Latest / Becker’s Healthcare Podcast / Rajiv Pramanik, MD, CIO and CHIO at Contra Costa Health

Transcript

Rajiv Pramanik, MD, CIO and CHIO at Contra Costa Health · Becker’s Healthcare Podcast

• 0:02
  - There's a version of AI in health care
• 0:04
  - that lives mostly in press releases,
• 0:06
  - pilot programs, partnership announcements,
• 0:09
  - theoretical
• 0:10
  - use cases.
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  - And then there's the version that lives in
• 0:13
  - the work, the CIO trying to get a
• 0:15
  - model into production without breaking a dozen workflows,
• 0:19
  - the revenue cycle leader weighing automation against accuracy,
• 0:22
  - the CISO who knows that every new integration
• 0:25
  - is a new attack surface.
• 0:28
  - Becker's eleventh annual IT and revenue cycle conference
• 0:31
  - is built for the people doing that work.
• 0:33
  - More than 2,500
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  - executive level attendees,
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  - 600 plus speakers,
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  - and four days of sessions designed around the
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  - real operational questions behind
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  - AI, cybersecurity,
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  - revenue cycle performance, and digital health.
• 0:48
  - Join us September 14 through the seventeenth.
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  - For the agenda and event details, visit beckershospitalreview.com
• 0:55
  - and click on the events tab in the
• 0:57
  - upper right.
• 1:00
  - This is Laura Dirdo with the Becker's Health
• 1:03
  - Care podcast.
• 1:04
  - I'm thrilled today to be join joined by
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  - doctor Rajeev Pramanik, who's the CIO and chief
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  - health informatics officer for Contra Costa Health.
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  - Doctor Permanik, it's a pleasure to have you
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  - on the podcast today.
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  - Likewise. Nice to meet you.
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  - Absolutely. Now I'm I'm excited for our conversation
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  - because I know we've got a lot to
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  - talk about. So much happening in the health
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  - care technology space. It is truly a transformative
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  - time. But before we dig in, can you
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  - tell me a little bit more about yourself
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  - and the health system?
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  - Yeah. Thank you.
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  - So we're Contra Costa Health, where I am
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  - the CIO, CHIO, and oversee the technology,
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  - and informatics aspects.
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  - Our system is a safety net provider and
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  - a health plan. We're outside of San Francisco,
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  - in a county,
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  - and we provide both medical be and behavioral
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  - health services and run the Medicaid health plan
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  - that serves about a quarter million lives here
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  - in the county.
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  - Well, it's great to hear. And, you know,
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  - such an important,
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  - patient population that you serve. And, you know,
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  - given your position, what are some of the
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  - most powerful forces that you're seeing right now
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  - shaping the digital health and IT at your
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  - organization?
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  - How do you anticipate that will evolve over
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  - the next year or so?
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  - Yeah. There's a, I mean, a lot of
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  - lot of forces. I mean, a day can't
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  - go by to, that you don't hear about
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  - AI and how it may affect and transform
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  - things.
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  - But in the short term, our primary objectives
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  - are around,
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  - addressing the the financial
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  - challenges with HR one, especially in the safety
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  - net Medicaid population,
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  - and,
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  - kind of the revenue revenue hits we anticipate.
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  - So this year is basically
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  - a bin and continues to be
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  - on how to get more cost efficiencies,
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  - how to,
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  - figure out where we're,
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  - you know, where we can generate more revenue,
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  - or more efficiently generate the same revenue.
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  - Absolutely. And, you know, that seems to be
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  - like such a,
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  - huge challenge for so many organizations when they're
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  - looking at, you know, where the future is
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  - headed and trying to figure out how they're
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  - going to, continue to bring that revenue in.
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  - What are some of the things that you
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  - are considering or talking about when you're looking
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  - at potential new revenue sources or,
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  - trying to identify ways that,
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  - you're gonna operate a little bit differently in
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  - the future?
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  - I mean, we're we're really looking at cost
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  - efficiencies,
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  - and automation,
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  - where we're seeing that where we do repetitive
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  - tasks, three or two or three people,
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  - kind of in the EHR configuration
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  - or security,
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  - etcetera. We're looking at ways we can automate
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  - that and get those people to do, more
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  - complex
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  - work,
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  - and and more oversight
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  - from a technology
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  - perspective. We're also looking at trying to move
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  - the work closer to where the information is.
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  - So,
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  - things like, adding people, etcetera, like moving that
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  - to the operational areas where they know who
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  - they're adding. And we have some governance
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  - and infrastructure we provide.
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  - But historically, we would get that info, put
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  - it in, have them check stuff, you know,
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  - go back over it, etcetera. But now if
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  - we get it right to the actual people
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  - who hold that info, we can try to
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  - make that faster, quicker,
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  - and more accurate.
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  - So that's on the efficiency perspective. We're looking
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  - at redundancies.
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  - We work with, you know, being a both
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  - payer and provider,
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  - and and part of a a larger county
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  - system.
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  - We have, overlapping
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  - technologies that we're looking to coordinate and improve
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  - and decrease,
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  - vendors,
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  - decrease potentially Swiss whole type security issues because
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  - different people are looking at different security, etcetera.
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  - So there's a lot of stuff we're doing
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  - trying to trying to just simplify and organize.
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  - Simple things that the number of SKUs for
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  - the laptops for almost 6,000 employees. Right?
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  - We had a big catalog. Do we really
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  - need a big catalog for laptops?
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  - I don't think so. So make that more
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  - easy, more efficient, and then the docking stations
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  - as a result will be more simple and
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  - work more efficiently. Think little things like that
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  - are really gonna hopefully affect our and improve
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  - our bottom lines.
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  - Absolutely. I I think you just really hit
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  - the nail on the head in terms of
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  - all the different ways that,
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  - there are opportunities
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  - out there in most organizations to find those
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  - efficiencies, to find the simplifications,
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  - and, you know, really put yourself in a
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  - strong position,
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  - to weather whatever is coming up next, especially
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  - with so much uncertainty right now in the
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  - health care space.
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  - I'm curious. Could you tell us about a
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  - a big swing that you took in the
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  - last year or so,
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  - something new that you tried potentially that paid
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  - off?
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  - What did you do, and what were the
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  - results?
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  - This is like the moonshot discussions. I know
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  - they're they sound great, but, I mean, over
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  - the last couple years, we've we've transformed our
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  - kind of infrastructure
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  - and approach to development and configuration
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  - to be agile.
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  - I don't know if that's a a moonshot
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  - or a large,
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  - but it was a large transformative
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  - effort to go from kind of this waterfall.
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  - We plan projects that are gonna be eighteen
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  - months to two week cycles and tracking that,
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  - making sure they're happening, and having closer oversight.
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  - And so that's been a big transformation
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  - from the
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  - IT. I think our operations
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  - and delivery provider pair, the actual businesses are
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  - seeing that. They're more involved. They're seeing where
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  - projects are, and they're also being able to,
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  - get a better product and an idea what
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  - the product is rather than at the end.
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  - So that that's been a big transformation that
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  - we were you know, we've been doing now
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  - and done about a year ago.
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  - As far as, obviously, everybody wants to hear
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  - about AI things, we have done things that
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  - are proven, are working in other organizations
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  - like ambient documentation tools, support our physicians and
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  - other providers.
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  - We've done some automation with our ticketing systems,
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  - so we don't have, like, operators having to
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  - assign. So our tier one ticketing is automated.
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  - But I don't think any of those are,
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  - like, sexy moonshots.
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  - So
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  - but they're just simple things,
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  - that that we wanted to do over time
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  - that's really coming together and letting us be
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  - more agile and also more responsive,
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  - to our businesses.
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  - Absolutely. And, you know, it's oftentimes those unsexy
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  - things that can make the biggest impact,
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  - or most important. And, you know, when you
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  - look at these changes that,
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  - you've been making bringing in whether it's the
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  - ambient technology or or trying to figure out
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  - how,
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  - you know, you become that agile organization.
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  - What is the change management on the people
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  - side been like? Can you tell me a
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  - little bit about, you know, what you've been
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  - able to do to bring people along and
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  - really put them in a strong position to
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  - actually incorporate and implement the things that you're
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  - talking about?
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  - Yeah. I I think
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  - because we're doing the agile, that requires a
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  - lot more interaction with your customers.
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  - Developing a better relationship
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  - with the customers is giving our staff a
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  - better idea of how integral and important they
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  - are
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  - to everybody.
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  - And that really makes them then be aware.
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  - It's like empathy happening.
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  - An example is when you're disassociated,
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  - you can things have road rage. In separate
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  - cars, you can get angry at each other.
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  - You don't know that other car or driver.
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  - Versus if you're just sitting next to them
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  - and you know them, you're not likely gonna
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  - get as angry. You are aware of what
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  - they need. They're aware of what you need,
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  - and you're more coordinated and cohesive as you
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  - move forward. And I think having that agile,
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  - more rapid iterative product cycles
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  - are really helping us get there,
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  - and really helping at least our staff in
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  - technology and informatics
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  - be more aware, more responsive, and also happier
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  - because they're seeing their products,
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  - you know, really, come to life.
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  - We're also having, you know, more more visits.
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  - Like, our staff isn't at some back office
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  - just sitting there doing what they're told. They're
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  - becoming curious. They're aware of the problems, and
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  - they themselves may be coming up with solutions
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  - because they're they really know the bigger picture
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  - rather than here's a report. Write it. We'll
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  - validate it. It's like, what's the reason for
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  - this report? Let's think through this. There may
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  - be other ways we can get this that's
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  - more informat that more,
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  - helpful to the end user. And the end
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  - user doesn't know what's out there either. So
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  - it's really that kind of coordinated cohesive,
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  - effort with the agile system that's helping us.
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  - That's helpful to understand. Thank you so much
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  - for digging a bit deeper there. Now I
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  - know we've touched a little bit on on
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  - AI, but what is, you know, one of
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  - the most important
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  - problems that you're trying to solve with either
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  - AI or technology today? I can imagine it's
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  - always evolving and moving target.
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  - But but what are some of the things
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  - that are are coming up or bubbling up,
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  - most recently that you're focused on?
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  - I mean, there's a there's both
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  - understanding the rapid regulatory changes and framework,
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  - and establishing good governance.
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  - You know, more recently, for example, you not
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  - only have to look at the model and
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  - how it works, make sure it's not biased.
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  - Now we have to look at drift. We
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  - have to look
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  - at auditing and annual audits and review and
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  - establishing
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  - that framework from the onset. Right? We are,
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  - a smaller organization. We're not an academic health
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  - center.
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  - So our our kind of steps into AI
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  - have been more technology,
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  - side of things,
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  - automation,
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  - looking at sentiment analysis of recordings,
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  - simple things like that. We are, doing some
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  - hard data science things, and those,
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  - those have kind of various levels of of
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  - success.
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  - So on those regions, we're kind of stepping
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  - back and seeing what our partners,
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  - both in the academic world, but also the
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  - large vendor partners are seeing proven and working
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  - before we are,
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  - kind of taking that on. We're also doing
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  - simple kind of, assistant
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  - type augmented
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  - augmentation type AI,
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  - you know, for as far as,
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  - security,
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  - information security tools,
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  - and also just kind of administrative
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  - co pilot, simple things like that.
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  - We're really seeing a lot of hype around
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  - some of these things.
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  - Also so,
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  - you know, that's where we're we're hey. We
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  - can't we can't do this independent of others.
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  - We're not gonna solve it ourselves. Let's see
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  - where it goes.
• 11:42
  - That makes a lot of sense. And, you
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  - know, it's just fascinating to,
• 11:46
  - kind of see all of the ways that
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  - the technology is evolving. But you're right, you
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  - know, in in trying to figure out the
• 11:52
  - governance and,
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  - understanding
• 11:55
  - what guardrails you need to put on and
• 11:57
  - and, you know, deeply consider before flipping the
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  - switch on any of these types of technologies,
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  - can really make a big difference.
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  - Before we wrap up here, I'm curious, what
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  - are you most curious about for the future?
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  - Oh, man. So I I I kind of,
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  - have a schizophrenic
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  - view on it. Some days, if I'm if
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  - I'm optimistic, I'm very optimistic. I think AI
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  - will, you know, really help us solve some
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  - of the problems. And then some days, I'm
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  - more cynical and pessimistic like, hey,
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  - whose problems is it gonna solve? The the
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  - technology and if they're sentient versus our problems.
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  - But I'm I'm really today is one of
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  - the optimistic days,
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  - and and I I do think that if
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  - we're using this right and the technology, we
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  - can really help. It's similar to,
• 12:43
  - many technology things. They've you know, we go
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  - up and down, but at the end, it
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  - really helps us in a positive way.
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  - And and I'm hopeful for AI to do
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  - that too in the health care field.
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  - I love it. And thank you so much
• 12:59
  - for joining us on the podcast today. This
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  - has been such a, great conversation. I I
• 13:04
  - really appreciate your time and expertise and look
• 13:07
  - forward to connecting with you again soon.