Latest / Becker’s Healthcare Podcast / Healthcare Upside / Down: The Hidden Risk & What Happens Before Your Patients Ever Walk In the Door

Transcript

Healthcare Upside / Down: The Hidden Risk & What Happens Before Your Patients Ever Walk In the Door · Becker’s Healthcare Podcast

• 0:00
  - Hello, everyone. This is Erica Spicer Mason with
• 0:02
  - Becker's Healthcare, and welcome to Healthcare Upside Down,
• 0:06
  - a podcast by Becker's Healthcare and ECG Management
• 0:09
  - Consultants,
• 0:09
  - where we explore the upsides and the downsides
• 0:12
  - of health care and the industry's most current
• 0:14
  - trends.
• 0:15
  - Really appreciate you all tuning in today. So
• 0:18
  - joining me for today's episode, we have two
• 0:20
  - leaders with us. We have doctor William Morris,
• 0:23
  - the chief medical officer at Tenor,
• 0:25
  - and Sarah Kier, principal at ECG Management Consultants.
• 0:30
  - Doctor Morris, Sarah, welcome to the podcast. Thank
• 0:32
  - you so much for being here today.
• 0:34
  - Thank you for having us. Thank you.
• 0:37
  - So thrilled to have you both. And before
• 0:38
  - we get into the conversation,
• 0:40
  - wanted to see if you could each share
• 0:42
  - just a little bit about yourselves just to
• 0:44
  - give our listeners an idea of where you're
• 0:46
  - coming from, the perspective you're bringing.
• 0:49
  - Doctor Morris, would you like to kick us
• 0:50
  - off with a brief intro?
• 0:52
  - Sure.
• 0:53
  - Please call me Will. So I'm a hospitalist,
• 0:56
  - so I experienced upside down,
• 0:59
  - clinically, I would say for,
• 1:01
  - my entire clinical practice where I saw those
• 1:04
  - patients who probably would have benefited from care
• 1:07
  - orchestration,
• 1:08
  - coming into the hospital. And then when I
• 1:10
  - discharge a patient, not sure if they necessarily
• 1:13
  - got to the right provider at the right
• 1:15
  - time at the right cost.
• 1:16
  - So really, really passionate around kind of the
• 1:18
  - care orchestration piece clinically from a technology,
• 1:22
  - perspective,
• 1:23
  - excited, but, there's also people in process
• 1:26
  - that is really, really required
• 1:28
  - to, you know, think about
• 1:30
  - transitions of care and, care navigation.
• 1:33
  - And so Tenor is a company laser focused
• 1:36
  - on referral orchestration, and it's a real pleasure
• 1:40
  - to have a true subject matter expert, like
• 1:43
  - Sarah,
• 1:44
  - who who's been, I would say, at the
• 1:46
  - fulcrum of referral and access management.
• 1:50
  - What a great tee up for Sarah. Thanks,
• 1:52
  - Will. Appreciate it. Sarah, you wanna tell us
• 1:54
  - a little bit about yourself as well? Yeah.
• 1:56
  - Thank you so much, Erica.
• 1:58
  - Sarah Kier, I have been in health care
• 2:01
  - operations management for over twenty five years. Across
• 2:04
  - that time, I've had the opportunity to serve
• 2:06
  - at three different academic medical centers, most recently
• 2:09
  - at Emory Healthcare, where I served as their
• 2:11
  - senior vice president of enterprise patient access. So
• 2:13
  - that did include referral management and all of
• 2:16
  - the glorious
• 2:17
  - fax, issues that we're going to get into
• 2:19
  - here in a minute.
• 2:21
  - I joined ECG management earlier this year in
• 2:23
  - January. Have been there for five months and
• 2:25
  - now have the opportunity to help
• 2:27
  - solve these critical access issues
• 2:29
  - nationwide, taking the lens of people process and
• 2:32
  - technology knowing that
• 2:33
  - without the people and process component, you can
• 2:35
  - have the best tech stack in America and
• 2:37
  - make thing that make bad things happen more
• 2:39
  - quickly.
• 2:40
  - So excited to get into this today.
• 2:42
  - Yeah. Sarah, thanks for rounding us out with
• 2:45
  - intros and the experience that both of you
• 2:47
  - are bringing to this conversation. I appreciate it
• 2:49
  - so much.
• 2:50
  - Before we get into kind of the more
• 2:52
  - granular pieces of access and what that's looking
• 2:55
  - like, I wanted to start high level.
• 2:58
  - When you both think about where organizations are
• 3:01
  - losing patients
• 3:02
  - and revenue right now, where does your mind
• 3:05
  - go first? And I'm curious if up upstream
• 3:07
  - intake, as we've kind of touched on already,
• 3:09
  - is it ever part of that conversation?
• 3:11
  - Sarah, you wanna kick us off? Yeah. I'd
• 3:13
  - be happy to. And I will declare my
• 3:15
  - bias, which is upstream is always part of
• 3:17
  - my conversation.
• 3:18
  - I am a Mhmm. I am an upstream
• 3:20
  - gal. And so when I when I think
• 3:23
  - about we where we lose patients, one of
• 3:25
  - the things I've heard as a refrain in
• 3:27
  - almost every health system I've worked with is
• 3:29
  - once people get here and once the clinicians
• 3:32
  - lay hands on them,
• 3:34
  - we are really confident and the patient is
• 3:36
  - really confident into the care that they're receiving.
• 3:38
  - It is the journey that we make the
• 3:40
  - patient go on to get into that clinical
• 3:43
  - care setting
• 3:44
  - that is frustrating
• 3:46
  - and
• 3:47
  - a burden and really full of friction and
• 3:49
  - confusion and anxiety.
• 3:51
  - And so when I think about where we're
• 3:52
  - losing the opportunity to serve folks,
• 3:55
  - I think it really is if you make
• 3:57
  - it that hard to try to find your
• 3:59
  - your way to the right care at the
• 4:00
  - right time with the right provider for the
• 4:02
  - right diagnosis,
• 4:04
  - folks will make a different choice. They will
• 4:05
  - vote with their feet and and go to
• 4:07
  - a health care system that has placed a
• 4:09
  - bigger emphasis on making that easy.
• 4:11
  - There's also a conversation to be had about
• 4:13
  - revenue loss as you get into those clinical
• 4:16
  - care settings and making sure that our documentation
• 4:18
  - supports what we're doing, that we have all
• 4:20
  - the right information in the right places.
• 4:22
  - But but I would argue
• 4:24
  - there needs to be much more emphasis on
• 4:26
  - Upstream than there is today.
• 4:28
  - The fact that we lose the opportunity to
• 4:30
  - care for patients before they've ever seen or
• 4:33
  - heard from a clinical care provider,
• 4:35
  - is an invisible problem in many organizations. We're
• 4:38
  - not measuring it well. We're not monitoring it
• 4:39
  - well, but it is very real.
• 4:41
  - Yeah. Sarah, thank you so much. Interesting how
• 4:44
  - you frame that as kind of an invisible
• 4:45
  - problem.
• 4:46
  - Will, I'm curious how this stacks up against
• 4:49
  - your point of view here and and where
• 4:50
  - you're thinking about organizations losing patients and revenue,
• 4:53
  - what comes to mind?
• 4:55
  - Yeah. I mean, I think about
• 4:57
  - it is about the patient. And, while the
• 5:00
  - organization might be losing it, so is the
• 5:02
  - patient, so is the referring provider, and so
• 5:04
  - is the, originating provider. I think through the
• 5:07
  - lens of the patient experience,
• 5:10
  - you know, you're navigating a really, really complex
• 5:12
  - environment clinically.
• 5:14
  - Lots of medical jargon, words, being told I
• 5:17
  - need to go see to a provider, but
• 5:20
  - you have financial barriers. Like, what is in
• 5:22
  - network? What is not? What is required? Prior
• 5:24
  - authorization.
• 5:25
  - And where should I go? How do I
• 5:27
  - know
• 5:28
  - a high quality provider who, you know, delivers,
• 5:32
  - appropriate,
• 5:33
  - you know, care at lowest cost?
• 5:35
  - And today, it's very it feels, you know,
• 5:37
  - very much like a invisible problem because it
• 5:39
  - is. It's Brownian motion.
• 5:42
  - You know, at Tenor,
• 5:43
  - we've been really blessed to kind of start
• 5:46
  - out at the periphery of
• 5:48
  - large complex organizations because that's where patients go.
• 5:52
  - Right? They can't get into
• 5:55
  - a highly qualified neurologist within,
• 5:57
  - you know, an AMC, and so they will
• 6:00
  - be happily absorbed in the community.
• 6:03
  - And and that's great, but how is that
• 6:05
  - information then communicated back to the referring provider?
• 6:07
  - How does that information take an action on?
• 6:10
  - How do you actually manage,
• 6:12
  - you know, those patients? And so
• 6:15
  - access is is such a complex issue. It's
• 6:17
  - a financial,
• 6:19
  - complexity. There's a technical
• 6:21
  - reality.
• 6:22
  - Sarah mentioned the word fax. Yes. Fax is
• 6:25
  - still the number one interface. And even though
• 6:27
  - if you have a small lowercase
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  - e in front of it, it's still an
• 6:31
  - unstructured fax.
• 6:32
  - And so how do you kind of manage
• 6:34
  - that from a technical spot? How do you
• 6:36
  - make the invisible visible? How do you create
• 6:39
  - actionable data such that
• 6:41
  - at the end of the day, we want
• 6:43
  - the right patient going to the right provider
• 6:45
  - at the right time at the right cost
• 6:48
  - in the right format. Format being could be
• 6:50
  - asynchronous. It could be a virtual visit or
• 6:53
  - an in person visit.
• 6:55
  - Yeah. Well,
• 6:56
  - appreciate
• 6:57
  - that additional perspective. And you mentioned
• 7:00
  - you you brought up the specialty
• 7:02
  - areas. I think the the specialty example you
• 7:04
  - gave was neurology. And, so I wanna go
• 7:06
  - a little bit deeper here on when it
• 7:08
  - comes to patient access.
• 7:09
  - Let's talk about what happens after a referral
• 7:12
  - successfully lands. You
• 7:14
  - know,
• 7:15
  - specialist wait times and wait lists can be
• 7:16
  - a lot higher than I'm
• 7:18
  - sure many organizations would like to see and
• 7:20
  - patients as well.
• 7:23
  - So how are teams deciding who gets seen
• 7:25
  - first? Where is that prioritization happening and how?
• 7:28
  - And and what are the consequences of getting
• 7:30
  - that wrong?
• 7:32
  - Yeah. I mean,
• 7:34
  - again, through the lens of a patient we've
• 7:36
  - all experienced. You go to a doc. They
• 7:38
  - go, you need to go see x provider.
• 7:41
  - We'll we'll do neurology, dermatology.
• 7:43
  - And they're like, yeah. You should be seen
• 7:45
  - soon. You walk out. They're like, great. We'd
• 7:47
  - love to see you. How's next, you know,
• 7:50
  - nine months?
• 7:52
  - That is scary if I'm a patient. Right?
• 7:54
  - I Google my condition, and now I'm really
• 7:57
  - scared.
• 7:58
  - And so
• 8:00
  - we think about then the side of the
• 8:02
  - providers. Right? They
• 8:05
  - want to see the right patient.
• 8:07
  - But when you
• 8:08
  - really, really weigh into
• 8:10
  - any specialist queue and you ask the fundamental
• 8:13
  - question, hey. Last time you were in clinic,
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  - you saw 20 patients. Of those 20 patients,
• 8:19
  - which of those patients actually were more appropriate
• 8:22
  - for a different provider?
• 8:24
  - We're actually more appropriate
• 8:26
  - with a econsult back to the primary care
• 8:28
  - physician where you can support the primary care
• 8:31
  - physician, but they can facilitate it. We're actually
• 8:33
  - more appropriate,
• 8:35
  - you know, for a specialist, but it would
• 8:37
  - have been nice if you did x, y,
• 8:39
  - and z beforehand.
• 8:41
  - And there's a lot of this work, and
• 8:42
  - I think it breeds burnout, which is top
• 8:45
  - of mind for providers because that's not a
• 8:47
  - that's not a satisfying
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  - day in clinic when
• 8:51
  - forty
• 8:52
  - to fifty percent of your patients
• 8:54
  - could have been triaged better.
• 8:56
  - That shows up in burnout, but it also
• 8:59
  - shows up in, hey. That's 50% of my
• 9:02
  - capacity that maybe I don't need a six
• 9:05
  - month waiting period. Right? Maybe I can actually
• 9:09
  - manage my my my wait list a a
• 9:11
  - lot more appropriately
• 9:14
  - if I have the right prioritization
• 9:16
  - and triage schema upstream.
• 9:19
  - And so we're really, really excited about this
• 9:21
  - concept of kind of care orchestration
• 9:24
  - of how do I get patients to the
• 9:26
  - right provider at the right time. And I
• 9:27
  - think that has
• 9:29
  - the paradoxical
• 9:31
  - impact of increasing
• 9:33
  - a supply limited specialist and actually improving
• 9:37
  - access.
• 9:38
  - I appreciate you expanding on the care orchestration
• 9:41
  - piece, Will. I know you had mentioned that
• 9:43
  - in some of your introductory comments. So the
• 9:45
  - way you laid that out makes a lot
• 9:46
  - of sense.
• 9:47
  - Sarah, anything else you'd add?
• 9:50
  - I mean, I I think the only thing
• 9:51
  - I would add is what Will lays out
• 9:53
  - is so exciting, and it is not the
• 9:55
  - way it's happening in most organizations right now.
• 9:58
  - Right? Just want just wanna call into contrast.
• 9:59
  - That is where we need to get to
• 10:01
  - for the for the twenty plus years I've
• 10:02
  - been focused on access.
• 10:05
  - Clinical acuity based scheduling, clinical acuity based prioritization
• 10:08
  - has been what we've considered the holy grail.
• 10:10
  - Right? The folks that can't wait because their
• 10:13
  - disease
• 10:14
  - trajectory is progressing at such a rapid rate
• 10:16
  - that weeks matter,
• 10:18
  - getting those folks in now for now, the
• 10:19
  - folks who are stable enough to wait, having
• 10:21
  - them either go through a different care channel,
• 10:23
  - like, well articulated, an evisit, a a virtual
• 10:26
  - visit,
• 10:27
  - That is the panacea. That's what we're going
• 10:29
  - for. Right? I don't I don't think many
• 10:31
  - organizations are doing it well today. I think,
• 10:34
  - I would offer a couple of perspectives or
• 10:36
  - or thoughts.
• 10:37
  - One of the ways I've seen it work
• 10:39
  - well at organizations
• 10:41
  - is if you have a clinical specialty who's
• 10:43
  - got a a really long wait time and
• 10:45
  - almost everyone picks on neurology. Right? Like, that
• 10:47
  - is just a it's a it's a national
• 10:49
  - crisis, truly. It's not anyone's fault. It's not
• 10:51
  - that organizations aren't doing the best with what
• 10:53
  - they have.
• 10:54
  - It is a real limitation.
• 10:57
  - We implemented something called a rapid
• 10:59
  - access virtual evaluation,
• 11:01
  - which is instead of scheduling you for that
• 11:04
  - appointment nine months out, we're gonna schedule you
• 11:07
  - for an assessment, a fifteen minute video visit
• 11:09
  - with an advanced practice provider or a physician,
• 11:12
  - where we do that intake to say, how
• 11:14
  - sick are you? What's going on? What does
• 11:16
  - it look like? That's one piece of the
• 11:18
  - puzzle, and that helps because you can catch
• 11:20
  - the folks who are not gonna do well.
• 11:21
  - You also establish that we've got you. We're
• 11:23
  - aware of you.
• 11:25
  - We are here for you. And if anything
• 11:26
  - changes as you're waiting, you can reach out.
• 11:28
  - You've got, lines of communication open. But the
• 11:31
  - second piece we have to get after in
• 11:33
  - that is, what if I tell Will that
• 11:36
  - he is gonna wait for nine months? Because
• 11:38
  - even though it's a big deal, he's more
• 11:40
  - stable
• 11:41
  - than Erica.
• 11:42
  - That we need to do a better job
• 11:43
  - there. We need to do a better job
• 11:45
  - of making milestones for patients, keeping them engaged,
• 11:47
  - keeping them encouraged, reducing anxiety. And so I
• 11:50
  - think there are complimentary lenses here about, yes,
• 11:53
  - we can. And if there's not an appropriate
• 11:56
  - offshoot path and you're really just gonna wait
• 11:58
  - in line for nine months, we need to
• 11:59
  - make that feel better than it does today
• 12:02
  - because it's a really hard job to sell
• 12:04
  - to someone.
• 12:05
  - Yeah. Yeah. The rapid access virtual evaluation, that's
• 12:08
  - a really great example, Sarah. And and and
• 12:11
  - on that, I would just love to pile
• 12:12
  - on what Sarah said, I think, is so
• 12:15
  - profound,
• 12:17
  - around
• 12:18
  - thinking of novel ways to engage the patient
• 12:22
  - and route them.
• 12:24
  - Just talk to a a very, very large
• 12:26
  - system, and they're using clinical pharmacists for a
• 12:29
  - lot of med management and triage. And so
• 12:32
  - there
• 12:33
  - is an embarrassment of riches within a large
• 12:36
  - system, and shame on us if we don't,
• 12:39
  - you know, think creatively
• 12:41
  - in ways to
• 12:43
  - expose and bring to life a lot of
• 12:45
  - these men and women at the benefit of
• 12:48
  - patients and access,
• 12:50
  - which I mean, when Sarah gives me that
• 12:51
  - example, like, I just like, the hair stands
• 12:54
  - up on the back because that is
• 12:57
  - just fundamentally
• 12:59
  - different
• 13:01
  - in in the way that we have to
• 13:02
  - do things differently.
• 13:04
  - Yeah. Yeah. Thank you for those add ons.
• 13:06
  - Well, let's go a little bit deeper there.
• 13:08
  - So, you know, whether we're talking about the
• 13:10
  - rapid access virtual evaluations,
• 13:13
  - whether we're talking about tech enabled triaging. You
• 13:16
  - know, organizations right now
• 13:18
  - are
• 13:19
  - looking at technology, especially AI investments
• 13:22
  - to support some of these access initiatives. And
• 13:25
  - there's been a wave of investment across health
• 13:28
  - systems,
• 13:29
  - in order to do so.
• 13:31
  - But I know that it's also something that
• 13:34
  - organizations need to have a very discerning eye
• 13:37
  - for. So I'd love to know from you
• 13:39
  - both. And, Sarah, maybe you can start us
• 13:41
  - with this based on your work with partners.
• 13:43
  - What should executives really be looking for when
• 13:46
  - it comes to technology partners and solutions? And
• 13:48
  - what are maybe some signs that something won't
• 13:51
  - hold up once it's put into practice?
• 13:54
  - Yeah. Erica, thank you for that question. It's
• 13:56
  - really important, and it is certainly top of
• 13:58
  - mind.
• 13:59
  - So a couple of comments on this. Everyone
• 14:02
  - I speak to,
• 14:03
  - dozens of conversations every week, every executive I'm
• 14:07
  - talking to at health systems nationally
• 14:09
  - believe they are way behind
• 14:12
  - on AI. There is this pervasive sentiment that
• 14:15
  - everyone else is doing more than we are,
• 14:17
  - and we need to hurry up and catch
• 14:18
  - up.
• 14:19
  - It's just an observation, not not a commentary,
• 14:21
  - not a judgment call, but if everyone's behind,
• 14:24
  - then no one's really ahead. And so I
• 14:25
  - think that the anxiety that everyone is channeling
• 14:28
  - on this is hot right now. I hope
• 14:30
  - that our temperature,
• 14:32
  - stays in the posture of bias to action,
• 14:35
  - but but becomes a little bit less, maybe
• 14:37
  - frenetic is the word I would choose as
• 14:39
  - we as we mature here. The second thing
• 14:41
  - I would say is
• 14:44
  - there's no shortage of vendors.
• 14:46
  - There's no shortage of technology solutions that can,
• 14:49
  - in fact, really
• 14:51
  - help solve some of these problems.
• 14:53
  - But the very first step always needs to
• 14:56
  - be which workflow are we trying to address.
• 14:59
  - I have seen,
• 15:01
  - time and again
• 15:02
  - that we use AI for the sake of
• 15:04
  - saying that we are using AI in a
• 15:06
  - in an attempt to gain efficiency or automation
• 15:09
  - or reduce
• 15:10
  - handling costs,
• 15:11
  - cost to serve.
• 15:13
  - And and we skip a step, which is
• 15:15
  - you have to really define what getting it
• 15:17
  - right looks like in the workflow.
• 15:19
  - You have to have really clearly codified
• 15:22
  - exception based processes,
• 15:24
  - and the exception based process cannot be, it
• 15:27
  - depends, go ask a human,
• 15:29
  - every single time or or the or the
• 15:31
  - technology
• 15:33
  - isn't gonna be allowed to do its job.
• 15:34
  - And so
• 15:35
  - the argument I would make for AI is
• 15:37
  - if you meet the criteria of you are
• 15:40
  - really clear on the problem you are trying
• 15:41
  - to solve,
• 15:43
  - you know what getting it right looks like,
• 15:45
  - and you have governance around how you're handling
• 15:48
  - exceptions and those things are standardized in the
• 15:51
  - workflow that you're talking about,
• 15:53
  - AI is a really useful tool, and it
• 15:55
  - can, and I've seen it, deliver meaningful results
• 15:58
  - inside organizations.
• 16:00
  - But if you try to outsource workflow or
• 16:02
  - process
• 16:03
  - to technology or AI,
• 16:06
  - what will happen is your problems will happen
• 16:08
  - faster,
• 16:09
  - and they will happen more often because now
• 16:11
  - you've hardwired it. And so, Erica, I hope
• 16:14
  - that that answers kind of the question, which
• 16:16
  - is what to look for. Looking inside
• 16:19
  - as the first important step
• 16:21
  - is critical. And then as you're choosing a
• 16:23
  - dance partner, as you're choosing a vendor, speaking
• 16:26
  - to clients who've used them about the real
• 16:28
  - real. How did it go? What did it
• 16:29
  - take? How was training? Were they responsive?
• 16:32
  - Always check your references,
• 16:34
  - and then leveraging, right, partners who are in
• 16:37
  - industry. I'll use ECG, but, really, any firm
• 16:39
  - that is working across hundreds of clients at
• 16:42
  - a time, they've got a they've got a
• 16:43
  - really informed perspective
• 16:45
  - on what is happening, what's working, and what's
• 16:47
  - struggling. And so ask other folks. You don't
• 16:49
  - need to do it by yourself. And I'll
• 16:51
  - ask, see what Will would add to that
• 16:53
  - from his perspective.
• 16:55
  - Yeah. I mean,
• 16:56
  - listen. As someone who ran IT,
• 16:59
  - technical debt and application rationalization is top of
• 17:02
  - mind. Complexity kills.
• 17:05
  - So one is a degree of humility when,
• 17:07
  - you know, you show up now wearing a
• 17:09
  - vendor hat because there is unbelievable
• 17:11
  - hyperbole out there.
• 17:14
  - There is a lot
• 17:16
  - of prioritization
• 17:17
  - distraction, and
• 17:18
  - I'll be the first to say that anyone
• 17:21
  - whose claims that access is solved by a
• 17:23
  - widget,
• 17:24
  - you run, you know, run away because it
• 17:26
  - it's not.
• 17:27
  - It is enabled
• 17:29
  - a specific workflow,
• 17:33
  - Tenor is a technical platform, we are
• 17:35
  - absolutely a services and services partner,
• 17:39
  - company. We need to partner with
• 17:41
  - companies that strategically look at the workflow. Again,
• 17:45
  - Sarah says it eloquently, you know, automating broken
• 17:47
  - just makes broken faster.
• 17:49
  - You know, as a physician and someone who
• 17:52
  - live, you know, forever in a large academic
• 17:54
  - medical center like Cleveland Clinic, we know that
• 17:57
  - the unbelievable financial,
• 17:59
  - pressures that health systems face.
• 18:01
  - So shame on us. It can't cost a
• 18:03
  - dollar and not create value. It has to
• 18:06
  - have hard ROI.
• 18:08
  - So the way I kind of think about
• 18:10
  - it is the following. Number one is,
• 18:12
  - it is such a complex solution. There is
• 18:14
  - no point solution. It has to be kind
• 18:16
  - of more of a platform
• 18:17
  - play because health care is local and the
• 18:20
  - environment, the different EHRs. And you might think,
• 18:22
  - oh, well, we have an enterprise EHR. But
• 18:24
  - your patients are coming from every variety known
• 18:28
  - to man or woman.
• 18:30
  - And so you gotta have kind of an
• 18:32
  - extensible platform. Number two is you gotta show
• 18:35
  - up with ears, not, like, not your voice.
• 18:37
  - You gotta listen and look at the workflows
• 18:40
  - and really ask the five why questions
• 18:43
  - and have
• 18:44
  - core,
• 18:45
  - you know, metrics of success.
• 18:47
  - We are
• 18:49
  - just absolutely maniacal about doing a pilot and
• 18:51
  - having milestones. Because if you don't measure an
• 18:54
  - outcome, then how do you know that you've
• 18:56
  - actually achieved anything? Right? You can't just have
• 18:58
  - AI for AI sakes.
• 19:00
  - I didn't, you know, make the jump into
• 19:02
  - vendor world to, you know, check the box
• 19:04
  - for the board to say, yay. We use
• 19:06
  - AI. That's not a win.
• 19:08
  - I wanna be invisible
• 19:11
  - to the clinicians'
• 19:12
  - EHR workflow. I wanna enable it quietly, but,
• 19:15
  - demonstrate value. And so two, the second point
• 19:18
  - is is pilot,
• 19:19
  - measure, drive outcome. And then three is
• 19:22
  - this is a journey. It's continuous improvement.
• 19:25
  - There is no magical solution to, quote, solve
• 19:28
  - access. Turning on open scheduling is not, yay,
• 19:31
  - mission accomplished.
• 19:33
  - Because you will always,
• 19:35
  - you know, deploy something, measure, and elevate a
• 19:38
  - new constraint.
• 19:39
  - And so to Sarah's point, it is absolutely
• 19:42
  - a continuous
• 19:44
  - improvement model
• 19:46
  - that, to me,
• 19:47
  - fundamentally
• 19:48
  - thinks about the patient care ecosystem and the
• 19:51
  - environments of care. So,
• 19:53
  - if you're looking for a one and done,
• 19:55
  - if you're looking for a point solution,
• 19:58
  - and, you know, it's a pretty PowerPoint from
• 20:01
  - Silicon Valley,
• 20:03
  - Please call me, and I'll walk you off
• 20:05
  - the the ledge.
• 20:08
  - Oh, well, I appreciate it. And, Sarah, excellent
• 20:11
  - considerations as well.
• 20:13
  - Just really candid advice you're sharing here. So,
• 20:16
  - to round us out and to really bring
• 20:18
  - it altogether, I know we've touched on what
• 20:21
  - these access challenges are looking like, what to
• 20:24
  - look for in technology and innovation to solve
• 20:27
  - some of these problems.
• 20:28
  - You know, if a CEO or a CFO
• 20:30
  - is listening right now and thinking, we have
• 20:32
  - this problem, whether that be the access points
• 20:36
  - or, you know,
• 20:37
  - vetting technology partners and providers,
• 20:40
  - but they're having a hard time making a
• 20:42
  - decision or prioritizing these issues. What do you
• 20:45
  - both think is the right first move to
• 20:47
  - make next?
• 20:49
  - I would offer
• 20:50
  - clarify your problem statement and your desired outcome.
• 20:53
  - Be really, really explicit, not just make it
• 20:56
  - better, make it faster.
• 20:57
  - Think about accuracy. Think about fidelity. Think about
• 21:01
  - consistency and experience. Thinking about will it reduce
• 21:03
  - anxiety in our patient population and move them
• 21:06
  - closer
• 21:07
  - to care in a more efficient way. I
• 21:10
  - think so getting clear on your problem statement
• 21:12
  - and making sure that there is broad support
• 21:14
  - and alignment that if we were to fix
• 21:16
  - this, it would it would substantively help. It
• 21:19
  - would make it better. That would be
• 21:22
  - recommendation number one. And then recommendation number two
• 21:24
  - is
• 21:25
  - find folks who have gone before you. Everyone
• 21:28
  - is moving at light speed towards AI.
• 21:30
  - Everyone has chosen a different starting place. Right?
• 21:32
  - There there's pockets of organizations who focused on
• 21:35
  - back end first or front end first.
• 21:37
  - Almost everybody's in on the ambient listening game.
• 21:40
  - Right? So
• 21:41
  - find a colleague
• 21:42
  - who has done this, who's evaluated vendors, who's
• 21:45
  - actually up and live. And if you don't
• 21:47
  - know who to ask, reach out. ECG, we
• 21:49
  - can help,
• 21:50
  - provide some some examples or or point you
• 21:52
  - in the right direction, but
• 21:54
  - make sure that the vendors you're entertaining
• 21:57
  - hold up not just when they're doing a
• 21:59
  - pitch deck or a demo because those almost
• 22:01
  - always go well.
• 22:03
  - Make sure they stand up to the Monday
• 22:05
  - morning 10AM
• 22:06
  - operational rush,
• 22:08
  - and and that it holds water in that
• 22:10
  - moment. And and,
• 22:11
  - you know, finally, I think to to Will's
• 22:13
  - point, which is really well taken, this is
• 22:15
  - a journey and it will be continuous improvement.
• 22:18
  - So
• 22:19
  - plan plan on resources that will not just
• 22:22
  - implement a project, but own new work.
• 22:25
  - Make sure you're engaging the right stakeholders from
• 22:27
  - the jump about if we do
• 22:29
  - and, like, for an example, if we
• 22:32
  - make fax transcription
• 22:34
  - go from 100%
• 22:35
  - manual effort to 20% manual effort,
• 22:38
  - What are we not doing today that we
• 22:40
  - could do with that energy in the future?
• 22:42
  - How do job descriptions need to shift?
• 22:44
  - How does upskilling need to happen inside of
• 22:47
  - our own workforce? So
• 22:48
  - think about sustainability
• 22:50
  - and think about the ripple effects that your
• 22:52
  - improvements
• 22:53
  - will have and just get ahead of that
• 22:55
  - get ahead of that conversation. I think those
• 22:56
  - would be my three.
• 22:58
  - Yeah.
• 22:59
  - Fantastic.
• 23:00
  - Will, anything you'd add before we get to
• 23:02
  - some closing thoughts here? Yeah. I'll just add,
• 23:04
  - you know, from my vantage point,
• 23:06
  - every large health system that I talk to
• 23:08
  - or read their Google,
• 23:10
  - you know,
• 23:12
  - values and mission, access is their number one
• 23:14
  - priority. And so if you're a CFO, CEO,
• 23:16
  - or board,
• 23:17
  - ask the question, is your
• 23:20
  - person who is in charge of access today
• 23:22
  - at the c suite?
• 23:24
  - Because I would implore that they should be.
• 23:26
  - Access is
• 23:28
  - probably the one, if not the second, extra
• 23:31
  - quality
• 23:32
  - as
• 23:34
  - you know, this is about patients
• 23:36
  - seeking
• 23:36
  - the best care within your organization.
• 23:39
  - And
• 23:40
  - I can't think of any other kind of
• 23:42
  - more laudable goal and initiative. It is not
• 23:45
  - a program. It is not a certainly not
• 23:47
  - a project.
• 23:48
  - It is a
• 23:50
  - responsibility it needs kind of at the c
• 23:52
  - suite level endorsement.
• 23:54
  - So for the men and women who are
• 23:55
  - performing these roles today as access officers or
• 23:59
  - others,
• 24:00
  - having, you know, that charge, which is important,
• 24:04
  - but also
• 24:05
  - the prerequisite
• 24:07
  - influence because you have to be able to
• 24:09
  - influence IT. You have to be able to
• 24:11
  - influence rev cycle. You have to be able
• 24:14
  - to influence the medical group.
• 24:16
  - And so I think of it through the
• 24:18
  - lens of if it is a priority for
• 24:20
  - your organization,
• 24:22
  - then
• 24:23
  - you need to elevate that person with not
• 24:26
  - just the responsibility.
• 24:28
  - They need to be empowered
• 24:29
  - with accountability and,
• 24:32
  - and leverage. Because I think that's kind of
• 24:34
  - the the the number one observation is if
• 24:36
  - everyone owes access, then no one does. And,
• 24:40
  - you know, empowering the people who are performing
• 24:42
  - it,
• 24:43
  - enabling them and giving them the tools to,
• 24:46
  - do bold, courageous, and different things,
• 24:50
  - I think will,
• 24:51
  - immediately,
• 24:53
  - distinguish those systems that are doing it right,
• 24:56
  - like Sarah kinda shared, and those systems that
• 24:59
  - will have access up on a slide, but
• 25:02
  - still at the end of the day,
• 25:04
  - they know when their loved ones are sick,
• 25:06
  - they're not going into the same queue. They're
• 25:08
  - going around it.
• 25:11
  - Mhmm. Yeah.
• 25:13
  - Well, I I love what you just said
• 25:14
  - because as the the closing question of the
• 25:16
  - day, I was curious what, from both your
• 25:19
  - points of view, it looks like when a
• 25:21
  - health system either,
• 25:23
  - you know, ignores some of these pain points
• 25:24
  - or really leans into them. When a system
• 25:27
  - genuinely gets this right, what does that look
• 25:29
  - like? And I think you're speaking to that
• 25:30
  - there, and it it brings us back full
• 25:32
  - circle to that care orchestration principle.
• 25:36
  - But wanted to open up the floor just
• 25:37
  - for one more minute and and give you
• 25:39
  - both the chance to share any closing thoughts
• 25:41
  - in that regard.
• 25:43
  - I mean, my favorite
• 25:44
  - new little game is any kind of chance
• 25:48
  - to kind of convene folks and leaders, whether
• 25:51
  - it be chief medical officers or IT folks.
• 25:53
  - I ask a fundamental easy question. Hey. You
• 25:56
  - work within a hospital.
• 25:58
  - When you get sick or your loved one
• 26:00
  - does, what do you do?
• 26:04
  - And it is fascinating,
• 26:05
  - probably not shocking that they go, well, listen.
• 26:08
  - Part of the benefit of working at, Saint
• 26:10
  - Elsewhere famous hospital is I know the person
• 26:13
  - to call, and I call them. And, miraculously,
• 26:16
  - I'm able to get seen.
• 26:18
  - And, you know, everyone kinda chuckles, but when
• 26:20
  - you think about that, that is a sobering
• 26:22
  - reality
• 26:24
  - that patients in the community certainly don't get.
• 26:27
  - And I'm not saying that, you know, we're
• 26:29
  - all to blame, but it is a universal
• 26:32
  - truth, and that to me is universally unacceptable.
• 26:35
  - We have to think about equitable,
• 26:38
  - fair,
• 26:39
  - appropriate care
• 26:40
  - regardless of what your badge says. And so,
• 26:44
  - again, I think the call to action,
• 26:47
  - and then the second point is there is
• 26:50
  - an amazing people in systems who have done
• 26:52
  - amazing things, and, you know, Sarah can share.
• 26:56
  - We have an embarrassment or riches of not
• 26:58
  - what necessarily like, here are the things that
• 27:00
  - work, but probably a laundry list of things
• 27:03
  - that haven't worked. And I think information sharing
• 27:06
  - and and thought leadership is is my walkaway,
• 27:10
  - message.
• 27:12
  - Fantastic.
• 27:13
  - Sarah,
• 27:14
  - what would you add here to close this
• 27:15
  - out?
• 27:16
  - Yeah. I I couldn't agree more with what
• 27:19
  - Will said. And that question, what do you
• 27:20
  - do when you need care, I think is
• 27:22
  - incredibly powerful.
• 27:25
  - I I guess, you know, what it should
• 27:27
  - like look like in the future if we
• 27:29
  - get it right
• 27:30
  - is that the answer to that question is
• 27:33
  - I I, reach out through our our standard
• 27:36
  - engagement channels, and I'm confident that they're going
• 27:38
  - to get me the care I need and
• 27:39
  - the options that I need with the right
• 27:41
  - information that I need to feel like I'm
• 27:43
  - receiving the care that's intended.
• 27:45
  - I don't know that any health system right
• 27:47
  - now across the country is there.
• 27:49
  - I think we're all aspiring to that. So
• 27:51
  - I I I do think that's a really
• 27:53
  - powerful and easy way to kind of measure
• 27:56
  - where are we at relative to that journey.
• 27:58
  - To answer your the inverse of the question,
• 28:00
  - what does this look like for folks who
• 28:01
  - kind of ignore this as a as a
• 28:03
  - pain point?
• 28:05
  - I think that we are going to begin
• 28:07
  - to realize
• 28:08
  - on a much larger scale that access to
• 28:11
  - care is safety and quality.
• 28:13
  - The adverse events that happen while people are
• 28:15
  - waiting for nine months if we aren't doing
• 28:17
  - acuity based screening,
• 28:19
  - the fact that we are delaying care by
• 28:21
  - sometimes weeks and months because of administrative errors
• 28:24
  - and unstructured data,
• 28:26
  - I think that's going to begin to compile.
• 28:28
  - I think that's about to be a larger
• 28:29
  - conversation nationally. And I think organizations that ignore
• 28:33
  - access to care systems and front end work
• 28:35
  - streams
• 28:36
  - as critical to act to safety and quality
• 28:39
  - do so at their own peril.
• 28:42
  - Sarah, thank you so much. And, Will, it's
• 28:44
  - been great having you both
• 28:46
  - on this podcast today. Appreciate your candor, your
• 28:49
  - insights, and
• 28:50
  - really sharing what you're seeing at a high
• 28:52
  - level view, in health care right now. It's
• 28:54
  - it's been immensely helpful for me, and I
• 28:56
  - imagine our listeners as well.
• 28:58
  - And, of course, today, we'd also like to
• 29:00
  - thank our podcast sponsor for this episode, ECG
• 29:03
  - Management Consultants.
• 29:05
  - Listeners, please be sure to tune in to
• 29:06
  - more podcasts from Becker's Healthcare by visiting our
• 29:09
  - podcast page at beckershospitalreview.com.