Latest / Becker’s Healthcare Digital Health + Health IT / Dr. Gregg Nicandri, Chief Medical Information Officer at University of Rochester Medical Center

Transcript

Dr. Gregg Nicandri, Chief Medical Information Officer at University of Rochester Medical Center · Becker’s Healthcare Digital Health + Health IT

• 0:02
  At athenahealth,
• 0:03
  we know your ambulatory practice wants healthier, a
• 0:06
  healthier business, healthier care teams, and healthier patients.
• 0:10
  But the complexities of modern health care tech
• 0:12
  make it hard for you and your care
• 0:14
  teams to focus on what matters
• 0:16
  most? That's where athenahealth can help. Our AI
• 0:19
  native all in one solutions reduce administrative burdens,
• 0:22
  streamline billing and payments, and deliver critical insights
• 0:25
  when clinicians need it most. That means fewer
• 0:28
  clicks, more time for patients, and stronger bottom
• 0:31
  lines.
• 0:32
  Practicing medicine is complex, but running a practice
• 0:35
  can be that much simpler with athenahealth.
• 0:38
  See how simpler is healthier@athenahealth.com.
• 0:44
  This is Laura Dierda with the Becker's Healthcare
• 0:46
  podcast. I'm thrilled today to be joined by
• 0:48
  doctor Greg Nicanry,
• 0:50
  chief medical information officer at the University of
• 0:52
  Rochester Medical Center. Doctor Nicanry, it's a pleasure
• 0:55
  to have you on the podcast today.
• 0:57
  Super excited to be here. Thank you for
• 0:58
  having me, Laura.
• 1:00
  Absolutely. Now I'm excited for our conversation because
• 1:03
  I know we're gonna be digging into some
• 1:05
  of the cool things that you're doing at
• 1:06
  the University of Rochester Medical Center and specifically
• 1:09
  around artificial intelligence and virtual care. But before
• 1:12
  we dive in, I'm wondering, can you share
• 1:14
  a little bit more about yourself and your
• 1:16
  work in health care?
• 1:18
  Sure.
• 1:19
  So I'm the chief medical information officer at
• 1:21
  the University of Rochester
• 1:23
  Medical Center, which is in Upstate New York.
• 1:27
  We're a mid sized system,
• 1:29
  basically covering
• 1:30
  the area between kinda Syracuse and Buffalo
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  down to,
• 1:35
  the the Pennsylvania border.
• 1:37
  I also am a practicing
• 1:39
  orthopedic surgeon,
• 1:42
  and, have been CMIO now for about six
• 1:45
  years.
• 1:46
  That's amazing to hear. And, you know, what
• 1:48
  incredible experience,
• 1:50
  especially leading into,
• 1:52
  you know, what is happening today in health
• 1:54
  care and the digital transformation.
• 1:56
  I know nearly half of medical practices reported
• 1:59
  using
• 2:00
  AI in some capacity over the last year,
• 2:02
  and it remains a key topic for health
• 2:04
  IT leaders. From your perspective, what are some
• 2:07
  of the use cases that are making a
• 2:09
  difference right now, and how are you leveraging
• 2:11
  them within University of Rochester Medical Center?
• 2:15
  Yeah. So I think,
• 2:17
  the, you know, biggest use case, at least
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  in in my wheelhouse where as chief medical
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  information officer,
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  my main task is
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  really to try to improve
• 2:30
  clinician experience
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  through leveraging
• 2:33
  technology
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  to optimize
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  workflows and and well-being. And,
• 2:38
  you know, ambient documentation
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  has been revolutionary
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  really for,
• 2:44
  the group of providers, particularly on the, ambulatory
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  clinical side.
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  You know, we've had a pretty big rollout
• 2:51
  with about,
• 2:52
  a thousand,
• 2:54
  licenses now distributed to providers who are using,
• 2:58
  our ambient documentation solution.
• 3:01
  We've got 75%
• 3:03
  of those are actually active users,
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  and, we've had really good outcomes,
• 3:10
  across the board from our,
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  well-being measures, our work after work measures, our
• 3:15
  chart closure rates,
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  and even, revenue improvement.
• 3:20
  That's amazing to hear. And, you know, certainly
• 3:22
  interesting to have that opportunity to use technology
• 3:25
  in a new way and and see,
• 3:27
  some pretty stark results.
• 3:29
  As virtual care expands from AI enabled tools
• 3:32
  and remote monitoring to broader digital health platforms,
• 3:36
  introducing new technology brings its own challenges.
• 3:39
  What advice do you have for leaders who
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  are navigating everything from governance to patient engagement?
• 3:43
  And can you share an example of how
• 3:45
  your organization is balancing innovation and operational constraints?
• 3:50
  I think,
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  you know, our, motto at URMC is meliora,
• 3:56
  which means ever better.
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  And it's important,
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  as you're kind of a continuous quality improvement
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  organization
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  that is always seeking and striving to improve,
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  to understand
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  that
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  the capacity for the organization
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  to actually
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  change and adapt
• 4:15
  is limited. And so you really have to
• 4:18
  understand
• 4:19
  who will be using the tools, how it
• 4:21
  will impact them.
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  And, ideally,
• 4:24
  you're working very closely with the people who
• 4:26
  design the technology, either the the
• 4:30
  vendors or,
• 4:31
  our own,
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  IT
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  group to ensure that it's usable
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  and that it's solving a problem
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  people who are going to be using the
• 4:39
  technology actually see. If it solves a problem
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  for them, obviously,
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  adoption is, much higher. And we we learned
• 4:47
  that, you know, through the
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  ambient documentation initiative.
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  You know, this was solving a huge problem,
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  and so it was very easy to get
• 4:55
  adoption,
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  wide uptake, and to very quickly see results.
• 5:01
  Whereas,
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  you know, other technologies depending on the level
• 5:04
  of impact
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  and the level of usability,
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  sometimes we've we've fallen short of that.
• 5:11
  Got it. That makes a lot of sense,
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  you know, and it is really great advice,
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  especially thinking through all of the different changes
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  in technologies that are coming down the pipe
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  today. And to your point, when you look
• 5:21
  at, the change management on the people side,
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  what has worked well to
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  really help them understand, you know, the technologies
• 5:29
  and
• 5:30
  increase the adoption as well as,
• 5:33
  you know,
• 5:34
  I guess, willingness to try new things and
• 5:37
  jump in?
• 5:39
  I think, really, what works well is
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  kind of having a strategy and a rationale
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  and having the strategy
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  actually come from
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  the people who work in our organization,
• 5:54
  frontline
• 5:55
  clinicians and staff.
• 5:57
  So I I think it's very easy to
• 5:58
  get stuck into the trap of, you know,
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  talking to vendors,
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  who, you know, say, hey. I've got this
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  really cool technology,
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  and I think
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  you have this problem,
• 6:11
  and you could use
• 6:13
  our technology to solve that problem. Or even
• 6:16
  with our, you know, our EHR saying,
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  you know, we think that you should do
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  this because we think it'll be great for
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  your organization.
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  Well,
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  you know, nobody knows our organization
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  better than
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  the people who work in it. And so
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  really
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  being close to them, staying close to them,
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  understanding
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  their pain points
• 6:38
  in saying and writing down kind of, you
• 6:41
  know, these are the things that are challenging
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  us.
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  Let's try to find some solutions that address
• 6:47
  these challenges and then go out and partner
• 6:50
  with your EHR vendor or some of the
• 6:52
  major, you know, incompetent,
• 6:54
  technology players like,
• 6:56
  you know, Microsoft or or Doximity or others,
• 7:00
  to to try to see if you can
• 7:01
  solve those problems together. I think that's been
• 7:04
  way more effective than,
• 7:06
  you know, just saying, everybody's got a chatbot.
• 7:09
  We should probably
• 7:10
  use a chatbot. What what should we what
• 7:13
  would should we use that chatbot for? And
• 7:15
  then just kinda trying a pilot and seeing
• 7:17
  how it goes.
• 7:19
  I think, you know, you need to start
• 7:21
  from the inside and and move out to
• 7:24
  the vendors as opposed to, the other way.
• 7:27
  Got it. That makes a lot of sense
• 7:28
  and is a really helpful way to look
• 7:31
  at things and make sure you've got yourself
• 7:33
  focused and the team focused as well. Now
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  I know there's been a lot of reach
• 7:37
  recent legislation,
• 7:39
  coming down the pipe when it comes to
• 7:40
  technology as well as health care. So how
• 7:43
  are you seeing some of both the state
• 7:45
  and federal regulations affect health care organizations and
• 7:48
  IT specifically? Have you had to adjust any
• 7:51
  of your strategies in response?
• 7:54
  So it has been
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  very challenging, especially with the recent, you know,
• 7:59
  government shutdown.
• 8:00
  Right? We had a pretty good,
• 8:03
  telehealth operation,
• 8:05
  going,
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  and we've we've had some providers because it's
• 8:09
  been in place for,
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  you know,
• 8:12
  now four or five years who have converted,
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  you know, their entire practice to remote.
• 8:18
  And, you know, unfortunately, if they see Medicare
• 8:21
  or Medicare Advantage patients,
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  we're no longer being reimbursed for those visits
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  because home for the patient is not
• 8:29
  any longer considered an appropriate site of service.
• 8:33
  We also, you know, stood up a hospital
• 8:35
  at home program that we actually launched and
• 8:37
  went live with in September, and we were
• 8:40
  getting some some really good results, to the
• 8:43
  point that,
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  you know, when we had to shut the
• 8:46
  doors,
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  on October 1, our,
• 8:49
  major insurance partner
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  contacted us and said, hey. Well, can can
• 8:53
  you just kinda keep keep that open for
• 8:55
  our patients at least?
• 8:57
  But it really wasn't
• 8:59
  viable, unfortunately,
• 9:01
  for for us to do that. And so,
• 9:03
  you know, I think it's
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  it's caused us to have to do a
• 9:06
  lot of extra work coming up with contingency
• 9:08
  plans. Not necessarily saying we're
• 9:13
  organization
• 9:14
  and
• 9:15
  pivot, you know, to,
• 9:18
  all brick and mortar in person visits,
• 9:21
  but really kind of trying to understand how
• 9:23
  we can be agile as an organization and
• 9:23
  pivot,
• 9:35
  see how see how quickly the policies can
• 9:38
  change and then the broader impact that it
• 9:39
  has upon programs like your,
• 9:42
  telehealth virtual visits as well as hospital at
• 9:45
  home. I mean, I think it's a great
• 9:47
  point you made that it can be challenging
• 9:49
  to spend time and energy and resources on
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  those contingency plans just because, you know, there
• 9:54
  are so many other things that you have
• 9:55
  to be focused on as well.
• 9:58
  Yep. Abs absolutely. Yeah. It's it's almost like
• 10:00
  you're doing,
• 10:02
  you know,
• 10:03
  probably a third extra work, because now you're
• 10:06
  having to come up with the solution based
• 10:08
  on the rules of today, but you've also
• 10:10
  gotta think about, a lot of what ifs,
• 10:14
  to make sure that the whole thing makes
• 10:15
  sense and you know what's gonna happen,
• 10:18
  if, you know, different rules and regulations,
• 10:21
  change or come into play or come into
• 10:23
  effect.
• 10:24
  Absolutely. Well, I think as we wrap up
• 10:27
  our conversation here, I'm curious, what's your top
• 10:29
  piece of advice for health care leaders
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  as they prepare for further advancements in technology
• 10:34
  as well as the increasing demands for care?
• 10:38
  So I think, you know, it's really
• 10:41
  just
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  adhering to to kind of sound,
• 10:45
  continuous
• 10:46
  improvement
• 10:48
  principles. Right? You wanna set up a system
• 10:51
  that facilitates
• 10:53
  agility. You want to continue to focus on
• 10:58
  clinician
• 10:59
  well-being, staff
• 11:01
  well-being,
• 11:02
  because that keeps them
• 11:04
  kind of engaged,
• 11:05
  and more willing to adapt to changes, which,
• 11:10
  as we've seen, are constantly coming, whether that's
• 11:12
  regulatory or whether that's brought upon by,
• 11:16
  technology.
• 11:17
  And just to remember that, you know, you're
• 11:19
  solving problems for patients and providers and keep
• 11:22
  it focused on them,
• 11:24
  not necessarily,
• 11:26
  you know, what's the easiest or what's the
• 11:28
  coolest new thing that you wanna try.
• 11:31
  I think, you know, there's a lot of
• 11:34
  things out there that, you know, you can
• 11:37
  do. There's a lot of problems to solve.
• 11:40
  And
• 11:41
  sometimes it's hard to kinda not chase after
• 11:43
  the shiny object,
• 11:45
  but to really focus on those things that
• 11:47
  are important,
• 11:49
  as opposed to always, you know, what seems
• 11:51
  like it's the urgent thing of the day.
• 11:54
  Absolutely. That's such a important reminder.
• 11:57
  Doctor Nicanjeri, thank you so much for joining
• 11:59
  us on the podcast today. This has been
• 12:01
  a really fun and fascinating conversation, and I
• 12:03
  look forward to connecting with you again soon.
• 12:06
  Alright. Thanks so much.
• 12:09
  At athena Health, we know your ambulatory practice
• 12:12
  wants healthier,
• 12:14
  a healthier business, healthier care teams, and healthier
• 12:17
  patients.
• 12:17
  But the complexities of modern health care tech
• 12:20
  make it hard for you and your care
• 12:22
  teams to focus on what matters most.
• 12:24
  That's where athenahealth can help. Our AI native
• 12:27
  all in one solutions reduce administrative burdens,
• 12:30
  streamline billing and payments, and deliver critical insights
• 12:33
  when clinicians need it most. That means fewer
• 12:36
  clicks, more time for patients, and stronger bottom
• 12:39
  lines.
• 12:40
  Practicing medicine is complex, but running a practice
• 12:43
  can be that much simpler with athenahealth.
• 12:46
  See how simpler is healthier at athenahealth.com.