Latest / Becker’s Healthcare Digital Health + Health IT / Dr. Tinu Tadese, Associate CMIO at University Hospitals Health System

Transcript

Dr. Tinu Tadese, Associate CMIO at University Hospitals Health System · 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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  Philips.
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  Hello, and welcome to the Becker's Healthcare Podcast,
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  recorded at the 9th Annual Health IT Digital
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  Health and RCM Conference. I'm joined today by
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  Tino Tedeshe, associate chief medical information officer at
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  University Hospitals Health System.
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  Tinu, to get us started, can you please
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  share a little bit about your background, your
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  organization, and your role at that organization?
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  Thank you for having me. I'm excited to
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  be speaking at this podcast. My name, like
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  you've heard, is Tinu Tadeshi, and I am
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  associate CMIO at University Hospitals.
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  I have responsibility
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  for the community hospitals.
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  My background is pediatrics. I'm a general pediatrician.
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  A few years ago, well, over a decade
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  now, I decided to go into informatics,
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  and I have worked for a health IT
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  company. I did that for about 6 years,
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  helping with design and, different things touring the
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  United States,
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  helping implement,
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  EHRs
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  across the country.
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  About 6 years ago, I decided to get
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  off the,
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  just
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  the hustle and bustle of traveling and became
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  a a VP of clinical informatics at Lake
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  Health System,
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  in Ohio.
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  That system was acquired by University Hospitals,
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  and I am now an associate CMIO,
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  for community care,
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  and regulatory.
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  So from a 3 hospital system, I became
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  responsible for,
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  12 hospitals.
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  So right now, that's what I do. We,
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  continue to work to improve our informatics
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  team.
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  Perfect. So as I'm sure you're aware, you
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  know, AI adoption is exploding in healthcare right
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  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? And
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  how is this informing your organization's innovation strategy?
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  Indeed, AI is exploding. It's exploding in such
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  a way that everywhere you turn it is
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  AI.
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  Well, so, about 2 years ago, you know,
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  it was like, oh, AI is going to
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  come and the question is,
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  do we wanna embrace it? What does that
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  mean for patient data? Is it gonna be
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  secure and so on?
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  Are we gonna have are we gonna be
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  infringing on patients' right, their data, and so
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  on?
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  Right now,
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  it's in everything.
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  EHR
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  has it in every way you can think
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  about for patient access.
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  It's in our documentation.
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  It's in our revenue cycle.
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  That's one of my specialties rev cycle as
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  well.
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  So we are using it in every which
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  way,
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  trying to see how can we simplify,
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  what we do on a day to day
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  basis for our clinicians
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  and also for operations.
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  So we we are also using it in
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  our
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  rev cycle,
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  managing denials,
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  interacting with payers,
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  also using it for physician documentation. We're using
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  it in a lot of ways. I can
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  go into details if you want me to.
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  Go for it. Yeah. Yeah. Yeah. Alright. Well,
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  I guess my first interaction with AI really
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  was about, 4 years ago when we started
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  to use AI in the area of,
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  physician documentation.
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  When you think about it, there is a
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  lot of data. There's a lot of regulation.
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  There are things
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  physicians need to do to be able to
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  make sure that they're,
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  paid for the services they've rendered.
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  Rev cycle being one of my passions, we
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  started to look at the business of care,
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  how can we assist
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  our physicians
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  to reduce the burden? How do you remember
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  all these things you're supposed to document to
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  be able to be paid for a certain
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  DRG?
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  And,
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  so what we did was we partnered with,
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  another,
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  well, we'll call it a 3rd party and,
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  just to give our physicians some help at
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  the point of care. So while they're documenting,
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  they start to get nudges as to you
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  mentioned this patient had chest pain,
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  and it looks like you're going towards this
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  diagnosis. Were you thinking of mentioning this? We
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  do not see this in your notes. Do
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  you wanna do that? Mhmm. And not leading
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  them to a diagnosis, but if you've made
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  a diagnosis
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  and you've, you know, talk, thought of 1
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  or 2 things to complete your,
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  your documentation,
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  we started to see do that, and we
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  started to realize almost immediately a return on
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  investment. So case mix index within a month
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  went up for specific
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  service lines. So that was my first interaction
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  with AI,
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  machine learning, large language models, just doing that
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  at the point of care, being able to
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  use
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  what AI can do to reduce the burden
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  on the physicians and yet get paid for
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  it. And then as things progressed, we started
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  to realize we could use it in so
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  many ways. So after we merged as a
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  health system
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  with university hospitals, university hospitals being one of
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  the greatest health systems I can think of
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  in the United States,
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  they already had things. So even last year,
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  they started to,
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  they got a grant where they're being able
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  to, do predictive analytics on cardiovascular
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  disease Oh, wow. Using large language models. We
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  have just been recently,
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  given a badge,
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  for our radiology department
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  for quality in AI. So there's a lot
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  we are doing with it, and it's just
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  exciting.
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  Of course, we are newly implemented.
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  EHR now has AI in every nook and
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  cranny of it. Mhmm. It's exciting. It's an
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  exciting time. Yeah. Well and and I'm curious.
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  You know, so you've been working with AI
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  for a while. How has your overall view
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  and, you know, understanding about what what what's
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  possible with AI and the expectations around that?
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  Like, how has that evolved over your time
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  working with it? So
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  initially, when I first started with this, it
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  was like, wow. This is amazing. Now Mhmm.
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  Let's talk about it. In in the amazing
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  way it is, it's the adoption was a
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  little hard. Right. So
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  providers,
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  or physicians are really used to their autonomy.
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  They wanna document what they wanna document.
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  I, being a physician, know I wanna scribble
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  2, 3 lines, do my Mhmm. Medical decision
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  management, just put it in there and go.
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  Well,
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  our payers were not gonna pay for that.
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  And and so I saw how that was
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  able to elevate
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  not just the documentation for patient care, but
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  how we got reimbursed in in a very,
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  I mean, it was like night and day.
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  So Right. I thought, okay, that that's not
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  bad.
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  Mhmm. And then now starting to think about
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  it, how do we do change management
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  to bring this
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  not just to the physician, but to nursing
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  and and to rev cycle?
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  So I saw,
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  how wide we could go and how deep
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  we could go,
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  and the turnaround
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  in implementation
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  was so short
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  compared to when we first started. Mhmm. It's
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  it's just so everything is in the clouds
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  now. Right. And you can something that would
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  have taken me 6 months to implement will
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  take 4 weeks now. It's amazing. Right. Right.
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  It is amazing. I can I can understand
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  your excitement now?
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  So, you know, on a daily basis, health
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  care leaders such as yourself
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  are managing greater volumes of data across, a
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  growing number of devices and care settings and
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  populations.
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  In this complex environment, what clinical data integration
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  tools or practices are you seeing drive improvements
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  in patient
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  outcomes and operations?
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  And, can you share an example or 2?
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  Yeah. So I I would say analytics
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  would be the place I wanna go with
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  that. Mhmm. You have all this data.
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  That's the one thing about implementing the EHR.
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  I was involved with the meaningful use, getting
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  Mhmm. Hospital systems from paper
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  to electronic medical records. This was exciting, it
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  was hard, but we did it. Now you
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  have all this data.
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  And if you are in an IDN or
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  complex organization
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  like I'm in, the question is how do
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  we reconcile
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  all this data and how do we bring
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  the standardization
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  or what what we call systemness
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  across the whole
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  health system? As you start to think of
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  various hospitals,
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  academia and community hospitals and the small,
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  critical access hospitals, how do you bring that
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  systemness
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  without losing
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  the uniqueness of each one? So
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  having
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  huge data, but that it goes through
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  analytics.
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  For me, that's where it all works. I
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  have an operational background as well. So when
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  we start to pull
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  pull data out and start to determine how
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  do we decrease our length of stay, how
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  do we increase our CMI across service lines,
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  that's where I start to use it. So
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  integrating tools that will help you
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  use that data in an operational way that
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  would make
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  decision making very easy. Right. Or
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  my patients are going to various health systems
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  other than my health system. Mhmm. Some are
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  going for cardiovascular
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  care even though we do have a great
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  center,
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  they're going elsewhere. When they go, how do
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  I see their data? So health information exchange,
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  making sure,
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  that we have the tools that bring in
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  the data from,
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  from wherever they go. In Ohio we have,
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  especially where I come from in Cleveland, we
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  have a lot of our patients flying
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  to Florida,
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  you know, when the weather is not as
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  nice.
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  How do I get that data? They come
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  back, and how do I use that data
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  in their day to day care? So
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  we have to integrate these tools.
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  Mhmm. So health and then clinical decision support
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  is another one. A lot of EHRs right
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  now have it, but it's clunky. Right. So
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  how do we streamline it, make sure it
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  it makes sense to the clinician, to the
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  physician at the point of care? These are
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  all tools that are available, but how do
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  you adopt it, Adopt them and use them
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  in a way that makes sense. Right. Right.
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  And so how can health care organizations and
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  health care leaders
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  better support IT and clinical teams as they
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  carry out some of these innovation initiatives?
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  And what are some of the, common pitfalls
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  here?
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  So,
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  just from my experience, collaboration
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  sometimes is lacking. We're very siloed.
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  IT many times is siloed
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  from clinical,
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  from operations. Mhmm. These are all very strong
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  departments
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  and,
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  aspects of health care. The the way to
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  make this work in this very fast changing
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  environment
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  is to make sure that we cross collaborate.
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  Mhmm. We have to have at the table
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  each time
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  operations. We have to have IT there, and
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  we have to have clinical there. Now one
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  of the pitfalls is clinical would go. So
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  one of my colleagues' physicians may go to
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  a conference
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  and they see all this great software and
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  applications.
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  And sometimes they are leaders, and they almost
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  signed off. And many times, they've signed off
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  on that
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  without asking IT,
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  one, do you already have it? Because we
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  may already have it. Right. Right. We just
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  may not have deployed it yet because of
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  so many priorities we have. Mhmm.
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  So why, well, you may say, well, my
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  department will will pay for it. Think about
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  that. It's not really your department because you're
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  of a health system. Right. So it's all
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  our money. Mhmm. It's not just your money.
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  Mhmm. So the question is, do we already
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  have it? A little bit more collaboration will
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  make this work. Mhmm.
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  And then infrastructure.
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  So
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  are we, as a as a leadership, are
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  we invest in put in the the the
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  investment where
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  we've we've said we wanna go? So you
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  have this great,
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  vision for innovation, but what does that really
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  mean? Right. It means infrastructure
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  and
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  and investment, not just of time, but but
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  money. Mhmm. Do we wanna do that?
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  So we can support
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  a lot of this initiatives
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  by by just thinking through collaboration,
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  money investment,
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  infrastructure investment,
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  training,
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  and having everyone at the table.
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  So what is your top piece of advice
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  for other health care leaders as they prepare
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  for, you know, further advancements and adoptions of
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  technology and greater demand for care?
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  I want us to think at the very
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  beginning, when we start to think about the
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  new thing you wanna do or innovation,
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  think about
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  the change management aspect of it. Mhmm. Mhmm.
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  What does that really mean?
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  And if you're in a big health system,
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  what does that mean when you think about
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  the microcultures?
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  I'll as a physician, I wanna talk about
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  the medical staff. So a lot of mergers
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  and acquisitions
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  happening right now. So when we start to
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  merge and acquire new
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  small critical access hospitals
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  or big,
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  community hospitals,
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  remember that there are micro cultures. Mhmm. How
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  are you gonna manage that? Right. You have
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  a great vision, but how do you bring
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  everyone together?
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  Otherwise, the vision will be hard to achieve
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  unless change management is a strong, strong pride
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  of of the planning Mhmm. From the get
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  go. Right. And so, you know, as we
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  wrap up this conversation,
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  you know, one thing that was really obvious
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  to me was just how passionate you are
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  about your job and your role in kind
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  of, like, technology and health care. And one
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  thing really stuck out to me, and that
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  was when you mentioned how excited you are
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  about seeing some of these things. And and
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  you you I'm just genuinely curious.
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  You know, 5, 10 years down the road,
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  is there a piece of technology or something
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  that will be possible with technology in the
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  future that you're just especially excited about?
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  So I am
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  excited about
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  centralization.
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  Mhmm.
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  There are a lot of things that we
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  are doing today that we're doing based on
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  almost 200 years Mhmm. Of health care, of
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  doing it the same way. Right. But the
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  question is,
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  with all the technology out there
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  and many times a patient is seen by
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  a physician and the physician spends 5 minutes.
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  If you spend 5 minutes and you were
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  scheduled for 15 minutes,
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  what was it that you were able to
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  do in 5 minutes?
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  And the remaining 10 minutes,
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  could we centralize all of that? Mhmm. Could
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  we do it in such a way that
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  somebody else picks up that aspect and does
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  it centrally so that you focus on what
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  you are the only person who can do.
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  So we have the central corporate
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  aspect of health care that is under guarded
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  by IT. Mhmm. We have all the tools,
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  really. Even now we have the tool. We
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  just have to reimagine
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  health care and how we deliver health care.
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  Mhmm. And and and with that in mind,
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  I am seeing that there are a lot
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  of things that are repetitive, that are redundant,
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  that we can cut out of, the way
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  we provide health care. It's an exciting time.
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  Right. Right. Right. Well, thank you so much
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  again. This was a great conversation. I absolutely
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  loved it. Thank you again for joining us
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  today. Thank you so much for having me.
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  My pleasure. You have a lovely rest of
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  your day. Thank you.