Latest / Becker’s Healthcare Digital Health + Health IT / Enhancing Interoperability & Health Equity through Technology at Mount Sinai: Insights from Patti Cuartas

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Enhancing Interoperability & Health Equity through Technology at Mount Sinai: Insights from Patti Cuartas · Becker’s Healthcare Digital Health + Health IT

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  This is Laura Dirda with the Becker's Healthcare
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  podcast.
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  I'm thrilled today to be joined by Patty
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  Cuentes,
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  executive director and associate CMIO at Mount Sinai
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  Health System. Patty, it's a pleasure to have
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  you on the podcast today.
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  Thank you so much, Laura. I'm happy to
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  be here.
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  Now I'm excited for our conversation because I
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  know Mount Sinai is doing some really amazing
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  things in technology,
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  in bridging out with some of the clinical,
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  care and care delivery as well as, you
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  know, a lot is happening within the,
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  physician assistant space and really excited to learn
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  more from your perspective about how that role
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  has evolved over time. But before we dive
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  into that, those questions, I was wondering, could
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  you tell me a little bit more about
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  yourself and your background?
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  Sure. Absolutely. Thank you for asking. So I
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  have been at Mount Sinai now for almost
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  9 years,
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  as an executive director and an associate CMIO
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  where
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  I'm responsible for
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  a lot of different
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  sometimes,
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  initiatives that are so different that it's very
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  difficult to see the thread. But I will
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  tell you what the thread is. But I
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  am I help support,
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  our Mount Sinai international team. So get to
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  travel to different countries and help the technology
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  work
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  in some of the hospitals and government systems
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  in different countries.
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  I work within
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  the,
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  health system
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  improving interoperability, which is what I'd like to
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  get into a little bit later.
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  I help support the emergency departments,
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  our social determinants of health
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  screening,
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  and,
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  I also
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  work
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  with a lot of our diversity initiatives and
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  health equity,
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  for from the technology
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  aspect, which,
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  you know, sometimes
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  it's easy to forget
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  that, really the the automation and and especially
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  now with a lot of the different AI
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  tools
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  create some bias if we're not really
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  paying attention,
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  to our health equity initiatives.
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  So that's a little bit of, what I
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  do at Mount Sinai.
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  I've been in the technology space for the
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  last 17 years
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  and I've been a PA for the last
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  24 years. And as a PA,
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  like a lot of PAs,
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  we are trained in a very general
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  broad sense
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  and I certainly have taken advantage of that.
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  I've worked in the emergency department for many
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  years. I worked in the surgical ICU and
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  the surgery department for many years. I worked
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  in oncology for many years
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  and I worked in,
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  running clinics in homeless shelters,
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  and even in small community health centers focused
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  on LGBTQ,
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  health care. So I've had a very diverse,
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  clinical
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  experience, and I try to bring some of
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  that to the technology space as well.
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  That's amazing to hear. And and certainly so
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  many aspects of the health care system that
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  you are able to touch on a regular
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  basis is just impressive to,
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  get a full understanding of everything you do
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  and all the accountabilities that you'll hold within
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  your role. That's really amazing. Thank you so
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  much for sharing with us. Now
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  what opportunities and headwinds do you have your
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  eye on right now and specifically through some
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  of these lenses that you talked about, whether
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  it be the technology
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  working with hospitals and teams even abroad to
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  implement that or,
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  diversity, equity, inclusion from the technology roles, social
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  determinants of health screening, and all of these
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  other areas,
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  What is really top of mind for you,
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  and what do you have your eye on,
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  over the next couple months here?
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  Well, thank you for for asking that. So
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  the I mentioned that there's a recurring theme
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  among the many initiatives,
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  and many projects
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  that I work on. And
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  that is really
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  it's almost like the, you know, all things
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  are new again, which is
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  the need for improved coordination
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  of patient care
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  through the use
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  of
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  data and data exchange and interoperability.
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  And because I'm involved in those multiple projects,
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  this is a recurrent theme
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  that keeps coming to the forefront.
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  You know, we we've had an increased focus,
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  for example, in the last couple of years
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  of
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  providing
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  patients access to their own data with the
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  21st Century Cures Act.
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  You know, where now patients get access to
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  their lab results and notes in real time
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  and improvements in the EMR's ability to allow
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  that access for for the patients,
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  and access to the patient's providers as well
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  via text messages and emails.
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  And, of course, you know, as I mentioned,
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  the realities of AI tools to automate some
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  administrative tasks,
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  there is definitely an increased interest in the
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  ways that we can exchange data on behalf
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  of patients.
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  And then, of course, now with the TEFCA
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  and the QHINDS,
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  conversation now in the forefront,
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  that's where, you know,
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  we kind of leave it to the IT
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  nerds to to figure it out, but it's
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  in the public eye. And we to me,
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  that is an opportunity
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  to invest more in using some of these
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  networks that exist already
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  and,
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  to allow for
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  a better understanding
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  from their our clinical and operational leaders within
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  health care,
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  because, you it's not just the IT folks
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  in this case. We need to be able
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  to educate and message to our clinical and
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  operational leaders
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  the way that we can serve patients
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  through technology.
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  So to me, the biggest opportunity and headwinds
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  that I have, at least in in my
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  eye, is
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  interoperability.
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  That's really fascinating to hear, you know, and
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  certainly interoperability.
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  You know, there's a lot of challenges still
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  within that space, but,
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  boy, to think about what it could do
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  once it's optimized and fully,
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  in a,
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  I guess, in a future where we are
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  interoperable, it seems like,
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  just a lot of possibilities
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  could open up. So, it's just really interesting
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  to to hear that as being a top
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  priority.
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  What within when you're thinking about what you
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  do at Mount Sinai, how are you moving
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  forward or moving closer to that reality where
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  you're able to be more interoperable and what
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  challenges or or lessons learned have you had?
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  Well,
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  a few,
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  challenges and opportunities.
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  There is obviously the challenge of making sure
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  that our infrastructure and our IT systems
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  are ready
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  for the different multiple ways that we have
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  to exchange data for patients,
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  and obviously to improve quality outcomes, improve the
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  way that we're able to have that data
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  accessible by by our patients and our community,
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  our community practices, our community of providers.
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  That is one piece that is a challenge
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  and an opportunity on the IT front, the
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  technical front.
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  The other is
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  related to,
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  and I mentioned it a little bit ago,
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  but just to expand on it, just education
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  and communication that's needed in this space.
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  And for myself and others in kind of
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  my field, it's the opportunity to be a
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  bit of a translator
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  to help simplify some of the language that
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  is typically used in the way that data
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  is a change, the standards. You know, everybody
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  says fire, but they, you know, don't really
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  understand what it is or, you know, what
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  does API even stand for or h l
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  seven? Like, all of that, we need to
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  be better
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  at educating,
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  communicating, and translating
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  for
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  our, again, clinical and operational leaders and just,
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  you know, decision makers because,
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  you know, we will need to continue to
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  invest
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  more time, effort and resources
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  into the ability to exchange data so that
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  we can, again,
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  serve our patients and our community better and
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  know that, you know, our patients travel and
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  we are trying to be more global just
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  like a lot of other industries
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  are are not local anymore. We're we're very
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  much global.
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  Oh, that's fantastic to hear, and I, you
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  know, can imagine there's a lot that goes
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  into
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  expanding your reach and thinking of yourselves more
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  as a global institution versus just the local,
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  communities that you serve. Now
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  from your perspective, how are you thinking about
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  growth and adding value to the health system
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  overall?
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  What what really is meaningful for you in
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  the work that you're doing?
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  I think, you know, again, being that translator,
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  being that educator, and,
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  you know, systems,
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  a lot of health care systems and organizations
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  are are limited in
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  where they can invest. Right? You know, you
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  you need to make choices.
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  And I do think that,
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  a way to grow a system and add
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  value
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  is
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  to help organizations
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  invest more in interoperability
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  because it's just a way to improve care
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  by coordination.
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  You know, you can cut costs, you can
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  improve outcomes, you can share in best practices.
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  You know, you can again get,
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  get and allow access to real time referrals
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  to grow a business and reports to better
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  serve communities and just improve
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  connections even with payers, you know, to improve
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  revenue collection.
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  And then
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  always thinking of the patient at the center
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  of care.
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  Again, just by broadening that definition
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  and bringing in,
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  as I mentioned in the beginning, the social
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  screening and the social data and bringing that
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  in
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  to the whole,
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  of the patient.
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  I love that. I think it's such an
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  important aspect of any health care delivery system,
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  as you said, just being intentional about,
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  how you're building out that network and connecting
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  smartly with,
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  patients
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  in in providing those services. And then 2,
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  I think it's interesting having that work dovetail
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  into some of the things you're doing on,
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  with payers
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  in in in that world as well.
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  It seems like it's a really ripe for
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  kind of innovation within that space, and so
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  that that's really, interesting to hear you talk
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  about that.
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  I'm wondering I I know for health systems
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  across the country, finances are tight for most
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  organizations
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  and margins are thin, but
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  what's really a risk or investment that's still
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  worth making this year over the or over
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  the next 12 months that could be really
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  meaningful in making progress towards some of the
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  goals you've laid out?
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  Well, I I think that, you know, we
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  we,
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  and a lot of other organizations
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  in the US,
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  experienced,
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  you know, the outage with change.
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  And, you know, I think a lot of
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  organizations are are looking to not make those
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  mistakes again or
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  be a little bit more self reliant or,
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  you know, look at other ways to exchange
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  data with payers, sometimes directly, sometimes through the
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  EMR.
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  And, you know, coming back to the theme
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  of
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  interoperability,
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  but also
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  making the best decision
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  for your organization in your system
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  means that you really have to understand what
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  are your options
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  and
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  where are your skills
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  in the technology,
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  department. Do you have the right set of
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  skills? Do you have the right people? Do
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  you have the right resources?
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  And
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  what is your growth in the business? What
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  are you looking to do? Right? So I
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  think that all of that is,
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  really
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  the work that needs to happen to create
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  the best opportunities for growth in the future
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  is is not
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  go back and rely on just one mechanism
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  of again, if we're talking about just, you
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  know, the the the bottom line, but also
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  try to diversify by understanding
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  the infrastructure
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  that you either have built or need to
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  build.
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  Does that make sense?
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  Yes. I I think so. You know, certainly,
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  as you mentioned,
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  I I really kinda gravitate toward that idea
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  of making sure you have the right skills,
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  people, and resources in place. And, you know,
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  that infrastructure to support all of it is
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  really important. And,
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  I think, especially when you're looking at what
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  happened with Change Healthcare and how I know
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  a lot of systems and, hospitals and and
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  practices are trying to figure out what they
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  can do,
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  to make sure they don't have all their
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  eggs in one basket in the future with
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  any big vendor like that and especially if
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  it's tied to the revenue cycle. So,
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  that's exactly right. That's exactly right, Laura. And,
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  you know, the other,
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  side to this is,
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  you know, every state is slightly different.
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  The regulations
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  around how we can share data is slightly
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  different.
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  Some states need patient consent,
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  some don't,
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  and some states are working on,
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  you know, again, the the waiver,
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  to be able to
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  screen more patients, for example, for social
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  social data. And I really do encourage
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  organizations
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  to take, you know, take a look inward
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  as to
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  who in their IT department,
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  understands this this space of interoperability.
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  You know, what decisions are being made, who
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  is making the decisions,
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  and what is the short term and long
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  term plan.
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  Because what I've seen in my own experience
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  working in different,
• 14:13
  organizations over the last couple of decades
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  is there's
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  there's always a shortfall in the amount of
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  resources
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  that are placed
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  and the amount of investment that is placed
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  in the way that organizations can share data.
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  And, again, that makes sense because of our
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  evolution
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  from the fee for fee for service
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  to now really looking at outcomes and quality
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  and value based care. We're not fully there
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  yet, so I do think that organizations need
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  to look a little bit more at the
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  way that data is exchanged.
• 14:48
  That makes a lot of sense and definitely,
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  really ties back nicely to some of the
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  things you mentioned earlier in our conversation about
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  interoperability and about,
• 14:57
  really securing that type of
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  back and forth between organizations
• 15:02
  to have that right type of patient experience,
• 15:04
  but also just really efficiently get things done.
• 15:07
  Now I'm wondering where do you see the
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  best opportunities for growth in the future?
• 15:13
  Well, you know, there isn't one size fits
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  all. Right? And, again, it's it's
• 15:18
  a bit individual
• 15:20
  in the way that you know, where an
• 15:21
  organization sits,
• 15:23
  you know, again, which state
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  or and even within their state, you know,
• 15:27
  what kind of care do they provide.
• 15:29
  So I do think that again, the way
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  that organizations need to grow depending on the
• 15:34
  system that you are.
• 15:37
  If you need if you wanna grow by
• 15:39
  receiving referrals, for example, because you have some
• 15:42
  specialty care that you wanna bring patients to,
• 15:46
  well, you need to invest again in those
• 15:48
  systems. Right? That is the biggest opportunity for
• 15:51
  growth. Right? You need to be able to
• 15:54
  not just say, you know, come to us
• 15:57
  because we provide
• 15:58
  the best care,
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  but come to us because we also make
• 16:02
  it easy.
• 16:03
  We make it easy for you to send
• 16:05
  our patients. For example, we make it easy
• 16:07
  to see the data about your patients. We
• 16:10
  make it easy in that we communicate with
• 16:13
  your patients and the referring providers. Let's say,
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  you know, the technology
• 16:18
  allows it to be easy.
• 16:21
  Sometimes
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  I've seen organizations not pay enough attention to
• 16:24
  that. You know, they again make decisions
• 16:27
  clinically and operationally, but they don't always understand
• 16:31
  the backbone of technology that is needed for
• 16:34
  that. So where I see the best opportunities
• 16:37
  for growth in the future,
• 16:39
  there's many and there it's individual,
• 16:42
  but part of it is to understand the
• 16:44
  technology that,
• 16:46
  lays underneath
• 16:48
  the ways to bring in referrals and data
• 16:51
  and expand your business that way.
• 16:55
  I love that. What a what a great
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  point and, you know, really, really cool to
• 16:59
  think about how technology can support,
• 17:02
  so many different
• 17:03
  connecting points and really provide us a better
• 17:06
  future of health care delivery. Patty, thank you
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  so much for joining us on the podcast
• 17:10
  today. This has been a really fun and
• 17:12
  fascinating conversation, and I look forward to connecting
• 17:15
  with you again soon.
• 17:16
  Thank you so much, Laura. Thank you for
• 17:18
  nerding out with me.