Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Bradley Crotty, VP and Chief Digital Engagement Officer at Froedtert Health

Transcript

Dr. Bradley Crotty, VP and Chief Digital Engagement Officer at Froedtert Health · Becker’s Healthcare - Clinical Leadership Podcast

• 0:00
  Would you like to exchange best practices and ideas to improve care,
• 0:03
  enhance operational efficiency,
• 0:05
  and address financial challenges with your peers?
• 0:08
  Becker's Healthcare is facilitating these conversations at their eighth annual
• 0:12
  health, IT Digital health and RCM meeting.
• 0:15
  You can check your eligibility for complimentary attendance at the Lincoln,
• 0:19
  the description. We are excited to welcome you in October.
• 0:23
  This is Laura Ddo with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr. Bradley,
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  karate Vice President and Chief Digital Engagement Officer at Frayer Health. Dr.
• 0:31
  Karate, it's a pleasure to have you on the podcast today.
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  Pleasure to be here. Thank you so much.
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  Now I know we have a lot to talk about.
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  There's so much happening in healthcare and really a lot in the digital
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  transformation space as well. But before we dive into my questions,
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  can you tell us a little bit more about yourself and your background?
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  Yeah, ab, absolutely. Um, so first of all, I am a, uh,
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  practicing, uh, primary care physician. I still continue to see, um,
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  patients, and I think that's a very important part of, uh,
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  the work that I do. Um,
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  the second part is I am an informatician. So, um,
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  uh, in clinical informatics relatively, uh, newer boarded, uh,
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  subspecialty, uh, in the practice of medicine.
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  And just a little bit about, um, my background. So I did, um,
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  my, uh, medical training and then my, uh, fellowship training,
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  uh, at the Beth Israel Deaconess Medical Center and had the pleasure of
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  working with some amazing, uh, mentors that have been bringing in digital,
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  um, since the 1960s into the clinical care environment. Uh,
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  those include, um, Charlie Saffron and then, uh, his mentors,
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  uh, Warner Slack and Howard Blight. So, Warner, um,
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  had first been using the, uh,
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  computers when they were the size of refrigerators, uh, in, uh,
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  to interview a patient. Uh, he had one of the first, if not the first, um,
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  article about computing in medicine in the New England Journal in 1967.
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  Um, and so it was an amazing opportunity to really learn, um, you know, from,
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  from these folks and to be able to carry, uh, their, their legacy forward of,
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  of using, uh, computing and digital to really improve care,
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  uh, and the, and the care experience.
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  Absolutely. I, I really love that. And definitely, you know,
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  that gap between the technology and the patient care really, you know,
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  is so important. And I,
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  I know you can really do a lot and add to the experience as well as the overall
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  care you delivered by leveraging technologies in the right way.
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  So I can imagine that experience as both the clinician as well as the background
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  of technology really puts you in a great spot to, um, a advance that and,
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  and connect with both teams on a level they understand to really, you know,
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  forward some of these initiatives in a, um, a more efficient way than, you know,
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  if, if you didn't have one foot in both worlds, so to speak.
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  Yeah, absolutely. The, the, you know, technology for technology's sake,
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  there's nothing special about that, and it's not gonna move any needles.
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  You really need to integrate it into the problem that you're trying to,
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  to solve. You know,
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  the thing about the history of computing and medicine that
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  those that taught me would always point out is that the technology may change
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  periodically, but the underlying process is often the same. Uh,
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  we may be taking care of people now through video.
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  It used to be taken care of people through telephone was a novelty.
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  But it's essentially you're still trying to do the same function,
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  diagnosis and treatment. The tools may differ, but the,
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  the process is really the same.
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  And we'll have new things that will come out in the future that we're not even
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  contemplating, um, uh, right, right now. Um,
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  but ultimately it's, it's you not about the, the technology.
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  It's really about the, the care, uh, that we're trying to deliver, uh, to,
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  to our patients and the, and help them lead the best lives they can.
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  Absolutely. I love that. And,
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  and just such an important philosophy and way to approach, um, you know, that,
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  that, um, the technology side of healthcare now, when you look at,
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  um, where you're at today,
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  what are some of the opportunities that you see for freighter as well as the
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  headwinds you have your eye on?
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  Let me start with the headwinds, um, first,
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  cuz it's really what everyone in our industry is, is talking about.
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  We know that, uh, the costs of, um,
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  really, uh, skilled labor clinicians, uh, nurses,
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  including nurses and therapists, um, the costs are,
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  are rising. And, um, also supplies are,
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  uh, the cost of supplies are rising too.
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  So you have these on this whole one front of, of rising costs,
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  and then your reimbursements, if anything, um, if they're moving,
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  are generally moving, uh, in a lower direction for the most part.
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  And so it really challenges the business models, uh,
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  that healthcare systems have right now. So,
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  so that's the headwind I think everyone in our industry is, is talking about,
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  uh,
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  I'm gonna flip it to that being an opportunity and really
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  say, well,
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  how can we really work to have the right
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  same end goal, which is taking care of people, um, having them have the,
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  the best, uh, health outcomes they can,
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  but do it in a way that is possibly radically,
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  uh, different. And we're doing it because we're, we're forced to,
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  to change. Um,
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  so opportunities that I think we need to look at are how we can use technology
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  to, uh,
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  continue to automate as many functions as we as we can because we, you know,
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  frankly have a hard time, um, getting, getting staffed to help. So what, uh, uh,
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  what can we automate? Um,
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  another is what can the patient and family members do within certain
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  guardrails, um,
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  on their own without needing to run everything through a,
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  uh, a professional. Um, so my mentors that I mentioned,
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  Warner Slack would always, uh, often equipped that the patient or, uh,
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  family members, often the least u utilized resource, uh, in the healthcare team.
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  Um, and he had a, uh, a family member who had diabetes,
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  and he said, well, he had to take insulin and if, if insulin, um,
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  if he didn't have to do it multiple times a day,
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  we would bring people into the hospital to, to give this medication.
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  But that's not practical. So we're gonna have to rely on the patient,
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  their family members to learn and, and, and manage it. And, um,
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  of course, uh, people manage their, uh,
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  diabetes all the time with their appropriate, uh, education and, and tools.
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  So how do we move more into that, uh, into that direction? I,
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  I think digital, um, is gonna play a really important role in both the,
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  the education and the support as well as the, uh,
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  guardrails so that we can intervene if someone is, is falling off track.
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  That makes a lot of sense, you know,
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  and really seems like a very promising way to, uh,
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  utilize and leverage technology to, um,
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  keep people healthy as much as possible and do things that you were never able
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  to do, you know, without that digital lens. From your perspective,
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  how are you thinking about growth and development and adding to the health
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  system overall, especially in a time where, as you mentioned, you know,
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  there's some, um, across the board,
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  financial challenges as well as it can be challenging to have the staffing
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  resources that you need to even do some of the basics at times. Um, you know,
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  how do you add value to an organization during times like these?
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  I think it, it's going back to that, how can we do things? Um,
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  how can we do things differently? Um, I, if you'll,
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  if you'll allow me a quick analogy, um, I've lived in the Milwaukee,
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  Wisconsin area for the last, um, six or seven years.
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  It's on a beautiful lake,
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  and I've been trying to go out and enjoy that lake periodically and learn how
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  to, to sail. Um, you need wind to be able to move. And the modern,
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  uh, sales and the sale, if you think about sales as a technology, um,
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  helps you, helps you move, um, if you have, uh,
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  wind, uh, coming at just the right angle, even if it is coming, uh,
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  from the front, uh, you can harness it and move to a different position.
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  You might have to take a few zigzags or tax as they call it, but, uh,
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  but you really need that, that, uh, that headwind, um,
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  to, uh, be able to move.
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  And what I'm thinking right now with the risk of being a little bit too
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  pollyannish is that, you know,
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  this is an important forcing function for us to learn how to do things, um,
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  differently. So how can we use that technology?
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  Maybe we're not able to go straight at the target like we want, but, um,
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  but with a little bit of navigation and using the wins in our technology, we,
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  we, we can get there. But, you know, ultimately it comes down to being able to,
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  to offer services and to do things differently that don't have the same cost
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  structures. So, um,
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  how can we digitally engage people as much as possible to, uh,
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  fulfill, um, care gaps, uh, without having to go through,
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  uh, nurses and care coordinators or have everything done at a,
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  at a clinical visit. Um, how can we grow, uh,
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  new lives and, and essentially taking care of more people, um,
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  and how can we do it through digital means, uh, through telemedicine,
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  but also through digital therapeutics and other ways of reaching people and
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  delivering the, the content and care, uh, that people can, um,
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  can use to,
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  to further their health And how can we think about the right partnerships that
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  enable us to, um, to do that.
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  So those are some of the ways that we've been thinking about, um, growth and,
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  and value, uh, at, at this time.
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  I love that. I,
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  I think that makes so much sense and definitely is helpful to understand, um,
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  you know, what you're still able to do within, um, you know,
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  the context of,
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  of today's environment and thinking through some of that as well, um, in,
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  in how you can improve the patient experience and, and really, um,
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  be more targeted with patients. You know,
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  what is one investment that's still worth making this year towards that goal?
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  Um, in, in, in making sure that you've got the best care possible.
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  So the investments that we cannot afford to, to not make and,
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  and to not make, um,
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  to not solidly make are investments in data and investments in the
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  infrastructure, uh, to deliver, uh, patient engagement. Um,
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  both of them are at this point, non-negotiable, uh, uh,
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  areas that are needed to, uh, get where we want to be. Um,
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  and the conversation that I think we need to have is
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  how do we look at these areas as assets?
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  We generally will look at, um, buildings as,
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  as assets and, and real estate, et cetera,
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  but how do we look at the investments and data and how do we look at the
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  investments in the infrastructure for digital engagement as,
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  as, uh, strategic assets? Um,
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  so I think we need to keep the foot on the gas pedal in,
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  in both of these areas, um, for, uh, data,
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  it's clinical data,
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  but it's also being able to marry that and bring that together with context of,
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  uh, where a patient is, um, in their, in their life and in their neighborhood,
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  uh, in their communities, uh, to also bring it in with other sources of data,
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  claims data, uh, et cetera, to put,
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  really get that a whole picture of who a person is together and,
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  um, not just use it for risk stratification, but really u to bring it into, um,
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  clinical care to make it available for, um,
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  care teams to make it available for our, our, uh,
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  systems of care, uh, to make sure that they have the, um, right interventions,
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  uh, targeted, uh, to the right, to the right people. Um,
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  and then in, in terms of the digital, uh, engagement, um,
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  for us,
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  it's been to continuing to invest in our digital engagement platform that we are
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  are building. Um,
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  while we do use our electronic health record and the digital engagement
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  capabilities within that, uh, we've also needed to bring together,
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  uh, experiences from our other digital therapeutics tools, uh,
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  from our, um,
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  our video visits and telemedicine infrastructure to really make the best
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  experience, um, possible.
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  And we think that's just like having a, a,
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  you know, a building or a, a center that a lot of people come through every day.
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  It needs to be well functioning, it needs to be inviting,
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  it needs to be welcoming, uh, and it needs to, uh, work really well. So,
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  um, we're gonna continue to move forward with, um, with those investments.
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  I love that. I think that's so important. And, you know, your focus on it,
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  being able to have a systems in place that really allow the care teams to target
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  the right people for the right treatments in, in the right, uh, um,
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  type of care. And then the patient engagement as well, it seems like,
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  is very forward thinking in terms of, um, how patients are,
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  are really able to interact with the healthcare system overall. And, and so,
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  you know,
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  when you look at some of these changes that are happening and that you're
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  making, has the care team been pretty receptive to that?
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  Or have there been some, uh, challenges and questions in terms of, um, you know,
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  whether this is really moving forward in the right direction for patients?
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  So one of the things I think we have to think about,
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  and I I bring this up with our care teams, um, when I talk, you know,
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  either one-on-one with clinicians or, or in group, is, um,
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  what's that right balance between care team autonomy and work, and then, uh,
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  systemness and, and systems of care. And I think we're,
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  we've reached an inflection point, uh,
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  or a tipping point where the clinicians have so
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  much on their plates that they're asking for help. Um, and,
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  and this is an opportunity where we can bring in,
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  in digital in the right way to really provide that, that help.
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  Now the flip side of that is it can't be a digital that, uh,
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  a digital intervention that results in another inbox message or puts everything
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  back on the, on the clinician, that's really not going to work out.
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  But if we, if we're able to do it right, we're able to provide that,
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  that help, uh, for the, for the clinicians, uh, you know,
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  an example that we're looking, um, hard at is, you know, the,
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  the issue of, um, patient portal messages and their, their growth. So, um,
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  this is an important value add for patients. It's,
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  it's often where patients are starting the care journey, um, with a question of,
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  should I come in or, or should I be seen? Or what, what would you do for this?
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  Um, but it's, it's, it's a reflection of where the care model needs to,
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  to change. Um, but if we're still in a locked in a fee for service,
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  uh, world, uh, we're not able to to accomplish that.
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  So how may we solve the problem of the, uh, of, of helping patients?
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  Um, and, and part of that may be not putting those on the,
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  on the, the clinicians to respond to those messages.
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  That's looking at systems of care to be able to take the intent of that message
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  and really help a patient, uh, solve their problem as quickly as possible.
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  And it may not go through the, um, care team. So we're,
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  we're gonna have this balance of, of autonomy and, and control versus,
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  um, teamwork and, and, um,
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  and we'll see where that goes, but I think we're in a point now where the,
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  the balance is really stru, uh, going towards, um,
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  let's help the care teams as much as possible.
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  I love it. Thank you so much for going through that with us and, and really, um,
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  you know, highlighting how the care teams are working through that.
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  Before we wrap up our conversation, I wanted to take an eye and,
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  and look at the future. What do you see as some of the best places in,
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  in ways to grow and develop,
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  especially as healthcare and technology in particular is evolving?
• 16:59
  Yeah, one of the things I think we all have to ask ourselves is what,
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  as a healthcare system, what, what is it that we are, um,
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  are going to, to do and, and be known for, um,
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  particularly academic systems, uh,
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  like us are going to take pride in,
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  in being able to solve complex, uh, problems and to be able to bring the latest,
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  uh, and best technology to patients and, and frankly, the,
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  some of the, uh, technology, um, whether it's, uh,
• 17:32
  CAR T therapy that we've, um, been working on and,
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  and have a lab here for, or it's, um, any of the, uh, newer can,
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  newer other cancer treatments, antibody, uh, based treatments, et cetera. It,
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  it's nothing short of, uh, miraculous. Um,
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  but is that all that we're going to do?
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  And what about the broader health of the, of the communities?
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  And I think that's an opportunity for us to, um,
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  to continue to grow that if, if we abdicated or delegated.
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  Um, I think we're missing opportunities to really, uh, one,
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  provide the best care available to patients in a integrated and non
• 18:17
  fragmented, uh, way. Um, and then, uh, two,
• 18:21
  develop a lifelong relationship with patients. So, you know,
• 18:26
  I think there's, there's often talk about, well,
• 18:29
  what do we give up and is wellness and, um, and kind of that,
• 18:34
  that low acuity something that we want to delegate, um, or,
• 18:39
  or partner with. And I think we have to look hard at, at that and, and say,
• 18:45
  you know, is, is that part of the full spectrum of care?
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  And if we're not gonna do it, do we have the right, um,
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  partners and infrastructure to be able to have those relationships, uh,
• 18:55
  with people that, that span ages and, and span time? And,
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  and so I think that's one of the things that I think all health systems, um,
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  need to look hard at. And, and I think if we do it right,
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  it also does unlock opportunities for us to, um,
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  grow, uh, in, in both our, uh, value to patients,
• 19:17
  uh, that we serve as, as well as to be able to grow our, um, our, uh,
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  footprint in, in our communities.
• 19:25
  That's fantastic to hear and in what a fascinating and thoughtful way that
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  you're approaching, um, that those initiatives in,
• 19:32
  in bringing technology into the fold. Dr. Karate,
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  thank you so much for being here today and for your time.
• 19:38
  I've really enjoyed our conversation and so glad that you'll be able to join us
• 19:42
  in October as well for our health IT Digital Health and Revenue Cycle event.
• 19:47
  I, I know there'll be a lot of discussion around many of the themes here from,
• 19:50
  um, technology automation and digital patient experience into AI and, and more.
• 19:56
  So I'm looking forward to that and,
• 19:57
  and so grateful that you'll be able to lend your expertise to us there as well.
• 20:02
  There's a lot coming. Thank you for the conversation, Lauren,
• 20:04
  and look forward to continuing it.
• 20:10
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