Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Alan Weiss, Vice President & Chief Medical Information Officer at BayCare Health System

Transcript

Dr. Alan Weiss, Vice President & Chief Medical Information Officer at BayCare Health System · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
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  the description. We are excited to welcome you in October.
• 0:22
  This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr. Alan Weiss,
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  chief Medical Information Officer at Bay Health. Dr.
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  Weiss is a pleasure to have you on the podcast today.
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  Glad to be here.
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  Now. I'm excited to have you here and,
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  and talk a little bit more about what you're doing on the, at Baker Health,
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  thinking about clinical informatics and how you're bridging the gap between
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  clinical and it. But before we dive into my questions,
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  can you tell me a little bit more about yourself and your background?
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  Sure. Um, so I am a general internist by background and practice. I,
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  after my residency,
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  I spent about 10 years practicing at the Cleveland Clinic while doing
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  informatics, helping them to roll out epic and improve it. In fact,
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  a lot of the work that I did reported directly to the C I O and they were
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  projects trying to improve patient care, improve the quality of care,
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  reduce the costs, making physicians more efficient. Uh,
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  I was doing that while practicing and teaching and doing a number of other
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  things for the Cleveland Clinic. And at some point I decided, you know, that,
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  um, I was sort of tired of, of doing too many jobs all at once and thought,
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  all right, I wanna do informatics full time.
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  Spent time working at the Cedar signing,
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  helping them roll out Epic on the inpatient side.
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  Transferred over to Memorial Herman in Houston, Texas,
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  where I helped them on the ambulatory side to convert from GE
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  centricity to Cerner.
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  And I've been here at the Bay Medical System for about five years as their
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  system cm. I o Just a, a a little bit more about my background.
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  I actually have a computer science undergraduate degree and spent a number of
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  years working in the pharmaceutical industry,
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  helping them create, uh, data and analytics that help to get, uh,
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  drugs on the market and,
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  and help to do reporting to the FDA into medical journals.
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  That was before I went to medical school. So I, I have a,
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  a background in technology and a background in data and analytics,
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  which helps me in the job that I do. You know, I also wanna mention that the,
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  the Baker Health System is the largest healthcare provider here in the Tampa Bay
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  area. We just opened our 16th hospital. We have, uh,
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  somewhere in the range of about 170 outpatient clinics and facilities.
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  We do roughly about 160,000 admissions a year,
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  somewhere close to 600 to 650,000 ED visits,
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  and over 2 million visits on the ambulatory side. So we're a,
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  a great healthcare system located in Tampa Bay,
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  and I'll say that I'm very impressed that they're, they're, uh,
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  they like to say that quality is their true north and they, they, uh,
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  practice what they preach. They really are trying to improve the,
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  the quality of the care that they provide. So that's a bit about me and,
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  and my organization.
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  Well, that's amazing to hear, and certainly, you know, what a great, uh,
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  span of opportunities you've had in healthcare,
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  both as you mentioned on the clinical side, as well as the technology side,
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  and really making a difference for organizations as they're trying to figure out
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  how to integrate technology, um,
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  in a way that will make their operations more efficient as well as boost patient
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  care. Now, when you look at where you're at at BayCare Health,
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  and especially as you mentioned,
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  an eye towards improving care quality in that care experience,
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  what are some of the big opportunities that you're looking at as well as the
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  headwinds you have your eye on right now?
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  Oof. Um, let me do the, um,
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  let me do opportunities right now. I, I, I think bay,
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  like other healthcare systems are as, uh,
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  struggling with the revenue aspect of
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  healthcare in a post pandemic, you know, covid endemic, uh,
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  kind of situation. You know,
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  most of us have found that there's been an increase in costs.
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  They're both supply costs, increases, uh, personnel cost increases,
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  and frankly, a a lack of,
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  of enough of the right qualified personnel for certain positions.
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  So we're struggling on that front. So from a revenue point of view,
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  a lot of healthcare systems like BayCare are,
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  are really trying to figure out how do you do more with less?
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  How do you make the system work, uh, achieve the efficiencies,
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  achieve the right patient quality and,
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  and do so in such a way that it,
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  it actually goes in accord with the mission that you have. And, and that's,
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  that's one of the biggest challenges that we have in,
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  in today's market in that regard. I'll, I'll tell you that, that, um,
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  EHR optimization remains a key challenge in there.
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  We are really looking for ways that we can help providers
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  decrease their burnout, become more efficient, and,
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  and that means rethinking the workflows inside of the electronic health record,
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  trying to make them more efficient,
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  trying to remove barriers to getting work done that are exist inside of the
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  ehr. We're trying to reduce the clutter of what they're seeing on the screens,
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  pointing them more towards the information that they need and they have to have
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  at their fingertips. Um, in some cases,
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  what we're doing inside the EHR is trying to automate tasks so that the, the,
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  uh, the providers don't have to do it and their staff don't have to do it. Uh,
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  for instance, we, we recently did some changes to the way we bill both vaccin
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  vaccinations and, uh, just a normal visits.
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  And that resulted in something like about a half million fewer, uh,
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  edits that needed to be done by our staff every single year. So, you know,
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  those kinds of, of automations, I, I think are,
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  are ways that we can add value to the system and help in the mission itself.
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  You know, once again, if you,
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  if you can take care of these issues inside of the electronic health record,
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  providers will be less burnt out.
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  They won't need as much staff because things will be getting done automatically.
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  It helps with the bottom line.
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  We are busy looking for those opportunities across our healthcare system, uh,
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  and, and really trying to see if there's some, some good synergies there. So it,
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  we, we've got a lot of projects, we've got a lot of challenges, but it's, um,
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  it's fascinating work. So that's one aspect of the opportunities.
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  The, the second aspect, I, I think that from the opportunity that,
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  that we're embracing is the whole notion of using artificial intelligence and,
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  and what that means when it comes to delivering patient care.
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  And we're exploring all kinds of AI types of applications, uh,
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  across our system. Some of those are, uh, AI applications dealing, let's say,
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  with radiology where it helps to identify images or where,
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  you know, identify strokes, identify other types of, of,
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  of results within images. Um,
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  in some cases it's just looking at the radiology reports and trying to see if
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  there's something that we can pull out of the radiology reports to help with
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  patient quality or patient follow up. We're, we're working on,
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  on a number of AI applications that are really focused in radiology. I,
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  I think that's, that's, uh, gonna pay off in the, in the long run. Uh,
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  the other types of AI applications that we're investigating is stuff that is
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  related to helping providers recognize conditions and document in a,
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  in a more comprehensive way so they don't forget those conditions.
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  And so that the,
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  the way they document helps to make sure that the people know the patient's
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  story in a better way. Um, one thing we're doing is, is exploring the,
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  the product nuance Dax. I think that's one of the,
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  the big opportunities out there. The,
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  a provider spend an awful lot of time developing their notes,
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  writing their notes. As a provider who's done that now for over 20 years,
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  it takes a lot of cognitive, um,
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  energy to go through and create the,
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  the notes and write 'em in such a way that they're comprehensive and communicate
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  the right types of, of features, the right types of decision making,
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  the right physical exam findings. We're,
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  we're hoping that nuanced acts by just listening to the conversation between the
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  patient and the provider can help write that note on behalf of the provider.
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  And by doing so, uh, help to reduce that cognitive burden. So we're,
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  we're looking at the different AI applications to help out and in some way,
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  once again, deal with patient quality issues, deal with, uh,
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  workflow issues and, and somehow help the providers at the point of care.
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  I love that. It sounds like, you know, really a, a helpful tool with, uh,
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  nuanced Act and other AI-driven, um,
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  technologies that can really make a big difference for hospitals and health
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  systems as they're, uh,
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  finding ways to become more efficient and decrease burnout. Um, and especially,
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  I, I know you talked a little bit too about E H R optimization, which, um,
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  is so crucial and so critical, especially as I know, you know,
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  a lot of organizations are experiencing some sort of staff or workforce
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  shortages and trying to continue to provide great levels of patient care.
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  It just, you know, makes everything more efficient.
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  And so I I'm so glad you mentioned that. Now,
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  when you look at where you're at today in,
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  in thinking about growth and development, what does that mean for you?
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  How are you thinking about growth and adding value to the organization overall?
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  Well, some of that growth and value or some of the things that I,
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  I just mentioned, you know, you, you, most of our,
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  our healthcare systems have an electronic health record. The vast majority do.
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  Are you utilizing that EHR in such a way that you can help accomplish that
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  mission? And, and most of us have a mission that involves the,
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  the health of the, the patients that we serve. And, and so I,
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  I wonder if there are additional ways that you could use the EHR to help
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  accomplish that mission and do so in such a way, as I just mentioned, to,
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  to reduce cost and make things more efficient. Uh, that to me is,
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  is a great opportunity for growth and for adding value to the organization.
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  You know,
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  I mentioned some of the automation we've put in place to do that kind of
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  automation is a win for our providers, a win for our staff,
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  and a win for the patients that are the,
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  the kind of opportunities that we're looking for. Um, once again, it,
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  it can reduce some of the burnout, some of the turnover,
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  some of the issues that we're facing. Those are,
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  are great opportunities within our organization. Uh, and I,
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  I think that's gonna add a lot of value overall. I, I do think that, um,
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  some of the other opportunities when it comes to using the EHR are trying to
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  figure out how you use the EHR to point the providers towards doing the right
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  thing, and in some way steer them away from doing the wrong thing. We,
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  we look at stuff like we,
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  we've put in some different processes to help reduce redundant testing.
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  You know, testing that shouldn't be done too often and is, is,
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  is just overly ordered.
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  We've put in a couple of different mechanisms to help reduce that and the
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  savings actually add up. And we,
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  we have literally millions of dollars of savings by having tests that that
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  shouldn't be run too often, get reduced in the process. Uh,
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  that's a win for our patients. Um, you know,
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  there's nothing that a patient likes worse than getting woken up in the middle
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  of the night to get, uh, stuck by a needle to draw blood.
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  They don't really need to have, uh, drawn in the first place. So it's a,
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  it's a win for the patients,
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  it's a win for the organization cuz it reduces our costs.
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  We've got lots and lots of activity around this whole cost reduction,
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  lab reduction,
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  test reduction effort that I think is gonna pay huge dividends for our
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  organization and uses the technology that we already have embedded within the
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  organization itself. That,
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  that kind of value is something that we're working on.
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  We've got lots of projects and,
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  and we're happy to share the projects we're focusing on,
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  but I think the same opportunities exist across all of the healthcare systems
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  that are out there.
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  Absolutely. I love that. And it's definitely helpful, you know,
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  as more organizations are thinking through what it will really take to, um,
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  you know,
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  become more a part of that value equation to really reduce that waste and
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  reduce areas where they're overspending and then, um,
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  become a more lean and efficient organization. I love that.
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  And to that point, you know,
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  I know a lot of what we've talked about already is trying to become more
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  efficient, trying to find ways to, um, you know, standardize things in,
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  in ways to, um,
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  meet the needs of the challenging environment we find ourselves in right now.
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  But, you know,
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  with an eye to the future and really what's best for patient care,
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  what is one investment or risk that's still worth taking this year?
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  Ooh, such a good question. I mean, the, the investments that I, I,
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  I think are worth doing are starting to look towards what is now becoming
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  ubiquitous in medicine. And I, I mentioned it earlier,
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  it's the whole notion of being able to use artificial intelligence, um, in the,
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  the clinical setting. I,
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  I think there are lots of opportunities that are out there. I, I remain, I,
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  I'm very hopeful with a lot of these. And I mentioned some of the,
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  the applications that we're investigating and starting to, uh, invest in,
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  such as the AI and radiology, the,
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  the document processing and the natural language processing.
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  These are just enormously helpful and really important, uh,
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  applications inside, uh, of your, your healthcare systems.
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  I I think that it is worth absolutely investing if you are in that healthcare
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  arena. But I also think we have to have a,
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  a little bit of a grain of salt in there. We have to,
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  to to work and have some trepidation in there. There's a,
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  an awful lot of vendors that are out there talking about artificial
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  intelligence when their applications probably aren't really artificial
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  intelligence. There's probably some pattern matching in there in a, uh,
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  you know, a a little parsing of language and there may be, you know,
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  some machine learning but isn't really the deep-seated AI that,
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  that people talk about. I,
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  I think we have to be careful in knowing which ones are the true AI and which
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  ones are, are just saying their AI as, as part of marketing. And I,
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  I think that's kind of a, something we have to be very careful about. Um, and,
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  and so I, I, I think that's something that, uh, you know,
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  it is certainly worth investing. Um, but I also think we have to do so in a,
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  in a, a way that that, uh,
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  makes sure that we understand and it's much more complicated than just going
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  ahead and, and ordering and installing it.
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  That makes a lot of sense. You know, and I, I,
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  I really appreciate you walking us through that because I know it's something
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  that a lot of hospitals and health systems are faced with in trying to
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  troubleshoot and figure out a real time. Now.
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  Before we wrap up our conversation,
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  I just wanted to look into the future just one bit more.
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  Where do you see some of the best opportunities, um,
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  for growth in the future for yourself as a cm i o as well as for the teams that
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  you work with?
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  So, a great question. I, I would tell you that,
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  that one of the growth opportunities within the CMIO area
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  is really just communication across CMIOs. Um, I, I, I think that,
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  that we have a,
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  a community of some pretty seasoned CMIOs that are out there and
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  being able to communicate on some of the challenges we have with certain
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  projects, certain technical challenges,
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  certain political challenges is an opportunity across the CMIO
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  continuum. And I think that's, there's opportunities there. I I,
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  I also think there's opportunities for some of the more seasoned CMIOs to help
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  mentor some of the younger CMIOs who are just starting out in the field. I,
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  I think that there's some excitement and some synergies there that that can be
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  very, very useful. So I, I think that that's, that's absolutely, um,
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  you know, uh, important. I, I, I did mention earlier, you know,
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  some of the EHR optimization and,
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  and I guess some of the stuff that I think we still can do a lot of is
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  the basic block and tackling of, uh, of informatics,
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  of trying to figure out better approaches to workflows,
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  better approaches to setting up screens inside the ehr. Uh, I,
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  I think that work never ends and the opportunities are enormous. The,
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  the hard part is, I think that everybody wants to head towards the,
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  the flashier types of analytical techniques and the flashier types of,
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  uh, uh, of, uh, technology like artificial intelligence. And, and I,
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  I certainly want to,
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  but I also recognize that a lot of the more basic work never ends.
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  And there those opportunities remain. I, I, I think it,
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  it'd be great if there were, uh, an easy button for this kind of work,
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  and unfortunately just it isn't there. It takes, um,
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  a lot of dedication and a lot of work, and it's painstaking. Um,
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  but it can be so rewarding when you, when you make the changes that are, are,
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  are so important to so many providers. Um, we have, by the way, we, we have a,
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  a program that we're starting and it's basically getting rid of, of,
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  of stupid things inside the ehr. We have, uh,
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  providers who are bringing up ideas about where in the EHR there's redundant
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  information or a screen set up in a way that doesn't make good cognitive sense.
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  Um, finding those kind of opportunities there, there's,
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  there's literally thousands of them across the EHR ecosystem.
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  I, I think that as we get further along, the ability that we have to,
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  to really improve how people interact with it,
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  it it's gonna be a very much a, a game-changing kind of situation. So I, I,
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  I throw those out as additional things that need to be done in the future never
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  will end, and we should always pay attention to.
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  Absolutely. I, I love it. I think that makes so much sense.
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  And definitely kind of that continued focus on the areas where there's always
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  gonna be opportunity for additional focus, additional optimization. EHR is,
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  I know they're so important in collecting the data, um, you know,
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  that's gonna make everything run and, and, and, uh,
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  really give you the insights and information that will help you in the future.
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  It makes a lot of sense. And I love your focus on mentorship too.
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  I know that's so important and so critical in many areas of healthcare,
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  but especially, um, for CMIOs and,
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  and physicians who are interested in more of the technology side.
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  Have you seen more of that interest grow over the years since you've been doing
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  this? Or, or where do things stand today?
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  Oh, I think there's definitely more interest in it. I mean, I, I, uh,
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  it's very interesting. As I talk to other CMOs,
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  everybody's talking about ai, but you know,
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  when I start talking about what problems are they solving with ai,
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  there's sort of a silence that comes up. I mean, we, we,
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  we love talking about it, and certainly as I mentioned,
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  there's good radiology aspects, there's natural language processing,
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  and that's gonna be very useful for us moving into the future.
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  But when it comes to all the rest of the, the simple things that,
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  that people encounter every day, that just takes hard work.
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  There's always that kind of work needed to be done across the healthcare system,
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  across the EHRs. That's, that's something we all talk about and mean.
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  I I think we,
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  we probably need to make sure that we are as good as possible on the basics
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  before we start using the more advanced types of, of technologies and analytics.
• 19:14
  Absolutely. That makes sense. Uh, Dr. Wise,
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  thank you so much for joining us on the podcast today.
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  This has been a really fun and interesting conversation,
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  and I look forward to connecting with you again soon.
• 19:24
  Sounds good. I look forward to it as well.
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