Latest / Becker’s Healthcare Digital Health + Health IT / Dr. Ashis Barad, Chief Digital and Information Officer at Allegheny Health Network

Transcript

Dr. Ashis Barad, Chief Digital and Information Officer at Allegheny Health Network · Becker’s Healthcare Digital Health + Health IT

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  - Becker Healthcare Podcast made for the people
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  who power US healthcare.
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  I'm Molly Gamble. Becker is thrilled today
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  to spend some time with Dr.
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  Ashish Barad, chief Digital Information Officer
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  with Allegheny Health Network.
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  Dr. Barad, thanks so much
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  for being our guest on the podcast today.
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  How are you? And where does the podcast find you?
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  - Thanks for having me, Molly.
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  I am excited to be on the podcast, and I am doing well.
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  I am in the city of Bridges, so Pittsburgh, Pennsylvania,
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  um, has a lot of bridges.
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  And being that I'm from Texas, um, it's a,
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  it's a new venture, but it's a fantastic town.
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  - Yeah. Well, for listeners who could use a,
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  a refresh on Allegheny Health Network
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  and based in Pittsburgh,
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  can you share a few other key facts about the system
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  and organization for our listeners just to get reacquainted?
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  - Yeah, happy to. So, yeah, Allegheny Health Network,
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  as you said, based outta Pittsburgh, Pennsylvania,
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  and Western Pennsylvania,
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  and is a 14 hospital system, about 2,500 beds,
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  uh, 22,000 employees and about 3000, uh, physicians, uh,
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  and other providers.
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  And, um, we serve around 29 counties here, uh,
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  in some portions of New York, Ohio, West Virginia,
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  about 5 billion in annual revenue.
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  Um, and we are owned by Highmark Health, uh, which is, um,
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  obviously a very large insurance company.
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  Uh, I believe it's the fourth,
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  the fifth largest Blue Cross Blue Shield, uh, in the US
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  and serves, uh, roughly five states,
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  but also has national members.
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  So it's just a, a unique aspect of
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  what makes a HNA bit different.
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  - Mm-Hmm. , you mentioned coming up from Texas.
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  I, I should let listeners know,
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  congratulations on passing the one year mark in your role
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  as CDIO.
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  You've been with Allegheny Health Network,
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  but you took on a new role, expanded to include the CIO hat
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  to your CDO role in January of 2023.
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  What have been the biggest lessons you've learned in this
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  time, in this past year,
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  ways you've grown throughout this past
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  year? What comes to mind?
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  - Yeah, I appreciate the question.
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  So thank you for the, for the congrats.
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  It's, it's been, um, really nice to, uh, kind
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  of own the quote unquote the, the full tech stack.
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  And I think, you know, to, as far as the lessons learned,
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  I think a few, you know, I came from a very,
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  very large health system in Texas,
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  and, um, I'm sure everybody liked each other
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  and everybody was good friends,
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  but you could only imagine
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  that the Chief Digital officer's roadmap may not always
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  align with the CMIO's roadmap, may not always align
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  with the CIO's roadmap and many others.
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  So, um, the fact that I wear all those hats, so, um,
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  I'm in charge of the informatics shop as well with Epic, um,
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  and the data shop as well as virtual help.
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  So I do, uh, wear a lot of hats, um,
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  depending on the meeting I go to,
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  probably from 30 minutes to 30 minutes.
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  But all of that really allows us to have one roadmap
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  that's very succinct
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  and has a kind of clear trajectory, vision, you know,
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  roadmap to it.
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  So that, that has really been, um, very helpful,
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  uh, to really be able to create impact.
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  And I guess that's the other point that I'll, uh,
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  answer your question with, which is, you know,
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  lessons learned in this role,
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  not just at a Allegheny Health Network,
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  but just in the industry, is, you know,
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  it's not just about disrupting healthcare.
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  I know we talk a lot about disrupting healthcare,
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  and trust me, I'm, I'm a big believer on the fact
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  that it needs to be disrupted, um, on some accounts.
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  But, you know, I see a lot of disruptors.
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  I don't always see a lot of factors.
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  And what I mean, it's just, it's
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  sometimes it is about the impact.
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  And I think we need to be very clear, um, about
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  what impact we're trying to achieve.
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  You know, many people will say, be very clear about
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  what problem you're trying to solve.
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  And I think we say it a lot,
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  but, um, I think many, many times, uh, we,
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  we get over our skis at times trying
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  to disrupt the process without really understanding
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  what impact we're trying to achieve.
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  So that's probably been one
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  of the biggest lessons in the last couple of years here.
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  Um, and trying to focus the team
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  and focus everybody's efforts on the impact.
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  - Mm-Hmm. . And then, I mean, I appreciate
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  that a lot because I remember, uh, probably
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  around 10 years ago, the slogan, oh, it was, what was it?
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  Something fast, fail fast.
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  This is gonna come more easily to you. Oh, yeah. I,
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  - Right.
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  I mean, I, the fail fast. Uh, I mean, I don't know.
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  You know, I mean, I, we, uh, so I,
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  before this for the listeners, you know,
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  I spent 11 years at Baylor Scott
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  and y um, so again, the the larger health system that I, um,
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  that I alluded to earlier, and gosh, I learned so much.
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  I called it my, um, you know, second fellowship.
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  Um, so I am a pediatric gastroenterologist.
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  I still practice, but it,
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  it was such a fabulous learning experience,
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  and we had a product team and experience team
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  and a design team, and, um, you know, it was just, um,
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  a very different experience.
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  So part of that is we did, you know, bring a lot
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  of traits from Amazon and Google and Best Buy
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  and other retail aspects.
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  And we talked a lot about within the product world
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  of failing fast, um, and lessons learned there.
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  And especially, you know, ones that I lead here is
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  that I think what often we don't realize
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  or think about, especially if you're,
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  if you didn't grow up in healthcare, is that, you know,
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  if you look, if you think back at the, the origins
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  of healthcare and the history of, of everything we've done,
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  including the EMR, it, it has been a bit up through the lens
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  of safety first, right?
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  I mean, even the, the Hippocratic Oath
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  that I took in medical school do no harm, um, that,
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  that inherently is saying, first think about safety, right?
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  Do no harm. So the, and,
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  and there's nothing wrong with that.
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  Absolutely nothing wrong with that. We should absolutely
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  think about that, especially in the age
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  of ai as we look at that.
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  That all being said though, fail fast
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  is conceptually at odds, you know, with
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  that concept of safety first.
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  So right, as a doc,
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  and I wanna bring in a new med, especially in pediatrics,
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  and I want to give, you know, some experimental medication
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  to a child for let's say Crohns disease.
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  I'm not going to just experiment and fail fast
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  and think about, you know, deal with it,
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  and I'll learn, I'll iterative, we'll be agile, uh,
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  and, and we'll sprint, you know, to figure out really,
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  you know, what the process is.
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  That's not gonna happen in medical care.
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  If I'm in the ICU, I want it to be tried and true,
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  and I want a lot of random, uh, controlled trials and,
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  and peer studies, and I want my, you know, professors
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  who mentored me to say, yes, I've done this 10 times
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  and it works, or it doesn't work, or, try this.
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  It's just inherent in our culture, in our training
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  that we really take a long time
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  before it actually hits bedside medicine.
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  So I think to, to your point, you know, inside
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  what we're trying to do with innovation now and digital
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  and virtual and AI and what have you, it is this mentality
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  of fail fast is, is really, uh, to many degrees,
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  just very culturally abrasive, um, to kind of the,
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  the core of, of how we're trained.
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  And so I think, you know, that doesn't mean
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  that it doesn't apply.
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  That doesn't mean we can't do those things.
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  But I think in my position, um, I'm well poised, I believe,
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  just as a practicing physician that's, you know,
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  I was section chief of a department.
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  I was a leader in a children's hospital for 16 years.
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  So I am, you know, I, I know the front lines.
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  I know operations, I know clinic, clinical medicine enough
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  to be able to know, you know,
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  what's really gonna fly inside that model.
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  What are you allowed to touch, if you will, and fast at,
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  and what's kind of sacred ground, if you will.
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  And you need to really be more thoughtful and careful
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  before you start disrupting, uh, certain models.
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  - Mm-Hmm. the slogan
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  or motto I butchered, there was
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  that from Mark Zuckerberg, the internal motto at Facebook
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  for early 2000 tens that move fast
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  and break things, which I think Facebook arguably very much
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  has broken a lot of things.
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  Um, but it, it talk about ideologically at odds.
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  I think that is one slogan, like you said,
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  culturally abrasive is a good term for it.
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  - Yeah, no, I, and, and,
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  and listen, I am that guy that wants to break things truly
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  and really, you know, re-engineer it
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  and rebuild it to be, you know,
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  whether it be consumer centric
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  or provide higher quality care
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  and decrease the burden on caregivers.
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  And we can go on and on, uh,
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  because I think there's some fundamental things
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  that we do need to kind of break, if you will, and,
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  and put them back together.
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  Um, so it is, it's just, it's a, it's, it, I, I, I often,
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  um, I I feel like Dr.
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  Je, Mr. Hyde sometimes, right?
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  Where I'm on one on one side of it, I'm talking about
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  how we're gonna break things, and then with the docs, I need
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  to make sure that I'm thoughtful, careful, responsible,
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  ethical, um, and pushing them at the right pace Mm-Hmm.
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  to be able within their comfort zone.
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  - Well talk a little bit about your vision, if you will.
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  Uh, you mentioned you are a physician,
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  you also are leading technology and digital efforts.
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  What's the vision you're working toward at a HN,
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  at a A HN right now?
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  Can you spell it out for us in a bit more detail
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  so we can envision it with you?
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  - Yeah, sure. Um, well, I think that, you know,
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  as I described the system,
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  it's very important context now as we talk about vision.
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  Um, you know,
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  what worked in Texas is not necessarily gonna work
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  in Western Pennsylvania.
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  And I, I do think, you know, um, healthcare is local
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  and the dynamics, the state laws, the, the policies, um,
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  as well as just the demographics, the payer mix population,
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  is it growing, is it not growing?
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  You know, all those things are really relevant.
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  So, you know, I'm sure Molly, as you talked to a lot
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  of different, um, chief digital officer, strategy officers,
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  what have you, um, there's, it, it, it's,
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  it's gonna be inherently different based on
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  what system they're at, what state they're at, uh,
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  they're they're in, and,
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  and what's the population that they're taking care of,
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  and what that, what does digital mean to them?
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  So, so having said that, being that, uh,
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  we have a very large, uh, payer that owns us, um,
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  and an enterprise, uh, that comes with that, with a, with a,
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  actually with many more companies besides Highmark, Inc.
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  Uh, in a diversified business model,
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  including an IT company, um, a dental company
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  and others, is we really look at a much broader ecosystem
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  and, and how Allegheny Health Network really fits into
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  that broader ecosystem.
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  So we, we talk often about Allegheny Health Network being a,
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  uh, pacesetter or a living laboratory, um, if you will,
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  within the broader Highmark, uh, strategy.
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  And that strategy is called Living Health.
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  Um, and the, the Highmark Health Living
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  Strategy, oh, sorry, excuse me.
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  Living Health Strategy, um, really focuses,
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  and I'll just be very kind of overly simplistic about it,
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  is, um, is really creating, um, personalized, proactive, uh,
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  simplified, um, experiences.
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  And these experiences, um, really lead to more engagement,
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  um, by, in, in, in Highmark Health terms, you know,
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  the member or the patient.
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  And if they're more engaged in their health, um,
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  and then, you know, that can lead to better outcomes.
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  Um, you know, as assuming we're, we're helping orchestrate
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  and navigate them to the right, uh, solutions, programs,
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  benefits, and those improved outcomes, um,
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  make healthcare more affordable.
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  Right? Which is important to us all
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  as we know we're not on that, uh, trajectory.
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  So, as I, I outline that, uh, being
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  that it's the Highmark Health, um, living health strategy
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  to say Allegheny Health Network plays a very,
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  very important role, um, in, in seeing how we actually, um,
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  make that actionable, make that really, truly, uh, come
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  to life inside of a, you know,
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  relatively large health system that is not also closed.
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  Um, half our claims are through Highmark Health,
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  and that means half our claims are
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  through governmental business and other commercial payers.
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  And so to be, um, doing that, um, inside
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  of an open system is, is really complex.
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  It's really tough. So building a strategy that, um,
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  really works, uh, in both worlds.
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  And, and so we are, uh, as of this year fully at risk, uh,
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  in a value-based care arrangement with all lines
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  of business, um, with Highmark Health, uh,
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  but we are also living in the fee for service world, um,
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  with, um, our other books of business, many of them,
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  not all of them, but many of them.
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  So, to, to then, that poses the issue for me
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  as you asked me about the vision.
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  It's how do you operate in both worlds at the same time
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  and really create these wonderful experiences for all people
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  that touch us and, um, and,
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  and our health system in many different ways.
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  Um, home virtual, um, physical assets, um, and digital
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  and, and still really, um, you know,
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  create those wonderful experiences, um, that lead
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  to engagement and better outcomes.
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  Um, it, it, it that's, you know, it's tough.
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  That's the, that's the vision, if you will.
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  Um, so, you know, within that, right, we're,
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  we're really thinking about orchestration of care.
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  That's kind of the, the key word that I'll use is,
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  is really, you know, being with people.
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  And I, I always envision a world where I know, we'll,
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  we built, we will be building
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  to especially generative AI now, in which, um,
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  we should know you need us before, you know, you need us.
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  And really, if you just simply said, you know, what is it
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  that you really want healthcare to get
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  to is, is I think we're there.
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  We have the data, we have a lot of the tools to be able
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  to do that, but we haven't really done that yet, right?
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  So I wanna build a role in which, you know,
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  before you know, that you need to engage with us, um,
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  you know, we have enough data, information, trust,
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  that's a big word there, um, to
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  where we can then help orchestrate
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  and navigate your healthcare journey
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  before you know, you need us.
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  And I think, um, as we really build that role
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  and are able to do that,
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  and I think a system like ours with the provider
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  and a payer, uh, really in a blended way, um, is,
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  is gonna have the, the data and the intelligence
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  and the engagement capabilities, uh, to perhaps
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  actually achieve that, to improve outcomes.
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  So that's, that's the vision. Mm-Hmm.
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  - , I mean, that's a pretty big vision.
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  And just to clarify when you say that,
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  how do you operate in both worlds at the same time?
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  You're talking about the fee for service
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  and the at at-risk models.
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  - That's right. That's right.
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  - Yeah. I, I mean, I remember the,
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  the phrase about like having one leg
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  and one foot on the dock, one on the boat.
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  It's been put to you so many more times,
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  but it's still very much true today, uh, as it was about 10,
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  15 years ago, it sounds like.
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  - Yeah, I haven't heard that,
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  but it certainly feels like that many days.
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  So, uh, yeah, that, that, that hits home.
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  Um, and, you know, I think that, uh, again, you know,
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  I'll put my physician hat on,
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  and it's important to say physicians don't
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  inherently treat patients different based on the
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  insurance card that they carry.
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  Um, when you walk into an emergency room,
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  when you walk into an office, when you walk in
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  and you do a video visit, the provider, the care team,
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  it's not just physicians, but nurses, the care team,
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  the whole EVS, it, they're not gonna look at that batch.
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  They're not gonna look at inside that, you know, section
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  of Epic and the storyboard to say, you know,
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  which insurance are you?
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  So as we solve for that, it's important that, you know,
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  we treat people as people, um,
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  and, um, so the, the solutions, the programs, the digital,
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  the, even the, the, you know, the physical, um, uh, programs
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  that we have, um, really be need to be able to solve, uh,
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  for all of our people that we serve.
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  Um, and so the challenge is, and,
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  and they're there is how do you find, uh, ways to do that
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  where you really don't have to go to the care teams
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  and say, I need you to look at
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  what bags they're wearing today.
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  Are they, are they at risk or are they paper service?
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  So it's a cha it's a tough challenge.
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  And some across the country, we've talked to a lot
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  of other health systems, some are going down that path
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  and saying, we're gonna really, you know, do this kind
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  of divergent model where we're gonna have care teams
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  that only take care of that risk,
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  and we're gonna have care teams that only take care of fee
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  for service and nothing wrong.
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  I just think that inherently we're trying to, um,
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  really create a world in which, um, we're just proactive
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  and preventative in the right way for all patients.
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  Um, but we do need to be thoughtful about how that, um,
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  you know, fiscally, um, uh, falls out.
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  - Ashish Barad, chief Digital Information Officer
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  with Allegheny Health Network, I wanna thank you again
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  for being my guest fan on the podcast.
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  Any closing thoughts you'd like
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  to leave our listeners with as we wind down?
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  - Oh, gosh. Um, I, um, would just say that,
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  um, I would encourage all, I, I did not in any way, um,
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  meant to mean to discourage any
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  of the disruptors that are out there.
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  I think that we need it in healthcare.
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  I encourage, uh, others to get into this and help us.
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  I think the future is partnership,
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  and we absolutely need outside thinkers
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  and other, uh, ecosystem partners that come in
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  and help us disrupt ourselves.
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  Um, and so, uh, I look forward to that role.
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  And, um, and Molly, thanks again
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  for having me on the Becker's podcast.
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  - Thanks for being our guest.