Latest / Becker’s Healthcare Digital Health + Health IT / Luis E. Taveras, PhD, Executive Vice President and Chief Digital and Information Officer at Jefferson Health

Transcript

Luis E. Taveras, PhD, Executive Vice President and Chief Digital and Information Officer at Jefferson Health · Becker’s Healthcare Digital Health + Health IT

• 0:02
  - There's a version of AI in health care
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  - For the agenda and event details, visit beckershospitalreview.com
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  - upper right.
• 1:00
  - This is Laura Dierda with the Becker's Healthcare
• 1:02
  - podcast. I'm thrilled today to be joined by
• 1:04
  - doctor Luis Tavares, executive vice president and chief
• 1:07
  - digital and information officer at Jefferson, which includes
• 1:10
  - Jefferson Health, Thomas Jefferson University, and Jefferson Health
• 1:13
  - Plans. Doctor Tavares, it's a pleasure to have
• 1:15
  - you on the podcast today.
• 1:17
  - Great being with you. Thank you for inviting
• 1:19
  - me.
• 1:20
  - Absolutely.
• 1:21
  - Now I'm excited for our conversation. I know
• 1:23
  - you're always doing some amazing things at Jefferson,
• 1:25
  - and certainly,
• 1:26
  - right now,
• 1:27
  - the transformation in health care is so, broad
• 1:30
  - and vast that it's hard to keep up.
• 1:32
  - But, I I know we're gonna talk a
• 1:34
  - little bit today about some of the things
• 1:36
  - that you've been able to accomplish in the
• 1:37
  - last year as well as your perspective on
• 1:39
  - the future. But before we do that, can
• 1:41
  - you just tell us a little bit more
• 1:42
  - about yourself and Jefferson?
• 1:46
  - So Jefferson,
• 1:47
  - we are
• 1:48
  - a regional system,
• 1:50
  - an academic medical center
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  - that includes, as you mentioned before, the university,
• 1:56
  - the health plan, and then the Jefferson Health,
• 1:59
  - which includes 33 different hospitals across this region
• 2:02
  - in Eastern Pennsylvania,
• 2:04
  - the Philadelphia regions, and South Jersey.
• 2:07
  - It also includes 700 or so care locations
• 2:10
  - across the region. And we'll continue to figure
• 2:13
  - out how to increase access to all the
• 2:15
  - populations that we serve
• 2:17
  - and really are focused on that. How do
• 2:19
  - we keep those communities that we serve healthy,
• 2:22
  - as much as we can?
• 2:26
  - That makes a lot of sense, and I
• 2:28
  - know it's top of mind for so many
• 2:29
  - communities across the country is looking at that
• 2:32
  - access problem and the health disparities gap, and
• 2:34
  - then how do we close it and really
• 2:36
  - make sure that,
• 2:38
  - community knows what's going on at the hospitals
• 2:40
  - and systems and and is able to work
• 2:42
  - with them on that. So, with that in
• 2:44
  - mind, could you tell me about some of
• 2:46
  - the most powerful forces that you're seeing shape
• 2:48
  - digital health and IT at Jefferson right now?
• 2:51
  - And how do you anticipate those are gonna
• 2:53
  - change in the next year or so?
• 2:55
  - So I I think it goes back to
• 2:56
  - that access discussion,
• 2:58
  - which is how do we increase access?
• 3:00
  - And don't think of it from the traditional
• 3:02
  - way, which is people come into the hospital
• 3:05
  - or people go into a clinic.
• 3:07
  - We have to think of new ways
• 3:10
  - of having our patients come to us and
• 3:12
  - us go to our patients because we're going
• 3:14
  - to have to figure out ways to meet
• 3:15
  - our patients where they are. So digital health,
• 3:18
  - virtual care, those are all things that we're
• 3:21
  - looking at, how to reach our patients through
• 3:23
  - all technologies that we now have available to
• 3:25
  - us.
• 3:30
  - That makes a lot of sense. You know,
• 3:31
  - I'm curious when you think about that network
• 3:33
  - of digital health and the opportunities
• 3:36
  - to connect with people outside of the hospitals
• 3:38
  - and clinics.
• 3:39
  - Can you talk us about the infrastructure that
• 3:41
  - you've built at Jefferson? I know,
• 3:43
  - it's pretty robust. And so how are you,
• 3:46
  - able to most efficiently and effectively make sure
• 3:48
  - that, you've got that digital patient experience,
• 3:51
  - going down? And, you know, what have you
• 3:53
  - been able to tweak about it over the
• 3:55
  - years to make it truly effective?
• 3:57
  - So one thing that we've been really working
• 3:59
  - the past decade, I would say,
• 4:02
  - is really virtual care.
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  - We have many areas that don't have all
• 4:07
  - the experts that we need,
• 4:09
  - top neurologists,
• 4:10
  - top cardiologists,
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  - but we have to provide that level of
• 4:13
  - care in those locations too.
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  - So we have someone
• 4:17
  - that's an expert,
• 4:19
  - highly known neurologist,
• 4:21
  - neurologist in the Philadelphia region, and we may
• 4:24
  - have a case up in the the Poconos,
• 4:26
  - which is two, three hours away,
• 4:28
  - that we may need,
• 4:30
  - that person to care for a patient up
• 4:32
  - there. And we provided the environment so virtually,
• 4:35
  - our physicians, our specialists
• 4:37
  - can really care for patients throughout the entire
• 4:39
  - organization.
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  - That's really cool to hear, and it definitely
• 4:44
  - seems like a a great advantage,
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  - of having that technology and being able to
• 4:49
  - share the expertise and,
• 4:51
  - go, you know, in that virtual setting. Now
• 4:54
  - can you go a little bit deeper and
• 4:55
  - tell us about a a big swing or
• 4:57
  - or project you did in the last year
• 4:59
  - that really paid off? What did you do,
• 5:00
  - and what were the results?
• 5:03
  - So that I think many people are
• 5:05
  - going through the same experience as us when
• 5:07
  - it comes to,
• 5:08
  - Ambien technology
• 5:10
  - and what we've done in that space.
• 5:12
  - About a month and a half ago, we
• 5:14
  - completed a 1,000,000
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  - note created through Ambient Technologies.
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  - So that that was an amazing accomplishment
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  - within a nine months period of rolling out
• 5:23
  - the solution that we have for Ambient.
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  - So our physicians have really, really adopted Ambien.
• 5:29
  - It's making a tremendous difference in their quality
• 5:32
  - of life.
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  - The fact that they can finish a discussion
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  - with a patient, a patient visit,
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  - and by the time they're done, the note
• 5:39
  - has been created. They look at that note.
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  - They approve that note, and they're done. They
• 5:43
  - don't have to worry about five, six hours
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  - later,
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  - creating that note for that patient or when
• 5:48
  - they go home spending all their time creating
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  - notes and catching up with notes for the
• 5:52
  - patient. So it's been a big, big game
• 5:54
  - changer for our medical staff to be able
• 5:56
  - to do that. Now we're looking at the
• 5:58
  - real impact that it will have, which is
• 6:00
  - in the nursing space. So we're doing a
• 6:02
  - couple of trials with nurses,
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  - because we think that it's gonna have the
• 6:06
  - similar effect for nurses. We've heard from nurses
• 6:09
  - already that on the on the pilot program,
• 6:11
  - I'm now able to take my lunch. I
• 6:13
  - was able to do that before. I'm now
• 6:15
  - able to leave at the end of my
• 6:17
  - shift instead of having to stay an hour
• 6:18
  - or two later doing documentation.
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  - So it's been truly impactful, and we're looking
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  - for many different ways to use that in
• 6:26
  - the inpatient setting in the in the ER
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  - when the patient comes into the ER.
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  - So, again, we're looking for different areas of
• 6:32
  - use, for that because it's been tremendous for
• 6:34
  - us.
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  - That's amazing to hear. And what a big
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  - difference, that makes for the clinical team when
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  - you're looking at being able to even take
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  - a lunch during the day or, be able
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  - to go home and spend time with your
• 6:48
  - families and not have to worry about that
• 6:50
  - documentation.
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  - So I'm curious as you're expanding this technology
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  - to the nursing staff,
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  - what's different, you know, for them than the
• 6:59
  - clinician or the physicians? And from your perspective,
• 7:02
  - you know, what are some of the roadblocks
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  - that, you're seeing, if any, as you're trying
• 7:07
  - to roll off this technology more broadly?
• 7:09
  - So when you think of the, the
• 7:12
  - the workflow
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  - for a physician doing a patient visit
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  - versus the nurse's workflow is completely different.
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  - The physicians are very used to having this
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  - discussion with a patient. The only big difference
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  - now is that they're actually facing the patient,
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  - which is terrific. Right? Instead of facing the
• 7:29
  - workstation, type it into the workstation, actually facing
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  - the patient. But But from that standpoint, it's
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  - normal. They they have this discussion all the
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  - time. For nurses, it's a very different story
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  - because
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  - most of what the nurses do
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  - is in silent.
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  - They take vitals.
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  - They look at the patient. They evaluate the
• 7:46
  - patient, but they don't really talk a lot
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  - to the patient. So now we're asking to
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  - do nursing out loud,
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  - which is talk to the patient. So as
• 7:54
  - you talk to the patient, the notes are
• 7:56
  - being captured. The other big difference is from
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  - a technology perspective,
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  - the physician's notes, even though they're structured, they're
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  - somewhat free flow.
• 8:06
  - On the nursing side, it's different because nurses'
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  - notes are based on templates.
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  - So the AI has to be much more
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  - intelligent to be able to complete those templates
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  - based on what it's hearing from the nurse
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  - and and discussion with the patient. So that's
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  - that's the big difference. So very different workflow,
• 8:22
  - very different way to adapt to it because
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  - the nurses are just not used to have
• 8:27
  - it being conversational.
• 8:31
  - That's fascinating to hear about it. Are, in
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  - your experience, nurses embracing that? Or,
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  - is it what's the change management like in
• 8:39
  - being able to do more nursing out loud?
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  - So we've seen with our, pilot,
• 8:45
  - pilot cases that we're running now that nurses
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  - are really embracing because they see the end
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  - result,
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  - what I mentioned earlier.
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  - The other interesting,
• 8:54
  - finding that we have is that, of course,
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  - we have a nursing school. So you have
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  - lots of,
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  - nurses that are in training that are shattering
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  - nurses on the floor.
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  - And what we're learning is that the students
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  - really love it because they don't have to
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  - try to figure out what the nurses are
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  - actually trying to do or say. They actually
• 9:13
  - hear it so that the learning is much
• 9:16
  - better than it was before.
• 9:19
  - That's cool to hear. And, definitely, I can
• 9:21
  - imagine we'll continue to evolve and grow and
• 9:23
  - and make a big difference for that nursing
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  - team.
• 9:26
  - Now,
• 9:27
  - that you are obviously
• 9:29
  - implementing the Ambient
• 9:31
  - technology and and, everything else is great to
• 9:34
  - hear. But what is then the next most
• 9:37
  - important problem that you're trying to solve with
• 9:39
  - AI or technology? What's,
• 9:42
  - kind of the next frontier for you?
• 9:45
  - So the the big, big frontier for us
• 9:47
  - is really thinking about
• 9:49
  - what AI allows us to do today.
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  - When you think about the way that we've
• 9:54
  - grown up in health care, and I've been
• 9:56
  - in in IT now for forty five years.
• 9:58
  - I've been in health care IT for forty
• 10:00
  - years, and I've been a CIO for the
• 10:02
  - last twenty five years in different organizations.
• 10:04
  - But they all we all function the same
• 10:06
  - way. 99%
• 10:08
  - of what we have, the applications that we
• 10:10
  - have, are things that we buy.
• 10:12
  - That's how we've grown up. We buy first
• 10:15
  - and very, very little internal development.
• 10:19
  - With the ability of AI today and how
• 10:21
  - quickly we can write our own code and
• 10:24
  - put on applications in place, we have to
• 10:26
  - really rethink that and say, do we now
• 10:29
  - switch from a buy
• 10:31
  - first
• 10:32
  - to a build first?
• 10:34
  - And what does that mean? What are the
• 10:36
  - implications of that?
• 10:37
  - Do I have to change the way that
• 10:39
  - I structure my IT team? Do I have
• 10:41
  - to now build development team and figure how
• 10:44
  - to support those applications?
• 10:46
  - So those are big, big question that I
• 10:47
  - think I'm not the only one that's, looking
• 10:49
  - at that today that we really have to
• 10:51
  - address because AI
• 10:53
  - is changing the way that we do things.
• 10:56
  - And I know we I you and I
• 10:57
  - have talked before about the fact that we
• 10:59
  - have to rethink computing in health care.
• 11:02
  - I'm kind of up in that to saying,
• 11:04
  - we really have to reimagine
• 11:06
  - computing in health care.
• 11:08
  - That's really where we have to go now
• 11:09
  - because a completely, completely different environment that we
• 11:12
  - where we live in the next three to
• 11:13
  - five years or even before that, given the
• 11:16
  - speed of how things are moving.
• 11:20
  - That's fascinating to hear. And, of course, as
• 11:22
  - you mentioned, you know, things are going so
• 11:23
  - quickly. And with, you know, the variety of
• 11:26
  - technologies coming out now, and and it seems
• 11:28
  - like more people are becoming,
• 11:31
  - familiar or or able to use them,
• 11:34
  - in a variety of different ways. And so
• 11:36
  - how are you dealing with or managing some
• 11:38
  - of that as as people are trying to
• 11:40
  - figure out how to command AI or doing
• 11:42
  - more of that building? What does that really
• 11:43
  - look like from both, you know, the opportunity
• 11:45
  - standpoint as well as the risk standpoint?
• 11:47
  - So the the key for us is really
• 11:51
  - education and awareness
• 11:54
  - to everyone across the organization. 65 different yes.
• 11:57
  - 65,000
• 11:58
  - colleagues across the organization.
• 12:00
  - How do we educate them on AI
• 12:02
  - so that we alleviate some of the fears
• 12:04
  - that exist out there in AI?
• 12:07
  - But then how do we get them to
• 12:08
  - understand how AI will fit into their environment
• 12:11
  - and make them much more effective than they
• 12:13
  - are today?
• 12:14
  - And that's a process that we started to
• 12:17
  - we have a very strong education program that
• 12:19
  - we have in place. We have a three
• 12:20
  - hour course that we've put together that we
• 12:23
  - can
• 12:24
  - deliver as a three hour course, contiguous,
• 12:26
  - or we can do as three different sessions.
• 12:28
  - And we're taking many parts of the organization
• 12:30
  - now, and we're starting to go through that
• 12:32
  - process Because it really, really comes down to
• 12:35
  - making helping people to feel really comfortable with
• 12:38
  - AI
• 12:39
  - and not fear that AI is gonna take
• 12:41
  - their job. That's not the intent. That is
• 12:44
  - absolutely not the intent for us. We're looking
• 12:46
  - to have a human in the loop, which
• 12:48
  - is it with whether it's a clinical application,
• 12:51
  - administrative application, or financial, there's always gonna be
• 12:53
  - a human in the loop. But our focus
• 12:55
  - is making our our team much more effective
• 12:57
  - than they are today using AI and other
• 13:00
  - new technologies that are coming down the road.
• 13:05
  - Got it. That's so interesting. It makes a
• 13:07
  - lot of sense in terms of, you know,
• 13:08
  - being able to leverage the humans for that
• 13:11
  - human capacity work and then,
• 13:13
  - technology for the ways that the technology can
• 13:15
  - support what you're trying to do in health
• 13:17
  - care delivery. So,
• 13:19
  - that's great. I think before we wrap up
• 13:20
  - here, just one more question.
• 13:22
  - What are you most curious about for the
• 13:24
  - future? What are you thinking about? And, really
• 13:27
  - excited to learn more about how it'll play
• 13:28
  - out.
• 13:30
  - So
• 13:31
  - I'm really thinking about
• 13:33
  - in the next
• 13:34
  - two years or so,
• 13:36
  - what is the impact of AI in every
• 13:39
  - facet of our organization?
• 13:41
  - So I'm not just looking at it from
• 13:43
  - the IT perspective because AI right now, AI
• 13:46
  - is not an IT,
• 13:48
  - area. It's really organizational
• 13:50
  - thing that we're looking at.
• 13:52
  - So that's one thing. But, also,
• 13:54
  - I'm really looking also five years down the
• 13:57
  - road,
• 13:58
  - right, when we get to quantum computing. How
• 14:01
  - is quantum gonna impact the way that we're
• 14:03
  - thinking now? Think of the impact that AI
• 14:05
  - is having. What's the possible impact of quantum
• 14:07
  - computing when it really gets to the point
• 14:09
  - where we can make it put it to
• 14:10
  - use in our environment?
• 14:12
  - It's it's gonna really, really change. I mean,
• 14:15
  - we're going through revolutionary changes now, but think
• 14:17
  - about going through that again in three, four,
• 14:19
  - five years when quantum really take takes over,
• 14:22
  - where AI is gonna leave us.
• 14:26
  - Yeah. It's fun to think about. Lots of
• 14:28
  - unknowns, it seems like, but, really could have
• 14:31
  - a transformative impact. And,
• 14:33
  - preparing today and then just thinking through everything
• 14:36
  - that is occurring now, it it seems like
• 14:38
  - a really important thing to be doing if
• 14:41
  - you yourself are a CIO or a digital
• 14:43
  - officer and leader of the health system.
• 14:46
  - Yeah. It it's, it's so exciting. You know,
• 14:48
  - like I said, I've been around this for
• 14:50
  - a very long time, and I try to
• 14:52
  - think about,
• 14:54
  - what in in my forty five years, what
• 14:56
  - has happened that's something similar to this? And
• 14:59
  - the only thing that I can think of
• 15:01
  - was back in the early eighties when we
• 15:02
  - announced the,
• 15:04
  - the personal computers and the impact that it
• 15:07
  - had.
• 15:08
  - But it's nothing compared to what AI is
• 15:10
  - what AI is doing now to really revolutionize
• 15:13
  - what we think, how we do things, and
• 15:16
  - how we can imagine how we can do
• 15:18
  - things.
• 15:19
  - Because we have to use imagine
• 15:21
  - imagination on how to use this technology
• 15:23
  - and also really focus on how do we
• 15:26
  - manage this technology from,
• 15:28
  - protecting the organization.
• 15:31
  - Because, yes, we have access to it. But
• 15:33
  - guess who else has access to it? All
• 15:35
  - these cyber criminals across the globe have access
• 15:37
  - to it. So we have to really make
• 15:38
  - sure that we not only use it for
• 15:41
  - the good that we have, but so also
• 15:42
  - for protecting the organization
• 15:44
  - from these folks that wanna hurt us in
• 15:46
  - many different ways.
• 15:48
  - Absolutely. That's such a great reminder. Doctor Tavares,
• 15:51
  - thank you so much for joining us on
• 15:52
  - the podcast today. This This has been an
• 15:54
  - informative conversation, you know, really
• 15:57
  - cool to think about and and reimagine what
• 15:59
  - health care is gonna look like and then,
• 16:01
  - how we can take steps today to get
• 16:03
  - there. So,
• 16:04
  - thank you so much for your time, and
• 16:06
  - I'm looking forward to
• 16:08
  - seeing you as well in September. I know
• 16:09
  - you'll be speaking at our health IT, digital
• 16:10
  - health room revenue cycle conference coming up, and
• 16:13
  - so it'll be fun to dig deeper into
• 16:15
  - many of these themes and see you in
• 16:16
  - person.
• 16:17
  - Yep. Looking forward to seeing you, and thanks
• 16:19
  - for having me today.