Latest / Becker’s Healthcare - Clinical Leadership Podcast / Jeffrey Hoffman, MD, FAAP, FAMIA, Chief Medical Information Officer at Nationwide Children’s Hospital

Transcript

Jeffrey Hoffman, MD, FAAP, FAMIA, Chief Medical Information Officer at Nationwide Children’s Hospital · Becker’s Healthcare - Clinical Leadership Podcast

• 0:04
  This is the Becker's Healthcare Podcast,
• 0:06
  created by the team of Becker's Healthcare,
• 0:08
  a multimedia company devoted to the people who power us healthcare.
• 0:11
  Four new 15 minute episodes are released daily containing industry news analysis
• 0:15
  and thought leadership.
• 0:16
  From powerful healthcare decision makers Support our show by leaving it a five
• 0:20
  star rating and review on Apple Podcast or other platforms you use.
• 0:23
  It's a chance to tell us what you like about the show and act on your feedback.
• 0:26
  Thanks for listening. Now here's the episode.
• 0:30
  This is Laura Dedo with the Becker's Healthcare Podcast.
• 0:34
  I'm thrilled today to be joined by Dr. Jeff Hoffman,
• 0:36
  chief Medical Information Officer at Nationwide Children's. Jeff,
• 0:39
  it's a pleasure to have you on the podcast today.
• 0:41
  Great to be here.
• 0:42
  Now, I know we have a lot to talk about. There's so much happening,
• 0:45
  especially heading into the fall, um, really with children's health, you know,
• 0:49
  a very much a busy season. But before we dive into the broader discussion,
• 0:52
  can you tell us a little bit more about yourself and your background?
• 0:55
  Sure. Uh,
• 0:56
  I am a clinical informaticist and pediatric emergency medicine physician at
• 1:00
  Nationwide Children's Hospital here in Columbus, Ohio.
• 1:03
  I've been a Chief Medical Information officer for about 12 years and seven years
• 1:08
  ago founded a division of clinical informatics in our department of peds.
• 1:11
  So I currently serve as the division chief as well.
• 1:14
  We have 10 physician informaticists and four clinical informatics fellows in our
• 1:20
  division,
• 1:20
  and we also supervise about three dozen or so e h r provider builders across the
• 1:24
  organization. So it's pretty, pretty large group that, uh, that is focused on,
• 1:29
  uh, provider, uh, interaction with technology and the service of,
• 1:33
  uh, healthcare and all the other goals we have at the institution.
• 1:38
  Absolutely. That's great to hear.
• 1:39
  And I know that sitting between the technology side of it as well as the medical
• 1:43
  and healthcare provider side, you know,
• 1:45
  it just seems like a perfect place to be right now with all the opportunities
• 1:49
  and digital transformation and,
• 1:50
  and working technology into the broader healthcare delivery, um, process.
• 1:55
  So I'm excited to hear your perspective on how that's all working. Um,
• 1:59
  given where we're at today,
• 2:00
  what are some of the big opportunities as well as headwinds that you have your
• 2:03
  eye on right now?
• 2:05
  Yeah,
• 2:06
  so right now we're certainly in an incredible period of opportunities in health
• 2:10
  IT and the use of information technology for, for health and wellness.
• 2:15
  Um, you know,
• 2:16
  for years we've been hearing and talking about things like big data,
• 2:19
  precision medicine,
• 2:20
  all these buzzwords without really a clear idea of how these things would
• 2:24
  directly impact what we do every day.
• 2:26
  And I think we're finally at the point where these technologies, uh,
• 2:30
  really have,
• 2:30
  have matured to the point that we may be getting close to some re reaching some
• 2:34
  of those lofty promises, uh, they held out. Um, yeah,
• 2:38
  I don't have to say much about the hype this year, especially around ai, uh,
• 2:43
  generative AI and the large language models like chat, G P T and all that. Um,
• 2:47
  but with, with tools like that and the,
• 2:50
  and the advances we've made in predictive analytics in general,
• 2:54
  I think everyone's now starting to see the potential for using tools like this
• 2:58
  in all kinds of different areas. Workforce efficiency, patient engagement,
• 3:02
  process automation, safety, quality, um, research. Um,
• 3:07
  of course we're, we're right at the top of the Gartner hype cycle right now. Uh,
• 3:10
  I don't even think it's peaked yet. And on the other side is that dreaded,
• 3:13
  you know,
• 3:13
  trough of disillusionment before things sort of settle down into practical
• 3:16
  applications with real benefits. So there's definitely headwinds. Um,
• 3:21
  and I think it's gonna depend on, um,
• 3:24
  I think those headwinds are really gonna depend,
• 3:26
  determine how these tools are gonna be be used and what impacts they're gonna
• 3:29
  really have. I mean, first of all, we got this incredible, um,
• 3:34
  you know, over hype right now,
• 3:36
  and a lot of companies are trying to capitalize on these inflated expectations.
• 3:39
  So everyone's rushing into incorporate generative AI and such into their
• 3:44
  platforms with, you know, different levels of success.
• 3:46
  And I think AI algorithm is probably the new buzzword. Um, so, you know, having,
• 3:52
  you know,
• 3:53
  having the knowledge and skills to kind of figure out if products and product
• 3:57
  claims are for real, um, you know, if you don't have that, uh,
• 4:01
  you might be wasting a lot of time and money on products that don't live up to
• 4:05
  their promises.
• 4:05
  So just sort of dealing with all of that noise coming from the vendor
• 4:10
  community, not knowing, you know, which are really good products,
• 4:13
  which ones haven't really been, uh, well tested yet in the wild. Um,
• 4:17
  and then on top of that, uh,
• 4:19
  we're facing a lot of pressure with provider and staff burnout,
• 4:23
  workforce shortages, you know, margins are being squeezed,
• 4:26
  patient expectations are at an all time high,
• 4:28
  especially with all this new technology out there. Um,
• 4:32
  and the amount of change these tools bring on is gonna,
• 4:35
  are gonna tax providers and staff who may be already struggling. So, um,
• 4:40
  you know,
• 4:40
  the challenge that me and a lot of my counterparts elsewhere have is trying to
• 4:44
  figure out, you know, which of these tools are most valuable, um, how to, how,
• 4:48
  you know,
• 4:49
  how quickly to implement them and how to minimize just the burden of change that
• 4:53
  we're gonna impose on our, on our workforce, and trying to do that.
• 4:56
  And that's a real delicate balance.
• 5:00
  And I can imagine it,
• 5:01
  it seems like the last couple years there's just been so much thrown at the
• 5:04
  clinical workforce in particular, trying to, um, you know,
• 5:08
  manage some of the challenges with covid and then workforce shortages and those
• 5:11
  kinds of things. And then now with additional data, as you mentioned,
• 5:15
  information, looking at how you can develop and deliver more, um,
• 5:19
  precise medical care and thinking about outcomes, um, how do you really,
• 5:24
  I guess,
• 5:24
  work through some of the people part of that change and making sure that people
• 5:28
  trust the technology and are excited about it,
• 5:30
  and then use it in the right way to deliver the best outcomes.
• 5:33
  Those are really good questions. Um,
• 5:35
  and I think one of the big mistakes oftentimes is we get so excited about the
• 5:39
  technology and what it can do,
• 5:40
  that we put it in there without really thinking about how it integrates into
• 5:43
  the, into the workflow that people do every day. And sometimes it's,
• 5:47
  it's actually that it's an assistant that's adding into their workflow something
• 5:50
  that, you know, might, might, you know, immediately provide benefit or help,
• 5:54
  but oftentimes it requires adjusting or changing a workflow that people might be
• 5:58
  very comfortable with.
• 5:59
  And so you first have to deal with just that anxiety around change in general.
• 6:03
  And then you throw into that the fact that, you know,
• 6:06
  some of these tools come without much explanation as to what they're doing and
• 6:11
  why. So to basically develop, you need to develop a fair amount of trust,
• 6:16
  uh, with the people that are gonna be using these tools and trust in two ways.
• 6:20
  One, that you have confidence that these tools, you know,
• 6:23
  have the accuracy they need, uh, don't, don't introduce additional risk, um,
• 6:27
  are equitable. Um, and at the same time trust that if,
• 6:30
  if things don't turn out that way that you're in position to, to,
• 6:35
  to deal with those,
• 6:35
  either mitigate those issues or maybe maybe switch to some other, uh, process.
• 6:41
  So I think just that two-way communication and trust, um,
• 6:45
  is really important. And if you, if you lose that early,
• 6:48
  it's really hard to get it back.
• 6:51
  That's such a great point, and definitely something to keep in mind, um,
• 6:54
  for all healthcare leaders as they're looking at this transition. Now, I,
• 6:58
  I wanted to ask, what do you,
• 7:00
  how are you thinking about growth and development as well as adding value to
• 7:03
  Nationwide Children's overall in the near future?
• 7:05
  What does that really look like for you? So.
• 7:08
  There's a few different ways to think about growth. You know,
• 7:11
  obviously as a provider organization,
• 7:13
  we're looking for opportunities to expand our services, our service offerings,
• 7:16
  geographic reach,
• 7:18
  but the explosion of telehealth has really dramatically changed the competitive
• 7:21
  landscape we're in. You know,
• 7:23
  we're a freestanding children's hospital in central Ohio,
• 7:25
  and we're the largest provider by far of pediatric services in our local region.
• 7:30
  And that has historically insulated us from a lot of competitive pressures,
• 7:34
  even in a state like Ohio,
• 7:35
  where we have four major children's hospitals within probably a two to three
• 7:38
  hour drive of each other. Um, but with telehealth now in the mix,
• 7:42
  we really have needed to double down on our areas of strength. We need to, we,
• 7:46
  we really are focusing on creating more dynamic destination programs and
• 7:50
  offering services that are difficult to find elsewhere.
• 7:54
  And the same thing's happening in terms of our IT platforms and services,
• 7:57
  you know,
• 7:58
  pretty much any clinical program these days rely heavily on technology to
• 8:02
  support all their patient care needs, population, health,
• 8:05
  quality improvement and so on. Um, so as a result,
• 8:08
  we've been heavily investing over the past several years in core capabilities
• 8:12
  really to take care of all those areas and to maximize the functionalities in,
• 8:17
  in what we have and what we own. So the E H R, of course, telehealth platforms,
• 8:21
  analytic tools and such. In our case,
• 8:23
  we put together a strong data science team so we could develop internal,
• 8:26
  internally things like predictive models and, uh, you know,
• 8:30
  use natural language processing, augment and virtual reality, things like that.
• 8:34
  Um, so we built up the technical infrastructure and skilled workforce to deploy
• 8:39
  these tools in,
• 8:39
  in real work clinical settings so that we can study their benefit and we
• 8:43
  continue to look for new opportunities, you know,
• 8:46
  to really take care of patients and families, but as importantly,
• 8:50
  to take care of our providers, our nurses,
• 8:52
  and the rest of our nearly 14,000 employees. So, so really it's,
• 8:56
  it's around really identifying what we are best at investing
• 9:01
  in that,
• 9:02
  and then letting that be our calling card both in our region and outside of
• 9:07
  our region.
• 9:09
  I love that. I,
• 9:10
  I think it's sort of just fascinating to hear about and think about ways that
• 9:14
  telemedicine, virtual care and all those other different and,
• 9:18
  and unique care delivery, um, I guess modalities, um,
• 9:21
  that have been popping up really can change the way you look at, um,
• 9:25
  healthcare in, in the competitive landscape. Now, I know, um,
• 9:29
  especially in the last year, uh,
• 9:31
  just resources within the hospital have been a little bit more pinched than
• 9:34
  usual, whether it's financial, manpower, work hours, et cetera,
• 9:39
  but it's still important to kind of look it through and think about, you know,
• 9:42
  where are areas we need to double down,
• 9:43
  as you mentioned that we're doing really well. So from your perspective,
• 9:46
  what is one risk or investment that's still worth making this year?
• 9:52
  So this might seem like an obvious choice,
• 9:54
  but I really think everyone should at least dip their toes into
• 9:59
  the newer AI tools if they can. The, especially the generative AI tools, um,
• 10:03
  things like chat, g p T based applications somewhere in their organization.
• 10:07
  You know,
• 10:07
  I don't expect everyone to have the technical capabilities to train their,
• 10:11
  our own, their own large language model or,
• 10:13
  or even tweak one that's commercially available. Um,
• 10:16
  but I think it's important to begin to understand what these things can do and,
• 10:19
  and as importantly, what they can't do,
• 10:21
  what everyone's comfort level is with this technology in terms of accuracy,
• 10:25
  bias, potential, legal liability, um, because, you know,
• 10:29
  this is a train that's coming and you, you can't,
• 10:32
  you're gonna be faced with using these tools at some point. Um,
• 10:35
  and like I said before,
• 10:36
  every vendor seems to be baking these sorts of tools into their products.
• 10:39
  And new companies seem to be popping up everywhere with entirely new types of
• 10:43
  products based on these kinds of technologies.
• 10:45
  So with all the hype and swirl and all these choices, it,
• 10:49
  it can really be hard to know where to start.
• 10:51
  My suggestion would be either to trial a feature like this in one of your
• 10:55
  existing applications, or, um,
• 10:58
  perhaps applied by a large or stable vendor that you trust, uh,
• 11:01
  or you can be more adventurous, try something, you know, totally new, um,
• 11:04
  even from a small or a new vendor, um,
• 11:07
  in an area basically where you can afford,
• 11:10
  afford it to fail if it doesn't deliver on its promise. You know,
• 11:13
  I personally have no doubt that these tools are gonna become ubiquitous and
• 11:18
  essential in the coming years. So, you know,
• 11:20
  you certainly don't wanna be left behind and you don't want to be behind the
• 11:24
  curve in adopting them.
• 11:25
  But really anybody who's trying to be on the cutting edge with these tools,
• 11:28
  I say caution, um, until we have more history with them,
• 11:32
  it's hard to know what specific, you know,
• 11:34
  technologies or platforms will fall utterly flat and which ones will be
• 11:38
  transformational. So I,
• 11:39
  I think it'll be really interesting to look back at this period and maybe,
• 11:42
  you know, five, six years from now and see what stuck and what sank.
• 11:48
  Yeah, truly, it seems like right now they're just, uh,
• 11:50
  such a broad field of technologies and companies and both established as well as
• 11:55
  startups that are trying to figure out where the sweet spot is for, um,
• 11:59
  really making a difference in the healthcare space. And when you look at,
• 12:02
  you know, um,
• 12:03
  yourself and Nationwide Children's and adopting new technologies or innovations,
• 12:07
  um, like you said, obviously you don't wanna be, uh, first to the punch, but,
• 12:12
  but don't wanna be lost either. Where do you really see yourself on that, um,
• 12:15
  I guess innovation scale in terms of, um, being able to,
• 12:19
  to wanting to jump in and, and, but,
• 12:22
  but also making that balance with not, you know, uh,
• 12:25
  taking on too much risk with something new.
• 12:28
  It is, it is a very delicate balancing act, um,
• 12:32
  partly because the resources to do these kinds of things,
• 12:34
  whether you're buying a, a commercial product or,
• 12:37
  or building things in house with local resources,
• 12:39
  it's expensive and there's risk involved. I think that, um, you know, in,
• 12:44
  in our case, uh,
• 12:45
  what we have decided to do is take a very deliberate,
• 12:50
  uh, use case focused approach. Um,
• 12:53
  while this meaning find things where we know we have a need,
• 12:56
  there isn't necessarily something out there that can do what we want it to do,
• 13:00
  or maybe in some cases there are and, and, and try them out and see,
• 13:04
  see how they work. So, you know, we've,
• 13:06
  we've deployed some really innovative predictive analytics tools, uh,
• 13:10
  for some of our high risk patient populations. Um,
• 13:14
  and that was done after a, a, a significant amount of not just development time,
• 13:19
  but testing and running scenarios and simulations and figuring
• 13:24
  out what the impact would be, not just on the benefits,
• 13:27
  but also the burden that they sometimes put on work workforce, uh, members. Um,
• 13:32
  and then also, um, you know, we, we definitely,
• 13:37
  uh, want to want to try to,
• 13:43
  um, see what our peers are doing. We want,
• 13:47
  we want to make sure that what the expectations that are being put on us by our
• 13:52
  patients, by our families, by our staff, um, you know,
• 13:55
  how others are addressing those. Um,
• 13:56
  because I think this is an area where we can really learn from each other. I,
• 14:00
  I don't think all of us, uh, really can afford to, uh,
• 14:04
  try things out ourselves without having some indication of,
• 14:08
  of how it's gone elsewhere. And I know that means someone has to go first,
• 14:11
  and sometimes that's us, but we're also happy to let others go first and,
• 14:15
  and us follow quickly behind.
• 14:17
  That makes a lot of sense and truly seems like a, a very smart strategy, um,
• 14:21
  in approaching the very many, uh,
• 14:23
  new technologies and opportunities there are in the digital transformation
• 14:27
  space. Now, before we wrap up our conversation,
• 14:30
  I just wanted to return to growth one more time.
• 14:32
  Where do you see some of the best opportunities in the future?
• 14:34
  I know we've talked through a few different, uh,
• 14:36
  key changes that are happening as healthcare evolves and healthcare delivery
• 14:40
  changes. What, what's your perspective on the future more long term?
• 14:45
  So from where I sit, um,
• 14:46
  what I see as some of the best opportunities for growth are in
• 14:51
  extending existing expertise, our existing expertise into, into new areas,
• 14:56
  new markets. Um, obviously telehealth and remote patient monitoring,
• 15:00
  e-consult services play a big part, but also really, um,
• 15:04
  developing and maintaining really strong partnerships regionally, nationally,
• 15:07
  and some cases internationally.
• 15:09
  There's historically been a lot of friction for outside providers and new
• 15:14
  patients trying to interact with health systems, and we're no exception to that.
• 15:18
  You know, patient access has historically been a major challenge, and I know,
• 15:21
  uh, we and others deal with that all the time. Uh,
• 15:24
  some of that can be facilitated or helped with technologies we're focusing on
• 15:28
  ones that can improve communication, both internally and externally.
• 15:32
  Certainly looking for ways to streamline operations, uh,
• 15:35
  referral routing automation, these AI powered chatbots.
• 15:38
  We're looking into paperless workflows we're trying to adopt and really lowering
• 15:42
  barriers to access, uh, from things as sort of that,
• 15:47
  that aren't always on the radar. Things like, uh, you know,
• 15:49
  transportation and travel difficulties where telehealth might be a solution or,
• 15:53
  you know,
• 15:54
  language barriers where remote interpretation services or auto translation tools
• 15:57
  could really be helpful. So, you know,
• 16:00
  focusing application of these tools and technologies can really attract new
• 16:04
  patients, looking for key services that, um, that we can offer and, uh,
• 16:09
  allow us to retain our existing patients who might be tempted to look elsewhere
• 16:12
  because we can provide the same amount of patient engagement that our peers do,
• 16:16
  and certainly they expect from dealing with, you know,
• 16:18
  other industries that have already adopted a lot of these same tools and, and,
• 16:23
  and technologies.
• 16:25
  That's a great point. It definitely, you know, makes a lot of sense. Uh,
• 16:29
  thank you so much for joining us on the podcast today, Jeff.
• 16:31
  This has been really a fun and interesting conversation and I look forward to
• 16:34
  connecting with you again soon.
• 16:35
  It's been fantastic. Thank you.
• 16:39
  It's so important for leaders at the top of organizations to keep learning,
• 16:42
  stay sharp,
• 16:43
  grow their networks to help our audience better do this in a more simplified,
• 16:47
  personalized, and meaningful way. Becker's Healthcare has launched my B h c,
• 16:52
  it's your trusted Becker's healthcare experience and more with content,
• 16:55
  connections, events and learning opportunities.
• 16:58
  Join the community free of charge@www.my dot becker's
• 17:03
  hospital review.com and we'll see you there.