Latest / Becker’s Healthcare Podcast / Raymond (Ray) Lowe, Senior Vice President and Chief Information Officer at AltaMed

Transcript

Raymond (Ray) Lowe, Senior Vice President and Chief Information Officer at AltaMed · Becker’s Healthcare Podcast

• 0:02
  - Every health system executive right now is being
• 0:04
  - asked to do something that has no useful
• 0:06
  - precedent,
• 0:07
  - make durable technology decisions in an environment that
• 0:10
  - looks meaningfully different every six months.
• 0:13
  - The pace isn't slowing,
• 0:14
  - the vendor landscape isn't getting simpler, and the
• 0:17
  - cost of missteps
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  - keeps rising.
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  - Becker's eleventh annual IT and Revenue Cycle Conference,
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  - The Future of AI and Digital Health, exists
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  - for exactly this challenge.
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  - Here, you'll find more than 2,500 executive level
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  - attendees,
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  - 600 plus speakers, and four days of sessions
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  - built around the questions leaders are actually wrestling
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  - with.
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  - How to scale AI responsibly,
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  - how to protect increasingly complex systems,
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  - how to bring more performance out of the
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  - revenue cycle, and how to make tech investments
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  - that hold up over time.
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  - Join us September fourteenth through the seventeenth at
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  - the Hilton Chicago.
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  - You can register on our events page at
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  - beckershospitalreview.com
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  - by clicking on the events tab in the
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  - upper right.
• 1:02
  - This is Laura Dierda with the Becker's Healthcare
• 1:04
  - podcast.
• 1:05
  - I'm thrilled today to be joined by Ray
• 1:06
  - Lowe, senior vice president, chief information officer at
• 1:09
  - AltaMed. Ray, it's a pleasure to have you
• 1:11
  - on the podcast today.
• 1:12
  - Well, good morning, Laura. It's always a pleasure
• 1:14
  - to come on Becker's and share what's going
• 1:16
  - on here at AltaMed.
• 1:18
  - Fantastic. Well, I'm excited to dig in. I
• 1:20
  - know we're gonna talk a lot about,
• 1:22
  - technology, the evolution of the CIO role, and
• 1:25
  - thinking through some of the dynamics that are
• 1:26
  - really,
• 1:28
  - having an impact on the future of where
• 1:30
  - health technology is going. But before we dive
• 1:32
  - in, can you tell us a little bit
• 1:33
  - more about yourself and Ultimate?
• 1:36
  - Yeah. So,
• 1:37
  - so my name is Ray Lo, and I've
• 1:39
  - been the chief information officer at Ultimate for
• 1:41
  - eight and a half years. So in that
• 1:43
  - time period, I've been able to do a
• 1:45
  - holistic transformation of the organization,
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  - including putting in Epic, Workday, among other things.
• 1:51
  - And,
• 1:52
  - about alternate health services, so we are actually,
• 1:56
  - one of the largest Medicaid providers in the
• 1:58
  - nation. From community health centers, we're actually the
• 2:01
  - largest in the country,
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  - treating over 500,000,
• 2:05
  - patients in the Los Angeles Orange County area.
• 2:09
  - And those are primarily Latino,
• 2:11
  - multi ethnic, non English speaking folks, 200% below
• 2:14
  - the poverty level.
• 2:16
  - In addition to that, a part of our
• 2:17
  - other divisions at Ultimate is, I believe that
• 2:20
  - the second largest PACE program, which is programs
• 2:23
  - all inclusive care of the elderly.
• 2:25
  - And then we also have an insurance product,
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  - Ultimate Health Network, which is a Medicaid
• 2:30
  - restriction, and Knox Keene, as well as Altura,
• 2:32
  - which provides managed services organization.
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  - All said and told, we're about 6,000 strong,
• 2:38
  - and we have about, 80 plus sites across
• 2:40
  - the Southern California area.
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  - That's fantastic to hear. And, you know, what
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  - a huge responsibility. So many facets of the
• 2:48
  - health care, delivery continuum, you know, that you've
• 2:50
  - covered at AltaMed. So thank you for describing
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  - all that to us. Now I can imagine,
• 2:55
  - you know, being the CIO
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  - of the,
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  - health system and organization
• 3:00
  - carries a lot of responsibilities,
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  - but, you know, you've very experienced in this
• 3:04
  - role. Can you tell us a little bit
• 3:05
  - about, how you have seen it change over
• 3:08
  - the years and what position you see it
• 3:10
  - today? Where is it headed? I'd love to
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  - just get your perspective on how you're seeing
• 3:14
  - the CIO role, evolve.
• 3:16
  - Yeah. Well, one, there was a great article
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  - in Becker's today that I read about the
• 3:19
  - changing role of the CIO. So I think
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  - it's it's very timely.
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  - You know, if I look over the last
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  - decade in terms of what the different,
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  - CIOs' roles
• 3:30
  - have been about ten years ago, it's really
• 3:33
  - about EHR implementation and delivery.
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  - That went on for quite a while. Then
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  - we went through the pandemic, so we're all
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  - very single focused in terms of happening, and
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  - we really push more towards a digital edge
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  - engagement.
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  - You know, as we move ahead more, we're
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  - continuing to do more value based care of
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  - focusing,
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  - alignment,
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  - in those spaces as well.
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  - And, you know, now we have this interesting
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  - thing called AI. You know, two or three
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  - years ago, I think we didn't quite understand
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  - it. I'm a big fan of CT Lin.
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  - He wrote a song about that, that he
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  - didn't understand AI and now embracing it. And
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  - now here it is. So,
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  - you know, AI to me is this is
• 4:12
  - really helping us improve our productivity.
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  - This is technology we need to
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  - embrace carefully.
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  - We have to be very thoughtful in terms
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  - of how we are enabling AI within our
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  - organizations. And and to me, it's focusing
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  - on
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  - improving productivity
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  - for,
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  - our staff, but also how do we make
• 4:30
  - it a better experience for our patients and
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  - providers.
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  - That makes a lot of sense. I know
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  - AI brings a lot of change with it.
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  - Obviously,
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  - a technology that hasn't really, you know, come
• 4:42
  - before and then is evolving quite quickly or
• 4:44
  - transforming the organization quite quickly. So,
• 4:47
  - from your perspective, I'm just really interested whether
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  - it's AI or or anything else. What are
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  - some of those powerful forces that you see
• 4:53
  - shaping health IT within the organization?
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  - How do you, see them, you know, making
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  - a big difference, especially as quickly as things
• 5:00
  - are moving?
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  - Yeah. So I think, you know, right now,
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  - there's a lot of headwinds really tied to
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  - financial constraints.
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  - You know, we're all health systems are facing
• 5:08
  - challenges with HR one b, reduced revenue. We're
• 5:11
  - Medicaid
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  - as well. So we're hit even stronger in
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  - terms of,
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  - UIS, which which stands for undetermined immigration status.
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  - So So as part of the new Medicaid
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  - requirements,
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  - in California, we're able to provide health care
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  - for all. And now with insurance requirements of
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  - Medicaid,
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  - a lot of folks will not be able
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  - to meet those requirements,
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  - unfortunately. And as a community health center, we
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  - are still chartered, right, to help everybody,
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  - you know, achieve health care. So when I,
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  - kinda look at the
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  - other challenges as a CIO is how do
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  - we still enable
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  - care?
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  - Right? Right? We don't wanna go backwards.
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  - How do we wrap our patients in technology?
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  - How do we improve the productivity
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  - so that we can have a net kind
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  - of reduction, improvement of cost and cost savings
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  - without without reducing quality or engagement?
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  - And,
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  - you know, there's a number of epic initiatives.
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  - We're an Epic shop that we are embracing,
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  - broadly across
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  - the industry is,
• 6:12
  - and then clinical voice,
• 6:14
  - Abridge, Nava, Suki are some of the leading
• 6:16
  - ones, Microsoft DAX as well. Epic has a
• 6:18
  - product,
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  - which has been well very well received by
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  - providers and truly helped them be much more,
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  - efficient
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  - and really improve their engagement type of patients
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  - by being able to talk to my natural
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  - voice versus typing.
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  - But when you look again at the, you
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  - know, back end productivity,
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  - things that are happening and coming out is
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  - I'm really excited about no summarizations,
• 6:40
  - helping our docs get a summary of a
• 6:42
  - number of encounters
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  - versus before they have to read it. There's
• 6:46
  - text assistance, you know, level of service and
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  - coding happening,
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  - you know, drafting patient instructions. So a lot
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  - of things to help our providers. You know,
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  - with that being said, right, we need to
• 6:57
  - make sure that the docs and the vast
• 6:59
  - purchasers
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  - are reviewing and approving.
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  - So AI is here to help us to
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  - suggest what the outcomes are, but we need
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  - to make sure, right, that we still have
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  - people in the loop at it and that
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  - they're not replaced.
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  - Beyond,
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  - you know, the, ERP space, you gotta look
• 7:13
  - at your CRM. You have to look at
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  - your you have to look at your ERP,
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  - your other patient community engagements around there as
• 7:19
  - well as your back end efficiencies.
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  - And the whole cyber world,
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  - with this wonderful thing called Mythos
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  - and the acceleration of what's happening is another
• 7:29
  - thing called project glass wing.
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  - It's really disruptive in terms of what's happening
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  - from the cyber defense perspective.
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  - Absolutely. I I can imagine all of those
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  - things, coming up so quickly or things you
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  - have to juggle plus knowing, you know, obviously,
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  - the financial constraints you talked about, you know,
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  - not unique, of course, being high in Medicaid,
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  - I can imagine, is particularly acute for UltaMed,
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  - but, something that many organizations are dealing with
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  - and then trying to understand where their investments,
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  - in in dollars for IT are gonna make
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  - the most difference, how they're gonna be more
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  - efficient,
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  - and then, you know, what's really necessary on
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  - the cybersecurity side, you know, that isn't cheap
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  - as well. And so,
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  - I'm curious from your perspective. Obviously, the CIO
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  - that's dealing with all of these things plus
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  - trying to keep up with the legacy
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  - technology and bring in new technology,
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  - how do you manage all of that? And
• 8:19
  - and where do you see your teams,
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  - really
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  - evolving to be the most useful when you're
• 8:24
  - thinking about the limited resources that you have?
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  - Yeah. So, you know,
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  - every every identity have a good use case
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  - behind it. You know? I I think the
• 8:35
  - time of kinda shining coins is is really
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  - moving away. And so when we look at
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  - the discipline required, especially,
• 8:41
  - from a governance perspective,
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  - we have use cases that are tied to
• 8:45
  - discrete outcomes that can be measurable.
• 8:47
  - So based on that criteria, right, you can
• 8:49
  - look at your application rationalization.
• 8:52
  - Right? You can also look at what type
• 8:54
  - of new investments do we need to make.
• 8:56
  - We need to be really clear with our
• 8:59
  - operational partners.
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  - How are they gonna help us pay for
• 9:02
  - that? Right? How are they gonna realize what
• 9:04
  - we need to accomplish again, you know, to
• 9:06
  - meet the quadruple aim of our organizations?
• 9:09
  - So, you know, it's it's governance.
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  - It's
• 9:13
  - it's, adhering to process.
• 9:15
  - A lot of folks are talking about AI
• 9:17
  - governance. I don't know if we all do
• 9:18
  - it well.
• 9:20
  - Right?
• 9:20
  - But, I really take everything back into a
• 9:23
  - business case, quality, financial,
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  - compliance, legal,
• 9:28
  - your type of outcomes measurements, and then taking
• 9:30
  - that back through
• 9:32
  - our our governance processes so we understand what
• 9:34
  - we're doing. And that helps the conversations.
• 9:37
  - Now in the CIO role, there's always tech
• 9:39
  - debt. There's always tech debt. There's applications
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  - that are,
• 9:44
  - not being supported, which, again, going for the
• 9:46
  - cyber side creates a new vulnerability.
• 9:48
  - So I think we need to be aware
• 9:50
  - of what's in our app stack, where our
• 9:52
  - problems can be, and we have to take
• 9:53
  - an active role saying how do we solve
• 9:55
  - that problem. We can't ignore it.
• 9:58
  - Again, going more on the cyber side,
• 10:00
  - today, it's not a matter if you're gonna
• 10:02
  - be breached. It's gonna matter of when you're
• 10:04
  - gonna be breached. And
• 10:06
  - when you are breached, how are you going
• 10:08
  - to contain this the most localized area So
• 10:11
  - it doesn't go systemically across your organization to
• 10:13
  - shut you down.
• 10:15
  - That makes a ton of sense. And I
• 10:16
  - think, especially, you know, you mentioned Mythos earlier
• 10:18
  - in project last week. I know initially,
• 10:21
  - not a lot of health care stakeholders that
• 10:23
  - were were part of,
• 10:25
  - the testing process or or the, identification of
• 10:28
  - vulnerabilities and those types of things. And I
• 10:30
  - know hospitals in particular are are some of
• 10:33
  - the biggest targets of, cybercriminals.
• 10:35
  - So, you know, when you think about, the
• 10:38
  - technology evolving to some of these Frontier AI,
• 10:40
  - mesos, other types of things,
• 10:42
  - what do you see as being the role
• 10:45
  - of, CIOs or health tech leaders in general
• 10:47
  - and being able to influence,
• 10:50
  - the safety and security of your institutions going
• 10:52
  - forward? How do you talk about that to
• 10:54
  - tech partners as well as, you know, your
• 10:56
  - hospital board?
• 10:57
  - Yeah. Very carefully is my answer.
• 11:00
  - It's it's challenging in terms of it. And
• 11:02
  - and a lot of this is how well
• 11:04
  - do you understand your ecosystem?
• 11:06
  - How well are you managing it?
• 11:09
  - Patch management
• 11:10
  - is a very simple thing. Everybody does it.
• 11:12
  - We usually do it once a week. Have
• 11:14
  - our change boards and maybe do three or
• 11:16
  - four. You know, now the orders are gonna
• 11:18
  - be ten, twenty, 30 from the vendors and
• 11:21
  - because the
• 11:22
  - the environment is so dynamic. Right? So that
• 11:25
  - whole change,
• 11:27
  - that that paradigm that many of us had
• 11:29
  - a couple years ago, we just do patch
• 11:31
  - manage on a regular basis. But with the
• 11:33
  - acceleration,
• 11:35
  - you know, tied to the AI enablement and
• 11:37
  - then and then you had quantum tuning behind
• 11:40
  - what's happening there as well. Everything is moving
• 11:42
  - so fast.
• 11:43
  - Right? Then we have to stay ahead of
• 11:45
  - or stay aligned with what's happening. And people
• 11:48
  - really are challenged to move that quickly. So
• 11:51
  - that's where the automation helps us.
• 11:54
  - Absolutely. I can imagine that, you know, it
• 11:56
  - makes a big difference being able to have
• 11:57
  - AI on your side as well, in in
• 11:59
  - in automation and everything else.
• 12:02
  - I I'm curious now if we're able to
• 12:03
  - take just a minute to talk about,
• 12:06
  - technology in in, you know, what you've accomplished
• 12:08
  - as well as what's ahead. Is there anything
• 12:10
  - you'd like to, tell us about your most
• 12:12
  - product from the last year, something that you've
• 12:14
  - tried out that's paid off?
• 12:16
  - Just love to get a sense of, you
• 12:18
  - know, what you've been able to accomplish and
• 12:20
  - then what you see as being the next
• 12:21
  - problem you're trying to solve with technology or
• 12:23
  - AI.
• 12:24
  - Yeah. So, I mean, I'm also very proud
• 12:26
  - about quality.
• 12:27
  - I'm proud about growth. Right? So we've been
• 12:29
  - able to do quite a lot with our
• 12:31
  - data and our analytics
• 12:33
  - looking at, research utilization, how we bring our
• 12:36
  - patients in, tying that in, again, through the
• 12:38
  - epic chart, through through CHEERS so we can
• 12:41
  - reach out to the folks. So we have
• 12:43
  - some really outstanding,
• 12:45
  - accomplishments
• 12:46
  - in in the area of colorectal cancer screening,
• 12:49
  - breast cancer screening,
• 12:51
  - well taught business as well in terms of
• 12:52
  - having folks come in in those areas.
• 12:55
  - You know, and and, of course, we're always
• 12:57
  - improving our quality
• 12:59
  - in the organization and and those goals around
• 13:01
  - there. So this year, we have a big
• 13:02
  - focus on hypertension and diabetic management.
• 13:06
  - I think it's a well known fact that,
• 13:08
  - weight is a major cause of many issues
• 13:10
  - that are happening out there. So how do
• 13:12
  - we focus on that? How do we educate?
• 13:14
  - How do we, you know, again, serve the
• 13:16
  - community? So that that's a good clinical win
• 13:18
  - that we've had as well. I think the
• 13:20
  - other real good we have is because we
• 13:22
  - speak to primarily non Latin excuse me, non
• 13:25
  - English speaking organization.
• 13:27
  - So it's really how do you translate and
• 13:29
  - how do we work to,
• 13:31
  - ensure we're closing the gap on health literacy.
• 13:34
  - Right?
• 13:35
  - You know, and and, again, that's your outreach,
• 13:37
  - that's your touch, that's really being the community
• 13:39
  - provider
• 13:40
  - and being there.
• 13:42
  - You know, we've had a few challenges in
• 13:44
  - Southern California.
• 13:46
  - Last year, there was the wildfires they talked
• 13:48
  - about, in Alta Via, Pasadena.
• 13:51
  - I mean, I was so proud of how
• 13:52
  - Ultimate responded in the passing convention Center. We
• 13:54
  - were there for six weeks.
• 13:57
  - Yeah. We're providing everything from wheelchairs to showers
• 14:00
  - to pharmacy refills,
• 14:02
  - you know, power cords in there. So we
• 14:05
  - really met
• 14:06
  - the needs of the community and if ever
• 14:08
  - been in an evacuation center with the Red
• 14:10
  - Cross, people have a lot of needs because
• 14:12
  - they have to
• 14:13
  - leap with with almost nothing. Right? So how
• 14:16
  - do you, you know, stay in touch, stay
• 14:17
  - human, you know, and keep moving ahead? So
• 14:19
  - those are, you know, some of the top
• 14:20
  - ones that I think that are are really,
• 14:22
  - really great for me. You know, technology continues
• 14:25
  - to move,
• 14:26
  - right, in terms of how we're moving to
• 14:28
  - those areas. And so, yeah, that's kind of
• 14:30
  - a continued journey.
• 14:33
  - I love that. That that makes a lot
• 14:35
  - of sense. You know? And it is really
• 14:36
  - helpful to understand that unique place that you're
• 14:38
  - in the community and and how you can,
• 14:40
  - improve the health literacy, what you really need
• 14:42
  - in order to reach the patients, and the
• 14:44
  - members that you're serving.
• 14:46
  - Now before we wrap up here, I just
• 14:47
  - have one more question. What are you most
• 14:49
  - curious about for the future?
• 14:52
  - Oh, this is the crystal ball question, you
• 14:54
  - know.
• 14:56
  - Well, I'm I'm look I'm very curious going
• 14:58
  - to Epic UGM, which is just around the
• 15:00
  - corner. You know, what if it's gonna show
• 15:02
  - us and where we need to move ahead,
• 15:04
  - you know.
• 15:05
  - I I think looking into the future
• 15:10
  - is five years from now. The next eighteen
• 15:12
  - months can be very disruptive or two years
• 15:14
  - from an AI perspective. So what is what
• 15:16
  - is the new normal
• 15:17
  - gonna look like? Right? Because there there's a
• 15:20
  - lot of things we don't know
• 15:22
  - where we'll have
• 15:23
  - increased productivity, which is great. And as we're
• 15:26
  - reskilling
• 15:27
  - workforce
• 15:29
  - to do other things, as we're building again
• 15:31
  - higher quality, higher expectations, being the community,
• 15:34
  - what is that gonna look like? I I
• 15:36
  - don't have a clear answer, you know, out
• 15:39
  - there. You know? I mean, you hear in
• 15:40
  - other countries
• 15:41
  - that, you know, you can go up to
• 15:43
  - the old almost like a mirror. Right? They
• 15:44
  - can do a full scan of you and
• 15:46
  - review you and, know, and kinda give you
• 15:48
  - an assessment. Almost I don't wanna say, like,
• 15:50
  - the star trek tricorder because that kinda dates
• 15:52
  - me. You know? But I really think that
• 15:54
  - kind of,
• 15:56
  - biometric review
• 15:57
  - is very exciting,
• 15:59
  - you know, in terms of what's happening.
• 16:01
  - And just,
• 16:02
  - how we as humans, you know, kind of
• 16:05
  - just adopt
• 16:06
  - our little AI companions,
• 16:08
  - to help us and not be afraid of
• 16:09
  - it. Right? But we need to train in.
• 16:10
  - Right? And don't I mean, sure that it's
• 16:12
  - doing the right thing. So,
• 16:14
  - I think it's a very exciting time to
• 16:17
  - see what's gonna be happening. It's all about,
• 16:19
  - for me personally, developing new muscle memory.
• 16:22
  - Right? It's a time to learn again. Right?
• 16:24
  - It's not a time to sit back and
• 16:25
  - observe. Right? We have to kinda jump in
• 16:27
  - the at least the the shallow end of
• 16:29
  - the pool just start embracing
• 16:31
  - and and learning these things and and staying
• 16:33
  - smart. Right?
• 16:36
  - Absolutely. That makes a lot of sense. I
• 16:38
  - think it's great advice for, you know, all
• 16:40
  - of us as we're, entering a period of
• 16:42
  - eye transformation, eye change. Ray, thank you so
• 16:44
  - much for joining us on the podcast today.
• 16:46
  - This has been such a a fascinating conversation,
• 16:48
  - really,
• 16:49
  - on the cutting edge of what's so important
• 16:51
  - for CIOs and strategic leaders of health systems.
• 16:53
  - And I look forward to continuing this conversation
• 16:56
  - and digging deeper into more at the health
• 16:58
  - IT and revenue cycle event, coming up in
• 17:00
  - September. I know you'll be speaking on a
• 17:02
  - panel, and and it'll be just truly fascinating
• 17:04
  - to have you there. Yeah. Thank you. And
• 17:06
  - thank you, Becker. The news is just great.
• 17:08
  - I read it every day, so thank you.