Latest / Becker’s Healthcare - Clinical Leadership Podcast / Using Virtual Care and AI to Reduce Burnout and Improve Hospital Care with Dr. FJ Campbell

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Using Virtual Care and AI to Reduce Burnout and Improve Hospital Care with Dr. FJ Campbell · Becker’s Healthcare - Clinical Leadership Podcast

0:00
This is Laura Dierda with the Becker's Healthcare
0:02
podcast. I'm thrilled today to be joined by
0:04
doctor FJ Campbell, chief medical officer at Ardent
0:07
Health. Doctor Campbell, it's a pleasure to have
0:08
you on the podcast today. Thank you, Laura.
0:11
Now I'm excited for our conversation. I know
0:12
we're gonna be digging deeper into AI technology
0:15
and some of the real real world benefits,
0:17
that you can get into and and digging
0:19
deep into those practical solutions
0:21
that AI can today truly, truly solve in
0:23
the health care space. But before we dive
0:25
in, can you just briefly introduce yourself and
0:27
tell us a little bit more about Ardent
0:29
Health?
0:30
Sure. I'm an emergency physician.
0:32
I've been with Ardent for about eight years
0:34
now.
0:35
The company, 30 hospitals across several markets.
0:40
We really focus on forming partnerships with academic
0:43
centers,
0:45
for improving community assets. We very clearly have
0:48
achieved success with that model. It's novel. It's
0:51
also effective.
0:53
Our hospitals really are cross section, which you're
0:55
gonna find in The United States, which means
0:56
we also have a cross sections of the
0:58
problems you encounter in delivery of health care
1:00
in The United States.
1:02
Notions of virtual care and AI are are
1:04
very attractive now, and they're very exciting.
1:07
And they and they pull out the futuristic
1:10
interests of so many people. But in our
1:12
world, with our practical problems, we need practical
1:15
solutions. So I look forward today to communicating
1:18
how
1:19
virtual care and AI specifically are bringing true,
1:24
measurable, both clinical, operational, and financial benefits,
1:28
so that more people can engage in this
1:30
work. Because, candidly, I need more people engaging
1:32
in this work. We need a community of
1:34
learners on this, and we don't have
1:36
enough facilities engaging in this. So that's very
1:39
much why I wanted to speak to you
1:40
today.
1:42
I love that. And I think this is
1:43
a conversation that certainly has a ripple impact
1:45
on so many hospitals and health systems and
1:47
organizations that listen to our podcast regularly because
1:50
you're right. I mean, looking at the technology
1:52
of virtual care AI,
1:54
being rooted into solutions and spaces where you
1:56
can truly find,
1:58
the biggest benefit, is the transformational aspect of
2:01
it. Now I know Ardent Health announced plans
2:03
to launch enterprise wide virtual physician, nurse, and
2:06
patient observation platform. You talk a little bit
2:08
more about that initiative and how it will
2:10
transform care delivery?
2:12
It's it started out of COVID,
2:14
like, so many things. Now there were some
2:16
positives that came out of COVID, and what
2:18
we realized is what we could do in
2:19
terms of lever leveraging
2:22
a telehealth visit,
2:25
for meeting our staffing needs and our
2:29
and our patient access needs.
2:31
But we were really also concentrating on the
2:33
realization that our nursing staff had just become,
2:37
completely burned out.
2:39
There was an untenable amount of volume of
2:41
work for nursing,
2:43
staff to do,
2:44
nursing leaders to manage,
2:46
a higher level of acuity than we'd ever
2:48
seen before,
2:50
and we had gotten into a cost curve
2:52
that had become unsustainable.
2:54
And with that,
2:56
the challenge that our board put in front
2:58
of us very
3:00
proactively
3:01
was we have to find a system for
3:04
load balancing
3:06
nursing
3:07
care, and very quickly, we arrived upon virtual
3:09
nurses.
3:10
So what our virtual nurses actually do,
3:14
we believe at Arden on the notion of
3:16
technology should be made by end users for
3:19
end users,
3:21
and that the real customer there is the
3:22
end user.
3:24
So we went to nursing leaders across the
3:26
enterprise and said, what do you want to
3:29
take off of your checklist? What do you
3:31
wanna take off of your to do list?
3:33
And the and the areas that quickly surfaced
3:35
were
3:36
we can't do admissions well, intakes well in
3:39
patients frequently because we're interrupted.
3:42
We can't do discharges well frequently because we're
3:44
interrupted.
3:46
And when it comes to,
3:48
maintaining, you know, purposeful rounding,
3:51
we can't necessarily maintain the schedule that we
3:53
would want to.
3:54
So it was those three areas that we,
3:57
effectively executed on. And what we found what
4:01
I found when I would go to the
4:02
markets with the units where we basically launch,
4:04
where we'd have, you know, virtual nurses, we
4:07
would have RNs, we'd have PCTs, sometimes we'd
4:09
have LPNs or LPNs depending on where you
4:11
are.
4:13
Nurses would come up to me, grab me
4:15
on the arm, and be like and pull
4:17
me over. You're like, you actually brought me
4:18
technology that helped
4:20
as if it was a novel concept, which
4:22
for so many clinicians, it is. Okay? And
4:25
they would show me their to do list.
4:27
Like, you see all these boxes here?
4:30
The ones that have red check marks through
4:33
it, the virtual nurse took care for me.
4:35
And the ones that have the black check
4:37
marks, I took care of for me.
4:39
This has literally allowed me to concentrate more
4:42
on my work
4:43
and identify where we have potential safety gaps,
4:47
where we have throughput gaps,
4:50
where I can actually connect with a patient
4:51
in a way that I haven't done before
4:53
because I can actually, like,
4:55
not be frantic.
4:58
So turnover on those units went down, but
5:00
here's the really, like, hard dollar impact.
5:03
Okay?
5:04
So on our note units
5:06
that have virtual nurses,
5:08
if you look at the cost of, like,
5:10
nursing care, which includes
5:12
contract labor, premium pay,
5:15
our our regular FTE nurses, and PCTs,
5:18
four areas,
5:20
Those are nursing expense. Nursing expense per patient
5:23
per day
5:24
has gone down consistently between $15 and $30
5:28
per patient per day.
5:31
This is more than covering what I have
5:32
to do on virtual nursing.
5:35
Now
5:36
let's move on to virtual sitting for a
5:37
moment and which actually we refer to in
5:39
our organization as
5:41
patient safety attendance.
5:43
Now the ROI for that, has been proven
5:47
by a number of organizations. One of the
5:49
first to really achieve success improving that ROI
5:51
was Avisure.
5:53
Okay?
5:54
I mean, they they wrote the book on
5:55
that.
5:56
And what you can find here is
6:00
when you're using
6:02
virtual patient safety,
6:04
attendance,
6:05
first of all, the AI algorithms
6:07
have become much more effective at seeing precursor
6:10
activities for a patient that can predict who's
6:12
going to fall,
6:15
which means you can have one patient safety
6:17
attendant
6:18
virtually monitoring
6:20
several patients.
6:22
So
6:23
what we're doing is we're taking people who
6:25
have been strictly patient safety attendants, and sometimes
6:28
that sitter could have been a nurse because
6:30
that's all we had,
6:32
or a PCT.
6:34
So we're now having our sitters if you're
6:36
gonna be a sitter, you're either gonna be
6:37
someone who is a PCT or you're working
6:40
in transport or some other capacity in the
6:41
hospital, but you're not a nurse
6:44
at $39 an hour or a contract labor.
6:47
Good god. Okay?
6:49
So to that end,
6:52
we have a system
6:54
that is allowing us to do sustainably
6:57
more effective identification of patients at risk for
6:59
falling
7:01
and at a cost structure
7:03
that actually is gonna create a situation where
7:05
when we look at what's going to drive
7:08
covering our costs
7:10
for all of our virtual care platform across
7:12
all of our enterprise,
7:14
our breakeven point is going to come well
7:17
within our contract from virtual sitting savings alone.
7:20
And, no, I cannot give you those exact
7:22
figures because I can't, and I I won't.
7:25
Okay?
7:26
But I can tell you that is what
7:27
you can count on. Okay?
7:31
Certainly with organizations like Abba Share or HelloCare,
7:34
that's what you can count on.
7:36
I have no disclosures.
7:38
Alright?
7:38
So with that in mind,
7:43
you have a cost sustainable model for sitting
7:45
that actually creates a cost sustainable model for
7:48
both nursing physician and attending from the savings
7:50
of that. But you're also gonna be looking
7:52
forward to about a 20% reduction in falls.
7:56
Remember,
7:58
for what we all have to do in
8:00
any kind of health care system, if you
8:02
wanna have a sustainable
8:03
transformation of care, you need a sustainable economic
8:06
model
8:08
and a clearly measurable clinical impact.
8:13
So let's move on to virtual physician for
8:15
a second.
8:16
When I think of late to stay,
8:19
and I'm in a smaller community hospital,
8:21
okay,
8:23
it is a really challenging circumstance
8:26
to have a whole host
8:28
of capabilities. When I think of them, I
8:30
think of capability and I think of capacity.
8:32
Capacity, do I have beds? Capability, do I
8:34
actually have the clinical resources?
8:37
Community hospitals,
8:39
as long as they can staff and have,
8:41
you know,
8:42
a capacity to break even even,
8:45
they will
8:47
bring more patients in.
8:49
The challenge they're going to have is, will
8:51
they have the clinicians and specifically the specialists
8:55
to execute on that care?
8:57
If I have a hospital that's a smaller
8:59
facility in a more distant community,
9:02
and ultimately I have a cardiologist only available
9:04
three days a week,
9:06
my length of stay is going to go
9:08
up.
9:10
And my ability to retain higher acuity patients
9:13
is going to go down.
9:15
And
9:16
EMS will, in time, know that and go
9:19
past my hospital.
9:21
But if I'm in a situation where
9:24
I have virtual care capabilities per room,
9:27
which then allows me to have virtual sitting,
9:30
and that's gonna drive your sustainable return on
9:33
investment,
9:35
virtual nursing, which is going to supplement that,
9:38
the the real and at that point, now
9:40
I can afford to have all these systems.
9:42
The real benefit becomes
9:44
I can now retain higher acuity patients
9:48
because through a virtual physician, I have that
9:50
cardiologist
9:51
seven days a week. I have that nephrologist.
9:54
I have that neurologist. I have that infectious
9:56
disease tending or pulmonologist.
9:59
Now people often come to me like, what
10:02
if the COVID waivers on virtual care go
10:04
away? Well, that would be a tsunami event
10:06
that would be very detrimental to the entire
10:08
health care delivery system in The United States,
10:10
so I'm not betting on that one. Okay?
10:13
But with that in mind,
10:15
what you're gonna find, especially as we're looking
10:18
at rural facilities,
10:20
and you think of the funding that's going
10:22
out in terms of the rural health funds,
10:24
that's $50,000,000,000
10:25
over five years.
10:28
If you wanna make sure you're protecting a
10:31
rural community,
10:33
you want that hospital to stay open.
10:36
In rural communities,
10:38
a hospital, even a 50 bed hospital might
10:40
be the only
10:42
destination for a hospital for two hours,
10:45
and a lot of The United States experiences
10:47
that.
10:49
So under the circumstances, if you wanna protect
10:51
rural communities
10:52
for the love of God, you better protect
10:54
those hospitals,
10:55
which means you have to get the specialist
10:57
to them.
10:58
And the only way to defeat time and
11:00
geography,
11:02
distance,
11:03
is through virtual care.
11:05
Because what's gonna happen is you're going to
11:07
actually be bringing specialty care to those regions.
11:11
So when people ask me about,
11:13
hey. How is this going to improve patient
11:15
safety? I'm like, do you have any other
11:16
solutions to that?
11:18
If you wanna really make sure that we
11:20
have an unsafe environment, let's make sure that
11:22
specialists can't get out to these communities.
11:25
So when people ask me, like, how is
11:26
virtual care, right, actually going to a like,
11:28
how are you gonna make sure it improve
11:30
and maintains patient safety? I'm like, like, in
11:32
comparison to what we have now?
11:35
Are you joking?
11:37
What we have now is not safe.
11:40
That's such a great point. And, you know,
11:41
definitely having that opportunity to bring in more
11:45
virtual care and,
11:46
expanding that capacity for nurses and physicians to
11:50
do more within the walls of the hospital
11:51
as well as on the outside, and connect
11:54
with patients. I know it was a huge,
11:55
huge,
11:57
win for the health system overall. And I'm
11:59
curious, you know, when you look at, incorporating
12:01
all of this into the daily workflows of
12:03
the clinicians, physicians, patients, etcetera,
12:07
what were some of the the challenges that
12:08
you ran up against? Because I know, you
12:10
know, it it's easy to say, hey. This
12:12
is gonna be helpful for you, but to
12:13
actually then get adoption and make sure you've
12:16
got the right, systems in place in in
12:18
the right, people leading these efforts, is critical.
12:21
So I'd love to hear a little bit
12:22
more about how you've been working through some
12:24
of those things and what you were really
12:26
able to accomplish with the right plan in
12:28
place and and leaders that were leading the
12:29
charge.
12:31
It was easy.
12:33
Let's start off with the patients. Here's what
12:35
the patients say. Wow. Someone actually was able
12:38
to talk to me for a full conversation.
12:41
I mean, that happened, like,
12:43
on day
12:45
point six.
12:48
The patients immediately gravitated to it.
12:51
All ages,
12:53
all backgrounds,
12:54
you name it. The first thing, they immediately
12:58
understood what was going on. And the first
13:00
thing it would say is, I really appreciate
13:02
the fact that I could, like, talk to
13:03
you this whole time.
13:04
Like, it seems like you're really paying attention
13:06
to me. That's the gist of what we
13:08
got. I mean, that happened right out of
13:10
the gate.
13:11
I mean, intentional design
13:14
really helped. Like, we didn't have people who
13:17
thought, wow. Virtual care. It's really cool. Here's
13:19
what I think we should do, and basically
13:21
push it down.
13:23
It was,
13:24
okay. Let's talk to people who are actually
13:26
gonna be doing this and actually gonna be
13:28
using this. What do they want?
13:32
Nurses, by definition, are incredibly
13:35
pragmatic individuals.
13:37
They've got a list of things they have
13:39
to do, they have to get done, and
13:40
they will MacGyver their way to it.
13:42
And they always do. And they're like, we're
13:45
gonna take care of this. We're gonna have
13:47
good intakes
13:48
to have a better history, a better understanding
13:50
of the medications you're on, a better understanding
13:52
of the concerns they have,
13:54
which gives a better understanding of what the
13:56
vulnerabilities are. And when we get to the
13:59
end, we're gonna have a better discharge
14:01
because so often and even HCAHPS looks at
14:04
this. Like, how will the patient appreciate
14:07
along the way what their care plan was?
14:09
Well, they can talk it out with a
14:10
virtual nurse
14:12
during their stay. And equally important, do you
14:15
understand what you have to do when you
14:17
leave?
14:18
These are well measured elements, and they are
14:21
the specific areas in each caps where our
14:23
units that have these tools are rising.
14:26
And that means, like, the thinkable.
14:28
Like, it's logical. It's believable
14:31
It's actually taking place because we're dedicating resources
14:34
to it.
14:36
So from a nursing perspective,
14:38
out of the gate,
14:40
win. Like, I'll go to units and nurses
14:42
will be like, I know. I'm like, hey.
14:44
A a number of our hospitals, we have
14:46
a competing hospital, like, literally across the street.
14:50
Like, you can hit it with a baseball
14:52
without even trying. Okay? So here's the deal.
14:56
I'll say, like, what do you think of
14:58
this? Like, how how if we took this
15:00
away, what would you do? And after they
15:02
tell me about how they would flip out,
15:04
they're like, I'll give you an example. I'm
15:06
getting offers right now from
15:09
hospital x, which is across the street, for
15:11
3 more dollars an hour. I'm not taking
15:13
that.
15:14
Now I'm not gonna tell you the game
15:16
of what we played in terms of how
15:17
much would you take,
15:19
but most people are like, here's why I
15:21
want this.
15:22
And it always gets back to something very
15:24
tangible
15:25
only in the eyes of the end user.
15:27
They're like,
15:28
I get to have lunch.
15:31
I get to go home on time,
15:34
and I'm not
15:37
just
15:37
going into this frenetic pace all day.
15:41
One of the things that we look at,
15:43
whether it's the sitting element, meaning patient safety
15:45
attendant, the nursing element, or the physician element
15:47
of virtual care, the goal here has been
15:50
to reduce cognitive burden.
15:53
Actually,
15:54
we got that page from research that was
15:56
done by NASA. The capacity to reduce mistakes
15:59
and reduce risk is clearly associated with reduction
16:03
of cognitive burden, which was a major focus
16:06
for us.
16:07
Our goal here, whether it's with nurses or
16:09
physicians in virtual care, isn't to make them
16:12
more productive, although that does happen,
16:16
or simply just to reduce cost, which has
16:18
clearly occurred.
16:19
The bigger threat in my mind,
16:22
I look at two lines.
16:24
There is the line basically demonstrating the sheer
16:28
number of individuals who are going to be
16:30
Medicare eligible by 2030, and that's just going
16:33
up, and it's sixty seven million people.
16:36
And another line that's not very good and
16:39
concerning is
16:40
by 2030,
16:43
the average age of physicians
16:46
is gonna be one of the the highest,
16:47
meaning closest to retirement that we've ever seen
16:50
before.
16:52
So as we're peaking
16:53
on our Medicare age population,
16:56
we are peaking in a population of physicians
16:59
and nurses
17:01
who are going to be considering retirement.
17:04
These tools
17:05
aren't just about,
17:07
you know, what we have to do
17:09
to sustain our care. These tools are
17:12
very specifically about,
17:14
I need to make sure that people wanna
17:16
keep on being
17:18
physicians and nurses and more prominently stated,
17:22
physicians and nurses who actually wanna work in
17:24
the hospital.
17:25
Because working in a hospital
17:27
is an incredibly
17:29
challenging experience
17:30
daily and certainly over time.
17:33
So a major focus for us is how
17:35
do we reduce the cognitive burden that's going
17:37
to allow us to retain our workforce?
17:40
So they want to be in the hospital.
17:43
I know you wanted to so that's the
17:44
whole story on virtual care. I know you
17:46
wanted to get into other elements of AI,
17:49
which
17:51
if you thought it was going to be
17:54
rather transactional
17:55
and
17:56
boringly pragmatic on virtual care. You should see
17:59
how boringly pragmatic I am on AI.
18:02
Absolutely. I love it. No. I I think,
18:03
you know, especially looking at AI, there's so
18:05
much opportunity right now, to become more efficient
18:08
as a health system,
18:09
and to deliver health care better, but it
18:11
it doesn't always take that transformational, you know,
18:14
huge pie in the sky ideas are really
18:16
big problems that are simple solutions, but make
18:19
such a big difference and have a real,
18:21
real impact on,
18:22
patient care and how the organization is running.
18:24
So I'd love to hear some of the
18:26
things that you've been doing in ways you've
18:28
been looking at AI, that is truly beneficial
18:30
across the board.
18:32
AI Scribe.
18:33
Full stop.
18:35
Okay.
18:37
And we'll get into that for a reason.
18:39
But when you think of what clinicians
18:42
if you start ranking,
18:44
like, when they get to the end of
18:45
their day and they're like, today was awful
18:47
if they had an awful day. Like, why
18:49
was today awful? Tell me why today was
18:50
awful.
18:51
They will talk about documentation
18:54
and the amount of time they have to
18:55
put into that.
18:57
On the physician side, it's what they have
19:00
to deal with in terms of authorizations.
19:04
And what's gotten lower on the list
19:06
would be malpractice concerns.
19:09
And the fourth would be
19:11
just like the sheer flood of patients
19:14
who have higher acuity conditions.
19:17
If you're gonna ask those kind of questions,
19:19
like, twenty years ago,
19:22
you wouldn't find
19:24
the malpractice concerns
19:26
and just the sheer flood of volume and
19:27
high acuity patients at the bottom or the
19:29
closer to the bottom of the list. They
19:31
would be at the top of the list.
19:32
They have been supplanted by
19:35
just the sheer grind
19:38
of documentation
19:39
burden.
19:40
And, you know, when you look at all
19:42
of the payers out there, okay,
19:45
you know, you start tracking what's going on
19:47
on their stock price, you're gonna start seeing
19:49
something that's not very shocking, and it's that
19:52
their denials activity and their authorization activity
19:55
goes off the hook.
19:57
And that means physicians have to spend that
20:00
time
20:01
working through that. Now what's really, really important
20:04
to appreciate here is when you're looking at
20:06
the payers, they are
20:08
exquisitely connected into
20:10
AI activities
20:11
to to basically
20:14
demand request for information relative to an authorization
20:16
or request for information for inpatient versus observation
20:19
status. And what we're going to get into,
20:21
and this is the most comedic element of
20:23
all of it, you're gonna have AI tool
20:24
versus AI tool.
20:26
Spy versus spy. Okay? So
20:30
but that's
20:31
one component. The AI scribe component that's so
20:34
meaningful
20:35
goes back to cognitive burden
20:38
and the pragmatism
20:39
of retaining your workforce.
20:41
Now right now, AI Scribe focuses
20:43
overwhelmingly on physicians
20:46
and their clinics.
20:47
And here's what we saw. Okay?
20:51
There are a number of very good tools.
20:53
We happen to use Ambiance.
20:55
Okay?
20:56
To that end, here are our results.
21:00
So
21:01
with that,
21:02
clinicians are, without even trying to, seeing about
21:05
one to one and a half more patients
21:07
a day.
21:08
We weren't looking for that. Remember, our goal
21:10
here isn't to make them more productive.
21:12
Our goal here is to reduce burnout
21:15
and retain them
21:17
because there is going to be a time
21:20
where if you aren't showing
21:22
what you are doing for physicians in general
21:26
to improve their workflows,
21:28
and we'll finish up on that, you're not
21:31
going to have
21:32
a medical staff.
21:34
So we brought in AI Scribe activities specifically
21:38
to drive
21:40
retention,
21:41
reduce burnout, reduce cognitive burden, and that happened
21:44
right out of the gate.
21:46
Like, we went from a 100 physician pilot
21:48
to commitment towards 900 clinicians.
21:51
Like,
21:53
my CEO was getting texts from physicians saying
21:57
things like, I saw 17 patients before lunch
22:00
today, and I know it was before lunch
22:02
because I've never gotten lunch in the last
22:04
five years, and I actually got lunch today.
22:06
You'll be getting texts from, I'm actually at
22:08
home having dinner with my family. Go back
22:11
to the virtual nursing piece.
22:14
What hit them in terms of why they
22:15
love it is because it hit them in
22:17
the field. For the nurses was I get
22:18
lunch, I go home on time, and it's
22:20
the same thing for the docs.
22:23
And they can say things like, I'm actually
22:25
having conversations with my patients. And these AI
22:28
systems are so effective in their mapping.
22:31
They're actually creating far better notes than they
22:33
were ever creating before.
22:35
So, sure, the E and M coding also
22:37
went up.
22:39
So,
22:40
you know, very confidently,
22:43
we are going to be
22:45
at a breakeven from this. And that's without
22:47
even getting into the kind of MA contracts
22:50
that are coming in the future where RAF
22:52
scores are really going to matter
22:54
and what you're basically doing to
22:57
achieve certain population health metrics that are gonna
23:00
be valuable to an MA contract with your
23:02
RAF scores,
23:03
that's when
23:05
the AI scribe tools are really going to
23:08
be showing their benefit. Like, generating, like, a
23:10
four or five, six x ROI
23:13
versus a one and a half x ROI
23:16
right now, but it is more than paying
23:18
for itself.
23:19
What's gonna happen next, though, is
23:22
we have to bring that technology into the
23:25
hospital, and you're going to see that with
23:28
hospitalists and ED attendees.
23:31
That will also pay for itself.
23:33
But if we're really going to have
23:37
a next step in the hospital,
23:39
it's gonna be about how AI scribes are
23:41
getting into nursing documentation, and that is a
23:43
hot area of
23:45
development for us
23:47
because I worry a lot about being able
23:49
to recruit physicians. I do.
23:51
I worry infinitely more about being able to
23:53
recruit nurses.
23:55
Okay.
23:57
Where are we at?
23:59
Absolute that's fantastic. And, you know, definitely,
24:02
makes a lot of sense. I appreciate you
24:03
talking through AI and looking at even what
24:06
the next steps are for the future. Are
24:08
there any other,
24:09
you know, big challenges that you see trying
24:11
to tackle next with technology?
24:14
Getting paid?
24:16
That's important.
24:19
When I think of the kind of systems
24:20
that are out there, like, here's an area
24:22
of health care that we just generally are
24:23
not good at, and I'm actually really policing
24:26
my language right now. Like, we just aren't
24:29
good at it. And that's vital signs.
24:31
And it's funny because they're vital.
24:34
But
24:35
to actually improve the deterioration indexes that exist
24:38
out there and there's some really, really good
24:40
ones. There's the stuff in Epic. Cerner's developing
24:42
some. You know, you've got another product out
24:44
there called AlertWatch. I mean, they're really, like,
24:48
they're all really good,
24:50
but they all require fuel.
24:53
And the fuel
24:55
would be a flood of data,
24:58
and the best data of all for these
25:01
deterioration indexes are vital signs.
25:05
So we need to have actual technologies,
25:08
and not just in the ICU,
25:10
that can monitor a patient.
25:12
And the and it's funny. The most
25:15
my new my favorite vital sign is respiratory
25:18
rate, which is ironic because for most clinicians,
25:20
they snicker and say, yeah. The respiratory rate
25:22
was sixteen, eighteen, or 20. Don't ask. Okay?
25:26
What it's not,
25:27
the subtleties in respiratory rate, we have found
25:31
with the technologies we use, and anyone who
25:33
wants to know what the technologies we're using
25:34
are can look us up. Okay?
25:36
But it's the ability to capture respiratory rate,
25:40
heart rate, even skin body temperature, and one
25:42
day blood pressure and pulse ox
25:45
every minute
25:47
allows for these systems to see the subtle
25:50
changes in either
25:51
increases in these rates or decreases in these
25:53
rates. And when that occurs and when it
25:55
actually happened more and more, you know, compressed
25:58
over time,
26:00
those patients who are showing those changes are
26:02
actually
26:04
demonstrating a higher risk for
26:06
eventually
26:07
compromising their overall condition requiring critical care.
26:11
Okay. Getting paid.
26:13
The ability to actually have that technology
26:16
to monitor those patients more effectively,
26:19
to use those DI tools,
26:21
you need automated patient monitoring, having the vital
26:24
signs
26:25
flow into those systems
26:27
not four times a day,
26:29
but 12 times an hour.
26:33
So it is a voluminous
26:35
change in how we execute on care to
26:37
identify the deteriorating patient.
26:40
It's like comparing the Pony Express
26:44
to a cell phone.
26:46
And that's
26:47
absolutely
26:48
within our reach,
26:50
and the feds have to figure out how
26:51
they're going to pay for that
26:53
because that kind of wearable technology,
26:56
you will then wear at home. Now for
26:57
what it's worth, the rural health fund,
27:00
there is no such thing as any of
27:01
the states applying for the rural health fund
27:03
dollars without including something along the lines of
27:06
wearables.
27:08
Where I think it's a little misguided is
27:10
you're talking about the general utilization of wearables.
27:12
I'm like, no. No. No. No. I mean,
27:13
there's a value for that, but it's not
27:15
nearly the value of you just had a
27:17
patient leave the most expensive place on planet
27:20
Earth in health care, and that's a hospital.
27:22
You wanna make sure that they don't have
27:24
to come back at least for thirty days,
27:27
if not longer. So the wearable technology, in
27:29
my view, will be much more,
27:33
generous in creating return on investment for the
27:35
federal government if they're saying it's wearables from
27:37
hospital to home.
27:40
So
27:42
a a challenge there is getting to that
27:44
next component,
27:45
which is on cognitive burden.
27:48
So it was, what do we have to
27:50
do to load balance?
27:53
What do we have to do to needing
27:55
capacity?
27:56
What do we have to do to load
27:57
balance and capabilities across an enterprise? And then
27:59
the third element here is,
28:01
in the trifecta,
28:03
how are we doing a better job of
28:04
identifying
28:05
the deteriorating patient? Because there is not a
28:07
nurse out there
28:09
anywhere
28:11
who goes through a whole week
28:13
without worrying
28:15
a decent amount about
28:17
who's the patient that I'm not going to
28:19
see
28:21
about to go down the tubes? There's no
28:23
hospitalist or ED doctor out there who doesn't
28:26
go on the shift and being like, which
28:27
one is the one that's going to catch
28:29
me off guard?
28:30
So being in a situation where you have
28:33
literally
28:34
technology that's watching your back to help you
28:36
identify the deteriorating patient fours before you could
28:41
is the third leg of the stool.
28:43
We have to balance capacity,
28:46
the volume of patients,
28:48
capabilities,
28:49
the resource to take care of highly acutely
28:51
ill patients,
28:52
and finally, the ability to identify the ones
28:55
who are deteriorating.
28:56
Those three things that we're trying to address
28:59
greatly reduce cognitive burden, sustain our staff, and
29:02
we feel like we have found sustainable models
29:05
to pay for this stuff. And I want
29:07
more people to know that because we need
29:08
more people doing this work.
29:10
Doctor Campbell, that's amazing insight and certainly such
29:13
a strong, strong reminder of what's truly important
29:16
and how technology can next really benefit what
29:19
you're doing in the patient care level as
29:21
well as for providers.
29:23
I really appreciate your time today, doctor Campbell,
29:24
and look forward to talking with you again
29:26
soon.
29:27
Alright. Thank you. Take care, Laura.