Episode 27 : A Revolutionary Framework for Smart Care Technology

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Intro/Outro:
Welcome to Smart from the Start, presented by care.ai, the Smart Care Facility, platform company and leader in AI and ambient intelligence for healthcare. Join Steve Lieber, former CEO of HIMSSS, as he interviews the brightest minds in the health provider space on truly transformative technologies that are modernizing healthcare.

Saul Marquez:
Hey, everybody, welcome back! I'm so excited to have Steve Lieber in the podcast. I learn so much from Steve every time we hang out and every time he's on the podcast, so I'm excited to have him back. For those of you that haven't had a chance to know about Steve, I, first of all, I'd be surprised. But if you haven't, let me tell you a little bit about him before we kick off today's podcast. He's a seasoned healthcare management executive with 40 years plus of experience in healthcare, primarily in the healthcare association management area. He served as president and CEO at HIMSS for nearly 18 years, and currently works as an independent consultant with notable clients such as CRI, the Healthcare Information Management Executives, also known as CHIME, and other well-known entities. Steve, so glad you're back.

Steve Lieber:
Thank you so much, Saul. It's great to be back with you. I always enjoy the chances we have to connect and talk about things that are going on in healthcare, and really happy to be back with you today.

Saul Marquez:
Yeah, likewise. And Steve, you always I don't know, you're just really good at staying ahead of the game, not necessarily going to where the puck is going, but you have a lot to do with directing where the puck goes. And certainly excited to be chatting with you yet on another topic. Today, we're going to be covering this idea of creating this smart hospital maturity model. It's a new concept that just came out. Talk to us a little bit more about it.

Steve Lieber:
I'm going to digress, maybe 15, 20 years here, and it'll be quick in back in 2004, '05, '06, that era, we looked at what was happening in healthcare. And at that point, electronic medical records were really starting to catch on in terms of people recognizing the importance of digitizing health records and that sort of thing. So at HIMSS, we developed the EMR adoption model. Now's the executive responsible for the creation of HIMSS analytics, which was the birthplace of EMRAM. Well, now fast forward to the current time period. And this past fall at the CHIME Fall Forum, I was talking with Chakri Toleti, who's the founder and CEO of care.ai, care.ai's company in the virtual nursing smart care facility, ambient Monitoring space. And Chakri and I were talking about it, and he said, I know your background with EMRAM. What do you think about coming up with some way of measuring how facilities are adopting smart care technology? So we started talking about it, and what what has happened is what we just have announced very recently, which is the development of the smart hospital maturity model. And the idea here is there's a lot of noise in this space. It's a new area. And yeah, you're right, it is directing the direction that healthcare is going, that sort of thing, by emphasizing things like we did with EMRAM. And the idea is to try to bring some common sense to this area of smart care facilities and technology. What is it that systems ought to do in terms of bringing about a smarter way of doing healthcare? And that's, that smartness is going to be measured on a couple of dimensions. One, of course, is clinical care. Let's be smart about it so that we are utilizing the best care processes, the best technologies to achieve the best outcome. It's also about efficiency. When we think about using smart technologies in our homes, for example, it makes us more efficient. We have the intelligence of devices doing things for us, and therefore we're more effective as well as more efficient. It's bringing order to all of that instead of hospitals and care facilities being left on their own just thinking, okay, what do we do? And there's so much here. You start out with the buzzword of the month, AI, and you and I both were at ViVE recently and people were throwing that term around like candy. And what does it mean? And it, quite honestly, it means different things to different people. Well, let's bring some better knowledge, some intelligence into this whole area. And that's the concept behind the model.

Saul Marquez:
I really love this idea, Steve, and really the opportunity that health system leaders have to start putting some logic and organizational principles and a measurement scale around where do I sit and how do I progress, who's involved in this? And like, who's putting the work together? Tell us a little bit more about the work being done.

Steve Lieber:
Sure. As I mentioned, Chakri Toleti at care.ai is really the person who birthed the concept. And so he said, Steve, and in your role as an independent consultant, would you work with us? You've got a background EMRAM. You know what it takes to put something like this together? They brought me on to work on this project. Full disclosure I was already working with them on some other things, and care.ai is bankrolling this. They're providing the financial underwriting for this. But in one of our objectives, or actually even better word, here's guiding principles is this is objective. It is vendor-neutral. care.ai may be providing the financial resources to bring this all together, but the clear direction from them is this is not about care.ai. This is about the area of smart care teams and smart care facilities. So we went to CHIME again, as you mentioned in my introduction, and the organization that I had done some consulting work with, and in fact, I served as their Executive Vice President and Chief Analytics officer for about three years after I left him, helping them build their capabilities in this area of survey research and help upgrade and bring into a more current status their digital health most wired survey. So we went to CHIME and said, okay, CHIME, we're interested in doing a sponsorship with you because you've got platforms that will help make this more visible to hospitals. You've got great relationship with the CIO community, and getting their engagement is going to be a key part of this. And so, care.ai signed a sponsorship agreement with CHIME to help leverage their executives who are involved in survey research and have the experience with digital health most wired. As a matter of fact, the guy over there, Lauren Pettit, used to work with me at HIMSS Analytics. He's got a background with EMRAM. So again, there's expertise there that CHIME's bringing into the project. We've got over 40 healthcare executives from around the country, so MDS, RNs, CIOs, digital officers, innovation officers, CEOs, CFOs, wanting to make sure we really cover the whole area of all of the professions that are involved in the care process, to be advisors to us on this project. Yeah, I've got experience, but I needed front-line people really playing the more significant role of what's the model look like, what are the areas we're going to cover in that sort of thing. And so as over 40 advisors that are working on this and from every major healthcare system that you can think of, not for-profit, huge national systems to small regional systems and specialty hospitals like children's hospitals and such. And so really we have, and it's also not a group that we're finished assembling. We are welcoming others to come into the project to help guide us on this. So it really is a very broad group that's directing the project in terms of the subject matter and the details. And then we've also reached out to some other organizations American Organization of Nurse Leaders, AOL, HFMA, which is financial management group Leapfrog. Those are three organizations that we have talked to, and they have now put an individual on the advisory panel. I don't want to overstate their involvement. There's not organizational endorsement, but at this point, but they do want to participate in it. They see the value of what we're doing, and so that's the group that really is involved in this. And it's a, almost a year-long project from conception to our really completing our first cycle. We're in the process right now of defining what is the model itself, what's the scope, how far in terms of breadth, how deep do you go in terms of topics, and that sort of thing. And we've got some elements that we've already landed on that I'm glad to share with you, but just one other thing, in terms of high level, what the model is, one thing in terms of coming up with a measurement, as you mentioned. We also want to be able to provide back to the facilities that participate in the survey, which drives the scoring of the model with an analytical piece back to them. We want to be able to show them. Here's where your opportunities are. Here's where your gaps are. Here are the things you ought to be thinking about in terms of next steps. And it, certainly a key objective is finding a credible designation for smart care facilities, but it's also about providing them with actionable analysis that illustrates their strengths and weaknesses, and so I'd say we're in this process. And what we will be doing is, this summer, we will have finished the model for what I'll call first round or beta testing, when we will send the survey out and anyone, any facilities can participate in it. It's not limited to just those who have been involved in the project, so that by the CHIME Fall Forum this coming November, we'll be able to talk about what we found, what's going on out there. And really, I think bringing some significant insights into the market as to what really is going on here, more than just simply anecdotal comments that we hear along the way.

Saul Marquez:
Well, Steve, that's very exciting, and what a great crew you guys have assembled and still open to recruiting more. So for anybody listening that is intrigued by this project, is is thinking about these things around smart hospitals, ways to improve and optimize, certainly a fantastic opportunity to learn more. In the show notes, we'll leave ways to reach out to Steve and the group on ways you could get engaged. But Steve, as people think about this, the insights that are going to come out of this sounds like also maybe a benchmarking component so that they know where they stand in terms of the maturity model. Why should people want to learn more? Why is this so important?

Steve Lieber:
I think clearly we see the value of having an element of machine learning have a role, and I'm being somewhat careful here in selecting my term's just one, because we're so new in understanding what role will machine learning take in healthcare. We know that having computing power that can analyze mountains of data that we could never process through our own labors, we need machines to help us plow through all that, to find trends and patterns and that sort of thing. So, you know, the value is to help them to understand how that can be done and how others are doing. And as you say, there is an element of benchmarking here, but it's also helping organizations understand where within the facility these sorts of technologies can be utilized and what the benefits are in different places. So the model is built around three major components. Humans, so recognizing that in the care process there are people involved of course. And there are really two types: patients and care team. We've got elements of the model that's focused on how you use smart technology in support of patients and the family care circle around them. We also want to explore how smart technology impacts and can be utilized by the care teams. So that's the people dimension. The next dimension is in environments. So we have locations where technology is going to be used, common areas. So waiting rooms, what do you do in waiting rooms in terms of having smart technology in the in terms of kiosks and other sort of things? You have the emergency department, you have your inpatient rooms, you have ambulatory facilities, clinics and labs and that sort of thing. You have long term and post-acute care facilities still part of the care continuum, and then you have what we're calling residential spaces. That's not only the home, but it's also places like hospice and such. When we start to think about healthcare in a big macro sort of perspective, not just simply what goes on this one incident, you go and see a doctor or admitted to a hospital. There is a huge continuum that technology and smart technology can run all the way through. And then we also have things that we got to be taking into consideration, such as the actual technologies themselves, infrastructure. How are the facilities, both hospital or clinics or whatever, wired to even accomplish all of this sort of stuff? And then we've got processes; so the third dimension, humans, environments, and processes. So we've got things like strategy, you know, what's the facility strategy. So in all of these areas, we're going to go through a process of examination. Now, again, it's a lot of areas, and you've got we've got to avoid survey fatigue of people seeing a survey. Like, I just can't even tackle this. There's so many questions. It's really working at finding the key questions so that on all of these dimensions, an organization can see what's happening, and where they are, and what the opportunities are. So that's why it's going to be in-depth. It's going to be insightful, and it's really going to help them think about where they're going as they look at adopting new technologies, smart technologies, and ultimately looking at the future. How far do we go in having intelligent technologies influence processes in healthcare, both administrative as well as clinical? So it covers a lot, and that's what the value is back to an organization, is not just looking at the one place where care.ai is with an ambient. It's not that it really is looking across the whole spectrum of healthcare.

Saul Marquez:
That's really insightful, Steve. And I love the framework of people, environments and process and really just putting it in these buckets. That really drives after an operational strategy, the approach that an organization is taking. And then are we left with the playbook like does this become a playbook, Steve?

Steve Lieber:
Maybe. And I hesitate there in saying yes. The way we're designing the scoring is that it does show a progression. It's going to start out with very limited to no in smart technologies up to the highest level, which will be the vision, I think is probably the best word here of the advisory panel of what the future of healthcare will be as it relates to smart care facilities. It will be a level that no one, there will not be a single facility in the world, which will be that we really are wanting to try to lay out a vision. Now, it's not going to be so detailed as to exactly where and what and that sort of thing because we don't know. Sure, there's a learning process, and the definition of that ultimate level will change over time, but each of the levels do build upon the one before. In a sense, yes, there is a roadmap. And just to give a quick example, at the lowest level you're really measuring what are called point solutions, a solution that solves one problem. That's really the lowest level of technology in this space from point solutions, then you then go to platforms. And platforms are a combination of point solutions, all feeding into a common command center or platform. And so you start to get a sense of how we're building this framework that really does build upon the one before. And so, in that respect, it is sort of a roadmap. It will not be so detailed as to say you should or must start here. The next thing you add is this, and then the next you add is that. It's more of a conceptual framework or roadmap.

Saul Marquez:
Yeah, it's a conceptual framework that shows progression, right, if you're maturing in the model. Love that. Not super interesting, Steve. I love how you think about things. I think it's great. This initiative is a fantastic one to really help a lot of organizations seeking this type of definition, and ways to put handles on something that doesn't yet to progress in these efforts to become better, efficient, more tailored to patients and the clinician burnout, which is really key.

Steve Lieber:
Yeah, and as we're, and you referenced this early on, we're all learning this kind of at the same time. Yeah, there are few places that are a little farther along, and we're certainly tapping into them. They sit on our advisory panel, but nobody has this figured out. There is no one who knows where we need to end up, and so it's a learning process. And that's a key role for associations, is bringing together people that, under ordinary circumstances, might have competitive interests both on the company's side as well as on the provider side, but bring them together in the interest of serving a common good. And that's what associations do, is bring together people, bring minds together so that you come out with things that really benefit society as a whole.

Saul Marquez:
That's fantastic, Steve, I can't thank you enough for coming on to share this exciting news with all of us. If anybody wants to learn more or participate, what's the best place for them to reach out to do that?

Steve Lieber:
Directly to me. I'm the one who's leading the project. And so I'm the point person for folks to reach out to to learn more about it, to see about getting involved. And as they buy, we're aiming for roughly July, we'll be out with the survey, and we'll certainly, through our various avenues, promote participation, which will be no charge. This is all about building knowledge. And at that point, certainly another opportunity because it is going to be something of an iterative process. We're going to learn from first round of surveys of things that we want to spend more time on and such. And so engaging in this and being a part now or this summer when we start to do data collection, there's great benefit to healthcare in general, and I think specifically to those that participate.

Saul Marquez:
Love it, Steve. Certainly want to thank you again. And folks, if this is of interest in the show notes, we'll leave. Best ways to get in touch with Steve. Steve will share those with us. And in the show notes, you'll find them there if you're driving and this sounds interesting, hit pause, pull over, send them a note, or if you're on a jog, maybe now's the time for a break, but certainly, some fantastic work being done here become a part of it. That's the best way that you, too, can help shape the future of healthcare. Steve, thank you so much for sharing this with us today.

Steve Lieber:
Always a treat, Saul. Thank you.

Intro/Outro:
Thanks for listening to Smart from the Start. For best practices in AI, and ambient intelligence, and ways your organization can help lead the era of smart hospitals, visit us at SmartHospital.ai, and for information on the leading Smart Care Facility platform, visit care.ai.

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