Latest / Becker’s Healthcare Digital Health + Health IT / Christopher A. Longhurst, MD, MS - Chief Medical Officer & Chief Digital Officer, Associate Dean & Clinical Professor at UC San Diego Health

Transcript

Christopher A. Longhurst, MD, MS - Chief Medical Officer & Chief Digital Officer, Associate Dean & Clinical Professor at UC San Diego Health · Becker’s Healthcare Digital Health + Health IT

• 0:00
  This is Laura Diet with the Becker healthcare
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  podcast, I'm thrilled today to be joined by
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  Doctor. Christopher Long chief Medical Ops. Or Chief
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  Digital Officer an associate Dean as well as
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  clinical professor at Uc San Diego Health. Doctor.
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  Long hers is a pleasure to have you
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  on the podcast today.
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  Sir Oh, thank you so much for having
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  me.
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  Now I'm really looking forward to our discussion.
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  I know there's a lot happening at Uc
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  San Diego Hal having to do with technology,
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  Ai, and really some revolutionary things on the
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  clinical care side. But before we dive into
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  that discussion, can talk a little bit more
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  about yourself and your background?
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  Sure.
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  I've been involved in healthcare administration leadership for
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  about 20 years. I finished my pediatric training
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  Packard Children's Hospital at Stanford. And joined what
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  I thought was going to be a 2
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  year project to implement electronic health record at
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  and, of course, that turned into a much
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  longer and more involved project. It was a
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  lot of fun because I had a background
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  that helped perfectly prepare me. Which is I
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  had taken time off during medical school to
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  do a master's degree in healthcare care informatics.
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  And so after implementation of the electronic health
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  record there, we found some really important outcomes
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  associated with reduction mortality
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  when we implemented our physician order entry and
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  I subsequently
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  ended up as the Chief Medical Information Officer
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  founded a fellowship program and clinical informatics at
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  Stanford.
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  I spent 15 years there
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  in total before I came down here at
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  Uc San Diego about 9 years ago. And
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  Initially came down to Uc San Diego to
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  serve as the Cio for the health system
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  and the professional schools, including the school of
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  Medicine
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  But after a few years, I stepped into
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  an additional role as the associate Chief Medical
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  Officer hoping to lead our quality and safety
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  in partnership with Our. Quality and patient safety
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  officer.
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  We learned a lot in that, particularly around
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  our public data reporting and local quality improvement
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  initiatives, with And I continue to chair the
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  quality council to this day, which has been
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  a really gratifying part of my role,
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  ultimately
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  ended up in the Chief Medical Officer role
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  and
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  been
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  continuing to help lead enterprise initiatives and we're
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  now expanding as we acquire new hospitals and
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  affiliate with others
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  and
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  have actually just hired
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  Chief Medical Officer for Hill crest La jolla,
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  as well as for our East campus, which
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  used to be the Prime auto hospital.
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  And so it's been a lot of fun
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  to experience period of huge clinical growth under
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  the leadership of our Ceo, Patty Mason.
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  That's great to hear. And you know, really
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  exciting to think about how technology has evolved
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  in the health space from coming in to
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  help implement a Ehr system to then completely
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  leading a, you know, a It digital initiatives,
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  it is really a cool career trajectory, from
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  your perspective, what are some of the biggest
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  issues that you're following in health care for
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  20 24?
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  Sure. There's a lot going on in health.
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  And
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  like, any large portion of the economy, I
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  think it starts with finance.
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  That we've seen things like Medicare advantage
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  plans going belly up,
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  our colleagues
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  at Scripps health
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  recently
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  discontinued
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  support of their Medicare Advantage plan. We've seen
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  a bunch more patients
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  And these are older sicker patients that are
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  really hard to manage from a risk standpoint.
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  And so
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  these type of financial questions are particularly difficult.
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  In the setting of the much larger trends.
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  So
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  we've seen, of course, inflation affecting supply cost
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  by 10 percent to 12 percent particularly here
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  in California,
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  We have strong labor presence and we've seen
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  labor costs increased 10 percent to 15 percent
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  and of course all the while.
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  Our reimbursement is not going up 10 or
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  15 percent.
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  It might be going up 2 or 3
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  percent or 4 percent and that's only for
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  the commercially insured patients, you know, we still
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  have
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  pretty fixed reimbursement in our government plans. And
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  so taken all together,
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  it's a really challenging time from a financial
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  standpoint and forces us all to really focus
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  on value and what investments we're making that
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  most directly benefit the patients that we serve.
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  That's such a great point. And know interesting
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  they bring up some of the different health
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  plans in the landscape of working with payers
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  as well as
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  thinking through how patients were able to access
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  and afford care, and then bringing that into
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  the broader strategy of
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  how you're caring for patients and thinking about
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  those patient populations. So, it's really interesting to
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  hear from your perspective and when taking that
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  into consideration and and looking ahead, what are
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  you most excited about for the future and
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  what makes you nervous?
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  Well, I am extraordinarily excited about the digital
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  transformation of health
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  and not just Ai, but that's certainly the
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  latest in a suite of tools.
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  For example, in our managed population, we run
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  a large Medicare shared savings plan accountable care
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  organization. And we started in that population doing
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  remote patient monitoring
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  and actually have over 3000 patients now. With
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  devices at home, transmitting blood pressure and glucose
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  ratings and our patients with diabetes
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  and
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  those type of
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  remote patient digital kind of tools.
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  And that's allowed us to better manage population.
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  We actually have data showing a reduction
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  blood pressure in our hypertensive patients, a reduction
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  hemoglobin A1c of our patients with diabetes.
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  And the kind of care
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  allows us to not only drive better outcomes
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  and reduce hospital emissions, but also save cost
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  to system overall and keep people healthy, keep
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  people out of the hospital So that's really
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  exciting from my standpoint because it's not something
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  it would have been possible 10 or 20
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  years ago.
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  On top of that, you layer in some
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  of these new Ai tools such as large
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  language models
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  or even just traditional machine learning. And we're
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  finding all sorts of
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  outstanding outcomes in the clinical side we found
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  earlier detection of Sepsis resulting in 20 percent
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  drop of mortality in our emergency department patients
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  with Sepsis, which is
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  really, really huge.
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  And
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  translates to 50 lives saves on annual basis
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  just here at Uc San Diego.
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  Imagine if that, you know, translated across the
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  300000
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  lives lost every year across America.
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  Similarly, we've leveraged large language models for things
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  like Ai generated draft messages to respond to
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  patients on the portal. And we found that
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  that decreases is cognitive burden decreases physician burnout
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  and results in increased satisfaction.
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  So lots of promising opportunities, and that's just
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  on the clinical side. Think about the business
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  side and there's certainly huge opportunities to help
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  make our revenue cycle more efficient so that
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  as we
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  acquire and affiliate with new hospitals, we can
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  expand our services
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  without having to, you know, add as many
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  people as we would otherwise.
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  And that efficiency also translates to better employee
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  satisfaction.
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  You know, we know that some of the
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  wrote tasks that can be done by Ai
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  you know, when we automate that that makes
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  our employees happier as well. So that that
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  leads to increased retention, increased
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  satisfaction at work and
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  overall sort of better healthcare care experience.
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  That's been fantastic to hear. And you know,
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  especially thinking about Ai in artificial intelligence,
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  in in some of the ways that as
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  you said, you can really help people have
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  a better work experience.
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  And at the same time, you know, help
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  become more efficient overall, I think that's really
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  cool and beneficial.
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  I I know, looking ahead to... Do you
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  see that will make health leaders more effective
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  and successful over the next 2 to 3
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  years? What do they need to know, especially
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  given the,
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  evolving health landscape and in tools that are
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  gonna become available to them?
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  That's a great question.
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  I think the skills from a leadership standpoint
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  don't change much over time. And building a
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  high functioning teams, teams that are
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  diverse and work well together, I think as
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  a skill that will continue to be important
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  I I think that as Ai begins to
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  really creep into every corner of health care
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  delivery, having a superficial understanding of how these
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  tools work.
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  Is actually important for some of our executive
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  leaders.
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  And I recently wrote an opinion with Dr.
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  Bob Walked and others about by the role
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  of the Chief Health Ai officer,
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  and we're fortunate to recruit. Doctor Car duke
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  Singh that serve as our Chief Health Ai
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  officer,
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  here at Uc San Diego Health. And I
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  think it's just a fantastic and important role
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  in moving forward to
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  identify where the opportunities are to leverage these
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  tools to drive the, clinical and business outcomes
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  that matter to our patients and to the
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  organization. And so that's 1 area that I
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  think investment is really needed. And
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  the thing that makes me nervous is not
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  about sort of bad tools it's about tools
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  that are poorly implemented with And so having
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  those local Ai governance and review processes, I
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  think are gonna be really, really important to
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  making sure that we drive the outcomes we
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  want and do not...
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  Inadvertently introduce unintended consequences.
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  That's touch a great point. Do you bring
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  up especially on the governance side. I know
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  things are changing quickly? So for health systems
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  that are really at their front stages of
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  of trying to implement Ai or figure out
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  what their strategy is. Where do you start?
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  What is most important for health organizations to
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  tackle so that they're not putting themselves to
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  undue risk as they're taking on and,
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  try and to implement new Ai technologies.
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  Yes, our local governance has been really helpful
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  in thinking through that. So for example, some
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  of our early
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  opportunities
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  were around
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  a low risk kind of areas
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  in the business that would not impact kind
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  of clinical care. And so we were looking
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  in cycle operations and other areas
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  even when we again
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  introducing clinical Ai,
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  we
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  ensure that our governance processes and principles like
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  keeping a human in the loop for accountability
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  we're adhere to, and that helps to really
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  mitigate potential risk. So that local governance, local
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  Ai principles, you, driving,
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  the problems is that should be solved. I
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  think is really key.
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  Fantastic. Doctor. Wagner. Thank you so much for
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  joining the podcast today. This has been a
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  really amazing discussion. And I look forward to
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  connecting with you again soon.
• 10:37
  Absolutely. Thanks for having me, Laura.