Latest / Becker’s Healthcare Podcast / Sri Adusumalli on AI, Digital Health and Transforming Care Delivery
Transcript
- 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.
- 0:11- 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
- 0:35- executive level attendees,
- 0:37- 600 plus speakers,
- 0:39- and four days of sessions designed around the
- 0:41- real operational questions behind
- 0:44- AI, cybersecurity,
- 0:45- revenue cycle performance, and digital health.
- 0:48- Join us September 14 through the seventeenth.
- 0:51- For the agenda and event details, visit beckershospitalreview.com
- 0:55- and click on the events tab in the
- 0:57- upper right.
- 0:59- This is Laura Dirdo with the Becker's Healthcare
- 1:01- podcast.
- 1:02- I'm thrilled today to be joined by doctor
- 1:04- Sari Adusamali,
- 1:05- vice president and chief health information officer at
- 1:07- Penn Medicine, as well as a practicing cardiologist.
- 1:10- Doctor Adusamali, it's a pleasure to have you
- 1:12- on the podcast today.
- 1:13- Laura, so great to join you. Thanks so
- 1:15- much for the for the time and the
- 1:16- opportunity.
- 1:18- Absolutely. Now I think this will be a
- 1:20- lot of fun. I know there's a lot
- 1:21- of things going on at Penn Medicine, and
- 1:23- certainly, it'll be great to hear,
- 1:25- about that and then how you're thinking about
- 1:27- the future. But before we dive in, can
- 1:28- you tell us a little bit more about
- 1:30- yourself and the organization?
- 1:32- Sure. Yeah. So,
- 1:34- as you mentioned, my name is Sridu Smiley.
- 1:36- I am the, vice president and chief health
- 1:38- information officer at Penn Medicine.
- 1:41- I'm a practicing cardiologist. I see patients in
- 1:44- the inpatient, outpatient,
- 1:45- procedural, and imaging settings,
- 1:47- And,
- 1:49- I work here at Penn Medicine, and we
- 1:51- are
- 1:52- a a health system academic medical center, consists
- 1:56- of seven hospitals
- 1:58- as well as hundreds of ambulatory
- 2:01- facilities
- 2:01- across,
- 2:02- New Jersey,
- 2:04- Pennsylvania, and soon to be Delaware as well.
- 2:06- And,
- 2:07- we have a couple of fun facts, about
- 2:10- us. The
- 2:11- first hospital in the country is a part
- 2:12- of Penn Medicine as well as the first,
- 2:14- first medical school.
- 2:16- So,
- 2:17- a a a long legacy of of innovation
- 2:19- going back, centuries.
- 2:22- Absolutely. That's great to hear. You know, really
- 2:24- exciting to have that type of,
- 2:26- history within the organization and then understanding that,
- 2:29- you know, what you want in order to
- 2:31- power forward is to be innovative health system,
- 2:33- be able to serve the community, and and
- 2:35- truly,
- 2:36- find the best way possible to fulfill those
- 2:38- missions. So,
- 2:40- I'm curious. First and foremost, can you tell
- 2:41- miss about the most powerful forces that you're
- 2:44- seeing shape digital health and IT in the
- 2:47- organization and how you anticipate they're gonna evolve
- 2:49- in the next year or so?
- 2:52- Yeah. Yeah. So I think that
- 2:54- there
- 2:55- are many of these forces, and I think
- 2:57- that
- 2:58- that, in particular,
- 2:59- there are a,
- 3:02- there is an opportunity at the moment to
- 3:04- reimagine
- 3:05- how we,
- 3:06- deliver care and how we practice medicine
- 3:09- that is that is driven by digital health
- 3:12- and technology, not only at our
- 3:14- organization, but but more broadly.
- 3:16- And I think this is,
- 3:18- of course, because the way that we consume
- 3:21- and use and action health information is changing,
- 3:24- largely driven by technology, in part by by
- 3:28- AI. I think that applies to our consumers,
- 3:31- and I use that word intentionally to our
- 3:33- consumers
- 3:34- and patients. It applies
- 3:36- to,
- 3:37- how they are interacting
- 3:39- with our offerings,
- 3:41- how they're interacting with their own health information
- 3:43- and learning about next steps in care and
- 3:45- accessing care. It applies to the the channels
- 3:48- of care that, whether they be synchronous or
- 3:51- asynchronous. A lot of those foundations were whether
- 3:53- they be brick and mortar or virtual, and
- 3:55- a lot of those foundations were set. Some
- 3:57- of those changes were also set in motion
- 3:58- during the during the COVID pandemic.
- 4:00- Flash of our clinicians,
- 4:02- who are increasingly
- 4:04- having different ways to interact with information
- 4:07- and have clinical decision support,
- 4:09- and ideally more more intuitive, more fluid approaches.
- 4:13- It applies to other aspects of our missions.
- 4:14- For example, our operations also have the opportunity
- 4:17- to be transformed by by technology and and
- 4:20- made, more efficient.
- 4:21- And, certainly, on on this applies on our
- 4:24- education and research missions as well as we
- 4:27- start to think about how do we train
- 4:29- the next generation of clinicians, what are the
- 4:31- skills that are most important,
- 4:33- and when and,
- 4:35- and and how do we
- 4:37- integrate that training with new and incoming technologies?
- 4:41- And finally,
- 4:42- on, of course, on the on the research,
- 4:45- perspective,
- 4:46- you know, what are there are plenty of
- 4:48- opportunities generated by AI that can help advance
- 4:51- our, research mission in in many ways.
- 4:53- So I would say across the board,
- 4:56- our three primary missions of clinical care, research,
- 4:59- and education,
- 5:01- are really being being reshaped with with available
- 5:04- technologies.
- 5:06- I think one of the
- 5:08- one of the the the the the themes
- 5:11- that is consistent across all of these is
- 5:13- change.
- 5:15- And I think the pace of change is
- 5:17- one force that has continued to accelerate,
- 5:20- and that's one thing that we've been thinking
- 5:22- about. How do we adapt to that pace
- 5:25- of change, keep pace, and also help lead
- 5:27- the change to be able to shape technologies
- 5:29- in ways that are beneficial to our,
- 5:31- to our patients, clinicians,
- 5:34- to our community,
- 5:35- and to the broader,
- 5:36- communities, both internal to the organization and those
- 5:39- which we serve.
- 5:41- That makes a lot of sense. You know?
- 5:42- And it's really cool to hear about how,
- 5:45- you're looking at technology and thinking about adoption,
- 5:48- how you're selecting the right things to bring
- 5:50- into the organization, and and then really,
- 5:53- looking to make that meaningful transformation. And to
- 5:55- your point, you know,
- 5:56- it takes a lot beyond just bringing the
- 5:59- technology in and installing it to actually get
- 6:02- that adoption and make sure that, your teams
- 6:04- are are ready to,
- 6:07- really optimize the technology in a meaningful way
- 6:09- and in a lot of change management too.
- 6:11- So
- 6:12- could you talk a little bit about that
- 6:13- process and what you found worked well or
- 6:15- the lessons learned as you've gone through and
- 6:18- then, you know, how the teams are dealing
- 6:20- with the rapid pace of change?
- 6:22- Yeah. I think that,
- 6:24- I think one of the the
- 6:27- the the realizations that we and others certainly
- 6:30- have as well is that given
- 6:32- that it's very
- 6:34- there there it's very easy to,
- 6:37- to build, and there are many new technology
- 6:40- even easier, I should say, to build. There
- 6:42- are many new technology products available. It's still,
- 6:44- by the way, just as hard to build,
- 6:46- something good, something very useful, something that folks
- 6:49- will adopt and and drive value.
- 6:52- That
- 6:53- and both building and identifying those those products,
- 6:57- takes a degree of taste, essentially.
- 7:00- And so what we've,
- 7:02- aimed to do is to be able to
- 7:04- anchor in our operational,
- 7:07- our clinical, our organizational
- 7:09- priorities
- 7:11- You and and use the anchoring in that
- 7:13- in those priorities, which is increasingly important
- 7:16- to be able to help, you know, curate
- 7:18- our taste and what are the right products
- 7:20- that we will,
- 7:23- shape and and implement from others and and
- 7:26- what we will we, for example, build ourselves.
- 7:28- And that's been a very helpful framing, and
- 7:30- I think it it it in in in
- 7:32- in other words, goes back to basics.
- 7:35- What what are the most important priorities, you
- 7:38- know, for our organization? And then how can
- 7:40- we bring the art of the possible of
- 7:42- what technology can do these days to those
- 7:44- priorities,
- 7:46- rather than,
- 7:48- you know, I think I think we'd be
- 7:51- sort of floating out in the breeze if
- 7:52- we're reacting to every single new piece of
- 7:54- technology without having that anchoring in what's most
- 7:57- important operationally and clinically to our organization.
- 8:01- And that's also the way that we articulate
- 8:03- that to,
- 8:05- to to our colleagues within within the organization.
- 8:08- I think, additionally,
- 8:10- the idea that that we can use this
- 8:13- moment that we have, this moment of change,
- 8:15- this set of moments of change and of
- 8:17- transformation
- 8:18- to be able to to change and and
- 8:20- drive things that maybe we wanted to do
- 8:22- for many years. For example,
- 8:24- you know, one one example that I think
- 8:25- resonates with many organizations is the process of
- 8:28- documentation.
- 8:29- That is a a a a very painful
- 8:33- process for many, and I think one that
- 8:35- could be more effective that we finally have
- 8:38- the opportunity to be able to use available
- 8:40- and incoming technologies to totally transform.
- 8:43- And so what what the new technologies give
- 8:45- us the opportunity to do is is the
- 8:47- excitement around them sort of opens the door
- 8:49- to saying, hey. Let's not just implement this
- 8:51- technology, but let's relook at the entire process.
- 8:54- What pieces of the, let's say, documentation process
- 8:57- do need to exist, don't need to exist,
- 9:00- And, and and taking the time to be
- 9:02- able to do that, to be able to
- 9:03- walk the process, to think about the people
- 9:05- in the process, which as we know is
- 9:07- sort of 80% of the work,
- 9:08- and do that first, and then sort of
- 9:11- shape what we do with technology based on
- 9:13- that is is increasingly, I think,
- 9:15- critical.
- 9:16- Absolutely. I love that. And, you know, I
- 9:18- really appreciate you digging a bit deeper there
- 9:20- because organizational philosophy and having the right approach,
- 9:23- can really make a big difference in terms
- 9:25- of the outcome and how,
- 9:27- you know, organizations really truly are able to
- 9:30- benefit from the technology.
- 9:32- Now could you tell us about a big
- 9:34- swing that you took in the last year
- 9:36- or so that paid off? What did you
- 9:37- do and what were the results?
- 9:39- Yeah. So, great question, Laura.
- 9:42- I'll tell you a bit about,
- 9:44- one of our internal,
- 9:45- initiatives, which is led by our Center for
- 9:48- Healthcare Transformation and Innovation and and also supported,
- 9:52- and and,
- 9:53- collaborated on by our data technology solutions organization
- 9:56- as well as many operational partners, which is
- 9:58- a internal product that we call, Chart Hero,
- 10:01- which essentially, if I were to boil it
- 10:03- down, is like a generative AI chatbot that
- 10:06- sort of is is grounded in foundation models,
- 10:09- but that is built into,
- 10:12- and and interacts with our EHR.
- 10:15- And so what that allows,
- 10:16- clinicians to and and the big swing that
- 10:18- we took was to start building this a
- 10:20- year and a half ago. I think this
- 10:22- this type of new interface is becoming increasingly
- 10:25- common, meaning this sort of chat based, more
- 10:27- fluid way to interact with and summarize and
- 10:30- synthesize information is, of course, very common now,
- 10:33- in our personal and professional lives. But a
- 10:36- year and a half ago, we sort of
- 10:37- took a big swing to say, hey, we're
- 10:38- going to we think that this could be
- 10:40- very helpful
- 10:42- in
- 10:43- inter in a creating a new way of
- 10:43- interacting with the information in the electronic health
- 10:46- record. And so we think that it's worth
- 10:48- taking the swing to build it ourselves because
- 10:49- it didn't exist, really, at that time, in
- 10:52- a in any sort of way that we
- 10:54- could purchase or or or partner. And we
- 10:57- thought it was valuable enough to that we
- 10:59- wanted to be able to learn from the
- 11:00- process of building it that this would be
- 11:02- one that we do ourselves. So, this is
- 11:05- now a product that's in the hands of
- 11:07- of hundreds of of clinicians across the organization,
- 11:10- and I would say it's one of the
- 11:12- technology products,
- 11:14- that that we built internally that has had
- 11:17- that essentially adopts itself because it's so useful.
- 11:19- And I think that's a lesson,
- 11:21- in in technology, and and oftentimes,
- 11:24- you know,
- 11:25- I think
- 11:26- folks think that clinicians and others might be
- 11:28- reticent to adopt new technology.
- 11:31- I I don't think that's necessarily the case.
- 11:33- I think, I think, you know, if you
- 11:35- have good usable technology that solves a problem,
- 11:39- folks, people will adopt it because we're we're,
- 11:41- you know, thirsty for that. And so in
- 11:43- this case, you know, being able to interact
- 11:46- with reams of information,
- 11:48- novels full of information, right, in the in
- 11:50- the electronic health record and synthesize that in
- 11:53- context for the question that you have in
- 11:55- the moment,
- 11:57- and and is is absolutely critical. So for
- 11:59- example, I'm a cardiologist, as I mentioned,
- 12:03- and, before I see a patient, I can
- 12:05- ask a question. I can put a prompt
- 12:07- into this tool, be able to say, hey.
- 12:09- You know, why, is this patient coming to
- 12:11- me today and synthesize all the relevant cardiac
- 12:14- testing, x, y, and z cardiac catheterization, echocardiogram.
- 12:17- And based on on that prompt and bit
- 12:20- of context
- 12:21- and also the rest of the context in
- 12:23- the EHR, this tool will deliver that that
- 12:25- summary, to me, that is specific to that
- 12:29- circumstance.
- 12:30- And there are many, many examples of this.
- 12:31- Like, you could do this in pre procedural
- 12:33- preparation,
- 12:35- pre imaging preparation,
- 12:37- But but that has been, you know, really
- 12:39- transformational, I would say, to our interactions with
- 12:42- information in in the, in the electronic health
- 12:44- record, and I think that's exemplified by the
- 12:46- use,
- 12:48- by folks, NPS and other feedback with relation
- 12:51- to the, to the application,
- 12:54- and, and we continue to expand its availability,
- 12:57- while at the same time thinking about how
- 12:59- do we responsibly do so because this is
- 13:01- a new type of interface we have to
- 13:02- learn. We have to learn how do folks
- 13:04- use it, what types of prompts are used,
- 13:06- how do we monitor it. And we worked
- 13:08- on building internal monitoring mechanisms,
- 13:11- you know, for for this as well.
- 13:14- So I think that that's a that's a
- 13:15- big swing that that we took that is
- 13:17- in the process
- 13:18- of of paying off and we continue to
- 13:20- explore what are what are new capabilities for
- 13:24- it. Fantastic. I you know, that is such
- 13:26- an impressive, technology to hear about and and
- 13:28- project. It seems like it's very
- 13:30- useful and could have a lot of benefits
- 13:32- for patients and the fact that you were
- 13:34- able to build that internally and and have
- 13:36- the,
- 13:37- skill sets and
- 13:38- and
- 13:39- design and ability to do that is really
- 13:41- cool to hear in such a inspiring story
- 13:44- as you're thinking about, you know, what, is
- 13:45- gonna actually make a difference for patients and
- 13:48- clinicians in the future.
- 13:49- Yeah. I mean, I think I think it's
- 13:51- both a a building and experience journey and
- 13:53- a learning journey as well.
- 13:55- You know? And I think that the the
- 13:57- this on a on a day to day
- 13:59- clinical basis that's taking tasks that would have
- 14:01- taken a a clinician,
- 14:03- you know, many clicks,
- 14:04- potentially in the EHR, plus ten, twenty, thirty
- 14:07- minutes, you know, potentially per patient depending on
- 14:09- how long a record is and condensing that
- 14:12- to essentially a click of a button.
- 14:14- And I think in many ways, that then
- 14:15- helps to advance other operational priorities. For example,
- 14:18- if it takes a click of a button
- 14:20- to prep prepare for a new patient, it
- 14:22- becomes even easier to be able to provide
- 14:25- access for new patients. So that's how we're
- 14:27- trying to connect, you know, technologies that will
- 14:29- both support, you know, priorities such as clinician
- 14:32- well-being,
- 14:33- as well as organizational priorities,
- 14:36- topmost of which is, access.
- 14:39- Got it. That's so helpful to hear. And,
- 14:41- you know, I I love that advice because
- 14:43- I think so many systems and organizations are
- 14:46- trying to figure out what is that,
- 14:48- right space to be in when you think
- 14:50- about, you know, building things internally and and
- 14:52- how to,
- 14:53- leverage the skill sets of their teams and
- 14:56- and keep the most important aspects of their
- 14:58- mission in place when they're trying to figure
- 15:00- out, you know, what's the technology and the
- 15:02- problem that they're solving.
- 15:04- And and to that point, from your perspective,
- 15:06- what is the most important problem that you're
- 15:08- trying to solve right now with AI and
- 15:10- technology?
- 15:12- Obviously, it was a great use case, and
- 15:13- then what's next?
- 15:15- Yeah. Yeah. I mean, I I would say
- 15:18- similar to many organizations,
- 15:19- you know, we are trying to,
- 15:22- solve the issue of
- 15:25- access to the care that we are, that
- 15:27- we have to offer access to our, clinical
- 15:30- expertise
- 15:31- for patients in our,
- 15:33- communities to need it. And so and I
- 15:36- think that has various dimensions as I was
- 15:38- just alluding to. It has dimensions in how
- 15:41- do we make it easy for a patients
- 15:43- on the patient and consumer side to understand
- 15:45- their health information. So we're working to implement
- 15:48- patient facing generative AI capabilities
- 15:50- to interact with health information, ask questions about
- 15:53- it, understand,
- 15:54- and then be matched to the right offering
- 15:56- at the right time, which, as I mentioned,
- 15:58- could be the right channel,
- 16:00- you know, brick and mortar virtual, asynchronous, synchronous,
- 16:03- the right clinician as well,
- 16:05- the right type of clinician, which can sometimes
- 16:07- be challenging in a complex, you know, in
- 16:09- any organization,
- 16:10- in any health care delivery organization to navigate.
- 16:13- And so, you know, that that's on the
- 16:16- on the patient end.
- 16:18- And, you know, by the way, there are
- 16:19- other jobs to be done in that too,
- 16:21- including being able to gather enough information ahead
- 16:24- of a visit, being able to prioritize,
- 16:27- referrals and understand, you know, within a large
- 16:29- group
- 16:30- of referrals and patients
- 16:32- and and consumers where are the where are
- 16:34- the very urgent needs that absolutely need to
- 16:37- need to be seen because they're they're clinically
- 16:39- urgent.
- 16:40- Then on the clinician side, we want to
- 16:42- make it easy and delightful and simple to
- 16:43- be able to provide that access. And and
- 16:46- those are things like the the tool I
- 16:47- mentioned earlier, Chart Hero, their aspects,
- 16:52- like, making it easier to,
- 16:54- actually, know, like many organizations are doing, create
- 16:57- documentation itself, for example, using ambient technologies
- 17:00- to be able to complete the whole arc
- 17:02- of the visit, which includes,
- 17:04- both the the prep, the intra visit, the
- 17:07- post visit, the communication with patients between visits,
- 17:10- which can also be simplified
- 17:12- using generative AI,
- 17:14- for example, with draft responses to in basket
- 17:17- messages.
- 17:18- And then, you know, I think it also
- 17:20- applies to our operations in service of access.
- 17:22- So, for example,
- 17:24- call center operations with regards to to voice
- 17:27- AI, I think it applies to,
- 17:30- the mechanisms in which we use to schedule,
- 17:33- for example, self scheduling and making that easier
- 17:36- to navigate for patients and for our organization.
- 17:38- So across patients and consumers, clinicians, and organizational
- 17:43- operations, the application of AI in all of
- 17:45- those domains is helping to advance our access
- 17:47- priorities.
- 17:49- That that's so interesting to hear and, like,
- 17:52- such a amazing way to think about how
- 17:54- you're looking at the mission, the priorities, everything
- 17:57- that you need to do, and then bringing
- 17:59- in the technology.
- 18:00- And I am so curious about the aspect
- 18:03- of, you know, asynchronous,
- 18:05- training within the clinician organization. I think, obviously,
- 18:08- it takes having the patients, be willing to
- 18:10- jump in and do that, but, that's a
- 18:12- change for clinicians too. And so I can
- 18:14- imagine
- 18:15- a lot that is going on, but it
- 18:17- sounds like you've been able to,
- 18:19- really transform
- 18:21- how care delivery is happening and and clinicians
- 18:23- are able to, pick that up and and
- 18:25- really bring forward that mission and, strategy in
- 18:28- a strong and meaningful way.
- 18:31- Yeah. Yeah. Yeah. Exactly. And I and and,
- 18:33- again, I think we need to make it
- 18:35- easy and relentless simplification
- 18:37- of sort of workflows,
- 18:38- ease, delight is what we're striving towards, you
- 18:41- know, and the and the technology that we're
- 18:43- bringing to to bear as well that we're
- 18:45- putting together.
- 18:47- I love that. The relentless simplification. I think
- 18:49- that it can be a rallying cry for
- 18:51- so many aspects of your organization, but especially
- 18:54- in health care. Yeah.
- 18:56- So before we wrap up, I'm curious, you
- 18:58- know, what are you most curious about for
- 19:00- the future?
- 19:02- Yeah. I mean, I I think that,
- 19:04- we are still in early early days, early
- 19:07- innings, of course, both with the technology and
- 19:09- certainly how we are applying it. And what
- 19:12- I'm curious about is how, as going back
- 19:15- to the my point earlier that increasing there's
- 19:17- there's lots of technology. We have to be
- 19:19- able to figure out how to knit it
- 19:21- together, how to orchestrate it. And I think,
- 19:24- being able to to orchestrate
- 19:27- what are a whole variety of solutions,
- 19:30- and then also to be able to build
- 19:32- shared context and shared memory
- 19:35- across those solutions. So all in service,
- 19:39- delightful and simple experiences for our patients and
- 19:41- clinicians and community and organization. I think I'm
- 19:44- curious about how,
- 19:46- about the best ways,
- 19:49- to be able to do that, to orchestrate,
- 19:51- and to knit together
- 19:53- capabilities
- 19:54- and how that will evolve. And that includes
- 19:56- the the the aspect of being able to
- 19:58- monitor,
- 20:00- all of those capabilities in in a fashion
- 20:02- that we're able to consume and then continually
- 20:04- learn, iterate, experiment on is something that I
- 20:07- I'm curious about, and I, we're very much
- 20:10- sort of in the process of of of
- 20:12- building and architecting mechanisms to do that.
- 20:15- That's amazing to hear and, you know, really
- 20:18- inspiring to think about everything you're doing at
- 20:19- Penn Medicine. Doctor Adesamali, thank you so much
- 20:22- for joining us on the podcast today. This
- 20:24- has been a really fun conversation and informative
- 20:27- to inspiring again. So thank you again for
- 20:29- your time, and I look forward to connecting
- 20:30- with you soon. Yeah. Thanks so much, Laura.
- 20:32- Thanks thanks to your time, and thanks to
- 20:34- the audience for listening.