Episode 14 : Digital Renaissance:

SFTS_Tressa Springmann.mp3: Audio automatically transcribed by Sonix

SFTS_Tressa Springmann.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

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 Hims, as he interviews the brightest minds in the health providers space on truly transformative technologies that are modernizing healthcare.

Steve Lieber:
Hello and welcome to Smart From the Start, I'm your host, Steve Lieber, and it is my pleasure to bring to you a series of conversations with some of the sharpest minds in health information technology. We'll discuss the smart directions healthcare companies and provider organizations are pursuing to create smart care teams. Today, I'm joined by Tressa Springman. Tressa has served as the Chief Information Officer of LifeBridge since 2012, and became its also became its Chief Digital Officer in 2020. Tressa is on the board of Chime, vice chair of the Shared Services Committee and chairman of the Technology Committee for Maryland State Health Information Exchange, and adjunct professor at Mount Saint Mary's University—past president of Maryland HIMS, among other roles and recognitions. Prior to joining LifeBridge Health, Tressa served as vice president and chief information officer for Greater Baltimore Medical Center and also held information technology positions at Integrated Health Services, Georgetown University Hospital, and other provider organizations and tech companies. Welcome, Tressa.

Tressa Springmann:
Thanks for having me, Steve. I'm looking forward to our discussion today.

Steve Lieber:
I am too, actually, for our listeners. Tressa and I have worked on a project or two before in her capacity on the board at Chime, and I have been a strategic advisor to Chime, and one of those places we're going to explore a little later in the conversation is the role of the CIO and how it's changing and that sort. So it's something I actually trust and have worked on before, and we'll pick up that conversation. But what I'd like to start out with is you and your current role. And as I introduced you, you started out as CIO and then added Chief Digital Officer; what are the differences or the different expectations? What changed there in terms of your role at LifeBridge?

Tressa Springmann:
Thank you for the question. I think, Steve, as new areas of focus come on the scene in provider organizations, typically, the leadership team settles through on how they want to go after it. As leaders, we all know that typically when we have something we need to focus on or capitalize on, we typically go a little bit deeper. But depending on the organization and the scope and the scale of the new body of work, or any extra focus or energy the organization wants, we've seen this cycle in the past. I started out in IT when there wasn't a CTO role or when I, as a result of HIPAA for a short period of time, was also the CISO in my organization. The Chief Analytics Officer is something we're seeing depending on the scale or scope of an organization. And frankly, with the new hype and reality around the excitement behind AI, even the Chief Artificial Intelligence Officer is being discussed. I guess what I would say is when digital started becoming a thing in our organization, we became very intentional about what was different for us. And we believed what was different was this whole new dimension of our technology serving our consumers and our community on the past, as we were all very comfortable in IT supporting the employees in an organization, including the clinicians that used all of our systems, but really putting into place tools and an entire appropriate support structure for JQ public to use these tools that were deploying was a whole different dimension. And as we looked at that journey, and initially, it was truly a digital consumer journey, I was asked to partner with our marketing or CMO or Chief Marketing Officer on this work, and he has taken a different focus and dimension. And I've been asked really to take the lead on. Once a consumer becomes a patient, how do we make sure that our technology tools are in line with our overall IT strategy? And this relationship with marketing has really grown. I think what I would observe, Steve, and even most recently, we're going down the path of bringing forward and revisiting our IT strategic planning process, which most organizations do every so often, or when they alter their key company strategies in that effort. I'm actually seeing that the organizations I'm reaching out to, are now calling these a digital plan, not an IT plan. So that vernacular of digital is actually, in some ways, becoming more the mainstream of how we are looking at and referring to the technology that enables a provider organization.

Steve Lieber:
If I'm hearing you correctly, the coming together of IT and digital or digital is IT and IT is digital. In other words, the differences are not so pronounced. And really they really do move hand in hand. And I guess most everything nowadays with technology is digital. So there's just it becomes something of an artificial separation when you push it into two different camps.

Tressa Springmann:
Yeah. And I think it dovetails with our call to action to be part of that senior team and a strategist. If we want to put everything under the IT umbrella or tent as we become digital as opposed to just doing digital, we're going to have this bloated IT function in an organization, and we've left people behind. We've not supported them in their own change process for digital enablement, whether it's in supply chain, in marketing, in research, etcetera.

Steve Lieber:
I won't ask you to say whether or not your colleagues are prepared for this change. I won't put you in that spot, but I'll ask it about you. Were there things that you had to do, or was it pretty natural in terms of moving into this role with an external consumer-facing responsibility as well as internal? How did you make the transition?

Tressa Springmann:
I'm still managing the transition, Steve. One aspect is creating a whole support structure in a very tough workforce and economically challenging time to make sure that if we're going to put these digital tools in the hands of our consumers that are well beyond just function feature of a portal, that we've got the right support measures for it. The alternative to that, and I think many people are hearing this, is that becomes a balance between what your employees and providers may want and what is expected of us by our patients. So there's that element. And then there's the second element, which is the question you were going to ask me, and this idea. Look, here's my example. 15 years ago, I had an IT function that was there to completely support nursing as we digitized their documentation process. Now, as our nurses are coming out of nursing school, this is the way they do it. They don't learn to do it on paper, they don't. This is just the way it's done. And each one of us is on a different change journey. And the same is true with my peers in this organization and externally. And I think part of our call to action, knowing how dynamic things are, is to dig deep on ourselves, being a change agent, and creating this readiness for the rest of the organization, including our peers on the executive team.

Steve Lieber:
Great insight, dynamic organization, change agent. What stresses man's view on change? Is it a stepwise logical sequence of events? Is it crazy, out-of-control transformation? Talk about your philosophy around change and actually what you're having to deal with, regardless of what your philosophy might be?

Tressa Springmann:
I think I'll repeat myself quite a bit, because my commitment to the organization I'm in is to do whatever is required in order for us to achieve our objectives. And I would say that each organization struggles on this change journey differently. But here's how I look at it, Steve. Most of us are really good at implementing technology. We have the project plan. We know how to get a charter going, manage an issues list, and we get to go live. And then everyone has this massive disappointment when six months later, no one's using the tool. So that implementation to adoption is phase one. That really was a wake-up call for me saying, where have we missed the boat? We've put a tool into place, but we haven't changed the way people are thinking. And frankly, even if we doubled down on that, what we really need to get to, and this isn't just adoption, but it's outcomes. So I've really spent the last couple of years studying Croci. I did some teaching in the Chime university around change to understand and develop a point of view on how to be a leader, where we're talking about outcome, accomplishment, and not just the go live date.

Steve Lieber:
Yeah, you're absolutely right. Let's not be measured on did you implement or not? But what did you get out of it? What was the result? What was the outcome?

Tressa Springmann:
finger-pointingAnd listen, a lot of times it can devolve in an organization into finger-pointing about, we spent all this money, and we didn't accomplish what we wanted. And why didn't you? And this wasn't nice job. We've got to get past that and get alignment way up front about surfacing and identifying barriers, not to going live but to getting and achieving the outcomes that our organization is expecting of us.

Steve Lieber:
Excellent. Totally agree there. So one of the things that we hear a lot about, and it's probably not probably it is the hype word of the year in iIT is artificial intelligence. Now you can't have a conversation without it coming up. And so, how are you separating the real from the hype around artificial intelligence and give us a little insight about where LifeBridge is in terms of looking at this as a tool?

Tressa Springmann:
So if you don't mind, I'm going to start with your last question and then move up to hype because think, like a lot of my peers, we've been using a lot of artificial intelligence tools for a long time, depending on how you're defining them. I take a definition from golly, maybe an article by Harvard Business Review. It was probably 4 or 5 years ago, and it talks about this spectrum of artificial intelligence. And in its most basic form, we're talking about robotic process automation, where there's not really any intelligence or learning, it's just rote repetition, but it makes us more effective. It's a way to automate, get things done more quickly. But then there's a whole maturity curve all the way up to more prescriptive AI, where the tool itself may not even have human in the loop and really is making the judgment calls. And so most of us have been playing down at this lower end of robotic process automation at like bridge. We've implemented bots for IS in revenue cycle or got a few things launching in the EHR space and recruitment. And by the way, with all this workforce pressure, as long as it extends our reach without but with good human oversight, it really allows us to do more with less. We have crept up on that maturity curve. Most folks are using alerts, they're using clinical algorithms, etcetera, etcetera. I would argue that to, external influencers started to occur that really brought into view a whole different understanding of what this could become. The first was the generative AI, and at the turn of this year, this acknowledgment that there are these learning tools out there and people have begun to use them, and they have access to lots and lots of data, FYI. So there was a heightened public awareness about this capability and frankly, about how this capability might be hitting a data source for its guidance that wasn't really curated. A large language model, that's just the public internet, if you will. I think that combined with our workforce shortages and, honestly, this pressure on all of us to really provide and to find performance improvement dollars, the economic pressure has tempted everybody to look at some of these tools in a manner in which perhaps we weren't using the right caution. From our perspective, I think in response to these early 2023 happenings, we decided to more formally put into place a governance process to really start educating and defining and coming up with our own vernacular about what is artificial intelligence. Look, I think you and I would both agree. Here's another example. At Lifebridge, in imaging, we're using a tool that goes through, and it compares diagnostic images to a massive portfolio of historical images.

Tressa Springmann:
And it serves up to the radiologist whether or not and the probability that it's just a normal compared to the thousands of images it's compared that image to. At the end, our radiologist is making the rendering of normal or abnormal, but they're getting the benefit of this process where it's not just relying on their personal experience, but this vast library of images. I think you and I both can hear that story and say, wow, that's a great use, very effective. And at the end of the day, it's still the clinician making the call. They're using it predictively, not prescriptively. And those are the types of things where we want to, ideally, with the excitement of the promise of this, commit to bringing joy back to medicine, whether or not it's through cleaning up someone's message box or message center, or being able to use these tools to cull vast amounts of information that otherwise the clinician themself is just not humanly possible to stay on top of. But not release our providers or our associates with their obligation that at the end of the day, the output of whatever tool they use, a generative AI tool or a calculator that they still own, the responsibility of the decision that's rendered.

Steve Lieber:
I think I can interpret from that an answer to the first part of my question. Good use case and a governance process will do the weeding out between the hype and the real because you will be able to evaluate tools in the context of what you're trying to accomplish versus just looking at AI tools randomly and trying to decide, okay, is that real or not? If you start out with the good use case and people in the field who know what they're trying to accomplish, you should be able to identify the better path. I will make a subjective judgment about which tools, but that sort of process is really a good guiding principle to hitting it down the right path with AI.

Tressa Springmann:
Yeah, I think you summarized it a lot better than I did. You pulled me back to point. Thank you.

Steve Lieber:
You're too nice. Virtual care became a necessity during Covid crisis and the lockdown and all that you had to. You no longer were seeing regular patients in inpatient facilities. A lot of remote care and that sort of thing. What I'm hearing is a lot of organizations have seen a decline in the amount of remote care or virtual care as compared to the lockdown period, but maybe more than before. So it hasn't gone back to to old baseline or anything. So, what's been your experience in terms of what's happened in virtual care?

Tressa Springmann:
Honestly, we're seeing a shift. I think if you look at you're absolutely right. The pandemic came about, and we had the benefit, or perhaps the foolish promise that we'd already made all those investments, especially in our physician practices, and nobody used them. They were just sitting out there. So we looked at as though we were really brilliant at the time. But in fact, back to that change conversation. There hadn't been a burning platform. The pandemic helped us with that. And you're right, our strictly our use cases around telehealth, predominantly in our practice setting, have diminished and then leveled out. They're a lot lower than they were when people were afraid to get out of their car or afraid to go see a doctor. However, in some respects, the cat's out of the bag. People have identified that technology wasn't the problem. And if you, Steve Lieber, decide that you physically want to go in and see your primary care doctor on the regular, but as it relates to getting a prescription for your son, who always has seasonal allergies in the spring, and for that, you just as soon not have to take a day off work, but just do something that's a little more convenient and in fact, maybe even just text base an asynchronous type interaction. We need to be able to offer those choices. You've seen the low-acuity food fight from others in the industry that are much more disruptive in terms of trying to offer very convenient choices and alternatives to traditional care.

Tressa Springmann:
So I guess what I would say is we've seen a shift. We are seeing people want choices and partake using asynchronous use cases. You've seen, and we've seen a lot of growth around remote patient monitoring. And although hospital at homes not reimbursed in Maryland, I know we're hearing some great use cases around that. When we think of telemedicine, whether it's interactive ICAM virtual type care or RPM remote patient monitoring, I actually think our denominator is bigger, but the use cases have become very different. Back to my comment about workforce shortages and about the economics, I think that it was really only recently where we were pulled. I know my team was pulled very much out of our physician practices and refocused on our hospitals to identify something that would make complete sense to you and me, which is why don't we have two way audio and video in every patient room? And as long as the patient consents, whether it's their family, whether it's a subspecialist based on a very unique care condition, they may have etcetera. We don't want to slow down length of stay or getting the right clinician to the bedside if it's because of a physical barrier. So that has really led to a bit of a pivot in these types of use cases.

Steve Lieber:
So carrying that out a little further into a specific area of ambient monitoring and virtual nursing, it's an area that I've talked a little bit before we started recording this session. Tell me a little bit about your experiences in this area.

Tressa Springmann:
Sure. I think I mentioned before, but perhaps not on this discussion. I have a digital care team that has both non-clinical and clinical agents in Manila, and then actually have some employees in Israel, and that and a number of mid-levels here in the US. And they really represent what we started seeing before the pandemic, which was especially social work, behavioral health. There have been access issues there for as long as I can remember. Before the whole pandemic, we had deployed as many of our peers had telestroke, tele-behavioral, and my certified social workers and behavioral health specialists in Israel were providing that seven-by-24 by 24 coverage to our ERS. So. I liken it to how we used to have different lab systems and radiology systems and pharmacy systems, and then we ended up with a whole integrated EMR. So five, six years ago, we deploy these carts everywhere that needed a virtual presence. And now what we've identified is I've got a robot going into an inpatient room, so my hospitalist can really cover 3 or 4 different physical sites. I've got a nurse or a pastoral care representative walking in with an iPad so that someone's family member who's half a world away but still wants to have a conversation with a loved one who's unable to do something on their own phone, or even a tele sitter for someone who we've got some concerns over the only way to make sure that we are, as an IT leader, propagating five different types of technology and support models is to recognize that in the future, or at least until our patients are so acute that this ability for them to interact does not exist. Instead of trying to enable the use case, let's more effectively technologically enable the patient's room, and then we aren't limited to those points of interaction.

Steve Lieber:
As we were talking beforehand. You talked about the role of stakeholders in making choices about directions you were going, particularly in the ambient monitoring. I thought that was a real good insight. And I'd like for you to repeat that here, because I think it's a good takeaway about how to approach projects.

Tressa Springmann:
Great. Yeah. And actually, it feeds back into my digital care team. Steve, when you specifically ask about virtual nursing, we're on our do over about a year and a half ago, we deployed technology to one of our hospitals in order to really make available some of our US-prepared nursing resources in Israel. But to do so virtually and take some of that documentation burden for the admission, assessment or packaging up all the discharge paperwork and really doing a fine job with discharge instructions with that patient before discharge. And boy, we learned a couple lessons and we learned them the hard way. And that's why we are on our do-over. And look I recognize, different cultures may not run into these same barriers where they may deal with them differently. But we learned two very important things. Number one, the IT people couldn't decide on the technology, and you would think we'd learn this long ago, Steve. But I was really pushing for solutions where that equipment in the room was non-proprietary. I kept thinking about struggling to get in there to repair things while there's a patient in a bed, having to worry about multiple device types and any given patient room. But at the end of the day, the way the system interacted with the bedside caregivers was so very important that they really led the way on the final solution and what they were comfortable with.

Tressa Springmann:
Then it makes sense. We were looking at it from a very practical and technological platform, and they were really looking at it as from a frame of reference, is this going to help me or make my day-to-day even more annoying? Because now instead of doing the admission assessment or do the discharge planning, I'm actually going to become like the IT tech because this isn't working effectively for me. So lesson one is, no matter how quickly you think you're going to solve something for someone, you really can't ever speak for them. And then number two, and this was definitely more cultural because my team in Israel, they're amazing care providers, but the care team at this hospital really felt very strongly that they wanted to at least begin the process with clinicians who had familiarity with the way they delivered care in that organization. So while we still have plans of widening the lens across our entire health system, and I've heard many who've done it successfully, what we learned is, at least when we begin the journey with a particular organization, that we can't overstate the importance of starting with individuals who not only know that organization or know that nursing culture, but in fact may even know how that single unit operates.

Steve Lieber:
You may have answered my last question, but I'm going to give you another opportunity to give that sort of overall perspective piece of advice our listeners or people like you, other CIOs and CTOs and all, and what you leave behind here and as you gave two great ones right there, but you may have something else that you could share with the listeners. That is something that you can you've taken away from your experiences that you think has some value to them.

Tressa Springmann:
Here's a spoiler alert for the audience, Steve sent me this question in advance, and I've really been turning it over in my mind as I think not only of our successes, but also things we could have done better. I would have to say in the context because we run hard every day like everybody else, three things are down, there are four crises. There's something on your boss's desk that you have to attend to. I think my particular advice would be to really recenter yourself frequently on what matters most for you, what matters most for your organization, and what's going to matter most for your patients. And that really helps frame in some of these examples that I've provided, where we might not be focusing on what matters most, like in this last example, this recognition that in order for change not only to be implemented but to be adopted and ideally to get our outcomes, that what mattered most here was not losing sight of the people that it was going to impact.

Steve Lieber:
Tressa, as always, this has been a fantastic conversation. I love talking with you. You are such a direct and very clear spokesperson for good IT, Strategic Management, and operations. I certainly have enjoyed the occasions you and I have had to work together at Chime, and I just really appreciate you being on this session with me today.

Tressa Springmann:
Thanks very much. It looks like you have quite the lineup and as always, your questions were spot-on and extremely relevant to what we're dealing with today Steve. So I appreciate your really kind words. I hope someone in the audience takes a moment to get a learning or two from it. But most importantly, I appreciate the opportunity to share time with you today. Thanks.

Steve Lieber:
Excellent, and to our listeners, thank you for joining us. I hope this series helps you make healthcare smarter and move at the speed of tech. Be well.

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

Sonix is the world’s most advanced automated transcription, translation, and subtitling platform. Fast, accurate, and affordable.

Automatically convert your mp3 files to text (txt file), Microsoft Word (docx file), and SubRip Subtitle (srt file) in minutes.

Sonix has many features that you'd love including powerful integrations and APIs, automatic transcription software, upload many different filetypes, enterprise-grade admin tools, and easily transcribe your Zoom meetings. Try Sonix for free today.