Latest / Becker’s Healthcare Digital Health + Health IT / On this episode, Bob Berbeco, Chief Information Officer at Mahaska Health

Transcript

On this episode, Bob Berbeco, Chief Information Officer at Mahaska Health · Becker’s Healthcare Digital Health + Health IT

• 0:02
  At athenahealth,
• 0:03
  we know your ambulatory practice wants healthier, a
• 0:06
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  But the complexities of modern health care tech
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  Practicing medicine is complex, but running a practice
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  See how simpler is healthier@athenahealth.com.
• 0:44
  This is Laura Dierdo with the Becker's Healthcare
• 0:46
  podcast. I'm thrilled today to be joined by
• 0:48
  Bob Berbecco, chief information officer at Mahaska Health.
• 0:51
  Bob, it's a pleasure to have you on
• 0:53
  the podcast today.
• 0:54
  Thank you. It's a pleasure to be here.
• 0:57
  Absolutely. Now I'm excited to have you on
• 0:59
  the line because I know technology is evolving
• 1:01
  so quickly, and it's such a fascinating time
• 1:04
  in health IT right now. And so it'll
• 1:06
  be great to get your perspective on several
• 1:07
  things as we,
• 1:09
  you know, talk through the conversation. But before
• 1:11
  we dive in, can you tell us a
• 1:13
  little bit more about yourself and your work
• 1:14
  in health care?
• 1:16
  Yeah. Absolutely.
• 1:18
  So,
• 1:18
  currently, I'm the chief information officer at Mahaska
• 1:22
  Health,
• 1:23
  and I lead all the organizational
• 1:27
  information technology initiatives.
• 1:29
  So data science,
• 1:31
  artificial intelligence,
• 1:33
  cybersecurity,
• 1:34
  informatics.
• 1:36
  And what my goal is is as I
• 1:39
  do that, we wanna ensure that they're seamless
• 1:42
  integration of those technologies
• 1:44
  to enhance patient care and operational efficiency.
• 1:47
  I was drawn to
• 1:49
  Mahaska Health by its meaningful mission
• 1:52
  and its, empowering culture.
• 1:55
  Passionate
• 1:56
  personally
• 1:57
  about fostering collaboration.
• 2:01
  Relationships are very important to me.
• 2:03
  I love mentoring
• 2:05
  emerging talent, and I look to make a
• 2:08
  a daily positive impact in health care and
• 2:10
  beyond.
• 2:10
  Prior to that, I've been a senior leader
• 2:13
  now in health care technology for about twenty
• 2:16
  seven years.
• 2:17
  I've done predictive analytics,
• 2:20
  process optimization,
• 2:21
  change management.
• 2:23
  I also was an operational director as a
• 2:26
  service line administrator,
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  data governance, experience design,
• 2:31
  a lot of things.
• 2:32
  I also have a six sigma black belt,
• 2:34
  so I'm very
• 2:36
  passionate about,
• 2:38
  optimization
• 2:39
  continual
• 2:40
  optimization process
• 2:41
  improvement.
• 2:43
  And then beyond that, personally,
• 2:46
  I I love to contribute
• 2:48
  within the arts and academic communities.
• 2:51
  I serve on the board of directors for
• 2:53
  the Indianapolis
• 2:54
  Ballet
• 2:55
  and
• 2:56
  the IU School of Science,
• 2:59
  and,
• 3:00
  I was,
• 3:02
  very
• 3:03
  humbled.
• 3:05
  I received a distinguished alumni award from the
• 3:08
  Science Alumni Association
• 3:10
  based upon the contribute,
• 3:12
  contributions I've made over the years. And then
• 3:15
  in a nutshell,
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  I am very committed
• 3:19
  and really enjoy fostering collaboration.
• 3:22
  I I love mentoring emerging talent.
• 3:26
  And just every day, I I I look
• 3:28
  to make a positive impact within health care
• 3:30
  and beyond.
• 3:31
  That's amazing to hear. And, you know, certainly
• 3:34
  a really fascinating journey you've had in health
• 3:37
  care and now, taking you to Mahaska where,
• 3:40
  I can imagine, you know, there's
• 3:43
  a really
• 3:44
  big need for your skills in technology. Before
• 3:47
  we, you know, dive deeper, can you tell
• 3:49
  us just a little bit more about Mahaska
• 3:51
  Health and and some of the things that
• 3:52
  you're doing there?
• 3:54
  Yeah. Absolutely.
• 3:55
  So Mahaska Health, we are a critical access
• 3:58
  hospital
• 3:59
  in rural Iowa.
• 4:01
  We're very focused on meeting the needs of
• 4:04
  our community, the health care needs, and doing
• 4:07
  beneficial things within the community.
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  We have been
• 4:12
  in Iowa now, I think, since 1910,
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  1912.
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  And,
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  every day,
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  we are,
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  we're growing.
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  We're growing our outpatient service lines.
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  We are doing,
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  services within inpatient.
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  And,
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  internally,
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  there are some things that we're working on
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  too with artificial intelligence
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  and EMR optimization,
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  workflow optimization,
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  a number of things that we're we're just
• 4:46
  looking to provide benefits both to our providers
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  and to our, the patients that come to
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  see us.
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  That's amazing to hear, and what a important
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  mission and service that is to the community.
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  Now I know nearly half of medical practices
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  report using AI in some capacity over the
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  last year. And our main is a key
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  topic for health IT leaders as well. Can
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  you tell me a little bit more about
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  that and, you know, what you're seeing in
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  AI today?
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  Yeah. Absolutely.
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  So from what I've seen,
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  the real impact today, shows up in in
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  three focus areas.
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  So first, you have ambient
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  clinical documentation,
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  also known as the the AI scribe or
• 5:29
  artificial intelligence scribe.
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  So within
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  our hospital, we do use a scribe today.
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  It's called MD Hub, and it's been well
• 5:38
  received by our providers.
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  And it's reduced, burnout and after hours charting.
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  Second,
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  there is the operational focus,
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  and revenue cycle copilots.
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  So what can we do that enables our
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  revenue cycle to
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  have better processes around denial,
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  prediction, and appeal drafting,
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  coding assistance, and then inbox triage? So we
• 6:04
  look at those, and we run those, like,
• 6:07
  process improvements. And it's incremental improvement that we
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  focus on.
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  Third,
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  there's care access and patient experience.
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  So we use dashboard
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  within our organization
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  to maintain line of sight. We look to
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  reduce no shows,
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  personalize the outreach that we do
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  through we're on Epic. So personalized outreach we
• 6:29
  do through MyChart and other mechanisms.
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  And then we look to route patients
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  so that wayfinding,
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  routing patients to the right side of care.
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  The second and the third items that I
• 6:41
  mentioned in relation to what we do at
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  our organization,
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  we've been reliant
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  on so we are a community connect,
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  and we have a partner, and we're on
• 6:52
  Epic.
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  So we've been reliant on our community connect
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  partner
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  and Epic's timeline for those. Our focus has
• 6:59
  been on the AI functionality
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  that is embedded within our EMR.
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  We
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  aren't resistant
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  to adding third party bolt ons. We do
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  look at those as well.
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  When we look at bolt ons to our
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  EMR,
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  we're looking for specific value that is shown
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  by those AI products that would not be
• 7:20
  something that would be available within Epic.
• 7:23
  Epic,
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  many folks who are listening to this podcast
• 7:27
  probably seen some of the road map items,
• 7:29
  that's been mentioned as far as what Epic
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  is looking to do for AI.
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  As they continue to release these,
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  we plan to adopt as soon as they
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  become available to us.
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  And our strategic road map, they're on it.
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  We
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  follow our Community Connect host partner. So UnityPoint
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  Health is our host partner for our epic
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  solution.
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  So long story short and in a nutshell,
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  we're prioritizing
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  AI
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  to remove administrative friction,
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  to protect
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  clinical time, the clinician's time, and
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  look to improve safety and experience.
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  So and we also as we do that,
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  we're mindful about measurement,
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  thoughtful about our change management approach, and adaptable
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  and pragmatic about tech. We're preparing ourselves
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  to to, roll in Epic
• 8:23
  as they come,
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  and we also are looking at those third
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  party tools where they show value for our
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  providers and organization.
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  Absolutely. That makes a lot of sense. You
• 8:35
  know, it's great to hear that you're using
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  it in the clinical as well as the
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  operational setting to really maximize,
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  the care you're able to give. Now I
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  I think especially during, you know, virtual care,
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  as that expands from AI enabled tools and
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  remote monitoring
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  to broader digital health platforms,
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  introducing new technology brings its own set of
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  challenges. Mhmm. So what advice do you have
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  for leaders who are navigating everything from the
• 9:01
  governance to,
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  patient engagement? And and can you share some
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  of the examples about how you've been able
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  to balance that innovation with operational constraints?
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  Absolutely. Absolutely. It's the fun of being in
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  the technical world. There's unlimited demand.
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  So the the biggest challenge
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  that
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  I see and face today is
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  managing that
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  large amount of demand
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  for the innovations that are out there within
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  the constraints of financial resources. So we have
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  limited people. We have limited money.
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  And every organization,
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  including Mahaska, we're all looking to stay ahead
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  of that technology
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  trend curve and adopt those new tools as
• 9:43
  they come in.
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  So the downside, you know, the the limitations
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  I mentioned
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  is that can restrict our ability to build,
• 9:52
  maintain, optimize the solution. So the approach that
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  I have is is,
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  mentioned three,
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  before. There's three now.
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  Three important threads
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  that I look to model at our organization
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  is, number one,
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  provider engagement by default.
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  So we look to, at Mahaska, our clinicians'
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  voices, our providers' voices are are a priority.
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  We wanna hear what they need. We wanna
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  hear what they're looking for. The goal is
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  is to essentially make their lives easier so
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  that they could focus on patient care. So
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  we gather their thoughts.
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  We go in with a beginner's mind, so
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  no assumptions.
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  We may have things that we've learned over
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  the past. We can apply those, those, but
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  we wanna learn from them. No assumptions. We
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  identify champions. We validate workflows,
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  and we do usability
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  functionality validation. So,
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  the issues
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  as we're going down this path are minimized,
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  and adoption isn't something that's like an afterthought.
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  Number two,
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  you want governance.
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  So we promote clear governance.
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  We determine the countabilities,
• 11:05
  communication pathways,
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  expected outcomes,
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  and, essentially,
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  we have a playbook.
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  So have a playbook drafted, have it in
• 11:14
  place before you go down the path of
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  of the work.
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  Last
• 11:19
  is a tiered demand process.
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  So as these things are coming in,
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  they're coming into a big funnel,
• 11:27
  technology funnel.
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  And how do you prioritize those things? How
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  do you structure it so that those are
• 11:32
  things that can be done with some of
• 11:35
  the limitations we have?
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  So we have two pathways.
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  One is a formal one, not highly bureaucratic,
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  not allowed to red tape, but there are
• 11:45
  steps, and it's for those items that are
• 11:47
  high lift, risk, cost.
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  So there's a little bit more involvement as
• 11:53
  far as how you structure those
• 11:55
  as they go into where you you pass
• 11:58
  them for deployment.
• 11:59
  The second is you have, like, a demand
• 12:02
  management light.
• 12:04
  So smaller, lower risk requests, initiatives,
• 12:07
  things that maybe you wanna throw against the
• 12:09
  wall, just see if they stick. Those go
• 12:11
  through DM light very quick. You can be
• 12:14
  very agile about it. You look at it.
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  Hey. Low risk, Low resource need. Let's go
• 12:19
  ahead and just try it out. So the
• 12:21
  overall goal of that process is, you know,
• 12:24
  find that business value as quickly as possible.
• 12:27
  You wanna do it with minimum waste. You
• 12:29
  don't wanna have a lot of resources cost
• 12:31
  associated with it and then find out where
• 12:33
  it's a failure.
• 12:34
  So,
• 12:35
  you know, get to the business value. And
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  then that light path you have will empower
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  you to get as quickly as possible
• 12:44
  to a quick win or a fail fast.
• 12:49
  Absolutely. That makes a lot of sense. You
• 12:51
  know, really embracing that mentality of trying new
• 12:54
  things and being quick to make a change
• 12:56
  as needed,
• 12:57
  you know, seems to be really important in
• 12:59
  the nimbleness of today.
• 13:01
  And I wanted to ask you as well,
• 13:03
  what are you seeing in some of the
• 13:04
  recent legislation both on the federal and state
• 13:07
  level,
• 13:08
  that affect health care organizations and health IT
• 13:11
  specifically?
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  Have you had to make any adjustments to
• 13:13
  your strategy in response?
• 13:16
  Yeah. Absolutely. Great question.
• 13:18
  You know, life of place and,
• 13:21
  environment is continually changing.
• 13:24
  Like, sometimes it it almost feels hard to
• 13:26
  keep up.
• 13:28
  And and so,
• 13:29
  really, our strategy
• 13:31
  I mentioned earlier, we are community connect partners.
• 13:34
  So our strategy to to meet as much
• 13:37
  as we can of those legislative needs is
• 13:40
  by putting
• 13:41
  Epic at the center of our strategy.
• 13:44
  So as a critical access hospital,
• 13:47
  you know, in serving a rural region,
• 13:51
  we our resources
• 13:53
  the benefit of having
• 13:55
  Epic
• 13:56
  is
• 13:57
  Epic is
• 13:59
  is is actually doing a lot of these
• 14:00
  things for us. So we have that relationship
• 14:03
  with UnityPoint,
• 14:04
  and we can focus on our,
• 14:08
  having a patient experience
• 14:10
  and and focus on that side of it,
• 14:12
  whereas the regulatory compliance
• 14:14
  ends up being embedded into many of the
• 14:16
  things that Epic's doing already. So a couple
• 14:18
  of examples that I have with that
• 14:20
  is you have the interoperability
• 14:23
  and pricing transparency rules.
• 14:25
  So,
• 14:26
  Tesco
• 14:27
  or it's the trusted, explained framework, and common
• 14:31
  agreement rule,
• 14:33
  those were adopted. Those are things that are
• 14:35
  out there. Thankfully, Epic
• 14:38
  has adopted it within their EMR,
• 14:41
  and they have, brought it into something called
• 14:44
  Epic Nexus.
• 14:46
  We have already signed into that. So we
• 14:49
  are now meeting the TEFCA rules.
• 14:52
  And through that,
• 14:53
  the big benefit is our clinicians now can
• 14:57
  access and send records nationwide
• 15:00
  under
• 15:01
  a single technical umbrella,
• 15:03
  of all the different sites that have Epic
• 15:05
  throughout The United States and, actually, beyond The
• 15:08
  United States.
• 15:09
  It reduces this need. You have a bunch
• 15:11
  of interfaces that can exist out there. There's
• 15:14
  that thing. The benefit is is that you
• 15:16
  don't need those. It enables us to actually
• 15:18
  be able to see these records very easily,
• 15:21
  quickly,
• 15:22
  reduce that clinical burden.
• 15:24
  On the pricing transparency side, we are continually
• 15:28
  we do have that out there on our
• 15:29
  website.
• 15:31
  We continually validate that machine readable data and
• 15:34
  make sure the estimator is available publicly.
• 15:37
  Now the
• 15:38
  big one so I I mentioned a couple
• 15:40
  of ones.
• 15:42
  You know, the,
• 15:44
  cybersecurity.
• 15:46
  A hospital is amongst the crowd. So cybersecurity,
• 15:50
  is something that is a huge focus,
• 15:52
  and it's something that the government and regulations
• 15:55
  and all of those is is something that,
• 15:57
  you know, is is very
• 16:00
  superior. And there's big repercussions for things if
• 16:03
  you're not doing what you should be doing.
• 16:06
  On the cybersecurity
• 16:07
  front, it is continuous for us. So we
• 16:11
  treat it as
• 16:12
  continually
• 16:13
  adapting,
• 16:14
  continually optimizing.
• 16:16
  We never stop. So as the best practice,
• 16:20
  we've mapped our controls to the health and
• 16:22
  human or health and human services,
• 16:25
  health care,
• 16:26
  performance goals for cybersecurity.
• 16:28
  So h h h a s.
• 16:31
  We've mapped to those. So that's our best
• 16:33
  practice.
• 16:34
  And we are continually reviewing
• 16:36
  and looking at our cybersecurity
• 16:39
  program to make sure that we're meeting all
• 16:42
  additional best practices,
• 16:44
  that are for health care. So as an
• 16:47
  example,
• 16:48
  we do education,
• 16:50
  continual education with our team members, our clinicians,
• 16:54
  our providers.
• 16:55
  We do pen tests,
• 16:58
  kinda test our seals
• 16:59
  and for leaks.
• 17:01
  We do risk assessments.
• 17:03
  We do external monitoring,
• 17:06
  and then we actually do dry runs. So
• 17:08
  we do incident response rehearsals
• 17:10
  with the team members, providers, leadership, all involved.
• 17:13
  We treat it as a true incident.
• 17:15
  And all of these things, those rehearsals especially,
• 17:19
  we test our processes.
• 17:20
  We find lessons that are learned. We bring
• 17:22
  them forward. We bake them into the program
• 17:25
  so that we we,
• 17:28
  optimize that program even further. And then the
• 17:31
  the last thing just to mention about cybersecurity
• 17:34
  is the education,
• 17:35
  it's it's actually been really good is we've
• 17:38
  involved our team members, our providers, our clinicians,
• 17:42
  and, you know, we're we're we're truly looking
• 17:44
  out for them too because these things happen
• 17:46
  on the personal side. So we do fish
• 17:48
  testing.
• 17:50
  We educate them. We make ourselves available if
• 17:52
  they have any questions or they receive something
• 17:55
  that might seem a little picky.
• 17:57
  And and the whole goal really is,
• 17:59
  not punitive. It's just really to grow their
• 18:01
  awareness
• 18:02
  and resistance
• 18:04
  to
• 18:05
  the Focal engineered attempt,
• 18:07
  that, you know, they're getting every day to
• 18:09
  gain access to our systems.
• 18:13
  That's really helpful to know and understand the
• 18:15
  plan there, because as you mentioned, cybersecurity
• 18:17
  is so critical
• 18:19
  alongside these other trends in looking at technology,
• 18:21
  interconnectivity, and, you know, how you can really,
• 18:24
  make the best experience for patients possible.
• 18:26
  Now with our last minute here, I wanted
• 18:28
  to ask, what's your top piece of advice
• 18:30
  for health care leaders as they prepare to,
• 18:33
  for the further advancement of technology and rising
• 18:35
  demands for care?
• 18:37
  Absolutely. So I would say two things.
• 18:40
  Be disciplined
• 18:41
  about the architectural
• 18:43
  plumbing
• 18:44
  and, the foundation,
• 18:46
  and be bold about the outcome.
• 18:48
  So be disciplined about your architecture, your data
• 18:51
  foundations.
• 18:52
  Invest in real business needs analysis.
• 18:56
  Make sure you look to measure value before
• 18:58
  you start projects,
• 19:00
  and stand up COEs around the different focus
• 19:03
  areas you you are looking to do. As
• 19:05
  an example, we're doing a data science and
• 19:07
  AI center of of excellence.
• 19:10
  And
• 19:12
  the the job of these things is to
• 19:14
  make,
• 19:16
  the business needs driven,
• 19:18
  repeatable,
• 19:19
  ethical expeditions.
• 19:21
  Second,
• 19:22
  run a structured, always improving playbook.
• 19:25
  So have a playbook.
• 19:27
  Determine what your current state is.
• 19:29
  Establish some some KPIs
• 19:32
  so that you have points of measurement
• 19:34
  and and use that
• 19:36
  as, like, your scorecard.
• 19:38
  Something that I like to do just because
• 19:40
  of my Six Sigma background is I have
• 19:42
  an a three.
• 19:43
  That's something you use within Six Sigma, and
• 19:45
  it basically becomes your report card. You map
• 19:47
  out the problem,
• 19:49
  root causes,
• 19:50
  the target future state, have it all on
• 19:52
  there, and you can you can adapt
• 19:55
  as as you're learning what you're learning.
• 19:57
  And,
• 19:58
  and then, you know, have some quick wins,
• 20:01
  test solutions, do a lightweight, track those results
• 20:04
  closely.
• 20:07
  Absolutely. I love that. Bob, thank you so
• 20:09
  much for joining us on the podcast today.
• 20:10
  This has been such a fun conversation
• 20:13
  inspiring to learn everything that you're thinking about
• 20:16
  and working on and planning for the future,
• 20:17
  and I look forward to catching up with
• 20:19
  you again soon. Excellent. Thank you so much.
• 20:24
  At athena Health, we know your ambulatory practice
• 20:27
  wants healthier,
• 20:28
  A healthier business, healthier care teams, and healthier
• 20:31
  patients.
• 20:32
  But the complexities of modern healthcare tech make
• 20:35
  it hard for you and your care teams
• 20:37
  to focus on what matters most.
• 20:39
  That's where athenahealth can help. Our AI native
• 20:42
  all in one solutions reduce administrative burdens,
• 20:45
  streamline billing and payments, and deliver critical insights
• 20:48
  when clinicians need it most. That means fewer
• 20:51
  clicks, more time for patients, and stronger bottom
• 20:54
  lines.
• 20:55
  Practicing medicine is complex,
• 20:57
  but running a practice can be that much
• 20:59
  simpler with athenahealth.
• 21:01
  See how simpler is healthier at athenahealth.com.