Latest / Becker’s Healthcare Podcast / Lisa Tank, President and Chief Hospital Executive, Hackensack University Medical Center, Hackensack Meridian Health

Transcript

Lisa Tank, President and Chief Hospital Executive, Hackensack University Medical Center, Hackensack Meridian Health · Becker’s Healthcare Podcast

• 0:02
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• 0:30
  Hello, and welcome to the Becker's Healthcare podcast.
• 0:34
  My name is Will Riley from r one.
• 0:37
  I'm joined today by Lisa Tank.
• 0:40
  Lisa is president and chief hospital executive
• 0:43
  at Hackensack University Medical Center, part of Hackensack
• 0:47
  Meridian Healthcare.
• 0:48
  Welcome to the podcast. Thank you so much.
• 0:50
  Thank you for being here. Thank you for
• 0:52
  having me.
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  Alright, Lisa. Well, to start us off, tell
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  us a little bit about your role. Tell
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  us a bit about, Hackensack University Medical Center.
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  Absolutely. Thank you. So once again, thank you
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  for having me.
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  I'm Lisa Tank. I am a geriatrician,
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  a board certified internist, and a board certified
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  geriatrician,
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  and,
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  I'm the president and the chief hospital executive
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  at Hackensack University Medical Center.
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  Hackensack
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  has been my home for about twenty five
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  years. I trained there as a fellow. So
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  I have grown in that institution, and the
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  institution has become a large academic
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  institution within the Northern New Jersey market.
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  It is the academic flagship for Hackensack Meridian
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  Health.
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  It is a robust tertiary quaternary center, and
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  it continues to thrive within a community that
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  is highly competitive and a market
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  that is highly,
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  motivated,
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  to perform
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  the highest level of clinical care and very
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  competitive in The US news market too.
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  Tell us a little bit about the the
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  the community around you. You're in Northern New
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  Jersey. You said it's competitive from a health
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  care perspective, but what's the demographic like? What
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  what what's the what's the surrounding area? Absolutely.
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  It is one of the
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  you have the two largest airports,
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  within that area. So you have the Newark
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  Airport and, JFK
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  within
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  couple of miles. So there is a highly
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  diverse community and highly,
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  populated community, pretty dense.
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  But I think the most important thing, I'll
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  tell you is it's one of the most,
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  popular counties to retire in. So you have
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  a large
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  aging
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  population, with a high mix of
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  patients living at home independently versus assisted living,
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  independent living. So it has a quite
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  a diverse age group too. And that's a
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  critical part to remember as we deliver as
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  we deliver health care across the entire continuum.
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  Fantastic. Okay. That's great. And we're gonna come
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  back and talk a little bit about patients
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  and how you maintain patient's interest in that
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  kind of environment later on. Let's talk first
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  about technology,
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  if we can. So, I mean, historically, health
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  care has moved
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  fairly cautiously,
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  around new technologies and adopting new technologies. Right?
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  Health care doesn't seem to have necessarily been
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  a leader in many waves of technology.
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  But,
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  I'm curious whether you think that's the same
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  with
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  AI because it feels like, potentially, it's different.
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  Can you talk about that a little? Yeah.
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  I think you're absolutely right. Healthcare has always
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  been a bit cautious and, sometimes I think
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  lagging
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  in terms of technology, but AI has revolutionized
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  that.
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  So if you look at health care currently
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  with AI adoption,
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  the
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  end end consumer is health care. Right? And
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  it is going to double
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  into billions. Absolutely.
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  So I think I think AI is a
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  critical piece,
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  and health care has understood now that anything
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  to do with
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  safety, quality,
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  seamless cost efficiency. So I always come back
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  to the quadruple aim. So the quadruple aim
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  is really focused on couple of things. Right?
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  This was something that was introduced by IHI
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  in the February,
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  and it focuses on patient experience.
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  How are you going to deliver the best
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  patient experience? Yeah. Second is how are you
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  going to manage population health? That's chronic disease
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  management
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  and focused on predictive analytics.
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  Third part about that is how are you
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  going to deliver cost efficient, you know, value
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  based care. Right? And now the fourth component
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  is how are you going to focus on
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  the well-being of your entire team, your workforce.
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  So if you look at that, AI is
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  a critical part of that. AI is embedded
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  within those and it layers in your foundation.
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  And what it tends to do is it,
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  number one, streamlines administrative
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  tasks
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  and it optimizes clinical models.
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  So if you combine those two together,
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  what you have is a great focus on
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  patient outcomes. Yes. I think that's why AI
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  is taking on a whole different role.
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  But I don't know if we are gonna
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  touch on this, but one of the critical
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  pieces that we have seen at Hackensack Meridian
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  Health is we were one of the early
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  adopters in AI.
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  And what we did is as we developed
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  AI, we created a governance model. And that
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  governance model is already set up initially
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  as soon as there is any project intakes.
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  So if I have a great idea, it
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  might be a great idea for me. But
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  how are you going to have those guardrails
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  embedded?
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  And,
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  what we've done is is a multi professional
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  model. There's ethics involved.
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  There's clinics clinicians involved. Legal is involved, compliance,
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  etcetera. So what you are able to do
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  is really deliver the highest level
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  of evidence based care
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  with
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  AI modules built in
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  with the governance structure. So you are always
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  on point,
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  and you're always,
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  you have somebody watching that Yeah. Or not
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  slipping or there is no what we call
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  is a drift or variation.
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  Sure. I wanted to yeah. It's I'm glad
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  you went there because has it been difficult
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  to get that governance system set up? I'm
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  curious about whether it's required new skills or
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  new ways of working or thinking, whether it's
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  been a challenge to implement in the c
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  suite, for example, at the health system, or
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  has it do you feel like it's just
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  evolved fairly fairly naturally as an extension of
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  what people are already doing and thinking about?
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  Yeah. I think I think it boils down
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  to the culture of the institution you are
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  in, Okay. It boils down to chain management.
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  So if you are early early adopter and
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  you are able to think through and be
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  nimble and flexible enough
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  to understand that if you are not going
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  to have the guardrails, you're probably going to
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  land up in a lane that is probably
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  not
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  safe for your patient
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  and not conducive for your clinic for your
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  clinicians to deliver health care. Uh-huh. So I
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  think one of the things that we did
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  upfront was
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  we wanted to launch into
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  AI,
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  but we understood
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  the risks with it. Mhmm. And we also
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  wanted to take away the anxiety from all
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  our, team members that this is not here
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  to replace you. This is absolutely something that's
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  going to be able to support you.
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  And,
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  I think that's that's how it all came
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  about. Right? Okay. Yeah.
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  Excellent. Continuing on the theme of of innovation.
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  So in in health care innovation,
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  you often hear about two sort of archetypes,
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  incumbents
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  like the large established health systems like you
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  or established payers or or established, like, legacy
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  vendors,
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  right, who kind of power the landscape and
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  control the data and the infrastructure and so
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  on. And then new entrants, insurgents. Right? People
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  coming in and changing the game and rewriting
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  the rules and so on. Do you have
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  a
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  a point of view on how you see
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  that dynamic playing out around the adoption of
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  AI?
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  Yeah. I think one of the things that
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  we focused on,
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  earlier on in Hackensack Meridian is we brought
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  AI within our own
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  infrastructure.
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  So rather than working with vendors,
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  we developed it within our infrastructure. So what
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  we did is we took our EHR, which
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  is Epic Yep. And built that AI platform
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  within it. So for a great example is
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  really thinking through clinical workflow.
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  We build the algorithms and decision making
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  absolutely in real time and at point of
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  care. So what that did is it allowed
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  the,
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  clinicians to really be able to streamline their
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  processes and engage with the patient.
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  But what it also did is it actually
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  made them change champions.
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  And they started embedding the workflows
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  much earlier on compared to other institutions.
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  Right. So I think working with vendors is
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  important, especially if you have a skills if
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  you don't have a skill set Uh-huh. That
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  they can bring to the table. But if
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  you can develop it within your institution, which
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  understands the culture.
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  So our DTS team, that's our digital transformation
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  teams, have been able to do that. So
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  we recruited highly skilled professionals that had the
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  experience in AI. We're able to That's interesting.
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  And and you're able to do that and
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  and have them want to come and and
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  work for you a a large
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  Yeah. Traditional,
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  for want of a better word, health care
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  provider. But I think the secret to that
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  really is,
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  and this is something I've learned in my
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  journey as I have developed,
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  at Hackensack,
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  is how do you bridge the clinic clinicians
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  with the operational?
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  So one of the things I tell my
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  residents and my students and
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  folks I work with, my peers is, if
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  there is a patient in that lane,
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  that's your lane, irrespective
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  of if you are in the operational track
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  or you're on the clinical track. K. And
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  what happened with AI
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  and folks who came in were they were
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  clinicians,
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  and they have now developed a training or
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  some form of specialization
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  in AI. So what that really did is
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  really brought those two areas together Yeah. And
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  created a very
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  high performing,
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  workforce,
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  that focused on outcomes. Right. I see. And
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  you've talked a little bit about
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  making things better from a clinical perspective and
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  from an administrative perspective. Absolutely. So perhaps you
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  feel that that that way of doing it
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  is allowing you to get at that. Absolutely.
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  And I think I think they're very connected.
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  So Yeah. If you look at
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  you know, I get asked this question all
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  the time. Where are you
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  where are you applying AI? Yeah. You're applying
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  AI.
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  So if clinically, if I'm applying AI, we
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  are always applying AI.
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  As clinicians, you want to know earlier on
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  who is at risk for what.
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  So if you already have the data, it's
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  it's big data.
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  Yeah. So if you embed that,
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  AI in your EMR or EHR as we
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  call it,
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  you can understand who what we call is
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  predictive analytics. Right? So you will know exactly
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  who, at what age,
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  which demographic is likelihood of developing. I'm just
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  using example for diabetes.
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  Right?
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  And that's what you wanna know. And once
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  you know earlier on, then you can develop
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  the resource allocation towards that population.
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  And the third part about that is you
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  can have targeted therapies.
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  Yep. Right? So you've already created a model
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  and a macro environment that is cost efficient
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  and sustainable Yep. Rather than throwing everything at
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  a patient and
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  hoping something sticks.
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  And administratively,
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  what we've done is we've really created models.
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  For example,
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  Hackensack University Medical Center, we are the fifth
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  busiest ED in the country. Right? Emergency room
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  in the country.
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  What's the most important thing to me is
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  throughput.
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  How do we get patients
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  through safely?
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  So what AI has helped us administratively and
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  taken the burden off the teams
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  is create
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  a a model that has predictive analytics built
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  in when we are going to have the
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  maximum amount of patients coming through the ED.
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  How do you triage them and then build,
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  staffing model on top of it and really
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  create a streamlined process so you are getting
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  the maximum productivity and the highest efficiency
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  and best outcomes.
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  Fantastic.
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  Staying on the administrative side of a little
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  bit Mhmm. Maybe looking more at the finance
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  aspects of administration,
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  but not solely there.
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  We're used to thinking of health care administration
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  being quite labor driven,
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  labor centric
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  with sort of technology
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  support and tools and and aids and things
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  like that. Right? But it but it feels
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  like that is starting to shift and that
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  with a a data centricity, for example, a
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  focus on analytics and so on, that actually
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  a lot of work can now be done
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  through a technology first paradigm rather than a
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  labor first paradigm.
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  Do you see that playing out for you,
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  and what are some of the implications of
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  that? I think absolutely. I mean, one of
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  the first places we saw it, with data
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  and,
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  AI again, you know, you can't use a
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  say a sentence without AI anymore. But what
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  it has done is in radiology.
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  Right?
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  K. It is tough to recruit radiologists.
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  They are they are not as many radiologists
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  that you would like. And radiologists
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  have a lifestyle that they do quite a
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  bit of work remotely.
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  So what we did is
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  give them those tools so that
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  they can take large amount of data and
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  process it with AI and with multiple data
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  points and streamline it and create a module
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  for them where they can have decision making
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  in real
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  time. Because in the past, what would happen
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  is they would have to go back and
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  do a second read and a third read
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  and verification. Now you can do that together.
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  So if you look at the labor costs
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  versus
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  the efficiencies with you have achieved with the
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  data and analytics,
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  they've been able to manage with not that
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  large of a recruitment process, and they've been
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  able to retain people because the work life
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  balance has been better. Got it. So I
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  think it's a it's a win win on
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  both ends. Yeah. But I'll come back to
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  the same point I always tell the team.
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  You have to make sure it is patient
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  centric. It has validation built in. And as
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  you just mentioned to me, it has quality.
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  The QI piece, really embedded. Yeah. Okay. Constantly
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  querying and doing quality,
• 14:55
  you know, evaluations and performance.
• 14:57
  So you've talked about providing,
• 15:00
  new new solutions that help clinicians and physicians
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  do their job well, that reduce administrative burden.
• 15:07
  You're bringing it back to the patient. Like,
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  what what does all this mean for the
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  patient, for you? And and perhaps with an
• 15:13
  eye on the very competitive market that you're
• 15:16
  in where you have to stay ahead?
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  I think it boils down to one only
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  one thing. It's patient experience. Right?
• 15:23
  As they always say,
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  everybody remembers how they were treated.
• 15:28
  And,
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  were you able to
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  speak to the patient in their what we
• 15:34
  call is not in the medical speak,
• 15:37
  really simplify it for the patient. And I
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  think I think the biggest advantage, I'll tell
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  you, through all this and the purpose we
• 15:44
  all do what we do is empowering the
• 15:47
  patient.
• 15:48
  Empowering the patient to be able to have
• 15:51
  insight and access, right, to their,
• 15:55
  to their information
• 15:57
  and have a partnership with the providers
• 15:59
  because we are in for the long run.
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  And as you know, health care is moving
• 16:04
  from a
• 16:05
  four walls of a hospital going into a
• 16:07
  outpatient setting and a home setting. And our
• 16:10
  goal is to really make sure that that
• 16:12
  partnership it's not a sprint for us. It's
• 16:14
  a partnership through the entire continuum, and we
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  wanna make sure that our patients trust us.
• 16:19
  So that's the foremost thing that's important to
• 16:22
  me. You know, North Star. Absolutely.
• 16:25
  Is there anything else, Lisa, that you want
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  to to add before we before we close?
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  Anything else on your mind as you think
• 16:31
  about next year, for example? Or
• 16:33
  I think I think it's all going to
• 16:35
  be about access.
• 16:36
  It's going to be about taking the care
• 16:38
  to the patient.
• 16:40
  All patients are not going to come to
• 16:41
  your come to the hospital
• 16:43
  and really leveraging
• 16:46
  all the different technologies
• 16:47
  and access points like telehealth, tele ICU,
• 16:50
  and all institutions are not going to be
• 16:52
  able to do that high level of care
• 16:54
  because the key is how are you also
• 16:56
  going to have
• 16:57
  financial sustainability
• 16:59
  and continue to evolve and,
• 17:01
  transform. So I think I think it's going
• 17:04
  to be a multifactorial
• 17:05
  way
• 17:06
  of providing health care in a different market.
• 17:09
  Lisa, thank you so much for sharing your
• 17:11
  thoughts today. I really appreciate it. It's been
• 17:13
  fun talking to you. Much. Thank you for
• 17:14
  having me. Thanks. Thank you.