Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Jordan Dale, System CMIO & Hospitalist at Houston Methodist

Transcript

Dr. Jordan Dale, System CMIO & Hospitalist at Houston Methodist · Becker’s Healthcare - Clinical Leadership Podcast

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  Would you like to exchange best practices and ideas to improve care,
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  enhance operational efficiency,
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  and address financial challenges with your peers?
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  Becker's Healthcare is facilitating these conversations at their eighth annual
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  health, it digital health and R C M meeting.
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  You can check your eligibility for complimentary attendance at the Lincoln,
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  the description. We are excited to welcome you in October.
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  This is Laura Dedo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr. Jordan Dale, system, c m I o,
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  and hospitalist at Houston Methodist.
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  Jordan is a pleasure to have you on the podcast today.
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  Thanks for having me.
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  Now, I know we've got a lot to talk about.
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  There's some fascinating things happening at Houston Methodist and really a,
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  a great opportunity right now in the healthcare space to implement some really
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  cool technologies. But before we dive into my questions,
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  can you tell me a little bit more about yourself and your background?
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  Yeah, absolutely, Laura. Um, I'm a biomedical engineer by training, uh,
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  that went into medicine as I saw the passion for patient care. And, um,
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  you know, when I was going through medical school,
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  it's when all the EHR implementations, um, started. So it kind of, uh,
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  struck me at,
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  at the right time and I was able to use some of my engineering background and,
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  uh, tech familiarness, uh, you know, to impact patient care on a broader scale.
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  Um,
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  so I've helped support clinical technology across health systems for the past 15
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  years. Um, and really passionate about it, about how it empowers our care teams,
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  uh, and our patients, uh, when it relates to their care.
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  That's a really, uh, great background in, in experiences to have,
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  and I can imagine in the last 15 years, the technology and adoption,
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  quite frankly has, has really changed and evolved.
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  Y Yeah, I would say the technology has certainly evolved. I,
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  I would say of my job, I think of, uh,
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  informatics kind of in the way that a lot of people in informatics do.
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  It's about people, process and technology.
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  I'd say that technology piece has gotten a lot easier. Um,
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  the people on process is still an opportunity for us to, you know, collaborate,
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  you know, on people. I think we still need to skill a lot of our clinicians, uh,
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  around what clinical informatics is and how they can use informatics and value
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  that and how they deliver patient care and,
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  and work with it and other stakeholders.
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  And then there's still a lot of processes that are being transformed across
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  healthcare, right? And some of those involve new or novel technology,
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  but a lot of them are just applying the existing technology in novel ways and
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  something we do a lot at Houston Methodist as well.
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  Absolutely. That's great to hear. It makes a lot of sense. Now.
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  What are some of the big opportunities that you're seeing,
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  especially at that intersection of clinical care and technology?
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  Could you tell me a little bit more about what you're doing at Houston Methodist
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  and then the headwinds that you have your eye on too?
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  Yeah, sure. I,
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  I mean some of the things that I think we learned through the pandemic and just
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  how out of the, um, nature and speed of,
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  of transformation at that time that we were successful was,
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  was really focused on virtualization. Um, so, you know,
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  telehealth is part of that,
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  but really virtualizing a lot of experiences using virtual nursing,
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  using other virtual services that can really be called in to, uh,
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  physical spaces, um, has really helped us in a lot of meaningful ways.
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  Um, and then centralizing some of those services or processes as well. Um,
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  and so on, on the virtual nursing end. Um,
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  we're very successful kind of building off of our virtual ICU platform that we,
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  uh, grew during the pandemic and,
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  and realizing the benefits of having somebody that was focused on a few tasks
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  was really skilled at those tasks,
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  but was kind of in a central location where they could, you know,
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  do that task across a broader, uh, care area or domain.
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  So the, our virtual nurses really focus on admission and discharge workflow. Um,
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  that can be, you know, kind of disruptive for a bedside nurse, um, you know,
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  when they're getting an admission discharge but also need to take care of their
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  patients that are, are still, you know, in the hospital.
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  So we were able to offload that task to our virtual nursing team. Um,
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  and I think both on the nursing side and the patient side,
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  the experience was wonderful. Um, you know,
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  there's some hesitancy at the beginning cuz it was a change and you know,
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  bedside nurses have been doing that task for forever, right? Um,
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  but it's really been eye-opening to us about how we can find a focused nurse on
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  a focused task. Uh, we get some time benefits, so we've reduced some of those,
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  uh,
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  tasks that were taking 40 minutes because a nurse may be disrupted or not be
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  focused on the task as, uh,
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  they're getting asked other questions across the other patients, uh,
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  down to 13 minutes. Um, and so we can really deliver that focused,
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  uh, and critical part in the care transition for a patient, um,
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  in a more high quality way with that, uh, technology.
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  And that really wasn't any novel technology.
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  I think we had a lot of that technology that we were using in other ways we just
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  thought of a different process and a transformation about how we're centralizing
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  those services. Uh, that's really been impactful.
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  So we've looked at a lot of services across our care domains that we could
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  virtualize and centralize. Um, and the centralization, right, helps focus,
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  like I mentioned, but also standardize, uh, some of that approach. And so,
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  you know, things like tele sitting, uh, could we virtualize, you know,
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  some pharmacy, um, interventions across our hospitals and, you know,
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  actively looking at ways that we could apply this in our ambulatory setting as
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  well. Um,
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  have started doing some work with centralizing refills and other kind of
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  administrative task rates that are difficult to really, um,
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  gain efficiency when you decentralize them, uh,
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  like they have been for for so long.
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  Got it. That makes a lot of sense. You know, it's fascinating to, to see how,
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  um, some of the ways where, like you said,
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  you can really apply the technologies to, um,
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  have more of a virtual nursing program or virtualized pharmacy that,
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  um, you know, really create the time efficiencies and are effective.
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  And I appreciate you touching on the culture element too because I think,
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  you know, that aspect of making a change really is, um,
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  sometimes more challenging than bringing on the technology and getting it all
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  work, right?
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  Is just to assure that team members that it'll be great and even potentially
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  have those time savings or they'll like it better the new way.
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  But it can certainly be scary I'm sure for some folks who are used to doing
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  something one way for a really long time.
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  Yeah, absolutely. And I, I think it's been, you know, it,
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  it took a lot of partnership and, um, guidance from, you know,
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  various stakeholders, uh, showcases with nursing and other, you know,
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  operational leaders to make them com comfortable with that transformation. Uh,
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  but like I said, now we've shown the benefit everybody's,
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  it's a win-win scenario and now kind of the sky's the limit cuz we've broke into
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  that, that culture shift just with this one, uh, approach.
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  And so it's helped us think about things that, you know, moving forward and uh,
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  one of the things that we're dedicated to at, at East Met this is,
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  is ambient intelligence, um, across a lot of our care domains.
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  So that's the other area where we might, uh, or we are actively using, uh,
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  things like computer vision within our inpatient rooms to track and
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  monitor things that, uh, again, were burdensome to our staff. Um, so again,
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  we had to really address, uh, concerns from a lot of different stakeholders.
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  Cause I think when you're putting a camera in the room that they're gonna be,
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  you know, viewed at all times. But it's really, you know,
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  I focus and I use that term computer vision intentionally cuz it really is that,
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  right? It's, it's looking and identifying a person or a patient, um,
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  it doesn't actually show, you know,
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  full video or anything like that so that we can use it in a way to track
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  processes,
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  to alarm patients that may be exiting beds or high risk for following.
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  Um, and so that really gives us a, a different layer of, uh,
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  intelligence that we otherwise wouldn't get unless we break through that kind of
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  comfort barrier, uh, that some other clinical teams have.
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  That's such a great point and definitely, you know,
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  awesome that you've been able to do that and really work with the team to gain
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  their trust and, and get some of the ball rolling on some of these things. Now.
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  I know it, it's definitely a lot happening, a lot of new technologies, a lot of,
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  uh, new capabilities coming through. How do you think about growth, uh,
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  from your perspective as C M I O and adding value to the organization overall?
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  What do you do to really make sure that the investments that you're making are,
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  are, uh, measurable and having impact at large?
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  Yeah, we have a very, I'd say through our center of innovation,
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  very structured group where we look at, um, you know,
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  technology in very focused areas at a smaller scale with,
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  with very specific, you know, ROI targets and KPIs. And,
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  but once those are achieved, um, we scale that very rapidly.
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  So I think that's just our engagement and support and the trust that we've
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  built. Um, I know, you know, we consider ourselves a,
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  an innovation organization, right? 30,000 employees.
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  Everybody's focused on innovation even though there might be a core set that's
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  really driving the things that we prioritize, um,
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  so we can engage and get that trust quickly if we're showing early results.
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  We also have the ability to, you know, fail fast and, and pivot, uh,
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  through that kind of focus group and evaluation. Um, so I think in terms of,
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  you know, growing and, and making sure that we're meeting the,
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  the needs of our health system strategy and value to our patients, um,
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  that's really helped us to do those early checks and then those early,
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  you know, KPIs or, uh,
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  targets that we're looking at are all really based on business still gonna give
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  us the same results at scale. Um, we really try to discourage things in,
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  in kind of silos or in very, you know, specific niche areas, uh,
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  cuz we wanna provide that benefit to all of our patients or all of our
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  clinicians. We know it has value.
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  So that's always a guiding principle when we start looking at, uh,
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  new technology or a process transformation.
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  Got it. I, I think that makes a lot of sense and I,
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  I love the methodical way that you really go about some of those, um, areas in,
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  in implementing the new technology and really thinking through how it makes
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  sense for the organization at large. Now, I know at this time in particular, um,
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  there resources overall but especially in healthcare are precious,
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  whether it's time or financial investments.
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  So what do you see as being one thing that is still very important to do this
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  year, whether it's a risk or investment or something that is worth doing on the
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  innovation side or otherwise, um,
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  that can really make a difference for patients or staff and team members?
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  Yeah, I, I think reducing, you know, workforce burden, um, you know,
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  before was, was something that was good to do to reduce burnout and retention.
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  Now it's essential. So I think we,
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  we look at all of this technology of how it's gonna reduce workforce,
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  workforce burden or help us scale, um, you know,
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  an outcome or achievement that we can make that really before was,
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  was tied to a, you know, uh,
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  a user and we could only get that benefit by scaling, uh, you know,
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  the workforce. We're really looking at things that can provide, you know,
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  extension of our workforce, uh, more rapidly or reduce that burden.
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  I think we're,
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  we're also very focused on still preserving that empathetic piece of healthcare
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  that, um, really technology should help support. Um,
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  so we definitely are not looking at things to, you know,
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  replace those types of experiences. Um,
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  that's why the transformation from the culture shift around virtual nursing and
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  helping nursing understand the benefit has been really impactful. You know,
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  they trust the virtual nurse to do their tasks,
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  but actually the bedside nurse gets more time to more meaningful conversations
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  with, you know, the patient because again, like I said,
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  they're spending 40 minutes on this task that now somebody's doing, you know,
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  for them and it's taking shorter amount of time. Uh,
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  so we're really bringing back some of that more meaningful interaction while
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  we're looking at the technology. So I would certainly recommend, you know,
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  it's those practice transformation things that you can use technology to drive,
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  but really encouraging your clinicians to kind of buy in to,
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  to breaking the status quo so you can reduce that burden, uh,
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  redesign the work and,
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  and really make sure that everybody's winning out of that experience.
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  Got it.
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  That makes a lot of sense and definitely it seems like a great place to focus
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  the energies and tensions, uh, that, that you have and it,
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  I'm sure things that are coming across your desk on a daily basis.
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  I wanted to look into the future just for a minute before we wrap up our
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  conversation here.
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  What do you see as some of the best opportunities for growth over the next year
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  or two? I know healthcare changes quickly and the technology sector even faster.
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  So, uh, from your perspective,
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  where do you really see some of the big opportunities and spaces where you are,
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  uh, focused on and investing into, um,
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  put yourself in a great spot for the next couple years?
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  Yeah,
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  outside of the things that I've already mentioned that will continue to scale
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  and kind of those concepts, I mean, I,
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  I think it's a very hot topic right now across technology, uh,
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  but certainly in healthcare as well is just the concept and,
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  and the leaps that generative AI has taken over the last, you know, six months,
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  I would say. Um, and I have a, I have a little bit of a different angle.
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  I think a lot of people focus on how it can do content creation, uh,
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  because that's how, you know,
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  most of the tools have been set up is kind of a chat interaction that creates
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  some content for me. You know, the, the struggle of a, um,
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  clinical informatics or health,
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  it has always been the amount of data that we create as clinicians, you know,
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  a lot of it's not normalized, um, or, um,
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  set up appropriately so we can actually unlock the potential for that for future
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  uses. Um, and I actually think that's one of the main, uh,
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  ways that we can really unlock that data by applying generative AI that can,
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  you know, drift across, um, you know,
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  data requirements to understand things in a much more, uh,
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  seamless or more human way than how we've been able to apply things like natural
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  language processing in the past.
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  So one example that we're looking at and actively have, uh,
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  across a few of our sites is ways that you can get to know your patients as
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  you're taking over their care in the hospital a little bit more quickly as a
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  physician or a nurse. You know, I'm,
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  I'm actually still a practicing hospitalist,
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  so I do inpatient care when I take over, you know, 20 patients, uh,
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  give or take a few, you know,
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  it's a tedious job of reviewing a lot of notes and finding the critical,
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  you know, values and if I miss something,
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  it could impact how I deliver care even if I was, you know,
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  trying to do my best. Um,
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  and so we've actually applied some generative AI technology that will help
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  generate a patient summary for me to kind of tee up the key past medical
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  history, current problems, you know, current, uh, medications they're receiving,
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  what consultants are following.
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  And before some of those data elements were really difficult to find cause they
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  were not discreet. Um, and this technology allows us to leverage that.
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  Other benefit of that is we can use things like that that are summarizing the
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  charts or encounters and we can actually use large language models and translate
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  that to different, uh, levels of comprehension, uh, across the, the healthcare,
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  you know, experience. So you could translate that to a different clinical role,
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  uh, let's say maybe one that's more pertinent to a physical therapist.
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  You could translate that to a patient or their family members, you know,
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  reading comprehension or, or you know, their, uh,
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  preferred language very quickly. And you know,
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  I think that's one of those examples where everybody wants to do that as a
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  clinician and provide that experience, but we're, we're not actually, um,
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  able to, you know, do that, um, you know, on the fly, um,
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  as well as maybe some of these technologies could do for our patients.
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  So I think it's a great way that we'll be able to better,
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  better serve our patients with this technology, but also unlock some of that,
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  you know, massive amounts of data, um,
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  that in some areas has been locked away in our systems, uh,
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  to really explain and get to know our patients and understand how we take care
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  of 'em better.
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  That's so fascinating to hear and definitely seems like a world where healthcare
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  is a lot more seamless and potentially, uh, better outcomes and,
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  and um, certainly something that is more enjoyable, although, you know,
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  it can still will have stressors, some stressors for sure. But, um,
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  definitely seems like there is a lot we can do in order to really improve that
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  patient and caregiver experience. So that's awesome to hear.
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  Absolutely.
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  Well, Jordan, thank you so much for joining us on the podcast today.
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  This has been a really fun conversation and we're excited to have you join us as
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  well at the, um, health IT Digital Health and Revenue Cycle event in October.
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  I think it's gonna be just a really fantastic, uh,
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  time there at the meeting and lots of these themes will come up into the
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  sessions and the discussions with you as well.
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  So looking forward to seeing you in person there.
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  Looking forward to it. Thank you so much.
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