,270 the nursing side and the provider side. 41 00:02:23,890 --> 00:02:28,520 And so we really need to be leveraging technologies 42 00:02:28,710 --> 00:02:33,160 that help us automate processes and be more efficient. Um, 43 00:02:33,160 --> 00:02:36,680 but a lot of those require changes in workflow. 44 00:02:37,500 --> 00:02:42,080 And our frontline clinicians, nurses, providers, uh, doctors, 45 00:02:42,560 --> 00:02:44,680 residents, uh, all, you know, 46 00:02:44,680 --> 00:02:49,600 are at a point where it's just very difficult for them to engage in all 47 00:02:49,600 --> 00:02:54,120 of these changes. Uh, and so there's definitely a, a balance. Uh, 48 00:02:54,120 --> 00:02:58,720 and so my team is, uh, really working hard, uh, focusing on, you know, 49 00:02:58,720 --> 00:03:03,720 some very key strategic initiatives, um, to, to help us, uh, 50 00:03:03,790 --> 00:03:08,520 through, but we're really, um, trying to focus on a few as opposed to, 51 00:03:09,140 --> 00:03:10,400 you know, I think with the pandemic, 52 00:03:10,400 --> 00:03:15,280 there was a lot of stuff that got put on the back burner, um, and, you know, 53 00:03:15,280 --> 00:03:18,640 there was a long backlog, uh, and it's easy to just say, all right, 54 00:03:18,640 --> 00:03:22,760 we're gonna do it all at once. Um, but understanding, you know, 55 00:03:22,760 --> 00:03:27,400 what the organization is capable of doing, we really are, are, um, 56 00:03:27,550 --> 00:03:29,560 kind of laser focused on trying to figure out, okay, 57 00:03:29,560 --> 00:03:33,600 what can we do well and effectively that actually leads to less, uh, 58 00:03:33,600 --> 00:03:38,200 burnout increased, uh, provider, uh, and uh, nursing satisfaction. 59 00:03:40,050 --> 00:03:41,980 That makes a lot of sense. You know, and it's really, 60 00:03:42,120 --> 00:03:45,300 it seems like the word of the year is just that simplification and really 61 00:03:45,300 --> 00:03:49,540 focusing in on where the most value is gonna be. So from your vantage point, 62 00:03:49,770 --> 00:03:51,060 what does that look like? Where, 63 00:03:51,060 --> 00:03:55,780 where are you able to add value and really see the organization and potentially 64 00:03:56,040 --> 00:03:58,420 get back to more of a growth trajectory in the future? 65 00:03:59,580 --> 00:04:03,520 So I think right now we're still kind of pushing through with our, 66 00:04:03,700 --> 00:04:08,000 our digital transformation strategy. So we had kind of a three-pronged, uh, 67 00:04:08,000 --> 00:04:12,840 five year approach, uh, focused on access first and then engagement and then, 68 00:04:13,420 --> 00:04:18,240 uh, driving value, uh, at the end. And so access was all about, uh, 69 00:04:18,240 --> 00:04:21,120 the digital front door and, you know, how do you find a provider? 70 00:04:21,260 --> 00:04:23,200 How do you schedule an appointment online? 71 00:04:23,420 --> 00:04:28,240 How do you do on-demand telemedicine and, and, and all the other, uh, 72 00:04:28,240 --> 00:04:30,840 things, e-visit you, check in, um, and that sort of thing. 73 00:04:30,840 --> 00:04:33,000 And we're largely kind of through that. 74 00:04:33,220 --> 00:04:36,600 And we were going to be heading towards engagement, 75 00:04:36,600 --> 00:04:39,680 which was how do you engage with the patients outside of the, 76 00:04:40,100 --> 00:04:43,880 the four walls of the medical center, um, you know, through, uh, 77 00:04:44,120 --> 00:04:48,640 clinical care pathways, uh, digital therapeutics, um, uh, 78 00:04:48,670 --> 00:04:52,920 apps and, and things like that. Um, but we've really pivoted more towards, 79 00:04:53,620 --> 00:04:55,720 um, value sooner. Uh, 80 00:04:55,720 --> 00:05:00,580 and where we're looking at value is really around automating things. Uh, 81 00:05:00,700 --> 00:05:03,500 a lot of the, uh, I'll say adminis trivia, uh, 82 00:05:03,500 --> 00:05:06,700 stuff that our nurses and our providers, uh, need to do on our, 83 00:05:06,700 --> 00:05:08,900 on a regular basis. And so that's, you know, 84 00:05:08,900 --> 00:05:13,820 leveraging things like ambient voice technology, um, looking at, uh, 85 00:05:13,850 --> 00:05:16,580 ways that you can do, you know, more, um, 86 00:05:16,760 --> 00:05:21,060 remote nursing activities or automate different, uh, nursing tasks, 87 00:05:21,640 --> 00:05:22,580 um, things like that. 88 00:05:24,470 --> 00:05:25,970 Got it. That's fascinating and, 89 00:05:25,990 --> 00:05:29,850 and really seems like there's a lot of opportunity there when you look at 90 00:05:29,850 --> 00:05:33,530 bringing in automation and, um, making I, 91 00:05:33,570 --> 00:05:34,970 I guess streamlining with some of the, 92 00:05:34,970 --> 00:05:38,850 whether it's artificial intelligence or other technology, bringing it in. Um, 93 00:05:39,120 --> 00:05:42,570 what does it look like to incorporate it and really integrate that into the 94 00:05:42,570 --> 00:05:45,490 larger workflows? How do you do that with the, um, 95 00:05:45,630 --> 00:05:49,290 the teams that you have with the nurses, doctors and, and clinical teams, 96 00:05:49,320 --> 00:05:51,170 just to make sure that, you know, 97 00:05:51,170 --> 00:05:54,770 everybody understands why that change is happening and feels like it's, uh, 98 00:05:54,850 --> 00:05:57,240 a helpful change versus a scary change? 99 00:05:58,940 --> 00:06:02,110 Yeah, I think that that's really been the biggest focus, 100 00:06:02,310 --> 00:06:04,110 I would say on our organization as a whole, 101 00:06:04,170 --> 00:06:08,670 is just kind of looking at our organizational change management process. So, 102 00:06:09,290 --> 00:06:10,050 um, you know, 103 00:06:10,050 --> 00:06:14,950 we historically would talk about a change coming and we'd send out a, 104 00:06:15,110 --> 00:06:19,870 a mass email that was designed for everybody. It was designed for nurses, 105 00:06:20,540 --> 00:06:22,390 doctors, administrators, 106 00:06:22,610 --> 00:06:25,710 and they were supposed to understand the whole program and the why. 107 00:06:26,010 --> 00:06:26,910 But when you do that, 108 00:06:27,960 --> 00:06:31,820 you kind of lose the what's in it for me for each of those specific groups 109 00:06:31,820 --> 00:06:36,220 because the what's in it for me is very different when you look at a nurse or a 110 00:06:36,220 --> 00:06:39,660 doctor and an administrator. And so, um, 111 00:06:39,830 --> 00:06:44,580 we're taking a more strategic approach about just that kind of awareness stage 112 00:06:44,600 --> 00:06:49,180 and trying to focus on, uh, verbal in-person delivery or, 113 00:06:49,520 --> 00:06:52,900 uh, via, uh, you know, by Zoom or you know, um, 114 00:06:52,900 --> 00:06:57,740 something like that as opposed to email and then actually having some ability to 115 00:06:57,740 --> 00:07:00,740 assess, you know, does the organization actually want this change? 116 00:07:00,800 --> 00:07:05,220 So you delivered the message. Did people actually hear it and say, okay, 117 00:07:05,220 --> 00:07:08,300 we want to participate in this, um, or not. 118 00:07:08,400 --> 00:07:11,420 And that's historically something that we haven't done. We've just kind of said, 119 00:07:11,950 --> 00:07:16,780 we're gonna do this, and then we roll out some training that says, alright, 120 00:07:17,520 --> 00:07:21,860 um, you know, here, here's what you're gonna need to know to be able to do it. 121 00:07:22,360 --> 00:07:26,220 And then it would just kind of go live on the go live date and, 122 00:07:26,360 --> 00:07:30,460 and kind of we would move on. And so we're really focusing on, okay, 123 00:07:30,760 --> 00:07:34,660 are people ready to actually engage? Did we really get the word out? Uh, 124 00:07:34,800 --> 00:07:37,100 and then we're still delivering the training. 125 00:07:37,520 --> 00:07:40,820 And then after training we're trying to determine, okay, you know, 126 00:07:40,840 --> 00:07:43,820 do they really have the skills that they need to be effective at this? 127 00:07:44,200 --> 00:07:45,420 And then after we're training, 128 00:07:45,430 --> 00:07:49,660 we're building in more of a stabilization process with these technology, uh, 129 00:07:49,660 --> 00:07:51,300 implementation so that, you know, 130 00:07:51,300 --> 00:07:54,180 it's not just turning the technology on and walking away, 131 00:07:54,640 --> 00:07:58,700 but how are we going to evaluate whether it was actually effective and what 132 00:07:58,700 --> 00:08:03,060 process do we have built in for making sure that we're getting the most out of 133 00:08:03,060 --> 00:08:07,580 it? That obviously slows down how quickly you can move to the next thing. 134 00:08:08,200 --> 00:08:11,660 And so, again, for us, it's kind of a little bit of a less is more approach. 135 00:08:11,750 --> 00:08:14,060 We're we're doing less projects, 136 00:08:14,440 --> 00:08:18,260 but we are aiming to execute much more effectively, uh, 137 00:08:18,280 --> 00:08:22,660 and drive a better ROI out of those few projects as opposed to kind of just 138 00:08:23,130 --> 00:08:24,740 dumping many projects on everybody. 139 00:08:26,480 --> 00:08:29,970 That really makes a lot of sense and sounds like a great approach to get 140 00:08:29,970 --> 00:08:33,810 everybody on board and kind of the one-on-one connections as well as, you know, 141 00:08:33,810 --> 00:08:35,890 making sure people really understand, uh, 142 00:08:36,120 --> 00:08:40,690 what benefit they're driving from the change. Uh, now from your perspective, 143 00:08:41,250 --> 00:08:41,450 I, 144 00:08:41,450 --> 00:08:44,890 I know that we've talked through this being somewhat of a challenging time right 145 00:08:44,890 --> 00:08:49,090 now in healthcare across the board and for many industries as well. Um, 146 00:08:49,150 --> 00:08:52,730 but still needing to keep an eye on the future and, you know, 147 00:08:52,730 --> 00:08:55,990 what is still a risk or investment that's worth, worth making this year, 148 00:08:56,070 --> 00:08:58,520 even if, you know, is a little bit of a, um, 149 00:08:58,950 --> 00:09:01,720 more pinched financially than before. It didn't have, you know, 150 00:09:01,720 --> 00:09:05,760 staffing shortages and other things that could be, uh, prohibitive and limiting. 151 00:09:05,860 --> 00:09:09,200 Uh, where do we still need to spend some of our precious health healthcare 152 00:09:09,400 --> 00:09:10,233 resources? 153 00:09:11,930 --> 00:09:16,110 So I think, you know, if you asked me two months ago, 154 00:09:16,810 --> 00:09:21,110 you know, I I definitely would've said, uh, in, in the area of the, 155 00:09:21,690 --> 00:09:26,470 you know, ambient ai, um, stuff to help with documentation burden, 156 00:09:26,470 --> 00:09:30,710 particularly with my lens as a, as a physician. Um, you know, 157 00:09:30,730 --> 00:09:35,270 cuz that's a large portion of, of what we do. Um, I, you know, 158 00:09:35,270 --> 00:09:39,190 I would say focus on documentation or, or in-basket. Um, 159 00:09:39,330 --> 00:09:42,390 but I would say with the advent of, uh, 160 00:09:42,670 --> 00:09:47,070 G P T four and these large language models and 161 00:09:47,070 --> 00:09:51,590 understanding how quick those are probably going to evolve over the next several 162 00:09:51,760 --> 00:09:56,150 years, we've actually kind of paused a little bit, uh, in, 163 00:09:56,250 --> 00:10:00,630 in thinking about when we want to invest to make sure that, you know, 164 00:10:00,630 --> 00:10:05,190 we're taking a platform approach and that we're being cost effective with these 165 00:10:05,190 --> 00:10:08,030 things. Because I think the cost of those types of solutions, 166 00:10:08,460 --> 00:10:13,070 obviously is significantly decreased, literally in the last couple of months. 167 00:10:13,290 --> 00:10:14,470 So I think, you know, 168 00:10:14,490 --> 00:10:19,110 one thing that we're really focused on right now is our clinical 169 00:10:19,110 --> 00:10:23,550 predictive, uh, uh, analytics. Um, you know, we, 170 00:10:24,130 --> 00:10:28,990 uh, had our sepsis, um, predictive model that we rolled out, 171 00:10:29,190 --> 00:10:34,110 I think, um, mid covid and, you know, we were having quite a few issues with it, 172 00:10:34,130 --> 00:10:35,350 you know, just firing, you know, 173 00:10:35,350 --> 00:10:39,070 we used to have the Covid bpa and it was the most ignored BPA in the, 174 00:10:39,170 --> 00:10:41,830 in the history, uh, of BPAs, um, 175 00:10:42,100 --> 00:10:44,190 BPAs for those who don't know our best practice advisories, 176 00:10:44,190 --> 00:10:48,150 there's a little pop-ups that basically, you know, fire in the chart and say, 177 00:10:48,150 --> 00:10:51,350 Hey, this patient might have sepsis, but they almost never did. 178 00:10:51,490 --> 00:10:55,750 And so providers kept clicking out of it, uh, and it became more of a, uh, 179 00:10:55,830 --> 00:11:00,230 a nuance in the, in, uh, a nuisance in the background. And so we went with, 180 00:11:00,250 --> 00:11:02,910 you know, something we thought would be more intelligent, um, 181 00:11:02,930 --> 00:11:05,670 or EMRs predictive model. Um, 182 00:11:05,690 --> 00:11:10,190 but even with that in instituting workflows, it was still firing, you know, 183 00:11:10,260 --> 00:11:14,590 73 times, uh, for every positive, uh, 184 00:11:14,590 --> 00:11:18,990 patient with sepsis. And, you know, for our, our doctors and nurses, 185 00:11:19,450 --> 00:11:22,110 you know, that's like, if your GPS takes you to the wrong place, 186 00:11:22,540 --> 00:11:26,790 74 out of 75 times, um, you're just not gonna use it. And so they, 187 00:11:26,790 --> 00:11:31,790 so they weren't using it. Um, and you know, there's potential and, you know, 188 00:11:31,790 --> 00:11:36,790 tons of opportunity to save patient lives, um, if this is employed correctly. 189 00:11:36,790 --> 00:11:41,790 And so we've kind of revisited with that and, and have, um, you know, 190 00:11:41,790 --> 00:11:45,710 engaged with some, some newer technology that allows that to fire, you know, 191 00:11:45,710 --> 00:11:46,990 three times for every patient. 192 00:11:47,210 --> 00:11:52,110 And it kind of fits within the clinician workflow and allows you 193 00:11:52,110 --> 00:11:56,880 to engage with the model almost like a clinical consult, which, you know, is, 194 00:11:57,060 --> 00:12:01,120 is, uh, much easier, um, on, on our clinicians and, 195 00:12:01,140 --> 00:12:04,600 and nurses and yields better adoption and obviously, um, 196 00:12:04,600 --> 00:12:08,040 because people are using it better, better outcome in, in life saved. 197 00:12:09,770 --> 00:12:13,070 That's great to hear. It really seems like it's something that, uh, 198 00:12:13,070 --> 00:12:17,030 makes a big difference for the organization. So, uh, certainly, um, 199 00:12:17,060 --> 00:12:19,990 very inspiring to hear about now. I wanted to, 200 00:12:20,090 --> 00:12:21,750 before we wrap up our conversation, 201 00:12:21,780 --> 00:12:23,710 look into the future just a little bit further. 202 00:12:24,080 --> 00:12:27,590 Where do you see some of the best growth opportunities for you as well as the 203 00:12:27,590 --> 00:12:28,430 teams that you work with? 204 00:12:29,830 --> 00:12:34,170 So I, I think it's definitely gonna be within, you know, uh, the, 205 00:12:34,310 --> 00:12:36,970 the large language models. Um, you know, 206 00:12:36,990 --> 00:12:41,610 the ability of those things to help with those administrative, 207 00:12:42,270 --> 00:12:46,650 uh, tasks that are all, um, put on us and, and are really, um, 208 00:12:47,250 --> 00:12:50,130 creating the largest amount of clinician burden. So the documentation, 209 00:12:50,430 --> 00:12:51,850 the in basket tasks. 210 00:12:52,610 --> 00:12:56,490 I think what'll be interesting is whether this is something that 211 00:12:57,740 --> 00:13:01,960 is solved by industry or the EHR vendors 212 00:13:02,660 --> 00:13:06,040 or whether that's something that, you know, 213 00:13:06,040 --> 00:13:10,920 we actually task our own innovation labs and innovation teams, uh, 214 00:13:10,980 --> 00:13:12,400 on solving, um, 215 00:13:12,400 --> 00:13:16,960 because the ability to create those things has just gotten, um, 216 00:13:17,260 --> 00:13:21,280 so much easier. And obviously we have to work through all of the, um, you know, 217 00:13:21,280 --> 00:13:24,600 the privacy, uh, considerations, uh, with them and, 218 00:13:24,900 --> 00:13:28,560 and really understanding what the, what the risks are. Um, 219 00:13:28,700 --> 00:13:32,360 so I think there's a lot of work that needs to go into evaluating our approach 220 00:13:32,360 --> 00:13:35,120 around those models. And, you know, 221 00:13:35,120 --> 00:13:38,160 that's something hopefully we'll be doing this year and then obviously, um, 222 00:13:38,160 --> 00:13:40,720 starting to really engage with that next year. 223 00:13:42,310 --> 00:13:46,160 Fantastic. I, I love it. It's just so, such a, a great way to think through, 224 00:13:46,180 --> 00:13:46,680 you know, 225 00:13:46,680 --> 00:13:50,880 how you're leveraging the technology and those large language models to, um, 226 00:13:50,880 --> 00:13:54,920 really make an impact on patient care as well as the administrative tasks, 227 00:13:54,920 --> 00:13:59,200 operational efficiency and those kinds of things. Um, Dr. McCanty, 228 00:13:59,200 --> 00:14:01,240 thank you so much for joining us on the podcast today. 229 00:14:01,240 --> 00:14:03,000 This has been such a fun discussion. And, 230 00:14:03,100 --> 00:14:06,400 and I'm also looking forward to seeing you in person at our Health IT Digital 231 00:14:06,400 --> 00:14:07,720 Health and Revenue Cycle event. 232 00:14:07,890 --> 00:14:11,240 It'll be great to have you speaking on a panel and really just adding a lot of 233 00:14:11,250 --> 00:14:14,000 color to the different themes we talked about here, 234 00:14:14,000 --> 00:14:17,480 as well as the overall discussion at the event. So we're looking forward to it. 235 00:14:18,610 --> 00:14:21,820 Yeah, I'm really excited. You know, I, it's funny, you know, 236 00:14:22,040 --> 00:14:25,820 that's gonna be in the, in the fall and it's just gonna be, I, 237 00:14:26,260 --> 00:14:28,700 I bet a lot is gonna have changed between now and the fall, 238 00:14:28,880 --> 00:14:32,620 so I'm really looking forward to getting together with everybody and, and, uh, 239 00:14:32,620 --> 00:14:33,453 talking. 240 00:14:33,630 --> 00:14:35,380 Absolutely. It'll be a lot to catch up with. 241 00:14:40,720 --> 00:14:44,050 It's so important for leaders at the top of organizations to keep learning, 242 00:14:44,240 --> 00:14:45,930 stay sharp, grow their networks, 243 00:14:46,320 --> 00:14:49,410 help our audience better do this in a more simplified, personalized, 244 00:14:49,510 --> 00:14:53,440 and meaningful way. Becker's Healthcare has launched my bhc, 245 00:14:53,950 --> 00:14:56,960 it's your trusted Becker's healthcare experience and more with content, 246 00:14:57,030 --> 00:14:59,240 connections, events and learning opportunities. 247 00:14:59,950 --> 00:15:04,840 Join the community free of charge@www.my dot becker's hospital 248 00:15:04,840 --> 00:15:06,680 review.com and we'll see you there.