Latest / Becker’s Healthcare Digital Health + Health IT / Dr. Bimal Desai, Chief Health Informatics Officer at Children's Hospital of Philadelphia

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Dr. Bimal Desai, Chief Health Informatics Officer at Children's Hospital of Philadelphia · Becker’s Healthcare Digital Health + Health IT

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  Philips is a health tech leader focused on
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  innovation that improves the health and well-being of
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  people. Our health care technology and informatics solutions
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  help care teams diagnose, treat, and manage more
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  patients with greater precision, speed, and confidence across
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  the care journey. With Philips, clinicians are empowered
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  with streamlined insights in the moments that matter
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  for every patient. Better care for more people.
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  Philips.
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  Hello. Welcome to the Becker's Health Care podcast,
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  recorded the 9th annual health IT, digital health,
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  and RCM conference in Chicago. We're joined today
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  by doctor Bimal Desai,
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  chief health informatics officer at Children's Hospital of
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  Philadelphia.
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  Bimal, to get us started, could you please
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  tell us a little about your background, your
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  role in your organization?
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  Sure. So I'm, Bimal Desai. I'm a practicing
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  pediatrician and the chief health informatics officer at
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  CHOP. I've been with the organization for about
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  25 years. Came there straight out of medical
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  school and just never left.
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  I'm board certified in pediatrics and in clinical
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  informatics.
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  And I oversee the programs in clinical informatics
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  and digital health, which in our organization includes,
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  remote patient monitoring, telehealth,
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  econsults,
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  and all those virtual
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  technologies.
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  Okay.
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  As you know, AI, adoption is exploding in
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  health care right now.
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  In your view, what's the most, significant or
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  promising application of this technology right now?
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  And,
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  how is this informing your organization's innovation strategy?
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  Yeah. That's a great question. And, as you
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  can tell from many of the presentations
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  here Mhmm. Probably the number one technology that
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  sort of captivated the imagination of health care
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  has been ambient,
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  listening or, artificial intelligence in general.
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  And,
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  I think that time will tell
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  if there are,
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  ways that we can use AI
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  beyond ambient Mhmm. That are just as effective,
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  or just as likely to help our health
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  systems.
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  And I'll give you one example.
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  We had a clinical division,
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  who did some work to try to measure
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  how much time
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  providers spend,
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  in what we call para clinical work. So
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  the kind of work that you are required
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  to do in order to see a patient,
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  but that's not direct patient care. Right. Right.
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  So this could be like pre certification,
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  prior authorization,
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  letters of medical necessity, complex scheduling, like all
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  these other healthcare tasks that you have to
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  do to complete a visit and take care
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  of a patient, but,
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  take time away from actually seeing patients. And
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  what I'm really excited about is the idea
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  that we might be able to use AI,
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  whether it's ambient tools, the for note summarization
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  for generation of these, some of these artifacts
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  that are required by insurance companies,
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  whether it's,
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  robotic process automation, whatever the platforms are, I
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  think that we're at the cusp of showing
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  that these technologies will actually have direct utility
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  or physicians, nurses, and allied health professionals. Mhmm.
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  And that feels different than it did, like,
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  even just 3 to 5 years ago, where
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  I think most health care providers felt like
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  they were
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  passive recipients or even victims of technology and
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  not like,
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  collaborators who could actually benefit from the technology.
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  So Right. That's what excites me about this.
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  Okay. Well, you know, on a daily basis,
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  health care leaders are managing greater volumes of
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  data and more devices across a growing number
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  of care settings and populations.
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  In this complex environment, what clinical data integration
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  tools or practices
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  are you seeing drive improvements in patient outcomes
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  and operations,
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  and can you share an example or 2?
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  For sure.
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  I've noticed
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  that inpatient care, specifically in, like, the intensive
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  care areas Mhmm. Has really exploded in complexity,
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  we have the ability
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  to do a lot more real time monitoring
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  through bedside monitors and integrated devices.
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  And we're at the point where the volume
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  of data
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  and the need for frontline providers to synthesize
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  and actually make decisions or take action on
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  those data is becoming
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  almost overwhelming. Right? So the most promising set
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  of tools I've seen, and these are not
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  necessarily new tools, but I think we're finding
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  a general
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  utility from them is the types of platforms
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  that the ECRI Institute calls CHIPS Mhmm. Platforms.
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  So these are consolidated health informatics platforms or
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  health information platforms. Correct. So you imagine it
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  takes real time waveforms from the bedside monitors.
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  It takes ventilator data. It can take pump
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  data. It can take, vital signs and lab
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  results and any other clinical parameters you want.
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  But the magic is that they can actually
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  render them in a in a single display
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  that just
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  completely reduces
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  the cognitive burden of having to look in,
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  like, 15 different places
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  in the medical record. And I was actually
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  coincidentally on service a few weeks ago
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  when I had an, an infant who was
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  having these unexplained spells. Mhmm.
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  And what we noticed was that when the
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  critical care team came down to assess the
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  child at our request, they were able to
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  pull up this CHIPS platform that we have
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  at Children's Hospital of Philadelphia
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  and immediately diagnose that this child was having
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  some, cardiac arrhythmias. Mhmm. That historically would have
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  taken a much, much longer time. This would
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  not have been a 3 minute task at
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  the bedside. It would have been way more
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  complicated. And, it really highlighted for me the
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  power of these sort of, you know, big
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  data platforms that can bring insight to the
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  just a huge amount of data that we're
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  seeing.
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  So how can health care organizations better support
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  IT and clinical teams as they carry out
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  innovation efforts? And, what are some of the
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  common pitfalls here?
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  Well, I think one of the things that
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  health systems can do is really make innovation
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  a strategic mandate. Mhmm. And I don't I
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  mean, more than sort of the lip service,
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  but I mean, like direct ties to your
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  strategic plan. So for example,
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  our organization has a recently refreshed enterprise strategy
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  that specifically calls out two things that are
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  of interest to my team. Well, it's all
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  interesting to my team, right, right, to specifically
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  that are relevant to my team. One of
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  them is what we're calling the next gen
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  operating model. So figuring out how our health
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  system will actually operate in the future, where
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  we're going to eliminate waste and ineffectiveness.
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  And the second one is to develop the
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  workforce of the future. Mhmm. So that means
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  cultivating a set of leaders who are facile
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  with technology, who actually know how we can
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  use technology to directly improve clinical care. And
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  the nice thing about having that as our
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  top level strategic
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  imperative
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  is that it gives my team direct visibility,
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  like every one of my projects, and in
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  my team's projects directly relate to that strategy.
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  Right. And so that also helps because
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  I'm can be somewhat reassured that we'll get
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  the resourcing and support and visibility that we
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  need for these initiatives.
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  Well,
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  you know, that brings me to my next
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  question. You talked about, like, fostering that next
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  leader or the next generation of leaders in
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  health care.
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  What advice do you have for these leaders
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  as they prepare for, you know, further advancements
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  in technology
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  and, greater demands for care?
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  Health care systems are getting larger, more complicated.
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  Mhmm. They have a lot of competing priorities,
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  you know, cybersecurity,
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  financial sustainability,
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  market expansion, and so on. And I think
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  my one advice would be to,
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  if you're a health system leader, even outside
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  of the technology space, is to say, is
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  to stay curious,
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  and to stay connected to the clinical enterprise.
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  So in high reliability theory, we talked we
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  talked about sensitivity to operations, like really have
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  a deep understanding
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  of what it's like to do the day
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  to day of patient care delivery.
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  Because that's where I think
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  we're discovering there is enormous opportunity for digital
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  transformation,
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  for clinical improvement,
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  and I think we'll be a better health
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  system because of it. Mhmm. Well, doctor Desai,
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  you know, it's very evident based on this
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  conversation. You're very passionate about working with data
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  and technology. And I'm curious, you know, with
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  your background at a at a children's hospital,
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  how is that, say, you know, maybe different
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  from, you know, with the adoption of technology,
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  what technologies,
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  you know, might excite you? What how does
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  that differ from, you know, say, a big
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  health system, community health center, and everything in
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  between? Like, what unique challenges are there? But,
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  also, like, in that children's hospital space, is
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  there technologies that you're super excited about coming
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  down the pipeline 5, 10 years that maybe
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  a major health system wouldn't be as focused
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  on? Yeah. I I think there's at least,
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  well, there's lots of differences, namely the size
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  and age of our patients. But,
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  one of the major differences is in reimbursement.
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  So as you know, children are covered under
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  Medicaid, not Medicare Mhmm. When they receive public
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  insurance.
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  And,
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  that has some very interesting ramifications, namely that
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  Medicaid is state administered. So individual states can
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  opt in or opt out of certain reimbursement
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  schemes.
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  And in our state, for example, we've had
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  to advocate
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  very heavily for reimbursement for telehealth and remote
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  patient monitoring and econsults and so on. And
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  so in some cases, we've been able to
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  get that concession from the payers,
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  or sometimes it's required actually legislative advocacy. So
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  that's sort of one difference is that it's
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  it's much more fragmented on a state by
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  state basis.
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  The second major difference is,
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  teen privacy. Right? We are beholden to state
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  laws in almost every state in the United
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  States,
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  that requires to protect certain types of health
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  care data.
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  And if the teen requests confidential care, we're
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  not allowed to share it with the parent.
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  That also differs by state. And so if
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  you're practicing in Texas, or if you're practicing
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  in Ohio, if you're practicing in Pennsylvania,
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  those state by state team privacy laws also
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  differ dramatically.
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  And the third difference is that there was
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  a tonne of stuff I would love to
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  do with commodity
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  off the shelf connected monitors, right, like pulse
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  oximeters and blood pressure cuffs, but
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  almost none of them have been FDA
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  approved in children. Oh, really? Most of the
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  consumer grade devices that you'll find
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  are actually FDA
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  cleared for use in patients 18 and older
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  with a giant caveat
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  of you can't use this in children in
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  in patients with preexisting
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  heart and lung conditions. Right?
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  Well, that completely
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  I don't wanna say eliminates, but it very
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  much hampers our ability to use them in
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  pediatrics because the populations that I want to
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  use these on are specifically children with heart
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  and lung conditions. Right. Right. Like infants who've
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  undergone congenital heart disease repair and stuff like
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  that. So that's I think that's a call
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  really to the device manufacturers is, like, don't
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  ignore the kids. Right. Like, we really have
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  a need for these devices,
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  especially if we wanna be able to do
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  more remote patient management, and care delivery at
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  home. And to your point about like, well,
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  what are the what are the opportunities I
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  see? I think remote care is exactly where
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  we should be looking in pediatrics.
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  Kids are maybe unique from adults in that
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  they are generally healthy, right? But the vast
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  majority of kids are very healthy. So if
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  you look at utilization of health care resources
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  in kids, it's very much skewed towards the
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  sickest children in the country. Right? The children
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  who have surgical conditions and chronic diseases and
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  stuff like that, but that's a very small
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  number of children. So if I stand up
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  remote remote patient monitoring program for children,
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  there might be a program that only impacts
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  60 children per year. Right. Right. Right. But
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  it's incredibly impactful for those 60 kids. Right.
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  Right. Right. Right. The finances are different. The
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  numbers are different. The utility is different. And
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  it's it just deserves a very different thought
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  process Right. And mental model than adult remote
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  care. Mhmm. Mhmm. Awesome. Well, doctor Desai, thank
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  you so much for joining us today on
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  the show. This conversation is an absolute pleasure.
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  Thank you so much again, and have a
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  lovely rest of your day. It was my
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  pleasure. Thanks for the invitation. Thank
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  you.