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Building a Measurable AI Strategy for Rural Health Systems with Bob Berbeco · Becker’s Healthcare Digital Health + Health IT

• 0:00
  - Hello, and welcome to the Becker's Healthcare Podcast.
• 0:02
  - My name is Chanel Banger, and I'm recording
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  - live at the Becker's eleventh annual Health IT
• 0:07
  - Digital Health and RCM Conference in Chicago. And
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  - I'm thrilled to be joined by Bob Berbecco,
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  - the chief information officer at Mahaska Health. Bob,
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  - I'm excited for our conversation today. But before
• 0:18
  - we dig in, can you tell us a
• 0:20
  - bit about yourself and your background? Absolutely.
• 0:22
  - So I,
• 0:24
  - work at Mahaska Health, and we're a rural
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  - health care organization,
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  - Southeast Iowa.
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  - And I lead information technology,
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  - data science, artificial intelligence,
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  - cybersecurity,
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  - informatics.
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  - And my role really sits at the intersection
• 0:41
  - of technology operations and patient care.
• 0:45
  - So my career
• 0:46
  - over,
• 0:48
  - few decades now has... I started very technical.
• 0:52
  - And then over over the years, I,
• 0:55
  - grew into executive leadership.
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  - And I look to apply, like, those technical
• 0:59
  - skills that I started with and what I
• 1:01
  - do as an executive.
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  - But, really, what I enjoy the most today
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  - is taking that experience and applying it in
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  - a environment where you can see the impact
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  - of decisions very directly.
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  - And at Mahaska, our goal is pretty simple.
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  - Make technology useful.
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  - Love it. And now that we have a
• 1:17
  - sense of your background,
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  - give us a quick state of the union.
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  - What has gone well this year, and what
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  - are you focused on for the rest of
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  - 2026?
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  - Yeah. Absolutely. So I would say that one
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  - of the initiatives that we've had that I'm
• 1:29
  - really proud of right now is we've really
• 1:32
  - matured our approach to AI. So, you know,
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  - AI's got all the buzz and it's got
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  - all the sizzle. And if you have the
• 1:39
  - chief title, everyone's coming to you and they
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  - wanna sell you AI products. So what we
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  - did is we moved away from this idea
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  - of launching
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  - a collection of isolated AI pilots,
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  - and
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  - we
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  - introduce structure to it.
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  - So now we have... We we call it
• 1:56
  - our center of excellence, but it also
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  - acts as a brainstorming group. We ideate. We
• 2:02
  - think about. We we put
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  - plans together in this group.
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  - And the the goal is is
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  - to have governance, prioritize
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  - measurement,
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  - and clear ownership
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  - as part of the process.
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  - And and I'm partnership based. So this group
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  - is...
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  - Got physicians.
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  - It's got clinicians.
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  - It has beta scientists. It has AI
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  - specialists,
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  - has myself.
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  - And and really what we do, we just
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  - get there and we we talk about the
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  - needs,
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  - you know, physician needs, clinician needs, and how
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  - can technology impact those. And it has been
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  - so worthwhile in so many different arenas.
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  - You know, we've been able to implement.
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  - And not only that, people talk about engagement
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  - when it comes to technology. If you start
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  - at the beginning, you start... I like to
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  - say the gemba start at the source. You
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  - create engagement by involving people. And if they're
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  - involved in the ideation piece,
• 3:00
  - you don't have this back end in engagement.
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  - And so that's one of the things that
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  - I've I've really felt like we've accomplished.
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  - And then some other things too is as
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  - we're implementing these,
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  - we are trying to be and doing,
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  - what we can to be regimented in our
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  - measurement.
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  - So we
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  - have blue dollars, which are like,
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  - workflow
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  - and steps avoided
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  - in time, create... Or capacity created, reduced time.
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  - And then you have green dollars, which are,
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  - like, the true hard dollar savings
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  - or additional revenue.
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  - And what we do is we start having
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  - what our goals are at the beginning, and
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  - then we measure it as it gets implemented.
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  - And, hopefully, we hit those goals.
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  - Because we're we're really looking to
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  - require technology to show operational value
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  - and not just technical capability.
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  - And
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  - we're we're smaller too, and you don't wanna
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  - have so much complexity in our environment. So
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  - we're trying to avoid redundancy
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  - We'll set. Got it. I love that you
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  - have all the different perspectives all working together
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  - Mhmm. To tackle the issues. And,
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  - on the flip side of that, what are
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  - the biggest headwinds that you're keeping an eye
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  - on and preparing for?
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  - Yeah. I would say one of the biggest
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  - challenges that we have right now is
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  - you have keep the lights on,
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  - what's going on today, and then you're also
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  - wanting to innovate. You're also wanting to
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  - be ready for what is new. And then
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  - the other thing too is health care is
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  - extremely complex.
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  - So,
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  - you know, in health systems, we're being asked
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  - to improve access,
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  - reduce burden,
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  - strengthen cybersecurity,
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  - optimize revenue cycle, have AI there too,
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  - improve the patient experience
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  - while you're still keeping the lights on every
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  - day. And from a technology perspective, that involves
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  - a lot of complexity. And the danger that
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  - we have is if we respond by just
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  - adding more technology and more point solutions, we're
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  - gonna create gonna create even bigger problem than
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  - what we have. So what we've done, our
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  - approach, is
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  - we look to simplify where we can
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  - and strengthen
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  - our data and our foundation, like our governance
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  - foundation. And then Epic is our
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  - EMR,
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  - and we we just look to use that.
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  - And then as we're adding those point solutions
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  - or those third parties,
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  - we're being extremely
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  - precise in
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  - exactly what are we looking to... What needle
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  - are we looking to move strategically, and does
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  - it fit within our strategic plan?
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  - So I'll... As a quick example,
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  - revenue cycle
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  - in particular,
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  - huge, enormous,
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  - capabilities for AI,
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  - denial prediction,
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  - appeal support, coding assistance,
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  - remittance analysis,
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  - workflow prioritization.
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  - And you look to apply AI to it,
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  - but you wanna also have human ownership and
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  - you wanna have measurable outcomes
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  - that are part of it.
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  - And so it's
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  - it's a lot, Janelle. It really is. It's
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  - a big it's a big, huge it's a
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  - big, huge balancing act. And,
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  - I think
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  - getting back to people, I mentioned people,
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  - is involving people at the beginning,
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  - having the engagement at the beginning, having a
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  - process around how we're implementing these, and then
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  - looking to to make things less complex anywhere
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  - we can.
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  - That's helpful context and leads me right into
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  - my next question.
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  - What is your best opportunity to grow in
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  - the next two to three years?
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  - I would say
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  - best opportunity that we have to grow right
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  - now is continue down the path that we've
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  - started with AI. So
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  - in in the Epic world, I'm gonna have,
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  - two...
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  - There's two foci that we have right now.
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  - So we have Epic, which is our EMR.
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  - Epic has tons of stuff that are coming
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  - out there,
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  - And they are focused on something called Penny,
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  - which is revenue cycle, something called Art, which
• 6:59
  - is clinical and physician based, and then something
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  - called EMI, which is patient based. And so
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  - what... We're already prepping for that. Like, okay.
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  - What can these do for us so that
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  - we are prepared? Our physicians are already coming
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  - to me extremely excited about AHRQ because they're
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  - seeing it. A couple of the physicians I,
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  - partnered with, they've gone to UGM, the Epic
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  - UGM, and they're
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  - they're... They saw it, and they're super excited.
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  - So now we're kinda like, okay. Let's lay
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  - down our foundation.
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  - We we have an idea what it is.
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  - We have an idea what it's gonna do.
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  - Let's let's start getting prepared for it.
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  - The other piece too is we're building our
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  - own. So
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  - Penny is revenue cycle focused with Epic.
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  - We are actually building something.
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  - We're calling it Mahi. It's, Mahaska Health AI,
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  - And we are building our own LLM
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  - and building our own ancient model
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  - that will look at our denials
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  - and
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  - look at how we can improve
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  - the issue that we would have all health
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  - care systems have it issues with denials
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  - and be proactive on the front end with
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  - it. And then we can use it for
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  - staff knowledge augmentation on the back end if
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  - if we have to have to work those
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  - claims denials.
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  - Got it. Got it. And
• 8:18
  - switching direction a bit, who do you admire
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  - as a leader from any industry and why?
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  - Good question.
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  - Something that has resonated with me all throughout
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  - my life, and it's it's not necessarily
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  - a leader within health care or, like, a
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  - technology leader or anything like that.
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  - I
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  - I follow...
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  - I'm not Buddhist,
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  - but there's a lot that is within Buddhism
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  - that I love to,
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  - incorporate into my life
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  - and
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  - do good things.
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  - And the other one is
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  - beginner's mind. So
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  - all all throughout my life, I've tried to
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  - channel that
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  - no matter how old you get or how
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  - smart you think you are. Always keep listening.
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  - Always keep looking at the people who are
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  - around you
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  - to to learn from.
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  - And so to answer your question succinctly,
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  - I would I would say the Dalai Lama.
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  - I love that. Well,
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  - Bob, I wanna thank you for your time
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  - today. But before I let you go, is
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  - there anything else that listeners should know?
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  - I would say, and this is related to
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  - what I just said.
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  - So
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  - a leadership lesson that I've learned over the
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  - years
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  - is no matter
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  - how smart you think you've become over the
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  - years,
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  - always be listening, always be seeking,
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  - always be looking out with those you look
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  - at to see if there's just a golden
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  - nugget that they might have that you can
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  - learn from. Don't don't shut down.
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  - That would be it. Well, that's a perfect
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  - spot to end. Bob, I wanna thank you
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  - once again for your time today for joining
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  - me on the Becker's Healthcare Podcast. Excellent. Thank
• 9:54
  - you.