Latest / Becker’s Healthcare Podcast / Dwight Raum, Executive Vice President and Chief Digital Information Officer at Rochester Regional Health

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Dwight Raum, Executive Vice President and Chief Digital Information Officer at Rochester Regional Health · Becker’s Healthcare Podcast

• 0:02
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• 1:01
  - This is Laura Dirdle with the Becker's Healthcare
• 1:03
  - podcast.
• 1:04
  - I'm thrilled today to be joined by Dwight
• 1:05
  - Rahm, executive vice president and chief digital information
• 1:08
  - officer at Rochester Regional Health. Dwight, it's a
• 1:11
  - pleasure to have you on the podcast today.
• 1:14
  - Good morning. Great to be here. Thanks for
• 1:16
  - having me.
• 1:17
  - Absolutely. Now I'm excited for our conversation because
• 1:20
  - I know there's some really interesting things you're
• 1:21
  - doing at Rochester Regional, so we'll dig into
• 1:23
  - that as well as your perspective on the
• 1:25
  - future. But before we dive in, can you
• 1:27
  - tell us a little bit more about yourself
• 1:29
  - and Rochester Regional Health?
• 1:31
  - Yeah. Very, very happy to share a bit
• 1:33
  - more about myself and background and and our
• 1:35
  - organization. So, again, I'm Dwight Rahm, chief digital
• 1:38
  - information officer at Rochester Regional Health. And I've
• 1:40
  - been here for about two and a half
• 1:42
  - years.
• 1:43
  - But I've been in health care for the
• 1:44
  - better part of twenty five years, including
• 1:47
  - long stints in an academic medicine and and
• 1:49
  - some startups along the way.
• 1:51
  - But when I came into Rochester Regional two
• 1:53
  - and a half years ago, it was really
• 1:54
  - with sort of this,
• 1:56
  - major drive towards transformation. You know, we as
• 1:59
  - an organization
• 2:01
  - are located in, Western Upstate New York and
• 2:04
  - we have a very large coverage area, about
• 2:06
  - nine hospitals.
• 2:07
  - We really cover the full continuum of care
• 2:09
  - across the entirety of the region.
• 2:11
  - And that includes large,
• 2:13
  - urban hospitals,
• 2:14
  - community hospitals, but also very, rural hospitals.
• 2:18
  - It's complemented by a really robust ambulatory network,
• 2:22
  - in addition to long term care and post
• 2:25
  - acute care facilities.
• 2:27
  - And that diversity of our our system and
• 2:29
  - the expanse and reach of that system means
• 2:31
  - that we have some unique challenges. You know,
• 2:33
  - the complexity of of the environment really drives,
• 2:37
  - a broad perspective when it comes to digital
• 2:39
  - and how we intend to use that.
• 2:42
  - So, you know, over the last two and
• 2:43
  - a half years, we've been really on this
• 2:45
  - journey of of transformation
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  - and using technology is underpinning a lot in
• 2:50
  - a lot of that transformation.
• 2:54
  - I love that. And I think, you know,
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  - having that technology backbone really can make a
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  - big difference as you're looking at all the
• 3:00
  - different ways that you need support to change
• 3:02
  - health care delivery and and become more patient
• 3:04
  - centric.
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  - Now I'm curious. Can you tell me a
• 3:07
  - little bit about,
• 3:09
  - the forces that you see powerfully shaping
• 3:12
  - digital health and IT within the system?
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  - What are you seeing today, and how do
• 3:16
  - you anticipate that will evolve over the next
• 3:17
  - year or so?
• 3:19
  - Yeah. I think we we kinda have to
• 3:21
  - start at the operating environment of of health
• 3:22
  - care, provider health care specifically right now. And
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  - it's, you know, very dynamic time.
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  - Hard to ignore the the major pressures that
• 3:30
  - are that are really changing and and reforming
• 3:33
  - the way health care operates.
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  - So we're, you know, with the results of
• 3:38
  - over the the implementation of the one beautiful
• 3:41
  - big bill, HR one, and and a lot
• 3:43
  - of the reforms that were,
• 3:45
  - included in that, you know, we're in a
• 3:47
  - sustained period of really doing a whole lot
• 3:49
  - more with, a lot less resources.
• 3:52
  - And I think a lot of those those
• 3:54
  - financial constraints aren't really episodic. These are structural
• 3:57
  - changes that will have
• 3:59
  - major impact on on how we provide care.
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  - And that will force prioritization,
• 4:04
  - discipline, and a lot more focus,
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  - on
• 4:07
  - ROI than I think historically health care has
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  - has brought to,
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  - to the evaluation of initiatives.
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  - I think the other major factors, you know,
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  - we
• 4:16
  - we're in a really unique
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  - demographic,
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  - cycle for the for The US where we
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  - have just a huge aging population.
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  - And that's just driving huge demand across every
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  - part of our system.
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  - And at the same time, we have this,
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  - you know, almost
• 4:32
  - flat or even in some cases declining workforce
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  - participation and and supply,
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  - to meet that demand. So, you know, there's
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  - this huge gap, you know, kinda yawning gap
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  - between
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  - supply and demand. And I think it's it's,
• 4:44
  - you know, it's manifesting in some really complex
• 4:47
  - ways.
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  - But the the long and short of it
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  - is I think that technology will have to
• 4:52
  - play a larger role in absorbing that that
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  - difference, that imbalance between the two.
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  - I think another factor
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  - is really the rise of AI. There's both,
• 5:02
  - you know, good and evil associated with AI.
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  - Obviously, from,
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  - you know, a a good perspective, the opportunities
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  - there are abundant.
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  - You You know, there's opportunity to bring forward,
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  - real optimizations
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  - in in the back end, the,
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  - back office functions
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  - of our operations and really take cost out
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  - and reduce complexity.
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  - But then I think if you look at
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  - some of the other opportunities,
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  - you know, around,
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  - you know, whether it's therapeutics or diagnosis,
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  - those are certainly there. But they're a lot
• 5:36
  - more risky and I think more challenging to
• 5:38
  - adopt and maintain and sustain within the system.
• 5:42
  - On sort of the dark side of AI,
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  - you know, the
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  - the the capabilities of AI are not just
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  - unique to the the application of efficiency and
• 5:52
  - and new and better ways of treating patients.
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  - They're also,
• 5:55
  - applied towards,
• 5:58
  - cyber attacks and information security. And I think
• 6:00
  - that's that's an an area that is is
• 6:03
  - going to rapidly develop,
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  - in the next, you know, I'd say twelve
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  - months.
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  - In a lot of ways, I think health
• 6:10
  - care is maybe not as prepared as as
• 6:12
  - it needs to be to to really deal
• 6:14
  - with that that onslaught of change.
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  - And I think the the last area, and
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  - this does sort of couple with with AI,
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  - and that's,
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  - you know, how are we as a as
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  - an industry
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  - going to deal with the the tension between
• 6:29
  - platforms and innovation?
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  - You know, we we're an epic shop.
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  - You know, we're very happy with with Epic
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  - and and the partnership that we have with
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  - them. But I think at the same time,
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  - there is this, you know, there's this tension.
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  - And it it can be good and productive,
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  - but how do you continue to innovate and,
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  - you know, do so in a way that
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  - is
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  - complimentary to your your platform decisions, but also
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  - manage that towards,
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  - you know, really doing new cutting edge things
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  - and and driving,
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  - you know, the the cause forward. I think
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  - there's just tremendous opportunity, but that is, I
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  - think, a shaping function and shaping,
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  - you know, element of our operating environment.
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  - That makes a ton of sense. And, you
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  - know, I I appreciate you talking about all
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  - of the opportunities there are with AI on
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  - the operational side, as well as some of
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  - the ways that you can build into the
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  - clinical workflows as well, but also some of
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  - the risks and the challenges. When you look
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  - at having innovation,
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  - and moving forward with new technology,
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  - there's always, areas that could not go quite
• 7:31
  - as planned or are thinking about cybersecurity
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  - and what that really means,
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  - for patient safety in data in the future.
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  - From your perspective, how do you balance
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  - this, the tension between trying to move quickly
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  - and be innovative and adopting technology with also
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  - wanting to make sure you've got the right
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  - governance in place that
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  - keeps you safe but doesn't slow things down
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  - too much.
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  - Yeah. I mean, so we've we've created a
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  - dedicated governance body for AI, and it it
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  - really does try to take this strategic view
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  - of how and where we'll apply AI
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  - with sort of this notion around full life
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  - cycle. Right? So as you as you bring
• 8:09
  - on a new, opportunity for from an AI
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  - perspective,
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  - you know, you have to do so in
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  - a way that's controlled and and kind of
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  - contained and piloted,
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  - with very clear success measures and and metrics.
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  - And, you know, what is the what's the
• 8:23
  - articulation of the story? Is it financial? Is
• 8:25
  - it is it quality and safety? Is it
• 8:28
  - workforce burden reduction? You know, what are the
• 8:30
  - things that you're actually trying to achieve with
• 8:32
  - it? But then also, you know, thinking about
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  - what is in the portfolio in terms of
• 8:36
  - existing capabilities. Is this competing with something like
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  - that? How do you balance that out? So
• 8:41
  - really our our AI center of excellence is
• 8:43
  - the vehicle that we use to not only
• 8:45
  - govern, but also that all those different dimensions
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  - of consideration
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  - and use that to, hold ourselves accountable to
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  - how and when we will make those investments
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  - and then curate them over the over the
• 8:57
  - entirety of their life cycle.
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  - Got it. That makes a ton of sense.
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  - And, you know, I appreciate that very clear
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  - and strategic view of how you're thinking about
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  - everything and then taking into account the quality,
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  - safety, financial aspects of, impacts when you're looking
• 9:13
  - at technology and,
• 9:15
  - being accountable for what that all means.
• 9:18
  - Now I wanted to zero in on a
• 9:20
  - project or initiative that you've done in the
• 9:22
  - last year or so. What's just a big
• 9:24
  - swing that you took that really paid off?
• 9:26
  - What did you do, and what were the
• 9:27
  - results?
• 9:29
  - Yeah. I mean, I think the the the
• 9:31
  - big swing for us has really been Ambient.
• 9:33
  - And I I suspect suspect many of the
• 9:35
  - listeners out there here in the space have
• 9:37
  - had similar experiences. But, you know, going back
• 9:39
  - a year ago, we were just coming out
• 9:40
  - of a pilot, where we had a limited
• 9:43
  - number of users,
• 9:44
  - using ambient scribes to
• 9:46
  - really, enhance their their their notes.
• 9:50
  - And that that was a early success. Right?
• 9:53
  - We were seeing really positive signal out of
• 9:55
  - the evaluation of of that that pilot that
• 9:58
  - we had done. But then we made the
• 9:59
  - decision to go big and and really roll
• 10:01
  - it out to to the enterprise.
• 10:04
  - So now we're not just quite a year
• 10:05
  - later. We're well over, a thousand active users,
• 10:08
  - and we're seeing just really great returns on
• 10:11
  - that. You know, sixty seven percent of our
• 10:13
  - clinicians are reporting
• 10:15
  - improved work satisfaction. You know, so the burnout
• 10:17
  - factor has really been diminished.
• 10:19
  - We're seeing two and a half hours a
• 10:21
  - week, in reclaim time. So they're really reducing
• 10:24
  - the amount of time that they're they're they're
• 10:25
  - spending in notes. The quality of the notes
• 10:27
  - has has really improved as well.
• 10:30
  - And then also, you know, you know, huge
• 10:32
  - reductions in in pajama time. So after hours
• 10:34
  - work has has really,
• 10:36
  - diminished as well.
• 10:38
  - And this was a bet. Right? I mean,
• 10:40
  - you know, I don't think we we anticipated
• 10:42
  - that we could get to quite to a
• 10:43
  - thousand users as quickly as we did. But
• 10:46
  - I think it speaks to
• 10:48
  - that partnership needed from a technology standpoint to
• 10:51
  - work directly with clinicians and
• 10:53
  - engage with them directly at the elbow to,
• 10:55
  - you know, show how the technology can be
• 10:58
  - an enabler and not just something that is
• 11:00
  - thrust upon them as another burden. And, you
• 11:03
  - know, this is one of those few success
• 11:05
  - stories in,
• 11:06
  - in health care IT where, you know, I've
• 11:09
  - I, over my career, had few opportunities to
• 11:12
  - have clinicians really banging down our door to
• 11:14
  - adopt something. This is one of those cases
• 11:16
  - where,
• 11:17
  - the technology really was in just such demand
• 11:20
  - because of the capability it brought that we
• 11:22
  - really did literally have positions,
• 11:24
  - asking for it, requesting it,
• 11:26
  - you know, to to be a part of
• 11:28
  - of the program as early as possible.
• 11:32
  - That's incredible to hear. And I know, so
• 11:34
  - important to have those types of relationships between
• 11:37
  - the clinical and technical teams,
• 11:39
  - going through projects like this. So I'm curious.
• 11:41
  - Could you talk one bit deeper about what
• 11:43
  - that looked like for the clinicians and the
• 11:46
  - technology leaders to be working,
• 11:48
  - together and and so closely and making sure
• 11:51
  - this was,
• 11:52
  - adopted and implemented in a way that benefited
• 11:54
  - both sides. I'm just curious. Is there anything
• 11:57
  - differently that you did to build that relationship
• 11:59
  - or foster those connections that made it work
• 12:02
  - so well?
• 12:03
  - Yeah. I mean, so this was this was
• 12:04
  - very much a joint effort with our chief
• 12:06
  - medical officer and myself at the time. And,
• 12:09
  - you know, so approaching and going into this
• 12:12
  - pilot really with the intention around burden reduction
• 12:15
  - was it was a key focus.
• 12:17
  - And then we we activated our health informatics
• 12:20
  - team as well. So there are three or
• 12:22
  - four, medical directors with our health informatics team
• 12:25
  - that were assigned to essentially work at the
• 12:28
  - elbow with our our providers to understand what
• 12:31
  - their experience
• 12:33
  - was, how we could use the technology to,
• 12:36
  - improve that experience and and really engage in
• 12:38
  - that that back and forth of adoption,
• 12:41
  - to ensure that we, you know, could,
• 12:44
  - demonstrate success early.
• 12:46
  - The other dimension here is health informatics became
• 12:50
  - very,
• 12:51
  - facile with the data. So, you know, using
• 12:54
  - data that we are pulling out of the
• 12:55
  - system to understand how users were struggling, how
• 12:58
  - they were succeeding, and then using that to
• 13:00
  - guide
• 13:01
  - interventions.
• 13:02
  - So this data driven approach to understanding what
• 13:05
  - was actually happening from an adoption standpoint and
• 13:07
  - then adapting,
• 13:09
  - based on what we're learning from from those
• 13:11
  - data.
• 13:12
  - That that feedback loop, that cycle, I think,
• 13:14
  - has been absolutely critical to us getting to
• 13:16
  - where we have been or where we are
• 13:18
  - now with with Ambient.
• 13:21
  - I love it. I I think that makes
• 13:22
  - a lot of sense, and it's cool to
• 13:24
  - hear about how you were able to bring
• 13:26
  - that cycle together in those
• 13:28
  - two departments to make this work. Now, one
• 13:31
  - more question around this project, but I know,
• 13:34
  - you know, getting users on board and adoption
• 13:37
  - is obviously,
• 13:38
  - a clear measure and mark of success. But
• 13:41
  - how are you thinking about success going forward?
• 13:43
  - Obviously, these technologies are huge investments. So how
• 13:47
  - do you continue to measure whether they're being
• 13:50
  - effective and and continue to see as the
• 13:52
  - technology evolves,
• 13:54
  - you know, whether it's going to be something
• 13:56
  - that continues to be super beneficial for you.
• 13:59
  - Yeah. I mean, I I think it, you
• 14:01
  - know, it does it does start with the
• 14:03
  - end in mind. Right? Where do you wanna
• 14:05
  - get to? How do you wanna achieve it?
• 14:06
  - What do you back walk the measurements into
• 14:08
  - that for?
• 14:09
  - And then you build the the measurements, you
• 14:12
  - know, program regime around that.
• 14:14
  - So that sounds very, you know, business like,
• 14:17
  - and I think it is. But it it
• 14:18
  - sort of it speaks to the discipline that
• 14:20
  - you need to have around the evaluation and
• 14:22
  - the opportunity of that,
• 14:24
  - the evaluation of the opportunity
• 14:26
  - and how you're going to put it through
• 14:28
  - its paces, and to be really disciplined
• 14:31
  - about that. So I I think the you
• 14:33
  - know, if I'm gonna riff here a moment
• 14:36
  - about the opportunities, I think, as I said
• 14:38
  - earlier in my comments, so much,
• 14:40
  - friction that we can take out of the
• 14:42
  - back office functions
• 14:44
  - and really streamline using,
• 14:46
  - you know, AI technology specifically.
• 14:48
  - And a lot of those are just sort
• 14:50
  - of they're just do it. Right? They're they're
• 14:52
  - kinda obvious things that as you as you
• 14:54
  - start to,
• 14:56
  - implement the technology
• 14:57
  - and you you measure it, you can see
• 15:00
  - right away the impact and, you know, have
• 15:02
  - a almost immediate return on on investment there.
• 15:05
  - I think for some of the other ones,
• 15:06
  - there will be there will be articles of
• 15:08
  - faith that we have to take. You know?
• 15:10
  - And in a lot of in a lot
• 15:11
  - of cases, that will be informed by what
• 15:13
  - peers are doing,
• 15:14
  - and also our own evaluation of the technology
• 15:17
  - and how we think it may have application
• 15:19
  - here. But even in those cases, we have
• 15:21
  - to, I think, have that discipline around measurements
• 15:24
  - and being very intentional with, you know, starting
• 15:27
  - at the end. How do we want this
• 15:28
  - to have real impact?
• 15:30
  - And then I think the third sort of
• 15:32
  - interesting
• 15:33
  - approach that I'm seeing more and more willingness
• 15:35
  - of vendors to take on is, will they
• 15:37
  - go at risk?
• 15:38
  - You know,
• 15:39
  - in many cases, it's not it's not the
• 15:42
  - finances that that are really the true expense.
• 15:44
  - It's the opportunity cost for us. You know,
• 15:47
  - we have limited bandwidth to take on,
• 15:50
  - pilots and to try new things.
• 15:52
  - Our our providers, our clinicians have limited bandwidth
• 15:55
  - to absorb and and learn new things. So
• 15:57
  - we'd be very judicious about what we select.
• 16:00
  - But, you know,
• 16:01
  - in those scenarios where a a vendor,
• 16:05
  - has enough confidence in their tools that they're
• 16:07
  - willing to go at risk, that at least
• 16:09
  - eliminates one of the financial constraints that may
• 16:11
  - be limiting our ability to to adopt or
• 16:14
  - trial something.
• 16:15
  - I think across all those, I'm just gonna,
• 16:17
  - again, come back and hammer the point home,
• 16:19
  - that discipline and starting with the end in
• 16:21
  - mind is is really critical.
• 16:24
  - That makes a ton of sense. And, you
• 16:26
  - know, that framework, I can imagine really puts
• 16:29
  - you in a position where,
• 16:30
  - you can smartly select the right partners and
• 16:33
  - then roll out the technology and and see
• 16:36
  - results,
• 16:37
  - coming through. I can imagine typically as you
• 16:39
  - would would want them to or at the
• 16:41
  - very least have the opportunities to make changes
• 16:43
  - so you can achieve those results. So, that
• 16:45
  - makes a ton of sense, and thank you
• 16:47
  - so much for sharing that with us more
• 16:48
  - broadly.
• 16:50
  - Now that you've gotten,
• 16:52
  - the ambient technology in place and rolling it
• 16:54
  - out to the whole company, what is the
• 16:56
  - next important problem that you're trying to solve
• 16:58
  - with either AI or technology?
• 17:02
  - Yeah. I think,
• 17:04
  - it it kinda comes back to where I
• 17:06
  - started with that supply
• 17:07
  - demand gap that I identified.
• 17:11
  - And I think it's real for for not
• 17:13
  - only us, but with almost all of the
• 17:15
  - industry at this point.
• 17:18
  - Technology, as I said earlier, has to fill
• 17:20
  - that gap.
• 17:22
  - And if I can if I can digress
• 17:23
  - for a moment here and tell a little
• 17:24
  - bit of a story around RH. You know,
• 17:26
  - as I said, when I came in, we
• 17:27
  - were we've been in transfer mode the transformation
• 17:30
  - mode since
• 17:31
  - I've I've been here. And and there have
• 17:33
  - kinda really been three or there are now
• 17:35
  - really what I consider three phases of that
• 17:37
  - transformation. The first one was about
• 17:39
  - financial transformation and and getting the organization back
• 17:42
  - to, you know, financial stability and and margin,
• 17:45
  - positive margin.
• 17:47
  - I think the second one was really around,
• 17:49
  - establishing
• 17:50
  - governance and structure across the system
• 17:53
  - to create an create
• 17:56
  - an integrated delivery network. And then I think
• 17:59
  - this third sort of phase is really the
• 18:01
  - taking that financial discipline from phase one, taking
• 18:05
  - that
• 18:06
  - governance
• 18:07
  - restructuring and integration of the system from a
• 18:10
  - leadership standpoint
• 18:11
  - into
• 18:12
  - the technology realm and manifesting it within our
• 18:15
  - systems.
• 18:16
  - So truly getting into system integration,
• 18:18
  - I think, is the is the the big
• 18:21
  - sort of nugget in front of us of
• 18:23
  - of opportunity.
• 18:25
  - Following that though are and and maybe even
• 18:28
  - concurrent with that is all of the opportunity
• 18:30
  - around application of AI.
• 18:32
  - So
• 18:34
  - it's really around getting back to basics
• 18:37
  - with our
• 18:38
  - our integrated,
• 18:40
  - technologies,
• 18:41
  - ensuring that we have one workflow
• 18:43
  - for,
• 18:44
  - the appropriate functions
• 18:46
  - and ensuring that we have
• 18:49
  - the ability to integrate and operate as a
• 18:51
  - single system, not a series of hospitals
• 18:54
  - actually having true integration across that, that entire
• 18:57
  - continuum of care.
• 19:01
  - Got it. And, you know, that's such a
• 19:03
  - a big, problem and something, as you said,
• 19:06
  - you know, so many health systems are trying
• 19:08
  - to figure out, looking at accessibility
• 19:10
  - and how they can expand their capacity for
• 19:12
  - serving
• 19:13
  - patients and and and, becoming more
• 19:16
  - accessible as well to their community.
• 19:19
  - And I I'm curious,
• 19:20
  - you know, you also mentioned
• 19:22
  - just kind of what this integration
• 19:25
  - takes,
• 19:26
  - in order to get health systems fully,
• 19:29
  - you know,
• 19:30
  - the the backbone of technology,
• 19:33
  - within the system. So,
• 19:35
  - where do you see some of these
• 19:37
  - things playing out over the next year? How
• 19:39
  - do you anticipate your teams and and role
• 19:42
  - might change as you're looking to
• 19:44
  - more broadly solve some of these issues and
• 19:46
  - and, create the type of organization
• 19:48
  - that will be the health system of the
• 19:50
  - future?
• 19:51
  - Yeah.
• 19:52
  - Great, great question. And I think,
• 19:55
  - you know,
• 19:56
  - in in so many ways, it's actually not
• 19:58
  - about technology
• 19:59
  - at at all.
• 20:01
  - I I think it's it's really around it's
• 20:03
  - about change management and how can organizations
• 20:06
  - adapt quickly,
• 20:08
  - and learn. You know, when you look at
• 20:10
  - where we are, we're
• 20:12
  - at a unique time. Right? The
• 20:14
  - the speed of innovation,
• 20:16
  - the rise of AI, the quality quantity and
• 20:19
  - the quality of the data that we have
• 20:20
  - access to.
• 20:22
  - Quite frankly, the technology
• 20:24
  - is outrunning our ability outpacing our ability to
• 20:27
  - absorb the change.
• 20:29
  - And I think the
• 20:31
  - the organizations
• 20:33
  - that will be successful
• 20:34
  - and,
• 20:36
  - you know, I I put RH right into
• 20:38
  - the mold of that
• 20:40
  - of this, you know, sort of challenge in
• 20:42
  - front of us is the organizations that will
• 20:44
  - be successful
• 20:46
  - will have the ability to adapt and change
• 20:48
  - rapidly
• 20:49
  - and accept,
• 20:51
  - you know, the the enhancements
• 20:52
  - of AI and the enhancements of technology integration.
• 20:56
  - And understand that,
• 20:58
  - these aren't things that are are being done
• 21:00
  - to them anymore. Right? This is this is
• 21:03
  - the application technology in support of
• 21:06
  - and done in conjunction with,
• 21:09
  - and I'm gonna come back to my comments
• 21:10
  - earlier around the importance of of health informatics
• 21:13
  - and
• 21:14
  - that sort of juxtaposition of technology with with
• 21:17
  - clinicians.
• 21:18
  - They play an incredibly important role there of
• 21:21
  - helping to be the
• 21:23
  - the the guides, navigators
• 21:25
  - of that change.
• 21:26
  - And the organizations that become really successful will
• 21:30
  - figure out how to do this at scale.
• 21:32
  - You know, the at the elbow,
• 21:34
  - experience
• 21:35
  - that we've we've deployed quite successfully
• 21:38
  - for our Ambient
• 21:40
  - will will work well, but, you know, it's
• 21:42
  - always gonna be constrained by
• 21:44
  - the number of of warm bodies we can
• 21:46
  - put into to that experience, right, to actually
• 21:49
  - put somebody at the elbow,
• 21:51
  - with clinicians.
• 21:53
  - And those organizations that can figure out how
• 21:55
  - to scale change, obviously, with the the application
• 21:58
  - of people, but also through the use of
• 21:59
  - technology,
• 22:00
  - hyper personalization,
• 22:02
  - using data,
• 22:03
  - to understand how providers are interacting with the
• 22:06
  - system
• 22:07
  - well or maybe, you know, for opportunities improvement.
• 22:10
  - Those who can systematize
• 22:11
  - and integrate that
• 22:12
  - into a feedback loop that can actually
• 22:15
  - drive virtuous change. I think those those are
• 22:18
  - really be the the the keys of success
• 22:20
  - for the future.
• 22:24
  - I love that. I I think being able
• 22:26
  - to power what you're doing, obviously, with technology,
• 22:29
  - but then
• 22:31
  - understanding the people, change management, the ability to
• 22:33
  - really, inject that energy into what what it
• 22:37
  - means to have the technology behind you makes
• 22:39
  - a big difference.
• 22:41
  - Before we wrap up here, I I wanted
• 22:43
  - to know what are you most curious about
• 22:44
  - for the future?
• 22:47
  - Yeah. I think,
• 22:48
  - you know, we we've entered this period of
• 22:50
  - time where we have, I think, exponential learning.
• 22:54
  - The the technologies are actually enabling us to
• 22:56
  - learn at a pace that we we could
• 22:58
  - never have done,
• 22:59
  - you know, even five years ago now. But
• 23:01
  - we're still sitting in a landscape that is,
• 23:04
  - you know, regulated,
• 23:07
  - managed,
• 23:09
  - individuals
• 23:10
  - who are are sort of dealing with,
• 23:12
  - the limitations of the human mind kind of
• 23:14
  - thing.
• 23:15
  - I think, you know, what's what I'm really
• 23:17
  - curious about is how this is all going
• 23:19
  - to sort of to roll out. Right? I
• 23:21
  - mean, there's a lot of tension here between
• 23:24
  - what the technology brings to the table and
• 23:26
  - and how quickly are
• 23:28
  - all those different aspects of regulation, organization,
• 23:31
  - and individuals can adapt to it.
• 23:35
  - And, you know, I think that has all
• 23:36
  - sorts of implications societally, you know, and and
• 23:39
  - what that may mean for,
• 23:42
  - generations,
• 23:43
  - that follow us, fast follow us.
• 23:46
  - But also, you know, what does it mean
• 23:47
  - in terms of our values as a society?
• 23:50
  - So I
• 23:52
  - I don't have the answers. I just think,
• 23:53
  - you know, as a as a student of,
• 23:56
  - of human nature and, you know, a citizen
• 23:59
  - of the world and in this country, it's
• 24:01
  - it's an interesting time to really see how
• 24:02
  - these things will manifest.
• 24:05
  - I absolutely agree. I think, there's so much
• 24:08
  - possibility and potential, but it it does,
• 24:11
  - inflict a good amount of change on, you
• 24:13
  - know, how we experience the world and think
• 24:16
  - about the world and relate to each other
• 24:17
  - too. So,
• 24:18
  - I I love that.
• 24:23
  - Dwyane, thank you so much for joining us
• 24:24
  - on the podcast today. This has been such
• 24:26
  - a fun conversation, you know, really thought provoking
• 24:29
  - as well as,
• 24:30
  - fascinating to hear about everything you're doing at
• 24:32
  - Rochester Regional, and I'm looking forward to continuing
• 24:34
  - this discussion as well at our,
• 24:36
  - health IT and revenue cycle conference coming up
• 24:39
  - in September. I know you'll be speaking on
• 24:41
  - a panel and, you know, digging into these
• 24:43
  - themes more deeply. So I'm looking forward to
• 24:45
  - seeing you there.
• 24:47
  - Laura, thank you very much. Very much enjoyed
• 24:49
  - our conversation too.